Ophthalmic laser treatment apparatus and treatment laser beam irradiation unit

Abstract

To more appropriately irradiate a patient's eye with a treatment laser beam.SOLUTION: An ophthalmologic apparatus includes an apparatus main body configured to irradiate a patient's eye with a first treatment laser beam via an objective lens, an irradiation unit including a scanning unit configured to scan a second treatment laser beam and configured to irradiate the second treatment laser beam via a final mirror disposed at an irradiation position in front of the objective lens, a moving unit configured to move the final mirror, an operation unit configured to input an operation signal, and a control unit. The control unit is configured to be shared by a manipulation function of inputting a movement signal for two-dimension movement of an application position of the second treatment laser light and a pattern setting function of setting a scanning pattern.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present disclosure relates to an ophthalmic laser treatment device that irradiates a patient's eye with treatment laser light, and a combination treatment laser light irradiation unit that can be mounted on the ophthalmic laser treatment device. [Background technology]

[0002] Ophthalmic laser treatment devices that irradiate a patient's eye with a treatment laser beam while observing the tissue of the patient's eye through a binocular microscope are known. Among these types of ophthalmic laser treatment devices, a combined laser treatment device has been proposed, which includes a treatment laser beam irradiation unit having a second treatment laser beam irradiation optical system that emits a second treatment laser beam (e.g., a photocoagulation laser) for a treatment purpose different from the first treatment laser beam, in addition to a first treatment laser beam (e.g., a YAG laser or an SLT laser) that is irradiated through a first treatment laser beam irradiation optical system and an objective lens of an observation optical system (see, for example, Patent Document 1). In this laser treatment device, a final mirror that reflects the second treatment laser beam from the second treatment laser beam irradiation optical system toward the patient's eye is configured to be movable (insertable and removable) in front of the objective lens of the first treatment laser beam irradiation optical system. When irradiating the second treatment laser beam, the final mirror is moved to an irradiation position in front of the objective lens of the first treatment laser beam irradiation optical system, and when irradiating the first treatment laser beam, the final mirror is moved to a retracted position from in front of the objective lens.

[0003] Furthermore, as a treatment laser light irradiation unit attached to a binocular microscope for observing a patient's eye, a laser treatment device is known which has a scanning unit that scans the tissue of the patient's eye with treatment laser light (e.g., photocoagulation laser) and is provided with a laser irradiation optical system that irradiates the patient's eye with the treatment laser light via a final mirror arranged in front of the objective lens of the microscope of the observation means (see, for example, Patent Document 2). In this laser treatment device, the surgeon can change the irradiation position of the treatment laser light irradiated on the patient's eye by moving the final mirror with a mechanical manipulator. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Publication No. 7-16253 [Patent Document 2] Japanese Patent Application Laid-Open No. 2011-212349 Summary of the Invention [Problem to be solved by the invention]

[0005] However, when a treatment laser light irradiation unit having a scanning unit for scanning treatment laser light as shown in Patent Document 2 is mounted on the laser treatment device main body provided with the above-mentioned first laser irradiation optical system, it may not be easy to properly irradiate the treatment laser light onto the patient's eye.

[0006] For example, when a treatment laser beam irradiation unit having a scanning section that scans the treatment laser beam over the tissue of a patient's eye is used, it is difficult to directly adopt a configuration in which the final mirror is moved by a mechanical manipulator mechanism in order to change the irradiation position of the treatment laser beam.

[0007] In view of the above-described conventional techniques, the present disclosure has as its technical object to provide an ophthalmic laser treatment apparatus and a treatment laser light irradiation unit that can more appropriately irradiate a patient's eye with treatment laser light. [Means for solving the problem]

[0008] (1) An ophthalmic laser treatment device according to an aspect of the present disclosure includes a laser treatment device main body that irradiates a patient's eye with a first treatment laser beam through an objective lens; a treatment laser beam irradiation unit mounted on the laser treatment device main body, the treatment laser beam irradiation unit having a scanning unit that scans tissue of the patient's eye with a second treatment laser beam different from the first treatment laser beam, and a second treatment laser beam irradiation optical system that irradiates the patient's eye with the second treatment laser beam through a final mirror placed at a predetermined irradiation position in front of the objective lens; a moving unit that moves the final mirror between the irradiation position and a predetermined retracted position off the optical path of the first treatment laser beam; and an operation unit that inputs an operation signal from an operator. and a control means, wherein the second treatment laser light irradiating optical system is configured to be capable of forming a plurality of spots arranged in a predetermined scanning pattern by scanning the second treatment laser light with the scanning section, the operation unit is configured to be combined with the scanning section and to have a manipulator function of inputting a movement signal for two-dimensionally moving the irradiation position of the second treatment laser light on the tissue of the patient's eye and a pattern setting function of setting the scanning pattern, and the control means is configured to control the scanning section based on a signal of the manipulator function and a signal of the pattern setting function input from the operation unit.

[0009] (2) A treatment laser beam irradiation unit according to an aspect of the present disclosure is a treatment laser beam irradiation unit mounted on a laser treatment device main body that irradiates a patient's eye with a first treatment laser beam through an objective lens, and includes: a second treatment laser beam irradiation optical system that has a scanning unit that scans a tissue of the patient's eye with a second treatment laser beam different from the first treatment laser beam; a moving means that moves the final mirror between the irradiation position and a predetermined retracted position off the optical path of the first treatment laser beam; an operation unit that inputs an operation signal from an operator; and a control means. The second treatment laser beam irradiating optical system is configured to be capable of forming a plurality of spots arranged in a predetermined scanning pattern by scanning the second treatment laser beam with the scanning unit, the operation unit is configured to be combined with the scanning unit and to have a manipulator function of inputting a movement signal for two-dimensionally moving the irradiation position of the second treatment laser beam on the tissue of the patient's eye and a pattern setting function of setting the scanning pattern, and the control means is configured to control the scanning unit based on a signal of the manipulator function and a signal of the pattern setting function input from the operation unit. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a diagram illustrating the overall configuration of an ophthalmic laser treatment device. [Figure 2] FIG. 2 is a diagram illustrating an optical system and a control system of the ophthalmic laser treatment apparatus. [Figure 3] FIG. 2 is a top view of the observation optical system. [Figure 4] FIG. 2 is a view showing the internal structure of the treatment laser light irradiation unit as viewed from the right side relative to the operator. [Figure 5] FIG. 2 is a front view of the internal structure of the treatment laser light irradiation unit as seen from the patient's eye. [Figure 6] FIG. 2 is a top view of the internal structure of the treatment laser light irradiation unit. [Figure 7] FIG. 2 is a perspective view illustrating the configuration of a mirror moving section. [Figure 8] FIG. 10 is a diagram illustrating a final mirror position detection mechanism. [Figure 9] 10A and 10B are diagrams showing an example of a screen displayed on the display of the first control box when the laser treatment device main body is in use, and an example of a screen displayed on the display of the second control box. [Figure 10] 10A and 10B are diagrams showing examples of scanning patterns in which spots of treatment laser light are arranged. [Figure 11] 1A and 1B are diagrams illustrating the configuration of a 3D mouse and input of operation signals. DETAILED DESCRIPTION OF THE INVENTION

[0011] [overview] Hereinafter, one exemplary embodiment will be described with reference to the drawings. Note that the items grouped in <> below can be used independently or in conjunction with each other.

[0012] For example, an ophthalmic laser treatment device (e.g., the ophthalmic laser treatment device 1) includes a laser treatment device main body (e.g., the laser treatment device main body 100), a treatment laser light irradiation unit (e.g., the treatment laser light irradiation unit 200), and a moving means (e.g., a mirror moving section 250). The ophthalmic laser treatment device may also include a control means (e.g., a control section 50).

[0013] For example, the ophthalmic laser treatment device includes a first treatment laser beam irradiating optical system (e.g., a first treatment laser beam irradiating optical system 110G) that irradiates a patient's eye with a first treatment laser beam via an objective lens (e.g., an objective lens 125). For example, a treatment laser beam irradiating unit is mounted on the laser treatment device body above the objective lens. The above side of the objective lens is the upper side with respect to the optical axis of the objective lens. The above side can also be said to be the side of the patient's head when the first treatment laser beam is irradiated onto the eye.

