Ophthalmic foot switches and ophthalmic surgical devices

Abstract

To provide a foot switch and surgical device for ophthalmic surgery that offer improved operability. [Solution] The oscillating part of the side switch rotates and oscillates left and right around a rotation axis extending in the front-rear direction, within a predetermined oscillation range between an inner standby position when the side switch is not operated and an outer operating position when the side switch is operated. The side switch biasing part biases the oscillating part toward the standby position within the oscillation range. When the oscillating part is in the standby position, the point of application of the force required to operate the push switch is located inside a virtual reference plane extending vertically upward from the rotation axis of the oscillating part. When the oscillating part begins to rotate and oscillate from the standby position toward the operating position, the height of the point of application gradually increases as it moves outward from the standby position.

Description

Technical Field

[0001] The present disclosure relates to an ophthalmic surgical foot switch connected to and used with an ophthalmic surgical device, and an ophthalmic surgical device including the ophthalmic surgical foot switch.

Background Art

[0002] During ophthalmic surgeries such as cataract surgery and vitreous surgery, the surgeon needs to hold the surgical instrument by hand. Therefore, in many ophthalmic surgical devices, a foot switch operated by the surgeon's foot is generally used to allow the surgeon with their hands occupied to control the operation.

[0003] For example, in the foot switch described in Patent Document 1, a side switch operated in the lateral direction is provided near the main pedal that is depressed by the surgeon. As a result, in addition to the signal from the depression operation of the main pedal, the signal from the operation of the side switch is also output to the ophthalmic surgical device. In recent years, a foot switch has also been proposed in which a push switch operated downward is further provided above the side switch operated in the lateral direction. By further providing the push switch, an increase in the types of signals that can be output to the ophthalmic surgical device is attempted.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] When a push switch is located above a side switch, the surgeon may want to operate only the push switch without operating the side switch. However, with conventional foot switches, even a slight downward diagonal force applied to the push switch would often not only operate the push switch downwards, but also operate the side switch laterally. Therefore, with conventional foot switches, the surgeon had to apply force directly downwards to the push switch, requiring techniques such as removing the heel from the foot switch and pressing the push switch from directly above. Thus, a foot switch for ophthalmic surgery with improved operability is desired.

[0006] A typical object of the present invention is to provide a foot switch and ophthalmic surgical apparatus that offer improved operability. [Means for solving the problem]

[0007] A typical embodiment of the ophthalmic surgery foot switch provided in this disclosure is an ophthalmic surgery foot switch connected to an ophthalmic surgery device used for operating on a patient's eye, which outputs a signal to the ophthalmic surgery device when operated by the surgeon's foot, comprising: a main pedal which outputs a first signal corresponding to the amount of operation when pressed downward by the surgeon's foot; a side switch provided to the side of the main pedal, protruding above the pressing surface of the main pedal, and which outputs a second signal when operated outward in a lateral direction; and a push switch provided above the side switch which outputs a third signal when operated downward, wherein the side switch The device comprises a swinging part that rotates and swings left and right about a rotation axis extending in the front-rear direction within a predetermined swing range between an inner standby position when the side switch is not operated and an outer operating position when the side switch is operated, and a side switch biasing part that biases the swinging part toward the standby position within the swing range, wherein when the swinging part is in the standby position, the position of the point of application of the force for operating the push switch that acts on the swinging part is located inside a virtual reference plane extending vertically upward from the rotation axis of the swinging part, and when the swinging part starts to rotate and swing from the standby position toward the operating position, the height of the point of application gradually increases as it moves outward from the standby position.

[0008] An ophthalmic surgical apparatus provided by a typical embodiment in this disclosure comprises the ophthalmic surgical apparatus.

[0009] The foot switch and ophthalmic surgical device described herein appropriately improve operability by the surgeon. [Brief explanation of the drawing]

[0010] [Figure 1] This diagram schematically shows the overall configuration of the ophthalmic surgical apparatus 1 of this embodiment. [Figure 2] This is a perspective view of the foot switch 40 for ophthalmic surgery according to this embodiment, viewed from the upper left. [Figure 3]This is a plan view of the foot switch 40 for ophthalmic surgery according to this embodiment. [Figure 4] This is a partial cross-sectional view taken in the direction of the arrow AA in Figure 3. [Figure 5] This is a perspective view of the peristaltic pump 60, seen from diagonally above. [Figure 6] This is a flowchart of the intraoperative processing performed by the ophthalmic surgical apparatus 1 of this embodiment. [Figure 7] This is a timing chart comparing an example of the operation of the perfusion pump and suction pump when pulsation suppression treatment is performed. [Figure 8] This is a flowchart showing the first aspect of sound instruction input processing. [Figure 9] This is a flowchart showing the second aspect of sound instruction input processing. [Modes for carrying out the invention]

[0011] <Overview> (First aspect) The ophthalmic foot switch illustrated in this disclosure is connected to an ophthalmic surgical device used for operating on a patient's eye and outputs a signal to the device when operated by the surgeon's foot. The ophthalmic foot switch of this disclosure comprises a main pedal, a side switch, and a push switch. The main pedal outputs a first signal corresponding to the amount of operation when pressed downward by the surgeon's foot. The side switch is located to the side of the main pedal, protruding above the pressing surface of the main pedal, and outputs a second signal when operated outward in the lateral direction. The push switch is located above the side switch and outputs a third signal when operated downward. The side switch comprises a swinging part and a side switch biasing part. The swinging part rotates left and right around a rotation axis extending in the front-rear direction within a predetermined swing range between an inner standby position when the side switch is not operated and an outer operating position when the side switch is operated. The side switch biasing part biases the swinging part toward the standby position within the swing range. When the oscillating part is in the standby position, the point of application of the force required to operate the push switch is located inside a virtual reference plane extending vertically upward from the rotation axis of the oscillating part. As the oscillating part begins to rotate and oscillate from the standby position towards the operating position, the height of the point of application gradually increases as it moves outward from the standby position.

[0012] In this case, even if a force including a downward force is applied to the oscillating part at the point of application while the oscillating part is in the standby position, the point of application is located inside the virtual reference plane, making it difficult for a force that would rotate the oscillating part to be applied. Therefore, when the push switch is operated, even if a force is applied to the push switch at an oblique downward and outward angle, the malfunction of the side switch rotating and oscillating along with the push switch is less likely to occur. Thus, it becomes easier for the operator to properly operate the ophthalmic foot switch.

[0013] In the present disclosure, a case is exemplified in which side switches are provided on both sides (each of the left and right sides) of the main pedal, and push switches are provided on each of the left and right side switches. However, the number of side switches may be one or three or more.

[0014] In a state where the side switch is disposed at the standby position, the direction in which the push switch is pressed may be inclined obliquely outward with respect to vertically downward. In this case, even if the operator presses the push switch in a direction obliquely outward with respect to vertically downward, only the push switch itself is pressed obliquely downward, and it is difficult for a force in the direction of rotational rocking outward to be applied to the side switch itself provided with the push switch. Therefore, the problem that the side switch also rotates and rocks together with the push switch during operation is less likely to occur.

[0015] The side switch may include a push switch support portion and a push switch biasing portion. The push switch support portion supports the push switch in a reciprocally movable state. The push switch biasing portion biases the push switch supported by the support portion upward along the reciprocating movement direction. In a state where the rocking portion is at the standby position, the position of the fulcrum of the push switch biasing portion may be located inside the virtual reference plane.

[0016] In this case, when the push switch is operated, the fulcrum of the push switch biasing portion serves as an action point and a force is applied to the rocking portion of the side switch. However, since the fulcrum of the push switch biasing portion is located inside the virtual reference plane, the problem that the side switch also rotates and rocks together with the push switch during operation is less likely to occur. Thus, it becomes easier for the operator to appropriately operate the ophthalmic foot switch.

[0017] The ophthalmic foot switch may further include a heel rest on the front side of the main pedal on which the heel of the operator's foot is placed. When the ophthalmic foot switch is viewed from above, a plurality of push switches may be provided within a range of a radius of 25 cm centered on the center of the heel rest.

