Patient interface system, method for coupling a patient interface to a patient interface holder, patient interface and patient interface holder

Abstract

Patient interface system (10) for positioning a patient's eye relative to a laser device for laser surgery, comprising a patient interface (12) for coupling to the patient's eye and a patient interface holder (14) for arranging the patient interface (12) on the laser device, wherein - the patient interface (12) has a first positioning device (30) for positioning the patient interface (12) on the patient's eye; and - the patient interface holder (14) comprises a holding device by means of which the patient interface (12) can be reversibly coupled to the patient interface holder (14); where the patient interface holder (14) comprises a connecting device (22) for coupling a camera system (24), and the patient interface holder (14) and the patient interface (12) have mutually corresponding channels which, in the coupled state of the patient interface holder (14) and the patient interface (12), jointly define an optical path (P) between the connecting device (22) and the first positioning device (30), characterized in that at least two assemblies (80a, 80b) together form a preferably groove-shaped guide device (18), along which a second positioning device (20) of the patient interface (12) for coupling to the patient interface holder (14) can be moved in a positively guided manner.

Description

[0001] The invention relates to a patient interface system for positioning a patient's eye relative to a laser device for laser surgery. The invention further relates to a method for coupling a patient interface to a patient interface holder of such a patient interface system, as well as to a patient interface and a patient interface holder for such a patient interface system.

[0002] Such a patient interface system can be used, for example, in the laser surgical treatment of a human or animal eye. The patient interface system is used to position and couple the patient's eye with a laser device that generates the laser radiation for treating the patient's eye. Corresponding laser devices have, for example, a base unit with a laser source for generating pulsed laser radiation, for example nano-, femto-, or picosecond laser pulses, as well as an application head that is coupled to the patient's eye via the patient interface system for treatment. The patient interface system is usually positioned between the patient's eye and a focusing system of the laser device. The fixed coupling is necessary to maintain the distance between the laser source and the laser beam.its focusing system and the patient's eye constant so that the laser surgical treatment can be carried out with the necessary high precision and the laser beam can be directed precisely onto the tissue of the patient's eye to be treated, for example the cornea.

[0003] A generic patient interface system comprises a patient interface for coupling to the patient's eye and a patient interface holder for arranging the patient interface on the laser device. The patient interface comprises a first positioning device for positioning the patient interface on the patient's eye. The patient interface holder, in turn, comprises a holding device by means of which the patient interface can be reversibly coupled to the patient interface holder. In the coupled or mounted state, the patient interface is thus coupled at one end to the patient's eye and at the other end to the patient interface holder, while the patient interface holder, in turn, is coupled to the laser device, ensuring correct alignment between the patient's eye and the laser source.

[0004] US 2017 / 0 281 407 A1 discloses a patient interface device comprising a first interface port configured to be connected to a laser surgical device; a second interface port configured to be connected to an eye of a patient, the second interface port containing an applanation lens for placement on a patient's eye during a laser surgical procedure; a chamber extending between the first interface port and the second interface port and defining a chamber therein, wherein air can be evacuated from the chamber by the laser surgical device via the first interface port;and a tubular light guide structure having a light receiving surface at a first end configured to receive light and a light emitting surface at a second end, the second surface being disposed adjacent the applanation lens and configured to provide the light near the patient's eye when the applanation lens is placed on the patient's eye;

[0005] WO 2018 / 025 169 A1 discloses an ophthalmic surgical system comprising a chassis with a laser source. The system comprises a bridge (gantry) connected to the chassis. The position of the bridge is adjustable. The system comprises a reference interface connected to the bridge. The reference interface includes a mounting interface at a distal portion of the reference interface that is configured to be connected to a patient interface for docking to an eye. The reference interface is configured to move to a first plate position proximal to the chassis and to a second plate position distal to the chassis. The system further comprises an optical head unit connected to the reference interface. The optical head unit includes a laser scanner and a beam splitter.The optical head unit is configured to move to a first head unit position proximal to a proximal end of the reference interface and to a second head unit position, which is a lockable surgical position proximal to a distal end of the reference interface.

[0006] US 2016 / 0 106 582 A1 discloses a surgical system with a patient interface between a patient's eye and the laser system, which is to be held to the eye by negative pressure. The patient interface can be a fluid-filled interface, with the fluid serving as a transmission medium for the laser. During a laser procedure, various inputs are monitored to detect a leak. These include a video recording of the eye, which shows air bubbles in the fluid medium, the force sensors on the patient interface, which detect the patient's movements, and the vacuum sensors, which directly measure the degree of suction between the patient interface and the eye.

[0007] US 2010 / 0 228 236 A1 discloses an adapter contact lens that is inserted into contact with an anterior corneal surface. The adapter comprises a contact lens portion with a corneal contact surface curvature that is flatter than that of the undeformed anterior corneal surface. When the contact lens is applied, the cornea deforms and assumes a deformed corneal curvature parallel to the flatter corneal contact surface. A retaining member surrounds the contact lens at the periphery and defines a suction channel structured to attach the adapter to the cornea through negative pressure when it is brought into contact with an ocular surface surrounding the contact lens portion.The suction channel is partially defined by a peripheral edge of the holder that extends outwardly from the holder portion and toward a geometric continuation of the corneal contact surface curvature, but does not intersect or extend beyond it.

[0008] A disadvantage of the known patient interface system is the fact that monitoring the laser surgical treatment is difficult because the optical path or beam path for the laser beam must be kept clear.

[0009] The object of the present invention is to provide a patient interface system that enables better monitoring of a laser surgical treatment procedure. A further object of the invention is to provide a method for coupling a patient interface to a patient interface holder of such a patient interface system, which enables better monitoring of a laser surgical treatment procedure. Finally, further objects of the invention are to provide a corresponding patient interface and a corresponding patient interface holder for such a patient interface system.