[0014] For example, the treatment laser beam irradiation unit includes a second treatment laser beam irradiation optical system (e.g., second treatment laser beam irradiation optical system 200G) that irradiates the patient's eye with a second treatment laser beam different from the first treatment laser beam via a final mirror (e.g., final mirror 228) located at a predetermined irradiation position in front of the objective lens (on the patient's eye side). For example, the predetermined irradiation position of the final mirror is set to a position on the optical axis of the objective lens, and the reference optical axis of the second treatment laser beam reflected by the final mirror and irradiated to the patient's eye is aligned (or substantially aligned) with the optical axis of the objective lens.

[0015] For example, the second treatment laser beam may be a laser beam for a different therapeutic purpose from the first treatment laser beam. In other words, the second treatment laser beam may be a laser beam for achieving a different therapeutic effect from the first treatment laser beam. If such a requirement is satisfied, the wavelength of the second treatment laser beam may be the same as the wavelength of the first treatment laser beam.

[0016] For example, the ophthalmic laser treatment device may include an observation optical system (e.g., the observation optical system 140G). For example, the observation optical system is configured to observe the patient's eye through the objective lens. For example, the observation optical system may include a microscope with binocular eyepieces (e.g., the microscope 141). Furthermore, for example, the ophthalmic laser treatment device may include an illumination optical system (e.g., the illumination optical system 130G). For example, the illumination optical system is configured to project illumination light onto the patient's eye through a segmented mirror (e.g., the segmented mirror 136), which is an example of a reflecting member located closer to the patient's eye than the objective lens. In this case, the predetermined irradiation position of the final mirror may be set between the objective lens and the reflecting member of the illumination optical system. This allows the second treatment laser beam to be irradiated without increasing the working distance when irradiating the second treatment laser beam compared to the working distance when irradiating the first treatment laser beam.

[0017] For example, the moving means is configured to move the final mirror between a predetermined irradiation position in front of the objective lens and a predetermined retracted position off the optical path of the first treatment laser beam (the optical path of the objective lens). The moving means is configured to move the final mirror, which is placed at the irradiation position, to the retracted position by moving it laterally relative to the objective lens. This allows the final mirror to be appropriately moved while avoiding interference with components of the treatment laser beam irradiation unit due to the movement of the final mirror. For example, even if the lens barrel of the second treatment laser beam irradiation optical system is located above the final mirror and close to the objective lens of the first treatment laser beam irradiation optical system, the final mirror can be retracted from in front of the objective lens without interfering with the lens barrel. Furthermore, even if a component of the illumination unit of the illumination optical system (e.g., a reflecting member of the illumination optical system) is located in front of the objective lens, the final mirror can be appropriately moved while avoiding interference with the component due to the movement of the final mirror.

[0018] In other words, for example, the moving means is configured to move the final mirror placed at a predetermined retracted position to an irradiation position between the objective lens and a reflecting member of the illumination optical system. Note that the lateral direction of the objective lens is the lateral direction when the treatment laser light irradiation unit is placed above the objective lens. Also, the lateral direction of the objective lens may be a lateral direction obliquely upward or downward with respect to the optical axis of the objective lens.

[0019] For example, the moving means may be configured to move the final mirror placed at a predetermined irradiation position to a predetermined retreat position by rotating it about a rotation axis (e.g., rotation axis R1) parallel to the optical axis of the objective lens. By using a rotation mechanism as the moving means, the final mirror can be appropriately moved laterally to avoid interference with the lens barrel of the second treatment laser irradiation optical system located above the final mirror, without complicating or increasing the size of the moving means. In this case, the final mirror is moved laterally diagonally upward or downward from the irradiation position.

[0020] For example, the moving means may be configured to include an arm (e.g., arm 265) that is attached rotatably around a rotation axis and supports the final mirror at its tip, and the arm may be configured to rotate around the rotation axis to rotate the final mirror laterally. Also, the arm may have a shape that extends above the final mirror when the final mirror is located at the irradiation position.

[0021] For example, the rotation axis may be located above the objective lens, and the predetermined retracted position may be set above the objective lens. In this case, the moving means may be configured to move the final mirror placed at the predetermined irradiation position to the predetermined retracted position laterally of the objective lens and above the objective lens. As a result, the final mirror is retracted above the objective lens, and is therefore out of the observation optical path of the observation optical system. Therefore, during treatment using the first treatment laser beam, the final mirror can be used in the same way as when the treatment laser beam application unit is not installed.

[0022] The rotation axis is preferably located directly above (or substantially directly above) the optical axis of the objective lens. In this case, the final mirror is moved to a retracted position beside the lens barrel (e.g., lens barrel 220a) of the treatment laser light irradiation unit.

[0023] Furthermore, for example, the treatment laser light irradiation unit may include a vertical adjustment mechanism (e.g., vertical adjustment mechanism 270A). For example, the vertical adjustment mechanism is configured to adjust the vertical tilt angle of the final mirror. In this case, the vertical adjustment mechanism may be configured to be moved together with the final mirror by a moving means. By moving the vertical adjustment mechanism together with the final mirror, the configuration does not become complicated or large.

[0024] Furthermore, for example, the treatment laser beam irradiation unit may include a detection means (e.g., a final mirror position detection mechanism 290). For example, the detection means is configured to detect whether the final mirror has been moved to a predetermined irradiation position or a predetermined retracted position. For example, when the detection means is provided, the control means may control the irradiation of the first treatment laser beam from the first treatment laser beam irradiation optical system and the irradiation of the second treatment laser beam from the second treatment laser beam irradiation optical system based on the detection result of the detection means. For example, when the detection means detects that the final mirror is located at the retracted position, the control means disables the irradiation of the second treatment laser beam and enables the irradiation of the first treatment laser beam. For example, when the detection means detects that the final mirror is located at the irradiation position, the control means disables the irradiation of the first treatment laser beam and enables the irradiation of the second treatment laser beam. For example, when the detection means detects that the final mirror is not located at either the retracted position or the irradiation position, the control means disables the irradiation of both the first treatment laser beam and the second treatment laser beam. This prevents the first treatment laser beam and the second treatment laser beam from being irradiated erroneously.

[0025] For example, the ophthalmic laser treatment device may include a trigger signal input means (e.g., a foot switch 54) for inputting a trigger signal for laser irradiation. For example, the trigger signal input means may be used for irradiating both the first treatment laser beam and the second treatment laser beam. In this case, the control means emits the first treatment laser beam based on the input of the trigger signal when the detection means detects that the final mirror is located at the retracted position, and emits the second treatment laser beam based on the input of the trigger signal when the detection means detects that the final mirror is located at the irradiation position.

[0026] For example, the treatment laser beam irradiating unit may include a housing portion (e.g., housing portion 280) for housing the final mirror, which is moved to a predetermined retracted position, in a cover on the side of the lens barrel (e.g., lens barrel portion 220a) of the second treatment laser beam irradiating optical system disposed above the final mirror. This prevents the operator from accidentally touching the final mirror during treatment with the first treatment laser beam. It also prevents dust and dirt from adhering to the final mirror.

[0027] For example, the ophthalmic laser treatment device may include an operation unit (e.g., a 3D mouse 53) and control means (e.g., the control unit 50) in addition to the above-mentioned laser treatment device main body, treatment laser beam irradiating unit, and moving means. For example, the second treatment laser beam irradiating optical system of the treatment laser beam irradiating unit has a scanning unit that scans the tissue of the patient's eye with a second treatment laser beam different from the first treatment laser beam, and is configured to irradiate the patient's eye with the second treatment laser beam via a final mirror located at a predetermined irradiation position in front of the objective lens. For example, the second treatment laser beam irradiating optical system is configured to be able to form a plurality of spots arranged in a predetermined scanning pattern by scanning the second treatment laser beam with the scanning unit.

