Ophthalmic laser treatment apparatus

Abstract

To provide an ophthalmic laser treatment apparatus capable of appropriately assisting a treatment with treatment laser light when a contact lens having a reflective surface is used.SOLUTION: A control unit acquires an irradiation plan in which an irradiation order of treatment laser light is defined for a plurality of irradiation spots scheduled to be irradiated with the treatment laser light, when the treatment laser light is radiated onto the tissue of a patient eye using a contact lens having a reflective surface for reflecting the treatment laser light and aiming light in a direction intersecting an optical axis. The control unit causes a display unit to display a guide for aligning a target position on the tissue to be irradiated with the treatment laser light, at least for the irradiation spot scheduled to be irradiated with the treatment laser light next among the plurality of irradiation spots scheduled to be irradiated with the treatment laser light, in accordance with the progress of the irradiation plan. The control unit controls driving of an irradiation position moving unit to move the irradiation position of the treatment laser light and aiming light.SELECTED DRAWING: Figure 11

Description

[Technical Field]

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

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

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

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

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

[0006] An ophthalmic laser treatment device provided by a typical embodiment of the present disclosure is an ophthalmic laser treatment device that irradiates a tissue of a patient's eye with a treatment laser beam upon input of an instruction to irradiate the tissue with the treatment laser beam, and includes: a treatment laser light source that emits the treatment laser beam; an aiming light source that emits aiming light to allow an operator to recognize a planned irradiation position of the treatment laser beam on the tissue; an irradiation position moving unit that moves an irradiation position on the tissue to be irradiated with the treatment laser beam and the aiming light; an observation optical system that allows the operator to observe an observation image of the tissue; a display unit that displays an image superimposed on the observation image observed by the operator; and a control unit, wherein the control unit reflects the treatment laser beam and the aiming light in a direction intersecting an optical axis. When the treatment laser beam is irradiated onto the tissue of the patient's eye using a contact lens having a reflective surface that reflects the treatment laser beam, the method includes: an irradiation plan acquisition step of acquiring an irradiation plan in which the order of irradiation of the treatment laser beam for a plurality of irradiation spots to be irradiated with the treatment laser beam is determined; a guide display step of displaying on the display unit a guide for aligning a target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot to be irradiated with the treatment laser beam among the plurality of irradiation spots to be irradiated with the treatment laser beam, according to progress of the irradiation plan; and an irradiation position movement step of moving the irradiation positions of the treatment laser beam and the aiming light by controlling the driving of the irradiation position movement unit.

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

[0008] [Figure 1]1 is an external view of an ophthalmic laser treatment device 1. FIG. [Figure 2] 1 is a diagram showing the optical system of the ophthalmic laser treatment device 1 as seen from the side. [Figure 3] 1 is a diagram showing the optical system of the ophthalmic laser treatment device 1 as viewed from above. [Figure 4] 2 is a schematic cross-sectional view of a patient's eye E and a contact lens 26. FIG. [Figure 5] 2 is a diagram showing a schematic view of an example of an observation area observed through a reflecting surface 27 of a contact lens 26. FIG. [Figure 6] FIG. 2 is an exploded perspective view of a contact lens 26, which is a partially rotational lens. [Figure 7] 1 is a view of a contact lens 26 provided with a spacing indicator 28, viewed from the side opposite to the side that comes into contact with a patient's eye E. FIG. [Figure 8] FIG. 2 is a diagram showing an example of an irradiation plan displayed on the control box 6. [Figure 9] 10A and 10B are explanatory diagrams for explaining a method for adjusting the aiming position of the irradiation spot. [Figure 10] FIG. 2 is a diagram showing an example of an observation field of an operator during treatment using the ophthalmic laser treatment apparatus of the first embodiment. [Figure 11] 3A to 3C are diagrams 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 first embodiment. [Figure 12] 4 is a flowchart of a treatment control process executed by the ophthalmic laser treatment apparatus 1 of the first embodiment. [Figure 13] FIG. 10 is a diagram showing an example of an observation field of an operator during treatment using the ophthalmic laser treatment apparatus of the second embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0009] <Summary> A first aspect of an ophthalmic laser treatment device exemplified in the present disclosure irradiates tissue of a patient's eye with treatment laser light in response to input of an instruction to irradiate treatment laser light. The ophthalmic laser treatment device includes a treatment laser light source, an aiming light source, an irradiation position moving unit, an observation optical system, a display unit, and a control unit. The treatment laser light source emits treatment laser light. The aiming light source emits aiming light to allow the surgeon to recognize the planned irradiation position of the treatment laser light on the tissue. The irradiation position moving unit moves the irradiation position on the tissue to be irradiated with the treatment laser light and the aiming light. The observation optical system allows the surgeon to observe an observation image of the tissue. The display unit displays an image superimposed on the observation image observed by the surgeon. The control unit executes an irradiation plan acquisition step, a guide display step, and an irradiation position moving step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan that determines the order in which the treatment laser beam is irradiated onto multiple irradiation spots to be irradiated with the treatment laser beam when irradiating the tissue of the patient's eye with the treatment laser beam using a contact lens having a reflective surface that reflects the treatment laser beam and the aiming beam in a direction intersecting the optical axis. In the guide display step, the control unit causes the display unit to display a guide for aligning a target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot to be irradiated with the treatment laser beam, among the multiple irradiation spots to be irradiated with the treatment laser beam, according to the progress of the irradiation plan. In the irradiation position movement step, the control unit moves the irradiation positions of the treatment laser beam and the aiming beam by controlling the drive of the irradiation position movement unit.

[0010] According to the ophthalmic laser treatment device of the present disclosure, a guide for aligning the target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot scheduled to be irradiated with the treatment laser beam is displayed on the display unit according to the progress of the irradiation plan. Therefore, the surgeon can check the guide while observing the observation image of the patient's eye tissue and adjust the position of the multiple target spots of the treatment laser beam on the tissue using the checked guide as a reference. Therefore, the surgeon can easily and appropriately irradiate each of the multiple planned irradiation spots with the treatment laser beam. Furthermore, in the ophthalmic laser treatment device according to the present disclosure, when the relative position of the device with respect to the subject's eye (hereinafter simply referred to as the "relative position of the device") moves, the position of the optical axis of the treatment laser beam and the aiming beam moves, thereby moving the irradiation position of the treatment laser beam and the aiming beam on the tissue. Furthermore, when a contact lens is rotated, the angle of the reflective surface of the contact lens changes, thereby moving the irradiation position of the treatment laser beam and the aiming beam on the tissue. However, the greater the amount of movement of the relative position of the device and the amount of rotation of the contact lens, the greater the amount of movement of the observation image observed by the surgeon, which may make it difficult to align the aiming position with an appropriate position on the tissue. Furthermore, if the relative position of the device and the angle of the contact lens are changed frequently, the efficiency of the treatment procedure may decrease. In contrast, in the ophthalmic laser treatment device according to the present disclosure, the irradiation position moving unit moves the irradiation position of the treatment laser beam and the aiming beam on the tissue of the patient's eye. Therefore, the surgeon can easily adjust the position of the irradiation spot on the tissue while suppressing the amount of movement of the observation image. The amount of operation by the surgeon is also likely to be reduced. Therefore, treatment with the treatment laser light when a contact lens having a reflective surface is used is appropriately assisted.

[0011] The technology exemplified in the present disclosure appropriately supports, for example, selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT). SLT is a treatment that reduces intraocular pressure in a patient's eye by irradiating the trabecular meshwork with a laser and destroying pigment cells in the trabecular meshwork. MLT is a treatment that reduces intraocular pressure in a patient's eye by irradiating the trabecular meshwork with a laser beam with lower energy than the laser used in SLT. This activates trabecular meshwork cells and improves the flow of aqueous humor. Note that MLT is less likely to leave marks due to irradiation of the treatment laser beam. If no marks are left due to irradiation of the treatment laser beam, the surgeon cannot determine the position of the previous irradiation of the treatment laser beam from the marks, making it difficult to accurately position the irradiation spot on the tissue. In contrast, the technology exemplified in the present disclosure appropriately supports treatment with the treatment laser beam using a guide or the like, even when no marks are left due to irradiation. This facilitates improved treatment accuracy and efficiency.

[0012] The configuration of the observation optical system that allows the surgeon to observe the observation image of the patient's eye tissue can be selected as appropriate. For example, the observation optical system may allow the surgeon to observe the observation image of the patient's eye through an eyepiece. Alternatively, the observation optical system may capture an image of the patient's eye tissue and display the captured image on a display device (e.g., a monitor or projector), allowing the surgeon to observe the observation image of the patient's eye.

[0013] The configuration of the display unit for superimposing an image on the observation image observed by the surgeon can also be selected appropriately. For example, when the surgeon observes the observation image through an eyepiece, the display unit may superimpose an image on the observation image observed through the eyepiece. In this case, the display unit may be configured to combine the optical observation image observed by the surgeon with an image displayed on the display unit and project the combined image onto the surgeon's eye. The display unit may also be configured to project an image onto the retina of the surgeon's eye by scanning a light beam over the retina. In other words, the display unit may be a so-called head-up display (HUD). In addition, when a display device (such as a monitor) displays a captured image (observation image) to allow the surgeon to observe the observation image, the display device may superimpose an image such as a spot spacing guide on the observation image. In other words, the display device may serve as both at least a part of the observation optical system and at least a part of the display unit.

[0014] The configuration of the irradiation position moving unit for moving the irradiation positions of the treatment laser beam and the aiming beam can also be selected appropriately. The irradiation position moving unit may move the irradiation positions of the treatment laser beam and the aiming beam by changing the positions of the optical axes of the treatment laser beam and the aiming beam relative to the position of the optical axis of the observation optical system. In other words, the irradiation position moving unit may be capable of moving the irradiation positions of the treatment laser beam and the aiming beam while maintaining the position of the observation optical axis of the observation optical system. For example, the irradiation position moving unit may include a deflection unit (e.g., a galvanometer mirror) that changes the deflection direction of the treatment laser beam and the aiming beam. Furthermore, the irradiation position moving unit may be configured to move an optical member (e.g., a lens) arranged on the optical axis of the treatment laser beam and the aiming beam in a direction intersecting the optical axis.

[0015] In the irradiation position moving step, the control unit may move the irradiation positions of the treatment laser beam and the aiming beam in the direction of travel defined by the irradiation plan to adjacent positions shifted by n appropriate intervals between the irradiation spots each time the treatment laser beam is irradiated onto n irradiation spots. In this case, even if the operator does not change the relative position of the device or the angle of the contact lens, the irradiation positions of the treatment laser beam and the aiming beam are automatically moved to or near the target position to which the treatment laser beam is next to be irradiated (the position on the tissue where the next irradiation spot is to be placed) each time the treatment laser beam is irradiated. This facilitates further improvement in the accuracy and efficiency of treatment.

[0016] When an instruction to skip irradiating the next n irradiation spots defined in the irradiation plan with the treatment laser beam (hereinafter referred to as a "skip instruction") is input, the control unit may move the irradiation positions of the treatment laser beam and the aiming beam to adjacent positions without irradiating the treatment laser beam. For example, if there is a non-irradiated area on the tissue that is not appropriate for irradiation with the treatment laser beam, the operator can input a skip instruction to skip irradiating the non-irradiated area with the treatment laser beam and resume treatment from the next scheduled irradiation spot. This makes it easier to proceed with treatment more smoothly.

[0017] When an instruction to move the irradiation positions of the treatment laser beam and the aiming beam is input in the irradiation position moving step, the control unit may move the irradiation positions of the treatment laser beam and the aiming beam in accordance with the input instruction. In this case, the surgeon can move the irradiation position to a desired position by inputting an instruction to move the irradiation position to the ophthalmic laser treatment device without changing the relative position of the device or the angle of the contact lens. Therefore, it is even easier to adjust the aim position of the treatment laser beam while suppressing the amount of movement of the observation image.

[0018] In the irradiation position moving step, the control unit may perform both a process of automatically moving the irradiation position based on the irradiation plan and a process of moving the irradiation position in response to an input instruction. In this case, even if the irradiation position automatically moved based on the irradiation plan deviates from the position to be next irradiated with the treatment laser light, the surgeon can adjust the irradiation position by inputting an instruction to move the irradiation position into the ophthalmic laser treatment device. Therefore, the amount of movement of the observation image is further reduced, and the accuracy and efficiency of treatment are likely to be further improved.

[0019] However, the ophthalmic laser treatment device may perform only one of the following processes: automatically moving the irradiation position based on the irradiation plan, or moving the irradiation position in response to an input instruction. For example, if the irradiation position automatically moved based on the irradiation plan is deviated from the next irradiation position of the treatment laser beam, the surgeon can adjust the irradiation position by slightly changing at least one of the relative position of the device and the angle of the contact lens. In this case, the amount of movement of the observation image is also small.

[0020] The control unit may irradiate one irradiation spot with the treatment laser beam each time an instruction to irradiate the treatment laser beam is input. In other words, "n = 1" may be used. For example, consider a case in which the treatment laser beam is irradiated to multiple irradiation spots each time an instruction to irradiate the treatment laser beam is input. In this case, the surgeon's workload is likely to be reduced, but the surgeon must accurately align all of the multiple irradiation spots with the treatment target area before inputting the irradiation instruction. In contrast, if the treatment laser beam is irradiated with one shot each time an instruction to irradiate the treatment laser beam is input, the surgeon can adjust the aim position of the treatment laser beam for each of the multiple irradiation spots before inputting the irradiation instruction. This makes it easier to align the positions of the multiple irradiation spots with the treatment target area more accurately. It also makes it easier to skip irradiating non-irradiated areas with the treatment laser beam.

[0021] However, the control unit may control the irradiation position moving unit based on the irradiation plan each time an instruction to irradiate the treatment laser beam is input, and irradiate each of the multiple irradiation spots with the treatment laser beam at appropriate intervals. In other words, "n≧2" may be used. In this case, the operator's workload can be further reduced.

[0022] In the guide display step, the control unit may display a spot spacing guide on the display unit, indicating an appropriate spacing between the multiple irradiation spots to be irradiated with the treatment laser light, according to progress of the irradiation plan. In this case, the surgeon can check the spot spacing guide while observing the observation image of the patient's eye tissue and adjust the arrangement of the multiple irradiation spots on the tissue with reference to the spot spacing guide. Thus, the surgeon can easily adjust the spacing between the irradiation spots to be irradiated with the treatment laser light to approach the appropriate spacing.

[0023] The control unit may adjust the spacing of at least some of the indicators included in the spot spacing guide to match the appropriate spacing between the irradiation spots. In this case, the surgeon can easily adjust the spacing between the irradiation spots to the appropriate spacing by irradiating the treatment laser beam multiple times in accordance with the spacing of the indicators included in the spot spacing guide. This makes it easier to perform treatment according to the treatment plan.

[0024] However, it is also possible to change the display mode of the spot spacing guide. For example, a part of the contact lens (e.g., the inner wall, etc.) may be provided with multiple spacing indicators (sometimes called "indexes") arranged at regular intervals to serve as a guide for the spacing of spots to be irradiated with treatment laser light. The control unit may match the spacing of at least some of the multiple indicators included in the spot spacing guide to the spacing of the spacing 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 spacing indicators observed through the observation optical system and the position and direction of the spot spacing guide displayed on the display unit, making it easier to more appropriately adjust the irradiation positions of the multiple treatment laser beams.