[0018] According to the ophthalmic foot switch of the present disclosure, it is less likely to cause a problem that the side switch is also operated together with the push switch even when the operator does not apply a force directly below the push switch. Therefore, the operator can operate the push switch by simply rotating the tip of the foot while placing the heel on the heel rest. Furthermore, by arranging a plurality of push switches within a range of a radius of 25 cm or less centered on the center of the heel rest, the operator can also operate the plurality of push switches while placing the heel on the heel rest. Thus, the operability of the ophthalmic surgical foot switch is further improved.

[0019] (Second aspect) The ophthalmic surgical device exemplified in the present disclosure supplies perfusion fluid from a perfusion fluid source into the eye of a patient, and aspirates waste fluid containing waste tissue of the patient's eye and the perfusion fluid from the eye. The ophthalmic surgical device of the present disclosure includes a perfusion path, an aspiration path, and a plurality of peristaltic pumps. The perfusion path passes the perfusion fluid supplied from the perfusion fluid source through a surgical instrument. The aspiration path passes the waste fluid aspirated from the eye through the surgical instrument. The peristaltic pump changes the pressure in the flow path by rotating while pressing a flexible flow path with a plurality of pump rollers. The control unit controls the ophthalmic surgical device. The plurality of peristaltic pumps include a perfusion pump and an aspiration pump. The perfusion pump is a peristaltic pump provided in the perfusion path for changing the perfusion pressure for supplying the perfusion fluid into the eye. The aspiration pump is a peristaltic pump provided in the aspiration path for changing the aspiration pressure for aspirating the waste fluid from the eye. When the control unit rotates the perfusion pump and the aspiration pump in parallel, the control unit executes a pulsation suppression step of suppressing the pulsation of the pressure in the eye by synchronizing the average rotation speeds of the perfusion pump and the aspiration pump in a state where the amount of phase shift of the rotation of the perfusion pump and the aspiration pump is adjusted.

[0020] According to the ophthalmic surgical device disclosed herein, both perfusion pressure and suction pressure are appropriately controlled by the perfusion pump and suction pump. However, simply using a perfusion pump and a suction pump alone may result in the pulsation of intraocular pressure caused by each pump being combined, potentially causing adverse effects on the patient's eye. In contrast, the ophthalmic surgical device disclosed herein synchronizes the average rotational speed while adjusting the phase difference between the rotation of the perfusion pump and the suction pump, thereby canceling out the pulsation of each pump and suppressing intraocular pressure pulsation. This makes it easier to perform surgery more appropriately.

[0021] The control unit may perform a phase shift adjustment step and a synchronous rotation step in the pulsation suppression step. In the phase shift adjustment step, the control unit adjusts the amount of phase difference in rotation to a predetermined amount by rotating one of the perfusion pump and suction pump at a higher speed than the other. In the synchronous rotation step, the control unit synchronizes the average rotation speeds of the perfusion pump and suction pump when the amount of phase difference has been adjusted to a predetermined amount by the phase shift adjustment step.

[0022] In this case, the phase shift adjustment step adjusts the phase shift so that the pulsations of each pump tend to cancel each other out, by setting the average rotation speeds of the two peristaltic pumps to different speeds. Once the phase shift is adjusted, synchronization of the average rotation speeds of the two peristaltic pumps begins. As a result, intraocular pressure pulsations are appropriately suppressed.

[0023] In the phase shift adjustment step, the control unit may adjust the amount of phase shift in rotation by stopping the rotation of one of the perfusion pump and suction pump while rotating the other. Alternatively, the control unit may adjust the amount of phase shift in rotation by rotating both the perfusion pump and suction pump and making the average rotational speed of one greater than the average rotational speed of the other.

[0024] Furthermore, the amount of phase shift adjusted in the phase shift adjustment step may be determined in advance through experiments or simulations, etc., to ensure that the pulsations of the two pulsating pumps cancel each other out as much as possible. Also, if a pressure sensor or the like capable of detecting changes in fluid pressure (including pulsations) is provided, the control unit may appropriately determine an amount of phase shift that ensures the pulsations of the two pulsating pumps cancel each other out as much as possible based on the detected changes in fluid pressure.

[0025] In the phase shift adjustment step, the control unit may adjust the phase shift of rotation to a predetermined amount by rotating the suction pump at an average rotational speed greater than that of the perfusion pump while the perfusion pump is stopped or rotating. In this case, for example, even if the surgeon has entered an instruction to perform drainage fluid suction, the possibility of the suction stopping or decreasing in suction force causing discomfort to the surgeon is reduced. Therefore, the surgery is more likely to be performed appropriately.

[0026] However, the control unit may adjust the phase difference between the rotations to a predetermined amount by rotating the perfusion pump at a higher average rotational speed than the suction pump while the suction pump is stopped or rotating. Even in this case, the phase difference between the two pumps is appropriately adjusted.

[0027] The control unit may perform a pulsation suppression step when starting the rotation of the suction pump while the perfusion pump is rotating. In typical ophthalmic surgery, the suction of waste fluid by the suction pump is started when perfusion pressure has already been generated by the perfusion pump. Performing a pulsation suppression step at the start of suction by the suction pump makes it easier to appropriately suppress intraocular pressure pulsations during suction.

[0028] The control unit may perform a perfusion pressure restoration step to restore the fluctuating perfusion pressure to the target range by controlling the drive of the perfusion pump when the perfusion pressure fluctuates. The control unit may also perform a pulsation suppression step when performing the perfusion pressure restoration step. For example, if the suction path of a surgical instrument becomes blocked, or if fluid leakage occurs, the control unit can restore the perfusion pressure to the target range by performing the perfusion pressure restoration step. However, when the perfusion pressure restoration step is performed, the synchronization between the perfusion pump and the suction pump, which were controlled by the pulsation suppression step, often becomes misaligned. Therefore, the control unit can perform a pulsation suppression step when performing the perfusion pressure restoration step to appropriately restart synchronization even if the synchronization of the two peristaltic pumps becomes misaligned. Thus, intraocular pressure pulsation becomes more easily suppressed.

[0029] In the pulsation suppression step, the control unit monitors the amount of phase difference in rotation while synchronizing the average rotational speeds of the perfusion pump and the suction pump, and may readjust the phase difference if the monitored phase difference falls outside the target range. Even when attempting to synchronize the average rotational speeds of two peristaltic pumps, synchronization may still occur. When synchronization is disrupted, the amount of phase difference in rotation may fall outside the target range. In response to this, the control unit can more effectively suppress the effects of pulsation by monitoring the phase difference during rotational synchronization and readjusting the phase difference if it falls outside the target range.

[0030] (Third aspect) The ophthalmic surgical apparatus illustrated in this disclosure comprises a foot switch, an audio input unit, and a control unit. The foot switch outputs a signal when operated by the surgeon's foot. Sound is input to the audio input unit. The control unit controls the ophthalmic surgical apparatus. The control unit can perform sound recognition processing on the sound input unit and execute a voice control step that generates a signal of instruction to the ophthalmic surgical apparatus based on the recognition result of the sound recognition processing. The control unit switches whether or not to enable the voice control step in response to the operation of the foot switch.

[0031] According to the ophthalmic surgical device disclosed herein, the surgeon can input instructions to the device by voice even when their hands are occupied. Furthermore, the surgeon can switch on or off sound control (sound-based instruction input control) by operating a foot switch. Therefore, if the surgeon disables sound control by operating the foot switch, sound recognition processing may be performed on unintended conversations, reducing the possibility of generating instructions contrary to the surgeon's intention. Also, if the surgeon wishes to input instructions during surgery when their hands are occupied, they can enable sound control by operating the foot switch, allowing them to input instructions to the ophthalmic surgical device by sound (voice, etc.). Thus, ophthalmic surgery is more likely to be performed appropriately.

[0032] The foot switch may include a main pedal and a sub-operator. The main pedal, when pressed downwards by the operator's foot, outputs a first signal corresponding to the amount of operation. The sub-operator is a separate unit from the main pedal and, when operated by the operator, outputs a second signal different from the first signal. The control unit may switch whether or not to enable the sound control step depending on the operation of the sub-operator.

