Ophthalmic surgical equipment and ophthalmic surgical cassettes

Abstract

To provide an ophthalmic surgical device and an ophthalmic surgical cassette that can appropriately suppress the effects of pulsation caused by a peristaltic pump. [Solution] The ophthalmic surgical apparatus comprises a perfusion pathway, a peristaltic perfusion pump, and a perfusion fluid reservoir chamber. The perfusion pathway allows perfusion fluid supplied from a perfusion fluid source to pass through the surgical instruments. The peristaltic perfusion pump is installed in the perfusion pathway and changes the pressure within the perfusion pathway by rotating while pressing the flexible perfusion pathway with multiple pump rollers. The perfusion fluid reservoir chamber is installed in the perfusion pathway between the peristaltic perfusion pump and the surgical instruments and stores the perfusion fluid in a sealed state with gas inside.

Description

Technical Field

[0001] The present disclosure relates to an ophthalmic surgical device for supplying a perfusion fluid into the eye of a patient and aspirating waste tissue in the eye as waste fluid together with the perfusion fluid, and an ophthalmic surgical cassette that is detachably attached to the ophthalmic surgical device.

Background Art

[0002] An ophthalmic surgical device used in ophthalmic surgery (for example, cataract surgery or vitreous surgery) needs to supply a perfusion fluid into the eye of a patient and aspirate waste fluid from the eye. For example, the device described in Patent Document 1 includes a peristaltic pump as a suction pump for aspirating waste fluid. The peristaltic pump can change the pressure of the fluid in the flow path by rotating while pressing a flexible flow path. In recent years, in addition to a suction pump that changes the pressure (suction pressure) for aspirating waste fluid, an ophthalmic surgical device equipped with a perfusion pump that changes the pressure (perfusion pressure) for supplying the perfusion fluid has also been proposed.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] In a peristaltic pump, it is easy to change the positive and negative of the pressure by reverse rotation, and it is also easy to replace the flow path (such as a tube). Therefore, various advantages can be obtained by adopting a peristaltic pump. Therefore, it is useful if a peristaltic pump can be used for the perfusion pump. On the other hand, when a peristaltic pump is used, as a result of the repeated contact of each of the plurality of pump rollers provided in the peristaltic pump with the flow path and separation from the flow path, fluctuations in the pressure of the fluid called pulsation occur. Therefore, it is desirable to be able to appropriately suppress the influence of pulsation by the peristaltic pump.

[0005] A typical object of the present invention is to provide an ophthalmic surgical apparatus and an ophthalmic surgical cassette that can appropriately suppress the effects of pulsation caused by a peristaltic pump. [Means for solving the problem]

[0006] An ophthalmic surgical apparatus provided by a typical embodiment of the present disclosure is an ophthalmic surgical apparatus that supplies an irrigation fluid from an irrigation fluid source into the eye of a patient's eye and aspirates waste liquid containing the patient's eye waste tissue and the irrigation fluid from the eye, comprising: an irrigation path for passing the irrigation fluid supplied from the irrigation fluid source through surgical instruments; a peristaltic irrigation pump provided in the irrigation path and rotating the flexible irrigation path while pressing it with a plurality of pump rollers to change the pressure in the irrigation path; and an irrigation fluid reservoir chamber provided in the path between the peristaltic irrigation pump and the surgical instruments in the irrigation path and for storing the irrigation fluid in a sealed state with gas inside.

[0007] An ophthalmic surgical cassette provided by a typical embodiment of the present disclosure is an ophthalmic surgical cassette that is detachably attached to an ophthalmic surgical apparatus that supplies irrigation fluid supplied from an irrigation fluid source into the eye of a patient's eye by supplying it to surgical instruments through an irrigation pathway, and aspirates waste liquid containing waste tissue and the irrigation fluid from the eye, wherein the ophthalmic surgical apparatus includes a peristaltic irrigation pump that changes the pressure in the irrigation pathway by rotating a flexible portion of the irrigation pathway while pressing it with a plurality of pump rollers, and the ophthalmic surgical cassette includes an irrigation fluid reservoir chamber provided on the path between the peristaltic irrigation pump and the surgical instruments in the irrigation pathway, and stores the irrigation fluid in a sealed state with gas inside.

[0008] The ophthalmic surgical device and ophthalmic surgical cassette described herein effectively suppress the effects of pulsation caused by peristaltic pumps. [Brief explanation of the drawing]

[0009] [Figure 1]This is a perspective view of the external appearance of ophthalmic surgical apparatus 1. [Figure 2] This diagram schematically shows the configuration of the ophthalmic surgical apparatus 1. [Figure 3] This is a view of a portion of the cassette 20 of this embodiment, seen from the back. [Figure 4] This is a perspective view of the cassette 20 as it is mounted in the cassette holding unit 14. [Figure 5] This is a front view of the peristaltic perfusion pump 50 and the pressing wall section 60 with the cassette 20 mounted on the cassette holding unit 14. [Figure 6] This is a front view of the peristaltic suction pump 80 and the pressing wall portion 90 with the cassette 20 mounted on the cassette holding unit 14. [Figure 7] This is a flowchart of the automated supply process performed by the ophthalmic surgical device 1. [Modes for carrying out the invention]