[0025] The type of spacing indicators provided on the contact lenses (e.g., the spacing and number of spacing indicators) 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 on the spot spacing guide) 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 smoothly.

[0026] The control unit may change the overall size of the spot spacing guide displayed on the display unit according to the magnification of the image observed by the observation optical system. That is, 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, the spot spacing guide appropriately indicates the appropriate spacing between the planned multiple irradiation spots.

[0027] The guide may include a shape that aligns with the appropriate reflection direction of the treatment laser light from the reflective surface of the contact lens toward the next irradiation spot. The control unit may determine the angle of the guide to be displayed by the display unit according to the progress of the irradiation plan and display the 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 in the direction indicated by the guide. Furthermore, since the guide is displayed by the display unit at an appropriate angle according to the progress of the irradiation plan, it is easier to adjust the aiming position more appropriately.

[0028] Furthermore, if the contact lens is provided with a spacing indicator, 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 indicator is positioned at the end of the direction indicated by the shape of the guide.

[0029] The control unit may display the end of each of the multiple indices included in the guide, the end of which is closer to the target position of the treatment laser beam, along a curve that approximates the curve of the arc-shaped treatment target area of ​​the patient's eye. In this case, when the guide is positioned at an appropriate position and angle relative to the next treatment target area, the distance between the end of each of the multiple indices on the target position side and the arc-shaped treatment target area is likely to be reduced. As a result, the surgeon can more easily adjust the next target position of the treatment laser beam by referring to the displayed guide.

[0030] The shape of the curve of the arc-shaped treatment target 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 target area.

[0031] The control unit may display at least some of the elements of the multiple indices included in the guide aligned along a straight line. For example, the control unit may display the centers of gravity of each of the multiple indices included in the guide aligned along a straight line. Furthermore, the control unit may display the ends of each of the multiple indices included in the guide opposite the target position of the treatment laser beam aligned along a straight line. In this case, the surgeon can more appropriately proceed with treatment by aligning the direction in which the elements of the multiple indices are aligned with the direction in which the target position of the treatment laser beam moves to the next target position. For example, the reflective surface of a contact lens may include an edge perpendicular to the direction extending outward from the central axis of the lens. In this case, the surgeon can move the target position of the treatment laser beam along the direction of the edge by aligning 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. Furthermore, even if the contact lens that has been 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.

[0032] However, the display mode of the guide may be changed. For example, the control unit may display a shape guide on the display unit, which has a shape similar to the shape of the treatment target area where the treatment laser beam is to be placed, along with or separately from the spot spacing guide (e.g., multiple indicators arranged at appropriate intervals) indicating the appropriate intervals between the multiple irradiation spots to be irradiated with the treatment laser beam. The control unit may also display at least the next planned position to be irradiated with the treatment laser beam (e.g., the "next target indicator" described below) along with the shape guide. In this case, the surgeon can easily align the target position with the multiple irradiation spots by aligning the position and direction of the treatment target area shown in the observation image with the position and direction of the shape guide superimposed on the observation image so that the shape indicated by the shape guide approximates the shape of the treatment target area.

[0033] The control unit may display a next targeting index on the guide to align the target position on the tissue to be next irradiated with the treatment laser beam. The control unit may move the position of the next targeting index to an adjacent position shifted by the appropriate interval of n irradiation spots in the direction of travel defined by the irradiation plan every time the treatment laser beam is irradiated to n irradiation spots (n is a natural number equal to or greater than 1). In this case, the surgeon can more easily adjust the next targeting position by aligning the target position on the tissue to be next irradiated with the treatment laser beam with the position of the displayed next targeting index.

[0034] When an instruction (hereinafter referred to as a "skip instruction") to skip irradiating the next n irradiation spots defined in the irradiation plan with the treatment laser light is input, the control unit may move the position of the next targeting index to an adjacent position shifted by the appropriate interval of n irradiation spots in the direction of travel defined in the irradiation plan without irradiating the treatment laser light. For example, if there is a non-irradiation spot where it is not appropriate to irradiate the treatment laser light, the operator can input a skip instruction to skip irradiating the non-irradiation spot with the treatment laser light and resume treatment from the next scheduled irradiation spot. This makes it easier to proceed with treatment more smoothly.

[0035] When the spot spacing guide includes multiple indices arranged at appropriate intervals between multiple irradiation spots, the indices other than the next target 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 target indices in a different manner from the irradiated indices and unirradiated indices (i.e., in a manner that can be distinguished by the surgeon). In this case, the surgeon can easily grasp the position of the next target indices. Furthermore, the control unit may display the next target indices, irradiated indices, and unirradiated indices in different manners. In this case, the surgeon can easily grasp the positional relationship between the next target indices, irradiated indices, and unirradiated indices, making it easier to proceed with treatment more smoothly.

[0036] However, the next targeting indicator does not have to be included in the guide. For example, the control unit may cause the display unit to display multiple indicators at predetermined intervals (e.g., appropriate intervals between multiple irradiation spots) without changing the display mode. Even in this case, the surgeon can appropriately position each of the multiple irradiation spots on the tissue by referring to the multiple indicators.

[0037] The shape of the treatment target area of ​​the patient's eye to be irradiated with the treatment laser beam may be arc-shaped or annular. With the display position and angle of the guide on the display unit fixed, the angular range of the arc-shaped area where the treatment laser beam is to be irradiated a specified number M (M≧2) of times is defined as the irradiation zone. The control unit may rotate the entire guide by the angle of one irradiation zone in the direction of progression defined by the irradiation plan each time the irradiation of all of the multiple irradiation spots in the irradiation zone under treatment is completed. In this case, with the display position and angle of the guide fixed, when treatment in one irradiation zone is completed, the angle of the displayed guide rotates to an angle corresponding to the treatment of the next irradiation zone. Therefore, the irradiation of each of the multiple irradiation zones with the treatment laser beam is automatically and appropriately assisted according to the progress of the irradiation plan.

[0038] The angle of the irradiation zone can be selected appropriately. For example, assume that the range of R degrees (R≦360) in a ring-shaped or arc-shaped treatment target area (e.g., trabecular meshwork, etc.) is divided into S irradiation zones, and the aim position is adjusted within each irradiation zone. In this case, the control unit may rotate the entire guide in the direction of travel determined by the irradiation plan by the angle of one irradiation zone (i.e., R / S degrees) each time irradiation of all of the multiple irradiation spots within the irradiation zone under treatment is completed. As a result, irradiation of the treatment laser light is appropriately assisted in each of the multiple irradiation zones.

[0039] In addition, when the irradiation position moving unit is controlled to irradiate each of n (n≧2) irradiation spots with treatment laser light each time an instruction to irradiate treatment laser light is input, the specified number of times M for irradiating treatment laser light while the display position and angle of the guide are fixed is a natural number greater than or equal to n.

[0040] When an instruction to rotate the entire guide for the next irradiation zone is input before the irradiation of all of the irradiation spots in the irradiation zone under treatment is completed, the control unit may rotate the entire guide by an angle corresponding to the extent to which treatment has progressed in the irradiation zone under treatment. In this case, even if the treatment in the irradiation zone has not been completed, the operator can rotate the entire guide and then move on to treatment in the next irradiation zone. This makes it easier to proceed with treatment more smoothly.

[0041] The method for calculating the angle when rotating the guide for the next irradiation zone can be selected appropriately. For example, the angle between two adjacent irradiation spots when viewed from the center of the circle through which the planned multiple irradiation spots pass is defined as A degrees, and the number of irradiation spots where treatment has progressed within the irradiation zone under treatment is defined as m. The angle corresponding to the range of treatment progress within the irradiation zone under treatment may be calculated by "A degrees x m spots." The number of irradiation spots where treatment has progressed, "m spots," may also include the number of irradiation spots where irradiation of the treatment laser light has been skipped due to the above-mentioned skip instruction.

[0042] When the control unit displays a next-targeting index on the guide for aligning the position of the next irradiation spot, the control unit may set the position of the next-targeting index at the end of the guide opposite to the treatment progress direction defined in the irradiation plan each time the guide is 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, making it easier to proceed with the treatment 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 of the indices other than the next-targeting index as unirradiated indexes each time the control unit rotates the multiple indices for the next irradiation section.

[0043] It is also possible to change the specific method for rotating the entire guide (e.g., multiple indicators in a spot spacing guide). For example, the control unit may rotate the guide by the angle of the irradiation section every time a rotation command is input by a user (e.g., an operator or an assistant). The rotation angle of the guide may also be set by the user.

[0044] The control unit may move the irradiation position of the treatment laser beam and the aiming beam in the direction opposite to the treatment progression direction determined in the irradiation plan every time the guide is rotated for the next irradiation zone, which makes it easier to smoothly start treatment for the next irradiation zone.

[0045] A second aspect of the ophthalmic laser treatment device exemplified in the present disclosure irradiates the tissue of a patient's eye with treatment laser light in response to input of an instruction to irradiate treatment laser light. The ophthalmic laser treatment device includes a treatment laser light source, an aiming light source, an irradiation position moving unit, an observation optical system, a display unit, and a control unit. The treatment laser light source emits treatment laser light. The aiming light source emits aiming light to allow the surgeon to recognize the planned irradiation position of the treatment laser light on the tissue. The irradiation position moving unit moves the irradiation position on the tissue to be irradiated with the treatment laser light and the aiming light. The observation optical system allows the surgeon to observe an observation image of the tissue. The display unit displays an image superimposed on the observation image observed by the surgeon. The control unit executes an irradiation plan acquisition step and a guide display step. In the irradiation plan acquisition step, the control unit acquires an irradiation plan that defines the order in which the treatment laser beam is irradiated onto multiple irradiation spots to be irradiated with the treatment laser beam when irradiating the tissue of the patient's eye with the treatment laser beam using a contact lens having a reflective surface that reflects the treatment laser beam and the aiming beam in a direction intersecting the optical axis. In the guide display step, the control unit displays, on the display unit according to progress of the irradiation plan, a guide for aligning the target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot to be irradiated with the treatment laser beam among the multiple irradiation spots to be irradiated with the treatment laser beam. In the guide display step, a non-adjacent position change step and a target position indicator display step are executed. In the non-adjacent position change step, when irradiation of n irradiation spots with the treatment laser beam is completed, the control unit changes the next aim position, to which the next target position on the tissue is to be aligned in the guide, to a non-adjacent position different from the adjacent position. The adjacent position is a position shifted by n appropriate intervals between the multiple irradiation spots in the direction of travel defined in the irradiation plan from the position of the irradiation spot where the treatment laser beam was previously irradiated. In the target position indicator display step, when executing the non-adjacent position change step, the control unit causes the display unit to display a target position indicator that indicates the position on the tissue at the adjacent position as the target position on the tissue to which the guide will be next aimed.

[0046] According to the ophthalmic laser treatment device of the present disclosure, a guide for aligning the target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot scheduled to be irradiated with the treatment laser beam is displayed on the display unit according to the progress of the irradiation plan. Therefore, the surgeon can check the guide while observing the observation image of the patient's eye tissue and adjust the position of the multiple target spots of the treatment laser beam on the tissue using the checked guide as a reference. Therefore, the surgeon can easily and appropriately irradiate each of the multiple planned irradiation spots with the treatment laser beam.

[0047] Furthermore, in the ophthalmic laser treatment device according to the present disclosure, when the relative position of the device with respect to the subject's eye (hereinafter simply referred to as the "relative position of the device") moves, the position of the optical axis of the treatment laser beam and the aiming beam moves, thereby moving the irradiation position of the treatment laser beam and the aiming beam on the tissue. Furthermore, when a contact lens is rotated, the angle of the reflective surface of the contact lens changes, thereby moving the irradiation position of the treatment laser beam and the aiming beam on the tissue. However, the greater the amount of movement of the relative position of the device and the amount of rotation of the contact lens, the greater the amount of movement of the observation image observed by the surgeon, which may make it difficult to align the irradiation spot with the appropriate position on the tissue. Furthermore, increasing the frequency of changing the relative position of the device and the angle of the contact lens tends to reduce the efficiency of the treatment procedure. In contrast, in the ophthalmic laser treatment device according to the present disclosure, the irradiation position moving unit moves the irradiation position of the treatment laser beam and the aiming beam on the tissue of the patient's eye. Therefore, the surgeon can easily adjust the position of the irradiation spot on the tissue while suppressing the amount of movement of the observation image. The amount of operation by the surgeon is also likely to be reduced. Therefore, treatment with the treatment laser light when a contact lens having a reflective surface is used is appropriately assisted.

[0048] On the other hand, the range within which the observation optical system allows the surgeon to observe the observation image and the range within which the irradiation position of the treatment laser beam and the aiming beam (hereinafter, sometimes simply referred to as the "light irradiation position") can be moved by the irradiation position moving unit are both finite. Therefore, when an attempt is made to adjust the arrangement of the multiple irradiation spots on the tissue using a guide superimposed on the observation image while the observation range of the observation image is fixed, the next aiming position indicated by the guide may deviate from the range of the observation image, or the light irradiation position may deviate from the movable range. In order to maintain the next aiming position indicated by the guide within the range of the observation image and the light irradiation position within the movable range, the control unit must also move the next aiming position to a non-adjacent position (e.g., in the opposite direction to the planned treatment direction) different from an adjacent position (a position shifted by n appropriate intervals of the multiple irradiation spots in the direction of travel defined by the irradiation plan from the position of the irradiation spot where the treatment laser beam was previously irradiated). In this case, by changing at least one of the relative position of the device and the angle of the contact lens so that the target position on the tissue is aligned with the next aiming position indicated by the guide at a non-adjacent position, it becomes possible again to adjust the arrangement of multiple irradiation spots on the tissue while keeping the range of the observation image fixed. However, if the next aiming position is moved to a non-adjacent position different from the adjacent position, the surgeon is likely to lose sight of the target position on the tissue (the position to be next irradiated with the treatment laser light) shown in the observation image.

[0049] In contrast, when the ophthalmic laser treatment device of the present disclosure moves the next target position of the guide to a non-adjacent position different from the adjacent position, a target position indicator is displayed on the display unit, indicating the position on the tissue at the adjacent position (i.e., the position on the tissue that would have been indicated by the next target indicator if the next target indicator had moved to the adjacent position) as the target position on the tissue to which the next target position of the guide should be adjusted. Therefore, the surgeon can grasp the target position on the tissue using the target position indicator superimposed on the observation image, and by aligning the grasped target position with the position indicated by the next target indicator, the surgeon can appropriately align the target position of the treatment laser beam to the target position. This provides appropriate assistance for treatment with treatment laser beams when contact lenses with reflective surfaces are used.

[0050] <Effects described in the specification> The target position indicator may be a mark placed around the target position, which is an adjacent position (i.e., the position on the tissue that would be indicated by the next target indicator if the next target indicator were to move to the adjacent position). In this case, the surgeon can understand the state of the tissue at the target position located inside the mark by looking at the observation image on which the mark is superimposed. This makes it easier for the surgeon to properly align the tissue located inside the mark with the position of the next target indicator.

[0051] However, it is also possible to change the display mode of the target position indicator. For example, the target position indicator may be a mark superimposed on an adjacent position (target position). Even in this case, the surgeon can appropriately grasp the target position based on the state of the tissue around the mark superimposed on the adjacent position (target position).

