Ophthalmic laser treatment apparatus

Abstract

To provide an ophthalmic laser treatment apparatus which can properly assist a treatment with treatment laser light when a contact lens having a reflection surface is used.SOLUTION: A control unit executes an irradiation plan acquisition step and a sight guide display step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan in which the irradiation order of treatment laser light is determined for a plurality of irradiation spots to be irradiated with the treatment laser light when the treatment laser light is radiated to a patient eye by using a contact lens having a reflection surface that reflects the treatment laser light in the direction intersecting an optical axis. In the sight guide display step, the control unit displays the sight guide that assists in adjusting the sight position of the treatment laser light adjusted by an operator to a proper position on an internal display part according to the progress of the irradiation plan.SELECTED DRAWING: Figure 10

Description

[Technical Field]

[0001] The present disclosure relates to an ophthalmic laser treatment device that treats tissue in a patient's eye by irradiating the tissue with treatment laser light. [Background technology]

[0002] Techniques for assisting treatment of a patient's eye with a treatment laser beam have been proposed. For example, an ophthalmic laser treatment device described in Patent Document 1 displays on a display screen a region to be irradiated with the treatment laser beam and also displays on the display screen the region irradiated with the treatment laser beam (the irradiated region) when the treatment laser beam is actually irradiated. The region to be irradiated and the irradiated region are displayed to allow the surgeon to check the progress of the treatment. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2014-233469 Summary of the Invention [Problem to be solved by the invention]

[0004] When treating tissue in a patient's eye with a therapeutic laser beam, a contact lens having a reflective surface that reflects the therapeutic laser beam may be used. For example, a contact lens having a reflective surface may be used to treat a ring-shaped trabecular meshwork located at the interface between the cornea and the iris of the eyeball. In this case, the surgeon must adjust the aim of the therapeutic laser beam by holding the contact lens and observing the tissue reflected on the reflective surface of the contact lens. Furthermore, when irradiating multiple tissue locations with the therapeutic laser beam, the surgeon must adjust the aim of the therapeutic laser beam by appropriately rotating the reflective surface of the contact lens. Therefore, accurate adjustment of the aim requires the surgeon's skill. Therefore, a technology that can appropriately assist treatment with a therapeutic laser beam when a contact lens having a reflective surface is used is desired.

[0005] A typical object of the present disclosure is to provide an ophthalmic laser treatment device that can appropriately assist treatment with a treatment laser beam when a contact lens having a reflective surface is used. [Means for solving the problem]

[0006] An ophthalmic laser treatment device provided by a typical embodiment of the present disclosure is an ophthalmic laser treatment device that irradiates tissue of a patient's eye with treatment laser light each time an instruction to irradiate treatment laser light is input, and includes: a laser irradiation optical system that irradiates the patient's eye with the treatment laser light; an observation optical system that allows an operator to observe an observation image of the patient's eye through an eyepiece; an internal display unit that is provided in the observation optical system and displays an image to the operator through the eyepiece; and a control unit, wherein the control unit executes the following steps when irradiating the patient's eye with treatment laser light using a contact lens having a reflective surface that reflects the treatment laser light in a direction intersecting with the optical axis: an irradiation plan acquisition step that acquires an irradiation plan that determines the order in which the treatment laser light is irradiated with multiple irradiation spots to be irradiated with the treatment laser light; and an aiming guide display step that displays an aiming guide on the internal display unit according to the progress of the irradiation plan, the aiming guide assisting the operator in adjusting the aiming position of the treatment laser light, which is adjusted by the operator, to an appropriate position.

[0007] According to the ophthalmic laser treatment device of the present disclosure, treatment with treatment laser light is appropriately assisted when a contact lens having a reflective surface is used. [Brief explanation of the drawings]

[0008] [Figure 1] 1 is an external view of an ophthalmic laser treatment device 1. FIG. [Figure 2] 1 is a diagram showing the optical system of the ophthalmic laser treatment device 1 as seen from the side. [Figure 3] 1 is a diagram showing the optical system of the ophthalmic laser treatment device 1 as viewed from above. [Figure 4] 2 is a schematic cross-sectional view of a patient's eye E and a contact lens 26. FIG. [Figure 5] 2 is a diagram showing a schematic view of an example of an observation area observed through a reflecting surface 27 of a contact lens 26. FIG. [Figure 6] FIG. 2 is an exploded perspective view of a contact lens 26, which is a partially rotational lens. [Figure 7] 1 is a view of a contact lens 26 provided with a spacing indicator 28, viewed from the side opposite to the side that comes into contact with a patient's eye E. FIG. [Figure 8] FIG. 2 is a diagram showing an example of an irradiation plan displayed on the control box 6. [Figure 9] 10A and 10B are explanatory diagrams for explaining a method for adjusting the aiming position of the irradiation spot. [Figure 10] 1 is a diagram showing an example of an observation field of an operator during treatment using the ophthalmic laser treatment apparatus 1 of the first embodiment. FIG. [Figure 11] 4 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the first embodiment. [Figure 12] 10A and 10B are diagrams showing an example of transition of the operator's observation field during treatment with the ophthalmic laser treatment apparatus 1 of the second embodiment. [Figure 13] 10 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the second embodiment. [Figure 14] FIG. 10 is a diagram showing an example of an observation field of an operator during treatment using the ophthalmic laser treatment apparatus 1 of the third embodiment. [Figure 15] FIG. 14 is an enlarged view of the angle guide 80 shown in FIG. [Figure 16] 10 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the third embodiment. [Figure 17] 10A and 10B are diagrams showing an example of transition of the operator's observation field during treatment with the ophthalmic laser treatment apparatus 1 of the fourth embodiment. [Figure 18] 10A and 10B are diagrams showing an example of transition of the operator's observation field during treatment with the ophthalmic laser treatment apparatus 1 of the fourth embodiment. [Figure 19] 10 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the fourth embodiment. [Figure 20]FIG. 11 is a diagram showing an example of an observation field of an operator during treatment using the ophthalmic laser treatment apparatus of the fifth embodiment. [Figure 21] 10A and 10B are diagrams showing an example of a transition of a part of the operator's observation field during treatment by the ophthalmic laser treatment apparatus 1 of the fifth embodiment. [Figure 22] 10A and 10B are diagrams showing an example of a transition of a part of the operator's observation field during treatment by the ophthalmic laser treatment apparatus 1 of the fifth embodiment. [Figure 23] 10 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the fifth embodiment. [Figure 24] FIG. 13 is a diagram showing an example of a transition of a part of the operator's observation field during treatment by the ophthalmic laser treatment apparatus 1 of the sixth embodiment. [Figure 25] FIG. 13 is a diagram showing an example of a transition of a part of the operator's observation field during treatment by the ophthalmic laser treatment apparatus 1 of the sixth embodiment. [Figure 26] FIG. 20 is a diagram schematically illustrating an example of transition of the optical path of the treatment laser beam in the sixth embodiment. [Figure 27] 13 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the sixth embodiment. [Figure 28] FIG. 13 is a diagram showing an example of the observation field of an operator during treatment with the ophthalmic laser treatment apparatus 1 of the seventh embodiment. [Figure 29] 10A and 10B are diagrams illustrating examples of changes in the spot interval guide. [Figure 30] 10A and 10B are diagrams illustrating examples of modifications of the spot interval guide according to the fourth embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0009] <Summary> The ophthalmic laser treatment device exemplified in the present disclosure irradiates the tissue of a patient's eye with treatment laser light each time an instruction to irradiate the patient's eye with treatment laser light is input. The ophthalmic laser treatment device includes a laser irradiation optical system, an observation optical system, an internal display unit, and a control unit. The laser irradiation optical system irradiates the patient's eye with treatment laser light. The observation optical system allows the surgeon to observe an image of the patient's eye through an eyepiece. The internal display unit is provided in the observation optical system and displays an image to the surgeon through the eyepiece. The control unit controls various aspects of the ophthalmic laser treatment device. The control unit executes an irradiation plan acquisition step and an aiming guide display step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan that determines the order in which the treatment laser light is to be irradiated onto multiple irradiation spots to be irradiated with the treatment laser light when the treatment laser light is irradiated onto the patient's eye using a contact lens having a reflective surface that reflects the treatment laser light in a direction intersecting the optical axis. In the aiming guide display step, the control unit causes the internal display unit to display an aiming guide that assists the surgeon in adjusting the aiming position of the treatment laser light to an appropriate position according to the progress of the irradiation plan.

[0010] According to the ophthalmic laser treatment device of the present disclosure, an aiming guide to assist the surgeon in adjusting the aiming position is displayed on the internal display unit according to the progress of the irradiation plan. Therefore, the surgeon can check the aiming guide while observing the patient's eye through the eyepiece (i.e., without taking his / her eye away from the eyepiece), and adjust the aiming position of the treatment laser beam by referring to the checked aiming guide. This allows the surgeon to more appropriately adjust the aiming position of the treatment laser beam.

[0011] When a treatment method that allows observation of treatment scars by the treatment laser beam is adopted, the surgeon can adjust the aim position of the treatment laser beam after checking the position of the treatment scar formed by the previous irradiation of the treatment laser beam. However, there are also cases where a treatment method that makes it difficult to check the treatment scars by the treatment laser beam (e.g., a treatment method performed with the treatment laser beam output set to a lower output than the output at which the treatment scars are formed) is adopted. In such cases, it becomes even more difficult to accurately adjust the aim position for each of the multiple irradiation spots to be irradiated with the treatment laser beam. However, by adjusting the aim position with reference to the aim guide, the surgeon can more easily adjust the aim position more accurately even when it is difficult to check the treatment scars by the treatment laser beam. However, the technology disclosed herein is also very useful when the treatment scars by the treatment laser beam can be observed.

[0012] The center of the display area in the internal display unit may coincide with the optical axis of the observation optical system (hereinafter sometimes referred to as the "observation optical axis"). In this case, the image is displayed in the display area in the internal display unit based on the observation optical axis of the observation optical system. Therefore, the surgeon can perform appropriate treatment while recognizing the image presented at an appropriate position in the field of view.

[0013] The optical axis of the treatment laser beam emitted by the laser irradiation optical system may also coincide with the optical axis of the observation optical system. In this case, the control unit can display an image at an appropriate angle in an appropriate direction centered on the optical axis of the treatment laser beam. Furthermore, when the laser irradiation optical system irradiates the patient's eye with an aiming laser beam (hereinafter also referred to as "aiming beam") to allow the surgeon to recognize the intended irradiation position of the treatment laser beam, the optical axis of the aiming laser beam may also coincide with the optical axis of the observation optical system. In this case, the surgeon visually recognizes the aiming beam at the center of the observation field and the display area of ​​the internal display unit, making it even easier to adjust the irradiation position of the treatment laser beam based on the aiming beam and the display content.

[0014] The control unit may display, on the internal display unit, a target site guide as an aiming guide, which serves as a reference for aligning the arc-shaped or annular treatment target site of the patient's eye observed by the surgeon through the observation optical system. In this case, the surgeon can more easily adjust the aiming position of the treatment laser light to an appropriate position by making various adjustments so that the arc-shaped or annular treatment target site observed through the observation optical system matches the displayed target site guide.

[0015] The target area guide may include a straight line portion parallel to the tangent direction of the arc-shaped or annular treatment area, tangent to the appropriate position of the next irradiation spot, as viewed from the surgeon's line of sight through the observation optical system. Focusing on a certain region on the circumference (a region whose angular range from the center of the circle is less than 180 degrees), the slope of the tangent line is uniquely determined at a specific point on the circumference. The angular range of the arc-shaped or annular treatment area observed through the reflective surface of the contact lens is less than 180 degrees. Therefore, by aligning the treatment area with the target area guide so that the tangent direction of the arc-shaped or annular treatment area (e.g., trabecular meshwork) matches the direction of the straight line portion of the target area guide, the aim position of the treatment laser light can be easily adjusted accurately. Furthermore, when the surgeon observes the arc-shaped or annular treatment area through the observation optical system, the curvature of the observed treatment area changes depending on the size of the patient's eye, the magnification of the observation optical system (hereinafter sometimes referred to as "observation magnification"), etc. However, the surgeon can align the tangent direction of the treatment target area with the direction of the straight portion of the treatment target area guide, regardless of the curvature of the observed treatment target area, making it easier for the surgeon to adjust the aiming position to the appropriate position.

[0016] The target area guide may include an arc-shaped portion corresponding to the arc-shaped arrangement of the multiple irradiation spots determined by the irradiation plan. In this case, the treatment area is aligned with the target area guide so that the arc shape of the treatment area matches the shape of the arc-shaped portion of the target area guide, making it easier to accurately adjust both the rotation angle of the reflective surface of the contact lens and the aim position of the treatment laser light.

[0017] The control unit may change the curvature of the arc-shaped portion of the target area guide displayed on the internal display unit according to the magnification of the observation optical system. In other words, the control unit may reduce the curvature of the arc-shaped portion of the target area guide as the magnification of the observation optical system increases. In this case, the arc-shaped portion of the target area guide changes appropriately according to the difference in appearance of the treatment area, which changes depending on the observation magnification. This makes it easier to adjust the aiming position.

[0018] The control unit may switch between displaying and hiding at least a part of the target area guide (e.g., a straight portion or an arc-shaped portion) on the internal display unit in response to an instruction input by the surgeon. In this case, when the treatment laser beam is actually irradiated toward the irradiation spot, at least a part of the target area guide is prevented from interfering with the aim of the treatment laser beam.

[0019] The configuration of the target area guide can also be modified. For example, the target area guide may include a straight line portion that, when viewed from the surgeon's line of sight in the observation optical system, is parallel to the appropriate reflection direction of the treatment laser light from the reflective surface of the contact lens to the next irradiation spot. In this case, the surgeon can appropriately adjust the rotation angle of the reflective surface of the contact lens by adjusting the rotation angle of the reflective surface so that the arc-shaped or annular treatment target area approaches perpendicular to the straight line portion of the target area guide.

[0020] The control unit may determine the angle of the target site guide to be displayed on the internal display unit according to the progress of the irradiation plan, and display the target site guide at the determined angle. In this case, the target site guide is displayed on the internal display unit at an appropriate angle according to the progress of the irradiation plan, making it easier to adjust the aiming position more appropriately.

[0021] In particular, when starting treatment according to the irradiation plan, the control unit may determine the angle of the target area guide according to the position or direction of the first irradiation spot determined by the irradiation plan. Each time irradiation of the treatment laser beam is performed (for example, each time an instruction to perform irradiation of the treatment laser beam is input), the control unit may rotate the angle of the displayed target area guide according to the traveling direction and traveling angle of the irradiation spot. In this case, each time irradiation of the treatment laser beam is performed, the target area guide is displayed at an appropriate angle according to the next irradiation spot.

[0022] Furthermore, among contact lenses having a reflective surface (sometimes called "goniolenses"), there are partially rotating lenses in which the portion including the reflective surface rotates a predetermined angle relative to the gripper held by the user with each operation by the user's finger. When a partially rotating lens is used, the control unit may acquire information about the predetermined rotation angle of the partially rotating lens being used (i.e., the angle by which the lens rotates with each operation). Each time a predetermined number of treatment laser beam irradiations to be performed within a range of one predetermined rotation angle are completed, the control unit may rotate the angle of the displayed target area guide by the predetermined rotation angle in the direction of travel of the irradiation spot. In this case, each time treatment laser beam irradiation within a range of one predetermined rotation angle is completed, the angle of the target area guide is rotated to an angle corresponding to the next range of the predetermined rotation angle. Therefore, even when treatment is performed using a partially rotating lens, the aiming position can be more appropriately adjusted.

[0023] The control unit may change the display method of the target area guide based on information about the contact lens being used. For example, if the contact lens being used is a contact lens that can be rotated as a whole by the surgeon, the control unit may execute a process to rotate the target area guide by the angle of travel of the irradiation spot each time irradiation of the treatment laser light is performed. Furthermore, if the contact lens being used is a partially rotating lens, the control unit may execute a process to rotate the target area guide by a specified rotation angle each time irradiation of the treatment laser light is completed a predetermined number of times. In this case, the display of the target area guide is appropriately changed depending on the contact lens being used, making it even easier to adjust the aim position of the treatment laser light.

[0024] In addition, even when a contact lens that can be rotated entirely by the surgeon is used instead of a partially rotating lens, a process of rotating the target area guide by a specified rotation angle may be executed each time a predetermined number of irradiations of the treatment laser light are completed. In this case, by using the displayed target area guide, the surgeon can easily proceed with treatment in the same procedure as when a partially rotating lens is used. Furthermore, the control unit may change the display method of the target area guide according to the settings input by the user (e.g., the surgeon, etc.).

[0025] The control unit may display an angle guide on the internal display unit as an aiming guide, which indicates the rotation angle of the reflective surface of the contact lens appropriate for the progress of the irradiation plan. In this case, the surgeon can adjust the rotation angle of the reflective surface of the contact lens by referring to the angle indicated by the angle guide, thereby adjusting the aiming position of the treatment laser beam with the angle of the reflective surface appropriately adjusted. This makes it even easier to adjust the aiming position of the treatment laser beam.

[0026] The angle guide may include at least one of a shape that corresponds to the appropriate angle of the arc-shaped or annular treatment target area of ​​the patient's eye where the next irradiation spot will be placed, and a shape that corresponds to the appropriate reflection direction of the treatment laser light from the reflective surface of the contact lens toward the next irradiation spot. The control unit may determine the angle of the angle guide to be displayed on the internal display unit according to the progress of the irradiation plan and display the angle guide at the determined angle. When an angle guide that corresponds to the appropriate angle of the treatment target area (e.g., a schematic diagram of the arc-shaped treatment target area or an arc-shaped line that corresponds to the treatment target area) is displayed, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens by adjusting the angle of the observed treatment target area so that it aligns with the angle guide. Furthermore, when an angle guide shaped according to the appropriate reflection direction of the treatment laser light is displayed, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens by adjusting the reflection direction of the treatment laser light so that it aligns with the angle guide. Furthermore, since the angle guide is displayed on the internal display unit at an appropriate angle according to the progress of the irradiation plan, the aim position can be more easily adjusted.

[0027] The specific aspect of the angle guide can be changed. For example, a schematic diagram of a contact lens showing an appropriate rotation angle of the contact lens for irradiating the next irradiation spot with the treatment laser beam may be displayed as the angle guide. In this case, the surgeon can easily adjust the rotation angle of the contact lens by bringing the rotation angle of the contact lens included in the observation field closer to the angle of the schematic diagram of the contact lens displayed as the angle guide.

[0028] Specifically, when starting treatment according to the irradiation plan, the control unit may determine the angle of the angle guide according to the position or direction of the first irradiation spot determined by the irradiation plan. Each time irradiation of the treatment laser beam is performed (e.g., each time an instruction to perform irradiation of the treatment laser beam is input), the control unit may rotate the angle of the displayed angle guide according to the traveling direction and traveling angle of the irradiation spot. In this case, each time irradiation of the treatment laser beam is performed, the angle guide is displayed at an appropriate angle according to the next irradiation spot.

[0029] Furthermore, when a partial rotation lens is used, the control unit may acquire information on the specified rotation angle of the partial rotation lens (i.e., the angle by which the lens rotates with one operation). Each time a predetermined number of treatment laser beam irradiations scheduled to be performed within a range of one specified rotation angle are completed, the control unit may rotate the angle of the displayed angle guide by the specified rotation angle in the direction of travel of the irradiation spot. In this case, each time treatment laser beam irradiation within a range of one specified rotation angle is completed, the angle of the angle guide is rotated to an angle corresponding to the next specified rotation angle range. Therefore, even when treatment is performed using a partial rotation lens, the aiming position can be more appropriately adjusted.

[0030] The control unit may change the display method of the angle guide based on information about the contact lens being used. For example, if the contact lens being used is a contact lens that can be rotated entirely by the surgeon, the control unit may execute a process to rotate the angle guide by the angle of travel of the irradiation spot each time irradiation of the treatment laser light is performed. Furthermore, if the contact lens being used is a partially rotating lens, the control unit may execute a process to rotate the angle guide by a specified rotation angle each time irradiation of the treatment laser light is completed a predetermined number of times. In this case, the display of the angle guide is appropriately changed depending on the contact lens being used, making it even easier to adjust the aim position of the treatment laser light.

[0031] A contact lens may have spacing indicators (sometimes called "indexes") arranged at regular intervals on a portion (e.g., the inner wall) to serve as a guide for the spacing of the spots to be irradiated with the treatment laser light. The angle guide may include a schematic diagram of the spacing indicators that imitates the spacing indicators on the contact lens. In this case, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens using the angle guide. In addition, by adjusting the aim positions of the multiple treatment laser beams while understanding the schematic diagram of the spacing indicators, the surgeon can easily adjust the distance between the multiple spots. In particular, if the contact lens to be used has spacing indicators, the surgeon can adjust the aim position more easily by comparing the spacing indicators on the contact lens with the schematic diagram of the spacing indicators displayed on the display unit.

[0032] The angle guide may be provided with a spot placement guideline diagram indicating the placement of a series of irradiation spots including the next irradiation spot among the irradiation spots in the irradiation plan. The control unit may transition the display of the next irradiation spot among the placement of irradiation spots included in the spot placement guideline diagram to an adjacent irradiation spot in the direction of travel defined in the irradiation plan each time irradiation of the treatment laser beam is performed. In this case, the operator can more appropriately adjust the next target position by understanding the position of the next irradiation spot displayed on the spot placement guideline diagram.

[0033] When a spacing index diagram is used, it is more desirable to display the spot placement guideline diagram so that it matches the target spacing indicated by the spacing index diagram. In this case, the surgeon can more appropriately adjust the next aiming position by understanding the positional relationship of the next irradiation spot indicated on the spot placement guideline diagram to the spacing index diagram.

[0034] As described above, a partially rotatable lens may be used as a type of contact lens, in which a portion including the reflective surface rotates a predetermined angle relative to a gripper held by the user each time the lens is operated by a user's finger. The control unit may further execute a rotation recommendation step of recommending to the surgeon to rotate the reflective surface of the contact lens by the predetermined rotation angle each time a predetermined number of treatment laser beam irradiations to be performed within one predetermined rotation angle are completed. In this case, the surgeon can appropriately grasp the timing when it is necessary to rotate the reflective surface by the predetermined angle, particularly when performing treatment using the partially rotatable lens.

[0035] The specific method for recommending rotation of the reflective surface by a specified angle can be selected as appropriate. For example, the control unit may recommend rotation of the reflective surface by at least one of sound and vibration. The control unit may also recommend rotation of the reflective surface by controlling the display of the internal display unit (for example, by rotating the pattern displayed on the internal display unit by a specified angle).

[0036] The control unit may display, on the internal display unit, an outer periphery guide as an aiming guide along the outer periphery of the field of view observed by the surgeon through the observation optical system, which indicates at least one of a rotation angle of the reflective surface of the contact lens appropriate for the progress of the irradiation plan and a direction of the irradiation spot to be irradiated with the treatment laser light. In this case, the surgeon can easily grasp at least one of an appropriate rotation angle of the reflective surface and a direction of the irradiation spot by visually checking the outer periphery guide displayed along the outer periphery of the field of view observed.

[0037] The outer periphery guide may be displayed in an arc-like or annular shape along the outer periphery of the observation field. The center of the arc-like or annular outer periphery guide may coincide with the optical axis of the observation optical system. In this case, the direction indicated by the outer periphery guide coincides with the direction from the center of the observation field. Therefore, the surgeon can properly understand the direction indicated by the outer periphery guide.