[0010] <Overview> (First aspect) The ophthalmic surgical apparatus of this disclosure supplies irrigation fluid from an irrigation fluid source into the eye of a patient. A first aspect of the ophthalmic surgical apparatus of this disclosure comprises an irrigation pathway, a peristaltic irrigation pump, and a pressing wall. The irrigation pathway allows the irrigation fluid supplied from the irrigation fluid source to pass through surgical instruments. The peristaltic irrigation pump is provided in the irrigation pathway. The peristaltic irrigation pathway changes the pressure within the irrigation pathway by pressing a flexible pressure-receiving portion within the irrigation pathway with pump rollers. The pressing wall clamps the pressure-receiving portion of the irrigation pathway between itself and the pump rollers of the peristaltic irrigation pump. The peristaltic irrigation pump comprises a roller unit. The roller unit has a plurality of pump rollers arranged along a circular arrangement centered on a rotation axis, and rotates around the rotation axis to sequentially bring the plurality of pump rollers into contact with the pressure-receiving portion. The pressing wall is positioned opposite the outer surface of the roller unit, forming an arc-shaped arrangement between it and the roller unit where the pressed portion of the perfusion path is positioned. The pressing wall is formed in a curved shape, extending from the upstream side, which is the perfusion fluid source side of the perfusion path, to the downstream side, which is the surgical instrument side. The distance between the downstream region, which is a certain area of ​​the pressing wall extending from the downstream end towards the upstream side, and the outer surface of the roller unit gradually increases as it approaches the downstream side.

[0011] According to the ophthalmic surgical apparatus of this disclosure, a peristaltic pump (peristaltic perfusion pump) is used to change the pressure (perfusion pressure) within the perfusion path. Peristaltic perfusion pumps allow for easy reversal of the positive and negative pressure by reversing rotation. They also allow for easy replacement of the flow path (tube, etc.). On the other hand, using a peristaltic perfusion pump can cause pulsation in the perfusion pressure. In response to this, the ophthalmic surgical apparatus of this disclosure incorporates a mechanism to suppress pulsation caused by the peristaltic perfusion pump in the pressing wall portion that sandwiches the pressed portion of the perfusion path between the pump rollers of the peristaltic perfusion pump. The roller unit rotates around its axis of rotation, causing multiple pump rollers to sequentially contact the pressed portion of the perfusion path. The pressing wall portion is positioned opposite the outer circumferential surface of the roller unit, forming an arc-shaped arrangement between it and the roller unit where the pressed portion is located. The distance between the downstream region, including the downstream end of the pressing wall, and the outer surface of the roller unit gradually increases as it approaches the downstream side. Therefore, as the pump roller rotates from the upstream side to the downstream side, the pump roller gradually moves away from the pressed portion in the downstream region, and the pressure in the perfusion path downstream of the peristaltic perfusion pump also gradually decreases. As a result, the effects of pulsation caused by the peristaltic perfusion pump (for example, fluctuations in intraocular pressure in the patient's eye due to pulsation) are appropriately suppressed.

[0012] The curvature of the upstream region, which is a certain region located upstream of the downstream region within the pressing wall, may be greater than the curvature of the downstream region. In other words, the radius of curvature of the curve in the upstream region may be smaller than the radius of curvature of the curve in the downstream region.

[0013] In this case, in the upstream region, as the pump roller rotates from upstream to downstream, the compressed portion of the perfusion path is more likely to remain strongly compressed. As a result, the pressure within the perfusion path changes appropriately. Furthermore, in the downstream region, as the pump roller gradually moves away from the compressed portion, the effects of pulsation from the peristaltic perfusion pump are appropriately suppressed. Therefore, surgery can be performed more effectively.

[0014] The distance between the upstream region of the pressing wall and the outer surface of the roller unit may be constant. In this case, in the upstream region, as the pump roller rotates from upstream to downstream, the pressed portion of the perfusion path is continuously pressed with a nearly constant force. Therefore, when the peristaltic perfusion pump is driven, the pressure within the perfusion path can be changed more appropriately.

[0015] Regardless of the rotation angle of the roller unit, at least one of the multiple pump rollers provided on the roller unit may press the area to be pressed against the upstream region of the pressing wall. In this case, there will be no period during the rotation of the roller unit when the area to be pressed is not sufficiently pressed by any of the pump rollers. In other words, even when the pump roller located in the downstream region gradually moves away from the area to be pressed, the area to be pressed will continue to be sufficiently pressed by the other pump rollers located in the upstream region. Therefore, the ophthalmic surgical device can appropriately suppress the effects of pulsation in the downstream region while appropriately changing the pressure in the perfusion pathway in the upstream region.

[0016] (Second aspect) The ophthalmic surgical apparatus illustrated in this disclosure supplies irrigation fluid from an irrigation fluid source into the patient's eye and aspirates waste fluid containing waste tissue and irrigation fluid from the patient's eye. A second aspect of the ophthalmic surgical apparatus of this disclosure comprises an irrigation pathway, a peristaltic irrigation pump, and an irrigation fluid reservoir chamber. The irrigation pathway passes irrigation fluid supplied from the irrigation fluid source through the surgical instruments. The peristaltic irrigation pump is provided in the irrigation pathway and changes the pressure within the irrigation pathway by rotating while pressing the flexible irrigation pathway with a plurality of pump rollers. The irrigation fluid reservoir chamber is provided in the irrigation pathway between the peristaltic irrigation pump and the surgical instruments and stores irrigation fluid with a gas sealed inside.

[0017] According to the ophthalmic surgical apparatus of the present disclosure, a peristaltic pump (peristaltic perfusion pump) is used to change the pressure (perfusion pressure) in the perfusion path. The peristaltic perfusion pump can easily change the positive and negative of the pressure by reverse rotation. Also, it is easy to replace the flow path (such as a tube). On the other hand, when using a peristaltic perfusion pump, pulsation may occur in the perfusion pressure. In contrast, the ophthalmic surgical apparatus of the present disclosure includes a perfusion fluid reservoir chamber in the perfusion path. Since gas is sealed inside the perfusion fluid reservoir chamber, fluctuations in the perfusion pressure are absorbed by the gas in the perfusion fluid reservoir chamber. Therefore, the influence of pulsation by the peristaltic perfusion pump (for example, fluctuations in the intraocular pressure of the patient's eye due to pulsation, etc.) is appropriately suppressed.