[0033] In this case, even while operating the main pedal, the surgeon can switch between enabling and disabling audible control by operating the sub-control unit while simultaneously operating the main pedal. Therefore, even during surgery when the surgeon's hands are occupied, they can appropriately input voice commands into the ophthalmic surgical device.

[0034] The sub-operator may be a side switch. The side switch is located beside the main pedal, protruding above the pedal's pressing surface, and outputs a second signal when operated outwards (laterally).

[0035] In this case, the surgeon can switch between enabling and disabling audible control even while operating the main pedal by moving their foot sideways while the main pedal is pressed. Therefore, the surgeon can appropriately input voice commands to the ophthalmic surgical device even when their hands are occupied during surgery.

[0036] However, the activation or deactivation of audible control may be switched by a sub-operator separate from the side switch. For example, a push switch located above the side switch may be used to switch between activating and deactivating audible control. Even in this case, the operator can activate audible control while operating the main pedal by operating the sub-operator with the foot opposite to the foot pressing the main pedal.

[0037] The control unit may enable the sound control step while the sub-operator is being operated and disable the sound control step when the sub-operator is not being operated. In this case, the surgeon can appropriately input audible instructions to the ophthalmic surgical device by generating sound while operating the sub-operator. Furthermore, since sound control is disabled when the sub-operator is not being operated, the possibility of inputting instructions contrary to the surgeon's intention is appropriately reduced. Therefore, ophthalmic surgery can be performed more appropriately.

[0038] The ophthalmic surgical apparatus may further include a speaker that generates sound. The control unit may output the instruction content recognized by the sound recognition process to the speaker while the sound control step is enabled. After outputting the instruction content to the speaker, the control unit may generate the signal for the instruction output to the speaker when the operation of the sub-operator is released. Also, if, after outputting the instruction content to the speaker, another instruction content is recognized by the sound recognition process while the operation of the sub-operator is still being performed, the control unit may output the newly recognized instruction content to the speaker. In this case, the surgeon only needs to repeatedly generate sound until the desired instruction content is recognized. Furthermore, the surgeon can disable sound control while generating the signal for the desired instruction by releasing the operation of the sub-operator when the desired instruction content is recognized. Thus, ophthalmic surgery can be performed more smoothly.

[0039] However, the specific method for switching the activation of sound control via a sub-operator can be selected as appropriate. For example, the foot switch may have side switches on both the left and right sides of the main pedal. The control unit may initiate activation of the sound control step (sound control) when one of the left or right side switches is operated. The control unit may also deactivate the sound control step while it is activated when one of the left or right side switches (which may be the same side switch that initiated activation, or a different side switch) is operated. In this case, the activation and deactivation of sound control are switched as appropriate at the timing of the side switch operation, making it easier to perform ophthalmic surgery smoothly.

[0040] Furthermore, the control unit may output the instruction content recognized by the sound recognition process to the speaker while the sound control step is enabled. After outputting the instruction content to the speaker, the control unit may generate the instruction signal output to the speaker when one of the left or right side switches is operated, while resetting without generating the instruction signal output to the speaker when the other side switch is operated. In this case, the instructions desired by the surgeon are more easily input to the ophthalmic surgical device with greater accuracy.

[0041] The foot switch may include a main pedal that outputs a first signal corresponding to the amount of operation when pressed downwards by the operator's foot. The control unit may enable the sound control step when the main pedal is pressed and disable the sound control step when the main pedal is not pressed.

[0042] The main pedal is always operated during ophthalmic surgery. Therefore, by activating the sound control step when the main pedal is operated, sound control is always active during ophthalmic surgery. On the other hand, when ophthalmic surgery is not being performed, sound control is appropriately disabled, so the possibility of unintended instructions being input is appropriately reduced. Thus, ophthalmic surgery can be performed more smoothly.

[0043] The ophthalmic surgical apparatus may further include a speaker that generates sound. The foot switch may include the side switch described above. The control unit may output the instruction content recognized by the sound recognition process to the speaker while the sound control step is enabled. The control unit may decide whether or not to actually generate the instruction signal output to the speaker, depending on the operation of the side switch.

[0044] As mentioned above, the surgeon can operate the side switch even while the main pedal is pressed down by moving their foot laterally. Therefore, depending on whether the instructions output by the speaker are the instructions they want, the surgeon can appropriately input the desired instructions into the ophthalmic surgical device by sound by operating the side switch while keeping the main pedal pressed down.

[0045] The specific method for inputting instructions using side switches can be selected as appropriate. For example, the foot switch may have side switches on both the left and right sides of the main pedal. The control unit may output the instruction content to the speaker, and then, when one of the left or right side switches is operated, generate the instruction signal output to the speaker, while when the other side switch is operated, it may reset without generating the instruction signal output to the speaker. In this case, the instructions desired by the surgeon can be more accurately input to the ophthalmic surgical device.

[0046] <Embodiment> (Overall structure) Hereinafter, one typical embodiment of the present disclosure will be described with reference to the drawings. First, with reference to Figure 1, the overall configuration of the ophthalmic surgical apparatus 1 of this embodiment will be described in general terms. The ophthalmic surgical apparatus 1 of this embodiment includes a surgical instrument connection unit 2, an irrigation fluid source connection unit 3, an irrigation path 10, an irrigation pump 11, a suction path 20, a suction pump 21, a pressure sensor 22, and a control unit 30, etc.

[0047] The surgical instrument connection section 2 connects surgical instruments to the ophthalmic surgical apparatus 1. The surgical instruments are operated by the surgeon and inserted into the patient's eye E. In the example shown in Figure 1, an ultrasonic handpiece (US handpiece) 7 used in cataract surgery is connected to the surgical instrument connection section 2 as a surgical instrument. The ultrasonic handpiece 7 has a tubular ultrasonic tip (US tip) 8 with a suction port at its tip. The ultrasonic handpiece 7 has a transducer 9 built into it. The transducer 9 generates ultrasonic vibrations. The generated ultrasonic vibrations are amplified and transmitted to the ultrasonic tip 8. The ultrasonic tip 8 performs ultrasonic vibrations, which cause the tissue of the patient's eye E (e.g., lens nucleus) to be crushed and emulsified. In addition, irrigation fluid is supplied into the patient's eye E via the irrigation pathway 10 and the ultrasonic handpiece 7. Furthermore, waste fluid containing waste tissue from the patient's eye E (e.g., crushed lens nucleus in cataract surgery) and irrigation fluid is aspirated from inside the eye via the ultrasonic handpiece 7 and the suction pathway 20.

[0048] In this embodiment, an example is given in which an ultrasonic handpiece 7 for cataract surgery is used as a surgical instrument. However, the techniques illustrated in this disclosure can also be applied when surgical instruments other than the ultrasonic handpiece 7 are used. For example, an irrigation and aspiration handpiece (IA handpiece), a vitreous cutter used in vitrectomy, etc., may be used as surgical instruments. In addition, multiple surgical instruments may be connected to the surgical instrument connection part 2. For example, a surgical instrument for supplying irrigation fluid to the body and a surgical instrument for aspirating waste fluid from the body may be connected to the surgical instrument connection part 2 separately.

[0049] The irrigation fluid source connection section 3 connects the irrigation fluid source 4 to the ophthalmic surgical apparatus 1. In this embodiment, an irrigation bottle filled with irrigation fluid (e.g., physiological saline) is used as the irrigation fluid source 4. The irrigation path 10 is a fluid path connecting the surgical instruments connected to the surgical instrument connection section 2 and the irrigation fluid source 4 connected to the irrigation fluid source connection section 3. The irrigation path 10 allows the irrigation fluid supplied from the irrigation fluid source 4 to pass through the surgical instruments and the eye of the patient E. In the ophthalmic surgical apparatus 1 of this embodiment, an irrigation pump 11 that changes the pressure of the irrigation fluid supplied from the irrigation fluid source 4 into the eye of the patient E (hereinafter referred to as "irrigation pressure") is provided in the irrigation path 10. Details of the irrigation pump 11 will be described later.

[0050] The suction path 20 extends from the surgical instrument connected to the surgical instrument connection part 2 to the waste fluid bag 25 that collects the aspirated waste fluid. The suction path 20 passes the waste fluid aspirated from inside the eye through the surgical instrument to the waste fluid bag 25. A suction pump 21 is provided in the suction path 20. The suction pump 21 changes the suction pressure for aspirating waste fluid from inside the patient's eye E. Details of the suction pump 21 will be described later.