[0038] The outer periphery guide may include a next aim guide indicating the direction of the next irradiation spot among the multiple irradiation spots in the irradiation plan. The control unit may shift the position of the next aim guide to a position corresponding to an irradiation spot adjacent to the irradiation spot in the direction of travel defined in the irradiation plan every time the treatment laser beam is irradiated. In this case, the surgeon can properly grasp the direction of the next irradiation spot from the next aim guide shifted along the outer periphery of the observation field of view.

[0039] The outer peripheral guide may include an irradiation completion guide that indicates the direction of an irradiation spot that has already been irradiated with the treatment laser beam among multiple irradiation spots in the irradiation plan. The control unit may change the displayed next aim guide to the irradiation completion guide each time irradiation with the treatment laser beam is performed. In this case, the surgeon can grasp the direction in which irradiation with the treatment laser beam has been completed and then appropriately adjust the next aim position using the next aim guide. This also makes it easier to grasp the progress of treatment.

[0040] The outer peripheral guide may include a non-irradiation guide indicating the direction of an irradiation spot to be irradiated with the treatment laser beam after the next irradiation, among the multiple irradiation spots in the irradiation plan. The control unit may change the non-irradiation guide, which was displayed in the direction of the irradiation spot in the next irradiation order defined in the irradiation plan, to a next aiming guide each time irradiation with the treatment laser beam is completed. In this case, the surgeon can appropriately adjust the next aiming position using the next aiming guide after understanding the direction of the spot to be irradiated with the treatment laser beam after the next irradiation. It also becomes easier to understand the progress of treatment.

[0041] The outer peripheral guide may include a section alignment guide that indicates the direction of an irradiation section, which is a section of multiple irradiation spots onto which the therapeutic laser light is irradiated while the rotation angle of the reflective surface of the contact lens is fixed, or the direction of the rotation angle of the reflective surface appropriate for irradiating the irradiation section with the therapeutic laser light. The control unit may shift the position of the section alignment guide to a position adjacent to the direction of travel defined in the irradiation plan each time irradiation of the same number of irradiation spots with the therapeutic laser light as the number of irradiation spots included in the irradiation section is completed. In this case, the section alignment guide allows the surgeon to easily grasp the direction of the multiple irradiation sections or the direction of the reflective surface for irradiating the irradiation spots within the irradiation section with the therapeutic laser light. This further facilitates adjustment of the angle of the reflective surface of the contact lens.

[0042] The control unit may display a section aiming guide for each specified angle range of the partial rotation lens. The control unit may move the position of the section aiming guide to an adjacent position in the direction of progression defined in the irradiation plan each time irradiation of the same number of treatment laser beams as the number of irradiation spots included in one specified angle range is completed. In this case, the section aiming guide is appropriately displayed according to the specifications of the partial rotation lens and the progress of treatment. Therefore, even when a partial rotation lens is used, the section aiming guide appropriately assists in adjusting the aiming position.

[0043] The specific configuration of the aiming guide can also be changed. For example, the control unit may display on the internal display unit an image of the treatment target area irradiated with the aiming light, which was captured by the imaging unit the previous time the treatment laser light was irradiated. In this case, the surgeon can adjust the next aiming position after understanding the area irradiated with the treatment laser light last time (i.e., the area where the aiming light appears in the displayed image). This makes it easier to irradiate the treatment laser light more appropriately.

[0044] When at least one of the angle guide and the outer periphery guide is displayed as the aiming guide, the ophthalmic laser treatment device can appropriately assist the operator in adjusting the aiming position even when the aiming guide is displayed on a display unit different from the internal display unit (for example, a display unit provided outside the observation optical system). In this case, the ophthalmic laser treatment device can also be expressed as follows. An ophthalmic laser treatment device that irradiates tissue of a patient's eye with treatment laser light each time an instruction to irradiate treatment laser light is input, the device comprising: a laser irradiation optical system that irradiates the patient's eye with the treatment laser light; an observation optical system that allows an operator to observe an observation image of the patient's eye through an eyepiece; a display unit that displays an image; and a control unit. The control unit executes the following steps when irradiating the patient's eye with treatment laser light using a contact lens having a reflective surface that reflects the treatment laser light in a direction intersecting with an optical axis: an irradiation plan acquisition step that acquires an irradiation plan that determines the order in which the treatment laser light is irradiated with multiple irradiation spots to be irradiated with the treatment laser light; and an aim guide display step that displays, on the display unit according to progress of the irradiation plan, an aim guide (at least one of an angle guide and an outer periphery guide) that assists the operator in adjusting the aim position of the treatment laser light to an appropriate position.

[0045] The ophthalmic laser treatment device may also perform only a process of recommending to the surgeon how to rotate the reflecting surface of the partially rotational lens, without performing a process of displaying the aiming guide. In this case, the ophthalmic laser treatment device may be expressed as follows: An ophthalmic laser treatment device that irradiates tissue of a patient's eye with treatment laser light every time an instruction to irradiate treatment laser light is input, the ophthalmic laser treatment device comprising: a laser irradiation optical system that irradiates the patient's eye with the treatment laser light; an observation optical system that allows the surgeon to observe an observation image of the patient's eye through an eyepiece; and a control unit, wherein, when a contact lens having a reflecting surface that reflects the treatment laser light in a direction intersecting with the optical axis is used in treatment with the ophthalmic laser treatment device, a gripper that is held by the user as a type of the contact lens may be used, and each time the gripper is operated once by the user's finger, a portion including the reflecting surface may be rotated. The control unit executes an irradiation plan acquisition step of acquiring an irradiation plan in which the order of irradiation of the treatment laser light for a plurality of irradiation spots to be irradiated with the treatment laser light is determined when the treatment laser light is irradiated to the patient's eye using the partial rotation lens, and a rotation recommendation step of executing a process of recommending to the surgeon to rotate the reflective surface of the contact lens by the specified angle each time a predetermined number of irradiations of the treatment laser light to be performed within the range of one of the specified angles are completed, in accordance with the progress of the irradiation plan.

[0046] An ophthalmic laser treatment device reflects a treatment laser beam off a reflective surface of a contact lens and irradiates a ring-shaped or arc-shaped treatment target area on a patient's eye with the treatment laser beam. The ophthalmic laser treatment device includes a laser irradiation optical system and an overlay display unit. The laser irradiation optical system irradiates the treatment laser beam. The overlay display unit displays a circumferential direction chart indicating the angle in the circumferential direction around the optical axis of the treatment laser beam, superimposed on an observation image including at least a portion of the treatment target area. In this case, by visually checking the circumferential direction chart superimposed on the observation image, the surgeon can appropriately grasp the direction of the treatment target area when the optical axis of the treatment laser beam is the center.

[0047] For example, in some cases, the contact lens is temporarily removed from the patient's eye during treatment of multiple spots. In this case, the surgeon can properly determine the direction (the circumferential angle around the optical axis of the treatment laser light) of the spot on the treatment target area irradiated with the treatment laser light immediately before removing the contact lens by referring to the circumferential direction chart. Therefore, when the removed contact lens is reattached to the patient's eye, the surgeon can adjust the angle of the contact lens while referring to the circumferential direction chart so that the aim position of the treatment laser light is properly adjusted in the direction of the next spot. This allows the surgeon to easily and properly adjust the aim position of the treatment laser light.

[0048] The center of the annular circumferential chart superimposed on the observation image may coincide with the position of the optical axis of the treatment laser beam in the observation image, which makes it easier to grasp the direction of the treatment area relative to the optical axis of the treatment laser beam.

[0049] The circumferential direction chart may include a plurality of indices arranged at equal angular intervals in the circumferential direction around the optical axis of the treatment laser light, which makes it easier to grasp the direction of the treatment target area more appropriately.

[0050] The superimposed display unit may display symbols (for example, numbers up to 12) that can be displayed in at least one of the directions on the dial of an analog clock at an appropriate position on the circumferential chart. In this case, the surgeon can properly grasp the direction of the treatment target area when the optical axis of the treatment laser light is at the center, in the same way as when grasping the time on an analog clock.

[0051] The superimposed display unit may display a circumferential direction chart fixed at a predetermined position within the display area of ​​the image. In this case, the circumferential direction chart is fixed at a predetermined position regardless of the state of the observation image, making it easier to accurately grasp the direction of the treatment target area relative to the optical axis of the treatment laser light. In this case, the relative positional relationship between the optical axis of an optical system (e.g., an observation optical system or an optical system of the observation and imaging unit, described below) that allows the surgeon to visually recognize the observation image and the optical axis of the treatment laser light may also be fixed. For example, the optical axis of the observation optical system and the optical axis of the treatment laser light may always coincide with each other.

[0052] Various display units can be used for the superimposed display unit that superimposes and displays the circumferential direction chart on the observation image. For example, the ophthalmic laser treatment device may include an observation optical system that allows the surgeon to observe an observation image including at least a portion of the treatment target area through an eyepiece. The superimposed display unit may be an internal display unit that displays an image to the surgeon through the eyepiece. The ophthalmic laser treatment device may also include an observation and photography unit that captures an observation image of the patient's eye. The superimposed display unit (e.g., a monitor) may superimpose and display the circumferential direction chart on the observation image captured by the observation and photography unit. The configuration of the superimposed display unit may be simple, in that it is not possible to change the image that is superimposed and displayed on the observation image.

[0053] The superimposition display unit may be capable of switching between superimposing and hiding the circumferential direction chart on the observation image. When it is not necessary for the surgeon to grasp the direction of the treatment target area, hiding the circumferential direction chart allows the surgeon to concentrate on observing the observation image. For example, the control unit may switch between displaying and hiding the circumferential direction chart depending on whether the treatment mode set by the surgeon is a treatment mode for performing treatment on a circular or arc-shaped treatment target area. In this case, a field of view appropriate for the set treatment mode is provided to the surgeon.

[0054] <Embodiment> Hereinafter, exemplary embodiments of the present disclosure will be described with reference to the drawings. An ophthalmic laser treatment device 1 of the present embodiment can treat a patient's eye E by irradiating the patient's eye E with a treatment laser light.

[0055] <Overall structure> The configuration of an ophthalmic laser treatment device 1 will be described with reference to Figures 1 to 3. As shown in Figure 1, the ophthalmic laser treatment device 1 of this embodiment includes a table section 2, a main body section 3, and a control box 6. The main body section 3 and the control box 6 are installed on the table section 2.

[0056] The main body 3 includes various components, such as the laser irradiation optical system 10, the illumination optical system 30, the observation optical system 40, the internal display unit 50, and the control unit 60 (see FIG. 2), which will be described later. The main body 3 also includes a base 4 and a joystick 5 (operation lever). The base 4 is a displacement unit equipped with a displacement mechanism, and can move at least a portion of the laser irradiation optical system 10, the observation optical system 40, the internal display unit 50, etc. in the vertical direction (Y direction in FIG. 1), the horizontal direction (X direction in FIG. 1), and the front-to-back direction (Z direction in FIG. 1). The displacement unit changes the positional relationship between the patient's eye and the laser irradiation optical system 10 in the vertical direction, the horizontal direction, and the front-to-back direction. The base 4 can also rotate at least a portion of the laser irradiation optical system 10, the observation optical system 40, the internal display unit 50, etc. in the horizontal direction around an axis extending in the vertical direction. By operating the joystick unit 5, the surgeon can move or rotate the laser irradiation optical system 10, the observation optical system 40, the internal display unit 50, etc., thereby adjusting the observation position of the patient's eye E and the irradiation position of the laser light (treatment laser light and aiming light). Note that the joystick unit 5 (e.g., the upper end of the joystick 5) in this embodiment is provided with an operation button operated by the surgeon. In this embodiment, the operation button on the joystick unit 5 is used as a trigger input means for inputting a trigger for irradiating the treatment laser light. Note that a foot switch or the like operated by the surgeon's foot may also be used as the trigger input means for inputting a trigger for irradiating the treatment laser light.

[0057] The control box 6 is equipped with an external display unit 7 provided outside the observation optical system 40 (see FIG. 2). The external display unit 7 is capable of displaying various images. A touch panel type operation unit is provided on the surface of the external display unit 7 of the control box 6. The control box 6 displays various parameters related to treatment on the external display unit 7 and also receives various instructions input from the user.

[0058] <Laser irradiation optical system> As shown in Figure 2, the laser irradiation optical system 10 of this embodiment includes a treatment laser light source 11, an aiming light source 12, an energy adjustment unit 13, a beam splitter 17, a photodetector 18, a safety shutter 19, a collimator lens 21, a dichroic mirror 22, an expander lens 23, a dichroic mirror 24, and an objective lens 25.

[0059] The treatment laser light source 11 emits treatment laser light for treating tissues of the patient's eye E. As an example, the laser light source 11 of this embodiment uses a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd:YAG) as a laser rod. In addition, a wavelength conversion element (not shown) can convert the infrared laser light (wavelength: 1064 nm) emitted by the laser light source 11 into visible laser light (wavelength: 532 nm).

[0060] The aiming light source 12 emits an aiming laser beam (hereinafter simply referred to as "aiming light") that indicates the position where the treatment laser beam is irradiated (i.e., the position of the irradiation spot). In this embodiment, a light source that emits a visible laser beam with a wavelength of 635 nm (red) is used as the aiming light source 12. However, it goes without saying that the wavelength of the aiming light can be changed as appropriate.

[0061] The energy adjusting unit 13 adjusts the amount of energy of the treatment laser beam irradiated onto the tissue of the patient's eye E. In this embodiment, the energy adjusting unit 13 includes a half-wave plate 14 and a polarizing plate 16. The half-wave plate 14 rotates around the optical axis of the treatment laser beam by a motor 15. The polarizing plate 16 is disposed at a Brewster angle. The combination of the half-wave plate 14 and the polarizing plate 16 adjusts the amount of energy of the treatment laser beam.

[0062] The beam splitter 17 reflects a portion of the treatment laser beam toward the photodetector 18. The photodetector 18 detects the amount of energy of the treatment laser beam by receiving the treatment laser beam reflected by the beam splitter 17. The safety shutter 19 moves between on and off the optical axis of the treatment laser beam by a shutter driver (e.g., a solenoid) 20. The safety shutter 19 is positioned on the optical axis of the treatment laser beam to block irradiation of the patient's eye E with the treatment laser beam.

[0063] The collimator lens 21 converts the aiming light emitted by the aiming light source 12 into a parallel beam. The dichroic mirror 22 combines the treatment laser light and the aiming light by coaxially aligning the optical axes of the treatment laser light and the aiming light. In this embodiment, the dichroic mirror 22 reflects the treatment laser light and transmits the aiming light, thereby combining the treatment laser light and the aiming light.

[0064] The expander lens 23 expands the beam of laser light (treatment laser light and aiming light) combined by the dichroic mirror 22. The laser light expanded by the expander lens 23 is reflected by the dichroic mirror 24 and passes through the objective lens 25. In this embodiment, the laser light passing through the objective lens 25 is irradiated onto the tissue of the patient's eye E via a contact lens 26 attached to the patient's eye E. The dichroic mirror 24 reflects almost all light of the wavelength of the reflected light of the treatment laser light reflected by the patient's eye E so that the reflected light is less likely to enter the surgeon's eye. Note that the irradiation optical system 10 may be provided with a configuration for adjusting the spot size of the laser light irradiated onto the tissue.

[0065] <Illumination optical system> The illumination optical system 30 illuminates an observation region including a tissue treatment target region. The illumination optical system 30 of this embodiment includes a lamp 31, a lens 32, an aperture 33, a lens group 34, and a prism 35. For example, a white light emitting element or the like can be used for the lamp 31. The illumination optical system 30 may also include a slit plate or the like for illuminating the observation region with slit light.

[0066] <Observation optical system> As shown in FIGS. 2 and 3, the observation optical system 40 is an observation means for allowing the surgeon to observe the patient's eye E, and has an optical axis L3 (see FIG. 3). As shown in FIG. 3, the observation optical system 40 of this embodiment has an optical axis L3R for presenting an observation image to the surgeon's right eye EoR and an optical axis L3L for presenting an observation image to the surgeon's left eye EoL. The observation optical system 30 of this embodiment may also be called binoculars. The observation optical system 40 of this embodiment includes an objective lens 25, a variable magnification optical system 42 (42R, 42L), protection filters 43 (43R, 43L), a half mirror 47, an erecting prism group 44 (44R, 44L), a field stop 45 (45R, 45L), eyepieces 46 (46R, 46L), etc. The surgeon can look through the eyepiece 46 to confirm the observation area of ​​the patient's eye E, the spot of the aiming light (in other words, the reflected light (return light) of the aiming light reflected by the patient's eye E), etc. In this embodiment, the observation plane (object plane) provided beyond the objective lens 41 and the field stop 45 located inside the device are in an optically conjugate positional relationship via the objective lens 41. In other words, the observation image of the patient's eye E is formed as an aerial image at the position of the field stop 45. In this embodiment, the magnification of the observation image observed by the surgeon is changed by the variable magnification optical system 42. The observation optical system 40 is provided with an encoder (not shown) for acquiring the magnification of the observation image obtained by the variable magnification optical system 42.

[0067] <Internal display> As shown in FIG. 2, the internal display unit 50 is provided in the observation optical system 40 and displays an image to the surgeon via the eyepiece 46. The internal display unit 50 includes a display 53, a lens 52, and a half mirror 51. Various images are displayed on the display 53. In this embodiment, an LCD (with backlight) is used as the display 53. Specifically, in this embodiment, a color LCD capable of displaying 1600 (H) × 1200 (V) is used as the display 53. As shown in FIG. 3, the half mirror 51 is disposed on the optical axis L3R. Specifically, the half mirror 51 is disposed between the protection filter 43R and the erecting prism group 44R.

[0068] The display light (display light) emitted from the display 53 travels along the optical axis L5 (see FIG. 3). Specifically, the display light from the display 53 passes through the lens 52 and is then reflected by the half mirror 51 toward the erecting prism group 44R. The half mirror 51 in this embodiment is a synthesizing means for synthesizing the optical observation image observed by the observation optical system 40 with the image displayed on the display 53. The half mirror 51 in this embodiment makes the optical axis L5 and the optical axis L3R coaxial. The display light reflected by the half mirror 51 travels through the erecting prism group 44R, the field stop 45R, and the eyepiece 46R in this order, and is focused on the fundus of the surgeon looking through the eyepiece 46R. The internal display unit 50 functions as a so-called head-up display (HUD).

[0069] In this embodiment, the display 53 and the field stop 45R are in an optically conjugate positional relationship. That is, the image displayed on the display 53 is formed as an aerial image at the position of the field stop 45R. The method of displaying an image to the surgeon via the eyepiece 46 is not limited to the method exemplified in this disclosure. For example, an LCD (liquid crystal panel) without a backlight may be disposed as the internal display unit at the position of the field stop 45R (on the optical axis L3R), and the control unit 60 may control the transmittance of each cell constituting the LCD to present information to the surgeon.

[0070] In this embodiment, the center of the display area in the internal display unit 50 coincides with the observation optical axis of the observation optical system 40. Therefore, an image is displayed in the display area in the internal display unit 50 based on the observation optical axis of the observation optical system 40. Therefore, the surgeon can perform appropriate treatment while recognizing the image presented at an appropriate position in the observation field through the eyepiece 46.

[0071] In this embodiment, the optical axis of the treatment laser beam emitted by the laser irradiation optical system 10 also coincides with the optical axis of the observation optical system 40 and the center of the display area on the internal display unit 50. Therefore, the internal display unit 50 can display an image at an appropriate angle in an appropriate direction centered on the optical axis of the treatment laser beam. Furthermore, in this embodiment, the optical axis of the aiming beam emitted by the laser irradiation optical system 10 also coincides with the optical axis of the observation optical system 40 and the center of the display area on the internal display unit 50. Therefore, the surgeon visually recognizes the aiming beam at the center of the observation field and the center of the display area on the internal display unit 50, making it even easier to adjust the irradiation position of the treatment laser beam based on the aiming beam and the display content on the internal display unit 50.

[0072] Although not shown, the observation optical system 40 of this embodiment incorporates a photographing optical system that captures an observation image of the patient's eye E, etc. The photographing optical system includes a half mirror, an imaging lens, and an imaging element. The half mirror is disposed on either the left or right observation optical path provided in the observation optical system 40. Light incident on the half mirror from the observation site, etc. via the objective lens 25 is reflected by the half mirror and enters the imaging element via the imaging lens. As a result, the observation image is captured by the photographing optical system.

[0073] <Control unit> The control unit 60 controls various parts of the laser treatment device 1. The control unit 60 of this embodiment includes a CPU (processor) 61, a ROM 62, a RAM 63, and a nonvolatile memory 65. The CPU 61 controls each part of the laser treatment device 1. The ROM 62 stores various programs, initial values, and the like. The RAM 63 temporarily stores various pieces of information. The nonvolatile memory 65 is a non-transitory storage medium that can retain its contents even when the power supply is cut off. For example, a USB memory detachably attached to the control unit 60 or a flash ROM built into the control unit 60 can be used as the nonvolatile memory 65. In this embodiment, the base unit 4, joystick unit 5, control box 6, laser light source 11, aiming light source 12, motor 15, photodetector 18, shutter driver 20, lamp 31, and display 53 are connected to the control unit 60.

[0074] <Treatment of trabecular meshwork> 4 and 5, an example of a treatment mode of the trabecular meshwork performed by the ophthalmic laser treatment device 1 of this embodiment will be described. In this embodiment, a case will be illustrated in which the trabecular meshwork, which is a ring-shaped (partially arc-shaped) tissue among the tissues of a patient's eye E, is the treatment target area. For example, selective laser trabeculoplasty (SLT) is a treatment method in which treatment laser light is irradiated onto the trabecular meshwork at the angle of the patient's eye E in order to increase the discharge of aqueous humor from the patient's eye E. In SLT, treatment laser light is irradiated multiple times over the entire circumference or part of the ring-shaped trabecular meshwork.

[0075] As shown in FIG. 4 , in the treatment of the trabecular meshwork in this embodiment, a contact lens 26 is fitted to the cornea C of the patient's eye E. For example, the contact lens 26 may be a gonioscope or a Goldmann tripod mirror for observing the angle A of the patient's eye E. The contact lens 26 is provided with a reflective surface (reflecting mirror) 27. The angle A is observed through the reflective surface 27. Therefore, as shown in FIG. 5 , in this embodiment, the entire periphery of the angle A is not observed simultaneously, but rather a portion of the angle A is observed in a fan-shaped manner. The fan-shaped portion of the annular angle A observed through the reflective surface 27 falls within an angular range of less than 180 degrees, with the center of the annular angle A as the reference. The reflective surface 27 of the contact lens 26 reflects the treatment laser light and the aiming light in a direction intersecting the optical axis extending from the objective lens 25 (see FIGS. 2 and 3 ) toward the patient's eye E, thereby irradiating the treatment laser light and the aiming light onto the trabecular meshwork TM, which is the treatment target area. That is, in this embodiment, in an observation state as exemplified in FIG. 5, the treatment laser light is irradiated onto the trabecular meshwork TM at the angle A via the reflecting surface 27, thereby performing treatment of the trabecular meshwork.