[0010] The objects are achieved according to the invention by a patient interface system having the features of patent claim 1, by a method according to patent claim 12 for coupling a patient interface to a patient interface holder of a patient interface system, and by a patient interface according to patent claim 13 and by a patient interface holder according to patent claim 14. Advantageous embodiments with expedient further developments of the invention are specified in the respective subclaims, wherein advantageous embodiments of each aspect of the invention are to be regarded as advantageous embodiments of the respective other aspects of the invention.

[0011] A first aspect of the invention relates to a patient interface system for positioning a patient's eye relative to a laser device for laser surgery, comprising a patient interface for coupling to the patient's eye and a patient interface holder for arranging the patient interface on the laser device, wherein the patient interface has a first positioning device for placing the patient interface on the patient's eye and the patient interface holder comprises a holding device by means of which the patient interface can be reversibly coupled to the patient interface holder.According to the invention, improved monitoring of a laser surgical treatment procedure is made possible in that the patient interface holder comprises a connecting device for coupling a camera system, and in that the patient interface holder and the patient interface have mutually corresponding channels which, when the patient interface holder and the patient interface are coupled, jointly define an optical path between the connecting device and the first positioning device. In other words, it is provided that a camera system can be arranged on the connecting device of the patient interface holder and can capture the area of the first positioning device, which serves to position the patient's eye, through the optical channel which, in the assembled state, is formed jointly by the patient interface holder and the patient interface.This, together with the mechanical coupling of the patient interface holder and the patient interface, enables the detection of the surgical field without disturbing the laser radiation, which allows for better monitoring of a laser surgical treatment procedure.

[0012] According to the invention, at least two assemblies together form a preferably groove-shaped guide device, along which a second positioning device of the patient interface can be positively guided for coupling to the patient interface holder. This allows for a particularly simple and reliable coupling of the patient interface to the patient interface holder, since any impermissible relative movements during coupling or uncoupling are prevented by the guide device.

[0013] In an advantageous embodiment of the invention, the channel of the patient interface holder is sealed in an end region facing away from the connecting device with a window transparent to wavelengths in the visible range. This prevents the ingress of contaminants from the surgical area or the environment, thus reliably protecting the camera system from contamination.

[0014] In a further advantageous embodiment of the invention, it is provided that the channels in the coupled state of the patient interface and the patient interface holder are arranged at an angle between 2° and 80°, that is to say, for example, at an angle of 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, 10°, 11°, 12°, 13°, 14°, 15°, 16°, 17°, 18°, 19°, 20°, 21°, 22°, 23°, 24°, 25°, 26°, 27°, 28°, 29°, 30°, 31°, 32°, 33°, 34°, 35°, 36°, 37°, 38°, 39°, 40°, 41°, 42°, 43°, 44°, 45°, 46°, 47°, 48°, 49°, 50°, 51°, 52°, 53°, 54°, 55°, 56°, 57°, 58°, 59°, 60°, 61°, 62°, 63°, 64°, 65°, 66°, 67°, 68°, 69°, 70°, 71°, 72°, 73°, 74°, 75°, 76°, 77°, 78°, 79° or 80° to a direction of intended laser radiation of the laser device. In other words, it is intended that the laser device with orThe camera system mounted in the connecting device is positioned at an angle to the laser beam incident on the patient's eye and captures the patient's eye obliquely from above. This allows for better detection of both the surgical site and the surrounding area.

[0015] In a further advantageous embodiment of the invention, the patient interface holder comprises an illumination device by means of which at least one region of the patient's eye can be illuminated, preferably perpendicular to a surface of a contact body of the first positioning device. The illumination device can have one or more light sources, such as LEDs. One or more light guides can also be provided. The illumination of the surgical site or the patient's eye can thus generally be direct and / or indirect. It is also possible to illuminate the area surrounding the patient's eye, which also contributes to improved monitoring of a laser surgical treatment procedure.

[0016] In a further advantageous embodiment of the invention, the patient interface and / or the patient interface holder comprise at least two interconnected assemblies. This facilitates the implementation of complex geometries and the assembly of various functional elements on the patient interface and / or the patient interface holder. Furthermore, different assembly types can be combined as needed, for example, to adapt the patient interface system to patient eyes of different sizes.

[0017] In a further advantageous embodiment of the invention, one of the assemblies carries the illumination device. This eliminates the need to provide and manage additional lighting. Furthermore, this ensures consistent and reliable illumination of the patient's eye or the surgical area at all times when the patient interface system is assembled.

[0018] In a further advantageous embodiment of the invention, it is provided that at least two assemblies comprise respective channels which together form the channel of the patient interface holder and / or the patient interface. This allows the optical path to be defined particularly flexibly and formed by assembling the assemblies. Alternatively or additionally, it is provided that at least one assembly comprises a suction channel which can be connected to a suction device and which, when the patient interface holder and patient interface are coupled, together with a fluid guide device of the patient interface forms a fluid path which fluidically couples the suction channel to a suction opening of the patient interface in the region of the first positioning device in order to hold the first positioning device in contact with the patient's eye by means of a relative negative pressure generated by the suction device.This makes it possible to implement not only the mechanical coupling of the patient interface and the patient interface holder, but also an optical coupling via the camera system and the optical channel, as well as a hydraulic coupling via the intake channel and the fluid guide device. This ensures a particularly high level of user comfort for a user, such as a physician, and also reduces the number of potential sources of error.

[0019] In a further advantageous embodiment of the invention, the connecting device is designed to couple a focusing system, by means of which the focus of the camera system can be adjusted to the patient's eye. This ensures high-quality optical detection of the patient's eye. The focusing system can optionally be integrated into the camera system or form a common assembly with it, which is mounted on the patient interface holder by means of the connecting device.

