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 spot interval guide display step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan when treatment laser light is irradiated 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 spot interval guide display step, the control unit displays the spot interval guide indicating a proper interval of a plurality of irradiation spots to be irradiated with the treatment laser light on an internal display part according to the progress of the irradiation plan.SELECTED DRAWING: Figure 17

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] There have been proposed techniques for assisting in the treatment of a patient's eye with a treatment laser beam. 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 a region irradiated with the treatment laser beam (irradiated region) when the treatment laser beam is actually irradiated. The region to be irradiated and the irradiated region are displayed for the purpose of allowing the surgeon to check the progress of the treatment. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2014-233469 A Summary of the Invention [Problem to be solved by the invention]

[0004] When treating tissue of 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 that exists at the contact portion between the cornea and the iris of the eyeball. In this case, the surgeon must hold the contact lens and observe the tissue reflected on the reflective surface of the contact lens to adjust the aiming position of the therapeutic laser beam. Therefore, the surgeon must be skilled in order to accurately adjust the aiming position. Furthermore, when irradiating multiple locations of the tissue with the therapeutic laser beam, the expected therapeutic effect may not be obtained unless the interval between the irradiation spots where the therapeutic laser beam is irradiated is matched to the expected interval. Therefore, a technology capable of appropriately supporting the treatment with the 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 light 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 therapeutic laser light each time an instruction to execute irradiation of therapeutic laser light is input, and includes a laser irradiation optical system that irradiates the patient's eye with therapeutic laser light, an observation optical system that allows an surgeon 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 surgeon through the eyepiece, and a control unit, wherein the control unit executes an irradiation plan acquisition step of acquiring an irradiation plan for 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 with the optical axis, and a spot spacing guide display step of displaying a spot spacing guide indicative of an appropriate spacing between multiple irradiation spots to which the therapeutic laser light is to be irradiated, on the internal display unit according to progress of the irradiation plan.

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

[0008] [Figure 1] 1 is an external view of an ophthalmic laser treatment device 1. FIG. [Diagram 2] FIG. 2 is a side view of the optical system of the ophthalmic laser treatment device 1. [Diagram 3] FIG. 2 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. [Diagram 5] 2 is a diagram showing a schematic diagram of an example of an observation site 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 diagram showing a contact lens 26 provided with a spacing index 28, viewed from the side opposite to the side that comes into contact with a patient's eye E. [Figure 8] FIG. 2 is a diagram showing an example of an irradiation plan displayed on the control box 6. [Figure 9] 11 is an explanatory diagram for explaining a method for adjusting the aiming position of an irradiation spot. FIG. [Figure 10] 1 is a diagram showing an example of an observation field of an operator during treatment with 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] 13A to 13C are diagrams showing an example of a transition of an operator's observation field of view 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 an ophthalmic laser treatment apparatus 1 of a second embodiment. [Figure 14] FIG. 11 is a diagram showing an example of an observation field of an operator during treatment with 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] 13 is a flowchart of a treatment control process executed by an ophthalmic laser treatment apparatus 1 of a third embodiment. [Figure 17] 13 is a diagram showing an example of a transition of an operator's observation field of view during treatment with the ophthalmic laser treatment apparatus 1 of the fourth embodiment. FIG. [Figure 18] 13 is a diagram showing an example of a transition of an operator's observation field of view during treatment with the ophthalmic laser treatment apparatus 1 of the fourth embodiment. FIG. [Figure 19] 13 is a flowchart of a treatment control process executed by an ophthalmic laser treatment apparatus 1 of a fourth embodiment. [Figure 20] FIG. 13 is a diagram showing an example of an observation field of an operator during treatment with the ophthalmic laser treatment apparatus of the fifth embodiment. [Figure 21] FIG. 13 is a diagram showing an example of a transition of a part of an operator's observation field of view during treatment by the ophthalmic laser treatment apparatus 1 of the fifth embodiment. [Figure 22] FIG. 13 is a diagram showing an example of a transition of a part of an operator's observation field of view during treatment by the ophthalmic laser treatment apparatus 1 of the fifth embodiment. [Diagram 23] 13 is a flowchart of a treatment control process executed by an ophthalmic laser treatment apparatus 1 of a fifth embodiment. [Figure 24] FIG. 13 is a diagram showing an example of a transition of a part of the operator's observation field of view during treatment by the ophthalmic laser treatment apparatus 1 of the sixth embodiment. [Diagram 25] FIG. 13 is a diagram showing an example of a transition of a part of the operator's observation field of view during treatment by the ophthalmic laser treatment apparatus 1 of the sixth embodiment. [Figure 26] FIG. 23 is a diagram illustrating an example of a transition of the optical path of a treatment laser beam in the sixth embodiment. [Figure 27] 13 is a flowchart of a treatment control process executed by an ophthalmic laser treatment apparatus 1 of a sixth embodiment. [Figure 28] FIG. 13 is a diagram showing an example of an operator's observation field during treatment with the ophthalmic laser treatment apparatus 1 of the seventh embodiment. [Figure 29]13A and 13B are diagrams illustrating examples of changes in the spot interval guide. [Diagram 30] 13A to 13C are diagrams illustrating examples of modifications of the spot interval guide according to the fourth embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] <Summary> The ophthalmic laser treatment device exemplified in the present disclosure irradiates the tissue of the patient's eye with the treatment laser light every time an instruction to irradiate the 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 the treatment laser light. The observation optical system allows the surgeon to observe an observation 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 operations of the ophthalmic laser treatment device. The control unit executes an irradiation plan acquisition step and a spot interval guide display step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan for irradiating the patient's eye with the 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. In the spot interval guide display step, the control unit causes the internal display unit to display a spot interval guide indicating an appropriate interval between a plurality of irradiation spots to be irradiated with the treatment laser light according to the progress of the irradiation plan.

[0010] According to the ophthalmic laser treatment device of the present disclosure, a spot spacing guide showing the appropriate spacing between multiple irradiation spots is displayed on the internal display unit according to the progress of the irradiation plan. Therefore, the surgeon can check the spot spacing guide while observing the patient's eye through the eyepiece (i.e., without taking his / her eye away from the eyepiece), and adjust the multiple aiming positions of the treatment laser light by referring to the spot spacing guide. Therefore, the surgeon can easily bring the spacing between the irradiation spots irradiated with the treatment laser light closer to the appropriate spacing.

[0011] In addition, when a treatment method that allows the treatment scar by the treatment laser light to be observed is adopted, the surgeon can adjust the target position of the treatment laser light from the next time onward after checking the position of the treatment scar formed by the irradiation of the treatment laser light from the previous time onward. However, there are also cases where a treatment method that makes it difficult to check the treatment scar by the treatment laser light (for example, a treatment method performed under a condition where the output of the treatment laser light is set to an output lower than the output at which the treatment scar is formed) is adopted. In this case, it becomes even more difficult to make the interval between the irradiation spots irradiated with the treatment laser light closer to the appropriate interval. However, by adjusting the multiple target positions with reference to the spot interval guide, the surgeon can more accurately adjust the interval between the irradiation spots even when it is difficult to check the treatment scar by the treatment laser light. However, the technology disclosed herein is also very useful when the treatment scar by the treatment laser light 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 light irradiated by the laser irradiating 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 light. Furthermore, when the laser irradiating optical system irradiates the patient's eye with an aiming laser light (hereinafter, also referred to as "aiming light") for allowing the surgeon to recognize the planned irradiation position of the treatment laser light, the optical axis of the aiming laser light may also coincide with the optical axis of the observation optical system. In this case, the surgeon visually recognizes the aiming light at the center of the observation field and the display area of ​​the internal display unit, so that it becomes even easier to adjust the irradiation position of the treatment laser light based on the aiming light and the display content.

[0014] The control unit may change the overall size of the spot spacing guide displayed on the internal display unit according to the magnification of the observation optical system. In other words, the control unit may increase the size of the spot spacing guide as the magnification of the observation optical system increases. In this case, even if the observation magnification is changed, a spot spacing guide of a size suitable for setting the spacing between the multiple irradiation spots to an appropriate interval is displayed on the internal display unit.

[0015] A part of the contact lens (e.g., the inner wall, etc.) may be provided with a plurality of interval indicators (sometimes called "indexes") arranged at regular intervals to serve as a guide for the intervals of the spots to be irradiated with the treatment laser light. The control unit may match the intervals of at least some of the indicators included in the spot interval guide to the intervals of the interval indicators on the contact lens. In this case, the surgeon can adjust the aiming position while referring to both the position and direction of the interval indicators observed through the observation optical system and the position and direction of the spot interval guide displayed on the internal display unit, thereby making it easier to more appropriately adjust the irradiation positions of the plurality of treatment laser lights.

[0016] The manner of the spacing indicators provided on the contact lenses (e.g., the spacing and number of spacing indicators, etc.) may differ depending on the type of contact lens. Therefore, the control unit may change the display method of the spot spacing guide (e.g., the spacing and number of multiple indicators in the spot spacing guide, etc.) based on information about the contact lens being used. In this case, an appropriate spot spacing guide is displayed according to the spacing indicators of the contact lens being used, making it easier for treatment to proceed more smoothly.

[0017] The control unit may cause at least some of the intervals of the multiple indicators included in the spot interval guide to coincide with the appropriate intervals of the multiple irradiation spots. In this case, the operator can easily bring the intervals of the irradiation spots of the treatment laser light closer to the appropriate intervals by causing the operator to cause the moving distance when moving the aim position of the treatment laser light from the previous aim position to the next aim position to coincide with the intervals of the multiple indicators included in the spot interval guide. This makes it easier to perform treatment according to the treatment plan more appropriately.

[0018] The spot spacing guide may include a shape that is aligned with an appropriate reflection direction of the treatment laser light to the next irradiation spot by the reflective surface of the contact lens. The control unit may determine the angle of the spot spacing guide to be displayed on the internal display unit according to the progress of the irradiation plan, and display the spot spacing guide at the determined angle. In this case, the surgeon can easily adjust the rotation angle of the reflective surface of the contact lens by adjusting the reflection angle of the treatment laser light so that it is aligned with the direction indicated by the spot spacing guide. Furthermore, since the spot spacing guide is displayed on the internal display unit at an appropriate angle according to the progress of the irradiation plan, it becomes easier to adjust the aiming position more appropriately.

[0019] Furthermore, if the contact lens is provided with a spacing index, the surgeon can more easily adjust the rotation angle by adjusting the rotation angle of the reflective surface of the contact lens so that the spacing index is positioned at the end of the direction indicated by the shape of the spot spacing guide.

[0020] The control unit may display a spot interval guide in a display area in the internal display unit at a position away from the aim position of the treatment laser light. The control unit may display the end of each of the multiple indices included in the spot interval guide on the aim position side of the treatment laser light along a curve that approximates the curve of the treatment site of the patient's eye, which is an arc shape. In this case, the spot interval guide is displayed at a position different from the aim position of the treatment laser light (i.e., the spot interval guide does not overlap with the aim position), so that the surgeon can set the position to which the treatment laser light is irradiated after appropriately grasping the state of the tissue at the aim position. Furthermore, by arranging the end of each of the multiple indices on the aim position side along a curve (arc shape), the distance between the end of each of the multiple indices on the aim position side and the arc shape treatment site becomes closer when the spot interval guide is arranged at an appropriate position with respect to the next aim position. As a result, the surgeon can more appropriately adjust the next aim position of the treatment laser light by referring to the spot interval guide.

[0021] The shape of the curve of the arc-shaped treatment area of ​​the patient's eye varies slightly from patient to patient, but does not vary significantly from patient to patient. Therefore, the end of each of the multiple indices on the side of the aiming position may be displayed along a curve that is predetermined based on the average shape of the treatment area.

[0022] The control unit may display a next aiming index for aligning the position of the next irradiation spot at a position in the spot interval guide that corresponds to the optical axis of the treatment laser light irradiated by the laser irradiation optical system. The control unit may move the position of the next aiming index in the spot interval guide by one appropriate interval of the multiple irradiation spots in the moving direction determined in the irradiation plan every time the treatment laser light is irradiated. In this case, the surgeon can adjust the next aiming position more easily by aligning the position on the tissue to be irradiated with the next treatment laser light, taking into account the position of the next aiming index on the optical axis of the treatment laser light (which also coincides with the optical axis of the aiming light when the aiming light is irradiated).

[0023] Among the multiple indices in the spot interval guide, the indices other than the next targeting indices are either irradiated indices corresponding to spots that have already been irradiated with the treatment laser light or unirradiated indices corresponding to spots that will be irradiated with the treatment laser light after the next time. The control unit may display the next targeting indices, the irradiated indices, and the unirradiated indices in different ways (i.e., ways that can be distinguished by the surgeon). In this case, the surgeon can easily grasp the positional relationship between the next targeting indices, the irradiated indices, and the unirradiated indices, which makes it easier to proceed with the treatment more smoothly.

[0024] The control unit may move the spot interval guide by one appropriate interval between the plurality of irradiation spots in the direction opposite to the moving direction determined in the irradiation plan every time the treatment laser beam is irradiated. In this case, the operator can adjust the aiming position every time so that the positions of the plurality of indicators that move every time the treatment laser beam is irradiated are constant positions on the observation image observed through the observation optical system, thereby making it easier to adjust the aiming position.

[0025] In addition, when the contact lens is provided with a spacing index, the surgeon can adjust each of the multiple target positions more easily by appropriately adjusting the positional relationship between the spacing index included in the observation image and the multiple indices of the spot spacing guide that move every time the irradiation of the treatment laser light is performed. Even if the contact lens is not provided with a spacing index, the surgeon can appropriately adjust each of the multiple target positions by appropriately adjusting the positional relationship between the characteristic part present in the tissue included in the observation image and the multiple indices of the spot spacing guide. For example, the surgeon can specify one characteristic part on the observation image, and execute at least one of a movement instruction to the device and a rotation operation of the contact lens so that a specific index (e.g., the leftmost index or the second index from the left, etc.) of the multiple indices matches the specified characteristic part every time the spot spacing guide moves by one appropriate interval of the irradiation spot (that is, every time the irradiation of the treatment laser light is performed). In other words, if the spot spacing guide includes multiple indices, each of the multiple target positions is appropriately adjusted by matching at least one of the multiple indices (that is, the above-mentioned specific index) with the characteristic part. When the position of the device relative to the subject's eye moves, the position of the optical axis of the treatment laser light moves, and the aim position of the treatment laser light also moves. When the contact lens is rotated, the angle of the reflecting surface of the contact lens changes, and the aim position of the treatment laser light also moves. In other words, in order for the operator to move the aim position of the treatment laser light, it is sufficient to at least either move the position of the device relative to the subject's eye or rotate the contact lens.

[0026] The control unit may display at least some of the elements of the multiple indices included in the spot interval guide aligned along a straight line. For example, the control unit may display the centers of gravity of the multiple indices included in the spot interval guide aligned along a straight line. The control unit may also display the ends of the multiple indices included in the spot interval guide opposite to the target position of the treatment laser light aligned along a straight line. The control unit may move the spot interval guide along the linear direction in which at least some of the elements of the multiple indices are aligned every time the treatment laser light is irradiated. In this case, the operator can proceed with the treatment more appropriately by matching the direction in which the elements of the multiple indices are aligned with the moving direction in which the target position of the treatment laser light is moved to the next target position. For example, the reflecting surface of the contact lens may include an edge perpendicular to the direction extending outward from the central axis of the lens. In this case, the operator can move the target position of the treatment laser light along the direction of the edge by matching the direction of the edge of the contact lens shown in the observation image with the linear direction in which the elements of the multiple indices are aligned. In addition, even if the contact lens that was in contact with the patient's eye is suddenly removed from the patient's eye, the surgeon can easily restore the position and orientation of the contact lens by aligning the direction of the edge of the contact lens shown in the observation image with the linear direction in which the multiple index elements are arranged.

[0027] When an instruction to omit irradiation of the treatment laser light to the next irradiation spot defined in the irradiation plan (hereinafter referred to as a "skip instruction") is input, the control unit may move the spot interval guide by one appropriate interval of the multiple irradiation spots in the moving direction defined in the irradiation plan or in the opposite direction to the moving direction. For example, when there is a non-irradiated area where it is not appropriate to irradiate the treatment laser light, the operator can input a skip instruction to skip irradiation of the treatment laser light to the non-irradiated area and resume treatment from the next scheduled irradiation spot. This makes it easier to proceed with the treatment more smoothly.

[0028] The shape of the treatment target part of the patient's eye to be irradiated with the treatment laser light may be arc-shaped or annular. The control unit may rotate the entire spot spacing guide. In this case, the entire spot spacing guide is rotated to match the shape of the treatment target part, which is arc-shaped or annular, so that the spot spacing guide appropriately assists in adjusting the aiming position regardless of the difference in the circumferential position of the irradiation spot.

[0029] The angular range of an arc-shaped region where the treatment laser light is to be irradiated a specified number M (M≧2) of times based on the spot spacing guide (i.e., irradiation of each of the specified number of irradiation spots with the treatment laser light) is to be performed is defined as an irradiation section. The control unit may rotate the spot spacing guide in the treatment progress direction determined by the irradiation plan by matching the rotation angle of the spot spacing guide with the angle of the irradiation section. In this case, treatment with the treatment laser light for each irradiation section can be smoothly performed on the arc-shaped or annular treatment target site.

[0030] The control unit may rotate the spot interval guide in the traveling direction determined by the irradiation plan every time the treatment laser light is irradiated. Assume that the treatment laser light is irradiated to each of N equally spaced irradiation spots within a range of R degrees (R≦360) on a ring-shaped or arc-shaped treatment target site. In this case, the angle by which the spot interval guide is rotated every time the treatment laser light is irradiated may be R / N degrees. Also, the angle by which the spot interval guide is rotated every time the treatment laser light is irradiated may be a rotation angle (unit angle T) of the contact lens required to move the aim position of the treatment laser light to the next irradiation spot. In this case, the operator can appropriately move the aim position of the treatment laser light to the next irradiation spot by simply rotating the contact lens by a unit angle without adjusting the position of the optical axis of the treatment laser light, as long as the optical path of the treatment laser light does not deviate from the plane of the reflecting surface of the contact lens. Note that the unit angle T is smaller than R / N degrees. This will be described in detail later.