[0076] The surgeon adjusts the rotation angle of the contact lens 26 (i.e., the angle of rotation around the axis of the contact lens 26) to adjust the reflection direction of the treatment laser light by the reflective surface 27 of the contact lens 26 when viewed from the surgeon's line of sight in the observation optical system 40. The surgeon also operates the joystick unit 5 to move the base unit 4, thereby adjusting the aiming position of the treatment laser light and the aiming light relative to the tissue of the patient's eye E to the spot S to be treated. After completing the adjustment of the aiming position, the surgeon operates the operation button on the joystick 5 or a foot switch, etc., to input an instruction to irradiate the spot S with the treatment laser light. In SLT, the treatment laser light is irradiated at a lower output (energy and irradiation time) than in argon laser trabeculoplasty (ALT) to prevent thermal degeneration of the tissue. Therefore, it is difficult for the surgeon to visually recognize changes in the condition of the treatment site (e.g., treatment scars) before and after surgery. A known SLT technique involves fixing the spot sizes of the treatment laser light and the aiming light to a predetermined size (e.g., 400 μm) and intermittently irradiating the treatment laser light along the trabecular meshwork TM so that multiple irradiation spots are adjacent to each other. Figure 5 schematically shows a portion of the technique in which the treatment laser light is intermittently irradiated so that multiple irradiation spots are adjacent to each other. In SLT, it is difficult to visually observe the treatment scar. In other words, the irradiated spot (spot S) irradiated with the treatment laser light is not visually observed by the operator, as shown in Figure 5.

[0077] <Contact lenses> An example of a contact lens 26 used in the treatment of trabecular meshwork in this embodiment will be described with reference to Figures 6 and 7. The contact lens 26 shown in Figures 6 and 7 is a partially rotating lens. In a partially rotating lens, each time a user (operator) operates the lens with their finger, a portion including the reflective surface 27 rotates by a specified angle relative to the grip portion 26A held by the user. In other words, each operation with the user's finger causes the portion including the reflective surface 27 to rotate circumferentially around the axis AX1, independently of other portions.

[0078] In detail, the contact lens 26 shown in FIG. 6 includes an annular gripping portion 26A and a rotating base 26B. The gripping portion 26A is generally cylindrical and is gripped by the user's fingers. The rotating base 26B has a cylindrical portion with an outer diameter substantially equal to the inner diameter of the generally cylindrical gripping portion 26A. The tip (bottom of the paper in FIG. 6) of the rotating base 26B forms a contact portion 26D that comes into contact with the patient's eye E. A light-transmitting window 29 (see FIG. 7) is formed in the contact portion 26D. A reflective surface 27 (see FIG. 7) is fixed to the inner side of the rotating base 26B. The gripping portion 26A is attached to the outside of the cylindrical portion of the rotating base 26B. The rotating base 26B can rotate relative to the gripping portion 26A. A plurality of protrusions 26C protruding outward are provided on the outer periphery of the rotating base 26B, on a portion that is exposed to the outside when the gripping portion 26A is attached. In this embodiment, a plurality of protrusions 26C (ten in the example shown in FIG. 6) are provided at equal intervals in the circumferential direction at the aforementioned specified angle (36 degrees in the example shown in FIG. 6). By hooking a finger on at least one of the protrusions 26C, the user can rotate the rotation base 26B, on which the reflective surface 27 is provided, relative to the grip portion 26A. Specifically, the user can grip and fix the grip portion 26A with multiple fingers (e.g., the index finger and thumb), and then hook the remaining finger (e.g., the middle finger) on the protrusion 26C to rotate only the rotation base 26B (the rotation axis is axis AX1). Therefore, less finger movement is required during rotation than when the reflective surface is rotated by rotating the entire contact lens. As a result, the contact lens 26 is more likely to be held in a stable state even when the reflective surface 27 is rotated.

[0079] The contact lens 26 shown in FIG. 6 is designed so that the rotation angle of the rotation base 26B with a single rotation operation by the user's finger stops at a specified angle. As an example, in the contact lens 26 shown in FIG. 6, a single operation rotates the rotation base 26B 36 degrees relative to the gripping portion 26A. Therefore, the rotation base 26B completes one rotation relative to the gripping portion 26A with 10 rotation operations in the same direction. It goes without saying that the specified angle can be changed. For example, there are partially rotating lenses in which a single operation rotates the rotation base 45 degrees relative to the gripping portion.

[0080] FIG. 7 is a view of the contact lens 26 viewed from the side opposite to the side that contacts the patient's eye E. As shown in FIG. 7, spacing indicators 28 are formed on a portion of the inner wall of the contact lens 26 (in the example shown in FIG. 7, the inner wall of the rotating base 26B). A plurality of spacing indicators 28 are arranged at regular intervals to serve as a guide for the intervals between spots to be irradiated with treatment laser light. In the example shown in FIG. 7, five linear spacing indicators are arranged at equal intervals. The spacing indicators 28 are formed on the inner wall of the contact lens 26 on the side opposite to the side on which the reflective surface 27 is provided. When the contact lens 26 is viewed from the side opposite to the side that contacts the patient's eye E, a reflected image 28Z of at least a portion of the spacing indicators 28 is reflected on the reflective surface 27. During treatment, a reflected image of the treatment target area of ​​the patient's eye E (in this embodiment, the trabecular meshwork) is also reflected on the reflective surface 27. Furthermore, a reflected image of the aiming light irradiated onto the treatment target area is also reflected on the reflective surface 27. Therefore, while grasping the position of the treatment target area and the targeting light reflected on the reflecting surface 27, the surgeon can sequentially adjust the target position of the treatment laser light to each of the multiple spots on the treatment target area using the reflected image 28Z of the interval index 28 as a guide. The diagrams of the observation field illustrated in each drawing in this disclosure are diagrams showing an enlarged view of the area corresponding to the area AR1 shown in FIG. 7 . The reflecting surface 27 is formed to a size that does not omit the reflected image of the interval index 28 (reflected image 28Z). In this embodiment, the treatment laser light is irradiated to the entire circumference of the trabecular meshwork TM by rotating the reflecting surface 27 around the axis AX1 while maintaining the center of the pupil of the patient's eye E and the center of the transparent window 29 in a state where they are approximately aligned, regardless of the type of contact lens 26 used (e.g., whether the interval index 28 is provided and whether it is a partially rotating lens). At this time, the area AR1 is appropriately adjusted to follow the displacement of the reflecting surface 27. Therefore, the operator scans the joystick unit 5 and moves it around the area AR1 around the axis AX1 while irradiating the entire circumference of the trabecular meshwork TM with the treatment laser light.

[0081] 6 and 7 is merely one of several types of contact lenses that can be used in treatment with the ophthalmic laser surgery apparatus 1 of this embodiment. Therefore, contact lenses other than the contact lenses 26 shown in FIGS. 6 and 7 can also be used in treatment with the ophthalmic laser treatment apparatus 1 of this embodiment. For example, a contact lens that has a reflecting portion 27 and a spacing index 28 but is not a partial rotational lens (i.e., the reflecting portion 27 is rotated by rotating the entire lens) can also be used in treatment. A partial rotational lens that does not have the spacing index 28 can also be used in treatment. It is also possible to use a contact lens that does not have the spacing index 28 and is not a partial rotational lens.

[0082] When a contact lens that requires the entire lens to be rotated in order to rotate the reflecting portion is used, the surgeon holds the contact lens with multiple fingers and rotates the entire contact lens while keeping the contact portion in contact with the patient's eye E. In this case, there is a limit to the angle by which the surgeon can rotate the entire lens without changing the way the contact lens is held (without having to readjust the grip). Furthermore, when the surgeon changes the way the contact lens is held, the positional relationship between the patient's eye E and the laser irradiation optical system 10 is likely to change. In contrast, the partially rotating contact lens 26 illustrated in Figures 6 and 7 allows the reflecting surface to be rotated by a specified angle without changing the way the contact lens is held.

[0083] An example of a treatment laser beam irradiation plan will be described with reference to FIG. 8 . FIG. 8 is a diagram showing an example of an irradiation plan displayed on the control box 6. In this embodiment, the irradiation plan is formulated by operating the control box 6. The irradiation plan determines the order of irradiation of multiple irradiation spots to be irradiated with the treatment laser beam when the patient's eye E is irradiated with the treatment laser beam using a contact lens 26 having a reflecting surface 27. The irradiation plan of this embodiment determines the irradiation range of the treatment laser beam in the annular treatment target area (in this embodiment, the trabecular meshwork TM) (i.e., the circumferential range in which multiple irradiation spots are arranged), the irradiation spot to be first irradiated with the treatment laser beam (the irradiation spot at the position of "START" shown in FIG. 8 ), the number of irradiation spots (the number in the denominator of "Shots" shown in FIG. 8 ), and the irradiation order of the treatment laser beam to each irradiation spot (including the irradiation direction; in FIG. 8 , the circumferential arrow indicates the direction of the irradiation order). In this embodiment, each time a treatment laser beam is irradiated, the irradiation spot adjacent to the irradiation spot for which irradiation has been completed becomes the next irradiation spot to be irradiated with the treatment laser beam, and "1" is added to the numerator of "Shots" shown in FIG. 8. Furthermore, each time a treatment laser beam is irradiated, the display of the spot (irradiated spot) corresponding to the spot for which irradiation has been completed, among the multiple irradiation spots arranged in an arc or ring shape (ring shape in FIG. 8), is changed to a display mode different from that of the other spots. Multiple treatment laser beam irradiations are performed sequentially in a clockwise or counterclockwise direction.

[0084] In this embodiment, the direction in which the treatment target area to be irradiated with the treatment laser light is actually located and the direction in which the reflecting surface 27 of the contact lens 26 is directed to observe the treatment target area are opposite directions with respect to the optical axis of the observation optical system 40. In this embodiment, the direction in which the treatment laser light should be irradiated is indicated by the direction in which the reflecting surface 27 is directed. However, the direction in which the treatment laser light should be irradiated may also be indicated by the direction in which the treatment target area is actually located. Note that in other embodiments described later, information about the contact lens used in treatment (e.g., at least one of information indicating whether the contact lens is a partial rotational lens, information about the specified angle of the partial rotational lens, information indicating whether the contact lens has spacing indicators 28, etc.) may be included in the irradiation plan.

[0085] As an example, in this embodiment, the surgeon specifies either the "full circumference" mode or the "half circumference" mode, thereby specifying both the planned irradiation area and the number of planned irradiation spots. Specifically, in this embodiment, a "full circumference" mode in which the treatment laser light is irradiated onto multiple spots around the entire circumference of the irradiating angle A, and a "half circumference" mode in which the treatment laser light is irradiated onto multiple spots around half the circumference of the irradiating angle A, are provided in advance. The default number of planned irradiation spots in the "full circumference" mode is set to 100. The default number of planned irradiation spots in the "half circumference" mode is set to 50. When the surgeon accepts the designation of the "full circumference" mode, the control unit 60 sets the planned irradiation area to the area around the entire circumference of the irradiating angle A and sets the number of planned irradiation spots to "100." In the example shown in FIG. 8 , the "full circumference" mode is specified. Furthermore, when the surgeon accepts the designation of the "half circumference" mode, the control unit 60 sets the planned irradiation area to the area around half the circumference of the irradiating angle A and sets the number of planned irradiation spots to "50." In this embodiment, when the surgeon designates the "half-circle" mode, he or she operates the touch panel or the like to designate the "upper half, lower half, right half, left half" or the like of the angle A, thereby designating the detailed position of the area to be irradiated in the angle A. The control unit 60 sets the area to be irradiated based on the input results.

[0086] It goes without saying that the method for accepting the designation of the planned irradiation area and the number of planned irradiation spots can be changed. For example, the laser treatment device 1 may be provided with modes other than the "full-circumference" mode and the "half-circumference" mode. The control unit 60 may accept a designation of an angle (within a range of 360 degrees or less) from the surgeon and set the area corresponding to the designated angle as the planned irradiation area. The control unit 60 may have the surgeon directly input the number of planned irradiation spots and set the input number of planned irradiation spots regardless of the selected mode. The control unit 60 may change the number of planned irradiation spots, which is predetermined for each mode, in response to an operation instruction from the surgeon. The control unit 60 may have the surgeon input the interval between two adjacent spots and calculate the number of planned irradiation spots based on the parameters of the planned irradiation area (e.g., the circumferential length of the treatment target area) and the input spot interval.

[0087] A method for adjusting the aiming position of the irradiation spot will be described with reference to FIG. 9. In this embodiment, the aiming position of the irradiation spot of the treatment laser light can be adjusted by adjusting the positional relationship between the patient's eye E and the laser irradiation optical system 10 by operating the joystick unit 5, or by rotating and / or moving the reflecting surface 27 of the contact lens 26. FIG. 9(A) shows a state in which the most recent irradiation of the treatment laser light has been completed. In the state of FIG. 9(A), the position of the irradiated spot SS, where irradiation of the treatment laser light has been completed, coincides with the position of the aiming light AI. From the state shown in FIG. 9(A), the surgeon must adjust the position of the aiming light AI (i.e., the aiming position of the irradiation spot) to the position of the next irradiation spot (the position immediately to the right of the irradiated spot SS in the example shown in FIG. 9).

[0088] 9(B) shows a state in which the aiming position has been adjusted from the state shown in FIG. 9(A) to the position of the next irradiation spot by operating the joystick unit 5 (i.e., with the angle of the reflecting surface 27 of the contact lens 26 fixed). In FIG. 9(B), the positions of the irradiated spot SS and the treatment target area (the trabecular meshwork TM in this embodiment) at the time of the previous irradiation completion of the treatment laser light are schematically shown by dotted lines. However, in reality, there is no treatment mark on the irradiated spot SS at the time of the previous irradiation completion, so it is difficult to accurately adjust the aiming position by operating the joystick unit 5.

[0089] FIG. 9(C) shows a state in which the aiming position has been adjusted from the state shown in FIG. 9(A) to the position of the next irradiation spot by rotating the reflecting surface 27 of the contact lens 26 (i.e., without operating the joystick unit 5). In FIG. 9(C), the positions of the irradiated spot SS and the treatment target area at the time of the previous irradiation of the treatment laser light are also shown by dotted lines. However, in reality, even in FIG. 9(C), there is no treatment mark on the irradiated spot SS at the time of the previous irradiation, making it difficult to accurately adjust the aiming position by rotating the reflecting surface 27. In the present disclosure, a guide is displayed on the internal display unit 50 to assist the surgeon in adjusting the aiming position.

[0090] First Embodiment 10 and 11, a treatment control process executed by the ophthalmic laser treatment device 1 of the first embodiment will be described. First, referring to FIG. 10, an aiming guide (a target site guide 71A and an outer periphery guide 75 in the first embodiment) displayed on the internal display unit 50 by the ophthalmic laser treatment device 1 of the first embodiment will be described. The aiming guide is displayed on the internal display unit 50 to assist the surgeon in adjusting the aiming position of the treatment laser beam to an appropriate position. As described above, methods for adjusting the aiming position include adjusting the positional relationship between the patient's eye E and the laser irradiation optical system 10 by operating the joystick unit 5, and rotating and / or moving the reflecting surface 27 of the contact lens 26. The surgeon can check the aiming guide while observing the tissue of the patient's eye E through the eyepiece 46 (i.e., without taking his / her eye away from the eyepiece 46) and adjust the aiming position of the treatment laser beam by referring to the checked aiming guide. Although details will be described later, the control unit 60 (CPU 61) of the ophthalmic laser treatment apparatus 1 causes the internal display unit 50 to display an aiming guide in accordance with the progress of the irradiation plan.

[0091] In the example shown in FIG. 10 , the surgeon observes an arcuate or annular treatment target area (the trabecular meshwork TM in the example shown in FIG. 10 ) and a spot AI of the aiming light irradiated onto the treatment target area through the observation optical system 40. The observed images of the treatment target area and the aiming light are reflected images from the reflective surface of a contact lens. Note that FIG. 10 illustrates a case where a contact lens is used that does not have the aforementioned spacing indicator 28 (see FIG. 7 ) and is not a partially rotational lens. As described above, in this embodiment, the center of the display area of ​​the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser beam, and the optical axis of the aiming light all coincide at the center O. Therefore, the internal display unit 50 can display images at an appropriate angle in an appropriate direction centered on the optical axes of the treatment laser beam and the aiming light. In other words, the surgeon visually recognizes the aiming light at the center of the observation field and the center of the display area of ​​the internal display unit 50. This further facilitates adjustment of the irradiation position of the treatment laser beam based on the aiming light and the display content of the internal display unit 50. When an instruction to irradiate the treatment laser beam is input, the treatment laser beam is irradiated onto the same spot as the spot AI of the aiming beam.

[0092] As shown in Fig. 10, the ophthalmic laser treatment device 1 of the first embodiment displays a target area guide 71A as an aiming guide on the internal display unit 50. The target area guide 71A serves as a reference for aligning the arc-shaped or annular treatment target area (the trabecular meshwork TM in the example shown in Fig. 10) of the patient's eye E observed by the surgeon via the observation optical system 40. The surgeon can easily adjust the aiming position of the treatment laser light to an appropriate position by making various adjustments so that the arc-shaped or annular treatment target area observed via the observation optical system 40 matches the displayed target area guide 71A.

[0093] The target region guide 71A shown in FIG. 10 includes a straight line parallel to the tangent direction that tangents to the appropriate position of the next irradiation spot, as determined by the irradiation plan, within the arc-shaped or annular treatment region (trabecular meshwork TM) as viewed from the surgeon's line of sight in the observation optical system. Due to the characteristics of a circle, when a line of a specific inclination tangents the circle, two points exist on the circumference, and the two points are located diametrically opposite each other relative to the center of the circle. Because the arc-shaped or annular treatment region being observed by the surgeon is reflected on the reflecting surface 27, the range of the fan-shaped portion of the treatment region observed through the reflecting surface 27 falls within an angular range of less than 180 degrees, with the center of the arc-shaped or annular treatment region as the reference point. As a result, the two points mentioned above cannot simultaneously fall within the observation field of view, and the treatment region having a tangent parallel to the inclination of the target region guide 71A is uniquely determined. Therefore, the operator operates at least one of the joystick unit 5 and the contact lens 26 to align the arc-shaped or annular treatment target area with the target area guide 71A so that the tangential direction of the arc-shaped or annular treatment target area coincides with the direction of the straight portion of the target area guide 71A, thereby facilitating accurate adjustment of the aiming position of the treatment laser light. Note that Fig. 10 shows a state in which the aiming position (the position of the aiming light spot AI) has been accurately adjusted to the appropriate position for the next irradiation spot.

[0094] Furthermore, when the surgeon observes an arc-shaped or annular treatment target area through the observation optical system 40, the curvature of the observed treatment target area changes depending on the size of the patient's eye E and the observation magnification of the observation optical system 40. This is because the observation range changes, and the treatment target area observed at the edge of the observation range is affected by the change in curvature. By adjusting the tangent direction of the treatment target area guide 71A to align with the center of the observation range, the treatment target area is observed near the center of the observation range, which is the position of the aiming light. Therefore, the surgeon can align the tangent direction of the treatment target area with the direction of the straight portion of the treatment target area guide 71A regardless of the size of the patient's eye E, the observation magnification, etc. This allows the surgeon to more easily adjust the aiming position to the appropriate position.

[0095] The target area guide 71A shown in FIG. 10 includes two straight lines parallel to the tangential direction. The positions of the optical axes of the treatment laser beam and the aiming beam (center O in FIG. 10) are located midway between the two straight lines. As a result, the center of the aiming beam spot AI observed by the surgeon is located midway between the two straight lines on the target area guide 71A. Therefore, the surgeon can align the tangential direction of the treatment area with the direction of the straight line portion of the target area guide 71A while simultaneously aligning the aim position of the treatment laser beam (the aiming beam spot AI) with the appropriate position on the treatment area. Note that the controller 60 adjusts the distance between the two straight lines on the target area guide 71A in accordance with the observation magnification of the observation optical system 40. As a result, the two straight lines on the target area guide 71A are displayed at an appropriate distance depending on the observation magnification, thereby facilitating the adjustment of the aim position appropriately regardless of the observation magnification. However, the target area guide 71A may have only one straight line portion. In this case, if the straight line portion passes through the positions of the optical axis of the treatment laser light and the optical axis of the aiming light, it becomes easier to align the aiming position with the appropriate position.

[0096] The control unit 60 determines the angle of the target region guide 71A to be displayed on the internal display unit 50 in accordance with the progress of the irradiation plan, and displays the treatment region guide 71A at the determined angle. Therefore, the target region guide 71A is displayed on the internal display unit 50 at an appropriate angle in accordance with the progress of the irradiation plan. This will be described in detail later.

[0097] 10, the ophthalmic laser treatment device 1 of the first embodiment displays an outer periphery guide 75 on the internal display unit 50 as an aiming guide. The outer periphery guide 75 indicates at least one of the rotation angle of the reflective surface of the contact lens appropriate for the progress of the irradiation plan (i.e., the direction in which the reflective surface 27 is positioned relative to the central axis AX1 of the contact lens 26) and the direction in which the irradiation spot to be irradiated with the treatment laser light is located (the direction in which the irradiation spot is located in the observation image using the contact lens 26). The outer periphery guide 75 is displayed along the outer periphery of the observation field observed by the surgeon via the observation optical system 40. As described above, the observation optical axis of the observation optical system 40 and the center of the display area of ​​the internal display unit 50 coincide with each other. Therefore, the outer periphery guide 75 is displayed along the outer periphery of the observation field based on the center of the display area of ​​the internal display unit 50, allowing the surgeon to easily grasp the appropriate direction.

[0098] Specifically, in this embodiment, multiple outer periphery guides 75 are arranged in an arc or ring shape along the outer periphery of the observation field. When moving one outer periphery guide 75, the control unit 60 moves it along an arc or ring line along the outer periphery of the observation field. The center of the arc or ring line on which the outer periphery guide 75 is displayed (in other words, the center of the outer periphery guide 75 or the center of curvature of the outer periphery guide 75) coincides with the observation optical axis of the observation optical system 40. Therefore, the surgeon can properly grasp the direction indicated by the outer periphery guide 75.

[0099] The outer periphery guide 75 includes a next aiming guide 75A. The next aiming guide 75A indicates the appropriate direction of the next irradiation spot to be irradiated with the treatment laser light, among the multiple irradiation spots defined in the irradiation plan. Each time treatment laser light is irradiated, the control unit 60 shifts the position of the next aiming guide 75A to a position corresponding to an adjacent irradiation spot in the direction of travel defined in the irradiation plan. For example, in the case of an irradiation plan in which 100 shots are irradiated clockwise around the entire circumference of the trabecular meshwork TM, the next aiming guide 75A may be shifted 3.6 degrees from the center O. Therefore, the surgeon can appropriately grasp the direction of the irradiation spot whose aiming position is to be adjusted next by the next aiming guide that shifts along the outer periphery of the observation field.

[0100] The outer peripheral guide 75 includes an irradiation completion guide 75B. The irradiation completion guide 75B indicates the direction of an irradiation spot that has already been irradiated with the treatment laser beam, among multiple irradiation spots defined in the irradiation plan. Each time irradiation with the treatment laser beam is completed, the control unit 60 changes the next aim guide 75A, which was displayed immediately before the irradiation, to the irradiation completion guide 75B. Therefore, the surgeon can grasp the direction in which irradiation with the treatment laser beam has been completed, and then appropriately adjust the next aim position using the next aim guide 75A. This also makes it easier to grasp the progress of the treatment.