[0020] In a further advantageous embodiment of the invention, the patient interface is made, at least in part, of a material that is transparent and / or light-conducting for wavelengths in the human-visible range. This allows a view of the patient's eye from the outside as well as illumination through a correspondingly designed wall of the patient interface.

[0021] Furthermore, a camera system for the patient interface system is disclosed, wherein the camera system comprises connecting means for coupling to the connecting device of the patient interface holder of the patient interface system. This allows the camera system to be coupled particularly easily to the patient interface system or inserted into the patient interface holder and, for example, fastened to the laser device together with the patient interface holder. This enables better monitoring of a laser surgical treatment procedure, since the patient interface system can be integrally equipped with the option of optically determining the surgical field. Further features and their advantages can be found in the descriptions of the first aspect of the invention, wherein advantageous embodiments of the first aspect of the invention are to be regarded as advantageous embodiments of the second aspect of the invention, and vice versa.

[0022] In an advantageous embodiment of the invention, the camera system comprises at least one component from the group consisting of a diaphragm, lens, spring element, spring bearing, camera housing, adjustment means, mounting block, and focus screw. This allows the camera system to be optimally adapted to its respective intended use and the design of the patient interface system.

[0023] A second aspect of the invention relates to a method for coupling a patient interface of a patient interface system according to the first aspect of the invention to a patient interface holder of a patient interface system according to the first aspect of the invention, in which the patient interface is moved relative to the patient interface holder until the patient interface and the patient interface holder are coupled and the mutually corresponding channels of the patient interface holder and the patient interface together delimit an optical path between the connecting device for the camera system and the first positioning device of the patient interface, wherein at least two assemblies together form a preferably groove-shaped guide device along which a second positioning device of the patient interface is positively guided for coupling to the patient interface holder.This enables better monitoring of a laser surgical treatment procedure, since a user, for example a physician, together with the mechanical coupling of the patient interface holder and the patient interface, also establishes an optical coupling without additional manipulation, which enables the camera system to capture the patient's eye or the surgical field without disrupting the laser radiation. Further features and their advantages can be found in the descriptions of the first aspect of the invention, with advantageous embodiments of the first aspect of the invention being regarded as advantageous embodiments of the second aspect of the invention, and vice versa.

[0024] A third aspect of the invention relates to a patient interface for a patient interface system according to the first aspect of the invention, wherein the patient interface comprises a channel which, in the coupled state of the patient interface holder and the patient interface, together with a corresponding channel of the patient interface holder, delimits an optical path between the connecting device of the patient interface holder and the first positioning device of the patient interface, wherein the patient interface has a second positioning device which, for coupling to the patient interface holder, is movable in a positively guided manner along at least two assemblies of the patient interface holder, which together form a preferably groove-shaped guide device.This enables better monitoring of a laser surgical treatment procedure, since a user, for example a physician, can establish an optical coupling without additional manipulation, along with the mechanical coupling of the patient interface holder and patient interface, which enables the camera system to capture the patient's eye or the surgical field without disrupting the laser radiation. Further features and their advantages can be found in the descriptions of the first and second aspects of the invention, with advantageous embodiments of the first and second aspects of the invention being regarded as advantageous embodiments of the third aspect of the invention, and vice versa.

[0025] A fourth aspect of the invention relates to a patient interface holder for a patient interface system according to the first aspect of the invention, wherein the patient interface holder comprises a connecting device for coupling a camera system and has a channel which, in the coupled state of the patient interface holder and patient interface, together with a corresponding channel of the patient interface, delimits an optical path between the connecting device and the first positioning device of the patient interface, wherein at least two assemblies together form a preferably groove-shaped guide device along which a second positioning device of the patient interface can be moved in a positively guided manner for coupling to the patient interface holder.This enables better monitoring of a laser surgical treatment procedure, since a user, for example a physician, can establish an optical coupling without additional manipulation, along with the mechanical coupling of the patient interface holder and patient interface, which enables the camera system to capture the patient's eye or the surgical field without disrupting the laser radiation. Further features and their advantages can be found in the descriptions of the first, second, and third aspects of the invention, with advantageous embodiments of the first, second, and third aspects of the invention being regarded as advantageous embodiments of the fourth aspect of the invention, and vice versa.

[0026] A further aspect of the invention relates to a method for preparing and / or performing a laser surgical treatment method on a patient's eye, in which a patient interface system according to the first aspect of the invention is provided and the patient interface is moved relative to the patient interface holder until the patient interface and the patient interface holder are coupled and the mutually corresponding channels of the patient interface holder and the patient interface together delimit an optical path between the connecting device for the camera system and the first positioning device of the patient interface.This enables better monitoring of the laser surgical treatment procedure, since a user, for example a doctor, together with the mechanical coupling of the patient interface holder and the patient interface, also establishes an optical coupling without additional manipulation, which enables the camera system to capture the patient's eye or the surgical field without disturbing the laser radiation.