[0018] The amount of gas sealed inside the perfusion fluid reservoir chamber may be adjustable. The ophthalmic surgical apparatus may further include a chamber pressure reduction pump and a chamber pressure sensor. The chamber pressure reduction pump reduces the pressure inside the perfusion fluid reservoir chamber by discharging the gas inside the perfusion fluid reservoir chamber to the outside. The chamber pressure sensor detects the pressure inside the perfusion fluid reservoir chamber. When the pressure inside the perfusion fluid reservoir chamber, which has been reduced by the chamber pressure reduction pump and detected by the chamber pressure sensor, reaches the set value, the discharge of the gas inside the perfusion fluid reservoir chamber by the chamber pressure reduction pump is stopped, and perfusion fluid may be supplied from the perfusion fluid source to the perfusion fluid reservoir chamber through the perfusion path.

[0019] The greater the amount of gas sealed inside the perfusion fluid reservoir chamber (hereinafter, may also be referred to as "the amount of air accumulation"), the easier it is to suppress the influence of pulsation by the peristaltic perfusion pump. However, the response speed (hereinafter, may also be referred to as "the response speed of perfusion pressure") until the perfusion pressure changed by the peristaltic perfusion pump is transmitted into the patient's eye decreases. On the other hand, the smaller the amount of air accumulation inside the perfusion fluid reservoir chamber, the higher the response speed of perfusion pressure. However, it becomes difficult to suppress the influence of pulsation by the peristaltic perfusion pump. Therefore, according to various factors that affect the perfusion pressure (for example, the material and dimensions of the perfusion path, etc.), by adjusting the amount of air accumulation in the perfusion fluid reservoir chamber to an appropriate amount, the influence of pulsation of perfusion pressure is appropriately suppressed in a state where the response speed of perfusion pressure is prevented from excessively decreasing.

[0020] Specifically, in a state where the pressure inside the perfusion fluid reservoir chamber (negative pressure lower than atmospheric pressure) reaches the set value, the discharge of gas inside the perfusion fluid reservoir chamber is stopped, and perfusion fluid is supplied into the perfusion fluid reservoir chamber, so that an air accumulation of an amount corresponding to the set value of pressure is likely to be formed inside the perfusion fluid reservoir chamber. That is, an air accumulation of the target amount is likely to be appropriately formed inside the perfusion fluid reservoir chamber. Therefore, the surgery by the ophthalmic surgical device is likely to be performed more appropriately.

[0021] The ophthalmic surgical device may further include a suction path, a suction pump, a vent path, a vent valve, and a perfusion valve. The suction path allows the waste liquid sucked from the eye through the surgical instrument to pass through. The suction pump is provided in the suction path and changes the suction pressure for sucking the waste liquid from the eye. The vent path connects between the perfusion fluid reservoir chamber and the surgical instrument in the perfusion path and between the surgical instrument and the suction pump in the suction path. The vent valve opens and closes the vent path. The perfusion valve is provided between the connection part of the vent path in the perfusion path and the surgical instrument and opens and closes the perfusion path. In a state where the path between the perfusion fluid reservoir chamber and the perfusion fluid source in the perfusion path is closed, the perfusion valve is closed, and the vent valve is opened, the gas inside the perfusion fluid reservoir chamber may be discharged to the outside by the suction pump. That is, the suction pump may function as a chamber pressure reduction pump.

[0022] In this case, the suction pump properly aspirates waste fluid from inside the patient's eye. When the vent valve closes the vent pathway, both the supply of irrigation fluid to the eye through the irrigation pathway and the aspiration of waste fluid from the eye through the suction pathway are properly performed. On the other hand, when the vent valve opens the vent pathway, irrigation fluid flows into the suction pathway through the vent pathway. Therefore, even if a phenomenon such as a temporary over-suction (a so-called "surge phenomenon") occurs due to the suction pathway being cleared of blockage by waste tissue, the vent valve control suppresses adverse effects caused by sudden changes in suction pressure.

[0023] Furthermore, the irrigation valve, vent valve, and suction pump expel the gas from the chamber to the outside, eliminating the need for additional components in the ophthalmic surgical apparatus to reduce the pressure inside the chamber. In other words, the components for aspirating waste fluid from the eye and for suppressing adverse effects from sudden changes in intraocular pressure are also used to reduce the pressure inside the chamber. Consequently, an appropriate amount of air is formed in the irrigation fluid reservoir chamber while keeping the configuration of the ophthalmic surgical apparatus simple.

[0024] However, it is also possible to change the method for reducing the pressure inside the irrigation fluid reservoir chamber. For example, with the portion of the irrigation pathway extending from the irrigation fluid reservoir chamber toward the surgical instrument side closed, the gas inside the irrigation fluid reservoir chamber may be discharged to the outside by rotating the peristaltic irrigation pump in the opposite direction to the direction that increases the irrigation pressure. In other words, the peristaltic irrigation pump may function as a chamber pressure reduction pump. Even in this case, it becomes unnecessary to provide a separate configuration for reducing the pressure inside the chamber in the ophthalmic surgical apparatus.

[0025] Furthermore, the ophthalmic surgical apparatus may employ a configuration for forming an appropriate amount of air pocket within the perfusion fluid reservoir chamber, separate from at least one of the perfusion valve, vent valve, suction pump, and peristaltic perfusion pump. For example, a chamber pressure reduction pump for discharging gas from the perfusion fluid reservoir chamber to the outside may be used separately from the suction pump and peristaltic perfusion pump.