[0101] The outer peripheral guide 75 includes a non-irradiation guide 75C. The non-irradiation guide 75C indicates the direction of an irradiation spot that is scheduled to be irradiated with the treatment laser beam after the next irradiation, among multiple irradiation spots defined in the irradiation plan. The control unit 60 changes the non-irradiation guide 75C, which was displayed in the direction of the irradiation spot in the next irradiation order defined in the irradiation plan, to the next aim guide 75A each time irradiation of the treatment laser beam is completed, thereby shifting the next aim guide 75A. In this case, the surgeon can grasp the direction of the irradiation spot that is scheduled to be irradiated with the treatment laser beam after the next irradiation, and then appropriately adjust the next aim position using the next aim guide 75A. This also makes it easier to grasp the progress of treatment.

[0102] The control unit 60 displays the next aiming guide 75A, the irradiation completion guide 75B, and the unilluminated guide 75C in a distinguishable manner (i.e., in different display modes). Therefore, the surgeon can easily recognize the type of the displayed outer periphery guide 75. The control unit 60 may selectively display one or two of the next aiming guide 75A, the irradiation completion guide 75B, and the unilluminated guide 75C. In this case, it is desirable to display at least the next aiming guide 75A. It is more desirable to display both the next aiming guide 75A and the irradiation completion guide 75B. The next aiming guide 75A may be, for example, a straight line extending to the center O through which the optical axis of the observation optical system 40 passes. It is sufficient if the next aiming guide 75A can guide the direction in which the reflecting surface 27 of the contact lens 26 is pointed.

[0103] The treatment control process in the first embodiment will be described with reference to Figure 11. All treatment control processes described below are executed by the CPU (controller) 61 of the control unit 60 when an instruction to start treatment is input via a touch panel or the like. The CPU 61 executes the treatment control process in accordance with a control program stored in the ROM 62 or non-volatile memory 65.

[0104] First, the control unit 60 acquires a treatment laser beam irradiation plan for the patient's eye E (S1). As described above, the irradiation plan determines the order of irradiation of multiple irradiation spots to be irradiated with the treatment laser beam when the patient's eye E is irradiated with the treatment laser beam using a contact lens 26 having a reflecting surface 27. The irradiation plan of this embodiment determines the treatment laser beam irradiation range (i.e., the circumferential range in which multiple irradiation spots are arranged) of the annular treatment target area (in this embodiment, the trabecular meshwork TM), the irradiation spot to be first irradiated with the treatment laser beam, the number of irradiation spots, and the irradiation order (including the irradiation direction) of each irradiation spot with the treatment laser beam. In this embodiment, each time treatment laser beam irradiation is performed once, the irradiation spot adjacent to the irradiation spot that has been completely irradiated becomes the irradiation spot to be irradiated with the treatment laser beam next. The treatment laser beam is irradiated multiple times in a clockwise or counterclockwise direction. In other embodiments described later, the irradiation plan may include information about the contact lens used in the treatment (for example, at least one of information indicating whether the contact lens is a partial rotational lens, information about the specified angle of the partial rotational lens, and information indicating whether the contact lens has spacing indicators 28 formed thereon). As an example, in this embodiment, the irradiation plan is formulated by operating the control box 6.

[0105] The control unit 60 displays the non-irradiated guide 75C in the direction of each of the multiple irradiation spots to which the treatment laser light is scheduled to be irradiated in the irradiation plan, within the outer periphery of the display area in the internal display unit 50 (i.e., the outer periphery of the observation field via the observation optical system 40) (S2).

[0106] The control unit 60 sets the value of an irradiation order counter "n," which specifies the order in which the treatment laser light is irradiated onto the multiple irradiation spots defined in the irradiation plan, to "1" (S3). The control unit 60 then displays a next aim guide 75A in the direction of the first irradiation spot defined in the irradiation plan, on the outer periphery of the display area of ​​the internal display unit 50 (S1). Furthermore, the control unit 60 determines the angle of the target area guide 71A according to the position or direction of the first irradiation spot defined in the irradiation plan, and displays the target area guide 71A at the determined angle on the internal display unit 50 (S5).

[0107] Next, the control unit 60 determines whether or not the operator has input an instruction to irradiate the treatment laser beam (S7). If the instruction to irradiate the treatment laser beam has not been input (S7: NO), the determination of S7 is repeated and the system enters a standby state. During this time, the operator adjusts the aim position of the treatment laser beam. As an example, when guiding irradiation to a region in the 6 o'clock direction in the actual trabecular meshwork TM, the control unit 60 may display a straight line extending horizontally (a unique angle corresponding to the aforementioned region) as the target region guide 71A. Furthermore, the target region guide 71A illustrated in FIG. 10 guides irradiation to a region diagonally downward to the left in the actual trabecular meshwork.

[0108] When an instruction to irradiate the treatment laser beam is input (S7: YES), the treatment laser beam is irradiated (S8). Next, it is determined whether the value of the irradiation order counter "n" has reached "N," the number of all irradiation spots to be irradiated with the treatment laser beam in the irradiation plan (S10). If irradiation of all irradiation spots with the treatment laser beam has not been completed (i.e., "n" has not reached "N") (S10: NO), "1" is added to the value of the irradiation order counter "n" (S11). The control unit 60 shifts the position of the next aim guide 75A to the position corresponding to the irradiation spot adjacent in the direction of travel defined in the irradiation plan (S12). The control unit 60 also changes the displayed next aim guide 75A to an irradiation completion guide 75B (S13). Furthermore, the control unit 60 rotates the angle of the displayed target site guide 71A according to the direction and angle of travel of the irradiation spot (S14). For example, in the case of an irradiation plan for irradiating the entire circumference of the trabecular meshwork TM with 100 adjacent shots, the control unit 60 rotates the target area guide 71A displayed on the internal display unit 50 in one direction by 3.6 degrees for each shot. Then, the process returns to S7. When irradiation of all irradiation spots with the treatment laser light is completed (i.e., when "n" reaches "N") (S10: YES), the process ends.

[0109] Second Embodiment The treatment control process executed by the ophthalmic laser treatment device 1 of the second embodiment will be described with reference to Figures 12 and 13. The configuration and control described in the first embodiment can be adopted for at least a part of the configuration and control in the second to fourth embodiments described below. Therefore, the description of the parts of the embodiments described below that can adopt the configuration and control described in the first embodiment may be omitted or simplified. In the second embodiment, the shape of the target area guide displayed on the internal display unit 50 is different from that of the first embodiment. As in the first embodiment, the second embodiment will be described using an example in which a contact lens that does not have a spacing indicator 28 (see Figure 7) and is not a partially rotational lens is used.

[0110] First, with reference to Fig. 12, an alignment guide (target area guide 71B in the second embodiment) displayed on the internal display unit 50 of the ophthalmic laser treatment device 1 of the second embodiment will be described. As described above, the target area guide serves as a reference for aligning the arc-shaped or annular treatment target area (the trabecular meshwork TM in the example shown in Fig. 12) of the patient's eye E observed by the surgeon via the observation optical system 40. The target area guide 71B shown in Fig. 12 includes an arc-shaped portion corresponding to the arc-shaped arrangement of multiple irradiation spots determined by the irradiation plan. Therefore, by aligning the treatment target area with the target area guide 71B so that the arc shape of the treatment target area matches the shape of the arc-shaped portion of the target area guide 71B, both the rotation angle of the reflective surface of the contact lens and the aim position of the treatment laser light can be easily and accurately adjusted.

[0111] Control unit 60 changes the curvature of the arc-shaped portion of target region guide 71B displayed on internal display unit 50 in accordance with the magnification of observation optical system 40. As a result, the arc-shaped portion of target region guide 71B changes appropriately in accordance with the difference in appearance of the treatment target region, which changes depending on the observation magnification, making it easier to adjust the aiming position.

[0112] In the second embodiment, a predetermined number of treatment laser beams are irradiated into fan-shaped irradiation zones while the angle of the reflective surface of the contact lens is fixed. After completing the predetermined number of treatment laser beam irradiations in one irradiation zone, the rotation angle of the reflective surface of the contact lens is changed (adjusted) by the surgeon, and the next predetermined number of treatment laser beams are irradiated into the next fan-shaped irradiation zone. In the example shown in FIG. 12, the angular range of one irradiation zone is 36 degrees. Therefore, when treatment is performed on the entire circumference of the treatment target area, a predetermined number of treatment laser beams are irradiated into each of the ten irradiation zones.

[0113] In FIG. 12(a), the control unit 60 first displays, on the internal display unit 50, an arc-shaped target region guide 71B corresponding to the arc-shaped arrangement of a predetermined number of irradiation spots (10 in the example shown in FIG. 12) to be arranged within the first irradiation section in the irradiation plan. In the state shown in FIG. 12(a), the arc-shaped treatment region being observed does not match the arc-shaped target region guide 71B displayed. Therefore, as shown in FIG. 12(b), the surgeon uses the contact lens and joystick unit 5 to align the arc-shaped treatment region with the arc-shaped target region guide 71B. As a result, the rotation angle of the reflective surface of the contact lens and the aiming position of the treatment laser beam approach the appropriate angle and position for irradiating the treatment laser beam to the irradiation spots determined by the irradiation plan. In the second embodiment, the surgeon can switch between displaying and hiding the target region guide 71B by operating a selector switch (not shown) provided on the joystick unit 5 (see FIGS. 12(b) and 12(c)). As shown in FIG. 12(c), the surgeon completes the irradiation of a predetermined number of treatment laser beams within the irradiation zone while fixing the rotation angle of the reflective surface of the contact lens (spots S irradiated with the treatment laser beam are shown by dotted lines in FIG. 12(c)). When irradiating a predetermined number of treatment laser beams, the surgeon may repeat the operation illustrated in FIG. 9(B), for example. As shown in FIG. 12(d), when the control unit 60 completes the irradiation of a predetermined number of treatment laser beams within the irradiation zone, it rotates the target area guide 71B by an angle equivalent to one irradiation zone (36 degrees in the example of FIG. 12) in the direction of travel of the next irradiation spot. The surgeon may then rotate the contact lens, etc., so that the arc of the rotated target area guide 71B matches the arc of the observed treatment target area. By repeating the above procedure, appropriate treatment is performed on each of the multiple irradiation zones. That is, in this embodiment, one cycle is a series of steps, which involves repeatedly adjusting the aiming position by shifting the observation image using the joystick unit 5, and then rotating the reflective surface of the contact lens by a large amount (approximately 36 degrees in the example shown in FIG. 12). By repeating this cycle multiple times, the treatment laser light is appropriately irradiated multiple times onto a wide range of the annular or arc-shaped treatment target area.The control unit 60 rotates the target area guide 71B at a timing when the reflective surface of the contact lens is rotated significantly based on a preset irradiation plan. As a result, even when, for example, a contact lens having a simple structure is used in combination with an ophthalmic laser treatment device 1 having a simple structure, the surgeon can easily adjust the positions of multiple irradiation spots appropriately over a wide area of ​​the treatment target area.

[0114] The treatment control process in the second embodiment will be described with reference to Fig. 13. First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S21). As described above, the treatment plan acquired in S21 defines the angle of one irradiation section, the number of times M that the treatment laser light is irradiated within each irradiation section, the total number N of times that the treatment laser light is irradiated onto the entire treatment target area, the irradiation spot that the treatment laser light is first irradiated onto, the irradiation order (including the irradiation direction) of the treatment laser light, etc.

[0115] The control unit 60 causes the internal display unit 50 to display an arc-shaped target site guide 71B corresponding to the arrangement of a predetermined number of irradiation spots arranged in the first irradiation zone (S22). The control unit 60 sets the value of a total irradiation number counter "n" that specifies the cumulative number of times the treatment laser light has been irradiated onto the entire treatment target zone to "0" (S23). Furthermore, the control unit 60 sets the value of an intra-zone irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated onto one irradiation zone to "0" (S24).

[0116] Next, the control unit 60 determines whether or not the surgeon has input an instruction to switch between displaying and hiding the target region guide 71B on the internal display unit 50 (S26). If a display switching instruction is input (S26: YES), the control unit 60 switches between displaying and hiding the target region guide 71B on the internal display unit 50 in accordance with the input instruction (S27). Thereafter, the process proceeds to S28.

[0117] The control unit 60 determines whether an instruction to irradiate the treatment laser beam has been input by the operator (S28). If an instruction to irradiate the treatment laser beam has not been input (S28: NO), the process returns to S26. During this time, the operator adjusts the aiming position of the treatment laser beam. If an instruction to irradiate the treatment laser beam has been input (S28: YES), the treatment laser beam is irradiated (S29). Next, the control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S30). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser beam to the entire treatment target area (S32). If irradiation of all irradiation spots with the treatment laser light has not been completed (i.e., "n" has not reached "N") (S32: NO), the control unit 60 determines whether the value of the intra-zone irradiation number counter "m" has reached the predetermined number of times "M" that the treatment laser light has been irradiated into one irradiation zone (S33). If irradiation of one irradiation zone with the treatment laser light has not been completed (i.e., "m" has not reached "M") (S33: NO), the process returns to S26, and the processes of S26 to S33 are repeated. If irradiation of one irradiation zone with the treatment laser light has been completed (S33: YES), the control unit 60 rotates the target area guide 71B by the angle of one irradiation zone in the direction of travel of the next irradiation spot (S34), and the process returns to S24 to proceed to treatment for the next irradiation zone. If irradiation of all irradiation spots with the treatment laser light has been completed (S32: YES), the process ends.

[0118] The process exemplified in the second embodiment may be modified. For example, when a partially rotating lens is used, the control unit 60 may acquire information on the specified rotation angle of the partially rotating lens (i.e., the angle rotated by one operation). Each time a predetermined number of treatment laser beam irradiations (corresponding to the aforementioned predetermined number "M") are completed within the range of one specified rotation angle (corresponding to the aforementioned "angle of one irradiation section"), the control unit 60 may rotate the angle of the displayed target area guide 71B by the specified rotation angle in the direction of travel of the irradiation spot. In this case, each time treatment laser beam irradiation within one specified rotation angle is completed, the angle of the target area guide 71B is rotated to an angle corresponding to the next specified rotation angle range. This makes it easier to adjust the aiming position more appropriately, even when treatment is performed using a partially rotating lens.

[0119] Furthermore, controller 60 may rotate the angle of displayed target area guide 71B in accordance with the direction and angle of travel of the irradiation spot each time treatment laser light is irradiated. In this case, each time treatment laser light is irradiated, target area guide 71B is displayed at an appropriate angle according to the next irradiation spot.

[0120] Controller 60 may change the display method of target area guides 71A and 71B based on information about the contact lens being used. For example, if the contact lens being used is a contact lens that can be rotated entirely by the surgeon, controller 60 may execute a process to rotate target area guide 71A by the angle of travel of the irradiation spot each time irradiation of the treatment laser light is performed. Alternatively, if the contact lens being used is a partially rotating lens, controller 60 may execute a process to rotate target area guide 71B by a specified rotation angle each time irradiation of the treatment laser light is completed a predetermined number of times. In this case, the display of target area guides 71A and 71B is changed appropriately depending on the contact lens being used, making it even easier to adjust the aim position of the treatment laser light.

[0121] Third Embodiment 14 to 16, a treatment control process executed by the ophthalmic laser treatment device 1 of the third embodiment will be described. First, with reference to Fig. 14 and Fig. 15, an aiming guide (in the third embodiment, an angle guide 80 and a section aiming guide 75D) and a previous irradiation image 88 that the ophthalmic laser treatment device 1 of the third embodiment causes to be displayed on the internal display unit 50 will be described.

[0122] As shown in Fig. 14, the ophthalmic laser treatment device 1 of the third embodiment displays an angle guide 80 as an aiming guide on the internal display unit 50. The angle guide 80 indicates the rotation angle of the reflective surface of the contact lens that is appropriate for the progress of the irradiation plan. By referring to the angle indicated by the angle guide 80 and adjusting the rotation angle of the reflective surface of the contact lens, the surgeon can adjust the aiming position of the treatment laser light with the angle of the reflective surface appropriately adjusted.

[0123] As shown in Fig. 15, the angle guide 80 of the third embodiment includes a schematic diagram 81 of a treatment target area. The shape of the schematic diagram 81 of the treatment target area is shaped to match the appropriate angle of the arc-shaped or annular treatment target area of ​​the patient's eye (in this embodiment, the trabecular meshwork TM shown in Fig. 14), where the irradiation spot to be next irradiated with the treatment laser light will be located. Therefore, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens by adjusting the angle of the treatment target area being observed so that it matches the schematic diagram 81 of the treatment target area.

[0124] Furthermore, the angle guide 80 of the third embodiment includes a shape that imitates the contour shape of the reflective surface of a contact lens and a shape that imitates the characteristic structure of the contact lens (in this embodiment, spacing indicator 28) that is reflected on the reflective surface when the reflective surface of the contact lens is oriented in an appropriate direction. In the example shown in FIGS. 14 and 15 , the control unit 60 displays the angle guide 80 in a direction that positions the reflective surface relative to the axis AX1 when viewed from the center of the display area of ​​the internal display unit 50. Therefore, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens by adjusting the reflective surface of the contact lens so that it is oriented along the angle guide 80.

[0125] The control unit 60 determines the angle of the angle guide 80 to be displayed on the internal display unit 50 in accordance with the progress of the irradiation plan, and displays the angle guide 80 at the determined angle. Therefore, by referring to the angle guide 80, the surgeon can adjust the angle of the reflective surface of the contact lens to an appropriate angle in accordance with the progress of the irradiation plan.

[0126] More specifically, in treatment using the ophthalmic laser treatment device 1 of the third embodiment, a contact lens (partial rotation lens) 26 shown in FIGS. 6 and 7 may be used. As described above, in the partially rotation contact lens 26, each time the lens is operated by a user's finger, a portion including the reflective surface 27 rotates a specified angle relative to the grip portion 26A held by the user. The control unit 60 rotates the angle of the angle guide 80 a specified angle each time a predetermined number of treatment laser beam irradiations to be performed within a range of one specified rotation angle (in other words, within one irradiation zone) are completed. Therefore, even when performing treatment using the partially rotation contact lens 26, the surgeon can adjust the angle of the reflective surface 27 to an appropriate angle by referring to the angle guide 80.

[0127] The control unit 60 recommends to the surgeon that the reflecting surface 27 be rotated by the specified rotation angle each time a predetermined number of treatment laser beam irradiations to be performed within a range of one specified rotation angle of the contact lens 26 (in other words, within one irradiation zone) are completed (i.e., each time adjustment of the aiming position to multiple locations using the joystick unit 5 is completed while maintaining the orientation of the reflecting surface 27 of the contact lens 26). Therefore, the surgeon can appropriately grasp the timing when the reflecting surface 27 needs to be rotated by the specified angle, particularly when performing treatment using a partially rotating contact lens 26. In this embodiment, the control unit 60 recommends the rotation of the reflecting surface 27 by generating a sound from the speaker. Therefore, the surgeon can grasp the timing when the reflecting surface 27 needs to be rotated even while looking through the eyepiece 46.

[0128] As shown in FIG. 15 , the angle guide 80 of the third embodiment includes a spacing index schematic diagram 82 that imitates the spacing index 28 (see FIG. 7 ) provided on the contact lens 26. As described above, the contact lens 26 used in treatment with the ophthalmic laser treatment device 1 of the third embodiment is provided with the spacing index 28. A plurality of spacing indexes 28 are arranged at regular intervals to serve as a guide for the spacing between spots to be irradiated with treatment laser light. As shown in FIG. 14 , at least a portion of the spacing indexes 28 is observed by the surgeon through the reflecting surface 27. In addition to being able to easily adjust the rotation angle of the reflecting surface 27 of the contact lens 26 using the angle guide 80, the surgeon can easily adjust the spacing between multiple spots by adjusting the aim positions of the multiple treatment laser beams while understanding the spacing index schematic diagram 82. In particular, if the contact lens 26 being used is provided with a spacing indicator 28, the surgeon can adjust the aiming position more easily by comparing the spacing indicator 28 of the contact lens 26 observed through the observation optical system 40 with the spacing indicator schematic diagram 82 displayed on the internal display unit 50 and then adjusting the aiming position.

[0129] The angle guide 80 of the third embodiment includes a spot placement guideline diagram 83. The spot placement guideline diagram 83 shows the arrangement of consecutive irradiation spots, including the irradiation spot to be next irradiated with the treatment laser beam, among the multiple irradiation spots defined in the irradiation plan. The control unit 60 shifts the display of the irradiation spot to be next irradiated with the treatment laser beam, among the multiple irradiation spot arrangements included in the spot placement guideline diagram 83, to the adjacent irradiation spot in the direction of travel defined in the irradiation plan each time the treatment laser beam is irradiated. Therefore, the surgeon can more appropriately adjust the next target position by understanding the position of the next irradiation spot displayed in the spot placement guideline diagram 83. In particular, in the angle guide 80 shown in FIGS. 14 and 15 , the spot placement guideline diagram 83 is displayed in a state that matches the approximate interval between the irradiation spots indicated by the spacing indicator schematic diagram 82. Therefore, the surgeon can more appropriately adjust the next target position by understanding the positional relationship of the next irradiation spot indicated in the spot placement guideline diagram 83 with respect to the spacing indicator schematic diagram 83.

[0130] As shown in Fig. 14, the ophthalmic laser treatment device 1 of the third embodiment displays a section aiming guide 75D on the internal display unit 50 as an outer periphery guide displayed along the outer periphery of the observation field. The section aiming guide 75D illustrated in Fig. 14 indicates the area of ​​the treatment target area according to the progress of the treatment plan (the area of ​​the treatment target area when the patient's eye E is viewed from the front without passing through the observation optical system 40). In the example shown in Fig. 14, among the bar graphs corresponding to each of the eight irradiation sections, the portion indicating the direction of the area of ​​the treatment target area corresponding to the irradiation of the treatment laser light to the current irradiation section is displayed in a manner different from the other portions (i.e., in a manner that can be distinguished from the other portions), thereby displaying the section aiming guide 75D. In Fig. 14, the angle guide 80 guides the direction in which the reflecting surface 27 of the contact lens 26 is directed, and the section aiming guide 75D indicates the direction of the area of ​​the treatment target area corresponding to the angle guide 80. In FIG. 14 , the section aiming guide 75D is positioned in the opposite direction to the angle guide 80, taking into consideration that the image observed through the contact lens 26 is a reflected image (virtual image). However, the section aiming guide 75D and the angle guide 80 may be positioned in the same direction. Each time the control unit 60 completes irradiation of the same number of treatment laser beams as the number of irradiation spots included in one irradiation section, it shifts the position of the section aiming guide 75D to a position adjacent to the direction of travel defined by the irradiation plan. Therefore, the operator can easily grasp the direction of the reflecting surface 27 for irradiating the treatment laser beam onto the irradiation spots within the irradiation section using the section aiming guide 75D. The section aiming guide 75D may indicate the direction of the irradiation section according to the progress of the treatment plan. In this case, the direction of the section aiming guide 75D is opposite to that when indicating the direction of the appropriate rotation angle of the reflecting surface 27.

[0131] The control unit 60 displays the section aiming guide 75D for each range of the specified angle of the partially rotational contact lens 26 (see FIGS. 6 and 7). Each time irradiation of the same number of treatment laser beams as the number of irradiation spots included in one specified angle range is completed, the control unit 60 shifts the position of the section aiming guide 75D to an adjacent position in the direction of progression defined in the irradiation plan. Therefore, the section aiming guide 75D is displayed appropriately according to the specifications of the partially rotational contact lens 26 and the progress of treatment.