[0027] Further features of the invention emerge from the claims, the figures and the description of the figures. The features and combinations of features mentioned above in the description, as well as the features and combinations of features mentioned below in the description of the figures and / or shown alone in the figures can be used not only in the respectively specified combination, but also in other combinations without departing from the scope of the invention. Thus, embodiments are to be regarded as encompassed and disclosed by the invention that are not explicitly shown and explained in the figures, but which emerge and can be produced by separate combinations of features from the explained embodiments. Embodiments and combinations of features are also to be regarded as disclosed that therefore do not have all the features of an originally formulated independent claim.Furthermore, embodiments and combinations of features are to be considered disclosed, in particular by the embodiments presented above, which go beyond or deviate from the combinations of features presented in the claims. This shows: Fig. 1 is a schematic perspective view of a patient interface system according to the invention according to a first embodiment; Fig. 2 a schematic bottom view of the patient interface system; Fig. 3 a schematic cross-sectional view of the patient interface system; Fig. 4 a schematic exploded view of an embodiment of a patient interface of the patient interface system according to the invention; Fig. 5 a schematic side view of the patient interface; Fig. 6 a schematic sectional view of the patient interface; Fig. 7 an enlarged view of the Fig. 6 shown detail area VII; Fig. 8 a schematic perspective view of a suction cup part of the patient interface from above; Fig. 9 an enlarged view of the Fig. 8 details shown IX; Fig. 10 a schematic top view of the patient interface; Fig. 11 is a schematic perspective view of an embodiment of a patient interface holder of the patient interface system according to the invention; Fig. 12 schematic side sections of locking bodies of the patient interface holder and perspective views of their corresponding locking surfaces of the patient interface; Fig. 13 a partial side sectional view of the patient interface in the area of opposing locking surfaces which interact with corresponding locking bodies of the patient interface holder; Fig. 14 a schematic exploded view of the patient interface holder; Fig. 15 is a schematic exploded view of a first assembly of the patient interface holder; Fig. 16 is a schematic exploded view of a second assembly of the patient interface holder; Fig. 17 a schematic and partial sectional view from above of an intake channel of the patient interface holder and part of a fluid guide device of the patient interface; Fig. 18 a schematic and partially transparent perspective view of the Fig. 17 shown area of the patient interface system; Fig. 19 is a schematic sectional view of a male connector engaging a corresponding female connector of the patient interface; Fig. 20 is a schematic sectional view of an embodiment of the patient interface; Fig. 21 is a schematic perspective view of an embodiment of a collecting container; Fig. 22 a schematic perspective view of the collecting container provided with a filter element; Fig. 23 a schematic perspective view of the patient interface in the area of a mounting opening for the collecting container; Fig. 24 is a schematic perspective view of the patient interface, with the collecting container arranged in the mounting opening; and Fig. 25 a schematic sectional view of the collecting container in the region of a connecting piece in which an end region of a vacuum hose is arranged.

[0028] Fig. Figure 1 shows a schematic perspective view of a patient interface system 10 according to a first embodiment of the invention. The patient interface system 10 serves to position a patient's eye (not shown) relative to a laser device (not shown) for laser surgery and comprises a patient interface 12 for coupling to the patient's eye and a patient interface holder 14 for arranging the patient interface 12 on the laser device. Fig. 1 will be discussed in conjunction with Fig. 2, which shows a schematic bottom view of the patient interface system 10. The patient interface 12 is in this case formed as a single piece from several assemblies glued together, while the patient interface holder 14 in this case consists of three exemplary assemblies in terms of number and orientation, which are screwed together and are explained in more detail below. The patient interface holder 14 comprises a holding device 16, by means of which the patient interface 12, which can basically be a single-use or disposable part, can be reversibly coupled to the patient interface holder 14 and which is designed to position the patient interface 12 in the coupled state relative to the patient interface holder 14. For this purpose, the holding device 16 comprises two opposing, groove-shaped guide devices 18, along which a second positioning device 20 (see Fig. 4) of the patient interface 12 is forcibly movable for coupling and decoupling. The patient interface 12 can thus be inserted into the holding device 16 of the patient interface holder 14 like a drawer for coupling and pulled out again for decoupling.

[0029] It can also be seen that the patient interface holder 14 comprises a connecting device 22 for coupling a camera system 24 and an illumination device 26, by means of which at least a region of the patient's eye is illuminated perpendicular to a surface of a contact body 28 or a contact plate 28 of a first positioning device 30 of the patient interface 12. For this purpose, the illumination device 26 comprises - in number and arrangement by way of example - four illuminants (e.g., LEDs) 32, the respective light cones of which are in Fig. 1 and Fig. 2 are represented by circles. Since the patient interface 12 is made entirely of an optically transparent material, or at least in the region of the first positioning device 30, which is brought into contact with the patient's eye for laser surgical treatment, the radiation from the illuminating means 32 penetrates the essentially funnel-shaped wall of the patient interface 12 in this region and thereby indirectly irradiates both the surgical area beneath the contact plate 28, which can also be referred to as a contact glass, and also directly its surroundings.

[0030] Furthermore, the patient interface holder 14 and the patient interface 12 can be connected to a suction device (not shown), for example a vacuum pump, in a manner described in more detail below, in order to generate a relative negative pressure and to hold the patient interface 12 or its first positioning device 30 in contact with the patient's eye. This can be seen in particular in Fig. 1, that all connecting cables 34 for the camera system 24 and the lighting device 26 as well as a vacuum hose 36 for connecting the suction device lead in the same direction from the patient interface holder 14 and are arranged on a side of the patient interface holder 14 opposite the insertion side of the patient interface 12. This allows the patient interface 12 to be coupled to or decoupled from the patient interface holder 14 particularly easily and reliably, wherein the coupling simultaneously locks, positions, and connects it to the camera system 24, the suction device, and the lighting device 26, without any additional manual interventions or work steps being required by a user.

[0031] Fig. 3 shows a schematic cross-sectional view of the patient interface system 10. In particular, the camera system 24 coupled by means of the connecting device 22 of the patient interface holder 14 can be seen, and the patient interface holder 14 and the patient interface 12 have mutually corresponding channels 38, which, when the patient interface holder 14 and the patient interface 12 are coupled, jointly define an optical path P between the connecting device 22 and the first positioning device 30. Within the scope of the present disclosure, identical or functionally equivalent elements are generally identified by identical reference numerals, unless otherwise specified.The channel 38 of the patient interface holder 14 is sealed in an end region facing away from the connecting device 22 with a window 40 transparent to wavelengths in the visible range, preventing foreign bodies from entering and interfering with the optical systems. When the patient interface 12 and the patient interface holder 14 are coupled, the channels 38 and thus the optical path P extend at an angle of approximately 45° to a direction of a designated laser radiation L of the laser device or to a surface of the contact plate 28 facing the laser device.