[0031] Hereinafter, a pattern in which the relative position of the device with respect to the subject's eye is moved when adjusting the aim position of each of a plurality of irradiation spots included in one irradiation zone (hereinafter referred to as a "movement adjustment pattern") will be mainly described.

[0032] In the movement adjustment pattern, if the irradiation of all of the irradiation spots in the irradiation section under treatment is not completed, the control unit may move the spot interval guide by one appropriate interval of the irradiation spots in the direction opposite to the moving direction defined in the irradiation plan every time the irradiation of the treatment laser light is performed. In this case, the control unit may execute only the process of moving the spot interval guide in parallel without rotating the irradiation spots. The control unit may rotate the entire spot interval guide by the angle of one irradiation section in the moving direction defined in the irradiation plan every time the irradiation of all of the irradiation spots in the irradiation section under treatment is completed. In this case, the irradiation of the treatment laser light multiple times in one irradiation section, the irradiation position of which can be adjusted only by moving the device, is appropriately assisted according to the progress of the irradiation plan. Furthermore, the irradiation of the treatment laser light to each of the irradiation sections is automatically and appropriately assisted according to the progress of the irradiation plan.

[0033] The angle of the irradiation section can be appropriately selected. For example, assume that the range of R degree (R≦360) in a ring-shaped or arc-shaped treatment target part (e.g., trabecular meshwork, etc.) is divided into S irradiation sections, and the aim position is adjusted in each irradiation section by the movement adjustment pattern. In this case, the control unit may rotate the entire spot interval guide by the angle of one irradiation section (i.e., R / S degree) in the traveling direction determined by the irradiation plan every time the irradiation of the treatment laser light to all of the multiple irradiation spots in the irradiation section under treatment is completed. As a result, the irradiation of the treatment laser light is appropriately assisted in each of the multiple irradiation sections. Note that, in the movement adjustment pattern, each irradiation section has an angle range in which the treatment laser light can be irradiated a specified number of times (multiple times) based on the spot interval guide with the angle of the spot interval guide fixed.

[0034] In addition, the control unit may not move the spot spacing guide by one appropriate interval when irradiating the treatment laser light, but may only rotate the entire spot spacing guide by the angle of one irradiation section when irradiation of the treatment laser light to all of the multiple irradiation spots in the irradiation section under treatment is completed.

[0035] Next, a description will be given of a pattern in which the surgeon mainly performs a rotation operation of the contact lens when adjusting the aiming position of each of the multiple irradiation spots contained in one irradiation section (hereinafter referred to as a "rotation adjustment pattern").

[0036] In the rotation adjustment pattern, if the irradiation of all of the irradiation spots in the irradiation section under treatment is not completed, the control unit may move the spot interval guide by one appropriate interval of the irradiation spots in the direction opposite to the moving direction defined in the irradiation plan each time the irradiation of the treatment laser light is performed. Furthermore, the control unit may rotate the contact lens by a rotation angle (hereinafter referred to as a "unit angle") required to move the aim position of the treatment laser light to the next irradiation spot in the moving direction defined in the irradiation plan each time the irradiation of the treatment laser light is performed. In this case, the irradiation of the treatment laser light multiple times in one irradiation section, the irradiation position of which can be adjusted by the rotation operation of the contact lens, is appropriately assisted according to the progress of the irradiation plan. Furthermore, the control unit may adjust the overall angle of the spot interval guide to an angle corresponding to the next irradiation section (i.e., for the next irradiation section) by rotating the entire spot interval guide in the moving direction defined in the irradiation plan each time the irradiation of all of the irradiation spots in the irradiation section under treatment is completed. In this case, the irradiation of each of the multiple irradiation zones with the treatment laser light is also automatically and appropriately assisted in accordance with the progress of the irradiation plan.

[0037] When irradiation of all of the irradiation spots in the irradiation section under treatment with the treatment laser light has not been completed, the control unit may rotate the spot interval guide by a unit angle and execute only the process without moving the spot interval guide by one appropriate interval of the irradiation spots each time irradiation of the treatment laser light is executed. Even in this case, the operator can easily adjust the aiming position to the next irradiation spot by rotating the contact lens.

[0038] In addition, the rotation angle (unit angle) of the contact lens required to move the target position of the treatment laser light to the next irradiation spot when the relative position of the device with respect to the subject's eye is not moved varies depending on various conditions. Here, it is assumed that the treatment laser light is irradiated N times at equal intervals within a range of R degrees (R≦360) on the ring-shaped or arc-shaped treatment target area. Also, it is assumed that a virtual approximation circle (i.e., a circle through which a plurality of planned irradiation spots pass) that passes through the ring-shaped or arc-shaped treatment target area is assumed. If the treatment laser light reflected by the reflecting surface of the contact lens always intersects with the center of the approximation circle when the subject's eye is viewed in a direction along the visual axis, the unit angle is R / N degrees. In this case, when the subject's eye is viewed in a direction along the visual axis, the turning radius of the treatment laser light coincides with the radius of the approximation circle.

[0039] However, when the target position is moved to the next irradiation spot only by rotating the contact lens without moving the relative position of the device with respect to the subject's eye, the treatment laser light does not always intersect with the center of the approximation circle. That is, in the rotation adjustment pattern, the treatment laser light is rotated around the reflection position on the reflection surface of the contact lens. In this case, when the subject's eye is viewed from the direction along the visual axis, the rotation radius of the treatment laser light is longer than the radius of the above-mentioned approximation circle. As a result, the unit angle T in the rotation adjustment pattern when the subject's eye is viewed from the direction along the visual axis is 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 according to the rotation radius of the treatment laser light when viewed from the direction along the visual axis (that is, the distance between the reflection position on the reflection surface of the contact lens and the position where the treatment laser light is irradiated), etc.

[0040] When the irradiation of all the irradiation spots in the irradiation section under treatment is completed, the angle by which the spot interval guide is rotated as a whole can be appropriately selected. For example, assume that the range of R degrees (R≦360) in a ring-shaped or arc-shaped treatment site is divided into S irradiation sections, and the treatment laser light is irradiated M times in each irradiation section. When the irradiation of M times of the treatment laser light is completed during treatment in one irradiation section, the total value of the rotation angle of the spot interval guide is (T×(M-1)) degrees, where T is the unit angle described above. In addition, the angle range of one irradiation section is R / S degrees. Therefore, the control unit may rotate the spot interval guide by (R / ST×(M-1)) degrees when the irradiation of all the irradiation spots in the irradiation section under treatment is completed. In this case, the overall angle of the spot interval guide is appropriately adjusted to the angle corresponding to the next irradiation section.

[0041] In addition, the control unit may perform a process of rotating the contact lens by the rotation angle (the unit angle T described above) required to move the aim position of the treatment laser light to the next irradiation spot, without performing a process of moving the spot spacing guide by one appropriate spacing between multiple irradiation spots each time the treatment laser light is irradiated.

[0042] For example, if the irradiation of all of the irradiation spots in the irradiation section under treatment with the treatment laser light has not been completed, the control unit may execute a process of rotating the contact lens by the rotation angle (the unit angle described above) required to move the aim position of the treatment laser light to the next irradiation spot, without executing a process of moving the spot interval guide by one appropriate interval of the irradiation spots every time the irradiation of the treatment laser light is executed. The control unit may adjust the entire angle of the spot interval guide to an angle corresponding to the next irradiation section (i.e., for the next irradiation section) by rotating the entire spot interval guide in the direction of travel determined by the irradiation plan every time the irradiation of all of the irradiation spots in the irradiation section under treatment with the treatment laser light is completed. In this case, the irradiation of each of the irradiation sections with the treatment laser light is also automatically and appropriately assisted according to the progress of the irradiation plan.

[0043] In the rotation adjustment pattern, when a skip instruction is input, the control unit may move the spot interval guide by one appropriate interval between the multiple irradiation spots in the direction of travel defined in the irradiation plan or in the direction opposite to the direction of travel. Furthermore, when a skip instruction is input, the control unit may rotate the spot interval guide by a contact lens rotation angle required to move the aim position of the treatment laser light to the next irradiation spot in the direction of travel defined in the irradiation plan. In this case, the operator can skip the irradiation of the treatment laser light to the non-irradiated area.

[0044] As described above, it is also possible to rotate the spot interval guide by the unit angle T without moving the spot interval guide by one appropriate interval between the multiple irradiation spots every time the treatment laser beam is irradiated. In this case, when a skip instruction is input, the control unit may rotate the spot interval guide by the unit angle T without irradiating the treatment laser beam.

[0045] When an instruction to rotate the entire spot interval guide for the next irradiation section is input before the irradiation of all of the irradiation spots in the irradiation section under treatment is completed, the control unit may rotate the entire spot interval guide by an angle corresponding to the range of treatment progress in the irradiation section under treatment. In this case, even if the treatment in the irradiation section is not completed, the operator can move on to the treatment in the next irradiation section after rotating the entire spot interval guide. Therefore, the treatment can be more smoothly progressed.

[0046] The method of calculating the angle when rotating the spot interval guide for the next irradiation section can be appropriately selected. For example, the angle between two adjacent irradiation spots when viewed from the center of the circle through which the planned irradiation spots pass is A degrees, and the number of irradiation spots in which the treatment has progressed in the irradiation section in which the treatment was in progress is m. The angle corresponding to the range in which the treatment has progressed in the irradiation section in which the treatment was in progress may be calculated by "A degrees x m". The number of irradiation spots in which the treatment has progressed, "m", may also include the number of irradiation spots in which the irradiation of the treatment laser light has been skipped due to the above-mentioned skip instruction.

[0047] When the control unit displays the next targeting index for adjusting the position of the next irradiation spot in the spot interval guide, the control unit may set the position of the next targeting index at the end opposite to the treatment progress direction defined in the irradiation plan every time the multiple indices are rotated for the next irradiation section. In this case, the position of the next targeting index is appropriately changed according to the progress of the irradiation plan, so that the treatment can proceed more smoothly. Furthermore, when the next targeting index, the irradiated index, and the unirradiated index are each displayed in a distinguishable manner, the control unit may set all indices other than the next targeting index as unirradiated indexes among the multiple indices every time the control unit rotates the multiple indices for the next irradiation section.

[0048] It is also possible to change a specific method for rotating the entire spot interval guide (e.g., multiple indicators in the spot interval guide). For example, the control unit may rotate the spot interval guide by the angle of the irradiation section every time a rotation instruction is input by a user (e.g., an operator or an assistant, etc.). Also, the rotation angle of the spot interval guide may be set by the user.

[0049] <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 irradiate a patient's eye E with a treatment laser light to treat the patient's eye E.

[0050] <Overall composition> The configuration of an ophthalmic laser treatment device 1 will be described with reference to Fig. 1 to Fig. 3. As shown in Fig. 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.

[0051] 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 unit 5 (operation lever). The base 4 is a displacement means having a displacement mechanism, and can move at least a part of the laser irradiation optical system 10, the observation optical system 40, the internal display unit 50, etc. in the up-down direction (Y direction in FIG. 1), the left-right direction (X direction in FIG. 1), and the front-back direction (Z direction in FIG. 1). The displacement means changes the positional relationship between the patient's eye and the laser irradiation optical system 10 in the up-down direction, the left-right direction, and the front-back direction. The base 4 can further rotate at least a part 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 up-down direction as the rotation center. The surgeon can adjust the observation position of the patient's eye E and the irradiation position of the laser light (treatment laser light and aiming light) by moving or rotating the laser irradiation optical system 10, the observation optical system 40, the internal display unit 50, etc. by operating the joystick unit 5. Note that the joystick unit 5 (for example, 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 of the joystick unit 5 is used as a trigger input means for inputting a trigger for executing irradiation of the treatment laser light. Note that a foot switch or the like operated by the surgeon's foot may be used as a trigger input means for inputting a trigger for executing irradiation of the treatment laser light.

[0052] The control box 6 includes an external display unit 7 provided outside the observation optical system 40 (see FIG. 2). The external display unit 7 can display 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 the treatment on the external display unit 7, and also accepts input of various instructions from the user.

[0053] <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.

[0054] The treatment laser light source 11 emits treatment laser light for treating tissue of the patient's eye E. As an example, in the laser light source 11 of this embodiment, a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd:YAG) is used 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 a visible laser light (wavelength: 532 nm).

[0055] The aiming light source 12 emits an aiming laser light (hereinafter, simply referred to as "aiming light") that indicates the position to be irradiated with the treatment laser light (i.e., the position of the irradiation spot). In this embodiment, a light source that emits a visible laser light with a wavelength of 635 nm (red) is used as the aiming light source 12. However, it goes without saying that the wavelength, etc. of the aiming light can be changed as appropriate.

[0056] The energy adjustment unit 13 adjusts the amount of energy of the treatment laser light irradiated to the tissue of the patient's eye E. The energy adjustment unit 13 in this embodiment 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 light by a motor 15. The polarizing plate 16 is disposed at a Brewster's angle. The combination of the half-wave plate 14 and the polarizing plate 16 adjusts the amount of energy of the treatment laser light.

[0057] The beam splitter 17 reflects a portion of the treatment laser light toward the photodetector 18. The photodetector 18 detects the amount of energy of the treatment laser light by receiving the treatment laser light reflected by the beam splitter 17. The safety shutter 19 moves between on and off the optical axis of the treatment laser light by a shutter drive unit (e.g., a solenoid) 20. The safety shutter 19 is disposed on the optical axis of the treatment laser light to block irradiation of the patient's eye E with the treatment laser light.

[0058] Collimator lens 21 converts the aiming light emitted by aiming light source 12 into a parallel light beam. Dichroic mirror 22 combines the treatment laser light and the aiming light by coaxially adjusting the optical axes of the treatment laser light and the aiming light. In this embodiment, dichroic mirror 22 reflects the treatment laser light and transmits the aiming light, thereby combining the treatment laser light and the aiming light.

[0059] The expander lens 23 expands the light beam of the 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 of the light of the wavelength of the reflected light so that the reflected light of the treatment laser light reflected by the patient's eye E is unlikely to enter the operator's eye. The irradiation optical system 10 may be provided with a configuration for adjusting the spot size of the laser light irradiated onto the tissue.

[0060] <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.

[0061] <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 be called binoculars. The observation optical system 40 of this embodiment includes an objective lens 25, a variable magnification optical system 42 (42R, 42L), a protective filter 43 (43R, 43L), a half mirror 47, an erecting prism group 44 (44R, 44L), a field stop 45 (45R, 45L), an eyepiece lens 46 (46R, 46L), and the like. The surgeon can look through the eyepiece 46 to confirm the observation site 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 surface (object surface) provided beyond the objective lens 41 and the field stop 45 arranged 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 by the variable magnification optical system 42.

[0062] <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 through 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. In particular, in this embodiment, a color LCD capable of displaying 1600 (H) x 1200 (V) is used as the display 53. As shown in FIG. 3, the half mirror 51 is disposed on the optical axis L3R. In particular, the half mirror 51 is disposed between the protection filter 43R and the erecting prism group 44R.

[0063] The display light (display light) emitted from the display 53 travels along the optical axis L5 (see FIG. 3). In detail, the display light emitted from the display 53 passes through the lens 52 and is then reflected by the half mirror 51 toward the erect prism group 44R. The half mirror 51 of this embodiment is a synthesis means for synthesizing the optical observation image observed by the observation optical system 40 and the image displayed on the display 53. The half mirror 51 of this embodiment makes the optical axis L5 and the optical axis L3R coaxial. The display light reflected by the half mirror 51 travels in this order through the erect prism group 44R, the field stop 45R, and the eyepiece 46R, 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).

[0064] In this embodiment, the display 53 and the field stop 45R are in an optically conjugate positional relationship. That is, the display image of 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, as the internal display unit, an LCD (liquid crystal panel) without a backlight may be disposed 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.

[0065] 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 appropriately perform treatment while recognizing the image presented at an appropriate position in the observation field via the eyepiece 46.

[0066] In addition, in this embodiment, the optical axis of the treatment laser light irradiated 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 of ​​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 light. Furthermore, in this embodiment, the optical axis of the aiming light irradiated 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 of ​​the internal display unit 50. Therefore, 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, which makes it even easier to adjust the irradiation position of the treatment laser light based on the aiming light and the display content of the internal display unit 50.

[0067] 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 via the objective lens 25 from the observation site, etc. 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.

[0068] <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 non-volatile 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 information. The non-volatile memory 65 is a non-transient storage medium that can retain the stored contents even if the power supply is cut off. For example, a USB memory detachably attached to the control unit 60, a flash ROM built into the control unit 60, and the like can be used as the non-volatile memory 65. In this embodiment, the control unit 60 is connected to the base unit 4, the joystick unit 5, the control box 6, the laser light source 11, the aiming light source 12, the motor 15, the photodetector 18, the shutter drive unit 20, the lamp 31, and the display unit 53, and the like.

[0069] <Treatment aspects of trabecular meshwork> An example of a treatment mode of the trabecular meshwork executed by the ophthalmic laser treatment device 1 of this embodiment will be described with reference to Fig. 4 and Fig. 5. 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 the patient's eye E, is set as the treatment target site. For example, selective laser trabeculoplasty (SLT) is a treatment method in which a treatment laser light is irradiated to 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, the treatment laser light is irradiated multiple times over the entire circumference or a part of the ring-shaped trabecular meshwork.