[0132] The ophthalmic laser treatment device 1 of this embodiment also includes a photographing optical system for capturing an observation image of the patient's eye E or the like. As shown in FIG. 14 , the control unit 60 displays a previous irradiation image 88 captured by the photographing optical system on the internal display unit 50. The previous irradiation image 88 is an image of the treatment target area irradiated with the aiming light, captured by the photographing optical system the previous time the treatment laser light was irradiated. For example, a still image captured immediately before or immediately after the previous irradiation of the treatment laser light may be displayed as the previous irradiation image 88. Since the treatment of this embodiment leaves no trace of the treatment laser light irradiation, an image of the treatment target area irradiated with the aiming light is used as the previous irradiation image 88. However, a graphic simulating a spot may be drawn at a predetermined position on the captured image (in this embodiment, a position coinciding with the optical axis of the treatment laser light). The surgeon can adjust the next aiming position after understanding the area previously irradiated with the treatment laser light (i.e., the area where the aiming light appears in the displayed previous irradiation image 88). This facilitates more appropriate irradiation of the treatment laser light.

[0133] The treatment control process in the third embodiment will be described with reference to Fig. 16. First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S41). The treatment plan acquired in S41 defines the specified angle of the partially rotational contact lens 26 to be used (i.e., the angle of one irradiation section), the number of times M the treatment laser light is irradiated within each irradiation section, the total number N of times the treatment laser light is irradiated onto the entire treatment target area, the irradiation spot to be first irradiated with the treatment laser light, the irradiation order of the treatment laser light (including the irradiation direction), etc. Note that information such as the specified angle of the contact lens 26 may be acquired based on information indicating the type of contact lens 26.

[0134] The control unit 60 displays the angle guide 80 and the section aiming guide 75D on the internal display unit 50 at an angle, direction, and position corresponding to the arrangement of the first irradiation section (S42). The control unit 60 sets the value of the total irradiation number counter "n," which specifies the total number of times the treatment laser light has been irradiated onto the entire treatment target area, to "0" (S43). Furthermore, the control unit 60 sets the value of the intra-section irradiation number counter "m," which specifies the number of times the treatment laser light has been irradiated onto one irradiation section, to "0" (S44). The control unit 60 sets the display of the next irradiation spot (next spot) to be irradiated with the treatment laser light in the spot arrangement guideline diagram 83 to the first spot in the order of irradiation with the treatment laser light among the multiple spots in the spot arrangement guideline diagram 83 (S45).

[0135] The control unit 60 determines whether or not the operator has input an instruction to irradiate the treatment laser beam (S47). If the instruction to irradiate the treatment laser beam has not been input (S47: NO), the determination of S47 is repeated. During this time, the operator adjusts the aim position of the treatment laser beam. If the instruction to irradiate the treatment laser beam has been input (S47: YES), the treatment laser beam is irradiated (S48). The control unit 60 also acquires an observation image of the treatment target area irradiated with the aim beam, which is captured by the imaging optical system when the treatment laser beam is irradiated (S49).

[0136] The control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S50). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the entire treatment target area with the treatment laser light (S52). If irradiation of all irradiation spots with the treatment laser light has not been completed (i.e., "n" has not reached "N") (S52: NO), the control unit 60 determines whether the value of the intra-section irradiation number counter "m" has reached the predetermined number "M" of irradiations of the treatment laser light within one irradiation section (S53). If irradiation of one irradiation section with the treatment laser light has not been completed (i.e., "m" has not reached "M") (S53: NO), the control unit 60 transitions the display of the next irradiation spot (next spot) to be irradiated with the treatment laser light among the multiple spots on the spot placement guideline diagram 83 to an adjacent spot in the direction of irradiation progress (S54). Furthermore, the control unit 60 causes the internal display unit 50 to display the observation image captured in S49 as the previous irradiation image 88 (S55), and the process returns to S47.

[0137] When irradiation of one irradiation zone with the treatment laser light is completed (S53: YES), the control unit 60 rotates the angle guide 80 by the specified angle of the internal rotation contact lens 26 (i.e., the angle of one irradiation zone) (S57). The control unit 60 shifts the position of the zone aiming guide 75D to a position adjacent to the direction of travel defined in the irradiation plan (S58). Furthermore, the control unit 60 recommends to the surgeon that the reflecting surface 27 be rotated by the specified rotation angle (S59), and the process returns to S44. When irradiation of all irradiation spots with the treatment laser light is completed (S52: YES), the process ends.

[0138] It is also possible to change the processing exemplified in the third embodiment. First, the display mode of the angle guide 80 may be changed. For example, a diagram or a photograph that allows the surgeon to understand the appropriate angle for the observation image of the treatment target area observed through the observation optical system 40 may be displayed on the internal display unit 50 as the angle guide. Also, a schematic diagram of the contact lens 26 as viewed from a direction along the observation optical axis may be displayed as the angle guide.

[0139] The angle guide 80 of the third embodiment is rotated by the angle range of the irradiation section each time a predetermined number of treatment laser beam irradiations to be performed in one irradiation section are completed. However, the control unit 60 may rotate the angle of the displayed angle guide 60 according to the traveling direction and traveling angle of the irradiation spot each time treatment laser beam irradiation is performed.

[0140] The angle guide 80, section aim guide 75D, and previous irradiation image 88 of the third embodiment are displayed on the internal display unit 50. However, even when at least one of the angle guide 80, section aim guide 75D, and previous irradiation image 88 is displayed on a display unit other than the internal display unit 50 (for example, the external display unit 7 of the control box 6 provided outside the observation optical system 40), the ophthalmic laser treatment device 1 can appropriately assist the surgeon in adjusting the aiming position.

[0141] <Fourth embodiment> The treatment control process executed by the ophthalmic laser treatment device 1 of the fourth embodiment will be described with reference to Figs. 17 to 19. Figs. 17 to 19 illustrate a case where treatment is performed using an internally rotating contact lens 26 (see Figs. 6 and 7) on which a spacing index 28 is formed. As shown in Figs. 15 and 16, the image observed by the observation optical system 40 includes a reflected image of the spacing index 28 reflected by the reflective surface 27 of the contact lens 26. A spot spacing guide 90 indicates to the surgeon the appropriate spacing between multiple irradiation spots to be irradiated with treatment laser light.

[0142] First, the flow of treatment using the spot spacing guide 90 will be described using the example shown in Fig. 17 and Fig. 18. Fig. 17 and Fig. 18 show an example in which adjacent irradiation is performed clockwise on the actual trabecular meshwork region from the bottom (Fig. 17) to the diagonally lower left (Fig. 18) based on an irradiation plan preset by the surgeon.

[0143] The irradiation plan of this embodiment includes the operator rotating the rotating base 26B clockwise. In Figures 17 and 18, the lower trabecular meshwork is reflected by the reflective surface of the contact lens and enters the operator's field of view. Therefore, in Figures 17 and 18, the images are upside down and the lower trabecular meshwork is reflected. On the reflective surface in Figures 17 and 18, when treatment for the irradiation spot progresses from right to left (i.e., counterclockwise), in the actual lower trabecular meshwork, treatment for the irradiation spot progresses from right to left (i.e., clockwise).

[0144] First, as shown in FIG. 17( a), the control unit 60 determines the angle of the spot spacing guide 90 to be displayed on the internal display unit 50 according to the progress of the irradiation plan (specifically, according to the direction of the irradiation section to be irradiated with the treatment laser light) and displays the spot spacing guide 90 at the determined angle. The indicators on the spot spacing guide 90 are aligned with the appropriate reflection direction of the treatment laser light by the reflective surface 27 of the contact lens 26 toward the next irradiation spot. FIG. 17 shows a guide for performing 10 adjacent irradiations on the lower region of the actual trabecular meshwork TM while maintaining the orientation of the reflective surface 27 of the contact lens 26. Based on the aforementioned regions, the indicators on the spot spacing guide 90 are arranged horizontally. The control unit 60 identifiably displays a next aiming indicator 90A on the spot spacing guide 90 for aligning the aiming position of the next treatment laser light. In the example shown in FIG. 17(a), the control unit 60 first displays a next targeting index 90A at a position overlapping with an index (in this embodiment, five indexes aligned with the reflected images of the five spacing indexes 28 observed through the reflecting surface 27 of the contact lens 26) located at the opposite end of the treatment progression direction defined in the irradiation plan (the index located at the right end in FIG. 17(a)) among the multiple indexes of the spot spacing guide 90. The indexes other than the one overlapping with the next targeting index 90A are set as non-irradiated indexes corresponding to at least a part of the spot to be irradiated with the treatment laser beam after the next irradiation. Furthermore, the control unit 60 displays the multiple indexes of the spot spacing guide 90 and the next targeting index 90A so that the next targeting index 90A corresponds to a position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. Note that the position where the next targeting index 90A is displayed does not need to be exactly aligned with the optical axis of the treatment laser beam. That is, the next target index 90A may be displayed at a position corresponding to the optical axis of the treatment laser beam so that the operator can recognize the position on the optical axis of the treatment laser beam.

[0145] The surgeon adjusts at least one of the rotation angle of the contact lens 26 and the relative position of the patient's eye E and the laser irradiation optical system 10, which is changed using the joystick unit 5, so that the positions of the multiple indices (five in this embodiment) on the spot spacing guide 90 coincide with the positions of the multiple targeting indices 28 reflected on the reflecting surface 27 of the contact lens 26 within the observation field. As shown in FIG. 17(b), when the positions of the multiple indices on the spot spacing guide 90 coincide with the positions of the targeting indices 28, the spot S to be next irradiated with the treatment laser beam is positioned on the straight line extending from the next targeting indices 90A on the spot spacing guide 90. The surgeon inputs an instruction to irradiate the treatment laser beam with the targeting beam positioned at the treatment area. As a result, the treatment laser beam is irradiated onto the spot S through which the optical axis of the laser irradiation optical system 10 passes.

[0146] As shown in FIG. 17(c), when the treatment laser beam irradiation is completed, the control unit 60 moves the index of the spot spacing guide 90 by one appropriate interval of the irradiation spot in the direction opposite (counterclockwise in FIG. 17) to the treatment progression direction (clockwise in FIG. 17) defined in the irradiation plan. As a result, the positions of the multiple indexes on the spot spacing guide 90 are shifted relative to the position of the aiming index 28. The control unit 60 then moves the position of the next aiming index 90A by one appropriate interval of the irradiation spot in the progression direction defined in the irradiation plan. Furthermore, the control unit 60 changes the index on which the next aiming index 90A was superimposed during the previous treatment laser beam irradiation to an irradiated index corresponding to a spot that has already been irradiated with the treatment laser beam. The irradiation plan of this embodiment is a plan for performing 10 adjacent irradiations using the spot spacing guide 90 consisting of five indexes, and one appropriate interval of the irradiation spot corresponds to half the interval between adjacent indexes on the spot spacing guide 90. In this embodiment, the distance between adjacent indices on the spot spacing guide 90 is 800 μm (twice the spot size of the treatment laser beam and the aiming beam). The surgeon adjusts the aiming position of the treatment laser beam by operating at least one of the joystick unit 5 and the contact lens (the joystick unit 5 in FIG. 17) so that the positions of the indices on the spot spacing guide 90 (five indices other than the next aiming beam 90A in FIG. 17(c)) and the position of the aiming beam 28 in the observation field again coincide. As shown in FIG. 17(d), when the positions of the indices on the spot spacing guide 90 and the position of the aiming beam 28 coincide and the position of the treatment target area coincide, the surgeon inputs an instruction to irradiate the treatment laser beam. Note that this embodiment is merely an example, and the moving direction of the spot spacing guide 90 may be reversed (guiding irradiation from the left end of the aiming beam 28 to the right in a counterclockwise direction).

[0147] As shown in FIG. 17(e), when the irradiation of the treatment laser beam is completed, the control unit 60 further moves the index of the spot spacing guide 90 by one appropriate interval of the irradiation spot in the direction opposite to the direction of advancement defined in the irradiation plan. The control unit 60 also moves the position of the next target index 90A by one appropriate interval of the irradiation spot in the direction of advancement defined in the irradiation plan. In the example shown in FIG. 17(e), the position of the next target index 90A coincides with the position of the second index from the end opposite the direction of advancement of the treatment among the multiple indexes on the spot spacing guide 90. The surgeon again aligns the positions of the multiple indexes on the spot spacing guide 90 with the position of the target index 28 in the observation field and inputs an instruction to irradiate the treatment laser beam (see FIG. 17(f)). The above procedure is repeated until irradiation of all of the multiple spots in one irradiation section with the treatment laser beam is completed. That is, the spot interval guide 90 assists the operator in repeatedly shifting the aiming position by one spot as illustrated in FIG. 9, thereby allowing the operator to grasp the intervals between a plurality of irradiation spots.

[0148] When irradiation of one irradiation zone with the treatment laser light (10 irradiations of the treatment laser light in the example shown in FIGS. 17 and 18) is completed, the state shown in FIG. 18(a) is reached. The control unit 60 automatically rotates the entire index of the spot spacing guide 90 in the direction of advancement by the angle of the irradiation zone. In the contact lens 26 used in this embodiment, the rotation base 26B rotates 36 degrees with one rotation (see FIG. 7). Therefore, the control unit 60 rotates the entire index of the spot spacing guide 90 by 36 degrees based on the irradiation plan. The control unit 60 also displays the next target index 90A at a position that overlaps with the index located at the end opposite to the treatment advancement direction defined in the irradiation plan. Furthermore, the control unit 60 designates all of the indexes of the spot spacing guide 90 other than the position overlapped by the next target index 90A as unirradiated indexes. The control unit 60 displays the multiple indices on the spot spacing guide 90 and the next target index 90A so that the next target index 90A corresponds to the position on the optical axis of the treatment laser light irradiated by the laser irradiation optical system 10. As a result, the observation image becomes as shown in FIG. 18(b). The surgeon rotates the reflective surface 27 of the contact lens 26 by a specified angle in the clockwise direction, which is the treatment progression direction, by operating the partially rotating contact lens 26 once (see FIG. 18(c)). As described above, the specified angle of the partially rotating contact lens 26 matches the angle by which the spot spacing guide 90 is rotated. Thereafter, irradiation of all of the multiple spots in the new irradiation section with the treatment laser light is repeated.

[0149] As described above, the spot spacing guide 90 is displayed to allow the user to understand the appropriate spacing between multiple irradiation spots to be irradiated with the treatment laser light. The spot spacing guide 90 is displayed on the internal display unit 50 according to the progress of the irradiation plan. Therefore, the surgeon can check the spot spacing guide 90 while observing the patient's eye E through the eyepiece 46 (i.e., without taking his / her eye away from the eyepiece 46) and adjust the multiple aim positions of the treatment laser light by referring to the spot spacing guide 90. Therefore, the surgeon can easily adjust the spacing between multiple irradiation spots to be irradiated with the treatment laser light to approximate the appropriate spacing.

[0150] As described above, in this embodiment, the center of the display area of ​​the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser beam, and the optical axis of the aiming beam are all aligned. Therefore, the internal display unit 50 can display the spot spacing guide 90 at an appropriate angle and in an appropriate direction centered on the optical axes of the treatment laser beam and the aiming beam. In other words, the surgeon visually recognizes the aiming beam at the center of the observation field and the center of the display area of ​​the internal display unit 50. This further facilitates adjustment of the irradiation position of the treatment laser beam based on the aiming beam and the display contents of the internal display unit 50.

[0151] The control unit 60 changes the spacing between the multiple indicators of the spot spacing guide 90 displayed on the internal display unit 50 in accordance with the magnification of the observation optical system 40. In other words, the control unit 60 increases the spacing between the indicators of the spot spacing guide 90 as the magnification of the observation optical system 40 increases. In this case, even if the observation magnification is changed, the spot spacing guide 90 corresponding to the appropriate spacing between the multiple irradiation spots (in this embodiment, corresponding to the five spacing indicators 28 that serve as a guide for the appropriate spacing between the multiple irradiation spots) is displayed on the internal display unit 50.

[0152] The control unit 60 matches the spacing of the multiple indicators on the spot spacing guide 90 to the spacing of the spacing indicators 28 on the contact lens 26 being used. Therefore, the surgeon can adjust the aiming position while referring to both the position and direction of the spacing indicators 28 observed through the observation optical system 40 and the position and direction of the spot spacing display unit 90 displayed on the internal display unit 50, thereby more appropriately adjusting the irradiation positions of the multiple treatment laser beams. As an example, in the fourth embodiment, the control unit 60 changes the display method of the spot spacing guide 90 (e.g., the spacing and number of the multiple indicators on the spot spacing guide 90, the rotation angle when rotating the spot spacing guide 90, etc.) based on information about the contact lens 26 being used. Therefore, an appropriate spot spacing guide 90 is displayed according to the spacing indicators 28 on the contact lens 26 being used, which facilitates smoother treatment.

[0153] As shown in FIGS. 17 and 18 , the spot spacing guide 90 includes a shape (in this embodiment, multiple linear indicators) that aligns with the appropriate reflection direction of the treatment laser light from the reflective surface 27 of the contact lens 26 toward the next irradiation spot. The control unit 60 determines the angle of the spot spacing guide 90 to be displayed on the internal display unit 50 in accordance with the progress of the irradiation plan and displays the spot spacing guide 90 at the determined angle. Therefore, the surgeon can easily adjust the rotation angle of the reflective surface 27 of the contact lens 26 by adjusting the reflection angle of the treatment laser light so that it is aligned with the direction indicated by the spot spacing guide 90. Furthermore, because the spot spacing guide 90 is displayed on the internal display unit 50 at an appropriate angle in accordance with the progress of the irradiation plan, the aiming position can be more appropriately adjusted. Furthermore, the surgeon can more easily adjust the rotation angle by adjusting the rotation angle of the reflective surface 27 of the contact lens 26 so that the spacing indicator 28 is positioned ahead of the direction indicated by the shape of the spot spacing guide 90.

[0154] 17 and 18, in addition to the multiple indices arranged at regular intervals on the spot spacing guide 90, the controller 60 displays a next targeting index 90A, which is used to align the position of the next irradiation spot at a position corresponding to the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10, in a manner different from the other indices. Each time treatment laser beam irradiation is performed, the controller 60 moves the position of the next targeting index 90A in the direction of travel defined by the irradiation plan by one appropriate interval between the multiple irradiation spots. Therefore, the surgeon can more easily adjust the next targeting position by aligning the position on the tissue to be irradiated with the next treatment laser beam, taking into account the next targeting index 90A, which indicates the position of the optical axis of the treatment laser beam (which also coincides with the optical axis of the aiming beam, if an aiming beam is irradiated).

[0155] Among the multiple indices on the spot spacing guide 90, the indices other than the next targeting indices 90A are either irradiated indices corresponding to at least a portion of a spot that has already been irradiated with the treatment laser light, or unirradiated indices corresponding to at least a portion of a spot that will be irradiated with the treatment laser light after the next time. The control unit 60 displays the next targeting indices 90A, the irradiated indices, and the unirradiated indices in different ways (i.e., in ways that can be distinguished by the surgeon). Therefore, the surgeon can easily grasp the positional relationship between the next targeting indices 90A, the irradiated indices, and the unirradiated indices, which makes it easier to proceed with treatment more smoothly.

[0156] 17, the control unit 60 moves the marks arranged at regular intervals (in this embodiment, at the same intervals as the interval marks 28 on the contact lens 26) on the spot spacing guide 90 by one appropriate interval between the irradiation spots in the direction opposite to the direction of travel defined in the irradiation plan each time the treatment laser beam is irradiated. The operator can adjust the aiming position more easily by adjusting the aiming position each time so that the positions of the marks that move each time the treatment laser beam is irradiated are constant positions on the observation image observed through the observation optical system 40 (in this embodiment, the positions of the marks on the spot spacing guide 90 coincide with the interval marks 28 on the observation image).

[0157] As described above, the shape of the treatment target area of ​​the patient's eye (the trabecular meshwork TM in FIGS. 17 and 18 ) to be irradiated with the treatment laser light is arc-shaped or annular. The control unit 60 rotates the entirety of the multiple indices arranged at regular intervals on the spot spacing guide 90. By rotating the entire indices on the spot spacing guide 90 to match the shape of the arc-shaped or annular treatment target area, the spot spacing guide 90 appropriately assists in adjusting the aiming position regardless of differences in the circumferential position of the irradiation spot.

[0158] Specifically, the control unit 60 rotates the spot spacing guide 90 in the treatment direction defined in the irradiation plan by matching the angle of each rotation of the spot spacing guide 90 with the angle of the irradiation zone (i.e., the angular range within which multiple irradiations of the treatment laser light based on the spot spacing guide 90 are possible with the angle of the spot spacing guide 90 fixed). As a result, treatment with the treatment laser light for each irradiation zone can be smoothly performed on the arc-shaped or annular treatment target area. In this embodiment, the rotation angle of the spot spacing guide 90 corresponding to the irradiation zone matches the specified angle through which the reflecting surface 27 of the partially rotatable contact lens 26 rotates in one operation.

[0159] The control unit 60 automatically moves the index of the spot spacing guide 90 by one appropriate spacing between the irradiation spots each time treatment laser light irradiation is performed until the treatment laser light irradiation to all of the spots in one irradiation section is completed. Furthermore, the control unit 60 automatically rotates the entire index of the spot spacing guide 90 in the direction of travel by the angle of the irradiation section each time treatment laser light irradiation to all of the spots in one irradiation section is completed. As a result, not only the treatment laser light irradiation within one irradiation section but also the treatment laser light irradiation to each of the irradiation sections is automatically and appropriately assisted according to the progress of the irradiation plan.

[0160] Furthermore, each time the control unit 60 rotates the multiple indices, it displays the next targeting index 90A at a position where it overlaps with an index located at the end opposite to the treatment progress direction defined in the irradiation plan (i.e., the position where the irradiation spot is first aimed after the index is rotated). As a result, the position of the next targeting index 90A is appropriately changed according to the progress of the irradiation plan, making it easier for the treatment to proceed more smoothly. Furthermore, each time the control unit 60 rotates the multiple indices, it sets all indices other than the position where the next targeting index 90A overlaps as non-irradiated indices.

[0161] The treatment control process in the fourth embodiment will be described with reference to Fig. 19. First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S61). The treatment plan acquired in S61 defines the specified angle of the partially rotational contact lens 26 to be used (i.e., the angle of one irradiation section), the number of times M the treatment laser light is irradiated within each irradiation section, the total number N of times the treatment laser light is irradiated onto the entire treatment target area, the irradiation spot to be first irradiated with the treatment laser light, the irradiation order of the treatment laser light (including the irradiation direction), etc. Note that information such as the specified angle of the contact lens 26 may be acquired based on information indicating the type of contact lens 26.

[0162] The control unit 60 displays the spot spacing guide 90 on the internal display unit 50 at an angle corresponding to the arrangement of the first irradiation zone (S62). The control unit 60 sets the value of a total irradiation number counter "n," which specifies the cumulative number of times the treatment laser light has been irradiated onto the entire treatment target area, to "0" (S63). Furthermore, the control unit 60 sets the value of an intra-zone irradiation number counter "m," which specifies the number of times the treatment laser light has been irradiated onto one irradiation zone, to "0" (S64). The control unit 60 sets the display position of a next targeting index 90A, which is the index for the next irradiation of the treatment laser light, among the multiple indexes on the spot spacing guide 90, to a position overlapping with the index located at the end opposite to the direction of progression of the irradiation order (S65).