[0032] Fig. Figure 4 shows a schematic exploded view of an embodiment of the patient interface 12 according to the invention. It can be seen that the patient interface 12 consists of several assemblies that are connected to one another by plug-in, shrink-fit, and adhesive connections. From top to bottom, the assemblies comprise an interface body 42, which includes the second positioning device 20, and a holder 44, by means of which the patient interface 12 can be held by a user with the thumb (from above) and index finger (from below) in order to couple the patient interface 12 to the patient interface holder 14 or to decouple it from the patient interface holder 14. The holder 44 has a concave, curved shape that allows for comfortable and secure gripping.Also visible is a female connector 45, into which a corresponding male connector 47 of the patient interface holder 14 engages when coupled to the patient interface holder 14, in order to achieve not only a mechanical coupling but also a fluidic coupling. Furthermore, the patient interface 12 comprises a filter element 46, which is arranged in a mounting opening 48 of a one-piece collecting container 50. Since the mounting opening 48 is asymmetrical in the present example, the filter element 46 can only be inserted into the mounting opening 48 in the correct orientation, thereby ensuring error-free installation. This is useful, for example, if the filter element 46 requires a unidirectional flow direction. The collecting container 50 in this case has a volume of approximately 120 mm. 3, making it large enough to safely prevent overflow or clogging during laser surgery. The volume of approximately 120 mm 3 Theoretically, approximately five laser surgical procedures can be performed, thus ensuring a sufficient safety buffer. For assembly, the collecting container 50, together with the filter element 46, is inserted into a corresponding mounting opening 52 of the interface body 42.

[0033] The collection container 50 comprises a connector 54 in which a first end region of a vacuum hose 56 is arranged. The opposite end region of the vacuum hose 56 is inserted into a further connector 54 for assembly, wherein the further connector 54 is formed on a suction cup part 58 of the patient interface 12 and opens into a suction opening 64. The suction cup part 58 also comprises the channel 38 for the camera system 24 and the first positioning device 30, which is placed on the patient's eye. The contact plate 28 is fixed, for example, glued, within the suction cup part 58 in the region of the first positioning device 30.

[0034] The female connector 45, the filter element 46, the collecting container 50 and the vacuum hose 56 together form a fluid guide device 60 which, in the coupled state of the patient interface 12 and the patient interface holder 14, together form a fluid path which fluidically couples a suction channel 62 of the patient interface holder 14 to a suction opening 64 of the patient interface 12 in the region of the first positioning device 30 in order to bring the first positioning device 30 into contact with the patient's eye or to hold it on the patient's eye by means of a relative negative pressure generated by the suction device.

[0035] Fig. Figure 5 shows a schematic side view of the patient interface 12 in the assembled state. In particular, the fluid guide device 60 can be seen, which fluidically connects the first positioning device 30 via the vacuum hose 56, the collecting container 50, and the filter element 46 to the female connector 45 in the interface body 42.

[0036] Fig. 6 shows a schematic sectional view of the patient interface 12 according to the Fig. 5 shown section plane VI-VI. Fig. 6 will be discussed in conjunction with Fig. 7, which shows an enlarged view of the Fig. 6 shows the detailed area VII. The contact body 28 is fluid-tightly bonded to the suction cup part 58 and has a concave underside that defines a cavity 66 into which the fluid guide device 60 opens. The first positioning device 30 further comprises a plurality of teeth 68 that are arranged in a ring-shaped manner, spaced apart from one another, in the end region of the patient interface 12 facing the patient's eye. The teeth 68, together with the contact body 28, ensure applanation of the patient's eye, while simultaneously minimizing the applanation forces and suction load.

[0037] Fig. 8 shows a schematic perspective view of the suction cup part 58 of the patient interface 12 from above, wherein the contact plate 28 is not yet mounted, so that the annularly arranged teeth 68 of the first positioning device 30 and mounting ribs 70 for the contact plate 28 can be seen. Fig. 9 shows an enlarged view of the Fig. 8 shown details IX, whereby the contact plate 28 is now inserted into the suction cup part 58 in the area above the teeth 68 and glued to it.

[0038] Fig. 10 shows a schematic top view of the patient interface 12. In particular, the second positioning device 20 can be seen, which in the present exemplary embodiment has three locking surfaces 72a, 72b, 72c, which are arranged in the shape of a triangle and between which a path for the laser beam L of the laser device is provided through the patient interface 12. Furthermore, the second positioning device 20 of the patient interface 12 comprises, by way of example, two ramps 74a, 74b in number and arrangement, wherein the ramps 74a, 74b are arranged in front of their associated locking surfaces 72a, 72b with respect to a coupling path K and rise along the coupling path K. In the present exemplary embodiment, the locking surface 72a has a frustoconical geometry, while the locking surface 72b is slot-shaped and the locking surface 72c is flat.In the coupled state of patient interface 12 and patient interface holder 14, the locking surfaces 72a-c interact with corresponding spring-loaded locking bodies 76a-c of the patient interface holder 14, resulting in the following restrictions of the three translational and three rotational degrees of freedom in the present embodiment: Locking surface 72a: 2 translational degrees of freedom blocked Locking surface 72b: 2 rotational degrees of freedom blocked Locking surface 72c: 1 degree of rotational freedom blocked

[0039] This means that the patient interface 12, when coupled to the patient interface holder 14, is not rigidly coupled, but is only slightly movable in the z-direction, i.e., perpendicular to the applanated patient eye or translationally along the direction of the laser beam L, in order to compensate for tolerances and enable easier coupling and decoupling without having to accept any loss of correct positioning. Furthermore, collars 78 of the second positioning device 20 can be seen, which, during coupling, are pushed into the groove-shaped guide devices 18 and moved in a forced manner like a drawer along the essentially linear coupling path K. Due to the ramps 74a, 74b, a continuously increasing insertion force is required for coupling until the locking bodies 76a, 76b engage with the locking surfaces 72a, 72b.This generates a clear haptic feedback for a user about the progress of the coupling process as well as about the coupling being completed due to the locking of the locking bodies 76a, 76b.