[0051] A pressure sensor 22 is installed between the surgical instrument connection part 2 and the suction pump 21 in the suction path 20 via a sensor connection part 23. The pressure sensor 22 detects the pressure of the fluid in the suction path 20. Therefore, the control unit 30 can (although not essential) determine whether or not there is an obstruction in the suction path 20 based on the pressure detection result from the pressure sensor 22.

[0052] The control unit 30 includes a CPU 31, ROM 32, and RAM 33, etc. The CPU 31 is a processor that controls various aspects of the ophthalmic surgical apparatus 1 (for example, control of the perfusion pump 11, suction pump 21, and surgical instruments). The ROM 32 stores various programs and initial values ​​for controlling the operation of the ophthalmic surgical apparatus 1. The RAM 33 temporarily stores various information.

[0053] The control unit 30 is connected to an operation unit 34, a non-volatile memory 35, a microphone 36, a speaker 37, and an ophthalmic surgery foot switch (hereinafter sometimes simply referred to as "foot switch") 40. The operation unit 34 receives input of various operation instructions from the surgeon, etc. Various devices can be used for the operation unit 34, such as a touch panel, operation buttons, a keyboard, a mouse, etc. The non-volatile memory 35 is a non-transient storage medium that can retain its contents even if the power supply is cut off. The ophthalmic surgery control program for executing various processes described later may be stored in the non-volatile memory 35. Sound (for example, the voice spoken by the surgeon, etc.) is input to the microphone (sound input unit) 36. In this embodiment, sound recognition processing is performed by the CPU 31 on the sound input to the microphone 36, so that the sound input to the microphone 36 is converted into information that can be processed by a computer (for example, text information, etc.). The foot switch 40 is operated by the surgeon's foot and outputs a signal to the control unit 30 according to the input operation instruction. Communication between the foot switch 40 and other components and the control unit 30 can be performed by various means of communication, such as wired communication, wireless communication, or network communication. During ophthalmic surgery, the surgeon is holding surgical instruments, making it difficult to input operating instructions to the ophthalmic surgical device 1 by hand. However, by using the foot switch 40, the surgeon's instructions can be appropriately input even during ophthalmic surgery.

[0054] In this disclosure, the term "processor" refers to one or more hardware processors configured to execute program code contained in a program (i.e., one or more instructions of a program). In other words, a "processor" is a hardware device capable of performing one or more programmed operations. For example, a "processor" may be a general-purpose or application-specific processor and may be at least one of a CPU, microprocessor, GPU, and DFP (Data Flow Processor).

[0055] In this disclosure, the term “memory” refers to one or more hardware memories that are non-transitional tangible recording media configured to record at least one of computer program code and data in a manner accessible from a processor. “Memory” can be implemented by memory technologies such as SRAM, SDRAM, non-volatile / flash type memory, or other types of memory. The computer program code that constitutes the program is recorded in memory and executed by the processor to enable various functions of the ophthalmic surgical apparatus 1.

[0056] In this disclosure, the term “circuit” refers to one or more logic circuits as hardware, configured to enable the ophthalmic surgical apparatus 1 to perform functions. In other words, “circuit” refers to one or more non-programmable devices. For example, “circuit” could be a custom IC designed to be non-programmable for a specific application.

[0057] In this disclosure, at least one of a circuit and a processor having memory storing computer program code enables the ophthalmic surgical apparatus 1 to function. The expression "at least one of a circuit and a processor" should be interpreted as disjunctive (logical OR) and not as at least one circuit and at least one processor.

[0058] (Foot switch) The foot switch 40 for ophthalmic surgery in this embodiment will be described in detail with reference to Figures 2 to 4. In Figure 2, the upper right side of the page is the front side of the foot switch, the lower left side is the rear side of the foot switch 40, the lower right side is the left side of the foot switch 40, the upper left side is the right side of the foot switch 40, the top of the page is the top side of the foot switch 40, and the bottom of the page is the bottom side of the foot switch 40. Figures 2 to 4 illustrate the orientation of the foot switch 40. As mentioned above, the foot switch 40 is connected to the ophthalmic surgery apparatus 1 by communication means such as wired communication or wireless communication. The foot switch 40 is operated by the surgeon's foot and outputs a signal corresponding to the input operation instruction to the control unit 30 of the ophthalmic surgery apparatus 1.

[0059] As shown in Figures 2 and 3, the foot switch 40 comprises a base 41, a heel rest 42, a main pedal 43, side switches 45L and 45R, and push switches 47L and 47R. The base 41 is placed on a flat surface and supports the entire foot switch 40. The heel rest 42 is located on the front side (in front of the main pedal 43) of the center of the upper surface of the foot switch 40 in the left-right direction. The operator's foot is placed on the upper surface of the heel rest.

[0060] The main pedal 43 is located at the rear of the upper part of the foot switch 40, in the center in the left-right direction (behind the heel rest 42). When the main pedal 43 is pressed downwards by the surgeon's foot, it outputs a first signal corresponding to the amount of operation to the control unit 30 of the ophthalmic surgical device 1. For example, as the amount of the pressing operation increases, the main pedal 43 may output a first signal to sequentially switch the mode to be performed by the ophthalmic surgical device 1 to irrigation mode (a mode that only supplies irrigation fluid into the eye), irrigation aspiration mode (a mode that both supplies irrigation fluid into the eye and aspirations waste fluid from the eye), and irrigation aspiration emulsification mode (a mode that performs irrigation fluid supply, waste fluid aspiration, and ultrasonic emulsification). In this embodiment, the main pedal 43 is always operated during the performance of ophthalmic surgery.

[0061] The side switches 45L and 45R are located on the sides of the main pedal 43. In this embodiment, side switch 45L is located on the left side of the main pedal 43, and side switch 45R is located on the right side of the main pedal 43. However, it is possible to change the number of side switches provided on the foot switch 40. For example, it is possible to provide side switches on only one of the left or right sides of the main pedal 43. The side switches 45L and 45R are located so as to protrude above the stepping surface of the main pedal 43 (i.e., the upper surface that the surgeon's foot contacts). By operating the side switches 45L and 45R outward, they can output a second signal different from the first signal described above to the control unit 30 of the ophthalmic surgery apparatus 1. In this embodiment, by operating the left side switch 45L outward, it outputs a second signal corresponding to the left side switch 45L. By operating the right side switch 45R outward, it outputs a second signal corresponding to the right side switch 45R. Although not shown in the diagram, the foot switch 40 includes a left-side detection unit that detects when the left-side switch 45L has been operated from the standby position to the operating position (the left end of the swing range), and a right-side detection unit that detects when the right-side switch 45R has been operated from the standby position to the operating position (the right end of the swing range).

[0062] The push switches 47L and 47R are located on top of the side switches 45L and 45R. In this embodiment, the left push switch 47L is located on top of the left side switch 45L. The right push switch 47R is located on top of the right side switch 45R. Note that a single side switch (for example, each of a pair of side switches 45L and 45R) may have multiple push switches. Alternatively, push switches may be located on only some of the multiple side switches. When the push switches 47L and 47R are operated downwards, a third signal different from the first and second signals described above can be output to the control unit 30 of the ophthalmic surgery apparatus 1.

[0063] (Configuration of side switch and push switch) Referring to Figure 4 and other figures, the configurations of the side switches 45L, 45R and push switches 47L, 47R in the foot switch 40 of this embodiment will be described in detail. Figure 4 is a partial cross-sectional view taken in the direction of line AA in Figure 3. In this embodiment, the configurations of the left side switch 45L and push switch 47L and the right side switch 45R and push switch 47R are symmetrical. Therefore, in order to simplify the explanation, the configurations of the left side switch 45L and push switch 47L will be described in detail below, and the explanation of the right side switch 45R and push switch 47R will be simplified.