[0028] For example, the operation unit may be configured to input signals from the surgeon. For example, the operation unit may be combined with a scanning unit to perform both a manipulator function for inputting a movement signal for two-dimensionally moving the irradiation position of the second treatment laser beam, which is irradiated onto the tissue of the patient's eye via the final mirror, on the tissue of the patient's eye, and a pattern setting function for setting the above-mentioned scanning pattern. For example, the control means may be configured to control the scanning unit based on a signal from the manipulator function and a signal from the pattern setting function input from the operation unit. This allows the treatment laser beam to be appropriately irradiated onto the patient's eye, even when a treatment laser beam irradiation unit having a scanning unit for scanning the treatment laser beam is installed. That is, even when a moving means for moving the final mirror in front of the objective lens is provided, a single operation unit can be used to two-dimensionally move the irradiation position of the second treatment laser beam on the tissue of the patient's eye and set the scanning pattern of the second treatment laser beam. This improves the usability of the ophthalmic laser treatment device.

[0029] For example, the operation unit may have one operation member capable of both a first operation (e.g., a tilt operation) operable in two dimensions and a second operation (e.g., a slide operation) operable in two dimensions by an operation different from the first operation. In this case, the control means may control the scanning unit by accepting either the first operation or the second operation signal input from the operation unit as a manipulator function signal (a signal for two-dimensionally moving the irradiation position of the second treatment laser light on the tissue of the patient's eye). In other words, the manipulator function signal is assigned to both the first operation operable in two dimensions on the operation member and the second operation operable in two dimensions by an operation different from the first operation. As a result, when inputting the manipulator function signal, an operator who is not good at the first operation can also input the signal by the second operation, and conversely, an operator who is not good at the second operation can input the signal by the first operation. This improves the usability of the operation unit. The ophthalmic laser treatment apparatus may be provided with an operation signal allocation means for allocating manipulator functions to a plurality of operation signals input by operating the operation unit.

[0030] Furthermore, the operation member of the operation unit may be capable of a third operation different from the first and second operations. When an operation signal for the third operation is input from the operation unit, the control means may control the scanning unit by accepting the signal as a return-to-origin signal for the manipulator function in order to return the irradiation position of the second treatment laser beam to the origin. This further improves the usability of the ophthalmic laser treatment device.

[0031] For example, the pattern setting function may be configured to be able to set at least one of a first setting for rotating the scanning pattern, a second setting for changing the interval (space) between the plurality of spots (the adjacent spots) constituting the scanning pattern, and a third setting for changing the shape of the arrangement of the plurality of spots (e.g., square, triangle, arc, number of spots, etc.). In this case, an operation signal for the pattern setting function may be input by an operation member of the operation unit, which is different from that for the manipulator function. Thus, the operation unit capable of inputting a signal for the manipulator function can also be used to change the predetermined scanning pattern in which the spots of the second treatment laser beam are arranged according to the treatment site.

[0032] For example, the operating member of the operating unit may be configured so that the operating member can be operated by grasping with the hand or finger while the surgeon is observing the patient's eye, thereby enabling the surgeon to operate without visually observing the patient's eye, thereby improving the usability of the ophthalmic laser treatment device and enabling the treatment laser light to be appropriately irradiated onto the patient's eye.

[0033] For example, when the ophthalmic laser treatment device includes the above-mentioned observation optical system (e.g., the observation optical system 140G), the final mirror may be configured to have a size that ensures at least 80% of the observation field of the observation optical system even when placed at a predetermined irradiation position and allows irradiation of the second treatment laser beam in a predetermined scanning pattern. This allows the treatment laser beam scanned by the scanning unit to be appropriately irradiated onto the patient's eye while observing the patient's eye.

[0034] Furthermore, for example, when the second treatment laser beam irradiating optical system includes a scanning unit (e.g., the scanning unit 230) and the ophthalmic laser treatment apparatus includes an illumination optical system as described above, the predetermined irradiation position of the final mirror may be set between the objective lens and a reflecting member of the illumination optical system (e.g., the split mirror 136). This allows the second treatment laser beam to be irradiated without increasing the working distance when irradiating the second treatment laser beam compared to the working distance when irradiating the first treatment laser beam.

[0035] [Example] An example of this embodiment will be described with reference to the drawings.

[0036] <Overall structure> Fig. 1 is a diagram illustrating the overall configuration of an ophthalmic laser treatment device 1. The ophthalmic laser treatment device 1 includes a laser treatment device main body 100 and a treatment laser light irradiation unit 200. The treatment laser light irradiation unit 200 can be mounted on the laser treatment device main body 100. Note that Fig. 1 shows the laser treatment device main body 100 as seen from the left side as viewed by an operator.

[0037] The laser treatment device main body 100 includes a first treatment laser light irradiating unit 110, an illumination unit 130, and an observation unit 140. The laser treatment device main body 100 also includes a face support unit 190. The face support unit 190 is configured to support the face of a patient. For example, the face support unit 190 includes a chin rest 192 on which the patient's chin is placed, and a forehead rest 194 on which the patient's forehead is placed. In FIG. 1 , with respect to the patient's eye supported by the face support unit 190, the left-right direction is defined as the X direction, the up-down direction is defined as the Y direction, and the front-back direction is defined as the Z direction when viewed from the operator positioned on the observation unit 140 side.

[0038] The first treatment laser beam irradiating unit 110 is configured to irradiate the patient's eye with the first treatment laser beam via an objective lens 125 (see FIG. 2). In FIG. 1, the first treatment laser beam irradiating unit 110 is mounted on a Y-moving stage 101. The Y-moving stage 101 is mounted so as to be movable in the Y direction relative to an XZ-moving stage 102, which is movable in the XZ directions. The XZ-moving stage 102 is mounted so as to be movable in the left-right direction (X direction) and the front-back direction (Z direction) on a table 104 relative to the patient's eye supported by a face support unit 190. The XZ-moving stage 102 is provided with a joystick 106 that is operated by the surgeon. By operating the joystick 106 in the XZ directions, the first treatment laser beam irradiating unit 110 is moved in the XZ directions together with the XZ-moving stage 102. By operating a rotary knob 106a of the joystick 106, the first treatment laser beam irradiating unit 110 is moved in the Y direction via a known up-and-down movement mechanism.

[0039] The illumination unit 130 is configured to project illumination light for observation onto the patient's eye. The illumination unit 130 is mounted on a Y-movement stage 101 and moved in the X, Y, and Z directions together with the first treatment laser light irradiating unit 110. The illumination unit 130 is mounted on the Y-movement stage 101 so as to be rotatable in the left-right direction around a V1 axis (see FIG. 1) set in front of the Y-movement stage 101 and extending in the up-down direction. This allows the left-right angle of the illumination light projected from the illumination unit 130 onto the patient's eye to be changed as desired.

[0040] The observation unit 140 is configured to allow the surgeon to observe the patient's eye. The observation unit 140 includes a binocular microscope 141. The observation unit 140 is mounted on the top of the first treatment laser light irradiating unit 110 and is moved in the X, Y, and Z directions together with the first treatment laser light irradiating unit 110.

[0041] The treatment laser light irradiation unit 200 is configured to irradiate the second treatment laser light, which is different from the first treatment laser light, onto the patient's eye via a final mirror 228 arranged at a predetermined irradiation position (on the patient's eye side) in front of the objective lens 125 (see Figure 2) of the first treatment laser light irradiation unit 110.

[0042] In addition, the ophthalmic laser treatment device 1 includes a control unit 50, a first control box 51 for the laser treatment device main body 100, a second control box 52 for the treatment laser light irradiation unit 200, a 3D mouse 53 which is an example of an operation unit for the treatment laser light irradiation unit 200, and a foot switch 54 which is an example of input means for inputting a trigger signal for irradiation of the treatment laser light (see FIG. 2). A commercially available 3D mouse 53 can be used.

[0043] <Optical system> 2 is a diagram illustrating the optical system and control system of the ophthalmic laser treatment apparatus 1. The laser treatment apparatus main body 100 includes a first treatment laser beam irradiating optical system 110G included in the first treatment laser beam irradiating unit 110, an illumination optical system 130G included in the illumination unit 130, and an observation optical system 140G included in the observation unit 140. The treatment laser beam irradiating unit 200 includes a second treatment laser beam irradiating optical system 200G. The second treatment laser beam from the second treatment laser beam irradiating optical system 200G is a laser beam that has a different therapeutic effect from that of the first treatment laser beam from the first treatment laser beam irradiating optical system 110G.