[0163] The control unit 60 determines whether or not the operator has input an instruction to irradiate the treatment laser beam (S67). If the instruction has not been input (S67: NO), the determination in S67 is repeated. During this time, the operator adjusts the aim position of the treatment laser beam. If the instruction to irradiate the treatment laser beam has been input (S67: YES), the treatment laser beam is irradiated (S68).

[0164] The control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S69). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser beam to the entire treatment target area (S72). If irradiation of all irradiation spots with the treatment laser beam has not been completed (i.e., "n" has not reached "N") (S72: NO), the control unit 60 moves the entire spot spacing guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the direction of travel of the irradiation spots (S74). Note that in S74, control is also executed to move the next aiming index 90A by one appropriate interval. Thereafter, the process returns to S67.

[0165] When irradiation of one irradiation zone with the treatment laser light is completed (S73: YES), the control unit 60 rotates the spot spacing guide 90 by the specified angle of the internal rotation contact lens 26 (i.e., the angle of one irradiation zone) (S77). The control unit 60 resets the next targeting index 90A and the unirradiated index (S78), and the process returns to S64. When irradiation of all irradiation spots with the treatment laser light is completed (S72: YES), the process ends.

[0166] Fifth Embodiment 20 to 23, a treatment control process executed by the ophthalmic laser treatment device 1 of the fifth embodiment will be described. Unlike the third and fourth embodiments, the fifth embodiment illustrates a case where treatment is performed using a contact lens 26 that does not have a spacing index 28 and is not a partially rotational lens. However, at least a part of the technology illustrated in the fifth embodiment can also be applied to a case where treatment is performed using a contact lens 26 that has a spacing index 28. The adjustment pattern for the aim position of the treatment laser light executed in the fifth embodiment is a pattern (hereinafter referred to as a "movement adjustment pattern") in which the relative position of the ophthalmic laser treatment device 1 with respect to the subject's eye is mainly moved when adjusting the aim position for each of multiple irradiation spots included in one irradiation zone. However, in the movement adjustment pattern, in addition to moving the relative position of the ophthalmic laser treatment device 1 with respect to the subject's eye, the contact lens may also be rotated. The irradiation section in the fifth embodiment refers to the angular range of an arc-shaped area (fan-shaped area) within which the treatment laser beam is to be irradiated a specified number M (M≧2) of times (i.e., irradiation of each of a specified number of irradiation spots with the treatment laser beam) based on the spot spacing guide 90. In the fifth embodiment, the center of the display area on the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser beam, and the optical axis of the aiming beam all coincide at the center O. In other words, the surgeon visually recognizes the spot AI of the aiming beam at the center of the observation field and the center of the display area on the internal display unit 50. The treatment laser beam is irradiated onto the same spot as the spot AI of the aiming beam.

[0167] First, an example of the field of view observed by the surgeon during treatment using the ophthalmic laser treatment device 1 of the fifth embodiment will be described with reference to Fig. 20. As in the fourth embodiment, the ophthalmic laser treatment device 1 of the fifth embodiment also allows the surgeon to grasp the intervals between multiple irradiation spots by displaying a spot interval guide 90 on the internal display unit 50. The spot interval guide 90 indicates to the surgeon the appropriate intervals between multiple irradiation spots to be irradiated with treatment laser light.

[0168] 20, the ophthalmic laser treatment device 1 of the fifth embodiment matches the spacing of the multiple indicators included in the spot spacing guide 90 to the appropriate spacing between the multiple irradiation spots. Therefore, the surgeon can easily bring the spacing between the irradiation spots of the treatment laser light closer to the appropriate spacing by matching the moving distance when moving the aim position of the treatment laser light from the previous irradiation spot to the spacing of the multiple indicators included in the spot spacing guide 90. This makes it easier to perform treatment according to the treatment plan more appropriately.

[0169] The ophthalmic laser treatment device 1 of the fifth embodiment displays a spot spacing guide 90 in a display area of ​​the internal display unit 50 at a position (a position slightly above in FIG. 20 ) away from the aiming position of the treatment laser beam (the position where the aiming beam AI is projected in FIG. 20 ). The ophthalmic laser treatment device 1 displays the end of each of the multiple indices included in the spot spacing guide 90 that is closer to the aiming position of the treatment laser beam (the lower end of each of the multiple indices in FIG. 20 ) along a curve that approximates the curve of the arc-shaped or annular treatment site of the patient's eye E (the trabecular meshwork in this embodiment). In the fifth embodiment, the spot spacing guide 90 is displayed at a position different from the aiming position of the treatment laser beam (the position where the aiming beam AI is projected) (i.e., the spot spacing guide 90 does not overlap with the aiming position). This allows the surgeon to set the irradiation position of the treatment laser beam after properly understanding the condition of the tissue at the aiming position. Furthermore, by arranging the end of each of the multiple markers on the side of the target position along a curve (arc-shaped), when the spot spacing guide 90 is positioned appropriately for the next target position, the distance between the end of each of the multiple markers on the side of the target position (the lower end in FIG. 20 ) and the arc-shaped treatment area becomes closer. As a result, the surgeon can more easily adjust the next target position of the treatment laser light by referring to the spot spacing guide 90. Note that in the example shown in FIG. 20 , the spot spacing guide 90 is displayed on the opposite side of the iris from the treatment area (the trabecular meshwork in this embodiment). However, the spot spacing guide may also be displayed closer to the iris than the treatment area.

[0170] Although the shape of the curve of the arc-shaped treatment area of ​​the patient's eye E varies slightly depending on the patient's eye, it does not vary significantly from one patient's eye to another. Therefore, the target position side end of each of the multiple markers may be displayed along a predetermined curve based on the average shape of the treatment area. As an example, in this embodiment, an experiment is performed in advance to observe a portion of the eye model simulating the trabecular meshwork (simulated trabecular meshwork) under predetermined conditions. A program for displaying the target position side end of each of the multiple markers along the shape of the simulated trabecular meshwork observed in the experiment is stored in advance in the non-volatile memory 65. Details of the process for displaying the target position side end of each of the multiple markers will be described later.

[0171] As in the fourth embodiment, the ophthalmic laser treatment device 1 displays a next targeting index 90A on the spot spacing guide 90, at a position corresponding to the optical axis of the treatment laser beam, for aligning the position of the next irradiation spot. Each time treatment laser beam irradiation is performed, the ophthalmic laser treatment device 1 moves the multiple indices included in the spot spacing guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the treatment progression direction defined in the irradiation plan. The ophthalmic laser treatment device 1 also moves the position of the next targeting index 90A within the spot spacing guide 90 in the progression direction defined in the irradiation plan by one appropriate interval between the multiple irradiation spots. As a result, the position of the next targeting index 90A is maintained at a position corresponding to the target position. The surgeon can more easily adjust the next targeting position by aligning the position on the tissue to be irradiated with the next treatment laser beam, taking into account the position of the next targeting index 90A on the optical axis of the treatment laser beam (which also coincides with the optical axis of the aiming beam, when irradiating aiming beam).

[0172] Among the multiple indices on the spot spacing guide 90, the indices other than the next targeting indices 90A are either irradiated indices 90B corresponding to spots that have already been irradiated with the treatment laser light or unirradiated indices 90C corresponding to spots that will be irradiated with the treatment laser light after the next time. The ophthalmic laser treatment device 1 displays the next targeting indices 90A, irradiated indices 90B, and unirradiated indices 90C in different ways (i.e., in ways that can be distinguished by the surgeon). Therefore, the surgeon can easily grasp the positional relationship between the next targeting indices 90A, irradiated indices 90B, and unirradiated indices 90C, which makes it easier to proceed with treatment more smoothly.

[0173] The ophthalmic laser treatment device 1 moves the entire spot spacing guide 90 by one appropriate spacing between the multiple irradiation spots in the direction opposite to the direction of travel defined in the irradiation plan each time treatment laser light is irradiated. The surgeon can more easily adjust the aiming position by adjusting the target position each time treatment laser light is irradiated so that the positions of the multiple indicators, which move each time treatment laser light is irradiated, are consistent on the image observed through the observation optical system 40. As described above, the fifth embodiment illustrates a case in which treatment is performed using a contact lens that does not have the spacing indicator 28 and is not a partially rotating lens. Even in this case, the surgeon can appropriately adjust each of the multiple aiming positions by appropriately adjusting the positional relationship between the characteristic features present in the tissue included in the image and the multiple indicators on the spot spacing guide 90. For example, the operator can specify one characteristic site on the observation image, and each time the spot spacing guide 90 moves by one appropriate interval of the irradiation spot (that is, each time the treatment laser light is irradiated), issue a movement instruction to the device so that a specific index (for example, the leftmost index or the second index from the left) among the multiple indexes matches the specified characteristic site. In other words, if the spot spacing guide 90 includes multiple indexes, each of the multiple target positions can be appropriately adjusted by matching at least one of the multiple indexes (a specific index) with the characteristic site.

[0174] The ophthalmic laser treatment device 1 of the fifth embodiment displays any of the elements of each of the multiple indices included in the spot spacing guide 90 along a straight line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indices 90A, 90B, and 90C included in the spot spacing guide 90 along a virtual linear angle reference line AL (not actually displayed on the internal display unit 50). In this embodiment, the centers of gravity of each of the multiple indices are displayed along the angle reference line AL. The ophthalmic laser treatment device 1 moves the spot spacing guide 90 along the linear direction in which the multiple indices are arranged each time treatment laser light is irradiated. In this case, the surgeon can more appropriately proceed with treatment by aligning the direction in which the multiple indices are arranged with the movement direction in which the aim position of the treatment laser light is moved to the next irradiation spot. For example, the reflective surface of a contact lens may include an edge perpendicular to the direction extending outward from the central axis of the lens. In this case, the surgeon can move the aim position of the treatment laser light along the edge direction by aligning the edge direction of the contact lens shown in the observation image with the linear direction of the multiple index elements. Also, even if the contact lens that was in contact with the patient's eye is temporarily removed from the patient's eye, the surgeon can easily restore the position and orientation of the contact lens by aligning the edge direction of the contact lens shown in the observation image with the linear direction of the multiple index elements.

[0175] Specifically, in this embodiment, each of the multiple markers is perpendicular to the angle reference line AL, and the center (center of gravity) of each marker is located on the angle reference line AL. When the multiple markers of the spot spacing guide 90 are positioned appropriately relative to the next irradiation spot, each marker of the spot spacing guide 90 extends from the angle reference line AL to near the treatment site (trabecular meshwork) in this embodiment. As a result, the positional relationship between the spot spacing guide 90 and the treatment site (e.g., the positional relationship between a specific marker and a characteristic site in the tissue) can be more easily grasped. Furthermore, the length of each of the multiple markers of the spot spacing guide 90 is symmetrical about the angle reference line AL. This makes it easier for the surgeon to grasp the direction in which each element of the multiple markers is located (i.e., the direction in which the angle reference line AL extends), making it easier to adjust the angle of the reflective surface of the contact lens to an appropriate angle. For example, the angle of the reflective surface can be adjusted to an appropriate angle by adjusting the angle of the reflective surface of the contact lens so that the direction of the angle reference line AL is tangent to the annular or arc-shaped treatment site. The multiple indicators on the spot interval guide 90 do not have to extend from the angle reference line AL to the vicinity of the treatment area. The indicators displayed near the treatment area may have an appropriate width so as to absorb individual differences in the curve of the treatment area.

[0176] The ophthalmic laser treatment device 1 of the fifth embodiment displays an outer periphery guide 75 as an aiming guide on the internal display unit 50. The outer periphery guide 75 includes a next aiming guide 75A, an irradiation completion guide 75B, and an unirradiated guide 75C. The outer periphery guide 75 may have the same configuration as the outer periphery guide 75 exemplified in the first embodiment (see FIG. 10). Therefore, a detailed description of the outer periphery guide 75 will be omitted.

[0177] Furthermore, the ophthalmic laser treatment device 1 of the fifth embodiment displays the total number of irradiation spots defined in the irradiation plan. In the example shown in FIG. 20, the number in the denominator of "SHOTS" is the total number of irradiation spots. Also, the number of irradiation spots for which treatment has been completed (i.e., the total number of irradiation spots for which irradiation of the treatment laser light has been completed and the total number of irradiation spots for which irradiation has been skipped) is displayed. In the example shown in FIG. 20, the number in the numerator of "SHOTS" is the number of irradiation spots for which treatment has been completed. Each time irradiation of the treatment laser light or skipping of irradiation is performed, "1" is added to the number in the numerator of "SHOTS." Also, in the example shown in FIG. 20, the mode of the aiming light AI being used and the energy of the treatment laser light are also displayed.

[0178] The flow of treatment using the spot spacing guide 90 will be described using the examples shown in FIGS. 21 and 22. In FIGS. 21 and 22, to facilitate understanding of the transition of the display of the spot spacing guide 90, the portion of the surgeon's field of view other than the vicinity of the spot spacing guide 90 displayed on the internal display unit 50 is omitted. Note that FIGS. 21 and 22 show an example of clockwise irradiation of an actual trabecular meshwork region extending from the bottom (FIG. 21) to the diagonally lower left (FIG. 22) based on an irradiation plan preset by the surgeon. In FIGS. 21 and 22, the lower trabecular meshwork is reflected by the reflective surface of the contact lens and enters the surgeon's field of view. Therefore, in FIGS. 21 and 22, the image is upside down, and the lower trabecular meshwork is captured. When treatment of the irradiation spot progresses from right to left (i.e., counterclockwise) on the reflective surface in FIGS. 21 and 22, treatment of the irradiation spot progresses from right to left (i.e., clockwise) in the actual lower trabecular meshwork.

[0179] First, as shown in FIG. 21(a), the control unit 60 determines the angle of the spot spacing guide 90 to be displayed on the internal display unit 50 in accordance with the progress of the irradiation plan, and displays the spot spacing guide 90 at the determined angle. The spot spacing guide 90 shown in FIG. 21 is a guide for irradiating the lower region of the actual trabecular meshwork TM a specified number of times, 10 times (i.e., a maximum of 10 times). The indicators of the spot spacing guide 90 shown in FIG. 21(a) are arranged horizontally to treat the lower region of the trabecular meshwork TM. The control unit 60 identifiably displays a next target indicator 90A in the spot spacing guide 90, which is used to adjust the target position of the next treatment laser beam. In the example shown in FIG. 21(a), the control unit 60 first displays the next target indicator 90A at the position of the indicator located at the end opposite to the progress direction of treatment defined in the irradiation plan (the indicator located at the right end in FIG. 21(a)). Among the multiple indices on the spot spacing guide 90, the indices other than the one overlapping the next target index 90A are set as non-irradiation indices corresponding to at least a part of the spot to be irradiated with the treatment laser beam after the next time. Furthermore, the control unit 60 displays the multiple indices on the spot spacing guide 90 so that the next target index 90A corresponds to a position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. As described above, the position at which the next target index 90A is displayed does not need to completely coincide with the optical axis of the treatment laser beam. In other words, it is sufficient that the next target index 90A is displayed at a position corresponding to the target position of the treatment laser beam so that the surgeon can recognize the target position to be irradiated with the treatment laser beam.

[0180] The surgeon adjusts at least one of the rotation angle of the contact lens and the relative position between the patient's eye E and the laser irradiation optical system 10, which is changed using the joystick unit 5, so that the position of the next target index 90A included in the spot spacing guide 90 corresponds to the first irradiation spot of the treatment laser light at the treatment site of the patient's eye E (the trabecular meshwork in this embodiment). If a characteristic feature is present in the tissue of the patient's eye E included in the observation image, the surgeon preferably grasps the positional relationship between at least one of the multiple indices (specific indices) on the spot spacing guide 90 and the characteristic feature of the tissue. In this case, in the subsequent treatment procedure, the surgeon can smoothly proceed with treatment for each of the multiple irradiation spots by adjusting the positional relationship between the specific indices and the characteristic feature of the tissue to the same positional relationship. As shown in FIG. 21(b), the surgeon inputs an instruction to irradiate the treatment laser light while aligning the position of the next target index 90A with the position corresponding to the first irradiation spot of the treatment laser light at the treatment site of the patient's eye E (the trabecular meshwork in this embodiment). As a result, the treatment laser light is irradiated onto the spot S through which the optical axis of the laser irradiation optical system 10 passes.

[0181] As shown in FIG. 21(c), when the irradiation of the treatment laser beam is completed, the control unit 60 moves all the indices on the spot spacing guide 90 by one appropriate interval of the irradiation spot in the direction opposite (to the right in FIG. 21) the treatment progression direction (to the left, clockwise in FIG. 21) defined in the irradiation plan. The control unit 60 also moves the position of the next targeting index 90A by one appropriate interval of the irradiation spot in the progression direction defined in the irradiation plan. As a result, the position of the next targeting index 90A is maintained at a position corresponding to the target position. Furthermore, the control unit 60 changes the index on which the next targeting index 90A was superimposed during the previous irradiation of the treatment laser beam to an irradiated index. As shown in FIG. 21(d), the surgeon can adjust the aim position of the next treatment laser beam by mainly operating the joystick unit 5 to move the tissue shown in the observation image by the respective intervals of the multiple indices on the spot spacing guide 90 in the treatment progression direction defined in the irradiation plan. Furthermore, the surgeon can adjust the positional relationship between at least one of the multiple indices (a specific indices) and the characteristic part of the tissue to the same positional relationship as the previous time, thereby adjusting the aim position of the next treatment laser beam. Therefore, the aim position can be easily adjusted appropriately. The surgeon inputs an instruction to irradiate the treatment laser beam with the next aim index 90A aligned with the position corresponding to the aim position of the next treatment laser beam (the state shown in FIG. 21(d)).

[0182] As shown in FIG. 21(e), when irradiation of the second irradiation spot with the treatment laser light is completed, the control unit 60 further moves all of the indices on the spot spacing guide 90 by one appropriate interval between irradiation spots in the direction opposite to the direction of travel defined in the irradiation plan. The control unit 60 also moves the position of the next targeting index 90A by one appropriate interval between irradiation spots in the direction of travel defined in the irradiation plan. As a result, the position of the next targeting index 90A is maintained at a position corresponding to the target position. The surgeon inputs an instruction to irradiate with the treatment laser light while the position of the next targeting index 90A is aligned with the position corresponding to the next irradiation spot of the treatment laser light (the state shown in FIG. 21(f)). The above procedure is repeated until irradiation of all of the multiple spots (10 spots in the examples shown in FIGS. 21 and 22) within one irradiation section with the treatment laser light is completed. As described above, the irradiation section is an arc-shaped angular range in which the treatment laser light is to be irradiated a specified number of times M (M≧2, M=10 in this embodiment) based on the spot interval guide 90.

[0183] When one irradiation section has been irradiated with the treatment laser beam a specified number of times, M (10 times in the example shown in FIGS. 21 and 22), the state shown in FIG. 22(a) is reached. The control unit 60 automatically rotates the entire index of the spot spacing guide 90 in the direction of advancement by the angle of one irradiation section. The control unit 60 also displays a next target index 90A at a position that overlaps with an index located at the end opposite the treatment advancement direction defined in the irradiation plan. Furthermore, the control unit 60 sets all the indices of the spot spacing guide 90 other than the position overlapped by the next target index 90A as unirradiated indices. The control unit 60 also displays the indices of the spot spacing guide 90 and the next target index 90A so that the next target index 90A corresponds to the position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. As a result, the observed image is as shown in FIG. 22(b). The surgeon rotates the reflective surface of the contact lens clockwise, which is the direction of treatment (see FIG. 22(c)). As described above, irradiation of all of the multiple spots in the new irradiation section with the treatment laser light is then repeated.

[0184] The ophthalmic laser treatment device 1 of the fifth embodiment can also accept a user instruction to rotate the entire spot spacing guide 90 before the irradiation of all of the irradiation spots in the irradiation zone under treatment with the treatment laser light is completed (i.e., during treatment of the irradiation spots in the irradiation zone). When an instruction to rotate the entire spot spacing guide 90 is input before the treatment of all of the irradiation spots in the irradiation zone under treatment is completed, the ophthalmic laser treatment device 1 rotates the entire spot spacing guide 90 by an angle corresponding to the extent to which treatment has progressed in the irradiation zone under treatment. Therefore, even if the treatment in each irradiation zone has not been completed, the surgeon can move on to treatment in the next irradiation zone after rotating the entire spot spacing guide 90.

[0185] The ophthalmic laser treatment device 1 of the fifth embodiment also allows a user to input a skip instruction (hereinafter referred to as a "skip instruction") to skip irradiating the next irradiation spot defined in the irradiation plan with the treatment laser light. When the skip instruction is input, the ophthalmic laser treatment device 1 moves the spot spacing guide 90 in the direction of travel defined in the irradiation plan or in the direction opposite to the direction of travel by one appropriate spacing between the multiple irradiation spots without irradiating the treatment laser light. Therefore, by inputting a skip instruction when there is a non-irradiation spot where it is not appropriate to irradiate the treatment laser light, the surgeon can skip irradiating the non-irradiation spot with the treatment laser light and resume treatment from the next scheduled irradiation spot. This allows treatment to proceed more smoothly. In other words, the ophthalmic laser treatment device 1 includes a skip unit that skips the irradiation step of the treatment laser light on some of the multiple irradiation spots defined in the treatment plan. Therefore, it becomes easier to appropriately achieve both convenience through treatment planning (e.g., guiding the irradiation of treatment laser light) and flexible treatment using skip means (e.g., a procedure for omitting irradiation of treatment laser light to non-irradiated areas discovered after the start of treatment according to the treatment plan).

[0186] As described above, in the fifth embodiment as well, the spot spacing guide 90 for allowing the user to grasp the appropriate spacing between multiple irradiation spots is displayed on the internal display unit 50 according to the progress of the irradiation plan. Therefore, the surgeon can check the spot spacing guide 90 while observing the patient's eye E through the eyepiece 46 (i.e., without taking his / her eye away from the eyepiece 46) and adjust the multiple aiming positions of the treatment laser beam by referring to the spot spacing guide 90.

[0187] Furthermore, the control unit 60 changes the spacing between the multiple indicators of the spot spacing guide 90 displayed on the internal display unit 50 in accordance with the magnification of the observation optical system 40. Therefore, even if the observation magnification is changed, the spot spacing guide 90 corresponding to the appropriate spacing between the multiple irradiation spots is displayed on the internal display unit 50.

[0188] The treatment control process in the fifth embodiment will be described with reference to FIG. 23. First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S81). The treatment plan acquired in S81 defines the angle between two adjacent irradiation spots, the angle of one irradiation section, the number of times M the treatment laser light is irradiated within each irradiation section, the total number N of times the treatment laser light is irradiated onto the entire treatment target area, the irradiation spot to be first irradiated with the treatment laser light, the irradiation order (including the irradiation direction) of the treatment laser light, etc. Note that if the angular range of the annular or arc-shaped treatment target area is R degrees (R≦360) and the number of irradiation spots irradiating the treatment laser light onto the treatment target area is N, the angle between two adjacent irradiation spots is "R / N" degrees. Furthermore, if the range of R degrees in the annular or arc-shaped treatment target area is divided into S irradiation sections, the angle of one irradiation section is "R / S" degrees.