[0064] As shown in Figure 4, the side switch 45L is equipped with a swinging part 50L. The swinging part 50L rotates and swings left and right around a rotation axis RA that extends in the front-rear direction. In detail, the swinging part 50L rotates and swings left and right around the rotation axis RA within a predetermined swing range OR between a standby position SP on the inside when the side switch 45L is not operated (the right end of the swing range OR shown by the arc-shaped arrow in Figure 4) and an operating position OP on the outside when the operation of the side switch 45L is completed (the left end of the swing range OR in Figure 4). The side switch 45L is also equipped with a side switch biasing part 46L that biases the swinging part 50L toward the standby position SP (i.e., to the right in Figure 4) within the swing range OR. Therefore, when the side switch 45L is not operated by the operator, the position of the swinging part 50L is maintained at the standby position SP by the biasing force of the side switch biasing part 46L. The side switch 45L is equipped with a sensor (not shown) that detects when the oscillating part 50L has been operated to the operating position OP within the oscillating range OR.

[0065] The side switch 45L comprises a push switch support portion 48L and a push switch biasing portion 49L. The push switch support portion 48L supports the push switch 47L in a reciprocating position. The push switch biasing portion 49L biases the push switch 47L, supported by the push switch support portion 48L, upward along the reciprocating direction PD. As a result, the position of the push switch 47L when not operated by the operator is maintained at the upper end within the range of reciprocating movement. The force applied to the push switch 47L to operate it acts on the oscillating portion 50L via the point of action POA near the fulcrum of the push switch biasing portion 49L. The side switch 45L is also equipped with a sensor (not shown) that detects when the push switch 47L is operated.

[0066] As shown in Figure 4, in this embodiment, the position of the point of application POA, where the force for operating the push switch 47L acts on the oscillating part 50L, is located inside the two-dimensional virtual reference plane VRP that extends vertically upward from the rotation axis RA of the oscillating part 50L (to the right of the virtual reference plane VRP in Figure 4). Furthermore, when the oscillating part 50L starts to rotate and oscillate from the standby position SP toward the operating position OP, the height of the point of application POA gradually increases as it moves outward from the standby position SP. Therefore, even if a force including a downward force is applied to the oscillating part 50L at the point of application POA while the oscillating part 50L is in the standby position SP, the point of application POA is located inside the virtual reference plane VRP, making it difficult for a force in the direction of rotation to be applied to the oscillating part 50L. Therefore, when the push switch 47L is operated, even if a force is applied to the push switch 47L diagonally downward and outward, the malfunction of the side switch 45L rotating and oscillating along with the push switch 47L is less likely to occur. As a result, the operator can operate the foot switch 40 appropriately.

[0067] In the example shown in Figure 4, when the oscillating unit 50L begins to rotate and oscillate from the standby position SP towards the operating position OP, the height of the point of application POA gradually increases. Subsequently, as the point of application POA passes the apex position VP located vertically above the rotation axis RA, the height of the point of application POA gradually decreases as it approaches the operating position OP.

[0068] In this embodiment, when the oscillating part 50L is in the standby position, the pivot point of the push switch biasing part 49L is located inside the virtual reference plane VRP (to the right in Figure 4). In this case, when the push switch 47L is operated, the pivot point of the push switch biasing part 49L becomes the point of application, and force is applied to the oscillating part 50L of the side switch 45L. However, because the pivot point of the push switch biasing part 49L is located inside the virtual reference plane VRP, the problem of the side switch 45L rotating and oscillating together with the push switch 47L is less likely to occur. Therefore, it becomes easier for the operator to operate the foot switch 40 appropriately.

[0069] As shown in Figure 4, when the side switch 45L and the oscillating part 50L are positioned in the standby position SP, the direction PD in which the push switch 47L is pressed is inclined diagonally outward (to the left in Figure 4) relative to the vertically downward direction. As a result, even if the operator presses the push switch 47L in a direction diagonally outward relative to the vertically downward direction, only the push switch 47L itself is pressed diagonally downward, and it becomes difficult for a force to be applied to the side switch 45L on which the push switch 47L is provided in a direction that causes it to rotate and oscillate outward. Therefore, the problem of the side switch 45L rotating and oscillating together with the push switch 47L is further reduced.

[0070] As shown in Figure 3, when the foot switch 40 of this embodiment is viewed from above, multiple push switches (in this embodiment, the left push switch 47L and the right push switch 47R) are provided within a radius 55 of 25 cm centered on the center 42C of the heel rest 42. As mentioned above, with the foot switch 40 of this embodiment, the problem of the side switches 45L and 45R being operated along with the push switches 47L and 47R without the practitioner applying downward force to the push switches 47L and 47R is less likely to occur. Therefore, the practitioner can operate the push switches 47L and 47R simply by rotating their toes and stepping down while keeping their heel on the heel rest 42 (that is, without removing their foot from the heel rest 42). Furthermore, by arranging multiple push switches 47L and 47R within a radius 55 of 25 cm centered on the central part 42C of the heel rest 42, the operator can operate the multiple push switches 47L and 47R while keeping their heel on the heel rest 42. Thus, the operability of the foot switch 40 is further improved.

[0071] (Peristaltic pump) Referring to Figure 5, the peristaltic pump 60 used as the perfusion pump 11 and suction pump 21 in the ophthalmic surgical apparatus 1 of this embodiment will be described. In the ophthalmic surgical apparatus 1 of this embodiment, the same peristaltic pump 60 is used for both the perfusion pump 11 and the suction pump 21. The peristaltic pump 60 can change the pressure of the fluid in the flow path by rotating while pressing against a flexible flow path (for example, the perfusion path 10 and the suction path 20).

[0072] As shown in Figure 5, the peristaltic pump 60 of this embodiment comprises a motor 61, an operating shaft 63, a roller unit 65, a slitted rotating part 68, and a sensor 69. The motor 61 rotates the operating shaft 63 around its axis. A stepping motor is used for the motor 61 in this embodiment. The operating shaft 63 protrudes outward (upward and downward in Figure 5) from both ends of the housing of the motor 61. The roller unit 65 is fixed to one end of the operating shaft 63. When the roller unit 65 is viewed from a direction along the axis of the operating shaft 63, the roller unit 65 has a plurality (six in this embodiment) of pump rollers 66 arranged in positions that are rotationally symmetrical (six rotational symmetry in this embodiment) with respect to the operating shaft 63. When the operating shaft 63 rotates, the plurality of pump rollers 66 rotate around the operating shaft 63. As a result, the fluid pressure in the fluid passage is changed as the passage adjacent to the roller unit 65 is compressed by the rotating pump rollers 66.

[0073] A slitted rotating part 68 is fixed to the end of the operating shaft 63 opposite to the end on which the roller unit 65 is fixed. When the slitted rotating part 68 is viewed from a direction along the axis of the operating shaft 63, slits that can be detected by the sensor 69 are formed on the outer circumference of the slitted rotating part 68 at positions corresponding to the positions where each of the multiple pump rollers 66 is installed in the roller unit 65 (i.e., positions that overlap with the installation positions of the pump rollers 66 when viewed from a direction along the axis of the operating shaft 63). In other words, when the slit reaches the position detected by the sensor 69, it means that one of the multiple pump rollers 66 has reached a predetermined position (a position that overlaps with the slit when viewed from the axial direction). Therefore, the control unit 30 can obtain that one of the pump rollers 66 has reached a predetermined position based on the detection result from the sensor 69.

[0074] In the peristaltic pump 60, the positive and negative pressure can be easily changed by reverse rotation, and the flow path (tube, etc.) can also be easily replaced. On the other hand, when using the peristaltic pump 60, the repeated contact and separation of each of the multiple pump rollers 66 equipped with the peristaltic pump 60 from the flow path results in fluctuations in the fluid pressure, known as pulsation. In particular, simply employing the peristaltic pump 60 for both the perfusion pump 11 and the suction pump 21 may cause the pulsation from the perfusion pump 11 and the pulsation from the suction pump 21 to combine, potentially leading to significant fluctuations in intraocular pressure. The ophthalmic surgical apparatus 1 of this embodiment makes it possible to suppress the effects of pulsation during intraoperative processing (see Figure 6).