[0070] As shown in FIG. 4, in the treatment of the trabecular meshwork in this embodiment, a contact lens 26 is attached to the cornea C of the patient's eye E. As an example, the contact lens 26 may be a gonioscopic mirror (a gonioscope) for observing the angle A of the patient's eye E or a Goldmann three-sided mirror. The contact lens 26 is provided with a reflecting surface (a reflecting mirror) 27. The angle A is observed through the reflecting surface 27. Therefore, as shown in FIG. 5, in this embodiment, the entire angle A (whole circumference) is not observed at the same time, but a part of the angle A is observed in a fan shape. The range of the fan-shaped part of the annular angle A observed through the reflecting surface 27 falls within an angle range of less than 180 degrees with the center of the annular angle A as the reference. The reflecting 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 FIG. 2 and FIG. 3) toward the patient's eye E, thereby irradiating the treatment laser light and the aiming light to the trabecular meshwork TM, which is the treatment target site. 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.

[0071] The surgeon adjusts the rotation angle of the contact lens 26 (i.e., the angle of the rotation direction around the axis of the contact lens 26) to adjust the reflection direction of the treatment laser light by the reflecting surface 27 of the contact lens 26 when viewed from the line of sight of the surgeon in the observation optical system 40. The surgeon also operates the joystick unit 5 to move the base unit 4 to adjust the aiming position of the treatment laser light and the aiming light on 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 or foot switch of the joystick 5 to input an instruction to irradiate the treatment laser light, thereby irradiating the spot S with the treatment laser light. In SLT, the treatment laser light is irradiated with a lower output (energy and irradiation time) than that of argon laser trabeculoplasty (ALT) in order to prevent thermal degeneration of the tissue. Therefore, it is difficult for the surgeon to visually recognize the change in the state of the treatment site before and after the operation (for example, treatment scars, etc.). As an SLT technique, a technique is known in which the spot sizes of the treatment laser light and the aiming light are fixed to a predetermined size (e.g., 400 μm, etc.) and the treatment laser light is intermittently irradiated along the trabecular meshwork TM so that multiple irradiation spots are adjacent to each other. FIG. 5 shows a schematic diagram of a part 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 check the treatment scar. In other words, the irradiated spot (spot S) irradiated with the treatment laser light is not visually checked by the operator as shown in FIG. 5.

[0072] <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 Figs. 6 and 7. The contact lens 26 shown in Figs. 6 and 7 is a partially rotating lens. In the partially rotating lens, a portion including the reflecting surface 27 rotates by a specified angle with respect to the gripping portion 26A gripped by the user every time the lens is operated once by the finger of the user (operator). In other words, when the lens is operated once by the finger of the user, the portion including the reflecting surface 27 rotates in the circumferential direction around the axis AX1 independently of other portions.

[0073] 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 substantially cylindrical and is gripped by a plurality of fingers of a user. The rotating base 26B has a cylindrical portion with an outer diameter substantially equal to the inner diameter of the substantially cylindrical gripping portion 26A. The tip (lower side of the paper surface in FIG. 6) of the rotating base 26B becomes a contact portion 26D that contacts the patient's eye E. A light-transmitting window 29 (see FIG. 7) is formed in the contact portion 26D. A reflecting 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 with respect to the gripping portion 26A. A plurality of protrusions 26C protruding outward are provided on the outer periphery of the rotating base 26B, which is exposed to the outside when the gripping portion 26A is attached. In this embodiment, a plurality of (ten in the example shown in FIG. 6) protrusions 26C are provided at equal intervals at the above-mentioned specified angle (36 degrees in the example shown in FIG. 6) in the circumferential direction. The user can rotate the rotation base 26B provided with the reflective surface 27 relative to the gripping part 26A by hooking a finger on at least one of the protrusions 26C. In detail, the user can hold and fix the gripping part 26A with a plurality of fingers (e.g., index finger and thumb), and hook the remaining fingers (e.g., middle finger) on the protrusion 26C to rotate only the rotation base 26B (the rotation axis is the axis AX1). Therefore, the movement of the fingers required for rotation is less than when the reflective surface is rotated by rotating the entire contact lens. As a result, the contact lens 26 is easily held in a stable state even when the reflective surface 27 is rotated.

[0074] The contact lens 26 shown in FIG. 6 is designed so that the rotation angle of the rotating base 26B caused by one rotation operation by the user's finger stops at a specified angle. As an example, in the contact lens 26 shown in FIG. 6, the rotating base 26B rotates 36 degrees relative to the gripping part 26A with one operation. Therefore, the rotating base 26B rotates once with respect to the gripping part 26A with ten 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 the rotating base rotates 45 degrees with respect to the gripping part with one operation.

[0075] 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, a spacing index 28 is formed on a part 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 indexes 28 are arranged at regular intervals to serve as a guide for the intervals of the spots to be irradiated with the treatment laser light. In the example shown in FIG. 7, five linear spacing indexes are arranged at equal intervals. The spacing index 28 is formed on the inner wall of the contact lens 26 on the side opposite to the side on which the reflecting 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 part of the spacing index 28 is reflected on the reflecting surface 27. In addition, during treatment, a reflected image of the treatment target site of the patient's eye E (in this embodiment, the trabecular meshwork) is also reflected on the reflecting surface 27. In addition, a reflected image of the aiming light irradiated to the treatment target site is also reflected on the reflecting surface 27. Therefore, the operator can adjust the target position of the treatment laser light to each of the multiple spots on the treatment target area by using the reflected image 28Z of the interval index 28 as a guide while grasping the position of the treatment target area and the target light reflected on the reflecting surface 27. The diagram of the observation field illustrated in each drawing in this disclosure is a diagram showing a state in which the area corresponding to the area AR1 shown in FIG. 7 is enlarged and observed. The reflecting surface 27 is formed to a size that does not miss the image (reflected image 28Z) of the interval index 28 reflected thereon. 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 state in which the center of the pupil of the patient's eye E and the center of the transparent window 29 are approximately aligned, regardless of the type of contact lens 26 used (for example, whether the interval index 28 is provided and whether it is a partially rotating lens). At this time, the area AR1 is appropriately made to follow the displacement of the reflecting surface 27. Therefore, the operator scans the joystick portion 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.

[0076] The contact lens 26 shown in Figs. 6 and 7 is merely one of several types of contact lenses that can be used in treatment with the ophthalmic laser surgery device 1 of this embodiment. Therefore, a contact lens different from the contact lens 26 shown in Figs. 6 and 7 can also be used in treatment with the ophthalmic laser treatment device 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 rotation type lens (i.e., the reflecting portion 27 is rotated by rotating the entire lens) can also be used in treatment. A partial rotation type 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 rotation type lens.

[0077] When a contact lens that needs to be rotated in its entirety 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 contact lens without changing (re-holding) the contact lens. Furthermore, when the surgeon changes the contact lens, 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 contact lens.

[0078] 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 control box 6 is operated to formulate an irradiation plan. In the irradiation plan, the order of irradiation of a plurality of irradiation spots to be irradiated with the treatment laser beam, etc., is determined when the treatment laser beam is irradiated to the patient's eye E using a contact lens 26 having a reflecting surface 27. In the irradiation plan of this embodiment, the irradiation range of the treatment laser beam in the annular treatment target site (in this embodiment, the trabecular meshwork TM) (i.e., the circumferential range in which the plurality of 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 for each irradiation spot (including the irradiation direction. In FIG. 8, the circumferential arrow indicates the direction of the irradiation order) are determined. In this embodiment, every time the treatment laser light is irradiated once, the irradiation spot adjacent to the irradiation spot for which irradiation has been completed becomes the irradiation spot to be irradiated next with the treatment laser light, and "1" is added to the numerator of "Shots" shown in Fig. 8. Also, every time the treatment laser light is irradiated once, 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. The treatment laser light is irradiated multiple times in sequence in a clockwise or counterclockwise direction.

[0079] 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 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 be indicated by the direction in which the treatment target area is actually located. Note that in other embodiments described later, information on 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 on the specified angle in the partial rotational lens, information indicating whether the interval indicator 28 is formed on the contact lens, etc.) may be included in the irradiation plan.

[0080] As an example, in this embodiment, the surgeon specifies both the planned irradiation area and the number of planned irradiation spots by specifying either the "full circumference" mode or the "half circumference" mode. In detail, in this embodiment, a "full circumference" mode in which the treatment laser light is irradiated to a plurality of spots over the entire circumference of the irradiating angle A, and a "half circumference" mode in which the treatment laser light is irradiated to a plurality of spots over a half circumference of the irradiating angle A are prepared in advance. The default value of the number of planned irradiation spots in the "full circumference" mode is set to 100. The default value of the number of planned irradiation spots in the "half circumference" mode is set to 50. When the designation of the "full circumference" mode is accepted by the surgeon, the control unit 60 sets the area over the entire circumference of the irradiating angle A as the planned irradiation area, and sets "100" as the number of planned irradiation spots. In the example shown in FIG. 8, the "full circumference" mode is specified. Also, when the designation of the "half circumference" mode is accepted by the surgeon, the control unit 60 sets the area over the half circumference of the irradiating angle A as the planned irradiation area, and sets "50" as the number of planned irradiation spots. In this embodiment, when the surgeon designates the "half circumference" mode, the surgeon 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 result.

[0081] It goes without saying that the method of accepting the designation of the planned irradiation area and the number of spots to be irradiated can be changed. For example, the laser treatment device 1 may have a mode other than the "full rotation" mode and the "half rotation" mode prepared in advance. The control unit 60 may accept the designation of an angle (within a range of 360 degrees or less) from the operator and set the area according to the designated angle to the planned irradiation area. The control unit 60 may have the operator directly input the number of spots to be irradiated and set the input number of spots to be irradiated regardless of the selected mode. The control unit 60 may change the number of spots to be irradiated, which is predetermined for each mode, according to an operation instruction by the operator. The control unit 60 may have the operator input the interval between two adjacent spots, and may calculate the number of spots to be irradiated according to the parameter of the planned irradiation area (for example, the circumferential length of the treatment target area) and the input interval between the spots.

[0082] A method for adjusting the aiming position of the irradiation spot will be described with reference to FIG. 9. In this embodiment, the method for adjusting the aiming position of the irradiation spot of the treatment laser light includes a method for adjusting the positional relationship between the patient's eye E and the laser irradiation optical system 10 by operating the joystick unit 5, and a method for performing at least one of a rotation operation and a movement operation of 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 the irradiation of the treatment laser light has been completed coincides with the position of the aiming light AI. The operator needs to adjust the position of the aiming light AI (i.e., the aiming position of the irradiation spot) from the state shown in FIG. 9(A) to the position of the next irradiation spot (the position immediately to the right of the position of the irradiated spot SS in the example shown in FIG. 9).

[0083] Fig. 9(B) shows a state where 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 completion of irradiation with the treatment laser light are shown by dotted lines. However, in reality, there is no treatment scar on the irradiated spot SS at the time of the previous completion of irradiation, so it is difficult to accurately adjust the aiming position by operating the joystick unit 5.

[0084] FIG. 9(C) shows a state in which the aiming position is adjusted 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) from the state shown in FIG. 9(A). In FIG. 9(C) as well, the positions of the irradiated spot SS and the treatment target site at the time of the completion of the previous irradiation of the treatment laser light are shown by dotted lines in a schematic manner. However, in reality, even in FIG. 9(C), there is no treatment scar on the irradiated spot SS at the time of the completion of the previous irradiation, and it is 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.

[0085] First Embodiment A treatment control process executed by the ophthalmic laser treatment device 1 of the first embodiment will be described with reference to Fig. 10 and Fig. 11. First, 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 with reference to Fig. 10. The aiming guide is displayed on the internal display unit 50 to assist the surgeon in adjusting the aiming position of the treatment laser light to an appropriate position. As described above, the method of adjusting the aiming position includes at least one of a method of adjusting the positional relationship between the patient's eye E and the laser irradiation optical system 10 by operating the joystick unit 5 and a method of rotating and 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 light by referring to the confirmed 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.

[0086] In the example shown in FIG. 10, the surgeon observes an arc-shaped or annular treatment target area (trabecular meshwork TM in the example shown in FIG. 10) and a spot AI of the aiming light irradiated to 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 reflected by the reflecting surface of a contact lens. Note that FIG. 10 illustrates a case where a contact lens that does not have the above-mentioned interval indicator 28 (see FIG. 7) and is not a partially rotating lens is used. As described above, in this embodiment, the center of the display area in the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser light, and the optical axis of the aiming light all coincide at the center O. Therefore, the internal display unit 50 can display an image at an appropriate angle in an appropriate direction centered on the optical axes of the treatment laser light 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 makes it even easier to adjust the irradiation position of the treatment laser light 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.

[0087] 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 an 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.

[0088] The target area guide 71A illustrated in FIG. 10 includes a straight line parallel to the tangent direction tangent to the appropriate position of the next irradiation spot determined by the irradiation plan in the arc-shaped or annular treatment target area (trabecular meshwork TM) as viewed from the line of sight of the surgeon in the observation optical system. Due to the characteristics of a circle, when a straight line with a specific inclination is tangent to the circle, there are two points on the circumference, and the two points are located opposite to the center of the circle. Since the arc-shaped or annular treatment target area observed by the surgeon is reflected on the reflecting surface 27, the range of the fan-shaped part of the treatment target area observed through the reflecting surface 27 falls within an angle range of less than 180 degrees based on the center of the arc-shaped or annular treatment target area. As a result, the above-mentioned two points do not fall within the observation field of view at the same time, and the treatment target area having a tangent parallel to the inclination of the target area guide 71A is uniquely determined. Therefore, the surgeon 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 treatment target area coincides with the direction of the straight portion of the target area guide 71A, which makes it easier to accurately adjust 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.

[0089] In addition, 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. When the tangential direction of the treatment target area is adjusted to match the target area guide 71A and the treatment target area, 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 match the tangential direction of the treatment target area to the direction of the straight part of the target area guide 71A regardless of the size of the patient's eye E and the observation magnification. Therefore, the surgeon can more easily adjust the aiming position to the appropriate position.

[0090] Target area guide 71A illustrated in FIG. 10 includes two straight lines parallel to the tangential direction described above. The positions of the optical axis of the treatment laser light and the optical axis of the aiming light (the position of center O in FIG. 10) are located in the middle of the two straight lines. As a result, the center of the spot AI of the aiming light observed by the surgeon is located in the middle of the two straight lines in target area guide 71A. Therefore, the surgeon can align the tangential direction of the treatment target area to the direction of the straight line portion of target area guide 71A, while simultaneously aligning the aim position of the treatment laser light (spot AI of the aiming light) to the appropriate position of the treatment target area. Note that control unit 60 adjusts the distance between the two straight lines in target area guide 71A according to the observation magnification of observation optical system 40. As a result, the two straight lines of target area guide 71A are displayed at an appropriate distance according to the observation magnification, so that the adjustment of the aim position is appropriately assisted regardless of the observation magnification. However, the straight line portion of target area guide 71A may be one. 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 to the appropriate position.

[0091] The control unit 60 determines the angle of the target site guide 71A to be displayed on the internal display unit 50 according to the progress of the irradiation plan, and displays the treatment site guide 71A at the determined angle. Therefore, the target site guide 71A is displayed on the internal display unit 50 at an appropriate angle according to the progress of the irradiation plan. This will be described in detail later.

[0092] As shown in FIG. 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 suitable for the progress of the irradiation plan (i.e., the direction in which the reflective surface 27 is disposed 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 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, so that the surgeon can easily grasp the appropriate direction.

[0093] In detail, in this embodiment, a plurality of 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 on 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.

[0094] The outer periphery guide 75 includes a next aiming guide 75A. The next aiming guide 75A indicates an appropriate direction of the irradiation spot to be irradiated with the treatment laser light next among a plurality of irradiation spots determined in the irradiation plan. The control unit 60 shifts the position of the next aiming guide 75A to a position corresponding to the irradiation spot adjacent to the traveling direction determined in the irradiation plan every time the irradiation of the treatment laser light is performed. 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 by 3.6 degrees with the center O as a reference. Therefore, the operator can appropriately grasp the direction of the irradiation spot to be adjusted next by the next aiming guide shifted along the outer periphery of the observation field.

[0095] 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 light among a plurality of irradiation spots defined in the irradiation plan. The control unit 60 changes the next aim guide 75A that has been displayed until immediately before the irradiation to the irradiation completion guide 75B every time the irradiation of the treatment laser light is completed. Therefore, the surgeon can appropriately adjust the next aim position using the next aim guide 75A after grasping the direction in which the irradiation of the treatment laser light has been completed. It also becomes easy to grasp the progress of the treatment.

[0096] The outer peripheral guide 75 includes a non-irradiated guide 75C. The non-irradiated guide 75C indicates the direction of the irradiation spot to which the treatment laser light is to be irradiated after the next irradiation among a plurality of irradiation spots determined in the irradiation plan. The control unit 60 changes the non-irradiated guide 75C, which was displayed in the direction of the irradiation spot in the next irradiation order determined in the irradiation plan, to the next aim guide 75A every time the irradiation of the treatment laser light is completed, thereby shifting the next aim guide 75A. In this case, the surgeon can appropriately adjust the next aim position by the next aim guide 75A after grasping the direction of the irradiation spot to which the treatment laser light is to be irradiated after the next irradiation. It is also easy to grasp the progress of the treatment.

[0097] The control unit 60 displays the next aiming guide 75A, the irradiation completion guide 75B, and the unirradiated guide 75C in a distinguishable manner (i.e., in different display manners). 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 unirradiated guide 75C. In this case, it is preferable to display at least the next aiming guide 75A. It is more preferable 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 that the next aiming guide 75A can guide the direction in which the reflecting surface 27 of the contact lens 26 is directed.

[0098] The treatment control process in the first embodiment will be described with reference to Fig. 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 according to a control program stored in the ROM 62 or non-volatile memory 65.