[0026] The ophthalmic surgical apparatus may further include a perfusion pressure sensor, which is installed between the peristaltic perfusion pump and the surgical instruments in the perfusion pathway and detects the pressure of the perfusion fluid supplied into the eye. The perfusion pressure sensor may also function as a chamber pressure sensor that detects the pressure in the perfusion fluid reservoir chamber. In this case, the perfusion pressure sensor appropriately detects the perfusion pressure within the perfusion path. Furthermore, when supplying perfusion fluid into the perfusion fluid reservoir chamber, the perfusion pressure sensor functions as a chamber pressure sensor to detect the pressure inside the perfusion fluid reservoir chamber. Therefore, there is no need to provide a separate dedicated sensor to detect the pressure inside the perfusion fluid reservoir chamber. Thus, an appropriate amount of air pocket is formed inside the perfusion fluid reservoir chamber while keeping the configuration of the ophthalmic surgical apparatus simple.

[0027] The perfusion pressure sensor may be installed in the perfusion fluid reservoir chamber itself, or downstream of the perfusion fluid reservoir chamber (i.e., on the surgical instrument side, opposite the peristaltic perfusion pump side). In this case, the perfusion pressure sensor can detect the perfusion pressure when pulsation is suppressed by the perfusion fluid reservoir chamber, making it easier to perform surgery more appropriately. However, it is also possible to install the perfusion pressure sensor upstream of the perfusion fluid reservoir chamber (on the peristaltic perfusion pump side).

[0028] The ophthalmic surgical apparatus may further include a control unit. The control unit may use a chamber pressure reduction pump to discharge gas from the perfusion fluid reservoir chamber until the pressure in the perfusion fluid reservoir chamber, as detected by a chamber pressure sensor, reaches a set value. When the pressure detected by the chamber pressure sensor reaches the set value, the control unit may stop the discharge of gas from the perfusion fluid reservoir chamber by the chamber pressure reduction pump and supply perfusion fluid from the perfusion fluid source to the perfusion fluid reservoir chamber through the perfusion path.

[0029] In this case, an appropriate amount of air pockets are automatically formed in the irrigation fluid reservoir chamber without the user having to operate a chamber pressure reduction pump or similar device. Therefore, ophthalmic surgery can be performed more easily and appropriately.

[0030] However, it is also possible for the user to manually create an air pocket in the perfusion fluid reservoir chamber by operating a chamber pressure reduction pump or the like, after determining whether the pressure in the perfusion fluid reservoir chamber has reached the set value.

[0031] The pressure setting in the perfusion fluid reservoir chamber may be adjustable. As mentioned above, it is desirable that the amount of air pockets in the perfusion fluid reservoir chamber be adjusted to an appropriate amount depending on various factors that affect the perfusion pressure (e.g., the material and dimensions of the perfusion pathway). By changing the pressure setting for forming air pockets in the perfusion fluid reservoir chamber, the amount of air pockets is changed, making it easier to perform surgery more effectively.

[0032] <Embodiment> Hereinafter, one typical embodiment of the present disclosure will be described with reference to the drawings. In this embodiment, an ophthalmic surgical apparatus 1 capable of performing both cataract surgery and vitrectomy on a patient's eye E will be described as an example. However, the techniques illustrated in this disclosure can also be applied to, for example, ophthalmic surgical apparatus capable of performing only cataract surgery, and ophthalmic surgical apparatus capable of performing only vitrectomy, etc.

[0033] (Overall structure) Referring to Figure 1, the overall configuration of the ophthalmic surgical apparatus 1 in this embodiment will be described. The ophthalmic surgical apparatus 1 in this embodiment comprises a main body 10 and an ophthalmic surgical cassette (hereinafter simply referred to as "cassette") 20. The main body 10 houses various components necessary for ophthalmic surgery. The cassette 20 is a disposable component containing various components that need to be kept clean, and is detachably attached to the main body 10. The cassette 20 in this embodiment comprises a cassette body 21 and a waste liquid container (e.g., a waste liquid bag) 22 in which waste liquid aspirated from inside the patient's eye E is stored.

[0034] The main unit 10 of the device comprises a monitor 11, a touch panel 12, a connection panel 13, a cassette holding unit 14, a perfusion liquid source holding unit 16, and a foot switch 18.

[0035] The monitor 11 is located on the upper front side of the main unit 10 of the device and displays various images. The monitor 11 may also display a screen for setting surgical conditions. For example, the user may select the surgical mode, set the function of the foot switch 18, specify the perfusion pressure, specify the suction pressure, specify the intraocular pressure, specify the ultrasound output, etc., on the surgical conditions setting screen. The touch panel 12 is located on the surface of the display surface of the monitor 11 and accepts input of various operation instructions from the user.

[0036] The connection panel 13 includes at least one connector to which cables and other components of the surgical instrument 30 are connected. The surgical instrument 30 is operated by the surgeon and comes into contact with or close proximity to the patient's eye E (in this embodiment, it is inserted into the eye of the patient's eye E). In this embodiment, the connection panel 13 is formed on the front of the housing of the device body 10.

[0037] The cassette holding unit 14 removably holds the cassette 20. In this embodiment, the cassette holding unit 14 is provided on the side of the housing of the device body 10. In this embodiment, with the cassette 20 positioned in a predetermined location on the cassette holding unit 14, the cover 15 is pushed toward the housing side, thereby loading the cassette 20 into the cassette holding unit 14. The device body 10 may have multiple cassette holding units 14.