[0044] <First treatment laser light irradiation optical system> The first treatment laser light irradiation optical system 110G includes a treatment laser light source 111, an aiming light source 112, an energy adjustment unit 113, a beam splitter 117, a photodetector 118, a safety shutter 119, a collimator lens 121, a dichroic mirror 122, an expander lens 123, a dichroic mirror 124, and an objective lens 125.

[0045] The treatment laser light source 111 emits treatment laser light for treating tissues of the patient's eye E. As an example, the treatment laser light source 111 of this embodiment uses a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd:YAG) as a laser rod, and emits infrared laser light (wavelength: 1064 nm). Furthermore, a wavelength conversion element (not shown) converts the infrared laser light (wavelength: 1064 nm) from the laser light source 111 into visible laser light (wavelength: 532 nm) and emits it.

[0046] The aiming light source 112 emits an aiming laser beam (hereinafter simply referred to as "aiming beam") 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 112.

[0047] The energy adjusting unit 113 adjusts the amount of energy of the treatment laser beam irradiated onto the tissue of the patient's eye E. For example, the energy adjusting unit 113 includes a half-wave plate 114 and a polarizing plate 116. The half-wave plate 114 is rotated by a motor 115 around the optical axis of the treatment laser beam. The polarizing plate 116 is disposed at a Brewster angle. The energy amount of the treatment laser beam is adjusted by the combination of the half-wave plate 114 and the polarizing plate 116.

[0048] The beam splitter 117 reflects a portion of the treatment laser beam toward the photodetector 118. The photodetector 118 detects the amount of energy of the treatment laser beam by receiving the treatment laser beam reflected by the beam splitter 117. The safety shutter 119 is moved between on and off the optical axis of the treatment laser beam by a shutter driver (e.g., a solenoid) 120. The safety shutter 119 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.

[0049] The collimator lens 121 collimates the aiming light emitted by the aiming light source 112. The dichroic mirror 122 reflects the treatment laser light and transmits the aiming light, coaxially combining the treatment laser light and the aiming light. The expander lens 123 expands the beam of the laser light (treatment laser light and aiming light). The expanded laser light is reflected by the dichroic mirror 124 and passes through the objective lens 125. The laser light that passes through the objective lens 125 travels along the optical axis L1 of the objective lens 125 and is irradiated onto the tissue of the patient's eye E via a contact lens CL worn on the patient's eye E. The dichroic mirror 124 reflects most of the light at the wavelength of the treatment laser light reflected by the patient's eye E, preventing it from entering the surgeon's eye. The irradiation optical system 110G may be provided with a configuration for adjusting the spot size of the laser light irradiated onto the tissue.

[0050] <Illumination optical system> The illumination optical system 130G includes an illumination light source 131, and in this order from the illumination light source 131 side, a condenser lens 132, a slit 133, a projection lens 134, a correction lens 135, a segmented mirror 136, etc. Illumination light emitted from the illumination light source 131 is projected onto the patient's eye E via the condenser lens 132, the slit 133, the projection lens 134, the correction lens 135, and the segmented mirror 136.

[0051] <Observation optical system> Fig. 3 is a top view of the observation optical system 140G. In Figs. 2 and 3, the observation optical system 40 is an observation means for allowing the surgeon to observe the patient's eye E, and has an optical axis L3 (see Fig. 3). As shown in Fig. 3, the observation optical system 140G 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 140G is used as a binocular microscope 141. The observation optical system 140G includes an objective lens 125 shared with the first treatment laser light irradiation optical system 110G, variable magnification optical systems 142 (142R, 142L), protective filters 143 (143R, 143L), erecting prism groups 144 (144R, 144L), field stops 145 (145R, 145L), and eyepieces 146 (146R, 146L). By looking through the eyepieces 146, the surgeon can confirm the observation area of ​​the patient's eye E, the spot of the aiming light (in other words, the reflected light (return light) of the aiming light reflected by the patient's eye E), etc.

[0052] In this embodiment, an observation plane (object plane) provided beyond the objective lens 125 and a field stop 145 disposed inside the device are in an optically conjugate positional relationship via the objective lens 125. That is, an observation image of the patient's eye E is formed as an aerial image at the position of the field stop 145. Note that in this embodiment, the magnification of the observation image observed by the surgeon is changed by the variable magnification optical system 142. The observation optical system 140G is provided with an encoder (not shown) for acquiring the magnification of the observation image obtained by the variable magnification optical system 142.

[0053] <Second treatment laser light irradiation optical system> The second treatment laser beam irradiating optical system 200G includes a treatment laser beam source 211 and an aiming beam source 212, both of which are provided in a laser beam source unit 210. For example, the treatment laser beam source 211 emits a second treatment laser beam having a wavelength in the visible range (e.g., 532 nm (green), 577 nm (yellow), 647 nm (red)) used for photocoagulation treatment of the fundus of a patient's eye. In this embodiment, the treatment laser beam source 211 is controlled to selectively emit one of two types of treatment laser beam (green / yellow). The aiming beam source 212 emits an aiming beam to allow the operator to recognize the planned irradiation position of the second treatment laser beam. For example, a wavelength of 670 nm (red) is used as the wavelength of the aiming beam. The second treatment laser beam from the treatment laser source 211 and the aiming light from the aiming light source 212 are combined by a beam combiner 213 , then condensed by a condenser lens 214 , and made incident on the incident end face of an optical fiber 218 .

[0054] The second treatment laser beam (hereinafter, the same applies to the aiming beam) emitted from the exit end face of the optical fiber 218 passes through a lens 221, a zoom lens 222, a scanning unit (scanning optical system) 230, a relay lens 224, a mirror 225, a collimator lens 226, and an objective lens (imaging lens) 227, and is reflected by a final mirror 228, so that it is irradiated onto the tissue of the patient's eye E through a contact lens CL. The spot size of the second treatment laser beam irradiated onto the tissue of the patient's eye E is changed by moving the zoom lens 222 in the optical axis direction. The movement position of the zoom lens 222 is detected by an encoder 222a.

[0055] The final mirror 228 is disposed on the optical axis LS1 of the objective lens 227 and at a tilted position P1 (see FIGS. 4 to 7) in front of (the patient's eye side of) the objective lens 125 of the first treatment laser beam irradiating optical system 110G. The irradiation position of the final mirror 228 is located on the optical axis of the objective lens 125, and the reference optical axis of the second treatment laser beam reflected by the final mirror 228 and irradiated onto the patient's eye coincides (or substantially coincides) with the optical axis L1 of the objective lens 125. The final mirror 228 is moved by a mirror moving unit 250 (described later) between the irradiation position P1 in front of the objective lens 125 and a predetermined retracted position P2 (see FIG. 5) out of the irradiation optical path of the first treatment laser beam of the first treatment laser beam irradiating optical system 110G.

[0056] The scanning unit 230 is configured to two-dimensionally scan the spot (irradiation position) of the second treatment laser beam on the tissue of the patient's eye E (e.g., on the fundus). For example, the scanning unit 230 includes a first galvanometer mirror 231 and a second galvanometer mirror 235, which are examples of scanner mirrors. The first galvanometer mirror 231 includes a mirror 232 and an actuator 233, and scans the second treatment laser beam irradiated onto the patient's eye E in the left-right direction (X direction) via the final mirror 228. The second galvanometer mirror 235 includes a mirror 236 and an actuator 237, and scans the second treatment laser beam irradiated onto the patient's eye E in the up-down direction (Y direction) via the final mirror 228. This allows the spot of the second treatment laser beam (as well as the spot of the aiming beam) to scan two-dimensionally on the tissue of the patient's eye E. The scanning unit 230 also functions as a manipulator that changes the irradiation position of the spot of the second treatment laser beam.