[0099] First, the control unit 60 acquires an irradiation plan of the treatment laser light for the patient's eye E (S1). As described above, the irradiation plan determines the order of irradiation of a plurality of irradiation spots to be irradiated with the treatment laser light when the treatment laser light is irradiated to the patient's eye E using the contact lens 26 having the reflecting surface 27. In the irradiation plan of this embodiment, the irradiation range of the treatment laser light in the annular treatment target site (in this embodiment, the trabecular meshwork TM) (i.e., the circumferential range in which the plurality of irradiation spots are arranged), the irradiation spot to be first irradiated with the treatment laser light, the number of irradiation spots, and the order of irradiation of the treatment laser light for each irradiation spot (including the irradiation direction) are determined. In this embodiment, every time the treatment laser light is irradiated once, the irradiation spot adjacent to the irradiation spot that has been irradiated is the irradiation spot to be irradiated with the treatment laser light next. The treatment laser light is irradiated multiple times in a clockwise or counterclockwise direction in sequence. In other embodiments described later, 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 on the specified angle of the partial rotational lens, and information indicating whether the interval indicator 28 is formed on the contact lens) may be included in the irradiation plan. As an example, in this embodiment, the irradiation plan is formulated by operating the control box 6.

[0100] The control unit 60 displays (S2) the non-irradiated guide 75C in the direction of each of a plurality of 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 of view via the observation optical system 40).

[0101] The control unit 60 sets the value of an irradiation order counter "n" that specifies the irradiation order of the treatment laser light for the multiple irradiation spots defined in the irradiation plan to "1" (S3). The control unit 60 causes the internal display unit 50 to display a next aim guide 75A in the direction of the first irradiation spot defined in the irradiation plan within the outer periphery of the display area. 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 causes the internal display unit 50 to display the target area guide 71A at the determined angle (S5).

[0102] Next, the control unit 60 judges whether or not an instruction to irradiate the treatment laser light has been input by the operator (S7). If an instruction to irradiate has not been input (S7: NO), the judgment of S7 is repeated and the system enters a standby state. During this time, the operator adjusts the aim position of the treatment laser light. 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 in the horizontal direction (a unique angle corresponding to the aforementioned region) as the target region guide 71A. Moreover, the target region guide 71A illustrated in FIG. 10 guides irradiation to a region in the actual trabecular meshwork in the lower left diagonal direction.

[0103] 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 the number "N" of all irradiation spots to which the treatment laser beam is to be irradiated in the irradiation plan (S10). If the 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 corresponding position of the irradiation spot adjacent to the moving direction determined in the irradiation plan (S12). In addition, the control unit 60 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 moving direction and moving angle of the irradiation spot (S14). As an example, in the case of an irradiation plan for irradiating 100 adjacent shots around the entire circumference of the trabecular meshwork TM, 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. After that, the process returns to S7. When irradiation of all the irradiation spots with the treatment laser light is completed (i.e., when "n" has reached "N") (S10: YES), the process ends.

[0104] <Second embodiment> The treatment control process executed by the ophthalmic laser treatment device 1 of the second embodiment will be described with reference to Figs. 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 site guide displayed on the internal display unit 50 is different from that of the first embodiment. In the second embodiment, as in the first embodiment, the description will be given by exemplifying a case in which a contact lens that does not have a spacing indicator 28 (see Fig. 7) and is not a partially rotating lens is used.

[0105] First, referring to Fig. 12, an aiming guide (in the second embodiment, a target area guide 71B) displayed on the internal display unit 50 by the ophthalmic laser treatment apparatus 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 illustrated in Fig. 12 includes an arc-shaped portion corresponding to the arc-shaped arrangement of the 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 reflecting surface of the contact lens and the aiming position of the treatment laser light can be easily and accurately adjusted.

[0106] Control unit 60 changes the curvature of the arc-shaped portion of target site 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 site guide 71B changes appropriately in accordance with the difference in how the treatment target site appears, which changes according to the observation magnification. This makes it easier to adjust the aiming position.

[0107] In the second embodiment, a predetermined number of irradiations of the treatment laser light are performed in a fan-shaped irradiation section with the angle of the reflective surface of the contact lens fixed. When the predetermined number of irradiations of the treatment laser light in one irradiation section is completed, the rotation angle of the reflective surface of the contact lens is changed (adjusted) by the operator, and the next fan-shaped irradiation section is irradiated with the treatment laser light a predetermined number of times. In the example shown in FIG. 12, the angle range of one irradiation section is 36 degrees. Therefore, when treatment is performed on the entire circumference of the treatment target area, a predetermined number of irradiations of the treatment laser light are performed in each of the ten irradiation sections.

[0108] In FIG. 12(a), first, the control unit 60 causes the internal display unit 50 to display an arc-shaped target site guide 71B corresponding to the arc-shaped arrangement of a predetermined number of irradiation spots (10 in the example shown in FIG. 12) arranged in the first irradiation section in the irradiation plan. In the state shown in FIG. 12(a), the arc shape of the observed treatment target site and the arc shape of the displayed target site guide 71B do not match. Therefore, as shown in FIG. 12(b), the surgeon adjusts the arc shape of the treatment target site to the arc shape of the target site guide 71B using the contact lens and the joystick unit 5. As a result, the rotation angle of the reflecting surface of the contact lens and the aiming position of the treatment laser light approach the appropriate angle and position for irradiating the treatment laser light to the irradiation spot determined by the irradiation plan. In the second embodiment, the surgeon can switch between displaying and hiding the target site guide 71B by operating a changeover switch (not shown) provided on the joystick unit 5 (see FIG. 12(b) and FIG. 12(c)). As shown in FIG. 12(c), the operator completes the irradiation of a predetermined number of treatment laser beams in the irradiation section while fixing the rotation angle of the reflecting 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 operator 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 in the irradiation section, it rotates the target site guide 71B by an angle for one irradiation section (36 degrees in the example of FIG. 12) in the direction of travel of the next irradiation spot. The operator may perform a rotation operation of the contact lens, etc., so that the arc of the rotated target site guide 71B matches the arc of the observed treatment target site. By repeating the above procedure, treatment is appropriately performed on each of the multiple irradiation sections. That is, in this embodiment, a series of steps from shifting the observation image using the joystick unit 5 to adjusting the aiming position multiple times to rotating the reflective surface of the contact lens by a large amount (about 36 degrees in the example shown in FIG. 12) constitutes one cycle. 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 site.The control unit 60 rotates the target area guide 71B at a timing when the reflective surface of the contact lens is largely rotated based on a preset irradiation plan. As a result, even when a contact lens having a simple structure is used in combination with an ophthalmic laser treatment device 1 having a simple structure, for example, the operator can easily appropriately adjust the positions of the multiple irradiation spots in a wide area of ​​the treatment target area.

[0109] 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 of the treatment laser light for the patient's eye E (S21). As described above, the treatment plan acquired in S21 determines the angle of one irradiation section, the number of times M that the treatment laser light is irradiated in each irradiation section, the total number N of times that the treatment laser light is irradiated to the entire treatment target area, the irradiation spot to which the treatment laser light is first irradiated, the irradiation order (including the irradiation direction) of the treatment laser light, etc.

[0110] 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 section (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 to the entire treatment target site to "0" (S23). Furthermore, the control unit 60 sets the value of an intra-section irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated to one irradiation section to "0" (S24).

[0111] Next, the control unit 60 determines whether or not an instruction to switch between displaying and hiding the target portion guide 71B on the internal display unit 50 has been input by the surgeon (S26). When a display switching instruction has been input (S26: YES), the control unit 60 switches between displaying and hiding the target portion guide 71B on the internal display unit 50 in accordance with the input instruction (S27). Thereafter, the process proceeds to S28.

[0112] The control unit 60 judges whether or not an instruction to irradiate the treatment laser light has been input by the operator (S28). If an instruction to irradiate the treatment laser light has not been input (S28: NO), the process returns to S26. During this time, the operator adjusts the aiming position of the treatment laser light. If an instruction to irradiate the treatment laser light has been input (S28: YES), the treatment laser light 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 judges whether or not the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser light to the entire treatment target area (S32). If the irradiation of all the irradiation spots is not completed (i.e., "n" has not reached "N") (S32: NO), the control unit 60 judges whether the value of the intra-section irradiation number counter "m" has reached the predetermined number of times "M" that the treatment laser light is irradiated in one irradiation section (S33). If the irradiation of one irradiation section is not 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 the irradiation of one irradiation section is completed (S33: YES), the control unit 60 rotates the target site guide 71B by an angle of one irradiation section in the direction of travel of the next irradiation spot (S34), and the process returns to S24, and the process proceeds to the process for the treatment of the next irradiation section. If the irradiation of all the irradiation spots is completed (S32: YES), the process ends.

[0113] It is also possible to change the process exemplified in the second embodiment. For example, when a partial rotation lens is used, the control unit 60 may acquire information on the specified rotation angle of the partial rotation lens to be used (i.e., the angle rotated by one operation). The control unit 60 may rotate the angle of the displayed target site guide 71B by the specified rotation angle in the traveling direction of the irradiation spot every time a predetermined number of times (corresponding to the above-mentioned predetermined number "M") of irradiations of the treatment laser light to be performed within the range of one specified rotation angle (corresponding to the above-mentioned "angle of one irradiation section") are completed. In this case, every time irradiation of the treatment laser light within the range of one specified rotation angle is completed, the angle of the target site guide 71B is rotated to an angle corresponding to the range of the next specified rotation angle. Therefore, even when treatment is performed using a partial rotation lens, the aiming position can be more appropriately adjusted.

[0114] Furthermore, controller 60 may rotate the angle of target area guide 71B displayed according to the moving direction and moving angle of the irradiation spot every time irradiation of the treatment laser light is performed. In this case, target area guide 71B is displayed at an appropriate angle according to the next irradiation spot every time irradiation of the treatment laser light is performed.

[0115] The control unit 60 may change the display method of the target area guides 71A and 71B based on information about the contact lens used. For example, if the contact lens used is a contact lens that is rotated as a whole by the surgeon, the control unit 60 may execute a process of rotating the target area guide 71A by the travel angle of the irradiation spot each time the treatment laser light is irradiated. Also, if the contact lens used is a partially rotating lens, the control unit 60 may execute a process of rotating the target area guide 71B by a specified rotation angle each time the treatment laser light is irradiated a predetermined number of times. In this case, the display of the target area guides 71A and 71B is appropriately changed according to the contact lens used, so that the aim position of the treatment laser light can be further easily adjusted.

[0116] <Third embodiment> The treatment control process executed by the ophthalmic laser treatment device 1 of the third embodiment will be described with reference to Fig. 14 to Fig. 16. First, the aiming guides (angle guide 80 and section aiming guide 75D in the third embodiment) and the 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 with reference to Fig. 14 and Fig. 15.

[0117] 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 a rotation angle of the reflective surface of the contact lens suitable for the progress of the irradiation plan. The surgeon can adjust the aim position of the treatment laser light with the angle of the reflective surface appropriately adjusted by adjusting the rotation angle of the reflective surface of the contact lens with reference to the angle indicated by the angle guide 80.

[0118] As shown in Fig. 15, the angle guide 80 of the third embodiment includes a schematic diagram of a treatment target area 81. The shape of the schematic diagram of a treatment target area 81 is shaped according to the appropriate angle of an arc-shaped or annular treatment target area of ​​a patient's eye (the trabecular meshwork TM shown in Fig. 14 in this embodiment) where an irradiation spot to be next irradiated with treatment laser light is to be placed. 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 is aligned with the schematic diagram of a treatment target area 81.

[0119] Moreover, the angle guide 80 of the third embodiment includes a shape imitating the contour shape of the reflective surface of a contact lens, and a shape imitating a characteristic structure of the contact lens (spacing indicator 28 in this embodiment) 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 Fig. 14 and Fig. 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 to be oriented along the angle guide 80.

[0120] 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.

[0121] In detail, in the treatment by the ophthalmic laser treatment device 1 of the third embodiment, the contact lens (partial rotation type lens) 26 shown in FIG. 6 and FIG. 7 may be used. As described above, in the partially rotation type contact lens 26, a part including the reflecting surface 27 rotates a specified angle with respect to the grip part 26A gripped by the user every time the partially rotation type contact lens 26 is operated once by the user's finger. The control unit 60 rotates the angle of the angle guide 80 by a specified angle every time a predetermined number of irradiations of the treatment laser light to be performed within a range of one specified rotation angle (in other words, within one irradiation section) are completed. Therefore, the surgeon can adjust the angle of the reflecting surface 27 to an appropriate angle by referring to the angle guide 80, especially when performing treatment using the partially rotation type contact lens 26.

[0122] The control unit 60 recommends the operator to rotate the reflecting surface 27 by a specified rotation angle each time a predetermined number of irradiations of the treatment laser light to be performed within a range of one specified rotation angle of the contact lens 26 (in other words, within one irradiation section) are completed (that is, each time adjustment of the target position to multiple locations by the joystick unit 5 is completed while maintaining the orientation of the reflecting surface 27 of the contact lens 26). Therefore, the operator can appropriately grasp the timing when the reflecting surface 27 needs to be rotated by the specified angle, especially 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 a speaker. Therefore, the operator can grasp the timing when the reflecting surface 27 needs to be rotated even while looking through the eyepiece 46.

[0123] As shown in FIG. 15, the angle guide 80 of the third embodiment includes a spacing index schematic diagram 82 imitating the spacing index 28 (see FIG. 7) provided on the contact lens 26. As described above, the contact lens 26 used in the treatment by the ophthalmic laser treatment device 1 of the third embodiment is provided with the spacing index 28. The spacing index 28 is arranged at a certain interval to serve as a guide for the spacing between spots to be irradiated with the treatment laser light. As shown in FIG. 14, at least a part of the spacing index 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 by the angle guide 80, the surgeon can easily adjust the spacing between the multiple spots by adjusting the aiming positions of the multiple treatment laser lights after grasping the spacing index schematic diagram 82. In particular, when the contact lens 26 being used is provided with a spacing index 28, the surgeon can adjust the aiming position more easily by comparing the spacing index 28 of the contact lens 26 observed through the observation optical system 40 with the spacing index schematic diagram 82 displayed on the internal display unit 50 and then adjusting the aiming position.

[0124] A spot arrangement guideline diagram 83 is added to the angle guide 80 of the third embodiment. The spot arrangement guideline diagram 83 shows the arrangement of continuous irradiation spots including the irradiation spot to be irradiated with the treatment laser light next among the multiple irradiation spots determined in the irradiation plan. The control unit 60 shifts the display of the irradiation spot to be irradiated with the treatment laser light next among the multiple irradiation spots included in the spot arrangement guideline diagram 83 to the irradiation spot adjacent thereto in the traveling direction determined in the irradiation plan every time the irradiation of the treatment laser light is performed. Therefore, the operator can adjust the next target position more appropriately by grasping the position of the next irradiation spot displayed in the spot arrangement guideline diagram 83. In particular, in the angle guide 80 shown in FIG. 14 and FIG. 15, the spot arrangement guideline diagram 83 is displayed in a state that matches the guideline interval of the irradiation spots indicated by the interval indicator schematic diagram 82. Therefore, the operator can adjust the next target position more appropriately by grasping the positional relationship of the next irradiation spot indicated in the spot arrangement guideline diagram 83 with respect to the interval indicator schematic diagram 83.

[0125] 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 a peripheral guide displayed along the peripheral part of the observation field. The section aiming guide 75D illustrated in FIG. 14 indicates the area of ​​the treatment target part according to the progress of the treatment plan (the area of ​​the treatment target part when the patient's eye E is viewed from the front without passing through the observation optical system 40). In the example illustrated in FIG. 14, among the bar graphs corresponding to each of the eight irradiation sections, the part indicating the direction of the area of ​​the treatment target part corresponding to the irradiation of the treatment laser light to the current irradiation section is displayed in a manner different from the other parts (i.e., in a manner that can be distinguished from the other parts), 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 part corresponding to the angle guide 80. In FIG. 14, the section aiming guide 75D is arranged 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 arranged in the same direction. The control unit 60 shifts the position of the section aiming guide 75D to a position adjacent to the traveling direction determined by the irradiation plan every time irradiation of the same number of treatment laser beams as the number of irradiation spots included in one irradiation section is completed. Therefore, the operator can easily grasp the direction of the reflection surface 27 for irradiating the treatment laser beam to the irradiation spot in the irradiation section by the section aiming guide 75D. In addition, 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 the direction of the appropriate rotation angle of the reflection surface 27.

[0126] The control unit 60 displays the section aiming guide 75D for each range of the specified angle of the partially rotating contact lens 26 (see Figs. 6 and 7) used. Each time irradiation of the same number of treatment laser beams as the number of irradiation spots included in one range of the specified angle is completed, the control unit 60 shifts the position of the section aiming guide 75D to an adjacent position in the progression direction defined by the irradiation plan. Therefore, the section aiming guide 75D is appropriately displayed according to the specifications of the partially rotating contact lens 26 and the progress of treatment.

[0127] The ophthalmic laser treatment device 1 of this embodiment also includes an imaging 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 causes the internal display unit 50 to display a previous irradiation image 88 captured by the imaging optical system. The previous irradiation image 88 is an image of the treatment target area irradiated with the aiming light, captured by the imaging optical system when the treatment laser light was previously 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. In the treatment of this embodiment, no irradiation mark of the treatment laser light remains, so that the previous irradiation image 88 uses an image of the treatment target area irradiated with the aiming light. However, a graphic simulating a spot may be drawn at a predetermined position of the captured image (in this embodiment, a position that coincides with the optical axis of the treatment laser light). The surgeon can adjust the next aiming position after grasping the area irradiated with the treatment laser light last time (i.e., the area where the aiming light appears in the displayed previous irradiation image 88). This makes it easier to irradiate the treatment laser light more appropriately.