[0075] (Processing to suppress pulsation) The intraoperative processing performed by the ophthalmic surgical apparatus 1 of this embodiment will be described with reference to Figures 6 and 7. The intraoperative processing is performed during surgery on the patient's eye E. Figure 6 illustrates the intraoperative processing while cataract surgery is performed on the patient's eye E using the ultrasonic handpiece 7 (see Figure 1). The CPU 31 of the control unit 30 executes the intraoperative processing illustrated in Figure 6 according to the ophthalmic surgical control program stored in the non-volatile memory 35.

[0076] First, the CPU 31 determines whether the operator has input an instruction to supply only irrigation pressure via the main pedal 43 of the foot switch 40 (S1). As described above, the main pedal 43 of the foot switch 40 in this embodiment outputs a signal to sequentially switch the mode to be performed by the ophthalmic surgical device 1 as the amount of the pedal operation increases: irrigation mode (a mode in which only irrigation fluid is supplied into the eye), irrigation aspiration mode (a mode in which both irrigation fluid is supplied into the eye and waste fluid is aspirated from the eye), and irrigation aspiration emulsification mode (a mode in which irrigation fluid is supplied, waste fluid is aspirated, and emulsification by ultrasound is performed). If the main pedal 43 is not pressed and no instruction to perform surgery has been input (S1: NO), the CPU 31 stops the rotation of the irrigation pump 11 (S2) and repeats the determination in S1.

[0077] If an instruction to execute the perfusion mode, which only supplies perfusion fluid into the eye, is received (S1:YES), the CPU 31 starts rotating the perfusion pump 11 at a rotation speed corresponding to the signal (S3). Next, the CPU 31 determines whether an instruction to start the perfusion suction mode, which simultaneously supplies perfusion fluid into the eye and suctions waste fluid from the eye, has been received by the main pedal 43 (S5). If an instruction to start the perfusion suction mode has not been received (S5:NO), the process returns to S1, and the processes from S1 to S5 are repeated.

[0078] When an instruction to start the perfusion and suction mode is received (S5: YES), the CPU 31 starts rotating the suction pump 21 at a rotation speed corresponding to the input signal, in addition to rotating the perfusion pump 11 (S6). Furthermore, the CPU 31 performs pulsation suppression processing (S12-S14) to suppress the pulsation of intraocular pressure in the patient's eye E caused by the perfusion pump 11 and the suction pump 21. If the phase and rotation speed of both the perfusion pump 11 and the suction pump 21 are matched, the pulsation from the perfusion pump 11 and the pulsation from the suction pump 21 will be combined. In contrast, the ophthalmic surgical apparatus 1 of this embodiment synchronizes the average rotation speed of the perfusion pump 11 and the suction pump 21 while appropriately adjusting the amount of phase difference between them, thereby canceling out the pulsation from the perfusion pump 11 and the suction pump 21 and suppressing their influence. As a result, surgery can be performed more appropriately.

[0079] In this embodiment, when the CPU 31 performs pulsation suppression processing (S12-S14), it first rotates one of the perfusion pump 11 and the suction pump 21 at a higher speed than the other (S12). As a result, the amount of phase difference between the perfusion pump 11 and the suction pump 21 fluctuates over time, allowing the amount of phase difference to be adjusted to a predetermined amount. At the timing when the amount of phase difference between the perfusion pump 11 and the suction pump 21 is adjusted to a predetermined amount, the CPU 31 synchronizes the average rotation speed of the perfusion pump 11 and the suction pump 21 (S13, S14). As a result, intraocular pressure pulsation is appropriately suppressed.

[0080] In step S12 of this embodiment, the CPU 31 adjusts the phase difference between the rotations to a predetermined amount by stopping the rotation of one of the perfusion pump 11 and the suction pump 21 while rotating the other. However, the CPU 31 may also adjust the phase difference between the rotations by rotating both the perfusion pump 11 and the suction pump 21 and making the average rotation speed of one greater than the average rotation speed of the other.

[0081] In detail, in S12 of this embodiment, the CPU 31 adjusts the phase difference of rotation to a predetermined amount by rotating the suction pump 21 at an average rotational speed greater than that of the perfusion pump 11 while the perfusion pump 11 is stopped or rotating. In this case, for example, even if the surgeon has entered an instruction to perform drainage fluid suction, the possibility of the suction stopping or the suction force decreasing, causing discomfort to the surgeon, is reduced. Therefore, surgery can be performed more appropriately.

[0082] Referring to Figure 7, an example of the operation of the perfusion pump 11 and suction pump 21 when pulsation suppression processing (S12-S14) is performed will be described. In Figure 7, "Perfusion pump contact start" indicates that the timing at which one of the multiple pump rollers 66 of the perfusion pump 11 begins to make contact with the perfusion path 10 has been detected by the sensor 69 (see Figure 5). "Perfusion pump pulse" indicates the pulse state of the motor 61 (pulse motor) that rotates the perfusion pump 11. "Suction pump contact start" indicates that the timing at which one of the multiple pump rollers 66 of the suction pump 21 begins to make contact with the suction path 20 has been detected by the sensor 69. "Suction pump pulse" indicates the pulse state of the motor 61 (pulse motor) that rotates the suction pump 21.

[0083] As shown in Figure 7, the CPU 31 controls the rotational speed of each peristaltic pump to suppress the generation of pulsation in each peristaltic pump when rotating the perfusion pump 11 and the suction pump 21. As a result, the rotational speed of the peristaltic pump changes during the rotational movement of one pump roller 66 (i.e., a rotational movement of approximately 60 degrees).

[0084] In this embodiment, the CPU 31 adjusts the phase difference between the perfusion pump 11 and the suction pump 21 to a phase difference that cancels out the pulsations and becomes small (preferably the smallest), and then synchronizes the average rotational speeds of the perfusion pump 11 and the suction pump 21 to suppress the effects of pulsations. During synchronization of average rotational speeds, the time T required for the rotational operation of one pump roller 66 of each of the perfusion pump 11 and the suction pump 21 is the same. In other words, during synchronization of average rotational speeds, the number of rotations of the pump roller 66 per unit time is also the same between the perfusion pump 11 and the suction pump 21.

[0085] In the example shown in Figure 7, initially only the perfusion pump 11 is rotating, and the suction pump 21 is stopped. Then, when the main pedal 43 is operated to input a command to start the perfusion-suction mode, which simultaneously supplies perfusion fluid to the eye and suctions waste fluid from the eye, the CPU 31 starts rotating the suction pump 21. Furthermore, the CPU 31 stops or slows down the rotation of the perfusion pump 11 so that the average rotation speeds of the perfusion pump 11 and the suction pump 21 are different. As a result, the amount of phase difference between the perfusion pump 11 and the suction pump 21 fluctuates over time. When the amount of phase difference is adjusted to a predetermined amount that reduces the effect of pulsation, the CPU 31 starts synchronizing the average rotation speeds of the perfusion pump 11 and the suction pump 21. As a result, the effect of pulsation is appropriately suppressed.

[0086] In this embodiment, the amount of phase shift of rotation adjusted in S12 to S14 is determined in advance by experiment or simulation, etc., so that the pulsations of the two peristaltic pumps (perfusion pump 11 and suction pump 21) cancel each other out as much as possible. However, if a pressure sensor or the like capable of detecting changes in fluid pressure (including pulsations) is provided, the CPU 31 may appropriately determine the amount of phase shift that makes it easier for the pulsations of the two peristaltic pumps to cancel each other out as much as possible, based on the detected changes in fluid pressure.

[0087] Returning to the explanation of Figure 6, in this embodiment, the CPU 31 performs pulsation suppression processing (S12-S14) when it further starts rotating the suction pump 21 (S6) while the perfusion pump 11 is rotating (S3). In a typical ophthalmic surgery, the suction of waste fluid by the suction pump 21 is started when the perfusion pressure has already been generated by the perfusion pump 11. By performing pulsation suppression processing at the start of suction by the suction pump 21, the pulsation of intraocular pressure during suction is more easily and appropriately suppressed.