[0052] The target position indicator may directly indicate the adjacent position (target position). Alternatively, the target position may be indicated by indicating a position related to the target position indicator or the adjacent position (target position). For example, the control unit may indicate the target position by indicating the position of the irradiation spot most recently irradiated with the treatment laser beam. As described above, the adjacent position (target position) is a position shifted from the position most recently irradiated with the treatment laser beam by n appropriate intervals between the multiple irradiation spots in the direction of travel defined by the irradiation plan. Therefore, by understanding the position of the irradiation spot most recently irradiated with the treatment laser beam from the target position indicator, the surgeon can appropriately understand the target position (a position adjacent to the irradiation spot most recently irradiated with the treatment laser beam).

[0053] After displaying the target position index on the display unit in the target position index display step, the control unit may erase the displayed target position index when an instruction to irradiate treatment laser light is input (e.g., after the irradiation instruction is input). When the position of the next target index indicated by the guide moves to a position different from the adjacent position, the surgeon uses the displayed target position index to determine the target position on the tissue to be irradiated next with treatment laser light, aligns the determined target position on the tissue with the position of the next target index, and inputs an instruction to irradiate treatment laser light into the ophthalmic laser treatment device. Therefore, after the instruction to irradiate treatment laser light is input, it is highly likely that the target position on the tissue has already been aligned with the position of the next target index, so it is not necessary to display the target position index. Therefore, the control unit can erase the target position index at an appropriate time by using the input of an instruction to irradiate treatment laser light as a trigger.

[0054] The ophthalmic laser treatment device may further include an imaging unit that captures an observation image in a state where the image is superimposed and displayed by the display unit. The control unit may present the surgeon with a reference image captured by the imaging unit when the target position index is displayed in the target position index display step. In this case, even after the surgeon changes at least one of the relative position of the device and the angle of the contact lens in order to align the target position on the tissue with the position of the next target index indicated by the guide (i.e., even if the actual target position on the tissue has shifted from the position indicated by the fixed target position index), the surgeon can re-identify the target position on the tissue indicated by the target position index by checking the presented reference image. Therefore, the surgeon can appropriately align the target position on the tissue identified by the target position index with the position of the next target index.

[0055] The method of presenting the reference image (observation image) with the target position index superimposed thereon to the surgeon can be selected as appropriate. For example, the control unit may display the reference image captured by the imaging unit in a portion of the display area of ​​the display unit that displays an image superimposed on the observation image. In this case, the surgeon can easily align the target position with the position of the next aiming index by comparing the observation image of the tissue at that time with the reference image when the target position index was displayed. Furthermore, the control unit may display the reference image (observation image) with the target position index superimposed thereon on a display unit different from the display unit that displays an image superimposed on the observation image.

[0056] After presenting the reference image to the surgeon, the control unit may stop presenting the reference image when an instruction to irradiate with treatment laser light is input (for example, after the instruction to irradiate with treatment laser light is input). As described above, after the instruction to irradiate with treatment laser light is input, it is highly likely that the target position on the tissue has already been aligned with the position of the next target index, so it is not necessary to present the reference image to the surgeon. Therefore, by using the instruction to irradiate with treatment laser light as an opportunity to stop presenting the reference image at an appropriate time, the control unit can stop presenting the reference image at an appropriate time.

[0057] The control unit may cause the position of the target position indicator superimposed on the display unit to follow the target position on the observation image as the observation image that the surgeon is made to observe through the observation optical system moves. In this case, even if the surgeon does not remember the target position on the tissue indicated by the target position indicator, the surgeon can easily and appropriately align the target position with the position of the next aiming indicator by taking into account the target position indicator that moves following the target position.

[0058] A specific method for causing the superimposed position of the target position index to track the target position on the observation image can be selected as appropriate. For example, the ophthalmic laser treatment device may include an imaging unit that captures observation images of the tissue of the subject's eye. The control unit may apply known image processing (e.g., pattern matching) to the observation images continuously captured by the imaging unit, identify the target position on the moving observation image, and move the display position of the target position index to track the identified target position.

[0059] However, the position of the displayed target position indicator may be fixed. Even in this case, the surgeon can appropriately align the target position on the tissue by aligning the target position on the tissue, as determined by the target position indicator, with the position of the next aiming indicator.

[0060] In the irradiation position moving step, the control unit may move the irradiation positions of the treatment laser beam and the aiming beam in the direction of travel defined by the irradiation plan to adjacent positions shifted by n appropriate intervals between the irradiation spots each time the treatment laser beam is irradiated onto n irradiation spots. In this case, even if the operator does not change the relative position of the device or the angle of the contact lens, the irradiation positions of the treatment laser beam and the aiming beam are automatically moved to or near the target position to which the treatment laser beam is next to be irradiated (the position on the tissue where the next irradiation spot is to be placed) each time the treatment laser beam is irradiated. This facilitates further improvement in the accuracy and efficiency of treatment.

[0061] The control unit may display on the guide a next aim index indicating a next aim position for aligning a target position on the tissue to be next irradiated with the treatment laser beam. The control unit may move the position of the next aim index to an adjacent position shifted by an appropriate interval of n irradiation spots in the direction of travel defined by the irradiation plan every time the treatment laser beam is irradiated to n irradiation spots (n is a natural number equal to or greater than 1). In this case, the surgeon can more easily adjust the next aim position by aligning the target position on the tissue to be next irradiated with the treatment laser beam with the position of the displayed next aim index.

[0062] The shape of the treatment target area of ​​the patient's eye to be irradiated with the treatment laser light may be arc-shaped or annular. With the display position and angle of the guide on the display unit fixed, the angular range of the arc-shaped area where the treatment laser light is to be irradiated a specified number M (M≧2) of times is defined as the irradiation zone. In the non-adjacent position changing step, the control unit may rotate the entire guide by the angle of one irradiation zone in the progression direction defined in the irradiation plan each time the treatment laser light irradiation is completed for all of the multiple irradiation spots in the irradiation zone under treatment. When rotating the entire guide, the control unit may display a target position indicator on the display unit, indicating a target position on the tissue at an adjacent position (i.e., the position on the tissue that would be indicated by the next target indicator if the next target indicator had moved to the adjacent position).

[0063] In this case, when treatment in one irradiation zone is completed while the display position and angle of the guide are fixed, the angle of the displayed guide rotates to an angle corresponding to treatment for the next irradiation zone. As a result, the next target position indicated by the guide is changed to a non-adjacent position different from the adjacent position. Furthermore, the position on the tissue that would have been indicated by the next target index if the next target index had moved to the adjacent position is indicated by the target position index. The surgeon can grasp the target position on the tissue using the target position index and align the grasped target position with the position indicated by the next target index, thereby smoothly starting treatment for the next irradiation zone. Therefore, the irradiation of each of the multiple irradiation zones with the treatment laser light is automatically and appropriately assisted according to the progress of the irradiation plan.

[0064] The control unit may move the irradiation position of the treatment laser beam and the aiming beam in the direction opposite to the treatment progression direction determined in the irradiation plan every time the guide is rotated for the next irradiation zone, which makes it easier to smoothly start treatment for the next irradiation zone.

[0065] <Embodiment> Hereinafter, exemplary embodiments of the present disclosure will be described with reference to the drawings. An ophthalmic laser treatment device 1 of the present embodiment can treat a patient's eye E by irradiating the patient's eye E with a treatment laser light.

[0066] <Overall structure> The configuration of an ophthalmic laser treatment device 1 will be described with reference to Figures 1 to 3. As shown in Figure 1, the ophthalmic laser treatment device 1 of this embodiment includes a table section 2, a main body section 3, and a control box 6. The main body section 3 and the control box 6 are installed on the table section 2.

[0067] 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 display unit 50, the photographing unit 55, and the control unit 60 (see FIG. 2 ), which will be described later. The main body 3 also includes a base 4, a joystick 5 (operation lever), and an irradiation position control unit 9. The base 4 is a displacement unit equipped with a displacement mechanism, and can move at least a portion of the laser irradiation optical system 10, the observation optical system 40, the display unit 50, the photographing unit 55, etc. in the vertical direction (Y direction in FIG. 1 ), the horizontal direction (X direction in FIG. 1 ), and the front-to-back direction (Z direction in FIG. 1 ). The displacement unit changes the relative positional relationship between the patient's eye and the laser irradiation optical system 10 in the vertical direction, the horizontal direction, and the front-to-back direction. The base 4 can also rotate at least a portion of the laser irradiation optical system 10, the observation optical system 40, the display unit 50, the photographing unit 55, etc. in the horizontal direction around an axis extending in the vertical direction. By operating the joystick unit 5, the surgeon can move or rotate the laser irradiation optical system 10, the observation optical system 40, the display unit 50, the imaging unit 55, etc., thereby adjusting the observation position of the patient's eye E and the irradiation position of the laser light (treatment laser light and aiming light). Note that the joystick unit 5 (e.g., the upper end of the joystick unit 5) in this embodiment is provided with an operation button operated by the surgeon. In this embodiment, the operation button on the joystick unit 5 is used as a trigger input means for inputting a trigger for irradiating the treatment laser light. However, a foot switch or the like operated by the surgeon's foot may also be used as the trigger input means for inputting a trigger for irradiating the treatment laser light.

[0068] The control box 6 is equipped with an external display unit 7 provided outside the observation optical system 40 (see FIG. 2). The external display unit 7 is capable of displaying various images. A touch panel type operation unit is provided on the surface of the external display unit 7 of the control box 6. The control box 6 displays various parameters related to treatment on the external display unit 7 and also receives various instructions input from the user.

[0069] The irradiation position operation unit 9 is operated by the surgeon to input an instruction to move the irradiation position of the laser beam (treatment laser beam and aiming beam) by the irradiation position moving unit 29, which will be described later. As an example, the irradiation position operation unit 9 in this embodiment is an operation lever, and the movement direction of the irradiation position of the laser beam is instructed depending on the direction in which the operation lever is tilted. However, the specific form of the irradiation position operation unit can be changed. For example, a plurality of operation buttons for inputting an instruction to move the irradiation position in any of two-dimensional directions may be adopted as the irradiation position operation unit. The surgeon may also issue a skip instruction, which will be described later, by operating the irradiation position operation unit 9.

[0070] <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 irradiation position moving unit 29, an expander lens 23, a dichroic mirror 24, and an objective lens 25.

[0071] The treatment laser light source 11 emits treatment laser light for treating tissues of the patient's eye E. As an example, the treatment laser light source 11 of this embodiment uses a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd:YAG) as a laser rod. In addition, a wavelength conversion element (not shown) can convert the infrared laser light (wavelength: 1064 nm) emitted by the treatment laser light source 11 into visible laser light (wavelength: 532 nm).

[0072] The aiming light source 12 emits an aiming laser beam (hereinafter simply referred to as "aiming light") that indicates the position where the treatment laser beam is irradiated (i.e., the position of the irradiation spot). In this embodiment, a light source that emits a visible laser beam with a wavelength of 635 nm (red) is used as the aiming light source 12. However, it goes without saying that the wavelength of the aiming light can be changed as appropriate.

[0073] The energy adjusting unit 13 adjusts the amount of energy of the treatment laser beam irradiated onto the tissue of the patient's eye E. In this embodiment, the energy adjusting unit 13 includes a half-wave plate 14 and a polarizing plate 16. The half-wave plate 14 rotates around the optical axis of the treatment laser beam by a motor 15. The polarizing plate 16 is disposed at a Brewster angle. The combination of the half-wave plate 14 and the polarizing plate 16 adjusts the amount of energy of the treatment laser beam.

[0074] The beam splitter 17 reflects a portion of the treatment laser beam toward the photodetector 18. The photodetector 18 detects the amount of energy of the treatment laser beam by receiving the treatment laser beam reflected by the beam splitter 17. The safety shutter 19 moves between on and off the optical axis of the treatment laser beam by a shutter driver (e.g., a solenoid) 20. The safety shutter 19 is positioned on the optical axis of the treatment laser beam to block irradiation of the patient's eye E with the treatment laser beam.

[0075] The collimator lens 21 converts the aiming light emitted by the aiming light source 12 into a parallel beam. The dichroic mirror 22 combines the treatment laser light and the aiming light by coaxially aligning the optical axes of the treatment laser light and the aiming light. In this embodiment, the dichroic mirror 22 reflects the treatment laser light and transmits the aiming light, thereby combining the treatment laser light and the aiming light.

[0076] The irradiation position moving unit 29 moves the irradiation position on the tissue of the patient's eye E, where the treatment laser beam emitted by the treatment laser source 11 and the aiming beam emitted by the aiming beam source 12 are irradiated. The irradiation position moving unit 29 moves the irradiation positions of the treatment laser beam and the aiming beam by changing the positions of the optical axes of the treatment laser beam and the aiming beam relative to the observation optical axis of the observation optical system 40. In this embodiment, the irradiation position moving unit 29 is disposed on the common optical path of the treatment laser beam and the aiming beam, which are made coaxial by the dichroic mirror 22, thereby moving the irradiation positions of the treatment laser beam and the aiming beam on the tissue while maintaining the coaxiality of the treatment laser beam and the aiming beam. In this embodiment, a deflection unit (a two-axis galvanometer mirror in this embodiment) that changes the deflection direction of the treatment laser beam and the aiming beam is used as the irradiation position moving unit 29. However, the configuration of the irradiation position moving unit can also be changed. For example, the irradiation position moving unit may change the irradiation position by moving an optical element (e.g., a lens) arranged on the optical axis of the treatment laser beam and the aiming beam in a direction intersecting the optical axis. In this embodiment, the observation surface, the display 53, and the spot position (focusing position) of the aiming beam are optically conjugate. At the observation surface, the observation optical axis, the center of the display area of ​​the display 53, and the optical axis (central axis) of the aiming optical system are aligned. The display size of the guide 90 displayed on the display 53 and the amount of movement of the aiming beam driven by the irradiation position moving unit 29 are determined taking into account the observation magnification. The device is manufactured and adjusted so that these conjugate relationships, center alignment, and observation magnification are satisfied. During the manufacturing and adjustment described above, the relationship between the displayable area of ​​the display 53 and the range in which the aiming beam can be moved by the irradiation position moving unit 29 is stored in the device's storage means. Therefore, the control unit controls the irradiation position moving unit 29 based on data stored in advance in the device (a program based on design values ​​(theoretical values) or adjustment values ​​stored during manufacturing adjustment), thereby making it possible to position (move) the spot center of the aiming light to a position of any coordinates on the display 53 (within the above-mentioned displaceable range) without performing image detection. Of course, it is also possible to move the aiming light by one spot in any direction. In this way, the irradiation position moving unit 29 of this embodiment performs control that takes into account and correlates the characteristics of the observation optical system and the characteristics of the display 53.

[0077] The expander lens 23 expands the beam of laser light (treatment laser light and aiming light) that has been combined by the dichroic mirror 22 and passed through the irradiation position moving unit 29. 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 that has passed through the objective lens 25 is irradiated onto the tissue of the patient's eye E via a contact lens 26 attached to the patient's eye E. The dichroic mirror 24 reflects almost all light of the wavelength of the reflected light of the treatment laser light so that the reflected light from the patient's eye E is less likely to enter the surgeon's eye. The laser irradiation optical system 10 may be provided with a configuration for adjusting the spot size of the laser light irradiated onto the tissue.

[0078] <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.