[0128] 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 of the treatment laser light for the patient's eye E (S41). The treatment plan acquired in S41 defines the prescribed angle of the partially rotating contact lens 26 to be used (i.e., the angle of one irradiation section), the number of times M that the treatment laser light is irradiated in each irradiation section, the total number N of times that the treatment laser light is irradiated to the entire treatment target area, the irradiation spot to which the treatment laser light is first irradiated, the irradiation order of the treatment laser light (including the irradiation direction), etc. It should be noted that information such as the prescribed angle of the contact lens 26 may be acquired based on information indicating the type of the contact lens 26.

[0129] The control unit 60 causes the internal display unit 50 to display the angle guide 80 and the section aiming guide 75D at an angle, direction, and position corresponding to the arrangement of the first irradiation section (S42). 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 to the entire treatment target area to "0" (S43). Furthermore, the control unit 60 sets the value of an intra-section irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated to one irradiation section to "0" (S44). The control unit 60 sets the display of the irradiation spot (next spot) to be irradiated with the treatment laser light next in the spot arrangement guideline diagram 83 to the spot that is the first spot to be irradiated with the treatment laser light among the multiple spots in the spot arrangement guideline diagram 83 (S45).

[0130] The control unit 60 judges whether or not an instruction to irradiate the treatment laser light has been input by the surgeon (S47). If an instruction to irradiate the treatment laser light has not been input (S47: NO), the judgment of S47 is repeated. During this time, the surgeon adjusts the aiming position of the treatment laser light. If an instruction to irradiate the treatment laser light has been input (S47: YES), the treatment laser light is irradiated (S48). The control unit 60 also acquires an observation image of the treatment target site irradiated with the aiming light, which is captured by the imaging optical system when the treatment laser light is irradiated (S49).

[0131] 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 judges whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the entire treatment target site with the treatment laser light (S52). If the 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 judges whether the value of the intra-section irradiation number counter "m" has reached the predetermined number "M" of irradiations of the treatment laser light in one irradiation section (S53). If the 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 irradiation spot (next spot) to be next irradiated with the treatment laser light among the multiple spots in the spot arrangement 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.

[0132] 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 a 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 traveling direction determined by the irradiation plan (S58). Furthermore, the control unit 60 recommends the operator to rotate the reflecting surface 27 by a 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.

[0133] It is also possible to change the processing exemplified in the third embodiment. First, the display manner of the angle guide 80 may be changed. For example, a diagram or a photograph that allows the surgeon to understand the appropriate angle of the observation image of the treatment target site 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.

[0134] The angle guide 80 of the third embodiment is rotated by the angle range of an irradiation section every time a predetermined number of irradiations of the treatment laser light 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 every time the treatment laser light is irradiated.

[0135] The angle guide 80, section aiming 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 aiming 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.

[0136] <Fourth embodiment> A 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, an observation image observed by an observation optical system 40 includes a reflected image of the spacing index 28 reflected by a reflecting surface 27 of the contact lens 26. A spot spacing guide 90 shows the surgeon the appropriate spacing between a plurality of irradiation spots to which the treatment laser light is to be irradiated.

[0137] First, a flow of treatment using the spot interval 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 in a clockwise direction on the actual trabecular meshwork region from the lower side (Fig. 17) to the diagonally lower left (Fig. 18) based on an irradiation plan preset by the surgeon.

[0138] The irradiation plan of this embodiment includes the operator rotating the rotating base 26B clockwise. In Fig. 17 and Fig. 18, the lower trabecular meshwork is reflected by the reflecting surface of the contact lens and enters the operator's field of view. Therefore, in Fig. 17 and Fig. 18, the upper and lower sides are inverted and the lower trabecular meshwork is reflected. On the reflecting surface in Fig. 17 and Fig. 18, when the treatment for the irradiation spot proceeds from right to left (i.e., counterclockwise), in the actual lower trabecular meshwork, the treatment for the irradiation spot proceeds from right to left (i.e., clockwise).

[0139] First, as shown in FIG. 17(a), the control unit 60 determines the angle of the spot interval 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 interval guide 90 at the determined angle. The index of the spot interval guide 90 is along the appropriate reflection direction of the treatment laser light to the next irradiation spot by the reflection surface 27 of the contact lens 26. FIG. 17 shows a guide for performing adjacent 10 irradiations while maintaining the orientation of the reflection surface 27 of the contact lens 26 to the lower region of the actual trabecular meshwork TM. Based on the above-mentioned region, the index of the spot interval guide 90 is arranged in the horizontal direction. The control unit 60 causes the spot interval guide 90 to identifiably display the next targeting index 90A for adjusting the targeting position of the next treatment laser light. In the example shown in FIG. 17(a), the control unit 60 first displays the next targeting index 90A at a position overlapping an index (in FIG. 17(a), an index located at the right end) located at the opposite end of the treatment progress direction determined in the irradiation plan among the multiple indices of the spot interval guide 90 (in this embodiment, five indices aligned with the reflected images of the five interval indices 28 observed through the reflecting surface 27 of the contact lens 26). Among the multiple indices of the spot interval guide 90, the indices other than the one located at the position overlapping the next targeting index 90A are set as non-irradiated indices corresponding to at least a part of the spot to be irradiated with the treatment laser light after the next time. Furthermore, the control unit 60 displays the multiple indices of the spot interval 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 light irradiated by the laser irradiation optical system 10. Note that the position where the next targeting index 90A is displayed does not need to completely coincide with the optical axis of the treatment laser light. 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 surgeon can recognize the position on the optical axis of the treatment laser beam.

[0140] 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 are changed by the joystick unit 5, so that the positions of the multiple indices (five in this embodiment) of the spot interval guide 90 and the positions of the multiple target indices 28 reflected on the reflecting surface 27 of the contact lens 26 in the observation field match. As shown in FIG. 17(b), when the positions of the multiple indices of the spot interval guide 90 and the position of the target indices 28 match, the spot S to be next irradiated with the treatment laser light is located on the straight line along which the next target indices 90A of the spot interval guide 90 extends. The surgeon inputs an instruction to irradiate the treatment laser light while aligning the position of the target light with the treatment target area. As a result, the treatment laser light is irradiated to the spot S through which the optical axis of the laser irradiation optical system 10 passes.

[0141] As shown in FIG. 17(c), when the irradiation of the treatment laser light is completed, the control unit 60 moves the index of the spot interval guide 90 in the direction opposite to the treatment progress direction (clockwise direction in FIG. 17) defined in the irradiation plan (counterclockwise direction in FIG. 17) by one appropriate interval of the irradiation spot. As a result, the positions of the multiple indexes of the spot interval guide 90 are shifted with respect to the position of the aiming index 28. The control unit 60 moves the position of the next aiming index 90A by one appropriate interval of the irradiation spot in the progress 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 irradiation of the treatment laser light to an irradiated index corresponding to a spot that has already been irradiated with the treatment laser light. The irradiation plan of this embodiment is a plan to perform 10 adjacent irradiations using the spot interval guide 90 consisting of five indexes, and one appropriate interval of the irradiation spot corresponds to half the interval between adjacent indexes of the spot interval guide 90. In this embodiment, the interval between adjacent indices of the spot interval guide 90 is 800 μm (twice the spot size of the treatment laser light and the aiming light). The operator adjusts the aiming position of the treatment laser light 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 of the spot interval guide 90 (five indices other than the next aiming index 90A in FIG. 17(c)) and the position of the aiming index 28 in the observation field match again. As shown in FIG. 17(d), when the positions of the indices of the spot interval guide 90 match the position of the aiming index 28 and the position of the aiming light match the position of the treatment target site, the operator inputs an instruction to perform irradiation of the treatment laser light. This embodiment is an example, and the moving direction of the spot interval guide 90 may be reversed (guiding the irradiation from the left end of the aiming index 28 to the right in a counterclockwise direction).

[0142] As shown in FIG. 17(e), when the irradiation of the treatment laser light is completed, the control unit 60 further moves the index of the spot interval guide 90 by one appropriate interval of the irradiation spot in the direction opposite to the moving direction 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 moving direction 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 on the opposite side of the moving direction of the treatment among the multiple indices in the spot interval guide 90. The operator again coincides the positions of the multiple indices of the spot interval guide 90 with the position of the target index 28 in the observation field, and inputs an instruction to perform irradiation of the treatment laser light (see FIG. 17(f)). The above procedure is repeated until the irradiation of all the multiple spots in one irradiation section with the treatment laser light is completed. That is, the spot interval guide 90 assists the surgeon in repeatedly shifting the aim position by one spot as exemplified in FIG. 9, thereby allowing the surgeon to grasp the intervals between a plurality of irradiation spots.

[0143] When irradiation of one irradiation section with the treatment laser light (10 times of irradiation of the treatment laser light in the example shown in FIG. 17 and FIG. 18) is completed, the state shown in FIG. 18(a) is obtained. The control unit 60 automatically rotates the entire index of the spot interval guide 90 in the proceeding direction by the angle of the irradiation section. In the contact lens 26 used in this embodiment, the rotating base 26B rotates 36 degrees with one rotation operation (see FIG. 7). Therefore, the control unit 60 rotates the entire index of the spot interval guide 90 by 36 degrees based on the irradiation plan. In addition, the control unit 60 displays the next target index 90A at a position where the next target index 90A overlaps with an index located at the end opposite to the proceeding direction of the treatment determined by the irradiation plan among the multiple indexes. Furthermore, the control unit 60 sets all the indexes of the spot interval guide 90 other than the position where the next target index 90A overlaps as non-irradiated indexes. The control unit 60 displays the multiple indices of the spot interval 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 the state shown in FIG. 18(b). The surgeon rotates the reflecting surface 27 of the contact lens 26 by a specified angle in the clockwise direction, which is the treatment progress 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 is the same as the angle by which the spot interval guide 90 is rotated. Thereafter, the irradiation of the treatment laser light to all of the multiple spots in the new irradiation section is repeated.

[0144] As described above, the spot spacing guide 90 is displayed to allow the user to understand the appropriate spacing between the 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 checked spot spacing guide 90. Therefore, the surgeon can easily bring the spacing between the multiple irradiation spots to be irradiated with the treatment laser light closer to the appropriate spacing.

[0145] As described above, in this embodiment, the center of the display area in the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser light, and the optical axis of the aiming light are all aligned. Therefore, the internal display unit 50 can display the spot interval guide 90 at an appropriate angle in an appropriate direction centered on the optical axes of the treatment laser light 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 in the internal display unit 50. This makes it even easier to adjust the irradiation position of the treatment laser light based on the aiming light and the display content of the internal display unit 50.

[0146] The control unit 60 changes the intervals between the multiple indicators of the spot interval 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 intervals between the indicators of the spot interval guide 90 as the magnification of the observation optical system 40 increases. In this case, even if the observation magnification is changed, the spot interval guide 90 corresponding to the appropriate intervals between the multiple irradiation spots (in this embodiment, corresponding to the five interval indicators 28 serving as a guide for the appropriate intervals between the multiple irradiation spots) is displayed on the internal display unit 50.

[0147] The control unit 60 matches the intervals of the multiple indicators of the spot interval guide 90 with the intervals of the interval indicators 28 of the contact lens 26 to be used. Therefore, the surgeon can adjust the aiming position while referring to both the position and direction of the interval indicators 28 observed through the observation optical system 40 and the position and direction of the spot interval display unit 90 displayed on the internal display unit 50, and can more appropriately adjust 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 interval guide 90 (for example, the intervals and number of the multiple indicators in the spot interval guide 90, and the rotation angle when rotating the spot interval guide 90, etc.) based on information on the contact lens 26 to be used. Therefore, the spot interval guide 90 appropriate for the interval indicators 28 of the contact lens 26 to be used is displayed, and the treatment can be more smoothly progressed.

[0148] As shown in FIG. 17 and FIG. 18, the spot interval guide 90 includes a shape (in this embodiment, a plurality of linear indicators) along the appropriate reflection direction of the treatment laser light to the next irradiation spot by the reflection surface 27 of the contact lens 26. The control unit 60 determines the angle of the spot interval guide 90 to be displayed on the internal display unit 50 according to the progress of the irradiation plan, and displays the spot interval guide 90 at the determined angle. Therefore, the operator can easily adjust the rotation angle of the reflection surface 27 of the contact lens 26 by adjusting the reflection angle of the treatment laser light so that it is in the direction indicated by the spot interval guide 90. Furthermore, since the spot interval guide 90 is displayed on the internal display unit 50 at an appropriate angle according to the progress of the irradiation plan, it becomes easier to adjust the aiming position more appropriately. Furthermore, the operator can more easily adjust the rotation angle by adjusting the rotation angle of the reflection surface 27 of the contact lens 26 so that the interval indicator 28 is located ahead of the direction indicated by the shape of the spot interval guide 90.

[0149] As shown in Fig. 17 and Fig. 18, the control unit 60 displays a next targeting indicator 90A for aligning the position of the next irradiation spot at a position corresponding to the optical axis of the treatment laser light irradiated by the laser irradiation optical system 10 in a manner different from other indicators, in addition to the multiple indicators arranged at regular intervals on the spot interval guide 90. The control unit 60 moves the position of the next targeting indicator 90A by one appropriate interval between the multiple irradiation spots in the traveling direction determined by the irradiation plan every time the treatment laser light is irradiated. Therefore, the surgeon can adjust the next targeting position more easily by aligning the position on the tissue to be irradiated with the next treatment laser light, taking into consideration the next targeting indicator 90A indicating the position of the optical axis of the treatment laser light (which also coincides with the optical axis of the aiming light when the aiming light is irradiated).

[0150] Among the multiple indices in the spot interval guide 90, the indices other than the next targeting indices 90A are either irradiated indices corresponding to at least a part of a spot that has already been irradiated with the treatment laser light, or unirradiated indices corresponding to at least a part 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 modes (i.e., modes 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 the treatment more smoothly.

[0151] 17, the control unit 60 moves the indices arranged at regular intervals (in this embodiment, at the same intervals as the interval indices 28 of the contact lens 26) on the spot interval guide 90 by one appropriate interval between the irradiation spots in the direction opposite to the direction of travel defined in the irradiation plan every time the treatment laser light is irradiated. The operator can adjust the aiming position more easily by adjusting the aiming position every time so that the positions of the indices that move every time the treatment laser light is irradiated are constant positions on the observation image observed through the observation optical system 40 (in this embodiment, the positions where the indices on the spot interval guide 90 match the interval indices 28 on the observation image).

[0152] 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 a plurality of indices arranged at regular intervals on the spot spacing guide 90. By rotating the entirety of the indices on the spot spacing guide 90 to match the shape of the treatment target area, which is arc-shaped or annular, the spot spacing guide 90 appropriately assists in adjusting the aiming position regardless of differences in the circumferential position of the irradiation spot.

[0153] In detail, the control unit 60 rotates the spot spacing guide 90 in the treatment progress direction determined by the irradiation plan by matching a single rotation angle of the spot spacing guide 90 with the angle of the irradiation section (i.e., the angle range in which the treatment laser light can be irradiated multiple times based on the spot spacing guide 90 with the angle of the spot spacing guide 90 fixed). As a result, the treatment with the treatment laser light for each irradiation section can be smoothly performed on the arc-shaped or annular treatment target site. In this embodiment, the rotation angle of the spot spacing guide 90 according to the irradiation section matches the specified angle by which the reflecting surface 27 of the partially rotating contact lens 26 rotates in one operation.

[0154] The control unit 60 automatically moves the index of the spot interval guide 90 by one appropriate interval between the multiple irradiation spots each time the irradiation of the treatment laser light is performed until the irradiation of all the multiple spots in one irradiation section is completed. In addition, the control unit 60 automatically rotates the entire index of the spot interval guide 90 in the traveling direction by the angle of the irradiation section each time the irradiation of all the multiple spots in one irradiation section is completed. As a result, not only the irradiation of the treatment laser light in one irradiation section but also the irradiation of the treatment laser light to each of the multiple irradiation sections is automatically and appropriately assisted according to the progress of the irradiation plan.

[0155] Moreover, the control unit 60 displays the next targeting index 90A at a position where the next targeting index 90A 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 rotation of the index) among the multiple indices every time the multiple indices are rotated. As a result, the position of the next targeting index 90A is appropriately changed according to the progress of the irradiation plan, so that the treatment can proceed more smoothly. Furthermore, the control unit 60 sets all the indices other than the position where the next targeting index 90A overlaps among the multiple indices as non-irradiated indices every time the control unit 60 rotates the multiple indices.

[0156] 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 of the treatment laser light for the patient's eye E (S61). The treatment plan acquired in S61 defines the prescribed angle of the partially rotating contact lens 26 to be used (i.e., the angle of one irradiation section), the number of times M that the treatment laser light is irradiated in each irradiation section, the total number N of times that the treatment laser light is irradiated to the entire treatment target area, the irradiation spot to which the treatment laser light is first irradiated, the irradiation order of the treatment laser light (including the irradiation direction), etc. It should be noted that information such as the prescribed angle of the contact lens 26 may be acquired based on information indicating the type of the contact lens 26.

[0157] The control unit 60 causes the internal display unit 50 to display the spot interval guide 90 at an angle corresponding to the arrangement of the first irradiation section (S62). 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 to the entire treatment target area to "0" (S63). Furthermore, the control unit 60 sets the value of an intra-section irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated to one irradiation section to "0" (S64). The control unit 60 sets the display position of a next targeting index 90A, which is an index for irradiating the treatment laser light next among the multiple indices of the spot interval guide 90, to a position overlapping with an index located at the end opposite to the progression direction of the irradiation order (S65).