[0057] In this embodiment, the start and stop of irradiation of the treatment laser light from the treatment laser light source 211 and the start and stop of driving of the scanning unit 230 are repeated in synchronization with each other, thereby forming multiple spots of the second treatment laser light arranged in a predetermined scanning pattern on the tissue of the patient's eye E.

[0058] <Therapeutic laser irradiation unit> The configuration of the treatment laser beam irradiation unit 200 will be described with reference to Figs. 4 to 8. Fig. 4 is a view of the internal structure of the treatment laser beam irradiation unit 200 as seen from the right side with the operator as the reference. Fig. 5 is a front view of the internal structure of the treatment laser beam irradiation unit 200 as seen from the patient's eye, Fig. 5(a) is a view of the state in which the final mirror 228 is located at the irradiation position P1, and Fig. 5(b) is a view of the state in which the final mirror 228 is located at the retracted position P2. Fig. 6 is a view of the internal structure of the treatment laser beam irradiation unit 200 as seen from above. Fig. 7 is a perspective view illustrating the configuration of the mirror moving section 250.

[0059] The treatment laser light irradiating unit 200 mounted on the laser treatment device main body 100 includes an optical element holding section 220 for holding optical elements from the lens 221 to the objective lens 227 of the second treatment laser light irradiating optical system 200G, an attachment section 240 for attaching the treatment laser light irradiating unit 200 to the laser treatment device main body 100, and a mirror moving section 250 for moving the final mirror 228.

[0060] 4, the base 241 of the treatment laser light irradiating unit 200 is mounted on the upper part of the laser treatment apparatus main body 100 via a pedestal 242 constituting the mounting part 240. A vertically extending support column 243 is rotatably held inside the pedestal 242, and the base 241 is fixed on the support column 243. Therefore, the position of the base 241 can be adjusted in the left-right direction around the central axis of the support column 243. The adjusted position of the base 241 in the left-right direction is fixed by tightening a fixing screw 244.

[0061] A lens barrel 220a (a cylindrical member that holds the objective lens 227 in FIG. 2) extending downward from the optical member holding portion 220 is supported by a support arm 247 that extends from the base 241 to the front side (toward the patient's eye).

[0062] <Mirror moving part> The mirror moving unit 250 is disposed on the base 241 and configured to move the final mirror 228 between a predetermined irradiation position P1 and a predetermined retracted position P2. For example, the mirror moving unit 250 is configured to move the final mirror 228 to the retracted position P2 by moving it laterally to the left or right (laterally relative to the operator) with respect to the optical axis L1 of the objective lens 125 disposed in the laser treatment device main body 100. The irradiation position P1 of the final mirror 228 is set to a position in front of the objective lens 125 on the optical axis L1 of the objective lens 125 disposed in the laser treatment device main body 100, as shown in FIG. 4 . Furthermore, the irradiation position P1 is set to a position between the split mirror 136 of the illumination optical system 130G and the objective lens 125. This allows the second treatment laser beam to be irradiated without increasing the working distance during irradiation of the second treatment laser beam relative to the working distance during irradiation of the first treatment laser beam.

[0063] The final mirror 228 placed at the irradiation position P1 is rotated about a rotation axis R1 parallel to the optical axis L1 of the objective lens 125, and is thereby moved to a retracted position P2 (see FIG. 5(b)) in the lateral direction of the objective lens 125. In this embodiment, the rotation axis R1 is positioned above the objective lens 125, and the retracted position P2 of the final mirror 228 is set above the objective lens 125. In other words, the final mirror 228 placed at the irradiation position P1 by the mirror moving unit 250 is moved to the retracted position P2 above the objective lens 125 in the lateral direction of the objective lens 125. For example, the rotation axis R1 is set directly above (including approximately directly above) the optical axis L1 of the objective lens 125. The rotation axis R1 may be positioned offset to the left or right with respect to the optical axis L1 of the objective lens 125, but if the weight of the optical element holding part 220 (including the optical elements from the lens 221 to the objective lens 227) is sufficient, it will be stable directly above the optical axis L1.

[0064] For example, the mirror moving unit 250 includes a lever 251 operated by the surgeon. The lever 251 is disposed on the side surface of the base 241. When the lever 251 is operated, a lever rotation shaft 253 extending laterally relative to the rotation axis R1 is rotated. The lever rotation shaft 253 is rotatably held by a block member fixed on the base 241. A bevel gear 255 is attached to the lever rotation shaft 253. In addition, a rotation shaft 257 having the rotation axis R1 as its center is rotatably held by a block member fixed on the base 241. A bevel gear 259 is also attached to the rotation shaft 257, and the bevel gear 259 meshes with the bevel gear 255. When the lever 251 is operated, the lever rotation shaft 253 is rotated, and the rotation is transmitted to the rotation shaft 257 via the bevel gears 255 and 259.

[0065] A mounting member 261 that holds the final mirror 228 is attached to the front side of the rotating shaft 257. The mounting member 261 includes a first mounting member 263 positioned on the base 241 and an arm 265 that extends downward from the front side of the first mounting member 263 (to the downward side when the final mirror 228 is located at the irradiation position). The final mirror 228 is attached to the lower end of the arm 265. The arm 265 supports the final mirror 228 so as to avoid the lens barrel portion 220a that extends downward of the optical element holding unit 220 and so that the center of the final mirror 228 is located on the optical axis LS1 of the objective lens 227. In other words, when the final mirror 228 is located at the irradiation position P1, the arm 265 has a shape that extends above the final mirror 228. By rotating the arm 265 about the rotation axis R1, the final mirror 228 is moved laterally relative to the objective lens 125.

[0066] The lower end of the downwardly extending barrel portion 220a is positioned lower or closer to the upper end of the objective lens barrel 110a (see FIGS. 1 and 4) that holds the objective lens 125 of the laser treatment device main body 100 by a predetermined distance or less (a distance that prevents the final mirror 228 from retracting upward). Therefore, if the final mirror 228 is retracted upward from the irradiation position, it will interfere with the barrel portion 220a. Therefore, in the present disclosure, the final mirror 228 is moved laterally to the left or right with respect to the objective lens 125 (optical axis L1) by the mirror moving unit 250, thereby avoiding interference with the barrel portion 220a.

[0067] <Final mirror size> The size of the final mirror 228 is determined taking into consideration the conflicting viewpoints of ensuring the field of view of the observation optical system 140G and ensuring the scanning range of the second treatment laser beam by the scanning unit 230 of the second treatment laser beam irradiation optical system 200G. To ensure the field of view of the observation optical system 140G, the size of the final mirror 228 needs to be as small as possible. Conversely, to ensure the scanning range of the second treatment laser beam, the size of the final mirror 228 should be large. Furthermore, when the treatment laser beam irradiation unit 200 including the second treatment laser beam irradiation optical system 200G is mounted on the laser treatment apparatus main body 100 including the first treatment laser beam irradiation unit 110, an extra dichroic mirror 124 of the first treatment laser beam irradiation optical system 110G is disposed in the optical path of the observation optical system 140G compared to when the treatment laser beam irradiation unit 200 is mounted on a slit lamp (slit lamp microscope) without the first treatment laser beam irradiation optical system 110G. Therefore, the optical path length is increased by that amount, and the amount of vignetting of the field of view by the final mirror 228 increases compared to when mounted on a slit lamp. For this reason, the final mirror 228 is made smaller in size compared to when mounted on a slit lamp.

[0068] For example, the size of the final mirror 228 is set so that, in the case of a predetermined observation magnification (for example, 12.5 times, which is frequently used) of the variable magnification optical system 142 of the observation optical system 140G, at least 80% of the observation field is secured, and the scanning unit 230 can irradiate (irradiate on the fundus tissue) the second treatment laser light in a predetermined scanning pattern in which multiple spots are arranged within the observation field range.

[0069] <Adjustment mechanism for the final mirror tilt angle> The treatment laser beam irradiation unit 200 includes an adjustment mechanism 270 configured to adjust the tilt angle of the final mirror 228 relative to the optical axis L1 of the objective lens 125. The adjustment mechanism 270 includes an up-down adjustment mechanism 270A (pitch tilt mechanism) that adjusts the tilt angle of the final mirror 228 in the up-down direction (pitch direction) relative to the optical axis L1, and a left-right adjustment mechanism 270B (yaw tilt mechanism) that adjusts the tilt angle of the final mirror 228 in the left-right direction (yaw direction) relative to the optical axis L1. The adjustment mechanism 270 is used to adjust the reference position of the second treatment laser beam reflected by the final mirror 228 and directed toward the patient's eye.