[0038] The perfusion fluid source holder 16 holds the perfusion fluid source 17. The perfusion fluid source 17 contains perfusion fluid. For example, physiological saline can be used as the perfusion fluid. The perfusion fluid source 17 and the surgical instrument 30 are connected by perfusion pathways 5 (5A, 5B, 5C). Perfusion pathways 5 guide the perfusion fluid in the perfusion fluid source 17 to the surgical instrument 30. As an example, in this embodiment, the perfusion fluid source 17 and the surgical instrument 30 are connected by a perfusion pathway (perfusion tube (sometimes called an infusion tube)) 5A connecting the perfusion fluid source 17 to the cassette 20, a perfusion pathway 5B provided inside the cassette 20 (see Figure 2), and a perfusion pathway (perfusion tube) 5C connecting the cassette 20 to the surgical instrument 30.

[0039] The surgical instrument 30 and the waste fluid container 22 are connected by suction pathways 6 (6A, 6B). The suction pathways 6 guide the waste fluid (including waste tissue and irrigation fluid) aspirated from inside the eye to the waste fluid container 22. As an example, in this embodiment, the surgical instrument 30 and the waste fluid container 22 are connected by a suction pathway (suction tube) 6A that connects the surgical instrument 30 to the cassette 20, and a suction pathway 6B (see Figure 2) provided inside the cassette 20.

[0040] The foot switch 18, when operated by the user, outputs a signal corresponding to the operation to the control unit 40 (see Figure 2) of the ophthalmic surgical apparatus 1. For example, the foot switch 18 may be operated to adjust the ultrasonic vibration of the movable tip provided at the tip of the surgical instrument 30, or to adjust the suction operation of waste tissue.

[0041] (Internal structure) Referring to Figure 2, the schematic configuration of the cassette 20 in this embodiment and the internal configuration of the device body 10 (see Figure 1) will be described. The cassette body 21 of the cassette 20 is equipped with a perfusion path 5B and a suction path 6B. The perfusion path 5B is part of the perfusion path 5 that passes the perfusion fluid supplied from the perfusion fluid source 17 to the surgical instrument 30. The suction path 6B is part of the suction path 6 that passes the waste fluid aspirated from inside the eye through the surgical instrument 30 to the waste fluid container 22.

[0042] The irrigation fluid is supplied into the eye from the irrigation fluid source 17 via the irrigation pathway 5 and surgical instrument 30, and then flows from the surgical instrument 30 through the suction pathway 6 to the waste fluid container 22. Therefore, of the irrigation fluid flow paths in the irrigation pathway 5 and suction pathway 6, the side facing the irrigation fluid source 17 is the upstream side, and the side facing the waste fluid container 22 is the downstream side. The irrigation pathway 5A extending from the irrigation fluid source 17 is connected to the upstream end of the irrigation pathway 5B of the cassette body 21. The irrigation pathway 5C connected to the surgical instrument 30 is connected to the downstream end of the irrigation pathway 5B of the cassette body 21. The suction pathway 6A connected to the surgical instrument 30 is connected to the upstream end of the suction pathway 6B of the cassette body 21.

[0043] The device body 10 is equipped with a peristaltic perfusion pump 50. The peristaltic perfusion pump 50 is installed in the perfusion path 5 (in this embodiment, the perfusion path 5B of the cassette body 21) to change the pressure of the fluid in the perfusion path (perfusion pressure). In this embodiment, the peristaltic perfusion pump 50 changes the perfusion pressure by rotating while pressing a flexible pressed portion of the perfusion path 5B with a plurality of pump rollers 53 (see Figures 4 and 5). The cassette body 21 is also equipped with a pressing wall portion 60. When the cassette body 21 is mounted in a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), the pressing wall portion 60 clamps the pressed portion of the perfusion path 5B between itself and the pump rollers 53 of the peristaltic perfusion pump 50 (see Figures 4 and 5). Details of the peristaltic perfusion pump 50 and the pressing wall portion 60 will be described later.

[0044] The cassette body 21 is equipped with a perfusion fluid reservoir chamber 70. The perfusion fluid reservoir chamber 70 is located on the path between the peristaltic perfusion pump 50 and the surgical instrument 30 in the perfusion path 5 (perfusion path 5B in this embodiment). The perfusion fluid reservoir chamber 70 stores the perfusion fluid with a gas (e.g., air) sealed inside. For example, when perfusion fluid is supplied to the perfusion fluid reservoir chamber 70 of this embodiment and a sealed gas (hereinafter referred to as "air reservoir") is formed inside, the chamber-side end of the portion of the perfusion path 5B extending upstream from the perfusion fluid reservoir chamber 70 and the chamber-side end of the portion extending downstream from the perfusion fluid reservoir chamber 70 are both located below the upper liquid level of the perfusion fluid and are immersed in the perfusion fluid. The air pocket is sealed by being surrounded by the inner wall of the perfusion fluid reservoir chamber 70 and the liquid surface of the perfusion fluid supplied into the perfusion fluid reservoir chamber 70.

[0045] By using a peristaltic perfusion pump 50 to change the perfusion pressure, it becomes easy to change the polarity of the perfusion pressure by reversing rotation. Furthermore, it is easy to replace the flow path (tube, etc.). On the other hand, using a peristaltic perfusion pump 50 may cause pulsation in the perfusion pressure. In response to this, the ophthalmic surgical apparatus 1 and cassette 20 of this embodiment are equipped with a perfusion fluid reservoir chamber 70 in the perfusion path 5 (5B). An air pocket is formed inside the perfusion fluid reservoir chamber in contact with the surface of the perfusion fluid (the gas is sealed), so fluctuations in perfusion pressure are absorbed by the air pocket in the perfusion fluid reservoir chamber 70. Therefore, the effects of pulsation in the perfusion pressure caused by the peristaltic perfusion pump 50 (for example, fluctuations in intraocular pressure in the patient's eye due to pulsation) are appropriately suppressed.