[0158] The control unit 60 judges whether or not an instruction to irradiate the treatment laser light has been input by the operator (S67). If an instruction to irradiate the treatment laser light has not been input (S67: NO), the judgment of S67 is repeated. During this time, the operator adjusts the aiming position of the treatment laser light. If an instruction to irradiate the treatment laser light has been input (S67: YES), the treatment laser light is irradiated (S68).

[0159] 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 judges whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser light to the entire treatment target site (S72). If the irradiation of all irradiation spots with the treatment laser light has not been completed (i.e., "n" has not reached "N") (S72: NO), the control unit 60 moves the entire spot interval guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the traveling direction 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.

[0160] When irradiation of one irradiation section 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 type contact lens 26 (i.e., the angle of one irradiation section) (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.

[0161] <Fifth embodiment> With reference to Figs. 20 to 23, the treatment control process executed by the ophthalmic laser treatment device 1 of the fifth embodiment will be described. In the fifth embodiment, unlike the third and fourth embodiments, a case where a treatment is performed using a contact lens in which the interval index 28 is not formed and which is not a partially rotating lens is illustrated. However, at least a part of the technique illustrated in the fifth embodiment can be applied to a case where a treatment is performed using a contact lens 26 in which the interval index 28 is formed. The adjustment pattern of 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 to each of a plurality of irradiation spots included in one irradiation section. 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 is an angular range of an arc-shaped area (a sector-shaped area) in which irradiation of the treatment laser light is scheduled to be performed a specified number of times M (M≧2) based on the spot spacing guide 90 (i.e., irradiation of each of a specified number of irradiation spots with the treatment laser light). In the fifth embodiment, the center of the display area in the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser light, and the optical axis of the aiming light all coincide at the center O. In other words, the surgeon visually recognizes the spot AI of the aiming light at the center of the observation field and the center of the display area of ​​the internal display unit 50. The treatment laser light is irradiated to the same spot as the spot AI of the aiming light.

[0162] First, an example of the observation field of the surgeon during treatment by 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 shows the surgeon the appropriate intervals between multiple irradiation spots to which the treatment laser light is to be irradiated.

[0163] 20, the ophthalmic laser treatment device 1 of the fifth embodiment matches the intervals of the multiple indices included in the spot interval guide 90 to the appropriate intervals of the multiple irradiation spots. Therefore, the surgeon can easily bring the intervals of the irradiation spots of the treatment laser light closer to the appropriate intervals by matching the moving distance when moving the aim position of the treatment laser light from the previous irradiation spot to the next irradiation spot to the intervals of the multiple indices included in the spot interval guide 90. This makes it easier to perform the treatment according to the treatment plan more appropriately.

[0164] The ophthalmic laser treatment device 1 of the fifth embodiment displays a spot interval 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 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 treatment site (the trabecular meshwork in this embodiment) of the patient's eye E, which is an arc or ring. In the fifth embodiment, 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) (i.e., the spot interval guide 90 does not overlap with the aiming position), so that the surgeon can set the irradiation position of the treatment laser light after appropriately grasping the state of the tissue at the aiming position. Furthermore, by arranging the end of each of the multiple indices on the side of the target position along a curve (arc-shaped), when the spot interval guide 90 is arranged at an appropriate position for the next target position, the distance between the end of each of the multiple indices on the side of the target position (the lower end in FIG. 20) and the arc-shaped treatment site becomes closer. As a result, the surgeon can more easily adjust the next target position of the treatment laser light appropriately by referring to the spot interval guide 90. In the example shown in FIG. 20, the spot interval guide 90 is displayed on the opposite side of the iris from the treatment site (the trabecular meshwork in this embodiment). However, the spot interval guide may be displayed on the iris side of the treatment site.

[0165] Although the shape of the curve of the arc-shaped treatment site of the patient's eye E varies slightly depending on the patient's eye, it does not change significantly for each patient's eye. Therefore, the target position side end of each of the multiple indices may be displayed along a curve that is predetermined based on the average shape of the treatment site. As an example, in this embodiment, an experiment is performed in advance to observe a part of the model eye that simulates the trabecular meshwork (simulated trabecular meshwork) under predetermined conditions. A program for displaying the target position side end of each of the multiple indices along the shape of the simulated trabecular meshwork observed by the experiment is stored in the non-volatile memory 65 in advance. The process for displaying the target position side end of each of the multiple indices will be described in detail later.

[0166] As in the fourth embodiment, the ophthalmic laser treatment device 1 displays a next targeting index 90A for aligning the position of the next irradiation spot at a position on the spot interval guide 90 corresponding to the optical axis of the treatment laser light. The ophthalmic laser treatment device 1 moves the multiple indices included in the spot interval guide 90 by one appropriate interval of the multiple irradiation spots in the direction opposite to the treatment progress direction defined in the irradiation plan every time the treatment laser light is irradiated. In addition, the ophthalmic laser treatment device 1 moves the position of the next targeting index 90A in the spot interval guide 90 by one appropriate interval of the multiple irradiation spots in the progress 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. The surgeon can adjust the next targeting position more easily by aligning the position on the tissue to be irradiated with the next treatment laser light, taking into account the position of the next targeting index 90A on the optical axis of the treatment laser light (which also coincides with the optical axis of the aiming light when the aiming light is irradiated).

[0167] Among the multiple indices in the spot interval guide 90, the indices other than the next targeting indices 90A are either the irradiated indices 90B corresponding to spots that have already been irradiated with the treatment laser light, or the 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, the irradiated indices 90B, and the unirradiated indices 90C in different modes (i.e., modes 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 90B, and the unirradiated indices 90C, which makes it easier to proceed with the treatment more smoothly.

[0168] The ophthalmic laser treatment device 1 moves the entire spot interval guide 90 by one appropriate interval of the multiple irradiation spots in the direction opposite to the moving direction determined by the irradiation plan every time the treatment laser light is irradiated. The operator can adjust the aiming position every time so that the positions of the multiple indices that move every time the treatment laser light is irradiated are constant positions on the observation image observed through the observation optical system 40. As described above, the fifth embodiment illustrates a case where the interval indices 28 are not formed and the treatment is performed using a contact lens that is not a partially rotating lens. Even in this case, the operator can appropriately adjust each of the multiple aiming positions by appropriately adjusting the positional relationship between the characteristic site present in the tissue included in the observation image and the multiple indices of the spot interval guide 90. For example, the surgeon can specify one characteristic site on the observation image, and each time the spot interval guide 90 moves by one appropriate interval of the irradiation spot (i.e., each time irradiation of the treatment laser light is performed), execute a movement instruction to the device so that a specific index (e.g., the leftmost index or the second index from the left, etc.) among the multiple indexes matches the specified characteristic site. In other words, if the spot interval guide 90 includes multiple indexes, each of the multiple target positions is appropriately adjusted by matching at least one of the multiple indexes (a specific index) with the characteristic site.

[0169] The ophthalmic laser treatment device 1 of the fifth embodiment displays any of the elements of the multiple indices included in the spot interval guide 90 in a line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indices 90A, 90B, and 90C included in the spot interval guide 90 in a line 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 the multiple indices are displayed in a line along the angle reference line AL. The ophthalmic laser treatment device 1 moves the spot interval guide 90 along the linear direction in which the elements of the multiple indices are arranged, every time irradiation of the treatment laser light is performed. In this case, the surgeon can proceed with the treatment more appropriately by matching the direction in which the elements of the multiple indices are arranged with the moving direction in which the aim position of the treatment laser light is moved to the next irradiation spot. For example, the reflecting surface of a contact lens may include an edge or the like perpendicular to the direction extending outward from the center axis of the lens. In this case, the surgeon can move the target 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 in which the multiple index elements are arranged. Even if the contact lens that was in contact with the patient's eye is once removed from the patient's eye, the surgeon can easily return the position and orientation of the contact lens to its original state by aligning the edge direction of the contact lens shown in the observation image with the linear direction in which the multiple index elements are arranged.

[0170] In detail, in this embodiment, each of the multiple indices is perpendicular to the angle reference line AL, and the center (center of gravity) of each indices is located on the angle reference line AL. When the multiple indices of the spot interval guide 90 are located at an appropriate position with respect to the next irradiation spot, each of the indices of the spot interval guide 90 extends from the angle reference line AL to the vicinity of the treatment site (trabecular meshwork) in this embodiment. As a result, the positional relationship between the spot interval guide 90 and the treatment site (for example, the positional relationship between a specific indices and a characteristic site in the tissue, etc.) can be more appropriately grasped. In addition, the length of each of the multiple indices of the spot interval guide 90 is symmetrical with respect to the angle reference line AL. Therefore, the operator can easily grasp the direction in which each element of the multiple indices is arranged (i.e., the direction in which the angle reference line AL extends), and therefore it becomes easier to adjust the angle of the reflecting surface of the contact lens to an appropriate angle. For example, it is also possible to set the angle of the reflecting surface to an appropriate angle by adjusting the angle of the reflecting surface of the contact lens so that the direction of the angle reference line AL is a direction tangent to the ring-shaped or arc-shaped treatment site. The multiple indicators of the spot interval guide 90 do not have to extend from the angle reference line AL to near the treatment site. The indicators displayed near the treatment site may have a suitable width to absorb individual differences in the curve of the treatment site.

[0171] 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 (see FIG. 10) illustrated in the first embodiment. Therefore, a detailed description of the outer periphery guide 75 will be omitted.

[0172] Moreover, the ophthalmic laser treatment device 1 of the fifth embodiment displays the total number of irradiation spots determined 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 (that is, the total number of irradiation spots for which irradiation of the treatment laser light has been completed and the irradiation of which 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. Every time irradiation of the treatment laser light and skipping of irradiation are 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.

[0173] The flow of treatment using the spot interval guide 90 will be described using the example shown in FIG. 21 and FIG. 22. In FIG. 21 and FIG. 22, in order to facilitate understanding of the transition of the display of the spot interval guide 90, the part of the observation field of the operator other than the vicinity of the spot interval guide 90 displayed on the internal display unit 50 is omitted. Note that FIG. 21 and FIG. 22 show an example of performing adjacent irradiation in a clockwise direction on the actual trabecular meshwork region from the lower side (FIG. 21) to the left diagonally lower side (FIG. 22) based on an irradiation plan previously set by the operator. In FIG. 21 and FIG. 22, the lower trabecular meshwork is reflected by the reflecting surface of the contact lens and enters the observation field of the operator. Therefore, in FIG. 21 and FIG. 22, the top and bottom are reversed and the lower trabecular meshwork is reflected. When the treatment for the irradiation spot proceeds from right to left (i.e., counterclockwise) on the reflecting surface in FIG. 21 and FIG. 22, the treatment for the irradiation spot proceeds from right to left (i.e., clockwise) on the actual lower trabecular meshwork.

[0174] First, as shown in FIG. 21(a), the control unit 60 determines the angle of the spot interval guide 90 to be displayed on the internal display unit 50 according to the progress of the irradiation plan, and displays the spot interval guide 90 at the determined angle. The spot interval guide 90 shown in FIG. 21 is a guide for performing a prescribed number of times (10 times at most) of irradiation on the lower region of the actual trabecular meshwork TM. The indicators of the spot interval guide 90 shown in FIG. 21(a) are arranged in the horizontal direction to treat the lower region of the trabecular meshwork TM. The control unit 60 causes the spot interval guide 90 to identifiably display a next target indicator 90A for adjusting the target position of the next treatment laser light. In the example shown in FIG. 21(a), the control unit 60 first causes the next target indicator 90A to be displayed at the position of the indicator (the indicator located at the right end in FIG. 21(a)) located at the end of the opposite side with respect to the progress direction of the treatment determined in the irradiation plan, among the multiple indicators of the spot interval guide 90. Among the multiple indices of the spot interval guide 90, the indices other than the one overlapping with the next targeting index 90A are set as non-irradiation indices corresponding to at least a part of the spot to be irradiated with the treatment laser light after the next time. Furthermore, the control unit 60 displays the multiple indices of the spot interval guide 90 so that the next targeting index 90A corresponds to a position on the optical axis of the treatment laser light 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 completely coincide with the optical axis of the treatment laser light. In other words, it is sufficient that the next targeting index 90A is displayed at a position corresponding to the targeting position of the treatment laser light so that the surgeon can recognize the targeting position to be irradiated with the treatment laser light.

[0175] 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 by the joystick unit 5, so that the position of the next target index 90A included in the spot interval guide 90 corresponds to the first irradiation spot of the treatment laser light in the treatment area of ​​the patient's eye E (the trabecular meshwork in this embodiment). Here, if there is any characteristic area in the tissue of the patient's eye E included in the observation image, it is desirable for the surgeon to grasp the positional relationship between at least one of the multiple indices (specific index) in the spot interval guide 90 and the characteristic area of ​​the tissue. In this case, in the subsequent treatment procedure, the surgeon can smoothly proceed with the treatment for each of the multiple irradiation spots by adjusting the positional relationship between the specific index and the characteristic area of ​​the tissue to the same positional relationship. As shown in FIG. 21(b), the surgeon inputs an instruction to perform irradiation of the treatment laser light with the position of the next target index 90A aligned to the position corresponding to the first irradiation spot of the treatment laser light in the treatment area of ​​the patient's eye E (the trabecular meshwork in this embodiment). As a result, the treatment laser light is irradiated to the spot S through which the optical axis of the laser irradiation optical system 10 passes.

[0176] As shown in FIG. 21(c), when the irradiation of the treatment laser light is completed, the control unit 60 moves all the indices of the spot interval guide 90 in the direction opposite to the treatment progress direction (clockwise, leftward in FIG. 21) defined in the irradiation plan (rightward in FIG. 21) by one appropriate interval of the irradiation spot. The control unit 60 also moves the position of the next target index 90A by one appropriate interval of the irradiation spot in the progress direction defined in the irradiation plan. As a result, the position of the next target index 90A is maintained at a position corresponding to the target position. Furthermore, the control unit 60 changes the index on which the next target index 90A was superimposed during the previous irradiation of the treatment laser light to an irradiated index. As shown in FIG. 21(d), the operator mainly operates the joystick unit 5 to move the tissue shown in the observation image by the intervals of the multiple indices of the spot interval guide 90 in the treatment progress direction defined in the irradiation plan, thereby adjusting the aim position of the next treatment laser light. The operator can also 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 light. Therefore, the aim position can be easily adjusted appropriately. The operator inputs an instruction to irradiate the treatment laser light in a state where the position of the next aim index 90A is aligned with the position corresponding to the aim position of the next treatment laser light (the state shown in FIG. 21(d)).

[0177] As shown in FIG. 21(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 interval guide 90 in the direction opposite to the moving direction defined in the irradiation plan by one proper interval of the irradiation spot. The control unit 60 also moves the position of the next targeting indicator 90A by one proper interval of the irradiation spot in the moving direction defined in the irradiation plan. As a result, the position of the next targeting indicator 90A is maintained at a position corresponding to the aiming position. The operator inputs an instruction to perform irradiation of the treatment laser light in a state where the position of the next targeting indicator 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 the irradiation of all the multiple spots (10 spots in the example shown in FIG. 21 and FIG. 22) in 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.

[0178] When the treatment laser light is irradiated a prescribed number of times M to one irradiation section (10 times in the example shown in FIG. 21 and FIG. 22), the state shown in FIG. 22(a) is reached. The control unit 60 automatically rotates the entire index of the spot interval guide 90 in the proceeding direction by the angle of one irradiation section. The control unit 60 also displays the next target index 90A at a position where the next target index 90A overlaps with an index located at the end opposite to the proceeding direction of the treatment defined in the irradiation plan. Furthermore, the control unit 60 sets all the indexes of the spot interval guide 90 other than the position where the next target index 90A overlaps as non-irradiated indexes. The control unit 60 displays the multiple indexes of the spot interval 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 is in the state shown in FIG. 22(b). The operator rotates the reflective surface of the contact lens clockwise, which is the treatment progression direction (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.

[0179] In addition, the ophthalmic laser treatment device 1 of the fifth embodiment can also input an instruction from a user to rotate the entire spot interval guide 90 before the irradiation of all of the irradiation spots in the irradiation section under treatment is completed with the treatment laser light (that is, during the treatment of the irradiation spots in the irradiation section). When an instruction to rotate the entire spot interval guide 90 is input before the treatment of all of the irradiation spots in the irradiation section under treatment is completed, the ophthalmic laser treatment device 1 rotates the entire spot interval guide 90 by an angle corresponding to the range of the treatment progressed in the irradiation section under treatment. Therefore, even if the treatment in each irradiation section is not completed, the surgeon can move on to the treatment in the next irradiation section after rotating the entire spot interval guide 90.

[0180] In addition, the ophthalmic laser treatment device 1 of the fifth embodiment can also input a user's instruction (hereinafter, referred to as a "skip instruction") to skip the irradiation of the treatment laser light to the next irradiation spot determined in the irradiation plan. When the skip instruction is input, the ophthalmic laser treatment device 1 moves the spot interval guide 90 by one appropriate interval of the multiple irradiation spots in the moving direction or the opposite direction determined in the irradiation plan without irradiating the treatment laser light. Therefore, the operator can input a skip instruction when there is a non-irradiated area where it is not appropriate to irradiate the treatment laser light, and resume treatment from the irradiation spot scheduled thereafter. This makes it easier to proceed with the treatment more smoothly. In other words, the ophthalmic laser treatment device 1 is provided with a skip means for skipping the irradiation step of the treatment laser light to some of the multiple irradiation spots determined in the treatment plan. Therefore, it becomes easier to appropriately achieve both convenience through the treatment plan (e.g., guiding the irradiation of the treatment laser light) and flexible treatment using the skip means (e.g., a procedure for omitting the irradiation of the treatment laser light to non-irradiated areas discovered after the start of treatment according to the treatment plan).

[0181] As described above, also in the fifth embodiment, 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 light by referring to the spot spacing guide 90.