[0070] The vertical adjustment mechanism 270A is attached to the first attachment member 263 and moved together with the final mirror 228 by the mirror moving unit 250. The vertical adjustment mechanism 270A has a rotary knob 271 that rotates around an axis R2 parallel to the rotation axis R1. When the rotary knob 271 is rotated, a moving member 272, with which a feed screw of the rotary knob 271 is engaged, moves in the axial direction of the axis R2. An arm rear end 265a of an arm 265 is connected to the moving member 272. The arm 265 is rotatable (tiltable) in the front-rear direction around a rotation support unit 274 disposed on the front side of the first attachment member 263 as a fulcrum. In addition, a tension spring 273 is disposed between the first attachment member 263 and the arm rear end 265a. The spring force of the tension spring 273 applies a force that moves the arm rear end 265a rearward. When the rotary knob 271 is rotated forward and backward, the moving member 272 is moved in the front-to-rear direction, and in conjunction with this movement, the arm 265 is rotated in the front-to-rear direction around the rotation support part 274 as a fulcrum. This adjusts the vertical tilt angle of the final mirror 228 attached to the tip of the arm 265. Once the vertical tilt angle of the final mirror 228 has been adjusted, the fixing screw 275 arranged near the rotary knob 271 is tightened, thereby fixing the rotation of the rotary knob 271 and fixing the vertical tilt angle of the final mirror 228.

[0071] 4, the left-right adjustment mechanism 270B is composed of a support 243 rotatably held inside the base 242, and a fixing screw 244. When the fixing screw 244 is loosened and the base 241 fixed to the support 243 is rotated left-right around the axis of the support 243, the left-right tilt angle of the final mirror 228 mounted on the base 241 is adjusted.

[0072] <Final mirror position detection mechanism> The treatment laser light irradiation unit 200 includes a final mirror position detection mechanism 290 configured to detect whether the final mirror 228 has been moved to the irradiation position P1 or the retracted position P2. The final mirror position detection mechanism 290 is disposed on the base 241 behind the mirror moving unit 250. Fig. 8 is a diagram illustrating the final mirror position detection mechanism 290, as viewed from behind. Fig. 8 shows a state in which the final mirror 228 is located at the irradiation position P1.

[0073] In Fig. 8, a slide plate 292 is disposed on a back plate 291 on a base 241 so as to be slidable in the X direction (left-right direction). The slide plate 292 is linked to the rotation of a rotation shaft 257 (for example, via a mechanism that converts rotational motion, such as a cam, into linear motion) and moves left-right in Fig. 8. A first detector 295 and a second detector 296, such as a microswitch, are disposed on both sides of an actuation plate 293 extending below the slide plate 292. In this embodiment, two first detectors 295 and two second detectors 296 are disposed. Even if one of the two first detectors 295 fails, the movement position of the final mirror 228 can be detected by the other.

[0074] When the final mirror 228 is moved to the irradiation position P1, the sliding plate 292 and the operating plate 293 are moved toward the first detector 295, and this movement is detected by the first detector 295. On the other hand, when the final mirror 228 is moved to the retracted position P2, the sliding plate 292 and the operating plate 293 are moved toward the second detector 296, as shown by the dotted line in FIG. 8, and this movement is detected by the second detector 296.

[0075] <Final mirror housing> As shown in FIG. 5(b), the treatment laser light irradiating unit 200 includes a housing 280 that houses the final mirror 228 in a cover when the final mirror 228 is moved to a retracted position P2. The retracted position P2 is set above the objective lens barrel 110a, which holds the objective lens 125, in the lateral direction of the objective lens barrel 110a. Therefore, the housing 280 is provided on the lateral side of the barrel 220a. For example, the housing 280 is provided in a cover that is integral with the cover of the treatment laser light irradiating unit 200. The housing 280 prevents the surgeon from accidentally touching the final mirror 228 during treatment with the first treatment laser beam. Furthermore, the housing 280 can prevent dust and dirt from adhering to the final mirror 228.

[0076] <Control system> The control unit 50 controls the entire ophthalmic laser treatment device 1. For example, the control unit 50 includes a CPU, RAM, ROM, nonvolatile memory, etc. The control unit 50 is connected to electrical components (laser light source, illumination light source, detector, scanning unit, etc.) of the laser treatment device main body 100 and the treatment laser light irradiation unit 200 and controls their operations. The control unit 50 is also connected to a first control box 51, a second control box 52, a 3D mouse 53, a foot switch 54, a storage unit 55, etc. The control unit 50 may also function as a receiving means for receiving various signals input from the first control box 51, the second control box 52, the 3D mouse 53, and the foot switch 54. The control unit 50 also functions as a display control means for controlling the display of the display 51a of the first control box 51 and the display 52a of the second control box 52. The control unit 50 controls the display of the displays 51a and 52a based on the detection result of the final mirror position detection mechanism 290.

[0077] The functions of the control unit 50 may be shared between the control units arranged in the first control box 51 and the second control box 52. In this case, the laser treatment device main body 100 is first installed in a medical facility, and the treatment laser light irradiation unit 200 is later added to easily configure the multifunction ophthalmic laser treatment device 1.

[0078] The first control box 51 has a display 51a and can set various parameters such as laser irradiation conditions of the laser treatment device main body 100. Similarly, the second control box 52 has a display 52a and can set various parameters such as laser irradiation conditions of the treatment laser light irradiation unit 200. The first control box 51 and the second control box 52 may be integrated into one unit and used in common by both the laser treatment device main body 100 and the treatment laser light irradiation unit 200.

[0079] <Operation> The operation of the ophthalmic laser treatment apparatus 1 having the above-described configuration will be described below. The operation of the laser treatment apparatus main body 100 and the operation of the treatment laser light irradiation unit 200 will be described separately below.

[0080] <Treatment operation by the laser treatment device> In the case of laser irradiation by the laser treatment device main body 100, the final mirror 228 is positioned at the retracted position P2. When the second detector 296 detects that the final mirror 228 is positioned at the retracted position P2, the control unit 50 controls the display 51a of the first control box 51, so that the irradiation conditions for laser irradiation with the first treatment laser beam can be set.

[0081] 9A and 9B are diagrams showing an example of a screen 600A displayed on the display 51a of the first control box 51 and an example of a screen 600B displayed on the display 52a of the second control box 52 when the laser treatment device main body 100 is in use. When the final mirror 228 is located at the retracted position P2, laser irradiation by the laser treatment device main body 100 is enabled, and based on this detection, the screen 600A on the first control box 51 side displays a display for setting the laser irradiation conditions by the laser treatment device main body 100, as shown in FIG. 9A. On the other hand, the screen 600B on the second control box 52 side displays a display 601B indicating that the treatment laser light irradiation unit 200 is unavailable (or that the laser treatment device main body 100 is in use). This allows the surgeon to easily recognize which control box is available and to appropriately set the laser irradiation conditions of the laser treatment device main body 100.

[0082] The laser treatment device main body 100 in this embodiment is equipped with a YAG mode and an SLT mode. The YAG mode is a treatment mode that aims to incise the posterior capsule, iris, and other tissues of the patient's eye by generating minute plasma with a YAG laser light having a wavelength of 1064 nm. The SLT mode is a treatment mode in which the YAG laser light is converted into laser light having a wavelength of 532 nm (green) by a wavelength conversion element, thereby selectively acting on pigmented cells in the trabecular fiber body. The YAG mode and the SLT mode can be selected using a switch 602 displayed on the screen 600A. Here, the case where the YAG mode is selected will be described.

[0083] For example, in YAG mode, irradiation conditions such as the energy amount of the treatment laser light, the focus shift of the treatment laser light, the light intensity of the aiming light, and the number of pulses emitted per laser irradiation (number of pulses in BURST mode) are set on screen 600A.