[0079] <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 (optical axes L3R and L3L shown in 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 40 of this embodiment may also be called binoculars. The observation optical system 40 of this embodiment includes an objective lens 25, variable magnification optical systems 42 (42R, 42L), protection filters 43 (43R, 43L), a half mirror 47, an erecting prism group 44 (44R, 44L), a field stop 45 (45R, 45L), and eyepieces 46 (46R, 46L). The surgeon can look through the eyepiece 46 to confirm the observed image of the tissue 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), and the image displayed on the display unit 50. In this embodiment, an observation plane (object plane) provided beyond the objective lens 41 and a field stop 45 disposed inside the device are in an optically conjugate positional relationship via the objective lens 41. In other words, an observed 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 observed 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 observed image obtained by the variable magnification optical system 42.

[0080] <Display section> The display unit 50 (see FIG. 2) displays an image superimposed on the image observed by the observation optical system 40 for the surgeon to observe. As an example, as shown in FIG. 2, the display unit 50 of this embodiment is provided in the observation optical system 40 and displays an image to the surgeon via the eyepiece 46. The display unit 50 includes a display 53, a lens 52, and a half mirror 51. Various images are displayed on the display 53. In this embodiment, an LCD (with backlight) is used as the display 53. Specifically, in this embodiment, a color LCD capable of displaying 1600 (H) × 1200 (V) is used as the display 53. As shown in FIG. 3, the half mirror 51 is disposed on the optical axis L3R. Specifically, the half mirror 51 is disposed between the protection filter 43R and the erecting prism group 44R.

[0081] The display light (display light) emitted from the display 53 travels along an optical axis L5 (see FIG. 3). Specifically, the display light from the display 53 passes through a lens 52 and is then reflected by a half mirror 51 toward the erecting prism group 44R. The half mirror 51 of this embodiment is a synthesizing means for synthesizing the optical observation image observed by the observation optical system 40 with the image displayed on the display 53. The half mirror 51 of this embodiment makes the optical axis L5 and the optical axis L3R coaxial. The display light reflected by the half mirror 51 travels through the erecting prism group 44R, the field stop 45R, and the eyepiece 46R in this order, and is focused on the fundus of the surgeon looking through the eyepiece 46R. The display unit 50 of this embodiment functions as a so-called head-up display (HUD).

[0082] In this embodiment, the display 53 and the field stop 45R are in an optically conjugate positional relationship. That is, the image displayed on the display 53 is formed as an aerial image at the position of the field stop 45R. The method of displaying an image to the surgeon through the eyepiece 46 is not limited to the method exemplified in this disclosure. For example, a backlight-free LCD (liquid crystal panel) may be disposed as the display unit at the position of the field stop 45R (on the optical axis L3R), and the control unit 60 may control the transmittance of each cell constituting the LCD to present information to the surgeon. The display unit may also be configured to project an image onto the retina of the surgeon's eye by scanning a light beam over the retina. The ophthalmic laser treatment device 1 may also capture an image of the tissue of the patient's eye E using the imaging unit 55 (described later) or the like, and display the captured image on a display device (e.g., the control box 6) to allow the surgeon to observe the observed image of the tissue of the patient's eye E. In this case, the display device may superimpose another image on the observed image. That is, the display device may function as both an observation optical system that allows the surgeon to observe an observation image of the tissue of the patient's eye E and a display unit that displays an image on the observation image.

[0083] In this embodiment, the center of the display area on the display unit 50 coincides with the observation optical axis of the observation optical system 40. Therefore, an image is displayed in the display area on the display unit 50 based on the observation optical axis of the observation optical system 40. Therefore, the surgeon can perform appropriate treatment while recognizing the image presented at an appropriate position in the observation field via the eyepiece 46.

[0084] <Photography Department> As shown in FIG. 2, the photographing unit 55 photographs an observation image of a patient's eye E or the like. More specifically, the photographing unit 55 of this embodiment photographs an observation image in which images are superimposed and displayed on the display unit 50. Although detailed illustration is omitted, the photographing unit 55 of this embodiment includes a half mirror, an imaging lens, and an imaging element. The half mirror is disposed on either the left or right observation optical path provided in the observation optical system 40. Light incident on the half mirror from the observation site or the like via the objective lens 25 is reflected by the half mirror and enters the imaging element via the imaging lens. As a result, an observation image is photographed by the imaging optical system.

[0085] <Control unit> The control unit 60 controls various aspects of the ophthalmic laser treatment device 1. The control unit 60 of this embodiment includes a CPU (processor) 61, a ROM 62, a RAM 63, and a nonvolatile memory 65. The CPU 61 controls each component of the ophthalmic laser treatment device 1. The ROM 62 stores various programs, initial values, and the like. The RAM 63 temporarily stores various pieces of information. The nonvolatile memory 65 is a non-transient storage medium that can retain its contents even when the power supply is interrupted. For example, a USB memory detachably attached to the control unit 60 or a flash ROM built into the control unit 60 can be used as the nonvolatile memory 65. In this embodiment, the control unit 60 is connected to the base unit 4, the joystick unit 5, the control box 6, the treatment laser light source 11, the aiming light source 12, the motor 15, the photodetector 18, the shutter driver 20, the lamp 31, the display 53, and the imaging unit 55.

[0086] In this disclosure, the term "processor" refers to one or more hardware processors configured to execute program code (i.e., one or more instructions of a program) included in a program. In other words, a "processor" is a hardware device capable of executing one or more programmed processes. For example, a "processor" may be a general-purpose or special-purpose processor, such as a CPU, a microprocessor, a GPU, or a Data Flow Processor (DFP), etc.

[0087] In this disclosure, the term "memory" refers to one or more hardware memories that are non-transitory tangible recording media configured to store computer program code and / or data accessible to a processor. The "memory" may be implemented using memory technologies such as SRAM, SDRAM, non-volatile / flash-type memory, or other types of memory. Computer program code that constitutes a program is stored in the memory and executed by the processor to cause the ophthalmic laser treatment device 1 to perform various functions.

[0088] In this disclosure, the term "circuit" refers to one or more hardware logic circuits configured to cause the ophthalmic laser treatment device 1 to perform a function. In other words, a "circuit" refers to one or more non-programmable devices. For example, a "circuit" may be a custom IC or the like that is non-programmably designed for a specific application.

[0089] In the present disclosure, a circuit and / or a processor having a memory storing computer program code implements functionality in the ophthalmic laser treatment device 1. The expression "a circuit and / or a processor" should be interpreted as a disjunction (logical OR), and not as at least one circuit and at least one processor.

[0090] <Treatment of trabecular meshwork> An example of a trabecular meshwork treatment performed by the ophthalmic laser treatment device 1 of this embodiment will be described with reference to FIGS. 4 and 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 a patient's eye E, is the treatment target. For example, selective laser trabeculoplasty (SLT) is a treatment method in which a therapeutic laser beam is irradiated onto the trabecular meshwork at the angle of the patient's eye E in order to increase the drainage of aqueous humor from the patient's eye E. Micropulse laser trabeculoplasty (MLT) is a treatment method in which a laser beam with lower energy than that used in SLT is irradiated onto the trabecular meshwork, activating trabecular meshwork cells and improving the flow of aqueous humor, thereby reducing the intraocular pressure of the patient's eye. Note that SLT and MLT are less likely to leave scars from the irradiation of the therapeutic laser beam. In SLT and MLT, the entire circumference or part of the ring-shaped trabecular meshwork is irradiated with a therapeutic laser beam multiple times. Note that SLT is based on the selective photohermolysis theory. As an example other than SLT and MLT, there is a known minimally invasive cell-selective laser treatment (see WO2017 / 174785 for details) in which pulses of around 200 ns are scanned to form a square spot with a side length of 50 μm during one sequence, resulting in the formation of a spot equivalent to a diameter of 400 μm. These share the same characteristics as adjacent irradiation along the trabecular meshwork, in that they are less likely to leave treatment scars. In the following explanation, SLT may be used as a representative of these irradiation methods.

[0091] As shown in FIG. 4 , in the treatment of the trabecular meshwork in this embodiment, a contact lens 26 is fitted to the cornea C of the patient's eye E. For example, the contact lens 26 may be a gonioscope or a Goldmann tripod mirror for observing the angle A of the patient's eye E. The contact lens 26 is provided with a reflective surface (reflecting mirror) 27. The angle A is observed through the reflective surface 27. Therefore, as shown in FIG. 5 , in this embodiment, the entire periphery of the angle A is not observed simultaneously, but rather a portion of the angle A is observed in a fan-shaped manner. The fan-shaped portion of the annular angle A observed through the reflective surface 27 falls within an angular range of less than 180 degrees, with the center of the annular angle A as the reference. The reflective surface 27 of the contact lens 26 reflects the treatment laser light and the aiming light in a direction intersecting the optical axis extending from the objective lens 25 (see FIGS. 2 and 3 ) toward the patient's eye E, thereby irradiating the treatment laser light and the aiming light onto the trabecular meshwork TM, which is the treatment target area. That is, in this embodiment, in an observation state as exemplified in FIG. 5, the treatment laser light is irradiated onto the trabecular meshwork TM at the angle A via the reflecting surface 27, thereby performing treatment of the trabecular meshwork.

[0092] By adjusting the rotation angle of the contact lens 26 (i.e., the angle of rotation around the axis of the contact lens 26), the surgeon can adjust the reflection direction of the treatment laser light by the reflecting surface 27 of the contact lens 26 when viewed from the surgeon's line of sight in the observation optical system 40. The surgeon can also operate the joystick unit 5 to move the base unit 4, thereby moving the relative position of the ophthalmic laser treatment device 1 (more specifically, the laser irradiation optical system 10) with respect to the patient's eye E, thereby adjusting 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. When the rotation angle of the contact lens 26 and the relative position of the device are changed, the observation image observed by the surgeon through the observation optical system 40 also moves. Furthermore, in this embodiment, the surgeon can also move the aiming positions of the treatment laser light and the aiming light without moving the observation image by operating the irradiation position operation unit 9. After completing the adjustment of the aiming position, the surgeon operates the operation button or foot switch of the joystick unit 5 to input an instruction to irradiate the treatment laser light, thereby irradiating the spot S with the treatment laser light. Note that in SLT, the treatment laser light is irradiated with a lower output (energy and irradiation time) than in argon laser trabeculoplasty (ALT) to prevent thermal degeneration of the tissue. Follow Therefore, it is difficult for the surgeon to visually recognize changes in the condition of the treatment site before and after surgery (for example, treatment scars, etc.). A known SLT and MLT technique involves fixing the spot sizes of the treatment laser light and the aiming light to a predetermined size (for example, 400 μm) and intermittently irradiating the treatment laser light along the trabecular meshwork TM so that multiple irradiation spots are adjacent to each other. Figure 5 schematically shows a portion of the technique in which the treatment laser light is intermittently irradiated so that multiple irradiation spots are adjacent to each other. With SLT and MLT, it is difficult to visually observe treatment scars. In other words, the irradiated spots (spots S) irradiated with the treatment laser light are not visually observed by the surgeon, as shown in Figure 5.

[0093] <Contact lenses> An example of a contact lens 26 used in the treatment of trabecular meshwork in this embodiment will be described with reference to Figures 6 and 7. The contact lens 26 shown in Figures 6 and 7 is a partially rotating lens. In a partially rotating lens, each time a user (operator) operates the lens with their finger, a portion including the reflective surface 27 rotates by a specified angle relative to the grip portion 26A held by the user. In other words, each operation with the user's finger causes the portion including the reflective surface 27 to rotate circumferentially around the axis AX1, independently of other portions.

[0094] In detail, the contact lens 26 shown in FIG. 6 includes an annular gripping portion 26A and a rotating base 26B. The gripping portion 26A is generally cylindrical and is gripped by the user's fingers. The rotating base 26B has a cylindrical portion with an outer diameter substantially equal to the inner diameter of the generally cylindrical gripping portion 26A. The tip (bottom of the paper in FIG. 6) of the rotating base 26B forms a contact portion 26D that comes into contact with the patient's eye E. A light-transmitting window 29 (see FIG. 7) is formed in the contact portion 26D. A reflective surface 27 (see FIG. 7) is fixed to the inner side of the rotating base 26B. The gripping portion 26A is attached to the outside of the cylindrical portion of the rotating base 26B. The rotating base 26B can rotate relative to the gripping portion 26A. A plurality of protrusions 26C protruding outward are provided on the outer periphery of the rotating base 26B, on a portion that is exposed to the outside when the gripping portion 26A is attached. In this embodiment, a plurality of protrusions 26C (ten in the example shown in FIG. 6) are provided at equal intervals in the circumferential direction at the aforementioned specified angle (36 degrees in the example shown in FIG. 6). By hooking a finger on at least one of the protrusions 26C, the user can rotate the rotation base 26B, on which the reflective surface 27 is provided, relative to the grip portion 26A. Specifically, the user can grip and fix the grip portion 26A with multiple fingers (e.g., the index finger and thumb), and then hook the remaining finger (e.g., the middle finger) on the protrusion 26C to rotate only the rotation base 26B (the rotation axis is axis AX1). Therefore, less finger movement is required during rotation than when the reflective surface is rotated by rotating the entire contact lens. As a result, the contact lens 26 is more likely to be held in a stable state even when the reflective surface 27 is rotated.

[0095] The contact lens 26 shown in FIG. 6 is designed so that the rotation angle of the rotation base 26B with a single rotation operation by the user's finger stops at a specified angle. As an example, in the contact lens 26 shown in FIG. 6, a single operation rotates the rotation base 26B 36 degrees relative to the gripping portion 26A. Therefore, the rotation base 26B completes one rotation relative to the gripping portion 26A with 10 rotation operations in the same direction. It goes without saying that the specified angle can be changed. For example, there are partially rotating lenses in which a single operation rotates the rotation base 45 degrees relative to the gripping portion.

[0096] FIG. 7 is a view of the contact lens 26 viewed from the side opposite to the side that contacts the patient's eye E. As shown in FIG. 7, spacing indicators 28 are formed on a portion of the inner wall of the contact lens 26 (in the example shown in FIG. 7, the inner wall of the rotating base 26B). A plurality of spacing indicators 28 are arranged at regular intervals to serve as a guide for the intervals between spots to be irradiated with treatment laser light. In the example shown in FIG. 7, five linear spacing indicators are arranged at equal intervals. The spacing indicators 28 are formed on the inner wall of the contact lens 26 on the side opposite to the side on which the reflective surface 27 is provided. When the contact lens 26 is viewed from the side opposite to the side that contacts the patient's eye E, a reflected image 28Z of at least a portion of the spacing indicators 28 is reflected on the reflective surface 27. During treatment, a reflected image of the treatment target area of ​​the patient's eye E (in this embodiment, the trabecular meshwork) is also reflected on the reflective surface 27. Furthermore, a reflected image of the aiming light irradiated onto the treatment target area is also reflected on the reflective surface 27. Therefore, while grasping the position of the treatment target area and the targeting light reflected on the reflecting surface 27, the surgeon can sequentially adjust the target position of the treatment laser light to each of the multiple spots on the treatment target area using the reflected image 28Z of the interval index 28 as a guide. The diagrams of the observation field illustrated in each drawing in this disclosure are diagrams showing an enlarged view of the area corresponding to the area AR1 shown in FIG. 7 . The reflecting surface 27 is formed to a size that does not omit the reflected image of the interval index 28 (reflected image 28Z). In this embodiment, the treatment laser light is irradiated to the entire circumference of the trabecular meshwork TM by rotating the reflecting surface 27 around the axis AX1 while maintaining the center of the pupil of the patient's eye E and the center of the transparent window 29 in a state where they are approximately aligned, regardless of the type of contact lens 26 used (e.g., whether the interval index 28 is provided and whether it is a partially rotating lens). At this time, the area AR1 is appropriately adjusted to follow the displacement of the reflecting surface 27. Therefore, the operator scans the joystick unit 5 and moves it around the area AR1 around the axis AX1 while irradiating the entire circumference of the trabecular meshwork TM with the treatment laser light.