[0088] Furthermore, the CPU 31 determines whether the pressure of the irrigating fluid supplied into the eye (irrigation pressure) has fluctuated due to, for example, blockage of the suction path of a surgical instrument or fluid leakage (S8). If the irrigation pressure has not fluctuated (S8: NO), the process proceeds directly to S11. If the irrigation pressure has fluctuated (S8: YES), the CPU 31 controls the drive of the irrigation pump 11 to perform an irrigation pressure restoration process to return the fluctuated irrigation pressure to within the target range (S9). When the irrigation pressure restoration process is performed, the synchronization between the irrigation pump 11 and the suction pump 21, which were controlled by the previous pulsation suppression process (S12~S14), often becomes misaligned. Therefore, when the irrigation pressure restoration process is performed, the CPU 31 performs the pulsation suppression process (S12~S14) again. As a result, even if the synchronization of the two peristaltic pumps becomes misaligned, the synchronization is appropriately restored.

[0089] Furthermore, while synchronizing the average rotational speeds of the perfusion pump 11 and the suction pump 21, the CPU 31 monitors the amount of phase difference in rotation and determines whether the amount of difference falls outside the target range (S11). If the amount of difference is within the target range (S11: NO), the process proceeds directly to S16. If the amount of phase difference in rotation falls outside the target range (S11: YES), the CPU 31 executes the pulsation suppression process (S12~S14) again. Even when attempting to synchronize the average rotational speeds of the two peristaltic pumps, synchronization may still occur. When synchronization is disrupted, the amount of phase difference in rotation may fall outside the target range. In response to this, the CPU 31 monitors the amount of phase difference during rotational synchronization and readjusts the amount of difference if it falls outside the target range, thereby more effectively suppressing the effects of pulsation.

[0090] The CPU 31 determines whether an instruction to execute the perfusion suction emulsification mode (a mode that performs all of the following: supply of perfusion fluid, suction of waste fluid, and emulsification by ultrasound) has been received (S16). If no instruction has been received (S16: NO), the process returns to S19. If an instruction to execute the perfusion suction emulsification mode has been received (S16: YES), the CPU 31 applies ultrasonic vibration to the ultrasonic tip 8 of the ultrasonic handpiece 7 (S17), and the process proceeds to S19.

[0091] The CPU 31 determines whether an instruction to stop suction (i.e., an instruction to switch to a perfusion mode that only supplies perfusion fluid into the eye) has been input (S19). If no instruction to stop suction has been input (S19: NO), the process returns to S8, and the processes from S8 to S19 are repeated. If an instruction to stop suction has been input (S19: YES), the CPU 31 stops the rotation of the suction pump 21 (S20), and the process returns to S1.

[0092] (Inputting instructions via sound) Referring to Figures 8 and 9, the process for receiving audible instructions from the surgeon will be described. The ophthalmic surgical device 1 of this embodiment can perform control (hereinafter referred to as "sound control") that generates instruction signals for the ophthalmic surgical device 1 by performing sound recognition processing on the sound input to the speaker 37. Therefore, by having the surgeon themselves input instructions by sound, the possibility of operations unintended by the surgeon being performed by other assistants is appropriately reduced. On the other hand, simply performing sound recognition processing may result in sound recognition processing being performed on conversations that are not intended to be instructions, potentially generating instructions contrary to the surgeon's intentions. In the sound instruction input processing of this embodiment (see Figures 8 and 9), enabling or disabling sound control can be switched by operating the foot switch 40. As mentioned above, during ophthalmic surgery, the surgeon is holding surgical instruments, making it difficult to input operation instructions to the ophthalmic surgical device 1 by hand. However, by using the foot switch 40, it is possible to appropriately switch whether or not to enable sound control even during ophthalmic surgery. As a result, the possibility of generating instructions contrary to the surgeon's intentions is reduced, and the audible instructions are more easily input to the ophthalmic surgical device 1.

[0093] (First aspect of sound instruction input processing) First, with reference to Figure 8, the first embodiment of the sound instruction input processing will be described. In the first embodiment of the sound instruction input processing, whether or not to enable sound control is switched depending on the operation of a sub-operation unit of the foot switch 40 that is different from the main pedal 43. Therefore, even while operating the main pedal 43, the surgeon can switch whether or not to enable sound control by operating the sub-operation unit while operating the main pedal 43. Thus, even during surgery when the surgeon's hands are occupied, voice instructions can be appropriately input to the ophthalmic surgical device 1.

[0094] In detail, in the sound instruction input processing of the first embodiment, the activation or deactivation of sound control is switched in response to the operation of at least one of the side switches 45L and 45R located on the side of the main pedal 43. Therefore, the operator can switch the activation or deactivation of sound control even while operating the main pedal 43 by moving their foot laterally while the main pedal 43 is pressed down. In the following, the case in which the suction flow rate of the suction pump 21 is changed from 20 mL / min to 30 mL / min will be explained as an example.

[0095] As shown in Figure 8, the CPU 31 determines whether the main pedal 43 of the foot switch 40 is being operated (S31). If the main pedal 43 is not pressed and no instruction to perform surgery has been input (S31: NO), the CPU 31 repeats the determination in S31 and enters a standby state. If the main pedal 43 is pressed (S31: YES), the CPU 31 starts outputting an operation instruction signal corresponding to the amount the main pedal 43 is pressed (S32). As described above, the main pedal 43 of the foot switch 40 in this embodiment outputs a signal to switch the mode to be executed by the ophthalmic surgery device 1 as the amount of the pressing operation increases. The CPU 31 outputs an operation instruction signal according to the mode.

[0096] Next, the CPU 31 determines whether at least one of the side switches 45L and 45R of the foot switch 40 has been operated (S34). If neither side switch 45L nor 45R has been operated (S34: NO), the process returns to S31, and steps S31 to S34 are repeated. If either side switch 45L or 45R has been operated (S34: YES), the CPU 31 enables sound control (S35).

[0097] In this embodiment, audible control is enabled while side switches 45L and 45R are operated, and disabled when side switches 45L and 45R are released. Also, in this embodiment, audible control is enabled regardless of whether either of the two side switches 45L or 45R is operated. However, audible control may be enabled only when one of the two side switches 45L or 45R is operated.

[0098] Next, the CPU 31 determines whether or not sound (e.g., speech) has been input to the microphone 36 (S37). For example, if the operator wants to change the suction flow rate from the suction pump 21 from 20 mL / min to 30 mL / min, they should say "flow rate 30" or "flow rate up by 10". If no sound is input (S37: NO), the process proceeds directly to S41. If sound is input (S37: YES), the CPU 31 performs sound recognition processing on the sound input to the microphone 36, converting the input sound into information that can be processed by a computer (e.g., text information). Based on the result of the sound recognition processing, the CPU 31 recognizes the content of the instruction given by sound (S38). Furthermore, the CPU 31 outputs the instruction content recognized in S38 to the speaker 37 (S39). For example, if the result of the sound recognition processing is "flow rate 30", the CPU 31 outputs the voice "flow rate 30" to the speaker 37. Therefore, the surgeon can confirm whether the intended instructions have been accurately recognized by the ophthalmic surgical device 1 by the sound output by the speaker 37.

[0099] In the first embodiment of the sound instruction input processing, if the intended instruction is accurately recognized by the ophthalmic surgical device 1, the surgeon can release the operation of the side switches 45L and 45R, thereby causing the ophthalmic surgical device 1 to actually generate (confirm) the signal of the instruction input by sound, while simultaneously ending (disabling) the sound control. In other words, the surgeon can have the ophthalmic surgical device 1 perform both the confirmation of the instruction content and the disabling of the sound control simply by releasing the operation of the side switches 45L and 45R. Furthermore, if the intended instruction is not accurately recognized by the ophthalmic surgical device 1, the surgeon can continue to operate the side switches 45L and 45R and repeatedly generate sounds (for example, "flow rate 30" or "flow rate up 10" in this example) until the desired instruction content is recognized by the ophthalmic surgical device 1. Note that if the operation of the main pedal 43 is released and the ophthalmic surgery is interrupted or terminated, the sound control will remain disabled.