[0084] After setting the laser irradiation conditions, the surgeon observes the affected area of ​​the patient's eye illuminated by the illumination light from the illumination unit 130 through the observation optical system 140G, and operates the joystick 106 to move the first treatment laser light irradiation unit 110 so as to align the aiming light with the affected area. After achieving alignment, the surgeon switches from the STANDBY state to the READY state using the switch 603 on the screen 600A. Thereafter, when the foot switch 54 is pressed, the treatment laser source 111 is activated, and the treatment laser light from the first treatment laser light irradiation optical system 110G is irradiated onto the affected area.

[0085] <Treatment operation by the treatment laser light irradiation unit> In the case of laser irradiation by the treatment laser light emitting unit 200, the operator operates the lever 251 to move the final mirror 228, which has been placed at the retracted position P2, to the emitting position P1. When the first detector 295 detects that the final mirror 228 has been placed at the emitting position P1, the screen 600B on the second control box 52 side is switched to a screen for setting the laser irradiation conditions by the treatment laser light emitting unit 200, as shown in Fig. 9(b). On the other hand, when the second detector 296 detects that the final mirror 228 has been moved from the retracted position P2, a message 601A is displayed on the screen 600A displayed on the display 51a of the first control box 51, indicating that the laser treatment apparatus main body 100 is unavailable (or that the treatment laser light emitting unit 200 is in use). If the final mirror 228 is not correctly positioned at either the irradiation position P1 or the retreat position P2, as shown in Fig. 9(c), the display 601A and 601B indicating that the mirror is unusable are displayed on the screen 600A and the screen 600B, respectively. This allows the operator to recognize which control box is usable and to appropriately set the laser irradiation conditions of the treatment laser light irradiation unit 200.

[0086] The screen 600B in FIG. 9(b) allows the user to set laser irradiation conditions for photocoagulation treatment using the treatment laser light irradiating unit 200. For example, the laser irradiation conditions may include the spot size of the treatment laser light, the energy amount of the treatment laser light, the coagulation time, the interval time for moving the spot position, and the light intensity of the aiming light. The treatment laser light irradiating unit 200 can form multiple spots arranged in a predetermined scanning pattern by scanning the spot of the treatment laser light with the scanning unit 230 in response to a single trigger signal. Therefore, the scanning pattern of the spot of the treatment laser light can be set as a laser irradiation condition. For example, the scanning pattern may include a square type in which multiple spots (e.g., 9 spots in a 3×3 matrix) are arranged in a square shape, a triangle type in which multiple spots are arranged in a triangular shape, and an arc type in which multiple spots are arranged on an arc. Multiple types of scanning patterns can be registered in advance, and the registered scanning patterns are stored in the storage unit 55. The registered scanning pattern can be set by being called from the storage unit 55 by operating a 3D mouse, which will be described later.

[0087] After setting the laser irradiation conditions of the treatment laser beam irradiation unit 200, the surgeon observes the affected area of ​​the patient's eye illuminated by the illumination light from the illumination unit 130 through the observation optical system 140G and aligns the aiming light with the affected area. After that, the switch 613 on the screen 600B is used to switch from STANDBY to READY, enabling the treatment laser beam to be emitted. Then, when the foot switch 54 is pressed, the trigger signal is input, which then drives the treatment laser source 211. The treatment laser beam emitted from the treatment laser source 211 is guided by the second treatment laser beam irradiation optical system 200G and reflected by the final mirror 228, thereby irradiating the affected area (fundus tissue) of the patient's eye. If a scanning pattern has been set, the spot of the treatment laser beam scans the tissue according to the scanning pattern.

[0088] 10 shows an example of a scanning pattern in which the spots of the treatment laser light are arranged. In this example, the scanning unit 230 sequentially scans the spots of the treatment laser light so that nine spots (3 × 3) are formed in a square shape at the irradiation position S1.

[0089] In photocoagulation treatment, the treatment laser beam is irradiated over a wide area of ​​the fundus tissue. Therefore, conventionally, the irradiation position of the treatment laser beam on the patient's eye is changed by the surgeon using a mechanical manipulator mechanism to move the final mirror located in front of the objective lens 125. However, when the treatment laser beam irradiation unit 200 having a scanning unit 230 that scans the treatment laser beam is installed, the final mirror 228 is moved between the irradiation position and the retracted position, making it difficult to adopt a mechanical manipulator mechanism as is.

[0090] Therefore, in the present disclosure, the 3D mouse 53, which is an example of an operation unit, is used as an electronic manipulator for two-dimensionally moving the irradiation position (spot position) of the second treatment laser beam on the tissue of the patient's eye by combining with the scanning unit 230. That is, the 3D mouse 53 is configured to be able to input a movement signal for two-dimensionally moving the irradiation position of the second treatment laser beam on the tissue of the patient's eye.

[0091] 11 is a diagram illustrating the configuration of the 3D mouse 53 and the input of operation signals. The 3D mouse 53 includes an operation unit 53a that is held by the surgeon's hand or fingers, and a base unit 53b. The operation unit 53a is tiltable in two dimensions, the x direction (left-right direction) and the y direction (front-back direction), relative to the base unit 53b. By tilting the operation unit 53a in the four directions, left-right, front-back, and rearward, four operation signals, namely, a left tilt signal, a right tilt signal, a forward tilt signal, and a rearward tilt signal, can be input. The operation unit 53a is also slidable in two dimensions, the x direction (left-right direction) and the y direction (front-back direction), relative to the base unit 53b. By sliding the operation unit 53a in the four directions, namely, left-right, front-back, and rearward, four operation signals, namely, a left slide signal, a right slide signal, a forward slide signal, and a rearward slide signal, can be input.

[0092] Furthermore, operation member 53a can be rotated left and right relative to base portion 53b, and two operation signals, a left rotation signal and a right rotation signal, can be input by rotating it. Furthermore, operation member 53a can be moved upward and downward relative to base portion 53b, and two operation signals, an up movement signal and a down movement signal, can be input by moving it. Furthermore, left button 53c1 and right button 53c2 are arranged on base portion 53b, and two operation signals, a left button signal and a right button signal, can be input by operating each of them.

[0093] In the 3D mouse 53 capable of inputting such a plurality of operation signals, for example, the manipulator function signals (signals for two-dimensionally moving the irradiation position of the second treatment laser light on the tissue of the patient's eye) are assigned a left tilt signal, a right tilt signal, a forward tilt signal, and a backward tilt signal, which are generated by tilting the operation member 53a in four directions (left, right, front, back, and rear). That is, when the left tilt signal and the right tilt signal are input, the control unit 50 controls the scanning unit 230 to move the irradiation position (irradiation spot) of the second treatment laser light irradiated on the tissue of the patient's eye in the X direction. Also, when the forward tilt signal and the backward tilt signal are input, the control unit 50 controls the scanning unit 230 to move the irradiation position (irradiation spot) of the second treatment laser light irradiated on the tissue of the patient's eye in the Y direction. For example, in the case of a scanning pattern, when the manipulator function signal is input, the irradiation position S1 in FIG. 10 is moved to the irradiation position S2.

[0094] Here, when inputting signals for the manipulator function, some surgeons may have difficulty tilting the operating member 53a. Therefore, in the device of this embodiment, signals for sliding the operating member 53a in four directions (left and right, forward and backward) are assigned as signal inputs for the manipulator function. That is, even when a left slide signal, a right slide signal, a forward slide signal, or a backward slide signal is input, the scanning unit 230 is controlled to move the irradiation position (irradiation spot) of the second treatment laser beam in the X and Y directions. In other words, whether an operation signal for a tilt operation or a slide operation is input from the 3D mouse 53, the control unit 50 receives the signal as a manipulator function signal for two-dimensionally moving the irradiation position of the treatment laser beam. As a result, when inputting a signal for the manipulator function, an operator who is not good at tilting, which is an example of the first operation of the 3D mouse 53, can input a signal by sliding, which is an example of the second operation of the 3D mouse 53, and conversely, an operator who is not good at sliding (second operation) of the 3D mouse 53 can input a signal by tilting (first operation) of the 3D mouse 53. Therefore, in the ophthalmic laser treatment device 1 of this embodiment, it is easy to input a signal for XY movement of the irradiation position, and the usability of the treatment laser light irradiation unit 200 is improved.