[0097] 6 and 7 is merely one of several types of contact lenses that can be used in treatment with the ophthalmic laser treatment device 1 of this embodiment. Therefore, contact lenses other than the contact lenses 26 shown in FIGS. 6 and 7 can also be used in treatment with the ophthalmic laser treatment 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 rotational lens (i.e., the reflecting portion 27 is rotated by rotating the entire lens) can also be used in treatment. A partial rotational lens that does not have the spacing index 28 can also be used in treatment. It is also possible to use a contact lens that does not have the spacing index 28 and is not a partial rotational lens.

[0098] When a contact lens that requires the entire lens to be rotated in order to rotate the reflecting portion is used, the surgeon holds the contact lens with multiple fingers and rotates the entire contact lens while keeping the contact portion in contact with the patient's eye E. In this case, there is a limit to the angle by which the surgeon can rotate the entire lens without changing the way the contact lens is held (without having to readjust the grip). Furthermore, when the surgeon changes the way the contact lens is held, the positional relationship between the patient's eye E and the laser irradiation optical system 10 is likely to change. In contrast, the partially rotating contact lens 26 illustrated in Figures 6 and 7 allows the reflecting surface to be rotated by a specified angle without changing the way the contact lens is held.

[0099] An example of a treatment laser beam irradiation plan will be described with reference to FIG. 8 . FIG. 8 is a diagram showing an example of an irradiation plan displayed on the control box 6. In this embodiment, the irradiation plan is formulated by operating the control box 6. The irradiation plan determines the order of irradiation of multiple irradiation spots to be irradiated with the treatment laser beam when the patient's eye E is irradiated with the treatment laser beam using a contact lens 26 having a reflecting surface 27. The irradiation plan of this embodiment determines the irradiation range of the treatment laser beam in the annular treatment target area (in this embodiment, the trabecular meshwork TM) (i.e., the circumferential range in which multiple irradiation spots are arranged), the irradiation spot to be first irradiated with the treatment laser beam (the irradiation spot at the position of "START" shown in FIG. 8 ), the number of irradiation spots (the number in the denominator of "Shots" shown in FIG. 8 ), and the irradiation order of the treatment laser beam to each irradiation spot (including the irradiation direction; in FIG. 8 , the circumferential arrow indicates the direction of the irradiation order). In this embodiment, each time a treatment laser beam is irradiated, the irradiation spot adjacent to the irradiation spot for which irradiation has been completed becomes the next irradiation spot to be irradiated with the treatment laser beam, and "1" is added to the numerator of "Shots" shown in FIG. 8. Furthermore, each time a treatment laser beam is irradiated, the display of the spot (irradiated spot) corresponding to the spot for which irradiation has been completed, among the multiple irradiation spots arranged in an arc or ring shape (ring shape in FIG. 8), is changed to a display mode different from that of the other spots. Multiple treatment laser beam irradiations are performed sequentially in a clockwise or counterclockwise direction.

[0100] In this embodiment, the direction in which the treatment target area to be irradiated with the treatment laser light is actually located and the direction in which the reflecting surface 27 of the contact lens 26 is directed to observe the treatment target area are opposite directions with respect to the optical axis of the observation optical system 40. In this embodiment, the direction in which the treatment laser light should be irradiated is indicated by the direction in which the reflecting surface 27 is directed. However, the direction in which the treatment laser light should be irradiated may also be indicated by the direction in which the treatment target area is actually located. Note that in other embodiments described later, information about the contact lens used in treatment (e.g., at least one of information indicating whether the contact lens is a partial rotational lens, information about the specified angle of the partial rotational lens, information indicating whether the contact lens has spacing indicators 28, etc.) may be included in the irradiation plan.

[0101] As an example, in this embodiment, the surgeon specifies either the "full circumference" mode or the "half circumference" mode, thereby specifying both the planned irradiation area and the number of planned irradiation spots. Specifically, in this embodiment, a "full circumference" mode in which the treatment laser light is irradiated onto multiple spots around the entire circumference of the irradiating angle A, and a "half circumference" mode in which the treatment laser light is irradiated onto multiple spots around half the circumference of the irradiating angle A, are provided in advance. The default number of planned irradiation spots in the "full circumference" mode is set to 100. The default number of planned irradiation spots in the "half circumference" mode is set to 50. When the surgeon accepts the designation of the "full circumference" mode, the control unit 60 sets the planned irradiation area to the area around the entire circumference of the irradiating angle A and sets the number of planned irradiation spots to "100." In the example shown in FIG. 8 , the "full circumference" mode is specified. Furthermore, when the surgeon accepts the designation of the "half circumference" mode, the control unit 60 sets the planned irradiation area to the area around half the circumference of the irradiating angle A and sets the number of planned irradiation spots to "50." In this embodiment, when the surgeon designates the "half-circle" mode, he or she operates the touch panel or the like to designate the "upper half, lower half, right half, left half" or the like of the angle A, thereby designating the detailed position of the area to be irradiated in the angle A. The control unit 60 sets the area to be irradiated based on the input results.

[0102] It goes without saying that the method for accepting the designation of the planned irradiation area and the number of planned irradiation spots can be changed. For example, the ophthalmic laser treatment device 1 may be provided with modes other than the "full-circumference" mode and the "half-circumference" mode. The control unit 60 may accept a designation of an angle (within a range of 360 degrees or less) from the surgeon and set the area corresponding to the designated angle as the planned irradiation area. The control unit 60 may have the surgeon directly input the number of planned irradiation spots and set the input number of planned irradiation spots regardless of the selected mode. The control unit 60 may change the number of planned irradiation spots, which is predetermined for each mode, in response to an operation instruction from the surgeon. The control unit 60 may have the surgeon input the interval between two adjacent spots and calculate the number of planned irradiation spots based on the parameters of the planned irradiation area (e.g., the circumferential length of the treatment target area) and the input spot interval.

[0103] Referring to Figure 9, publicly known An example of a method for adjusting the aiming position of the irradiation spot will be described. figure 9(A) shows the state after the most recent irradiation of the treatment laser beam has been completed. In the state of FIG. 9(A), the position of the irradiated spot SS where irradiation of the treatment laser beam has been completed coincides with the aiming position (position of the aiming beam) AI. From the state shown in FIG. 9(A), the operator needs to adjust the irradiation position AI (i.e., the aiming position of the irradiation spot) to the position of the next irradiation spot (in the example shown in FIG. 9, the position immediately to the right of the position of the irradiated spot SS).

[0104] 9(B) shows a state in which the aiming position has been adjusted from the state shown in FIG. 9(A) to the position of the next irradiation spot by operating the joystick unit 5 (i.e., with the angle of the reflecting surface 27 of the contact lens 26 fixed). In FIG. 9(B), the positions of the irradiated spot SS and the treatment target area (the trabecular meshwork TM in this embodiment) at the time of the previous irradiation completion of the treatment laser light are schematically shown by dotted lines. However, in reality, there is no treatment mark on the irradiated spot SS at the time of the previous irradiation completion, so it is difficult to accurately adjust the aiming position by operating the joystick unit 5.

[0105] 9(C) shows a state in which the aiming position has been adjusted from the state shown in FIG. 9(A) to the position of the next irradiation spot by rotating the reflecting surface 27 of the contact lens 26 (i.e., without operating the joystick unit 5). In FIG. 9(C), the positions of the irradiated spot SS and the treatment target area at the time of the previous irradiation completion of the treatment laser light are also shown by dotted lines. However, in reality, even in FIG. 9(C), there is no treatment mark on the irradiated spot SS at the time of the previous irradiation completion, and it is difficult to accurately adjust the aiming position by rotating the reflecting surface 27.

[0106] As described above, it can be seen that the observation image observed by the surgeon moves in both cases of operating the joystick unit 5 (see FIG. 9(B)) and rotating the contact lens 26 (see FIG. 9(C)). The more frequently the observation image moves, the more difficult it becomes to align the aiming position with an appropriate position on the tissue, and the more likely it is that the efficiency of the treatment work will decrease. In contrast, the ophthalmic laser treatment device 1 of this embodiment can move the irradiation positions of the treatment laser light and the aiming light on the tissue of the patient's eye E using the irradiation position moving unit. This allows the surgeon to easily adjust the position of the irradiation spot on the tissue while suppressing the amount of movement of the observation image. Furthermore, for example, the number of times the contact lens needs to be operated to move the observation image (change the aiming position) is significantly reduced. Furthermore, the ophthalmic laser treatment device 1 of this embodiment displays a guide on the display unit 50 to assist the surgeon in adjusting the aiming position.

[0107] First Embodiment 10 to 12, a treatment control process executed by the ophthalmic laser treatment device 1 of the first embodiment will be described. The ophthalmic laser treatment device 1 of the present embodiment displays, on the display unit 50, a guide 90 for aligning a target position on the tissue to be irradiated with the treatment laser light with each of a plurality of irradiation spots to be irradiated with the treatment laser light, according to the progress of the irradiation plan. Furthermore, the ophthalmic laser treatment device 1 can move the irradiation positions of the treatment laser light and the aiming light on the tissue using the irradiation position moving unit 29. Therefore, even when the rotation angle of the contact lens 26 and the relative position of the device are maintained (i.e., even when the observation image observed on the display unit 50 is fixed), the light irradiation position moves on the tissue. Furthermore, the ophthalmic laser treatment device 1 displays, on the display unit 50, a target position indicator 92 (see FIGS. 11(l) and 11(m)) indicating the target position PP (see FIG. 11(k)) on the tissue shown in the observation image to be next irradiated with the treatment laser light. In this embodiment, the center of the display area on the display unit 50 coincides with the observation optical axis of the observation optical system 40. In this embodiment, a case will be described in which one shot of treatment laser light is emitted each time an instruction to irradiate treatment laser light is input by the surgeon.

[0108] First, an example of the observation field of the surgeon during treatment using the ophthalmic laser treatment device 1 of the first embodiment will be described with reference to Fig. 10. As shown in Fig. 10, the display unit 50 of this embodiment can superimpose an image on the observation image observed by the surgeon using the observation optical system 40. In the example shown in Fig. 10, the ophthalmic laser treatment device 1 superimposes a peripheral index 75, a guide 90, and the like on the observation image of the tissue of the patient's eye including the trabecular meshwork TM.

[0109] The outer peripheral index 75 indicates at least one of the approximate rotation angle of the reflective surface of the contact lens appropriate for the progress of the irradiation plan (i.e., the direction serving as a guide for positioning the reflective surface 27 relative to the central axis AX1 of the contact lens 26) and the approximate direction in which the irradiation spot to be irradiated with the treatment laser light is located (the approximate direction in which the irradiation spot is located in the observation image using the contact lens 26). The outer peripheral index 75 is displayed along the outer periphery of the observation field observed by the surgeon via the observation optical system 40. As described above, the observation optical axis of the observation optical system 40 and the center of the display area of ​​the display unit 50 coincide with each other. Therefore, by displaying the outer peripheral index 75 along the outer periphery of the observation field based on the center of the display area of ​​the display unit 50, the surgeon can easily grasp the appropriate direction.

[0110] Specifically, in this embodiment, multiple outer periphery indices 75 are arranged in an arc or ring shape along the outer periphery of the observation field. When moving one outer periphery indices 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 indices 75 are displayed (in other words, the center of the outer periphery indices 75 or the center of curvature of the outer periphery indices 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 indices 75.

[0111] The outer peripheral index 75 includes a next direction index 75A. The next direction index 75A indicates the direction of the next irradiation spot to be irradiated with the treatment laser beam among the multiple irradiation spots defined in the irradiation plan. The control unit 60 shifts the position of the next direction index 75A to a position corresponding to an irradiation spot adjacent to the irradiation spot in the direction of travel defined in the irradiation plan each time the treatment laser beam is irradiated. 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 direction index 75A may be shifted 3.6 degrees from the center O. Therefore, the surgeon can grasp the general direction of the irradiation spot whose aiming position is to be adjusted next by the next direction index 75A shifted along the outer peripheral portion of the observation field.

[0112] The outer peripheral indicator 75 includes a completion direction indicator 75B. The completion direction indicator 75B indicates the direction of an irradiation spot that has already been irradiated with the treatment laser beam, among multiple irradiation spots defined in the irradiation plan. Each time irradiation with the treatment laser beam is completed, the control unit 60 changes the next direction indicator 75A, which was displayed immediately before the irradiation, to the completion direction indicator 75B. Therefore, the surgeon can grasp the direction in which irradiation with the treatment laser beam has been completed and then appropriately adjust the next aiming position using the next direction indicator 75A. This also makes it easier to grasp the progress of the treatment.

[0113] The peripheral area index 75 includes a non-irradiation direction index 75C. The non-irradiation direction index 75C indicates the direction of a spot to be irradiated with the treatment laser beam after the next irradiation, among multiple irradiation spots defined in the irradiation plan. The control unit 60 changes the non-irradiation direction index 75C, which was displayed in the direction of the irradiation spot in the next irradiation order defined in the irradiation plan, to the next direction index 75A each time irradiation of the treatment laser beam is completed, thereby shifting the next direction index 75A. In this case, the surgeon can grasp the direction of the irradiation spot to be irradiated with the treatment laser beam after the next irradiation, and can appropriately adjust the next aiming position using the next direction index 75A. This also makes it easier to grasp the progress of treatment.

[0114] The control unit 60 displays the next direction indicator 75A, the completed direction indicator 75B, and the unirradiated direction indicator 75C in a distinguishable manner (i.e., in different display modes). Therefore, the surgeon can easily recognize the type of the displayed outer peripheral indicator 75. The control unit 60 may selectively display one or two of the next direction indicator 75A, the completed direction indicator 75B, and the unirradiated direction indicator 75C.

[0115] The guide 90 serves as a guide for aligning the target position on the tissue to be irradiated with the treatment laser beam with at least the next irradiation spot to be irradiated with the treatment laser beam among a plurality of irradiation spots to be irradiated with the treatment laser beam. The control unit 60 displays the guide 90 in accordance with a predetermined irradiation plan.

[0116] The guide 90 of this embodiment also serves as a spot spacing guide, indicating the appropriate spacing between multiple irradiation spots to be irradiated with the treatment laser light. Therefore, the surgeon can check the guide 90 while observing the image of the patient's eye tissue and adjust the placement of the multiple irradiation spots on the tissue by referring to the appropriate spacing indicated by the guide 90. This allows the surgeon to easily adjust the spacing between the irradiation spots to be irradiated with the treatment laser light closer to the appropriate spacing.

[0117] In this embodiment, the control unit 60 adjusts the intervals between the multiple indicators 90A, 90B, and 90C included in the guide to match the appropriate intervals between the multiple irradiation spots. Therefore, the surgeon can easily adjust the intervals between the multiple irradiation spots to the appropriate intervals by irradiating the treatment laser light multiple times in accordance with the intervals between the multiple indicators 90A, 90B, and 90C included in the guide 90. This makes it easier to perform treatment according to the treatment plan more appropriately.