[0046] Furthermore, in this embodiment, the amount of gas sealed inside the perfusion fluid reservoir chamber 70 (amount of air pocket) can be adjusted. The larger the amount of air pocket sealed inside the perfusion fluid reservoir chamber 70, the easier it is to suppress the effect of pulsation by the peristaltic perfusion pump 50, but the response speed (hereinafter sometimes referred to as "response speed of perfusion pressure") from the perfusion pressure changed by the peristaltic perfusion pump 50 to the inside of the patient's eye decreases. On the other hand, the smaller the amount of air pocket inside the perfusion fluid reservoir chamber 70, the better the response speed of perfusion pressure, but the harder it is to suppress the effect of pulsation by the peristaltic perfusion pump 50. Therefore, by adjusting the amount of air pocket inside the perfusion fluid reservoir chamber 70 to an appropriate amount according to various factors that affect the perfusion pressure (for example, the material and dimensions of the perfusion path 5), the effect of perfusion pressure pulsation is appropriately suppressed while preventing an excessive decrease in the response speed of perfusion pressure.

[0047] The device body 10 is equipped with a suction pump 80. The suction pump 80 is installed in the suction path 6 (in this embodiment, the suction path 6B of the cassette body 21) to change the suction pressure in the suction path 6 for aspirating waste fluid from inside the eye (surgical instruments 30). Furthermore, as will be described in detail later, the suction pump 80 in this embodiment also functions as a chamber pressure reduction pump, which reduces the pressure inside the chamber by discharging gas from inside the irrigation fluid reservoir chamber 70 to the outside when supplying irrigation fluid into the irrigation fluid reservoir chamber 70. In other words, the suction pump 80 in this embodiment also functions as a chamber pressure reduction pump.

[0048] As an example, the suction pump 80 in this embodiment employs a peristaltic pump, similar to the peristaltic perfusion pump 50. The suction pump 80 in this embodiment changes the suction pressure by rotating while pressing a flexible portion of the suction path 6B with multiple pump rollers (not shown). The cassette body 21 also includes a pressing wall portion 90. When the cassette body 21 is mounted in a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), the pressing wall portion 90 sandwiches a part of the suction path 6B between itself and the pump rollers of the peristaltic suction pump 80. However, it is also possible to change the configuration of the suction pump 80. For example, a venturi pump, which sends pressurized gas to a venturi tube to create a low pressure, may be used as the suction pump 80. Furthermore, the ophthalmic surgical apparatus 1 may employ multiple types of suction pumps 80. In this embodiment, the suction pump 80 is connected to the downstream side of the suction path 6B, below the vent path 7 (described later) and the suction pressure sensor 35 (described later).

[0049] The device body 10 is equipped with a perfusion valve 24. The perfusion valve 24 switches the supply and blockage of perfusion fluid to the surgical instruments 30 through the perfusion path 5 (perfusion path 5B in this embodiment) by opening and closing the perfusion path 5. In this embodiment, the cassette body 21 of the cassette 20 is mounted at a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), thereby connecting the perfusion valve 24 to the perfusion path 5B of the cassette body 21. More specifically, the perfusion valve 24 in this embodiment is connected downstream of the point where the vent path 7 (details to be described later) branches off from the perfusion path 5B (i.e., the connection point of the vent path 7).

[0050] The ophthalmic surgical apparatus 1 (in this embodiment, the apparatus body 10 to which the cassette 20 is attached) is equipped with a vent path 7. The vent path 7 connects the irrigation fluid reservoir chamber 70 to the suction path 6 between the surgical instrument 30 and the suction pump 80. However, the vent path 7 may also connect the irrigation fluid reservoir chamber 70 and the surgical instrument 30 in the irrigation path 5, and the suction path 6 between the surgical instrument 30 and the suction pump 80. In this embodiment, the vent path 7 is provided in the cassette body 21. In the cassette body 21, the vent path 7 connects the irrigation fluid reservoir chamber 70 to the suction path 6B. More specifically, the vent path 7 connects the suction path 6B between the surgical instrument 30 and the suction pump 80.

[0051] The device body 10 is equipped with a vent valve 25. The vent valve 25 switches between allowing and blocking fluid movement within the vent path 7 (i.e., fluid movement between the perfusion fluid reservoir chamber 70 or perfusion path 5B and the suction path 6B) by opening and closing the vent path 7. In this embodiment, the cassette body 21 of the cassette 20 is mounted at a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), thereby connecting the vent valve 25 to the vent path 7 of the cassette body 21.

[0052] When the vent valve 25 closes the vent path 7, both the supply of irrigation fluid into the eye via the irrigation path 5 and the suction of waste fluid from the eye via the suction path 6 are performed appropriately. On the other hand, when the vent valve 25 opens the vent path, irrigation fluid flows directly into the suction path 6 through the vent path 7. Therefore, even if a phenomenon such as a temporary over-suction (a so-called "surge phenomenon") occurs when the blockage of the suction path 6 by waste tissue is released, the adverse effects of a sudden change in suction pressure are suppressed by opening the vent valve 25. In this embodiment, the irrigation fluid reservoir chamber 70 is directly connected to the suction path 6 via the vent path 7, thereby suppressing fluctuations in the irrigation pressure within the irrigation path 5 when the vent valve 25 is opened.