[0100] Specifically, the CPU 31 determines whether the operation of the main pedal 43 has been released (S41). If the operation of the main pedal 43 is released (S41: YES), the CPU 31 disables the sound control (S44) and the process returns to S31. If the operation of the main pedal 43 is not released (S41: NO), the CPU 31 determines whether the operation of the side switches 45L and 45R has been released (S42). If neither the operation of the main pedal 43 nor the side switches 45L and 45R has been released (S42: NO), the process returns to S37 and the sound input becomes possible again. If the operation of the side switches 45L and 45R is released (S42: YES), the CPU 31 generates and outputs a signal to execute the instruction content that was recognized in S38 and output in S39 immediately before (last) (in this example, the instruction content of "flow rate 30" or "flow rate 10 up" regarding the suction flow rate) (S43). Next, CPU31 disables sound-based control (S44), and processing returns to S31.

[0101] It is also possible to change the specific content of the sound instruction input processing in the first embodiment. For example, the CPU 31 may start enabling sound control when one of the left and right side switches 45L, 45R is operated. While sound control is enabled, the CPU 31 may disable sound control when one of the left and right side switches 45L, 45R (which may be the same side switch that started the activation, or a different side switch) is operated again. In this case, the enabling and disabling of sound control is switched appropriately at the timing of the operation of the side switches 45L, 45R, making it easier to perform ophthalmic surgery smoothly. In addition, after outputting the recognized instruction content to the speaker 37, the CPU 31 may generate a signal to execute the instruction output to the speaker 37 when one of the left and right side switches 45L, 45R is operated, while resetting without generating a signal for the instruction output to the speaker 37 when the other side switch is operated. In this case, the instructions desired by the surgeon can be more accurately input into the ophthalmic surgical device 1.

[0102] (Second aspect of sound instruction input processing) Referring to Figure 9, the second mode of sound instruction input processing will be described. In the second mode of sound instruction input processing, sound control is enabled when the main pedal 43 of the foot switch 40, which is pressed by the surgeon's foot, is being operated, and sound control is disabled when the main pedal 43 is not being operated. The main pedal 43 is always operated during ophthalmic surgery. Therefore, by enabling sound control when the main pedal 43 is being operated, sound control is always enabled during ophthalmic surgery. On the other hand, when ophthalmic surgery is not being performed (when the main pedal 43 is not being operated), sound control is appropriately disabled, so the possibility of unintended instructions being input is appropriately reduced. Therefore, ophthalmic surgery can be performed more smoothly.

[0103] As shown in Figure 10, the CPU 31 determines whether or not the main pedal 43 of the foot switch 40 is being operated (S51). If the main pedal is not pressed and no instruction to perform surgery has been input (S51: NO), the CPU 31 repeats the determination in S51 and enters a standby state. If the main pedal 43 is pressed (S51: YES), the CPU 31 starts outputting an operation instruction signal corresponding to the amount the main pedal 43 is pressed (S52). Furthermore, the CPU 31 enables audible control while the main pedal 43 is pressed (S53).

[0104] Next, the CPU 31 determines whether or not sound (e.g., speech) has been input to the microphone 36 (S55). For example, if the operator wants to change the suction flow rate from the suction pump 21 from 20 mL / min to 30 mL / min, they should say "flow rate 30" or "flow rate up by 10". If no sound is input (S55: NO), the process proceeds directly to S59. If sound is input (S55: YES), the CPU 31 performs sound recognition processing on the sound input to the microphone 36, converting the input sound into information that can be processed by a computer (e.g., text information). Based on the result of the sound recognition processing, the CPU 31 recognizes the content of the instruction given by the sound (S56). Furthermore, the CPU 31 outputs the instruction content recognized in S56 to the speaker 37 (S57). For example, if the result of the sound recognition processing is "flow rate 30", the CPU 31 outputs the voice "flow rate 30" to the speaker 37. Therefore, the surgeon can confirm whether the intended instructions have been accurately recognized by the ophthalmic surgical device 1 by the sound output by the speaker 37.

[0105] In the second embodiment, of the pair of left and right side switches 45L and 45R, one side switch is used to confirm the recognized instruction, and the other side switch is used to cancel the recognized instruction. The CPU 31 determines whether the side switch used to confirm the instruction has been operated (S59). If it has not been operated (S59: NO), the process proceeds directly to S62. If the side switch used to confirm the instruction has been operated (S59: YES), the CPU 31 generates and outputs a signal to execute the instruction recognized in S56 and output in S57 (in this example, the instruction content for the suction flow rate is "flow rate 30" or "flow rate 10 up") (S60).

[0106] The CPU 31 also determines whether the side switch for canceling the instruction has been operated (S62). If it has not been operated (S62: NO), the process proceeds directly to S65. If the side switch for canceling the instruction has been operated (S62: YES), the CPU 31 cancels the instruction recognized in S56 and output in S57 (S63), and the process proceeds to S65.

[0107] The CPU 31 determines whether the operation of the main pedal 43 has been released (S65). If the operation of the main pedal 43 has not been released (S65: NO), the process returns to S55, and sound control continues. If the operation of the main pedal 43 is released (S65: YES), the CPU 31 disables sound control (S66), and the process returns to S51.

[0108] The technologies disclosed in the above embodiments are merely examples. Therefore, it is possible to modify the technologies exemplified in the above embodiments. First, it is also possible to implement only some of the technologies exemplified in the above embodiments. For example, when performing the sound instruction input processing exemplified in Figures 8 and 9, the foot switch 40 exemplified in Figures 2 to 4 may be used, or a different foot switch may be used. Furthermore, the in-operative processing exemplified in Figure 6 and the sound instruction input processing exemplified in Figures 8 and 9 may both be performed by the same ophthalmic surgical device 1, or only one of the processes may be performed. [Explanation of Symbols]

[0109] 1 Ophthalmic surgery equipment 4 Irrigation fluid source 10 Perfusion pathways 11 Perfusion pump 20. Suction route 21 Suction pump 30 Control Unit 31 CPU 35 Non-volatile memory 36 Mike 37 speakers 40 Foot switches for ophthalmic surgery 42 Heel rest 43 Main pedal 45 (45L, 45R) Side Switch 47 (47L, 47R) Push-button switch

Claims

1. An ophthalmic surgical foot switch that is connected to an ophthalmic surgical device used to operate on a patient's eye and outputs a signal to the ophthalmic surgical device when operated by the surgeon's foot, The main pedal, which is operated by the operator's foot by pressing it downwards, outputs a first signal corresponding to the amount of operation, A side switch is provided on the side of the main pedal, protruding above the pressing surface of the main pedal, and which outputs a second signal when operated outward in the lateral direction. A push switch is provided above the aforementioned side switch and outputs a third signal when operated downwards, Equipped with, The aforementioned side switch is A swinging part that rotates and swings in the left-right direction about a rotation axis extending in the front-rear direction, within a predetermined swing range between an inner standby position when the side switch is not operated and an outer operating position when the side switch is operated, The swinging part is biased towards the standby position within the swinging range by a side switch biasing part, Equipped with, When the oscillating part is in the standby position, the point at which the force for operating the push switch acts on the oscillating part is located inside a virtual reference plane extending vertically upward from the rotation axis of the oscillating part. An ophthalmic foot switch characterized in that, when the oscillating part starts to rotate and oscillate from the standby position toward the operating position, the height of the point of action gradually increases as it moves outward from the standby position.

2. An ophthalmic foot switch according to claim 1, A foot switch for ophthalmic surgery, characterized in that, when the side switch is positioned in the standby position, the direction in which the push switch is pressed is inclined diagonally outward with respect to the vertically downward direction.

3. A foot switch for ophthalmic surgery according to claim 1 or 2, The aforementioned side switch is A push switch support portion that supports the push switch in a state where it can move back and forth, A push switch biasing part biases the push switch, which is supported by the push switch support part, upward along the reciprocating movement direction, Equipped with, An ophthalmic foot switch characterized in that, when the oscillating part is in the standby position, the pivot point of the push switch biasing part is located inside the virtual reference plane.

4. An ophthalmic foot switch according to any one of claims 1 to 3, Further in front of the main pedal, there is a heel rest on which the operator's heel rests. An ophthalmic foot switch characterized in that, when viewed from above, it is provided with a plurality of push switches within a radius of 25 cm centered on the center of the heel rest.

5. An ophthalmic surgical apparatus equipped with an ophthalmic foot switch according to any one of claims 1 to 4.

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