[0095] Furthermore, in the 3D mouse 53 of this embodiment, at least one of an upward movement signal and a downward movement signal resulting from an up / down movement operation of the operation member 53a, which is an example of the third operation, may be assigned as an input of an operation signal for the manipulator function that returns the irradiation position to the origin. For example, when an upward movement signal or a downward movement signal of the operation member 53a is input and the operation signal is received by the control unit 50, the scanning unit 230 is controlled to return the irradiation position S2 in FIG. 10 to the origin, i.e., the irradiation position S1.

[0096] Furthermore, when combined with the scanning unit 230, the 3D mouse 53 of this embodiment functions not only as a manipulator but also as a signal input for a pattern setting function for setting a scanning pattern in which spots of the second treatment laser light are arranged. For example, operation signals for rotating the operation member 53a left and right are assigned as signals for rotating the operation pattern. The input signals are received by the control unit 50. For example, in FIG. 10, the scanning pattern for the irradiation position S3 is rotated 90 degrees left or right relative to the scanning pattern for the irradiation position S1.

[0097] Furthermore, for example, the button operation signals of the left button 53c1 and the right button 53c2 are assigned as signals for changing (increasing or decreasing) the interval D between adjacent spots. In Fig. 10, the scanning pattern for the irradiation position S4 is an example in which the interval D between adjacent spots is increased compared to the scanning pattern for the irradiation position S1.

[0098] It should be noted that the pattern setting functions of rotating the scan pattern and changing the interval D between adjacent spots described above are merely examples, and settings of various other scan patterns may be assigned to various operations of the 3D mouse 53. For example, of the upward movement signal and downward movement signal of the operation member 53a, the upward movement signal may be assigned as a signal for sequentially calling and setting the types of scan patterns (square type, triangle type, arc type, etc.) stored in the storage unit 55. It should be noted that the assignment of operation signals for the 3D mouse 53 can be arbitrarily set on a predetermined setting screen of the control box 52.

[0099] In this way, the 3D mouse 53 is used not only for inputting signals for the manipulator function but also for inputting signals for setting the scanning pattern of the second treatment laser beam, so that the surgeon can appropriately irradiate the patient's eye with the treatment laser beam by manually operating the 3D mouse 53 while looking through the microscope 141 of the observation optical system 140G without taking his / her eyes off the microscope 141. Furthermore, the usability of the treatment laser beam irradiation unit 200 is improved.

[0100] <Example of transformation> In the above embodiment, the mirror moving unit 250 moves the final mirror 288 to the retracted position P2 in the lateral direction of the objective lens 125 by rotating the final mirror 288 around the rotation axis R1, but this is not limited to this. For example, the mirror moving unit 250 may move the final mirror 288 placed at the irradiation position P1 linearly in the lateral direction relative to the optical axis of the objective lens 125 so as to avoid interference with the lens barrel unit 220a, and then move the final mirror 288 to the retracted position P2 by linear or rotational movement upward. [Explanation of symbols]

[0101] 1. Ophthalmic laser treatment device 50 control section 53 3D Mouse 53a Operating member 100 Laser treatment device body 110G First treatment laser light irradiation optical system 125 objective lens 130G illumination optical system 136 Split Mirror 200 Therapeutic laser light irradiation unit 200G Second treatment laser light irradiation optical system 228 Final Mirror 230 Scanning Unit 250 Mirror moving part 270A Vertical adjustment mechanism 290 Final mirror position detection mechanism

Claims

1. a laser treatment device body for irradiating a patient's eye with a first treatment laser beam through an objective lens; a treatment laser beam irradiation unit mounted on the laser treatment device body, the treatment laser beam irradiation unit having a scanning section for scanning a second treatment laser beam different from the first treatment laser beam on tissue of a patient's eye, and a second treatment laser beam irradiation optical system for irradiating the second treatment laser beam onto the patient's eye via a final mirror disposed at a predetermined irradiation position in front of the objective lens; a moving means for moving the final mirror between the irradiation position and a predetermined retreat position away from the optical path of the first treatment laser beam; an operation unit for inputting a signal of an operation by a surgeon; a control means; the second treatment laser beam irradiating optical system is configured to form a plurality of spots arranged in a predetermined scanning pattern by scanning the second treatment laser beam with the scanning unit; the operation unit is configured to be combined with the scanning unit to have a manipulator function of inputting a movement signal for two-dimensionally moving the irradiation position of the second treatment laser light on tissue of a patient's eye, and a pattern setting function of setting the scanning pattern; 10. An ophthalmic laser treatment apparatus, wherein the control means is configured to control the scanning unit based on a signal of the manipulator function and a signal of the pattern setting function input from the operation unit.

2. The ophthalmic laser treatment device of claim 1, the operation unit has an operation member capable of both a first operation operable in two-dimensional directions and a second operation operable in two-dimensional directions by an operation different from the first operation, An ophthalmic laser treatment device characterized in that the control means is configured to accept either the first operation or the second operation as a signal for the manipulator function when an operation signal is input from the operation unit.

3. 3. The ophthalmic laser treatment device according to claim 2, the operating member is further capable of a third operation different from the first operation and the second operation, The ophthalmic laser treatment device is characterized in that, when an operation signal for the third operation is input from the operation unit, the control means accepts it as a signal for the manipulator function for returning the irradiation position of the second treatment laser light to the origin.

4. The ophthalmic laser treatment device according to any one of claims 1 to 3, the pattern setting function is configured to be able to set at least one of a first setting for rotating the scan pattern, a second setting for changing an interval between the plurality of spots constituting the scan pattern, and a third setting for changing a shape of an arrangement of the plurality of spots, An ophthalmic laser treatment device characterized in that the operation signal for the pattern setting function is input by an operation member of the operation unit, which is different from the operation of the manipulator function.

5. The ophthalmic laser treatment device according to any one of claims 1 to 4, The ophthalmic laser treatment apparatus is characterized in that the operation unit is configured as a 3D mouse that allows an operator to input a plurality of operation signals by holding an operation member in his / her hand.

6. The ophthalmic laser treatment device according to any one of claims 1 to 5, an observation optical system for observing a patient's eye through the objective lens; An ophthalmic laser treatment device characterized in that the final mirror, even when placed at the irradiation position in front of the objective lens, ensures at least 80% of the observation field of view of the observation optical system and has a size that allows irradiation of the second treatment laser light in the predetermined scanning pattern.

7. The ophthalmic laser treatment device according to any one of claims 1 to 6, an illumination optical system that projects illumination light onto the patient's eye via a reflecting member that is disposed closer to the patient's eye than the objective lens; An ophthalmic laser treatment apparatus, wherein the irradiation position is set between the objective lens and the reflecting member.

8. a treatment laser beam irradiation unit mounted on a laser treatment device body that irradiates a patient's eye with a first treatment laser beam through an objective lens, a second treatment laser beam irradiation optical system having a scanning unit for scanning a second treatment laser beam, which is different from the first treatment laser beam, on tissue of the patient's eye, and irradiating the second treatment laser beam onto the patient's eye via a final mirror disposed at a predetermined irradiation position in front of the objective lens; a moving means for moving the final mirror between the irradiation position and a predetermined retreat position away from the optical path of the first treatment laser beam; an operation unit for inputting a signal of an operation by a surgeon; a control means; the second treatment laser beam irradiating optical system is configured to form a plurality of spots arranged in a predetermined scanning pattern by scanning the second treatment laser beam with the scanning unit; the operation unit is configured to be combined with the scanning unit to have a manipulator function of inputting a movement signal for two-dimensionally moving the irradiation position of the second treatment laser light on tissue of a patient's eye, and a pattern setting function of setting the scanning pattern; The treatment laser light irradiation unit is characterized in that the control means is configured to control the scanning unit based on a signal of the manipulator function and a signal of the pattern setting function input from the operation unit.

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