[0189] The control unit 60 displays the spot spacing guide 90 on the internal display unit 50 at an angle corresponding to the arrangement of the first irradiation zone (S82). The control unit 60 sets the value of a total irradiation number counter "n," which specifies the cumulative number of times the treatment laser light has been irradiated onto the entire treatment target area, to "0" (S83). Furthermore, the control unit 60 sets the value of an intra-zone irradiation number counter "m," which specifies the number of times the treatment laser light has been irradiated within one irradiation zone, to "0" (S84). The control unit 60 sets the display position of a next targeting index 90A, which is the index for the next irradiation of the treatment laser light, among the multiple indexes on the spot spacing guide 90, to a position overlapping with the index located at the end opposite to the direction of progression of the irradiation order (S85).

[0190] Here, an example of a method for displaying the end of each of the multiple indices included in the spot interval guide 90 on the side of the target position along a curve in S82 and S94 (described later) will be described. First, the control unit 60 sets the length (i.e., the length in the direction perpendicular to the angle reference line AL shown in FIG. 20) of the indices to be next irradiated with the treatment laser light (i.e., the next target indices 90A) to the shortest initial value. The control unit 60 sets the lengths (lengths in the direction perpendicular to the angle reference line AL) of the multiple indices other than the next target indices 90A so that the longer the distance between the next target indices and the next target indices 90A, the greater the increase in the length from the initial value set as the length of the next target indices 90A. The relationship between the distance between the next target indices 90A and the length of each indices may be predetermined so that the position of the end of each of the multiple indices on the side of the target position is arranged along the shape of the simulated trabecular meshwork observed through experiments. Alternatively, the length of each indices may be calculated so that the length of each indices increases from the initial value in proportion to the distance between the next target indices 90A and the next target indices 90A. When the lengths of all the indices have been set, each of the indices included in the spot interval guide 90 is displayed on the internal display unit 50 with the set length.

[0191] The control unit 60 determines whether an instruction to irradiate the treatment laser beam has been input by the operator (S87). If an instruction to irradiate the treatment laser beam has not been input (S87: NO), the control unit 60 determines whether an instruction to omit irradiation of the next irradiation spot defined in the irradiation plan (i.e., a "skip instruction") has been input (S88). If a skip instruction has not been input (S88: NO), the control unit 60 determines whether an instruction to rotate the entire spot spacing guide 90 (hereinafter referred to as an "intermediate rotation instruction") has been input before the irradiation of all the irradiation spots in the irradiation zone under treatment with the treatment laser beam is completed (S89). If no instruction has been input in S87 to S89, the determinations in S87 to S89 are repeated, and the system enters a standby state. During this time, the operator adjusts the aim position of the treatment laser beam.

[0192] When an instruction to irradiate the treatment laser beam is input (S87: YES), the treatment laser beam is irradiated (S90). The control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S91). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser beam to the entire treatment target area (S92). If the prescribed number of irradiations of the treatment laser beam (including skipped irradiations in this embodiment) have not been completed (i.e., "n" has not reached "N") (S92: NO), the control unit 60 determines whether the prescribed number of irradiations of the treatment laser beam to the irradiation section under treatment have been completed (i.e., whether the value of the intra-section irradiation number counter "m" has reached the number "M" of irradiations of the treatment laser beam to one irradiation section) (S93). If the irradiation of the treatment laser beam into the irradiation zone under treatment is not completed (S93: NO), the control unit 60 moves the entire spot spacing guide 90 by one appropriate spacing between the multiple irradiation spots in the direction opposite to the direction of travel of the irradiation spots (S94). Note that in S94, control is also executed to move the next aiming index 90A by one appropriate spacing. Then, the process returns to S87.

[0193] When irradiation of one irradiation zone with the treatment laser light is completed (S93: YES), the control unit 60 rotates the entire spot spacing guide 90 by the angle of one irradiation zone (prescribed angle) (S95). The control unit 60 resets the next targeting index 90A and the non-irradiated index (S98), and the process returns to S84. When irradiation of all irradiation spots with the treatment laser light is completed (S92: YES), the process ends.

[0194] Furthermore, if a skip instruction is input before an instruction to irradiate treatment laser light is input (S88: YES), the control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S91), and executes the processes of S92 to S95 and S98. That is, if irradiation of all irradiation spots with treatment laser light has not been completed ("n" has not reached "N") (S92: NO), the control unit 60 moves the entire spot spacing guide 90 by one appropriate spacing between the multiple irradiation spots in the direction of travel of the irradiation spots or in the direction opposite to the direction of travel without irradiating treatment laser light (S94). The direction in which the spot spacing guide 90 is moved may be determined according to an instruction input by the surgeon. Also, if "n" has reached "N" (S92: YES), the control unit 60 rotates the entire spot interval guide 90 by a specified angle (S95), and resets the next targeting index 90A and the unirradiated index (S98).

[0195] Furthermore, if a mid-treatment rotation instruction is input before an instruction to irradiate with the treatment laser beam is input (S89: YES), the control unit 60 calculates the angle corresponding to the extent of treatment progress within the irradiation zone under treatment as the angle by which to rotate the spot spacing guide 90 (S96). The specific calculation method for the rotation angle in S96 can be selected appropriately. For example, the angle between two adjacent irradiation spots as viewed from the center of a virtual circle through which the planned multiple irradiation spots pass is set to A degrees, and the number of irradiation spots through which treatment progressed within the irradiation zone under treatment is set to m (which corresponds to the value of the intra-zone irradiation number counter m in this embodiment). In this embodiment, the control unit 60 calculates the angle corresponding to the extent of treatment progress within the irradiation zone under treatment by "A degrees x m." The number of irradiation spots through which treatment progressed, "m," includes the number of irradiation spots for which irradiation with the treatment laser beam was skipped due to a skip instruction. The control unit 60 rotates the entire spot spacing guide 90 by the angle calculated in S96 in the treatment direction defined in the treatment plan (S97). If the number of irradiation spots where treatment has progressed, "m", is "0", the angle calculated in S96 will be "0 degrees", and the spot interval guide 90 will not be rotated in S97. Thereafter, a process for resetting the next targeting index 90A and the unirradiated index is performed (S98), and the process returns to S84.

[0196] Sixth Embodiment A treatment control process executed by the ophthalmic laser treatment device 1 of the sixth embodiment will be described with reference to FIGS. 20 and 24 to 27. In the sixth embodiment, as in the fifth embodiment, a case where treatment is performed using a contact lens 26 that does not have a spacing index 28 and is not a partially rotational lens will be described. However, at least a part of the technology exemplified in the sixth embodiment can also be applied to a case where treatment is performed using a contact lens 26 that has a spacing index 28. The adjustment pattern for the aim position of the treatment laser light executed in the sixth embodiment is a pattern in which the contact lens is mainly rotated when adjusting the aim position to each of multiple irradiation spots included in one irradiation zone (hereinafter referred to as a "rotation adjustment pattern"). However, in the rotation adjustment pattern, in addition to rotating the contact lens, the relative position of the ophthalmic laser treatment device 1 with respect to the subject's eye may also be moved. The irradiation zone in the sixth embodiment is an angular range of an arc-shaped area (a sector-shaped area) where irradiation of the treatment laser light (i.e., irradiation of each of the specified number of irradiation spots with the treatment laser light) is scheduled to be performed a specified number M (M≧2) of times based on the spot spacing guide 90. In the sixth embodiment, the center of the display area of ​​the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser beam, and the optical axis of the aiming beam all coincide at the center O. In other words, the surgeon visually recognizes the spot AI of the aiming beam at the center of the observation field and the center of the display area of ​​the internal display unit 50. The treatment laser beam is irradiated onto the same spot as the spot AI of the aiming beam.

[0197] The field of view of the surgeon during treatment using the ophthalmic laser treatment device 1 of the sixth embodiment is the same as the field of view of the fifth embodiment shown in FIG. 20. As shown in FIG. 20, the ophthalmic laser treatment device 1 of the sixth embodiment also displays a spot spacing guide 90 on the internal display unit 50, allowing the surgeon to understand the spacing between multiple irradiation spots. The ophthalmic laser treatment device 1 matches the spacing between multiple indicators included in the spot spacing guide 90 to the appropriate spacing between multiple irradiation spots. The ophthalmic laser treatment device 1 displays the spot spacing guide 90 in the display area of ​​the internal display unit 50 at a position (a position slightly above in FIG. 20) away from the aiming position of the treatment laser light (the position where the aiming light AI is projected in FIG. 20). The ophthalmic laser treatment device 1 displays the end of each of the multiple indices included in the spot interval guide 90 on the side of the aiming position of the treatment laser light (the lower end of each of the multiple indices in FIG. 20) along a curve that approximates the curve of the arc-shaped or ring-shaped treatment site (the trabecular meshwork in this embodiment) of the patient's eye E. The spot interval guide 90 is displayed at a position different from the aiming position of the treatment laser light (the position where the aiming light AI is projected).

[0198] As shown in FIG. 20 , the ophthalmic laser treatment device 1 of the sixth embodiment displays a next aiming index 90A, which is used to align the position of the next irradiation spot, at a position on the spot spacing guide 90 that corresponds to the optical axis of the treatment laser beam. The ophthalmic laser treatment device 1 moves and rotates the multiple indices included in the spot spacing guide 90 each time treatment laser beam irradiation is performed (details will be described later). Furthermore, the ophthalmic laser treatment device 1 moves the position of the next aiming index 90A within the spot spacing guide 90 by one appropriate interval between the multiple irradiation spots in the direction of travel defined by the irradiation plan. The surgeon can more easily adjust the next aiming position by aligning the position on the tissue to be irradiated with the next treatment laser beam, taking into account the position of the next aiming index 90A on the optical axis of the treatment laser beam.

[0199] Among the multiple indices on the spot interval guide 90, the indices other than the next targeting indices 90A are either irradiated indices 90B corresponding to spots that have already been irradiated with the treatment laser light or unirradiated indices 90C corresponding to spots that will be irradiated with the treatment laser light after the next time. The ophthalmic laser treatment device 1 displays each of the next targeting indices 90A, the irradiated indices 90B, and the unirradiated indices 90C in different ways (i.e., in ways that can be distinguished by the surgeon).

[0200] As shown in FIG. 20 , the ophthalmic laser treatment device 1 of the sixth embodiment displays any element of each of the multiple indices included in the spot spacing guide 90 along a straight line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indices 90A, 90B, and 90C included in the spot spacing guide 90 along a virtual linear angle reference line AL (not actually displayed on the internal display unit 50). In this embodiment, the centers of gravity of each of the multiple indices are displayed along the angle reference line AL. In this case, the surgeon can more appropriately proceed with treatment by aligning the direction in which the elements of the multiple indices are arranged with the direction in which the aim position of the treatment laser light is moved to the next aim position. Specifically, each of the multiple indices is perpendicular to the angle reference line AL, and the center (center of gravity) of each indice is located on the angle reference line AL. The lengths of each of the multiple indices of the spot spacing guide 90 are symmetrical with respect to the angle reference line AL. Therefore, the surgeon can easily grasp the direction in which each element of the multiple indicators is arranged (i.e., the direction in which the angle reference line AL extends), making it easier to adjust the angle of the reflective surface of the contact lens to an appropriate angle.

[0201] The ophthalmic laser treatment device 1 of the sixth embodiment displays an outer periphery guide 75 as an aiming guide on the internal display unit 50. The outer periphery guide 75 includes a next aiming guide 75A, an irradiation completion guide 75B, and an unirradiated guide 75C. The outer periphery guide 75 may have a configuration similar to that of the outer periphery guide 75 (see FIG. 10) exemplified in the first embodiment. The ophthalmic laser treatment device 1 of the sixth embodiment displays the total number of irradiation spots defined in the irradiation plan. The ophthalmic laser treatment device 1 also displays the number of irradiation spots for which treatment has been completed (i.e., the total number of irradiation spots for which irradiation with the treatment laser light has been completed and the total number of irradiation spots for which irradiation has been skipped). In the example shown in FIG. 20, the mode of the aiming light AI being used and the energy of the treatment laser light are also displayed.

[0202] The flow of treatment using the spot spacing guide 90 in the sixth embodiment will be described using the examples shown in FIGS. 24 to 26. In FIGS. 24 and 25, to facilitate understanding of the transition of the display of the spot spacing guide 90, the portion of the surgeon's field of view other than the vicinity of the spot spacing guide 90 displayed on the internal display unit 50 is omitted. Note that FIGS. 24 and 25 show an example in which, based on an irradiation plan preset by the surgeon, adjacent irradiation is performed clockwise on an actual trabecular meshwork region extending from the bottom (FIG. 24) to the diagonally lower left (FIG. 25). In FIGS. 24 and 25, the lower trabecular meshwork is reflected by the reflective surface of the contact lens and enters the surgeon's field of view. Therefore, in FIGS. 24 and 25, the image is upside down, and the lower trabecular meshwork is captured. When treatment for the irradiation spot progresses from right to left (i.e., counterclockwise) on the reflective surface in FIGS. 24 and 25, treatment for the irradiation spot progresses from right to left (i.e., clockwise) on the actual lower trabecular meshwork.

[0203] First, as shown in FIG. 24(a), the control unit 60 determines the angle of the spot spacing guide 90 to be displayed on the internal display unit 50 (more specifically, the angle at which the multiple indicators included in the spot spacing guide 90 are arranged) in accordance with the progress of the irradiation plan, and displays the spot spacing guide 90 at the determined angle. The spot spacing guide 90 shown in FIG. 24 is a guide for irradiating the region below the actual trabecular meshwork TM a specified number of times, 10 times (i.e., a maximum of 10 times). The multiple indicators of the spot spacing guide 90 shown in FIG. 24(a) are arranged in the horizontal direction to treat the region below the trabecular meshwork TM. That is, in the state shown in FIG. 24(a), the multiple indicators included in the spot spacing guide 90 are arranged along a first reference line R1 extending in the horizontal direction.

[0204] The control unit 60 identifiably displays a next targeting index 90A in the spot spacing guide 90 to align the targeting position of the next treatment laser beam. In the example shown in FIG. 24(a), the control unit 60 first displays the next targeting index 90A at the position of the index located at the opposite end of the spot spacing guide 90 relative to the treatment progress direction defined in the irradiation plan (the index located at the right end in FIG. 24(a)). The other indexes on the spot spacing guide 90, other than those overlapping with the next targeting index 90A, are designated as non-irradiated indexes corresponding to at least a part of the spot to be irradiated with the treatment laser beam after the next treatment. Furthermore, the control unit 60 displays the multiple indexes on the spot spacing guide 90 so that the next targeting index 90A corresponds to a position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. As described above, the position where the next targeting index 90A is displayed does not need to be perfectly aligned with the optical axis of the treatment laser beam. That is, the next aim index 90A may be displayed at a position corresponding to the aim position of the treatment laser beam so that the operator can recognize the aim position to be irradiated with the treatment laser beam.

[0205] The surgeon adjusts at least one of the rotation angle of the contact lens and the relative position between the patient's eye E and the laser irradiation optical system 10, which is changed using the joystick unit 5, so that the position of the next aiming index 90A included in the spot spacing guide 90 corresponds to the initial irradiation spot of the treatment laser light on the treatment site of the patient's eye E (the trabecular meshwork in this embodiment). As shown in FIG. 24(b), the surgeon inputs an instruction to irradiate the treatment laser light while aligning the position of the next aiming index 90A with the position corresponding to the initial irradiation spot of the treatment laser light on the treatment site of the patient's eye E (the trabecular meshwork in this embodiment). As a result, the treatment laser light is irradiated onto a spot S through which the optical axis of the laser irradiation optical system 10 passes. In the state shown in FIG. 24(b), the treatment laser light is reflected on the reflective surface of the contact lens to the right of the center in the figure.

[0206] As shown in FIG. 24(c), when the irradiation of the treatment laser beam is completed, the control unit 60 moves all the indices of the spot spacing guide 90 by one appropriate interval of the irradiation spot in the direction opposite to the treatment progression direction (clockwise, i.e., leftward in FIG. 24) defined in the irradiation plan. Furthermore, when the irradiation of the treatment laser beam is completed, the control unit 60 rotates all the indices of the spot spacing guide 90 by a unit angle T in the treatment progression direction (clockwise in FIG. 24) defined in the irradiation plan. The unit angle T is the rotation angle of the contact lens required to move the aim position of the treatment laser beam from the previous irradiation spot to the next irradiation spot. That is, the control unit 60 rotates the entire spot spacing guide 90, which was aligned along the reference line R1 in the state shown in FIGS. 24(a) and 24(b), by the reference angle to align it along the second reference line R2 (see FIGS. 24(c) and 24(d)). As a result, multiple irradiations of the treatment laser light within one irradiation zone, in which the irradiation position can be adjusted by rotating the contact lens, are appropriately assisted according to the progress of the irradiation plan.

[0207] The control unit 60 moves the position of the next targeting index 90A by one appropriate interval of the irradiation spot in the direction of travel defined by the irradiation plan. As a result, the position of the next targeting index 90A is maintained at a position corresponding to the target position. Furthermore, the control unit 60 changes the index on which the next targeting index 90A was superimposed during the previous irradiation of the treatment laser beam to an irradiated index. As shown in FIG. 24(d), the surgeon can adjust the targeting position of the treatment laser beam from the previous irradiation spot to the next irradiation spot by rotating the contact lens by the aforementioned reference angle. The surgeon can also adjust the targeting position of the next treatment laser beam by adjusting the positional relationship between at least one of the multiple targets (a specific target) and the characteristic part of the tissue to the same positional relationship as the previous time. This facilitates appropriate adjustment of the targeting position. The surgeon inputs an instruction to irradiate the treatment laser beam while the position of the next targeting index 90A is aligned with the targeting position of the next treatment laser beam (the state shown in FIG. 24(d)). In the state shown in Fig. 24(d), the treatment laser beam is reflected from a position on the reflective surface of the contact lens closer to the center than in the state shown in Fig. 24(b). In this embodiment, when the treatment laser beam is repeatedly irradiated within the same irradiation zone, the treatment laser beam is reflected from the right side of the reflective surface of the contact lens in the first half of the irradiation, and from the left side of the reflective surface in the second half of the irradiation. In other words, in this embodiment, the treatment laser beam is reflected from the vicinity of the center of the reflective surface of the contact lens equally on both sides.

[0208] As shown in FIG. 24(e), when the irradiation of the second irradiation spot with the treatment laser light is completed, the control unit 60 further moves all the indices of the spot spacing guide 90 by one appropriate interval of the irradiation spot in the direction opposite to the direction of advancement defined in the aiming plan. Furthermore, when the irradiation of the second irradiation spot with the treatment laser light is completed, the control unit 60 rotates all the indices of the spot spacing guide 90 by a unit angle T in the direction of advancement of the treatment defined in the irradiation plan. That is, the control unit 60 rotates the entire spot spacing guide 90, which was aligned along the reference line R2 in the state shown in FIGS. 24(c) and 24(d), by the reference angle to align it along the third reference line R3 (see FIGS. 24(e) and 24(f)). The control unit 60 moves the position of the next aiming index 90A by one appropriate interval of the irradiation spot in the direction of advancement defined in the aiming plan. As a result, the position of the next aiming index 90A is maintained at a position corresponding to the aiming position. The surgeon rotates the contact lens by a reference angle to align the position of the next targeting index 90A with the position corresponding to the next irradiation spot of the treatment laser light (see FIG. 24(f)). Then, the surgeon inputs an instruction to irradiate the treatment laser light. The above procedure is repeated until irradiation of all of the multiple spots (10 spots in the example shown in FIGS. 24 and 25) in one irradiation zone with the treatment laser light is completed. As described above, the irradiation zone is the angular range of an arc-shaped area where irradiation of the treatment laser light is scheduled to be performed a specified number of times M (M≧2, M=10 in this embodiment) based on the spot spacing guide 90.

[0209] Immediately before the first irradiation zone is irradiated with the treatment laser beam a specified number of times, M (10 times in the example shown in FIGS. 24 and 25), the observed image is as shown in FIG. 25(a). In the state shown in FIG. 25(a), the spot spacing guide 90 is rotated by a unit angle T×(M−1) degrees compared to before the first irradiation spot is irradiated with the treatment laser beam (see FIGS. 24(a) and 24(b)). That is, in the state shown in FIG. 25(a), the entire spot spacing guide 90 is aligned along the tenth reference line R10. When irradiation with the treatment laser beam is completed for all M irradiation spots in the first irradiation zone (i.e., when irradiation with the treatment laser beam is completed for the tenth irradiation spot), the control unit 60 rotates the entire spot spacing guide 90 in the direction of travel defined by the irradiation plan, thereby adjusting the overall angle of the spot spacing guide 90 to an angle corresponding to the first irradiation spot of the next irradiation zone. For example, assume that the range of R degrees (R≦360) in a ring-shaped or arc-shaped treatment area is divided into S irradiation zones, and each irradiation zone is irradiated with treatment laser light M times. During treatment in one irradiation zone, when M irradiations of treatment laser light are completed, the total rotation angle of the spot spacing guide 90 is (T×(M−1)) degrees, where T is the unit angle. The angular range of one irradiation zone is R / S degrees. Therefore, when irradiation of all of the irradiation spots in the irradiation zone under treatment with treatment laser light is completed, the control unit rotates the spot spacing guide 90 by (R / ST×(M−1)) degrees. As a result, in the state shown in FIGS. 25(b) and 25(c), the entire spot spacing guide 90 is aligned along the eleventh reference line R11. The control unit 60 also displays the next targeting indicator 90A at a position overlapping with the indicator located at the end opposite to the treatment progress direction defined in the irradiation plan. Furthermore, the control unit 60 sets all the indices of the spot interval guide 90 other than the position where the next targeting index 90A overlaps as non-irradiation indices. The control unit 60 displays the indices of the spot interval guide 90 and the next targeting index 90A so that the next targeting index 90A corresponds to the position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. As a result, the observation image becomes as shown in FIG. 25(b).The operator rotates the reflective surface of the contact lens and operates the joystick to move the position of the optical axis of the treatment laser beam, thereby aligning the target position of the treatment laser beam with the position of the next targeting index 90A (see Figure 25(c)). After that, irradiation of all of the multiple spots in the second irradiation section with the treatment laser beam is repeated.

[0210] The ophthalmic laser treatment device 1 of the sixth embodiment can also accept input of a user instruction to rotate the entire spot spacing guide 90 before the irradiation of all of the multiple irradiation spots in the irradiation zone under treatment with the treatment laser light is completed (i.e., during treatment of the irradiation spots in the irradiation zone). When an instruction to rotate the entire spot spacing guide 90 is input before the treatment of all of the multiple irradiation spots in the irradiation zone under treatment is completed, the ophthalmic laser treatment device 1 rotates the entire spot spacing guide 90 by an angle corresponding to the range of treatment progress within the irradiation zone under treatment.

[0211] Furthermore, the ophthalmic laser treatment device 1 of the sixth embodiment can also input a user instruction (hereinafter referred to as a "skip instruction") to skip irradiating the next irradiation spot defined in the irradiation plan with the treatment laser light. When a skip instruction is input, the ophthalmic laser treatment device 1 moves the spot spacing guide 90 by one appropriate spacing between the multiple irradiation spots in the direction of travel defined in the targeting plan or in the direction opposite to the direction of travel, without irradiating the next irradiation spot with the treatment laser light.