[0182] Furthermore, the control unit 60 changes the intervals between the multiple indicators of the spot interval 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 interval guide 90 corresponding to the appropriate intervals between the multiple irradiation spots is displayed on the internal display unit 50.

[0183] 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 of the treatment laser light for the patient's eye E (S81). In the treatment plan acquired in S81, the angle between two adjacent irradiation spots, the angle of one irradiation section, the number of times M that the treatment laser light is irradiated in each irradiation section, the total number N of times that the treatment laser light is irradiated to the entire treatment target area, the irradiation spot to be irradiated with the treatment laser light first, the irradiation order of the treatment laser light (including the irradiation direction), etc. are determined. Note that, if the angle range of the annular or arc-shaped treatment target area is R degrees (R≦360) and the number of irradiation spots that irradiate the treatment laser light on the treatment target area is N, the angle between two adjacent irradiation spots is "R / N" degrees. Also, 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.

[0184] The control unit 60 causes the internal display unit 50 to display the spot interval guide 90 at an angle corresponding to the arrangement of the first irradiation section (S82). 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 to the entire treatment target area to "0" (S83). Furthermore, the control unit 60 sets the value of an intra-section irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated within one irradiation section to "0" (S84). The control unit 60 sets the display position of a next targeting index 90A, which is an index for irradiating the treatment laser light next among the multiple indices of the spot interval guide 90, to a position overlapping with an index located at the end opposite to the progression direction of the irradiation order (S85).

[0185] 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 target position side 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 index for irradiating the treatment laser light next (i.e., the next target index 90A) to the shortest initial value. The control unit 60 sets the length (length in the direction perpendicular to the angle reference line AL) of the multiple indices other than the next target index 90A so that the longer the interval between the next target index 90A and the next target index 90A, the greater the increase in the length from the initial value set as the length of the next target index 90A. The relationship between the interval between the next target index 90A and the length of each index may be determined in advance so that the position of the end of each of the multiple indices on the target position side is arranged along the shape of the simulated trabecular meshwork observed by an experiment. Also, the length of each index may be calculated so that the length of each index increases from the initial value in proportion to the interval between the next target index 90A and the next target index 90A. When the lengths of all the indices are set, each of the indices included in the spot interval guide 90 is displayed on the internal display section 50 with the set length.

[0186] The control unit 60 judges whether or not an instruction to perform irradiation of the treatment laser light has been input by the operator (S87). If an instruction to perform irradiation has not been input (S87: NO), the control unit 60 judges whether or not an instruction to omit irradiation of the treatment laser light to 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 judges whether or not an instruction to rotate the entire spot interval guide 90 (hereinafter referred to as an "intermediate rotation instruction") before the irradiation of all of the multiple irradiation spots in the irradiation section under treatment with the treatment laser light is completed has been input (S89). If no instruction has been input in S87 to S89, the judgments of S87 to S89 are repeated and the system enters a standby state. During this time, the operator adjusts the aiming position of the treatment laser light.

[0187] When an instruction to perform irradiation of the treatment laser light is input (S87: YES), the treatment laser light 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 judges whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser light to the entire treatment target site (S92). If the prescribed number of irradiations of the treatment laser light (including the number of skipped irradiations in this embodiment) to all irradiation spots has not been completed (i.e., "n" has not reached "N") (S92: NO), the control unit 60 judges whether the prescribed number of irradiations of the treatment laser light to the irradiation section under treatment has been completed (i.e., whether the value of the intra-section irradiation number counter "m" has reached the number of irradiations of the treatment laser light to one irradiation section "M") (S93). If the irradiation of the treatment laser beam into the irradiation section under treatment is not completed (S93: NO), the control unit 60 moves the entire spot interval guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the moving direction of the irradiation spots (S94). Note that in S94, control is also executed to move the next targeting indicator 90A by one appropriate interval. After that, the process returns to S87.

[0188] When irradiation of one irradiation zone is completed (S93: YES), the control unit 60 rotates the entire spot interval guide 90 by an angle (prescribed angle) for one irradiation zone (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 is completed (S92: YES), the process ends.

[0189] Furthermore, when a skip instruction is input before an instruction to irradiate the treatment laser beam 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 the treatment laser beam is not completed (if "n" does not reach "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 the treatment laser beam (S94). The direction in which the spot spacing guide 90 is moved may be determined according to an instruction input by the surgeon. 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 target index 90A and the unirradiated indexes (S98).

[0190] Furthermore, when a midway rotation instruction is input before an instruction to perform irradiation of the treatment laser light is input (S89: YES), the control unit 60 calculates an angle corresponding to the range in which the treatment has progressed in the irradiation section during treatment as an angle for rotating the spot interval guide 90 (S96). A specific calculation method of the rotation angle in S96 can be appropriately selected. For example, the angle between two adjacent irradiation spots when 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 in which the treatment has progressed in the irradiation section during treatment is set to m (in this embodiment, this corresponds to the value of the intra-section irradiation number counter m). In this embodiment, the control unit 60 calculates the angle corresponding to the range in which the treatment has progressed in the irradiation section during treatment by "A degrees x m". The number of irradiation spots in which the treatment has progressed, "m", also includes the number of irradiation spots in which the irradiation of the treatment laser light has been skipped due to a skip instruction. The control unit 60 rotates the entire spot interval guide 90 in the progression direction determined in the treatment plan by the angle calculated in S96 (S97). If the number of irradiation spots where treatment has progressed, "m", is "0", the angle calculated in S96 is "0 degrees", so the spot interval guide 90 is not rotated in S97. After that, a reset process for the next targeting index 90A and the unirradiated index is performed (S98), and the process returns to S84.

[0191] Sixth embodiment A treatment control process executed by the ophthalmic laser treatment device 1 of the sixth embodiment will be described with reference to FIG. 20 and FIG. 24 to FIG. 27. In the sixth embodiment, as in the fifth embodiment, a case where a treatment is performed using a contact lens that does not have the interval index 28 and is not a partially rotating lens will be illustrated. However, at least a part of the technique illustrated in the sixth embodiment can be applied to a case where a treatment is performed using a contact lens 26 that has the interval index 28. The adjustment pattern of the aim position of the treatment laser light executed in the sixth embodiment is a pattern (hereinafter referred to as a "rotation adjustment pattern") in which the contact lens is mainly rotated when adjusting the aim position to each of a plurality of irradiation spots included in one irradiation section. 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 section in the sixth embodiment is an angle range of an arc-shaped area (a sector-shaped area) in which irradiation of the treatment laser light is scheduled to be performed a specified number of times M (M≧2) based on the spot interval guide 90 (i.e., irradiation of the treatment laser light to each of the specified number of irradiation spots). In the sixth embodiment, the center of the display area in the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser light, and the optical axis of the aiming light all coincide at the center O. In other words, the surgeon visually recognizes the spot AI of the aiming light at the center of the observation field and the center of the display area in the internal display unit 50. The treatment laser light is irradiated onto the same spot as the spot AI of the aiming light.

[0192] The observation field of the operator during treatment by the ophthalmic laser treatment device 1 of the sixth embodiment is the same as that of the fifth embodiment shown in FIG. 20. As shown in FIG. 20, the ophthalmic laser treatment device 1 of the sixth embodiment also allows the operator to grasp the interval between multiple irradiation spots by displaying a spot interval guide 90 on the internal display unit 50. The ophthalmic laser treatment device 1 matches the interval between multiple indicators included in the spot interval guide 90 with the appropriate interval between multiple irradiation spots. The ophthalmic laser treatment device 1 displays the spot interval 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).

[0193] As shown in FIG. 20, the ophthalmic laser treatment device 1 of the sixth embodiment displays a next aim index 90A for aligning the position of the next irradiation spot at a position on the spot interval guide 90 corresponding to the optical axis of the treatment laser light. The ophthalmic laser treatment device 1 moves and rotates a plurality of indexes included in the spot interval guide 90 every time the treatment laser light is irradiated (details will be described later). In addition, the ophthalmic laser treatment device 1 moves the position of the next aim index 90A in the spot interval guide 90 by one appropriate interval of the plurality of irradiation spots in the traveling direction determined by the irradiation plan. The surgeon can adjust the next aim position more easily by aligning the position on the tissue to be irradiated with the next treatment laser light, taking into account the position of the next aim index 90A on the optical axis of the treatment laser light.

[0194] Among the multiple indices in 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 a different manner (i.e., in a manner that can be distinguished by the surgeon).

[0195] As shown in FIG. 20, the ophthalmic laser treatment device 1 of the sixth embodiment displays any of the elements of the multiple indices included in the spot interval guide 90 in a line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indices 90A, 90B, and 90C included in the spot interval guide 90 in a line 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 the multiple indices are displayed in a line along the angle reference line AL. In this case, the surgeon can proceed with the treatment more appropriately by matching the direction in which the elements of the multiple indices are arranged with the moving direction in which the aim position of the treatment laser light is moved to the next aim position. In detail, each of the multiple indices is perpendicular to the angle reference line AL, and the center (center of gravity) of each indices is located on the angle reference line AL. The length of each of the multiple indices of the spot interval guide 90 is 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 for him or her to adjust the angle of the reflective surface of the contact lens to an appropriate angle.

[0196] The ophthalmic laser treatment device 1 of the sixth embodiment displays an outer periphery guide 75 on the internal display unit 50 as an aiming guide. 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 can 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 determined in the irradiation plan. In addition, the number of irradiation spots where treatment has been completed (that is, the total number of irradiation spots where irradiation of the treatment laser light has been completed and the total number of irradiation spots where irradiation has been skipped) is displayed. In addition, in the example shown in FIG. 20, the mode of the aiming light AI used and the energy of the treatment laser light are also displayed.

[0197] The flow of treatment using the spot interval guide 90 in the sixth embodiment will be described using the examples shown in Figs. 24 to 26. In Figs. 24 and 25, in order to facilitate understanding of the transition of the display of the spot interval guide 90, the part of the observation field of the operator other than the vicinity of the spot interval guide 90 displayed on the internal display unit 50 is omitted. Note that Figs. 24 and 25 show an example of performing adjacent irradiation in a clockwise direction on the actual trabecular meshwork region from the lower side (Fig. 24) to the left diagonally lower side (Fig. 25) based on an irradiation plan previously set by the operator. In Figs. 24 and 25, the lower trabecular meshwork is reflected by the reflecting surface of the contact lens and enters the observation field of the operator. Therefore, in Figs. 24 and 25, the top and bottom are reversed and the lower trabecular meshwork is reflected. When the treatment for the irradiation spot proceeds from right to left (i.e., counterclockwise) on the reflecting surface in Figs. 24 and 25, the treatment for the irradiation spot proceeds from right to left (i.e., clockwise) on the actual lower trabecular meshwork.

[0198] First, as shown in FIG. 24(a), the control unit 60 determines the angle of the spot interval guide 90 to be displayed on the internal display unit 50 (specifically, the angle at which the multiple indicators included in the spot interval guide 90 are arranged) according to the progress of the irradiation plan, and displays the spot interval guide 90 at the determined angle. The spot interval guide 90 shown in FIG. 24 is a guide for performing the specified number of irradiations, 10 times (i.e., up to 10 times), on the lower region of the actual trabecular meshwork TM. The multiple indicators of the spot interval guide 90 shown in FIG. 24(a) are arranged in the horizontal direction to treat the lower region of the trabecular meshwork TM. That is, in the state shown in FIG. 24(a), the multiple indicators included in the spot interval guide 90 are arranged along the first reference line R1 extending in the horizontal direction.

[0199] The control unit 60 identifiably displays a next targeting index 90A for adjusting the targeting position of the next treatment laser beam in the spot interval guide 90. 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 (the index located at the right end in FIG. 24(a)) located at the opposite end of the spot interval guide 90 with respect to the treatment progress direction determined in the irradiation plan. Among the multiple indices of the spot interval guide 90, the indices other than the one overlapping with the next targeting 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 of the spot interval guide 90 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 described above, the position where the next targeting index 90A is displayed does not need to completely coincide 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 light so that the surgeon can recognize the aim position to be irradiated with the treatment laser light.

[0200] 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 by the joystick unit 5, so that the position of the next targeting index 90A included in the spot interval guide 90 corresponds to the first 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 perform irradiation of the treatment laser light in a state where the position of the next targeting index 90A is aligned to a position corresponding to the aim position of the first 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 to 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 reflecting surface of the contact lens on the right side of the center on the paper.

[0201] As shown in FIG. 24(c), when the irradiation of the treatment laser light is completed, the control unit 60 moves all the indicators of the spot interval guide 90 in the direction opposite to the treatment progress direction (clockwise in FIG. 24, leftward) determined in the irradiation plan by one appropriate interval of the irradiation spot. In addition, when the irradiation of the treatment laser light is completed, the control unit 60 rotates all the indicators of the spot interval guide 90 by a unit angle T in the treatment progress direction (clockwise in FIG. 24) determined 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 light from the previous irradiation spot to the next irradiation spot. That is, the control unit 60 rotates the entire spot interval guide 90, which was aligned along the reference line R1 in the state of FIG. 24(a) and (b), by the reference angle to align it along the second reference line R2 (see FIG. 24(c) and (d)). As a result, multiple irradiations of therapeutic laser light within one irradiation section, in which the irradiation position can be adjusted by rotating the contact lens, are appropriately assisted according to the progress of the irradiation plan.

[0202] The control unit 60 moves the position of the next target index 90A by one appropriate interval of the irradiation spot in the moving direction determined by the irradiation plan. As a result, the position of the next target index 90A is maintained at a position corresponding to the target position. Furthermore, the control unit 60 changes the index on which the next target index 90A was superimposed during the previous irradiation of the treatment laser light to an irradiated index. As shown in FIG. 24(d), the operator can adjust the target position of the treatment laser light from the previous irradiation spot to the next irradiation spot by rotating the contact lens by the above-mentioned reference angle. In addition, the operator can adjust the target position of the next treatment laser light by adjusting the positional relationship between at least one of the multiple indices (a specific index) and the characteristic part of the tissue to the same positional relationship as the previous time. Therefore, the target position is easily adjusted appropriately. The operator inputs an instruction to perform irradiation of the treatment laser light in a state where the position of the next target index 90A is adjusted to a position corresponding to the target position of the next treatment laser light (the state shown in FIG. 24(d)). In the state shown in Fig. 24(d), the treatment laser light is reflected at 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 light is repeatedly irradiated in the same irradiation section, the treatment laser light is reflected on the right side of the reflective surface of the contact lens in the first half, and on the left side of the page in the second half. In other words, in this embodiment, when the treatment laser light is reflected, the vicinity of the center of the reflective surface of the contact lens is likely to be used equally on both the left and right sides.

[0203] 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 indicators of the spot interval guide 90 by one appropriate interval of the irradiation spot in the direction opposite to the moving direction determined by the aiming plan. Also, when the irradiation of the second irradiation spot with the treatment laser light is completed, the control unit 60 rotates all the indicators of the spot interval guide 90 by a unit angle T in the moving direction of the treatment determined by the irradiation plan. That is, the control unit 60 rotates the entire spot interval guide 90, which was aligned along the reference line R2 in the state of FIG. 24(c) and (d), by a reference angle to align it along the third reference line R3 (see FIG. 24(e) and (f)). The control unit 60 moves the position of the next aiming indicator 90A by one appropriate interval of the irradiation spot in the moving direction determined by the aiming plan. As a result, the position of the next aiming indicator 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 aiming index 90A with the position corresponding to the next irradiation spot of the treatment laser light (see FIG. 24(f)). The surgeon then inputs an instruction to irradiate the treatment laser light. The above procedure is repeated until irradiation of the treatment laser light to all of the multiple spots in one irradiation section (10 spots in the example shown in FIG. 24 and FIG. 25) is completed. As described above, the irradiation section 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.

[0204] Immediately before the first irradiation section is irradiated with the treatment laser light a prescribed number of times M (10 times in the example shown in FIG. 24 and FIG. 25), the observation image is in the state 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 light (see FIG. 24(a) and (b)). That is, in the state shown in FIG. 25(a), the entire spot spacing guide 90 is arranged along the tenth reference line R10. When the irradiation of all M irradiation spots in the first irradiation section with the treatment laser light is completed (that is, when the irradiation of the tenth irradiation spot with the treatment laser light is completed), the control unit 60 rotates the entire spot spacing guide 90 in the traveling direction determined by the irradiation plan, thereby adjusting the entire angle of the spot spacing guide 90 to an angle corresponding to the first irradiation spot of the next irradiation section. For example, assume that the range of R degrees (R≦360) in a ring-shaped or arc-shaped treatment site is divided into S irradiation sections, and the treatment laser light is irradiated M times in each irradiation section. During treatment in one irradiation section, when the irradiation of the treatment laser light is completed M times, the total value of the rotation angle of the spot interval guide 90 is (T×(M−1)) degrees, where T is the unit angle described above. In addition, the angle range of one irradiation section is R / S degrees. Therefore, when the irradiation of the treatment laser light to all of the multiple irradiation spots in the irradiation section under treatment is completed, the control unit rotates the spot interval guide 90 by (R / ST×(M−1)) degrees. As a result, in the state shown in FIG. 25(b) and (c), the entire spot interval guide 90 is arranged along the eleventh reference line R11. In addition, the control unit 60 displays the next target index 90A at a position overlapping the index located at the end opposite to the treatment progress direction determined by the irradiation plan among the multiple indexes. Furthermore, the control unit 60 sets all the indices of the spot interval guide 90, except for the position where the next targeting index 90A overlaps, as non-irradiated 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 light irradiated by the laser irradiation optical system 10. As a result, the observation image becomes the state shown in FIG. 25(b).The operator rotates the reflecting surface of the contact lens and operates the joystick to move the position of the optical axis of the treatment laser light, thereby aligning the target position of the treatment laser light with the position of the next targeting index 90A (see FIG. 25(c)). After that, irradiation of all of the multiple spots in the second irradiation section with the treatment laser light is repeated.