[0040] Fig. 11 shows a schematic perspective view of the already in Fig. 1 of the embodiment of the patient interface holder 14 according to the invention of the patient interface system 10 without a coupled patient interface 12. It can be seen in particular that the patient interface holder 14 in this case comprises three interconnected assemblies 80a-c. Assembly 80a functions as the upper holding assembly, assembly 80b as the lower holding assembly, and assembly 80c as the illumination holder. The assemblies 80a, 80b together form the groove-shaped guide device 18. The assembly 80a further comprises the connecting device 22, into which the camera system 24 is inserted.

[0041] Fig. 12 shows schematic lateral sections of locking bodies 76a-c of the patient interface holder 14, which interact with their corresponding locking surfaces 72a-c of the patient interface 12 when the patient interface 12 and the patient interface holder 14 are coupled. The locking bodies 76a-c are ceramic balls of the same diameter, which are rigidly attached to the patient interface holder 14. These ceramic balls are, on the one hand, mechanically very robust and, on the other hand, can easily slide along the surface and the ramps 74a, 74b of the second positioning device 20 during the coupling process. It is understood that, in principle, different materials such as steel or plastic can also be used. The individual locking bodies 76a-c can, in principle, also be made of different materials and / or have different geometries.Below the individual pairings, perspective partial top views of the locking surfaces 72a-c of the patient interface 12 without the locking bodies 76a-c are shown.

[0042] Fig. Figure 13 shows a partial side sectional view of the patient interface 12 in the region of opposing locking surfaces 72b, 72b', which interact with corresponding locking bodies 76b, 76b' of the patient interface holder. Unlike the locking body 76b, the locking body 76b' is spring-loaded and ensures a reliable coupling of the patient interface 12 and the patient interface holder 14, since the patient interface 12 and the patient interface holder 14 can only be moved relative to one another in the coupled state by overcoming the total spring force of all spring-loaded locking bodies 76a'-c'. However, by overcoming the total spring force, at least a translational movement in the z-direction, i.e. against the spring forces F, is possible, so that the patient interface 12 and the patient interface holder 14 are not rigidly connected but spring-elastically even in the coupled state, or do not behave like a one-piece body.The locking bodies 76b, 76b' as well as the locking bodies 76a, 76a', 76c, 76c' (not explicitly shown) form, together with their corresponding locking surfaces 72a-c, 72a'-c', a locking device 82. The locking bodies 76a'-c' are also designed as ceramic balls and are arranged together with respective springs 84 in a housing 86. It is understood that the locking bodies 76a'-c' can also be made of different materials and / or have different geometries. Likewise, it can be provided that all springs 84 have the same or different spring forces F.

[0043] Fig. Figure 14 shows a schematic exploded view of the patient interface holder 14. It can be seen that, in the illustrated embodiment, the camera system 24 can be plugged into the connecting device 22 and screwed to the first assembly 80a. The assembly 80b carries the spring-loaded locking bodies 76a'-c' mounted in their housings 86. Also visible is the intake channel 62 and the male connector 47 arranged therein, which is connected to the vacuum hose 36. Also clearly visible is the illumination device 26, which in this case comprises four LEDs and is integrated into the third assembly 80c and is electrically supplied via its connecting cable 34.

[0044] Fig. Figure 15 shows a schematic exploded view of the first assembly 80a of the patient interface holder 14 from an oblique bottom view. In particular, the locking bodies 76a-c, which are not spring-loaded but rigidly mounted in the first assembly 80a, are visible here. These locking bodies are inserted into corresponding mounting openings in the assembly 80a. Four screws 88 are also shown as fastening means, by means of which the assemblies 80a-c are screwed together. It is understood that other fastening means, a different number of fastening means, and a different orientation of the fastening means may also be provided.

[0045] Fig. 16 shows a schematic exploded view of the second assembly 80b of the patient interface holder 14. Of the locking device 82, only the housings 86 of the spring-loaded locking bodies 76a'-c' are shown, which are inserted into corresponding mounting openings of the second assembly 80b. Furthermore, it can be seen that the vacuum hose 36 is connected to the male connector 47 and inserted into the intake channel 62. The connector 47, in turn, is subjected to force by another spring-loaded locking body 76d', of which only the housing 86 is also shown. The housing 86 of this locking body 76d' is secured to the second assembly 80b by means of a clamp 90.