[0118] The control unit 60 changes the spacing between the multiple indices of the guide 90 displayed on the display unit 50 in accordance with the magnification of the observation optical system 40. In other words, the control unit 60 increases the spacing between the multiple indices on the guide 90 as the magnification of the observation optical system 40 increases. In this case, even if the observation magnification is changed, the guide 90 that corresponds to the appropriate spacing between the multiple irradiation spots is displayed on the display unit 50.

[0119] The control unit 60 displays a next targeting index 90A on the guide 90, which is used to align the target position on the tissue to be next irradiated with the treatment laser beam. Each time the treatment laser beam is irradiated onto one irradiation spot, the control unit 60 moves the position of the next targeting index 90A in the direction of travel defined by the irradiation plan to an adjacent position shifted by one appropriate interval between the multiple irradiation spots. Therefore, the surgeon can easily adjust the target position of the next treatment laser beam by aligning the target position on the tissue to be next irradiated with the treatment laser beam with the position of the displayed next targeting index 90A.

[0120] In the present embodiment, when the spot spacing guide includes multiple indices arranged at appropriate intervals between multiple irradiation spots, the indices other than the next targeting index 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. As shown in FIG. 10 , the control unit 60 displays the next targeting index 90A in a different display mode from the irradiated indices 90B and the unirradiated indices 90C (i.e., in a mode that can be distinguished by the surgeon). This allows the surgeon to easily grasp the position of the next targeting index 90A. Specifically, the control unit 60 displays the next targeting index 90A, the irradiated indices 90B, and the unirradiated indices 90C in different displays. This allows the surgeon to easily grasp the positional relationships between the next targeting index 90A, the irradiated indices 90B, and the unirradiated indices 90C, thereby facilitating smoother treatment progress.

[0121] In the ophthalmic laser treatment device 1 of this embodiment, the end of each of the multiple indices included in the guide 90 on the side of the target position of the treatment laser beam (the lower end of each of the multiple indices in FIG. 10 ) is displayed along a curve that approximates the curve of the arc-shaped or ring-shaped treatment region of the patient's eye E (the trabecular meshwork TM in this embodiment). Therefore, when the guide 90 is placed at an appropriate position and angle with respect to the next treatment region, the distance between the end of each of the multiple indices on the side of the target position (the lower end in FIG. 10 ) and the arc-shaped treatment region is likely to become closer. As a result, the surgeon can more easily adjust the next target position of the treatment laser beam by referring to the guide 90. Note that in the example shown in FIG. 10 , the guide 90 is displayed on the opposite side of the iris from the treatment region (the trabecular meshwork TM in this embodiment). However, the guide may be displayed closer to the iris than the treatment region.

[0122] Although the shape of the curve of the arc-shaped treatment target area of ​​the patient's eye E varies slightly depending on the patient's eye, it does not vary significantly from patient to patient. Therefore, the end of each of the multiple markers on the target position side may be displayed along a curve that is predetermined based on the average shape of the treatment target area. As an example, in this embodiment, an experiment is performed in advance to observe a portion of the eye model that simulates the trabecular meshwork (simulated trabecular meshwork) under predetermined conditions. A program for displaying the end of each of the multiple markers on the target position side along the shape of the simulated trabecular meshwork observed in the experiment is stored in the non-volatile memory 65 in advance.

[0123] The ophthalmic laser treatment device 1 of this embodiment displays any of the elements of each of the multiple indices included in the guide 90 along a straight line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indices 90A, 90B, and 90C included in the guide 90 along a virtual linear angle reference line AL (not actually displayed on the display unit 50). In this embodiment, the centers of gravity of each of the multiple indices are displayed along the angle reference line AL. In this case, the surgeon can more appropriately proceed with treatment by aligning the direction in which the multiple indices are aligned with the direction in which the aim position of the treatment laser light moves to the next irradiation spot. For example, the reflective surface of a contact lens may include an edge perpendicular to the direction extending outward from the central axis of the lens. In this case, the surgeon can move the aim position of the treatment laser light along the edge direction by aligning the direction of the edge of the contact lens shown in the observation image with the linear direction in which the multiple indices are aligned. Furthermore, even if the contact lens that has been 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.

[0124] Specifically, in this embodiment, each of the multiple markers is perpendicular to the angle reference line AL, and the center (center of gravity) of each marker is located on the angle reference line AL. When the multiple markers of the guide 90 are positioned appropriately relative to the next irradiation spot, each marker of the guide 90 extends from the angle reference line AL to near the treatment target area (trabecular meshwork) in this embodiment. As a result, the positional relationship between the guide 90 and the treatment target area (e.g., the positional relationship between a specific marker and a characteristic area in the tissue) can be more easily grasped. Furthermore, the length of each of the multiple markers of the guide 90 is symmetrical about the angle reference line AL. This makes it easier for the surgeon to grasp the direction in which each element of the multiple markers is located (i.e., the direction in which the angle reference line AL extends), making it easier to adjust the angle of the reflective surface of the contact lens to an appropriate angle. For example, the angle of the reflective surface can be adjusted to an appropriate angle by adjusting the angle of the reflective surface of the contact lens so that the direction of the angle reference line AL is tangent to the annular or arc-shaped treatment area. The multiple indicators on the guide 90 do not have to extend from the angle reference line AL to the vicinity of the treatment area. The indicators displayed near the treatment area may have an appropriate width so as to absorb individual differences in the curve of the treatment area.

[0125] Furthermore, the ophthalmic laser treatment device 1 of this embodiment displays the total number of irradiation spots defined in the irradiation plan on the display unit 50. In the example shown in FIG. 10, the number in the denominator of "SHOTS" is the total number of irradiation spots. Also, the number of irradiation spots for which treatment has been completed (i.e., the total number of irradiation spots for which irradiation with treatment laser light has been completed and irradiation for which irradiation has been skipped) is displayed. In the example shown in FIG. 10, the number in the numerator of "SHOTS" is the number of irradiation spots for which treatment has been completed. Each time treatment laser light irradiation or skipping of irradiation is performed, "1" is added to the number in the numerator of "SHOTS." Also, in the example shown in FIG. 10, the mode of the aiming light used and the energy of the treatment laser light are also displayed.

[0126] The flow of treatment using the guide 90 will be described using the example shown in FIG. 11. In FIG. 11, to facilitate understanding of the transition of the display of the guide 90 and the transition of the irradiation position of the treatment laser beam and the aiming beam (the irradiation position AI of the aiming beam in FIG. 11), the portion of the surgeon's observation field other than the vicinity of the guide 90 displayed on the display unit 50 is omitted. Note that FIG. 11 shows an example in which, based on an irradiation plan preset by the surgeon, adjacent irradiation is performed clockwise on an actual region of the trabecular meshwork TM extending from the lower to the diagonally lower left. In FIG. 11, the lower trabecular meshwork TM is reflected by the reflective surface of the contact lens and enters the surgeon's observation field. Therefore, in FIG. 11, the image is upside down, and the lower trabecular meshwork TM is reflected in the surgeon's observation field. When treatment for multiple irradiation spots progresses from right to left (i.e., counterclockwise) on the reflective surface in FIG. 11, treatment for the irradiation spots progresses from right to left (i.e., clockwise) on the actual lower trabecular meshwork TM.

[0127] First, as shown in FIG. 11(a), the control unit 60 determines the angle of the guide 90 to be displayed on the display unit 50 in accordance with the progress of the irradiation plan, and displays the guide 90 at the determined angle. The guide 90 shown in FIG. 11 is used to irradiate the lower region of the actual trabecular meshwork TM a specified number of times, 10 times (i.e., a maximum of 10 times). The multiple indices of the guide 90 shown in FIG. 11(a) are arranged horizontally to treat the lower region of the trabecular meshwork TM. The control unit 60 identifiably displays a next targeting indicator 90A in the guide 90, which is used to adjust the targeting position of the next treatment laser beam. In the example shown in FIG. 11(a), the control unit 60 first displays the next targeting indicator 90A at the position of the indicator located at the end opposite to the progress direction of the treatment determined in the irradiation plan (the indicator located at the right end in FIG. 11(a)). Among the multiple indices on the guide 90, the indices other than those 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, when the display of the guide 90 starts, the control unit 60 controls the driving of the irradiation position moving unit 29 to position the irradiation position AI of the treatment laser light and the aiming light at the position indicated by the next targeting index 90A (in this embodiment, a position adjacent to one side of the extension direction of the next targeting index 90A). In this embodiment, the irradiation position AI at the start of the display of the guide 90 is positioned so as not to overlap with the next targeting index 90A. Therefore, it is less likely that the next targeting index 90A will make it difficult for the surgeon to grasp the irradiation position AI indicated by the aiming light.

[0128] 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 (so-called "relative position of the device"), which is changed using the joystick unit 5, so that the position of the next targeting indicator 90A included in the guide 90 corresponds to the initial target position in the treatment area of ​​the patient's eye E (the trabecular meshwork TM in this embodiment). Note that in FIGS. 11(a) and 11(b), the surgeon may adjust at least one of the relative positions of the contact lens and the device so that the irradiation position AI indicated by the aiming light coincides with the initial target position in the tissue. Furthermore, by adjusting at least one of the relative positions of the contact lens and the device, the surgeon brings the curve of the end of each of the multiple indicators included in the guide 90 on the side of the targeting position of the treatment laser light closer to the arc-shaped or annular curve of the treatment area of ​​the patient's eye E. Here, if any characteristic area is present 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 indicators (specific indicator) in the guide 90 and the characteristic area of ​​the tissue. In this case, even if the positional relationship between the guide 90 and the tissue of the patient's eye E shifts in the subsequent treatment procedure, the surgeon can restore the original positional relationship between the guide 90 and the tissue by adjusting the positional relationship between the specific index and the characteristic part of the tissue to the same positional relationship. In the state shown in FIG. 11(b), the surgeon inputs an instruction to irradiate the treatment laser beam to the ophthalmic laser treatment device 1. As a result, the treatment laser beam is irradiated to the irradiation position AI indicated by the aiming beam.

[0129] 11(b) and 11(c), after one shot of treatment laser light is emitted, the control unit 60 moves the irradiation position AI of the treatment laser light and the aiming light to an adjacent position offset by one appropriate interval between the multiple irradiation spots in the direction of travel defined by the irradiation plan. Therefore, even if the operator does not change the relative position of the device or the angle of the contact lens, the irradiation position AI of the treatment laser light and the aiming light automatically moves to or near the target position where the treatment laser light is to be next irradiated (the position on the tissue where the next irradiation spot is to be placed) after each shot of treatment laser light is emitted.

[0130] In this embodiment, when an instruction to move the irradiation position AI of the treatment laser beam and the aiming beam is input via the irradiation position operation unit 9, the control unit 60 moves the irradiation position AI on the tissue in accordance with the input instruction. Therefore, the surgeon can move the irradiation position AI to a desired position by inputting an instruction to move the irradiation position AI into the ophthalmic laser treatment device 1 without changing the relative position of the device or the angle of the contact lens. This facilitates adjusting the aim position of the treatment laser beam while minimizing the movement of the observation image. Because the shape of the treatment target area varies, the irradiation position AI automatically moved based on the irradiation plan may deviate from the target position on the tissue to be next irradiated with the treatment laser beam. However, by inputting an instruction to move the irradiation position AI into the ophthalmic laser treatment device 1, the surgeon can fine-tune the irradiation position AI to the target position while minimizing the movement of the observation image. This facilitates further improvement in the accuracy and efficiency of treatment. Even if the automatically moved irradiation position AI deviates from the target position on the tissue to be irradiated with the next treatment laser beam, it is highly likely that the surgeon will only need to fine-tune the irradiation position AI in a direction perpendicular to the direction of the trabecular meshwork. In this case, since the troublesome one-spot movement has already been performed automatically, the surgeon only needs to move the irradiation position AI slightly by rotating the contact lens, etc.

[0131] Furthermore, after one shot of treatment laser light is completely irradiated, the control unit 60 moves the position of the next targeting indicator 90A to an adjacent position offset by one appropriate interval between the multiple irradiation spots in the direction of travel defined by the irradiation plan. Therefore, the surgeon can more easily adjust the next targeting position by aligning the target position on the tissue to be next irradiated with the treatment laser light with the position of the displayed next targeting indicator 90A. In this embodiment, the next irradiation position AI is automatically shifted by one spot each time the treatment laser light is irradiated onto one spot. Therefore, the surgeon can determine whether to irradiate or skip (non-irradiate) by observing the state (e.g., pattern) of the trabecular meshwork on a spot-by-spot basis, while still enjoying the effect of simplifying the operation during adjacent irradiations due to the automatic shift. Furthermore, because the surgeon only needs to align a point (one spot) with the trabecular meshwork (line), there is no need for a complex alignment operation of aligning a line (arc pattern) with the line (trabecular meshwork path) as required when irradiating an arc pattern in which multiple irradiation spots are arranged in an arc. When fitting the arc pattern to the trabecular meshwork, it is thought that fitting the arc pattern to the trabecular meshwork tends to become more difficult (or severe) in proportion to the length of the arc pattern.

[0132] In the state shown in FIG. 11(c), the surgeon inputs an instruction to irradiate the treatment laser beam into the ophthalmic laser treatment device 1. As a result, the treatment laser beam is irradiated to the irradiation position AI indicated by the aiming beam. Thereafter, the treatment laser beam is irradiated a specified number of times, 10 times (i.e., a maximum of 10 times), to one irradiation zone in the trabecular meshwork TM, using the same procedure as described with reference to FIGS. 11(b) and 11(c) (see FIGS. 11(c) to 11(k)). The irradiation zone is the angular range of an arc-shaped region over which the treatment laser beam is to be irradiated a specified number of times, M (M≧2; in the example shown in FIG. 11, M=10), with the display position and angle of the guide 90 on the display unit 50 fixed.

[0133] 11(k) and 11(l), when the irradiation of all of the multiple (10 in FIG. 11) irradiation spots in the irradiation zone under treatment with the treatment laser light is completed, the control unit 60 rotates the entire guide 90 by the angle of one irradiation zone in the direction of travel defined by the irradiation plan. In other words, when the treatment in one irradiation zone is completed with the display position and angle of the guide 90 fixed, the angle of the displayed guide 90 rotates to an angle corresponding to the treatment of the next irradiation zone. Therefore, the irradiation of each of the multiple irradiation zones with the treatment laser light is automatically and appropriately assisted according to the progress of the irradiation plan.

[0134] The angle of the irradiation zone can be selected as appropriate. As an example, the ophthalmic laser treatment device 1 of this embodiment divides the range of R degrees (R≦360) in a ring-shaped or arc-shaped treatment target area (in this embodiment, the trabecular meshwork TM) into S irradiation zones, and adjusts the aiming position within each irradiation zone. Each time irradiation of all of the multiple irradiation spots within an irradiation zone under treatment with the treatment laser light is completed, the control unit 60 rotates the entire guide 90 by the angle of one irradiation zone (i.e., R / S degrees) in the traveling direction determined by the irradiation plan. As a result, the irradiation of the treatment laser light is appropriately assisted in each of the multiple irradiation zones.

[0135] As shown in Figures 11(k) and 11(l), when the control unit 60 rotates the guide 90 for the next irradiation section, it sets the position of the next targeting index 90A at the end of the rotated guide 90 opposite to the treatment progress direction determined in the irradiation plan. As a result, the position of the next targeting index 90A is appropriately changed according to the progress of the irradiation plan, making it easier to proceed with the treatment more smoothly. Furthermore, every time the control unit 60 rotates the guide 90 including multiple indices for the next irradiation section, it sets all of the multiple indices other than the next targeting index 90A as unirradiated indices 90C (see Figure 10).