[0205] The ophthalmic laser treatment device 1 of the sixth embodiment can also input an instruction from a user 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 the 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 range in which the treatment has progressed in the irradiation zone under treatment.

[0206] 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 determined in the irradiation plan with the treatment laser light. When a skip instruction is input, the ophthalmic laser treatment device 1 moves the spot interval guide 90 by one appropriate interval between the multiple irradiation spots in the traveling direction determined in the aiming plan or in the direction opposite to the traveling direction without irradiating the treatment laser light.

[0207] With reference to FIG. 26, a rotation angle (unit angle T) of the contact lens required to move the target position of the treatment laser light to the next irradiation spot when the relative position of the device with respect to the subject's eye is not moved (i.e., the optical axis of the treatment laser light is not moved) will be described. In the example shown in FIG. 26, it is assumed that the treatment laser light is irradiated N times (100 times in this embodiment) at equal intervals within a range of R degrees (360 degrees in this embodiment) at the ring-shaped or arc-shaped treatment target site (trabecular meshwork TM in this embodiment). In addition, it is assumed that a virtual approximation circle (i.e., a circle through which a plurality of planned irradiation spots S pass) passing through the ring-shaped or arc-shaped treatment target site is passed. In a state where the subject's eye is viewed in a direction along the visual axis (the state shown in FIG. 26), if the treatment laser light reflected by the reflecting surface 27 of the contact lens always intersects with the center C of the approximation circle, the unit angle T is R / N degrees (3.6 degrees in this embodiment). In this case, when the examinee's eye is viewed in a direction along the visual axis, the radius of gyration of the treatment laser light coincides with the radius of the approximation circle (that is, the distance from the center C to the irradiation spot S).

[0208] However, when the aiming position is moved to the next irradiation spot only by rotating the contact lens 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 reflecting surface 27 of the contact lens. In fact, in the example shown in FIG. 26, if the angle of the reflecting surface 27 of the contact lens is set to the angle (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 reflecting surface 27 of the contact lens is set to the angle (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. In addition, even if the angle of reflecting surface 27 of contact lens 27 is set to an angle (angle indicated by 27C) for irradiating the third irradiation spot SC with the treatment laser beam, the treatment laser beam does not intersect with center C of the approximation circle when viewed from the direction of the visual axis of the patient's eye. As shown in Fig. 26, when the angle of reflecting surface 27 of contact lens 27 is rotated while maintaining the position of the optical axis of the treatment laser beam, the treatment laser beam is rotated around reflection position RP on reflecting surface 27.

[0209] 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 light, the turning radius of the treatment laser light (the distance from the reflection position RP to the irradiation spots SA, SB, SC) becomes longer than the radius of the approximation circle (the distance from the center C to the irradiation spots SA, SB, SC) when the test eye is viewed from the direction along the visual axis. As a result, the unit angle T in the rotation adjustment pattern when the test eye is viewed from the direction 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 according to the turning radius of the treatment laser light when viewed from the direction 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, SC to which the treatment laser light is irradiated), etc.

[0210] 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 of the treatment laser light for the patient's eye E (S101). The treatment plan acquired in S101 prescribes the angle between two adjacent irradiation spots, the angle of one irradiation section, the number of times M that the treatment laser light is irradiated in each irradiation section, the total number N of times that the treatment laser light is irradiated to 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.

[0211] The control unit 60 causes the internal display unit 50 to display the spot interval guide 90 at an angle corresponding to the arrangement of the first irradiation section (S102). 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 to the entire treatment target area to "0" (S103). Furthermore, the control unit 60 sets the value of an intra-section irradiation number counter "m" that specifies the number of times the treatment laser light has been irradiated within one irradiation section to "0" (S104). The control unit 60 sets the display position of the next target index 90A, which is an index for irradiating the treatment laser light next among the multiple indices of the spot interval guide 90, to a position overlapping with an index located at the end on the opposite side of the progression direction of the irradiation order (S105). Note that the method of displaying the end of each of the multiple indices included in the spot interval guide 90 on the target position side along a curve can be the same as the method shown in the fifth embodiment.

[0212] The control unit 60 judges whether or not an instruction to perform irradiation of the treatment laser light has been input by the operator (S107). If an instruction to perform irradiation has not been input (S107: NO), the control unit 60 judges whether or not an instruction to omit irradiation of the treatment laser light 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 judges whether or not an instruction to rotate the entire spot interval guide 90 (hereinafter referred to as an "intermediate rotation instruction") before the irradiation of all of the multiple irradiation spots in the irradiation section under treatment with the treatment laser light is completed has been input (S109). If no instruction has been input in S107 to S109, the judgments of S107 to S109 are repeated and the system enters a standby state. During this time, the operator adjusts the aiming position of the treatment laser light.

[0213] When an instruction to perform irradiation of the treatment laser light is input (S107: YES), the treatment laser light 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 judges whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser light to the entire treatment target site (S112). If the prescribed number of irradiations of the treatment laser light (including the number of skipped irradiations in this embodiment) to all irradiation spots has not been completed (i.e., "n" has not reached "N") (S112: NO), the control unit 60 judges whether the prescribed number of irradiations of the treatment laser light to the irradiation section under treatment has been completed (i.e., whether the value of the intra-section irradiation number counter "m" has reached the number of irradiations of the treatment laser light to one irradiation section "M") (S113). If the irradiation of the treatment laser light into the irradiation section under treatment is not completed (S113: NO), the control unit 60 moves the entire spot interval guide 90 by one appropriate interval between the multiple irradiation spots in the direction opposite to the moving direction of the irradiation spots. The control unit 60 also rotates the entire spot interval guide 90 by the above-mentioned unit angle T (S114). Note that in S114, control is also executed to move the next aiming index 90A by one appropriate interval. After that, the process returns to S107.

[0214] When irradiation of one irradiation zone is completed (S113: YES), the control unit 60 rotates the entire spot interval 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 is completed (S112: YES), the process ends.

[0215] Furthermore, when a skip instruction is input before an instruction to perform irradiation of the treatment laser light 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" without irradiating the treatment laser light (S111), and executes the processes of S112 to S115 and S118. Furthermore, when an instruction to rotate midway is input before an instruction to perform irradiation of the treatment laser light is input (S109: YES), the control unit 60 calculates an angle corresponding to the range in which the treatment has progressed in the irradiation section that was being treated as an angle for rotating the spot interval guide 90 (S116). A specific calculation method for the rotation angle in S116 can be appropriately selected. 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 above-mentioned unit angle is set to T degrees, and the number of irradiation spots in which the treatment has progressed in the irradiation section that was being treated is set to m (in this embodiment, it corresponds to the value of the intra-section irradiation number counter m). In this embodiment, the control unit 60 calculates the angle corresponding to the range where the treatment has progressed within the irradiation section where the treatment was in progress by "(A degree - T degree) x m pieces". The number of irradiation spots where the treatment has progressed, "m pieces", includes the number of irradiation spots where the irradiation of the treatment laser light has been skipped due to a skip instruction. The control unit 60 rotates the entire spot interval guide 90 in the progression direction determined in the treatment plan by the angle calculated in S116 (S117). Thereafter, a reset process of the next targeting index 90A and the non-irradiated index is performed (S118), and the process returns to S104.

[0216] Seventh embodiment With reference to FIG. 28, an ophthalmic laser treatment device 1 of the seventh embodiment will be described. The ophthalmic laser treatment device 1 of the seventh embodiment includes a laser irradiation optical system 10 (see FIG. 2) and an overlapping display unit. The overlapping display unit displays a circumferential chart 100 (details of which will be described later) in an overlapping manner on an observation image including at least a part of a ring-shaped or arc-shaped treatment target part (in this embodiment, the trabecular meshwork TM) in a patient's eye. The overlapping display unit of the seventh embodiment uses the internal display unit 50 (see FIG. 2 and FIG. 3) described in the first to sixth embodiments. However, it is also possible to use a configuration other than the internal display unit 50 as the overlapping display unit. For example, a transmissive electroluminescence (EL) panel (which may be organic or inorganic) may be used as the overlapping display unit. In addition, the circumferential chart 100 may be formed on the surface of a plate glass by deposition or the like, and the formed deposition part may be illuminated by a separate light source, so that the circumferential chart 100 is overlappingly displayed in a predetermined color (for example, green, etc.). It is more preferable that the circumferential chart 100 can be lit (in other words, brightened) and presented to the surgeon. In this case, for example, even if the observation image is partially or entirely dark due to the observation conditions, the surgeon can easily grasp the circumferential 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, etc.) may display another image, etc., superimposed 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.

[0217] 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 angle in the circumferential direction around the optical axis O of the treatment laser light, superimposed on the observation image. Therefore, the surgeon can properly grasp the direction of the treatment target site when the optical axis of the treatment laser light is the center by visually checking the circumferential direction chart 100 superimposed on the observation image. For example, in the middle of treatment of a plurality of irradiation spots, the contact lens may be temporarily removed from the patient's eye. In this case, the surgeon can properly grasp the direction (the circumferential angle around the optical axis of the treatment laser light) of the spot irradiated with the treatment laser light just before removing the contact lens by referring to the circumferential direction chart. Therefore, when the once removed contact lens is put back on the patient's eye, the angle of the contact lens can be adjusted while referring to the circumferential direction chart so that the aiming position of the treatment laser light is appropriately adjusted in the direction where the next spot is located. Therefore, the surgeon can easily and properly adjust the aiming position of the treatment laser light.

[0218] 28, the internal display unit aligns the center of an annular circumferential direction chart 100 superimposed on the observation image with the position through which the optical axis O of the treatment laser light passes in the observation image. Therefore, the direction of the treatment site with respect to the optical axis O of the treatment laser light as the center can be more appropriately grasped by the circumferential direction chart 100.

[0219] The circumferential direction chart 100 illustrated in FIG. 28 includes a plurality of indices arranged at equal angles in the circumferential direction centered on the optical axis O of the treatment laser light. Therefore, the plurality of indices arranged at equal angles makes it easier to properly grasp the direction of the treatment target area. In detail, the superimposed display unit of the seventh embodiment displays symbols (e.g., numbers up to 12, etc.) that can be displayed in at least one of the directions of the dial of an analog clock at appropriate positions (12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock positions in the example illustrated in FIG. 28) on the circumferential direction chart 100. That is, the circumferential direction chart 100 is displayed according to the clock position. Therefore, the surgeon can properly grasp the direction of the treatment target area when the optical axis of the treatment laser light is the center, in the same way as when grasping the time on an analog clock. It is also possible to change the specific aspect of the circumferential direction chart. For example, an index arranged to the right of the optical axis O of the treatment laser light may be set to 0 degrees, and a plurality of indices (e.g., indices in the form of angle values, etc.) 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 only letters (which may be numbers), or may be composed of a combination of letters and shapes. When letters are used as indices, the angle interval between the letters is preferably 15 degrees or more. In addition, multiple indices may be linked to each other. Multiple circumferential direction charts having 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.

[0220] The superimposition display unit fixes and displays the circumferential direction chart 100 at a predetermined 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 light, etc., the circumferential direction chart 100 is fixed and displayed at a predetermined position, so that the direction of the treatment target site when the optical axis O of the treatment laser light is the center can be more accurately grasped. In the seventh embodiment, the relative positional relationship between the optical axis of the optical system for allowing the surgeon to visually recognize the observation image and the optical axis O of the treatment laser light is also fixed. In other words, the optical axis of the observation optical system and the optical axis O of the treatment laser light always coincide with each other.

[0221] The superimposition display unit can switch between superimposing and not displaying 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 part, the circumferential direction chart 100 is hidden, so that the surgeon can concentrate on observing the observation image. In the seventh embodiment, the control unit 60 switches between displaying and not displaying 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 ring-shaped or arc-shaped treatment target part (hereinafter referred to as "annular treatment mode"). Therefore, a field of view according to the set treatment mode is appropriately provided to the surgeon. 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 annular treatment mode. For example, the control unit 60 may superimpose and display the circumferential direction chart 100 in the annular treatment mode, while superimposing and displaying 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. 10 and 20. In FIG.

[0222] 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 used, and the adjustment method of the aim position to the adjacent irradiation spot (see FIG. 9). The control unit 60 may perform a display based on the irradiation plan on the internal display unit 50. 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 is rotated as a whole to adjust the angle of the reflecting surface is used, the display control of the first embodiment or the fifth embodiment may be performed. When the control unit 60 inputs a trigger signal, it irradiates the treatment laser light and changes the display of the internal display unit 50 based on the irradiation plan.

[0223] The embodiments disclosed herein are illustrative in all respects and should not be considered as limiting. The scope of the present invention is indicated 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 adopt only a part of the techniques described in each of the first to fifth embodiments. It is also possible to adopt the techniques of multiple different embodiments in appropriate combination in an ophthalmic laser treatment device.

[0224] The configuration of the spot interval guide in the fourth embodiment is an example. Therefore, it is possible to change the configuration of the spot interval guide. In other words, if the adjustment of the observation site by the surgeon (for example, adjustment by operating the joystick unit 5 and adjustment by rotating or moving the contact lens, etc.) is appropriately guided so that the spot interval 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 (for example, a predetermined position relative to the reflected image 28Z of the interval index 28 included in the observation image, or a predetermined position relative to the outline of a part of the contact lens included in the observation image, etc.), the user can easily grasp the appropriate interval of the multiple irradiation spots. The spot interval guide may be called an alignment guide for aligning the target position with the desired part of the trabecular meshwork TM.

[0225] FIG. 29 shows a modified example of the spot interval guide exemplified in the fourth embodiment. In FIG. 29(a) to (e), the reflected image 28Z of the interval index 28 (see FIG. 7) provided on the contact lens 26 is shown by a dotted line. As shown in FIG. 29(a), the spot interval guide 901 may include a plurality of graphics having a shape corresponding to each of the plurality of reflected images 28Z of the interval index 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 image 28Z of the interval index 28. As shown in FIG. 29(c), the spot interval guide 903 may include a graphic having a shape surrounding the entirety of the plurality of reflected images 28Z of the interval index 28. As shown in FIG. 29(d), the spot interval guide 904 may be configured by two graphics that are aligned with the reflected image of the leftmost index and the reflected image of the rightmost index among the plurality of reflected images 28Z of the interval index 28. As shown in Fig. 29(e), the spot interval guide 901 may be configured by one graphic that is aligned with the reflection image of the center index among the multiple reflection images 28Z of the spacing index 28. As described above, the configuration of the spot interval guide that is aligned with the reflection image 28Z of the spacing index 28 can be appropriately selected. Also, as shown in Fig. 29(f), the spot interval guide may be aligned with a part of the contact lens 26 included in the observation image instead of the reflection image 28Z of the spacing index 28. The spot interval guide 906 shown in Fig. 29(f) includes an arc-shaped graphic that is aligned with the arc-shaped contour of the contact lens 26 in the observation image.

[0226] The configurations of the spot interval guides in the fifth and sixth embodiments are also merely examples. FIG. 30 shows examples of modifications of the spot interval guides exemplified in the fifth and sixth embodiments. Each of the multiple indicators 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 indicators included in the spot interval guide. For example, in the example shown in FIG. 30, each of the multiple indicators (next target indicator 91A, irradiated indicator 91B, and unirradiated indicator 91C) included in the spot interval guide 91 is a circle. Note that indicators such as line segments, regular polygons, and stars may be displayed as the indicators of the spot interval guide.

[0227] Also, the spot interval guide 91 shown in FIG. 30 includes a frame 92 surrounding a plurality of indices. The frame 92 shown in FIG. 30 surrounds a plurality of indices and extends in a direction along the angle reference line AL. Therefore, the surgeon can easily adjust the angle of the reflecting 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 a part of the elements in the spot interval guide 91 (the end of the frame 92 on the aiming position side in FIG. 30) is displayed along a curve that approximates the curve of the treatment site (the trabecular meshwork TM in this embodiment) of the patient's eye E, which is arc-shaped or annular. As a result, when the spot interval guide 91 is placed at an appropriate position with respect to 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, the surgeon can more easily adjust the next aiming position of the treatment laser light more appropriately by referring to the spot interval guide 91. [Explanation of symbols]

[0228] 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 section 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 layout guideline 88 Previous exposure image 90,91 Spot Spacing Guide 90A, 91A Next targeting indicator 92 Frame 100 Circular 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, An irradiation plan acquisition step is to acquire an irradiation plan 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 spot spacing guide display step, which displays a spot spacing guide indicating the appropriate spacing between multiple irradiation spots to be irradiated with therapeutic laser light on the internal display unit in accordance with the progress of the irradiation plan, 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 ophthalmic laser treatment apparatus is characterized in that the control unit changes the size of the spot spacing guide displayed on the internal display unit according to the magnification of the observation optical system.

4. An ophthalmic laser treatment device according to claim 1, The spot spacing guide includes 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 spot spacing guide to be displayed on the internal display unit according to the progress of the irradiation plan, and displaying the spot spacing guide at the determined angle.

5. An ophthalmic laser treatment device according to claim 1, The control unit, In the display area of ​​the internal display unit, the spot spacing guide is displayed at a position separated from the targeting position of the treatment laser beam, An ophthalmic laser treatment device characterized in that the end of each of the multiple indicators included in the spot spacing guide, on the side of the targeting position of the treatment laser light, is displayed along a curve that approximates the curve of the treatment area of ​​the patient's eye, which is arc-shaped or ring-shaped.

6. An ophthalmic laser treatment device according to any one of claims 1 to 5, The shape of the treatment area of ​​the patient's eye to which the treatment laser light is irradiated is arc-shaped or annular. The control unit is characterized by rotating the entire spot spacing guide, thereby providing an ophthalmic laser treatment device.

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