[0212] Referring to FIG. 26, the rotation angle (unit angle T) of the contact lens required to move the aim position of the treatment laser beam to the next irradiation spot when the relative position of the device with respect to the subject's eye (i.e., the optical axis of the treatment laser beam) is not moved will be described. In the example shown in FIG. 26, it is assumed that the treatment laser beam is irradiated N times (100 times in this embodiment) at equal intervals within a range of R degrees (360 degrees in this embodiment) on the annular or arc-shaped treatment target area (the trabecular meshwork TM in this embodiment). Also, it is assumed that a virtual approximate circle (i.e., a circle through which multiple planned irradiation spots S pass) passes through the annular or arc-shaped treatment target area. When the subject's eye is viewed in a direction along the visual axis (as shown in FIG. 26), if the treatment laser beam reflected by the reflective surface 27 of the contact lens always intersects with the center C of the approximate circle, the unit angle T is R / N degrees (3.6 degrees in this embodiment). In this case, when the eye to be examined is viewed in a direction along the visual axis, the radius of gyration of the treatment laser light coincides with the radius of the approximate circle (that is, the distance from the center C to the irradiation spot S).

[0213] However, when the aiming position is moved to the next irradiation spot by rotating the contact lens alone without moving the position of the device relative to the subject's eye, the treatment laser beam does not always intersect with the center C of the approximation circle when viewed from the direction of the visual axis of the patient's eye. That is, in the rotation adjustment pattern, the treatment laser beam is rotated around the reflection position RP on the reflective surface 27 of the contact lens. In fact, in the example shown in FIG. 26 , if the angle of the reflective surface 27 of the contact lens is set to the angle (indicated by 27A) for irradiating the first irradiation spot SA with the treatment laser beam, the treatment laser beam intersects with the center C of the approximation circle when viewed from the direction of the visual axis of the patient's eye. However, if the angle of the reflective surface 27 of the contact lens is set to the angle (indicated by 27B) for irradiating the second irradiation spot SB with the treatment laser beam, the treatment laser beam does not intersect with the center C of the approximation circle when viewed from the direction of the visual axis of the patient's eye. Furthermore, even when the angle of the reflecting surface 27 of the contact lens 27 is set to an angle (indicated by 27C) for irradiating the third irradiation spot SC with the treatment laser beam, the treatment laser beam does not intersect with the center C of the approximation circle when viewed from the direction of the visual axis of the patient's eye. As shown in Figure 26, when the angle of the reflecting surface 27 of the contact lens 27 is rotated while maintaining the position of the optical axis of the treatment laser beam, the treatment laser beam rotates around the reflection position RP on the reflecting surface 27.

[0214] 26, when the angle of the reflecting surface 27 of the contact lens 27 is rotated while maintaining the position of the optical axis of the treatment laser beam, the radius of rotation of the treatment laser beam (the distance from the reflection position RP to the irradiation spots SA, SB, and SC) becomes longer than the radius of the approximation circle (the distance from the center C to the irradiation spots SA, SB, and SC) when the subject's eye is viewed along the visual axis. As a result, the unit angle T in the rotation adjustment pattern when the subject's eye is viewed along the visual axis becomes smaller than R / N degrees. Therefore, the unit angle T in the rotation adjustment pattern may be set within a range smaller than R / N degrees depending on the radius of rotation of the treatment laser beam when viewed along the visual axis (i.e., the distance between the reflection position RP on the reflecting surface 27 of the contact lens and the irradiation spots SA, SB, and SC onto which the treatment laser beam is irradiated), etc.

[0215] The treatment control process in the sixth embodiment will be described with reference to Fig. 27. First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S101). The treatment plan acquired in S101 defines the angle between two adjacent irradiation spots, the angle of one irradiation section, the number of times M the treatment laser light is irradiated within each irradiation section, the total number N of times the treatment laser light is irradiated onto the entire treatment target area, the irradiation spot to be first irradiated with the treatment laser light, the irradiation order (including the irradiation direction) of the treatment laser light, etc.

[0216] The control unit 60 displays the spot spacing guide 90 on the internal display unit 50 at an angle corresponding to the arrangement of the first irradiation zone (S102). The control unit 60 sets the value of a total irradiation number counter “n,” which specifies the total number of times the treatment laser light has been irradiated onto the entire treatment target area, to “0” (S103). Furthermore, the control unit 60 sets the value of an intra-zone irradiation number counter “m,” which specifies the number of times the treatment laser light has been irradiated within one irradiation zone, to “0” (S104). The control unit 60 sets the display position of a next targeting indicator 90A, which is the indicator for the next irradiation of the treatment laser light, among the multiple indicators on the spot spacing guide 90, to a position overlapping with an indicator located at the end opposite the progression direction of the irradiation order (S105). The method for displaying the end of each of the multiple indicators included in the spot spacing guide 90 on the target position side along a curve can be the same as the method described in the fifth embodiment.

[0217] The control unit 60 determines whether an instruction to irradiate the treatment laser beam has been input by the operator (S107). If an instruction to irradiate the treatment laser beam has not been input (S107: NO), the control unit 60 determines whether an instruction to omit irradiation of the treatment laser beam to the next irradiation spot defined in the irradiation plan (i.e., a "skip instruction") has been input (S108). If a skip instruction has not been input (S108: NO), the control unit 60 determines whether an instruction to rotate the entire spot spacing guide 90 (hereinafter referred to as an "intermediate rotation instruction") has been input before the irradiation of all the irradiation spots in the irradiation zone under treatment with the treatment laser beam is completed (S109). If no instruction has been input in S107 to S109, the determinations in S107 to S109 are repeated, and the system enters a standby state. During this time, the operator adjusts the aim position of the treatment laser beam.

[0218] When an instruction to irradiate the treatment laser beam is input (S107: YES), the treatment laser beam is irradiated (S110). The control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S111). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser beam to the entire treatment target area (S112). If the prescribed number of irradiations of the treatment laser beam (including skipped irradiations in this embodiment) have not been completed (i.e., "n" has not reached "N") (S112: NO), the control unit 60 determines whether the prescribed number of irradiations of the treatment laser beam to the irradiation section under treatment have been completed (i.e., whether the value of the intra-section irradiation number counter "m" has reached the number "M" of irradiations of the treatment laser beam to one irradiation section) (S113). If the irradiation of the treatment laser beam into the irradiation zone under treatment is not complete (S113: NO), the control unit 60 moves the entire spot spacing guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the direction of travel of the irradiation spots. The control unit 60 also rotates the entire spot spacing guide 90 by the aforementioned unit angle T (S114). Note that in S114, control is also executed to move the next targeting indicator 90A by one appropriate interval. Then, the process returns to S107.

[0219] When irradiation of one irradiation zone with the treatment laser beam is completed (S113: YES), the control unit 60 rotates the entire spot spacing guide 90 to an angle corresponding to the next irradiation zone (S115). The control unit 60 resets the next targeting index 90A and the non-irradiated index (S118), and the process returns to S104. When irradiation of all irradiation spots with the treatment laser beam is completed (S112: YES), the process ends.

[0220] Furthermore, if a skip instruction is input before an instruction to perform treatment laser beam irradiation is input (S108: YES), the control unit 60 adds "1" to each of the values ​​of the total irradiation number counter "n" and the intra-section irradiation number counter "m" (S111) without irradiating the treatment laser beam, and executes the processes of S112 to S115 and S118. Furthermore, if an instruction to rotate mid-treatment is input before an instruction to perform treatment laser beam irradiation is input (S109: YES), the control unit 60 calculates an angle corresponding to the range of treatment progress within the irradiation section that was being treated as the angle by which to rotate the spot spacing guide 90 (S116). The specific calculation method of the rotation angle in S116 can be selected appropriately. For example, the angle between two adjacent irradiation spots as viewed from the center of a virtual circle through which the planned multiple irradiation spots pass is set to A degrees, the aforementioned unit angle is set to T degrees, and the number of irradiation spots that have progressed within the irradiation section that was being treated is set to m (which corresponds to the value of the intra-section irradiation number counter m in this embodiment). In this embodiment, the control unit 60 calculates the angle corresponding to the range of treatment progress within the irradiation zone that was being treated by "(A degrees - T degrees) x m." The number of irradiation spots where treatment progressed, "m," includes the number of irradiation spots where irradiation of the treatment laser light was skipped due to a skip instruction. The control unit 60 rotates the entire spot spacing guide 90 by the angle calculated in S116 in the progression direction defined in the treatment plan (S117). Thereafter, the next targeting index 90A and the unirradiated index are reset (S118), and the process returns to S104.

[0221] Seventh Embodiment An ophthalmic laser treatment device 1 according to a seventh embodiment will be described with reference to FIG. 28. The ophthalmic laser treatment device 1 according to the seventh embodiment includes a laser irradiation optical system 10 (see FIG. 2) and an overlay display unit. The overlay display unit displays a circumferential chart 100 (details of which will be described later) superimposed on an observation image including at least a portion of a ring-shaped or arc-shaped treatment target region (the trabecular meshwork TM in this embodiment) in a patient's eye. The overlay display unit according to the seventh embodiment uses the internal display unit 50 (see FIGS. 2 and 3) described in the first to sixth embodiments. However, a configuration other than the internal display unit 50 can also be used as the overlay display unit. For example, a transmissive electroluminescence (EL) panel (which may be organic or inorganic) may be used as the overlay display unit. Alternatively, the circumferential chart 100 may be formed on the surface of a glass plate by vapor deposition or the like, and the deposited portion may be illuminated with a separate light source, thereby superimposing the circumferential chart 100 in a predetermined color (e.g., green). It is more preferable that the circumferential direction chart 100 be lit (in other words, brightened) and presented to the surgeon. In this case, for example, even when the observation image is partially or entirely dark due to the observation conditions, the surgeon can easily understand the circumferential direction chart 100. The ophthalmic laser treatment device 1 may also include an observation and photography unit that captures an observation image of the patient's eye. The superimposition display unit (e.g., a monitor) may superimpose another image or the like on the observation image captured by the observation and photography unit. The superimposition display unit may have a simple configuration that does not allow the image to be superimposed on the observation image to be changed.

[0222] As shown in FIG. 28 , the superimposed display unit of the ophthalmic laser treatment device 1 of the seventh embodiment displays a circumferential direction chart 100, which indicates the circumferential angle around the optical axis O of the treatment laser beam, superimposed on the observation image. Therefore, by visually checking the circumferential direction chart 100 superimposed on the observation image, the surgeon can properly grasp the direction of the treatment target area with respect to the optical axis O of the treatment laser beam. For example, a contact lens may be temporarily removed from the patient's eye during treatment of multiple irradiation spots. In this case, the surgeon can properly grasp the direction of the spot irradiated with the treatment laser beam just before removing the contact lens (the circumferential angle around the optical axis O of the treatment laser beam) by referring to the circumferential direction chart. Therefore, when the removed contact lens is reattached to the patient's eye, the surgeon can adjust the angle of the contact lens while referring to the circumferential direction chart so that the aim position of the treatment laser beam is properly adjusted to the direction of the next spot. This allows the surgeon to easily and properly adjust the aim position of the treatment laser beam.

[0223] 28, the internal display unit aligns the center of an annular circumferential direction chart 100 superimposed on the observation image with the position of the optical axis O of the treatment laser beam in the observation image. Therefore, the circumferential direction chart 100 makes it easier to grasp the direction of the treatment site relative to the optical axis O of the treatment laser beam.

[0224] The circumferential direction chart 100 illustrated in FIG. 28 includes multiple indices arranged at equal angular intervals in the circumferential direction around the optical axis O of the treatment laser beam. Therefore, the multiple indices arranged at equal angular intervals allow the operator to more appropriately grasp the direction of the treatment target area. Specifically, the superimposed display unit of the seventh embodiment displays symbols (e.g., numbers up to 12) that can be displayed in at least one direction on the dial of an analog clock at appropriate positions on the circumferential direction chart 100 (at the 12, 3, 6, and 9 o'clock positions in the example illustrated in FIG. 28). That is, the circumferential direction chart 100 is displayed according to the clock position. Therefore, the operator can appropriately grasp the direction of the treatment target area with respect to the optical axis O of the treatment laser beam, in the same way as when the operator grasps the time on an analog clock. The specific form of the circumferential direction chart can be changed. For example, an index located to the right of the optical axis O of the treatment laser beam may be set to 0 degrees, and multiple indices (e.g., indexes in the form of angle values) may be displayed every 15 degrees counterclockwise. The shape of one or more indices may be different from the shape of the other indices. Some or all of the indices may be composed of letters (which may be numbers) only, or may be composed of a combination of letters and shapes. When letters are used as indices, the angular interval between the letters is preferably 15 degrees or more. Furthermore, multiple indices may be linked together. Multiple circumferential direction charts with different aspects may be stored in the storage device. In this case, the surgeon may be able to select a circumferential direction chart to be displayed on the superimposed display unit from the multiple circumferential direction charts.

[0225] The superimposed display unit displays the circumferential direction chart 100 at a fixed position within the display area of ​​the image. Therefore, regardless of the state of the observation image, the treatment plan, the cumulative number of irradiations of the treatment laser beam, etc., the circumferential direction chart 100 is fixed and displayed at a fixed position, making it easier to accurately grasp the direction of the treatment target area with the optical axis O of the treatment laser beam as the center. In the seventh embodiment, the relative positional relationship between the optical axis of the optical system that allows the surgeon to visually recognize the observation image and the optical axis O of the treatment laser beam is also fixed. In other words, the optical axis of the observation optical system and the optical axis O of the treatment laser beam always coincide with each other.

[0226] The superimposition display unit can switch between superimposing and hiding the circumferential direction chart 100 on the observation image. Therefore, when it is not necessary for the surgeon to grasp the direction of the treatment target area, the circumferential direction chart 100 is hidden, allowing the surgeon to concentrate on observing the observation image. In the seventh embodiment, the control unit 60 switches between displaying and hiding the circumferential direction chart 100 depending on whether the treatment mode set by the surgeon or the like is a treatment mode for performing treatment on a circular or arc-shaped treatment target area (hereinafter referred to as the "circumferential treatment mode"). Therefore, a field of view according to the set treatment mode is appropriately provided to the surgeon. Note that the control unit 60 may change the shape of the circumferential direction chart 100 based on whether the treatment mode selected by the surgeon is the circular treatment mode. For example, the control unit 60 may superimpose the circumferential direction chart 100 in the circular treatment mode, while superimposing a cross-shaped chart (e.g., a reticle for aiming) or the like in other treatment modes. Furthermore, the control unit 60 may switch between displaying the circumferential direction chart 100 illustrated in FIG. 28 and the outer periphery guide 75 illustrated in FIGS.

[0227] At least one of the embodiments disclosed above may be executed according to a set irradiation plan. As described above, the irradiation plan is formulated by setting at least one of the irradiation area, the number of irradiations, the type of contact lens to be used, and the method of adjusting the aiming position to adjacent irradiation spots (see FIG. 9). The control unit 60 may display on the internal display unit 50 based on the irradiation plan. For example, when the use of the contact lens of FIG. 6 is selected, the display control of the fourth embodiment may be performed. When a contact lens that can be rotated as a whole to adjust the angle of the reflective surface is used, the display control of the first or fifth embodiment may be performed. When a trigger signal is input, the control unit 60 irradiates the treatment laser light and changes the display on the internal display unit 50 based on the irradiation plan.

[0228] The embodiments disclosed herein are illustrative in all respects and should not be considered limiting. The scope of the present invention is defined by the claims, not by the above description, and is intended to include all modifications within the scope of the claims and their equivalents. For example, it is possible to employ only a part of the techniques described in each of the first to fifth embodiments. It is also possible to employ an appropriate combination of techniques from multiple different embodiments in an ophthalmic laser treatment device.

[0229] The configuration of the spot spacing guide in the fourth embodiment is merely an example. Therefore, the configuration of the spot spacing guide can be changed. In other words, if the surgeon is appropriately guided to adjust the observation site (e.g., by operating the joystick unit 5 and by rotating or moving the contact lens) so that the spot spacing guide displayed by the internal display unit 50 is positioned at a predetermined position in the observation image observed by the surgeon through the observation optical system 40 (e.g., a predetermined position relative to the reflected image 28Z of the spacing indicator 28 included in the observation image, or a predetermined position relative to the outline of a portion of the contact lens included in the observation image), the user can easily grasp the appropriate spacing between the multiple irradiation spots. The spot spacing guide may also be referred to as an alignment guide for aligning the target position with the desired portion of the trabecular meshwork TM.

[0230] FIG. 29 shows modified examples of the spot interval guide exemplified in the fourth embodiment. In FIGS. 29(a) to 29(e), the reflected images 28Z of the spacing indicators 28 (see FIG. 7) provided on the contact lens 26 are schematically shown by dotted lines. As shown in FIG. 29(a), the spot interval guide 901 may include multiple graphics having shapes corresponding to the multiple reflected images 28Z of the spacing indicators 28. As shown in FIG. 29(b), the spot interval guide 902 may include a graphic corresponding to the length from the left end to the right end of the reflected images 28Z of the spacing indicators 28. As shown in FIG. 29(c), the spot interval guide 903 may include a graphic having a shape that surrounds the entire multiple reflected images 28Z of the spacing indicators 28. As shown in FIG. 29(d), the spot interval guide 904 may be configured with two graphics that are aligned with the reflected images of the leftmost and rightmost indicators, respectively, of the multiple reflected images 28Z of the spacing indicators 28. As shown in Figure 29(e), the spot spacing guide 901 may be configured with a single graphic that is aligned with the reflection image of the middle index among multiple reflection images 28Z of the spacing index 28. As described above, the configuration of the spot spacing guide that is aligned with the reflection image 28Z of the spacing index 28 can be selected as appropriate. Also, as shown in Figure 29(f), the spot spacing guide may be aligned with a portion of the contact lens 26 included in the observation image instead of the reflection image 28Z of the spacing index 28. The spot spacing guide 906 shown in Figure 29(f) includes an arc-shaped graphic that is aligned with the arc-shaped contour of the contact lens 26 in the observation image.

[0231] The configurations of the spot interval guides in the fifth and sixth embodiments are also merely examples. FIG. 30 shows modified examples of the spot interval guides exemplified in the fifth and sixth embodiments. Each of the multiple indices of the spot interval guide 90 exemplified in the fifth and sixth embodiments has a rectangular shape extending in a direction perpendicular to the angle reference line AL (see FIG. 20). However, it is also possible to change the shape of each of the multiple indices included in the spot interval guide. For example, in the example shown in FIG. 30, each of the multiple indices included in the spot interval guide 91 (next targeting indices 91A, irradiated indices 91B, and unirradiated indices 91C) is circular. Note that line segments, regular polygons, stars, and other shapes may be displayed as the indices of the spot interval guide.

[0232] The spot spacing guide 91 shown in FIG. 30 also includes a frame 92 that surrounds multiple indicators. The frame 92 shown in FIG. 30 surrounds multiple indicators and extends in a direction along the angle reference line AL. Therefore, the surgeon can easily adjust the angle of the reflective surface of the contact lens to an appropriate angle based on the direction in which the frame 92 extends. Furthermore, in the example shown in FIG. 30 , at least some elements of the spot spacing guide 91 (in FIG. 30 , the end of the frame 92 on the aiming position side) are displayed along a curve that approximates the curve of the arc-shaped or ring-shaped treatment site (the trabecular meshwork TM in this embodiment) of the patient's eye E. As a result, when the spot spacing guide 91 is positioned appropriately for the next aiming position, the distance between the end of the frame 92 on the aiming position side and the arc-shaped treatment site is likely to be reduced. Therefore, by referring to the spot spacing guide 91, the surgeon can more easily adjust the next aiming position of the treatment laser beam more appropriately. [Explanation of symbols]

[0233] 1. Ophthalmic laser treatment device 6 Control Box 7 External display 10 Laser irradiation optical system 26 Contact lenses (partial rotational lenses) 26A Grip 26B Rotating base 27 Reflective surface 28 Interval index 40 Observation optical system 46 Eyepiece 50 Internal display 60 Control Unit 61 CPU 71A, 71B Target area guide 75 Outer periphery guide 75A Next Targeting Guide 75B Irradiation Completion Guide 75C Unirradiated Guide 75D Section Aiming Guide 80 Angle Guide 81 Schematic diagram of treatment area 82 Interval index schematic diagram 83 Spot placement guideline 88 Previous irradiation image 90,91 Spot Spacing Guide 90A, 91A Next target indicator 92 Frame 100 Circumferential Chart

Claims

1. An ophthalmic laser treatment device that irradiates the patient's eye tissue with therapeutic laser light each time an instruction to perform irradiation of therapeutic laser light is input, A laser irradiation optical system that irradiates the patient's eye with therapeutic laser light, An observation optical system that allows the operator to observe the patient's eye through an eyepiece, The observation optical system includes an internal display unit that displays an image to the operator via the eyepiece, Control unit and Equipped with, The control unit, A step of acquiring an irradiation plan, which determines the irradiation order of the therapeutic laser light to multiple irradiation spots to be irradiated with therapeutic laser light, when irradiating the patient's eye with therapeutic laser light using a contact lens having a reflective surface that reflects the therapeutic laser light in a direction intersecting the optical axis, A targeting guide display step, which displays a targeting guide on the internal display unit in accordance with the progress of the irradiation plan, to assist in adjusting the targeting position of the treatment laser beam, which is adjusted by the operator, to the appropriate position, An ophthalmic laser treatment device characterized by performing the following.

2. An ophthalmic laser treatment device according to claim 1, An ophthalmic laser treatment device characterized in that the center of the display area in the internal display unit coincides with the optical axis of the observation optical system.

3. An ophthalmic laser treatment device according to claim 1, The control unit, An ophthalmic laser treatment device characterized in that a target area guide, which serves as a reference for aligning the arc-shaped or annular treatment target area of ​​the patient's eye observed by the operator through the observation optical system, is displayed on the internal display unit as the aiming guide.

4. An ophthalmic laser treatment device according to claim 3, The control unit, An ophthalmic laser treatment device characterized by determining the angle of the target area guide to be displayed on the internal display unit according to the progress of the irradiation plan, and displaying the target area guide at the determined angle.

5. An ophthalmic laser treatment device according to claim 1, The control unit, An ophthalmic laser treatment device characterized in that an angle guide indicating the rotation angle of the reflective surface of the contact lens suitable for the progress of the irradiation plan is displayed on the internal display unit as the aiming guide.

6. An ophthalmic laser treatment device according to claim 5, The angle guide includes at least one of the following shapes: a shape that aligns with the appropriate angle of the arc-shaped or annular treatment area of ​​the patient's eye where the next irradiation spot is positioned, and a shape that aligns with the appropriate reflection direction of the treatment laser light to the next irradiation spot by the reflective surface of the contact lens. The control unit, An ophthalmic laser treatment device characterized by determining the angle of the angle guide to be displayed on the internal display unit according to the progress of the irradiation plan, and displaying the angle guide at the determined angle.

7. An ophthalmic laser treatment device according to claim 1, One type of contact lens is a partially rotating lens in which, with each operation by the user's finger, the portion including the reflective surface rotates by a predetermined angle relative to the gripping portion held by the user. The control unit, An ophthalmic laser treatment device characterized by further performing a rotation recommendation step, in accordance with the progress of the irradiation plan, which recommends to the operator that the reflective surface of the contact lens be rotated by the specified angle each time a predetermined number of irradiations of treatment laser light, which are to be performed within a single specified angle range, are completed.

8. An ophthalmic laser treatment device according to claim 1, The control unit, An ophthalmic laser treatment device characterized in that, along the outer periphery of the field of view observed by the operator via the observation optical system, an outer periphery guide indicating at least one of the rotation angle of the reflective surface of the contact lens suitable for the progress of the irradiation plan, and the direction of the irradiation spot to which the treatment laser light should be irradiated, is displayed on the internal display unit as a aiming guide.

Images