[0136] 11(k) and 11(l), when the control unit 60 rotates the guide 90 for the next irradiation section, it controls the driving of the irradiation position moving unit 29 to move the irradiation position AI of the treatment laser beam and the aiming beam in the direction opposite to the treatment progression direction defined in the irradiation plan. As an example, in this embodiment, when the control unit 60 rotates the guide 90 for the next irradiation section, it positions the irradiation position AI of the treatment laser beam and the aiming beam at the position indicated by the next aiming index 90A (in this embodiment, a position adjacent to one side in the extension direction of the next aiming index 90A). As a result, treatment for the next irradiation section can be started smoothly.

[0137] In FIGS. 11(l) and 11(m), the surgeon adjusts at least one of the rotation angle of the contact lens and the relative position of the device so that the position of the next target index 90A included in the guide 90 corresponds to the next target position in the tissue of the patient's eye E. Note that in FIGS. 11(l) and 11(m), the surgeon may also adjust at least one of the relative positions of the contact lens and the device so that the irradiation position AI indicated by the aiming light coincides with the next target position. Furthermore, by adjusting at least one of the relative positions of the contact lens and the device, the surgeon brings the curve of the end of each of the multiple indexes included in the guide 90 that is closest to the target position of the treatment laser beam closer to the arc-shaped or annular curve of the treatment target site of the patient's eye E. When the state shown in FIG. 11(m) is reached, the surgeon inputs an instruction to irradiate the treatment laser beam into the ophthalmic laser treatment device 1, thereby irradiating the treatment laser beam to the target position. Thereafter, treatment proceeds in the same manner as in FIGS. 11(b) to 11(k).

[0138] In the present disclosure, an adjacent position is defined as a position shifted by n appropriate intervals (one interval in this embodiment) of the multiple irradiation spots from the position of the irradiation spot where the treatment laser light was previously applied in the direction of travel defined in the irradiation plan. As described above, in FIGS. 11(b) to 11(k), the treatment laser light is applied to the multiple irradiation spots while the position and angle of the guide 90 are fixed. Therefore, in FIGS. 11(b) to 11(k), the next aim position indicated by the next aim indicator 90A is an adjacent position. Meanwhile, the range within which the surgeon can observe the observation image through the observation optical system 40 and the range within which the irradiation position AI of the treatment laser light and the aiming light can be moved by the irradiation position moving unit 29 are both finite. Therefore, if an attempt is made to adjust the arrangement of the multiple irradiation spots on the tissue using the guide 90 superimposed on the observation image while the observation range of the observation image is fixed, the next aim position indicated by the guide 90 may fall outside the range of the observation image, or the light irradiation position AI may fall outside the movable range. Therefore, in order to maintain the next target position 90A indicated by the guide 90 within the range of the observation image and to maintain the light irradiation position AI within the movable range, the control unit 60 also needs to move the next target position to a non-adjacent position different from the adjacent position. As shown in FIGS. 11(k) and 11(l), in this embodiment, the control unit 60 may also move the next target position to a non-adjacent position different from the adjacent position PP shown in FIG. 11(k) (the position indicated by the next target index 90A in FIG. 11(l)). In this case, the surgeon adjusts at least one of the rotation angle of the contact lens and the relative position of the device so that the position indicated by the next target index 90A included in the guide 90 corresponds to the next target position on the tissue of the patient's eye E. This again makes it possible to adjust the arrangement of multiple irradiation spots on the tissue while keeping the range of the observation image fixed.

[0139] However, if the next aiming position is moved to a non-adjacent position different from the adjacent position PP, the surgeon is likely to lose sight of the target position on the tissue (the position to be irradiated with the treatment laser light next) shown in the observation image. In contrast, when the ophthalmic laser treatment device 1 of this embodiment moves the next aiming position of the guide 90 to a non-adjacent position different from the adjacent position PP (see FIG. 11(k)), the display unit 50 displays a target position indicator 92 indicating the position on the tissue at the adjacent position PP (i.e., the position on the tissue that would have been indicated by the next aiming indicator 90A if the next aiming indicator had moved to the adjacent position). The position on the tissue indicated by the target position indicator 92 is the target position to which the next aiming position of the guide 90 is to be aligned. Therefore, the surgeon can grasp the target position on the tissue using the target position indicator 92 superimposed on the observation image (for example, memorize the characteristics of the trabecular meshwork pattern at the location indicated by the target position indicator 92), and then align the grasped target position with the position indicated by the next aiming indicator 90A, thereby appropriately aligning the aim position of the treatment laser light to the target position. Therefore, treatment with the treatment laser light when a contact lens having a reflective surface is used is appropriately assisted.

[0140] As described above, the control unit 60 of this embodiment rotates the entire guide 90 in the direction of travel defined in the irradiation plan by the angle of one irradiation zone each time irradiation of all of the irradiation spots in the irradiation zone under treatment with the treatment laser light is completed. When rotating the entire guide 90, the control unit 60 causes the display unit 50 to display a target position indicator 92 indicating the target position on the tissue at the adjacent position PP (i.e., the position on the tissue that would have been indicated by the next targeting indicator if the next targeting indicator had moved to the adjacent position). Therefore, irradiation of each of the multiple irradiation zones with the treatment laser light is automatically and appropriately assisted according to the progress of the irradiation plan.

[0141] As shown in FIG. 11(l), in this embodiment, the target position indicator 92 displayed on the display unit 50 is a mark arranged around the target position, which is the adjacent position PP (i.e., the position on the tissue that would be indicated by the next target indicator 90A if it were assumed that the next target indicator 90A had moved to the adjacent position PP), at least at the start of displaying the target position indicator 92. Therefore, the surgeon can grasp the state of the tissue at the target position located inside the mark by using the observation image on which the mark is superimposed. This makes it easier for the surgeon to appropriately align the tissue located inside the mark with the position of the next target indicator 90A.

[0142] 11(l), a ring-shaped mark surrounding the target position (at least the adjacent position PP at the time when the display of the target position indicator 92 starts) is used as the target position indicator 92. However, the specific form of the mark placed around the target position can be selected as appropriate. For example, marks placed at multiple locations around the target position (for example, the four corners of a rectangular area surrounding the target position) may be used as the target position indicator.

[0143] However, the display mode of the target position indicator may be changed. For example, the target position indicator may be a mark superimposed on the adjacent position PP (target position). Even in this case, the surgeon can appropriately grasp the target position PP based on the state of the tissue surrounding the mark superimposed on the adjacent position PP (target position). The target position indicator may indicate a position relative to the adjacent position PP (target position). For example, the control unit 60 may indicate the target position by indicating the position of the irradiation spot most recently irradiated with the treatment laser beam using the target position indicator. In this embodiment, the adjacent position PP (target position) is a position shifted by one appropriate interval between the multiple irradiation spots from the position most recently irradiated with the treatment laser beam in the direction of travel defined by the irradiation plan. Therefore, the surgeon can appropriately grasp the target position (the position PP adjacent to the irradiation spot most recently irradiated with the treatment laser beam) by grasping the position of the irradiation spot most recently irradiated with the treatment laser beam using the target position indicator.

[0144] 11(m) and 11(n), the control unit 60 displays the target position indicator 92 on the display unit 50, and then erases the displayed target position indicator 92 upon receiving an instruction to irradiate the treatment laser beam. As shown in FIGS. 11(l) and 11(m), when the position of the next target indicator 90A indicated by the guide 90 moves to a position different from the adjacent position PP (see FIG. 11(k)), the surgeon uses the displayed target position indicator 92 to determine the target position on the tissue to be irradiated with the treatment laser beam next, aligns the determined target position on the tissue with the position of the next target indicator 90A, and inputs an instruction to irradiate the treatment laser beam into the ophthalmic laser treatment device 1. Therefore, after the instruction to irradiate the treatment laser beam is input, it is highly likely that the target position on the tissue has already been aligned with the position of the next target indicator 90A, so it is not necessary to display the target position indicator 92. Therefore, the control unit 60 can erase the target position indicator 92 at an appropriate timing by taking the input of an instruction to irradiate the treatment laser light as a trigger.

[0145] As shown in FIGS. 11(l) and 11(n), the control unit 60 of the first embodiment causes the display unit 50 to adjust the superimposed display position of the target position indicator 92 to track the target position on the observation image as the observation image observed by the observation optical system 40 moves. Therefore, even if the surgeon does not remember the target position on the tissue indicated by the target position indicator 92, the surgeon can easily and appropriately adjust the target position to the position of the next aiming indicator 90A by taking into account the target position indicator 92, which moves to track the target position. Note that a specific method for adjusting the superimposed position of the target position indicator 92 to track the target position on the observation image can be selected as appropriate. In the first embodiment, the control unit 60 applies known image processing (e.g., pattern matching) to the observation images continuously captured by the imaging unit 55 (see FIG. 2) to identify the target position on the moving observation image (by learning image features using the region of interest (ROI) region on which the target position indicator 92 is superimposed), and then moves the display position of the target position indicator 92 to track the identified target position.

[0146] The ophthalmic laser treatment device 1 of this embodiment can also accept a user's instruction to rotate the entire guide 90 before the irradiation of all of the irradiation spots in the irradiation zone under treatment with the treatment laser light is completed (i.e., during treatment of the irradiation spots in the irradiation zone). When an instruction to rotate the entire 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 guide 90 by an angle corresponding to the extent to which treatment has progressed in the irradiation zone under treatment. Therefore, even if the treatment in each irradiation zone has not been completed, the surgeon can move on to treatment in the next irradiation zone after rotating the entire guide 90.

[0147] The angle between two adjacent irradiation spots as viewed from the center of the circle through which the planned irradiation spots pass is defined as A degrees, and the number of irradiation spots where treatment has progressed within the irradiation section where treatment was in progress is defined as m. In this embodiment, the angle corresponding to the range of treatment progress within the irradiation section where treatment was in progress is calculated by "A degrees x m spots." The number of irradiation spots where treatment has progressed, "m spots," also includes the number of irradiation spots where irradiation of the treatment laser light has been skipped due to a skip instruction, which will be described later.

[0148] The ophthalmic laser treatment device 1 of this embodiment also allows a user to input a skip instruction (hereinafter referred to as a "skip instruction") to skip irradiating the next irradiation spot defined in the irradiation plan with the treatment laser beam. When the skip instruction is input, the control unit 60 moves the irradiation position AI of the treatment laser beam and the aiming beam to an adjacent position without irradiating the treatment laser beam. When the skip instruction is input, the control unit 60 also moves the position of the next aiming index 90A in the direction of travel defined in the irradiation plan to an adjacent position shifted by n appropriate intervals (one interval in this embodiment) between the multiple irradiation spots without irradiating the treatment laser beam. Therefore, if there is a non-irradiation spot where it is not appropriate to irradiate the treatment laser beam, the surgeon can input a skip instruction to skip irradiating the non-irradiation spot with the treatment laser beam and resume treatment from the next scheduled irradiation spot. This allows for smoother treatment progression. That is, the ophthalmic laser treatment device 1 includes a skip unit that skips the irradiation step of the treatment laser beam to some of the multiple irradiation spots defined in the treatment plan. Therefore, it becomes easier to appropriately achieve both convenience through treatment planning (e.g., guiding the irradiation of treatment laser light) and flexible treatment using skip means (e.g., a procedure for omitting irradiation of treatment laser light to non-irradiated areas discovered after the start of treatment according to the treatment plan).

[0149] The treatment control process in the first embodiment will be described with reference to Fig. 12. All treatment control processes described below are executed by the CPU (controller) 61 of the control unit 60 when an instruction to start treatment is input via a touch panel or the like. The CPU 61 executes the treatment control process in accordance with a control program stored in the ROM 62 or non-volatile memory 65.

[0150] First, the control unit 60 acquires an irradiation plan for the patient's eye E with the treatment laser light (S1). As described above, the irradiation plan determines the order of irradiation of multiple irradiation spots to be irradiated with the treatment laser light when the patient's eye E is irradiated with the treatment laser light using a contact lens 26 having a reflecting surface 27. The irradiation plan in this embodiment determines the irradiation range of the treatment laser light in the annular treatment target area (in this embodiment, the trabecular meshwork TM) (i.e., the circumferential range in which multiple irradiation spots are arranged), the irradiation spot to be first irradiated with the treatment laser light, the angle between two adjacent irradiation spots, the angle of one irradiation section, the number of times M the treatment laser light is irradiated within each irradiation section, the total number N of irradiations of the entire treatment target area with the treatment laser light, the irradiation spot to be first irradiated with the treatment laser light, the irradiation order of the treatment laser light (including the irradiation direction), etc. Note that if the angular range of the annular or arc-shaped treatment target area is R degrees (R≦360) and the number of irradiation spots to be irradiated with the treatment laser light on the treatment target area is N, the angle between two adjacent irradiation spots is "R / N" degrees. Furthermore, when the R-degree range of a ring-shaped or arc-shaped treatment target area is divided into S irradiation zones, the angle of one irradiation zone is "R / S" degrees. In this embodiment, after each irradiation of the treatment laser beam, the irradiation spot adjacent to the irradiation spot that has been completely irradiated becomes the irradiation spot to be irradiated with the treatment laser beam next. Multiple irradiations of the treatment laser beam are performed sequentially in a clockwise or counterclockwise direction. As an example, in this embodiment, an irradiation plan is formulated by operating the control box 6.

[0151] The control unit 60 displays the guide 90 on the display unit 50 at an angle corresponding to the arrangement of the first irradiation zone (S2). The control unit 60 sets the value of the total irradiation number counter "n," which specifies the cumulative number of times the treatment laser light has been irradiated onto the entire treatment target area, to "0" (S83). As a result, the observation field of view by the operator becomes as shown in FIG. 11(a).

[0152] The control unit 60 sets the value of a total irradiation number counter "n," which specifies the number of times the treatment laser light has been irradiated to all of the multiple irradiation spots defined in the irradiation plan, to "0" (S3). The control unit 60 also sets the value of an intra-section irradiation number counter "m," which specifies the number of times the treatment laser light has been irradiated within one irradiation section, to "0" (S4). The control unit 60 sets the display position of a next targeting index 90A, which is the index for the next irradiation of the treatment laser light, among the multiple indexes included in the guide 90, to a position overlapping with the index located at the end opposite to the direction of progression of the irradiation order (S5).

[0153] The control unit 60 determines whether an instruction to irradiate the treatment laser beam has been input by the operator (S7). If an instruction to irradiate the treatment laser beam has not been input (S7: NO), the control unit 60 determines whether an instruction to omit irradiation of the treatment laser beam to the next irradiation spot defined in the irradiation plan (i.e., a "skip instruction") has been input (S8). If a skip instruction has not been input (S8: NO), the control unit 60 determines whether an instruction to rotate the entire guide 90 (hereinafter referred to as an "intermediate rotation instruction") before completing irradiation of all of the multiple irradiation spots in the irradiation section under treatment with the treatment laser beam has been input (S9). If an intermediate rotation instruction has not been input (S9: NO), the control unit 60 determines whether an instruction to move the irradiation position AI of the treatment laser beam and the aiming beam has been input by the irradiation position moving unit 29 (S10). If an instruction to move the irradiation position has not been input (S10: NO), the control unit 60 determines whether or not the target position indicator 92 (see FIGS. 11(l) and 11(m)) is displayed on the display unit 50 (S11). If no instruction has been input in S7 to S11, the determinations of S7 to S11 are repeated and the system enters a standby state.