[0053] The device body 10 is equipped with a perfusion pressure sensor 34. The perfusion pressure sensor 34 is located between the peristaltic perfusion pump 50 and the surgical instrument 30 in the perfusion path 5. In this embodiment, the cassette body 21 of the cassette 20 is mounted at a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), thereby connecting the perfusion pressure sensor 34 to the perfusion path 5C, the perfusion path 5B of the cassette body 21, or the perfusion fluid reservoir chamber 70. The perfusion pressure sensor 34 detects the pressure (perfusion pressure) of the perfusion fluid supplied into the eye through the perfusion path 5 and the surgical instrument 30. Furthermore, as will be described in detail later, the perfusion pressure sensor 34 in this embodiment also functions as a chamber pressure sensor to detect the pressure inside the perfusion fluid reservoir chamber 70 when supplying perfusion fluid into the perfusion fluid reservoir chamber 70. In other words, the perfusion pressure sensor 34 in this embodiment also functions as a chamber pressure sensor.

[0054] The perfusion pressure sensor 34 may be located downstream of the perfusion fluid reservoir chamber 70 in the perfusion path 5 (5B) (i.e., on the surgical instrument 30 side, opposite to the peristaltic perfusion pump 50 side). In this case, the perfusion pressure sensor 34 can detect the perfusion pressure when pulsation is suppressed by the perfusion fluid reservoir chamber 70, making it easier to perform surgery more appropriately. However, it is also possible to install the perfusion pressure sensor 34 upstream of the perfusion fluid reservoir chamber 70 in the perfusion path 5 (i.e., on the peristaltic perfusion pump 50 side), or on the perfusion fluid reservoir chamber 70 itself.

[0055] The device body 10 is equipped with a suction pressure sensor 35. The suction pressure sensor 35 detects the pressure of the fluid in the suction path 6 (suction pressure). For example, the control unit 40 can determine whether or not there is an obstruction in the suction path 6 based on the pressure detection result from the suction pressure sensor 35. The control unit 40 can also estimate the intraocular pressure of the patient's eye E based on the perfusion pressure detected by the perfusion pressure sensor 34 and the suction pressure detected by the suction pressure sensor 35. In this embodiment, the cassette body 21 of the cassette 20 is mounted at a predetermined mounting position on the device body 10 (in this embodiment, the cassette holding unit 14 shown in Figure 1), so that the suction pressure sensor 35 is connected to the suction path 6B of the cassette body 21, or to the suction path 6B side of the vent valve 25 in the vent path 7.

[0056] The main unit 10 of the device includes a control unit 40. The control unit 40 is electrically connected to various components of the ophthalmic surgical apparatus 1 (for example, a monitor 11, a touch panel 12, a foot switch 18, a perfusion valve 24, a vent valve 25, a perfusion pressure sensor 34, a suction pressure sensor 35, a peristaltic perfusion pump 50, and a suction pump 80, etc.). The control unit 40 in this embodiment includes a CPU (processor) 41, a ROM 42, a RAM 43, and a non-volatile memory (NVM) 44. The CPU 41 controls the various parts of the ophthalmic surgical apparatus 1. The ROM 42 stores various programs, initial values, etc. The RAM 43 temporarily stores various information. The non-volatile memory 44 is a non-transient storage medium that can retain its contents even when the power supply is cut off. For example, a hard disk drive, flash ROM, and a removable USB memory may be used as the non-volatile memory 44.

[0057] 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).

[0058] 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.

[0059] 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.

[0060] 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.

[0061] (cassette) The physical configuration of the cassette 20 of this embodiment will be described with reference to Figures 3 and 4. Figure 3 is a view of a part of the cassette 20 (cassette body 21) of this embodiment, seen from the back. In Figure 3, the flow of perfusion fluid in the perfusion path 5 (5B) is shown by a thick dotted line, the flow of waste liquid in the suction path 6 (6B) is shown by a thick dashed line, and the flow of perfusion fluid in the vent path 7 is shown by a thick dashed line. In the example shown in Figure 3, the perfusion path 5B is located on the right side of the cassette body 21. The upstream end of the perfusion path 5B (the upper right end in Figure 3) is connected to the perfusion fluid source 17 (see Figures 1 and 2) via the perfusion path 5A (see Figure 2). The perfusion fluid reservoir chamber 70 is provided in the middle of the perfusion path 5B in the cassette body 21. At the bottom of the irrigation fluid reservoir chamber 70, there is an irrigation valve connection section 124 to which the irrigation valve 24 (see Figure 2) of the ophthalmic surgical device 1 is connected. The irrigation path 5C (see Figure 2) is connected to the back side of the irrigation valve connection section 124 on the cassette body 21 and extends downward. Above the irrigation fluid reservoir chamber 70 on the cassette body 21, there is an irrigation pressure sensor connection section 134 to which the irrigation pressure sensor 34 (see Figure 2) is connected.

[0062] The pressing wall portion 60 is provided adjacent to the flexible pressed portion 5P of the perfusion path 5B. As shown in Figure 4, when the cassette 20 is mounted on the cassette holding unit 14, the pressing wall portion 60 provided on the cassette body 21 clamps the flexible pressed portion 5P of the perfusion path 5B between itself and the pump roller 53 (see Figures 4 and 5) of the peristaltic perfusion pump 50 (see Figures 2, 4, and 5).

[0063] In the example shown in Figure 3, the suction path 6B is located on the left side of the cassette body 21. The upstream end of the suction path 6B (upper end in Figure 3) is connected to the surgical instrument 30 via the suction path 6A (see Figure 2). The downstream end of the suction path 6B (lower end in Figure 3) is connected to the waste liquid container 22 (see Figure 2).