[0046] Fig. Figure 17 shows a schematic and partial sectional view from above of the suction channel 62 of the patient interface holder 14 and a portion of the fluid guide device 60 of the patient interface 12 coupled to the patient interface holder 14. Due to the engagement of the male connector 47 in the female connector 45, the patient interface holder 14 and the patient interface 12 are fluidically coupled, so that the patient interface 12 can be held in contact with the patient's eye by means of a relative negative pressure generated by a suction device connected to the vacuum hose 36. The female connector 45 has an inner cone in which a corresponding outer cone of the male connector 47 is arranged in the coupled state.In this case, the outer cone and the inner cone have a contact angle of approximately 12°, which on the one hand ensures a gas-tight connection and on the other hand ensures quick and uncomplicated coupling and decoupling with a force of at most approximately 2 N by an axial movement along the coupling path K. Although the male connector 47 and the female connector 45 could also be interchanged, the shown arrangement of the female connector 45 on the patient interface 12 has the advantage of reducing the risk of contamination between unpacking and coupling of the patient interface 12, since the contact surface of the female connector 45 is less exposed to the environment than with a male connector 47. By reducing the risk of contamination, not only possible hygiene problems but also later connection problems are avoided.While the male connector 47 is in direct contact with the wall of the female connector 45, a certain amount of play is allowed in the area indicated by arrow XVII.

[0047] How to Fig. 18, which is a schematic and partially transparent perspective view of the Fig. As shown in the area of the patient interface system 10 shown in Figure 17, the male connector 47 is mounted in a floating manner and is movable in all three spatial directions, with the connector 47 being pressed by the locking body 76d' toward the female connector 45. This allows for a particularly reliable and gas-tight connection while compensating for any manufacturing tolerances. Fig. For further clarification, Figure 19 shows a schematic sectional view of the connector 47 which engages the female connector 45 of the patient interface 12.

[0048] Fig. 20 shows a schematic sectional view of an embodiment of the patient interface 12. In particular, the suction opening 64 into which the connecting piece 54 opens can be seen. Furthermore, it is clear that the suction cup part 58 has a circumferential collar 100 into which the interface body 42 is inserted and adhesively bonded to the suction cup part 58. The design of the collar 100 ensures self-centering during assembly. Because the collar 100 has a vertical section in addition to a horizontal section on which the interface body 42 rests, horizontal and vertical tolerances can be compensated for by the geometric design of the collar 100. The collar 100 forms a reservoir for excess adhesive and ensures that adhesive is drawn into the gap between the interface body 42 and the suction cup part 58 by capillary forces.This ensures a high-quality, material-locking connection between both components of the patient interface 12.

[0049] Fig. 21 shows a schematic perspective view of an embodiment of a collecting container 50 and will be described below in conjunction with Fig. 22, which shows a schematic perspective view of the collecting container 50, which is provided with the filter element 46. In Fig. 21, that the mounting opening 48 for the filter element 46 is asymmetrical and has a circumferential edge 102. When the collecting container 50 with the filter element 46 is inserted into its associated mounting opening 52 of the interface body 42 and heated, this edge 102 collapses, reducing the gap between the collecting container 50 and the interface body 42 and clamping the filter element 46 between the two parts in a reliable and fluid-tight manner.

[0050] Fig. 23 shows a schematic perspective view of the patient interface 12 in the region of its mounting opening 52 for the collecting container 50. The walls of the interface body 42 delimiting the mounting opening 52 have ribs 108 directed outwards on one side and inwards on the other, so that the collecting container 50, which has complementary ribs 108, can be inserted into the mounting opening 52 without tilting. A support surface 106 of the patient interface 12 has a circumferential lip 104 on its inner circumference, which, together with the edge 102, contributes to the lateral sealing of the filter element 46 when mounted. Fluid can therefore only flow from the connecting piece 54 through the collecting container 50, the filter element 46, and the connecting piece 54. Fig. 24 shows a schematic perspective view of the patient interface 12, wherein the collecting container 50 is arranged and fixed in the mounting opening 52.

[0051] Fig.25 shows a schematic sectional view of the collecting container 50 in the region of its connecting piece 54. The connecting piece 54 has a mounting channel 110 in which an end region of the vacuum hose 56 is arranged. The mounting channel 110, in turn, has an inner diameter that decreases in three stages along an assembly direction XXV, starting from an insertion opening whose inner diameter is larger than an outer diameter of the vacuum hose 56. In the first section S1, which serves for fixing, the inner diameter of the mounting channel 110 is, as mentioned, larger than the outer diameter of the vacuum hose 56 and is coated with an adhesive for assembly. In the second section S2, which serves for positioning, the inner diameter of the mounting channel 110 is only slightly larger than the outer diameter of the vacuum hose 56, thereby centering the vacuum hose 56 in the mounting channel 110.In the third section S3, which also serves for positioning, the inner diameter of the mounting channel 110 is smaller than the outer diameter of the vacuum hose 56. The vacuum hose 56 is thus pushed into the mounting channel 110 until it stops in the third section S3, ensuring correct axial positioning. It is understood that the connecting piece 54 of the suction cup part 58 can be designed analogously.

[0052] The parameter values specified in the documents for defining process and measurement conditions for characterizing specific properties of the subject matter of the invention are to be considered as being included within the scope of the invention, even in the case of deviations - for example due to DIN tolerances and the like. List of reference symbols 10 Patient interface system 12 Patient interface 14 patient interface holders 16 Holding device 18 Guide device 20 second positioning device 22 Connecting device 24 camera system 26 Lighting equipment 28 contact bodies 30 first positioning device 32 bulbs 34 connection cables 36 vacuum hose 38 channel 40 windows 42 interface bodies 44 holders 45 connector 46 filter element 47 connecting piece 48 Mounting opening 50 collection containers 52 Mounting opening 54 connecting piece 56 vacuum hose 58 Suction cup part 60 Fluid guide device 62 intake duct 64 intake opening 66 cavity 68 teeth 70 mounting ribs 72a Rest area 72b Rest area 72c rest area 72a' Rest area 72b' Rest area 72c' rest area 74a Ramp 74b Ramp 76a locking body 76b locking body 76c locking body 76a' spring-loaded locking body 76b' spring-loaded locking body 76c' spring-loaded locking body 76d' spring-loaded locking body 78 collar 80a assembly 80b assembly 80c assembly 82 locking device 84 springs 86 housings 88 screws 90 bracket 100 collars 102 Rand 104 Lippe 106 contact surface 108 ribs 110 mounting channel P optical path K coupling path L Laser radiation F spring force