[0154] When the instruction to irradiate the treatment laser beam is input (S7: YES), the treatment laser beam is irradiated (S13). If the target position indicator 92 (see FIGS. 11(l) and 11(m)) is displayed on the display unit 50, the control unit 60 erases the target position indicator 92 from the display unit 50 upon input of the instruction to irradiate the treatment laser beam (S14). 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" (S16). The control unit 60 determines whether the value of the total irradiation number counter "n" has reached the total number "N" of irradiations of the treatment laser beam to the entire treatment target area (S17). If the treatment laser beam has not been irradiated a predetermined number of times to all irradiation spots (including skipped irradiations in this embodiment) (i.e., if "n" has not reached "N") (S17: NO), the control unit 60 determines whether the treatment laser beam has been irradiated a predetermined number of times to the irradiation zone under treatment (i.e., whether the value of the intra-zone irradiation number counter "m" has reached "M," the number of times the treatment laser beam has been irradiated to one irradiation zone) (S19). If the treatment laser beam has not been irradiated to the irradiation zone under treatment (S19: NO), the control unit 60 moves the irradiation position AI of the treatment laser beam and the aiming beam to an adjacent position shifted by n appropriate intervals (one interval in this embodiment) of the multiple irradiation spots in the direction of travel defined by the irradiation plan. The control unit 60 also moves the position of the next aiming index 90A to an adjacent position shifted by n appropriate intervals (one interval in this embodiment) of the multiple irradiation spots in the direction of travel defined by the irradiation plan (S20). In S20, control is also executed to change the previous next targeting index 90A to the already-irradiated index 90B. After that, the process returns to S7.

[0155] When irradiation of one irradiation zone with the treatment laser beam is completed (S19: YES), the control unit 60 rotates the entire guide 90 by the angle of one irradiation zone (a specified angle) (S22). The control unit 60 resets the next targeting indicator 90A and the unirradiated indicator 90C (S30). Furthermore, the control unit 60 displays the target position indicator 92 at an adjacent position PP (a position shifted by n appropriate intervals between multiple irradiation spots in the direction of travel defined by the irradiation plan from the position of the irradiation spot where irradiation of the treatment laser beam was previously completed) (S31), and the process returns to S4. Thereafter, a process for treating the next irradiation zone is executed. When irradiation of all irradiation spots with the treatment laser beam is completed (S17: YES), the process ends.

[0156] Furthermore, if a skip instruction is input before an instruction to irradiate the treatment laser light is input (S8: 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" (S16), and executes the processes of S17, S19, S20, S22, S30, and S31.

[0157] Furthermore, if a mid-treatment rotation instruction is input before an instruction to irradiate with the treatment laser beam is input (S9: YES), the control unit 60 calculates the angle corresponding to the range of treatment progress within the irradiation zone during treatment as the angle by which to rotate the guide 90 (S24). As described above, in this embodiment, the angle between two adjacent irradiation spots as viewed from the center of the virtual circle through which the planned irradiation spots pass is defined as A degrees, and the number of irradiation spots through which treatment progressed within the irradiation zone during treatment is defined as m (which corresponds to the value of the intra-zone irradiation number counter m in this embodiment). In this embodiment, the control unit 60 calculates the angle corresponding to the range of treatment progress within the irradiation zone during treatment by "A degrees x m." The number of irradiation spots through which treatment progressed, "m," includes the number of irradiation spots for which irradiation with the treatment laser beam was skipped due to a skip instruction. The control unit 60 rotates the entire guide 90 in the treatment direction determined in the treatment plan by the angle calculated in S24 (S25). If the number of irradiation spots where treatment has progressed, "m", is "0", the angle calculated in S24 is "0 degrees", and therefore the guide 90 is not rotated in S25. Thereafter, a process for resetting the next targeting index 90A and the unirradiated index is performed (S30), and further a process for displaying the target position index 92 at the adjacent position PP is performed (S31), and the process returns to S4.

[0158] Furthermore, if an instruction to move the irradiation position AI of the treatment laser beam and the aiming beam is input by the irradiation position moving unit 29 before the instruction to irradiate the treatment laser beam is input (S10: YES), the control unit 60 controls the driving of the irradiation position moving unit 29 to move the irradiation position AI of the treatment laser beam and the aiming beam to a position according to the input instruction, and the process proceeds to S11. Therefore, if the irradiation position AI automatically moved in S20 is deviated from the next target position on the tissue, for example, the surgeon can adjust the irradiation position AI without moving the observation image by inputting an instruction to move the irradiation position AI.

[0159] Furthermore, if the target position indicator 92 (see FIGS. 11(l) and 11(m)) is displayed on the display unit 50 (S11: YES), the control unit 60 causes the position at which the target position indicator 92 is superimposed on the display unit 50 to follow the target position on the observation image as the observation image that the surgeon is made to observe through the observation optical system 40 moves (S28). Thereafter, the process returns to S7. An example of the process of S28 has already been described, so its description will be omitted here.

[0160] Second Embodiment The processing executed by the ophthalmic laser treatment device 1 of the second embodiment will be described with reference to Fig. 13. Note that the processing in the first embodiment can be adopted for at least a part of the processing in the second embodiment. Therefore, the description of the processing in the second embodiment that can adopt the processing in the first embodiment will be omitted or simplified.

[0161] In the first embodiment described above, as the observation image observed by the surgeon through the observation optical system 40 moves, the position at which the target position indicator 92 is superimposed on the display unit 50 follows the target position on the observation image. On the other hand, as shown in Fig. 13, the control unit 60 in the second embodiment fixes the position of the target position indicator 92 displayed on the display unit 50. Even in this case, the surgeon can properly align the aim position to the target position by aligning the target position on the tissue grasped by the target position indicator 92 with the position of the next aim indicator 90A.

[0162] As described above, the imaging unit 55 can capture an observation image in a state in which the images are superimposed and displayed by the display unit 50. In the second embodiment, the control unit 60 presents the reference image 95 captured by the imaging unit 55 to the surgeon when the target position indicator 92 is displayed on the display unit 50 (for example, when the display of the target position indicator 92 is started). In this case, even after the surgeon changes at least one of the relative position of the device and the angle of the contact lens in order to align the target position on the tissue with the position of the next target indicator 90A indicated by the guide 90 (i.e., even if the actual target position on the tissue has shifted from the position indicated by the fixedly displayed target position indicator 92), the surgeon can re-identify the target position on the tissue indicated by the target position indicator 92 by checking the presented reference image 95. Therefore, the surgeon can appropriately align the target position on the tissue identified by the target position indicator 92 with the position of the next target indicator 90A.

[0163] 13, the control unit 60 displays a reference image 95 captured by the imaging unit 55 in a part of the display area of ​​the display unit 50, which displays an image superimposed on the observation image. Therefore, the surgeon can easily align the target position with the position of the next aiming index 90A by comparing the observation image of the tissue at that time with the reference image 95 when the target position index 92 was displayed.

[0164] After presenting the reference image 95 to the surgeon, the control unit 60 stops presenting the reference image 95 when an instruction to irradiate with treatment laser light is input. As described above, after an instruction to irradiate with treatment laser light is input, it is highly likely that the target position on the tissue has already been aligned with the position of the next aiming index 90A, so it is not necessary to present the reference image 95 to the surgeon. Therefore, by using the instruction to irradiate with treatment laser light as an opportunity to stop presenting the reference image 95 at an appropriate time, the control unit 60 can stop presenting the reference image 95 at an appropriate time.

[0165] The embodiments disclosed herein are illustrative in all respects and should not be considered limiting. The scope of the present invention is defined by the claims, not by the above description, and is intended to include all modifications within the meaning and scope of the claims and their equivalents. For example, it is possible to employ only a portion of the techniques described in each of the embodiments. It is also possible to employ an appropriate combination of techniques from different embodiments in the ophthalmic laser treatment device 1.

[0166] The ophthalmic laser treatment device 1 of the above embodiment performs both a process of automatically moving the irradiation position of the treatment laser beam and the aiming beam based on an irradiation plan and a process of moving the irradiation position in response to an input instruction. However, the ophthalmic laser treatment device 1 may perform only one of the processes of automatically moving the irradiation position based on an irradiation plan and moving the irradiation position in response to an input instruction. For example, if the irradiation position automatically moved based on the irradiation plan deviates from the next position to be irradiated with the treatment laser beam, the surgeon can adjust the irradiation position by simply slightly changing at least one of the relative position of the device and the angle of the contact lens. In this case, the amount of movement of the observation image is also small.

[0167] The ophthalmic laser treatment device 1 of the above embodiment irradiates one irradiation spot with a single shot of treatment laser light each time an instruction to irradiate treatment laser light is input. For example, assume that multiple irradiation spots are irradiated with treatment laser light each time an instruction to irradiate treatment laser light is input. In this case, although the amount of work performed by the surgeon is likely to be reduced, the surgeon must accurately align all of the multiple irradiation spots with the treatment target area before inputting the irradiation instruction. In contrast, if one shot of treatment laser light is irradiated each time an instruction to irradiate is input, the surgeon can adjust the aim position of the treatment laser light for each of the multiple irradiation spots before inputting the irradiation instruction. This makes it easier to more accurately align the positions of the multiple irradiation spots with the treatment target area. It also makes it easier to skip irradiating non-irradiated areas with treatment laser light.

[0168] However, the control unit 60 may control the irradiation position moving unit 29 based on the irradiation plan each time a treatment laser irradiation instruction is input, and irradiate each of the multiple irradiation spots with the treatment laser beam multiple times at appropriate intervals. In this case, the amount of work performed by the surgeon can be further reduced. For example, if two irradiations (for two spots) are performed in response to one irradiation instruction, the amount of work can be reduced while still providing a feeling of operation similar to that of single irradiation (for each spot).

[0169] Furthermore, useful effects can be obtained even if the next targeting index 90A is not displayed in a manner different from the other indexes on the guide 90. For example, the control unit 60 may cause the display unit 50 to display multiple indexes at predetermined intervals (for example, appropriate intervals between multiple irradiation spots) without changing the display manner. Even in this case, the surgeon can appropriately position each of the multiple irradiation spots on the tissue by referring to the multiple indexes. [Explanation of symbols]

[0170] 1. Ophthalmic laser treatment device 9 Control section for irradiation position 10 Laser irradiation optical system 11 Therapeutic laser light source 12 Aiming Light Source 26 Contact Lenses 29 Irradiation position moving part 40 Observation optical system 50 Display section 55 Photography Department 60 Control Unit 90 Guide 90A Next Aim Indicator 92 Target position index 95 Reference Images

Claims

1. An ophthalmic laser treatment device that irradiates a tissue of a patient's eye with a treatment laser beam upon input of an instruction to irradiate the tissue with the treatment laser beam, a treatment laser light source that emits treatment laser light; an aiming light source that emits aiming light to allow an operator to recognize a planned irradiation position of the treatment laser light on the tissue; an irradiation position moving unit that moves an irradiation position on the tissue to which the treatment laser light and the aiming light are irradiated; an observation optical system that allows an operator to observe an observation image of the tissue; a display unit that displays an image superimposed on the observation image observed by the surgeon; A control unit; Equipped with The control unit an irradiation plan acquisition step of acquiring an irradiation plan in which an irradiation order of the treatment laser beam for a plurality of irradiation spots to be irradiated with the treatment laser beam is determined when the treatment laser beam and the aiming beam are irradiated to the tissue of the patient's eye using a contact lens having a reflective surface that reflects the treatment laser beam and the aiming beam in a direction intersecting with an optical axis; a guide display step of displaying, on the display unit according to progress of the irradiation plan, a guide for aligning a target position on the tissue to be irradiated with the treatment laser light with at least an irradiation spot to be next irradiated with the treatment laser light among a plurality of irradiation spots to be irradiated with the treatment laser light; an irradiation position moving step of moving the irradiation positions of the treatment laser light and the aiming light by controlling driving of the irradiation position moving unit; An ophthalmic laser treatment device characterized by performing the above.

2. 10. The ophthalmic laser treatment device according to claim 1, the control unit moves the irradiation positions of the treatment laser beam and the aiming beam in the direction of travel defined by the irradiation plan to adjacent positions shifted by an appropriate interval of n irradiation spots each time the treatment laser beam is irradiated onto n irradiation spots in the irradiation position moving step.

3. 3. The ophthalmic laser treatment device according to claim 2, The control unit an ophthalmic laser treatment device that, when an instruction to omit irradiation of the next n irradiation spots defined in the irradiation plan with the treatment laser beam is input, moves the irradiation positions of the treatment laser beam and the aiming beam to the adjacent positions without irradiating the treatment laser beam.

4. 4. An ophthalmic laser treatment apparatus according to claim 1, an ophthalmic laser treatment device characterized in that, when an instruction to move the irradiation position of the treatment laser beam and the aiming light is input in the irradiation position moving step, the control unit moves the irradiation position of the treatment laser beam and the aiming light in accordance with the input instruction.

5. 5. An ophthalmic laser treatment apparatus according to claim 1, The ophthalmic laser treatment device is characterized in that, in the guide display step, the control unit displays a spot spacing guide on the display unit, which indicates the appropriate spacing between multiple irradiation spots to be irradiated with treatment laser light, according to the progress of the irradiation plan.

6. 6. The ophthalmic laser treatment device according to claim 5, The ophthalmic laser treatment device is characterized in that the control unit causes the intervals of at least some of the multiple indicators included in the spot interval guide to coincide with the appropriate intervals of the multiple irradiation spots.

7. 7. An ophthalmic laser treatment device according to claim 5, The ophthalmic laser treatment device is characterized in that the control unit changes the size of the spot interval guide displayed on the display unit according to the magnification of the observation image by the observation optical system.

8. 8. An ophthalmic laser treatment device according to claim 1, The control unit a next targeting indicator for aligning the target position on the tissue to be irradiated with the treatment laser light next is displayed on the guide; an ophthalmic laser treatment device that moves the position of the next aiming index to an adjacent position shifted by an appropriate interval of n of the plurality of irradiation spots in the direction of travel defined by the irradiation plan every time irradiation of n irradiation spots with treatment laser light is performed.

9. 9. An ophthalmic laser treatment device according to claim 1, the shape of the treatment target area of ​​the patient's eye to be irradiated with the treatment laser light is arc-shaped or annular; When the angle range of an arc-shaped region where the treatment laser light is to be irradiated a predetermined number of times M (M≧2) is set as an irradiation section while the display position and angle of the guide on the display unit are fixed, The control unit an ophthalmic laser treatment device characterized in that, each time irradiation of all of a plurality of irradiation spots within the irradiation zone during treatment with treatment laser light is completed, the entire guide is rotated in the direction of travel determined by the irradiation plan by the angle of one of the irradiation zones.

10. 10. The ophthalmic laser treatment device according to claim 9, The control unit An ophthalmic laser treatment device characterized in that, when an instruction to rotate the entire guide for the next irradiation section is input before irradiation of all of the multiple irradiation spots in the irradiation section under treatment with treatment laser light is completed, the entire guide is rotated by an angle corresponding to the range to which treatment has progressed in the irradiation section under treatment.

11. 11. An ophthalmic laser treatment device according to claim 9 or 10, The control unit controls the driving of the irradiation position moving unit each time the guide is rotated for the next irradiation section, thereby moving the irradiation position of the treatment laser light and the aiming light in the direction opposite to the treatment progression direction determined in the irradiation plan.

Images