Claims

[1] Patient interface system (10) for positioning a patient's eye relative to a laser device for laser surgery, comprising a patient interface (12) for coupling to the patient's eye and a patient interface holder (14) for arranging the patient interface (12) on the laser device, wherein - the patient interface (12) has a first positioning device (30) for positioning the patient interface (12) on the patient's eye; and - the patient interface holder (14) comprises a holding device by means of which the patient interface (12) can be reversibly coupled to the patient interface holder (14); where the patient interface holder (14) comprises a connecting device (22) for coupling a camera system (24), and the patient interface holder (14) and the patient interface (12) have mutually corresponding channels which, in the coupled state of the patient interface holder (14) and the patient interface (12), jointly define an optical path (P) between the connecting device (22) and the first positioning device (30), characterized by , that at least two assemblies (80a, 80b) together form a preferably groove-shaped guide device (18), along which a second positioning device (20) of the patient interface (12) for coupling to the patient interface holder (14) can be moved in a positively guided manner. [2] Patient interface system (10) according to claim 1, characterized bythat the channel (38) of the patient interface holder (14) is closed in an end region facing away from the connecting device (22) with a window (40) transparent to wavelengths in the range visible to humans. [3] Patient interface system (10) according to claim 1 or 2, characterized by that the channels in the coupled state of the patient interface (12) and the patient interface holder (14) run at an angle between 2 ° and 80 ° to a direction of a designated laser radiation (L) of the laser device. [4] Patient interface system (10) according to one of claims 1 to 3, characterized by that the patient interface holder (14) comprises an illumination device (26) by means of which at least one region of the patient's eye can be illuminated, preferably perpendicular to a surface of a contact body (28) of the first positioning device (30). [5] Patient interface system (10) according to one of claims 1 to 4, characterized by that the patient interface (12) and / or the patient interface holder (14) comprises at least two assemblies (80a-c) coupled to one another. [6] Patient interface system (10) according to claims 4 and 5, characterized by that one of the assemblies (80c) carries the lighting device (26). [7] Patient interface system (10) according to claim 5 or 6, characterized bythat at least two assemblies (80a-c) comprise respective channels which together form the channel (38) of the patient interface holder (14) and / or of the patient interface (12) and / or that at least one assembly (80b) comprises a suction channel (62) which can be connected to a suction device and which, in the coupled state of the patient interface holder (14) and the patient interface (12), together with a fluid guide device (60) of the patient interface (12), forms a fluid path which fluidically couples the suction channel (62) to a suction opening (64) of the patient interface (12) in the region of the first positioning device (30) in order to hold the first positioning device (30) in contact with the patient's eye by means of a relative negative pressure generated by the suction device. [8] Patient interface system (10) according to one of claims 1 to 7, characterized bythat the connecting device (22) is designed for coupling a focusing system by means of which a focus of the camera system (24) on the patient's eye can be adjusted. [9] Patient interface system (10) according to one of claims 1 to 8, characterized by that the patient interface (12) consists at least in part of a material that is transparent and / or light-conducting for wavelengths in the range visible to humans. [10] Patient interface system (10) according to one of claims 1 to 9, characterized by that it comprises a camera system (24) and connecting means (88) via which the camera system (24) is coupled to the connecting device (22) of the patient interface holder (14) of the patient interface system (10). [11] Patient interface system (10) according to claim 10, characterized bythat the camera system (24) comprises at least one component from the group diaphragm, lens, spring element, spring bearing, camera housing, adjusting means, mounting block and focus screw. [12] Method for coupling a patient interface (12) of a patient interface system (10) according to one of claims 1 to 9 to a patient interface holder (14) of a patient interface system (10) according to one of claims 1 to 9, wherein the patient interface (12) is moved relative to the patient interface holder (14) until the patient interface (12) and the patient interface holder (14) are coupled and the mutually corresponding channels of the patient interface holder (14) and the patient interface (12) jointly delimit an optical path (P) between the connecting device (22) for the camera system (24) and the first positioning device (30) of the patient interface (12), wherein at least two assemblies (80a, 80b) together form a preferably groove-shaped guide device (18), along which a second positioning device (20) of the patient interface (12) for coupling to the patient interface holder (14) is moved in a forced manner. [13] Patient interface (12) for a patient interface system (10) according to one of claims 1 to 9, wherein the patient interface (12) comprises a channel (38) which, in the coupled state of the patient interface holder (14) and the patient interface (12), together with a corresponding channel (38) of the patient interface holder (14), delimits an optical path (P) between the connecting device (22) of the patient interface holder (14) and the first positioning device (30) of the patient interface (12), wherein the patient interface (12) has a second positioning device (20) which, for coupling to the patient interface holder (14), is movable in a positively guided manner along at least two assemblies (80a, 80b) of the patient interface holder (14), which together form a preferably groove-shaped guide device (18). [14] Patient interface holder (14) for a patient interface system (10) according to one of claims 1 to 9, wherein the patient interface holder (14) comprises a connecting device (22) for coupling a camera system (24) and has a channel (38) which, in the coupled state of the patient interface holder (14) and the patient interface (12), together with a corresponding channel (38) of the patient interface (12), delimits an optical path (P) between the connecting device (22) and the first positioning device (30) of the patient interface (12), wherein at least two assemblies (80a, 80b) together form a preferably groove-shaped guide device (18) along which a second positioning device (20) of the patient interface (12) can be moved in a positively guided manner for coupling to the patient interface holder (14).

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