[0064] The pressing wall portion 90 is provided adjacent to the flexible pressed portion 6P of the suction path 6B. As shown in Figure 4, when the cassette 20 is mounted in the cassette holding unit 14, the pressing wall portion 90 provided on the cassette body 21 clamps the pressed portion 6P of the suction path 6B between itself and the pump roller 83 (see Figures 4 and 6) of the peristaltic suction pump 80 (see Figures 2, 4, and 6).

[0065] In the example shown in Figure 3, the vent path 7 is located slightly to the left of the center of the cassette body 21. One end of the vent path 7 is connected to the perfusion path 5B, and the other end is connected to the suction path 6B. A vent valve connection section 125 is formed in a part of the vent path 7 in the cassette body 21, to which the vent valve 25 (see Figure 2) of the ophthalmic surgical device 1 is connected. In addition, a suction pressure sensor connection section 135 is formed in the vent path 7 in the cassette body 21, closer to the suction path 6B than the vent valve connection section 125, to which the suction pressure sensor 35 (see Figure 2) is connected.

[0066] (Peristaltic perfusion pump - pressure wall section) Referring to Figure 5, the configuration of the peristaltic perfusion pump 50 and the pressing wall portion 60 of this embodiment will be described in detail. Figure 5 is a front view of the peristaltic perfusion pump 50 and the pressing wall portion 60 with the cassette 20 mounted on the cassette holding unit 14. For the sake of easier understanding of the explanation, the perfusion path 5 (5B, 5P) is not shown in Figure 5, and instead the flow of perfusion fluid passing through the perfusion path 5 is shown with dashed lines and arrows. In Figure 5, the upper side is the upstream side of the perfusion path 5 (i.e., the side with the perfusion fluid source 17), and the lower side is the downstream side of the perfusion path 5 (i.e., the side with the surgical instruments 30). As mentioned above, the peristaltic perfusion pump 50 changes the perfusion pressure in the perfusion path 5 by rotating while pressing the flexible pressed portion 5P (see Figure 3) of the perfusion path 5 (5B) with the pump roller 53.

[0067] The peristaltic perfusion pump 50 of this embodiment includes a roller unit 51. The roller unit 51 rotates about a rotation axis O by an actuator (not shown), such as a motor. The roller unit 51 includes a plurality of pump rollers 53. Each pump roller 53 has a cylindrical contact area on its outer circumference that contacts the pressed portion 5P. The plurality of pump rollers 53 are arranged in the roller unit 51 along a circular arrangement position S centered on the rotation axis O. In this embodiment, six pump rollers 53 are arranged at equal intervals along the arrangement position S. When the roller unit 51 rotates about the rotation axis O, the plurality of pump rollers 53 sequentially contact the pressed portion 5P, moving while pressing the pressed portion 5P. As a result, the perfusion pressure in the perfusion path 5 changes. In the example shown in Figure 5, as the roller unit 51 rotates in the direction of arrow R, the perfusion pressure in the perfusion path 5 downstream of the roller unit 51 increases, and perfusion fluid is supplied into the eye.

[0068] The pressing wall portion 60 is formed in a shape that curves smoothly from the upstream side to the downstream side of the perfusion path 5B. The pressing wall portion 60 sandwiches the portion to be pressed 5P between itself and the pump roller 53 of the roller unit 51 of the peristaltic perfusion pump 50. In detail, the pressing wall portion 60 is positioned opposite the outer circumferential surface of the roller unit 51, thereby forming an arc-shaped position PP between itself and the roller unit 51 where the portion to be pressed 5P of the perfusion path 5B is positioned.

[0069] In the perfusion path 5B, a certain (partial) region of the smoothly curved pressing wall 60 extending from the upstream side to the downstream side is defined as the downstream region 60A, extending from the downstream end 62 towards the upstream side. In this embodiment, as shown in Figure 5, the distance D between the downstream region 60A and the outer surface of the roller unit 51 (i.e., the circular trajectory traced by the outer ends of each of the multiple pump rollers 53 provided by the roller unit 51) gradually increases as it approaches the downstream side. Therefore, when the pump roller 53 rotates in the direction of arrow R from the upstream side to the downstream side, in the downstream region 60A, the pump roller 53 moves away gradually rather than suddenly away from the pressed portion 5P of the perfusion path 5B. Consequently, the pressure in the perfusion path 5 downstream of the peristaltic perfusion pump 50 also gradually decreases. As a result, the effects of pulsation by the peristaltic perfusion pump 50 (for example, fluctuations in intraocular pressure in the patient's eye due to pulsation) are appropriately suppressed.

[0070] Of the pressing wall portion 60, a certain (partial) region located upstream of the downstream region 60A is defined as the upstream region 60B. In this embodiment, as shown in Figure 5, the pressing wall portion 60 is formed such that the curvature of the upstream region 60B is greater than the curvature of the downstream region 60A. In other words, the radius of curvature in the upstream region 60B is smaller than the radius of curvature in the downstream region 60A. Therefore, in the upstream region 60B, as the pump roller 53 rotates from the upstream side to the downstream side in the direction of arrow R, the pressed portion 5P of the perfusion path 5B is more likely to be strongly pressed continuously. As a result, the pressure in the perfusion path 5 changes appropriately as the roller unit 51 rotates. Furthermore, in the downstream region 60A, as the pump roller 53 gradually moves away from the pressed portion 5P, the effect of pulsation by the peristaltic perfusion pump 50 is appropriately suppressed. Thus, surgery can be performed more appropriately.

[0071] In this embodiment, the distance between the upstream region 60B of the pressing wall 60 and the outer circumferential surface of the roller unit 51 (i.e., the circular trajectory traced by the outer ends of each of the multiple pump rollers 53 provided by the roller unit 51) is constant. As a result, in the upstream region 60B, the pressed portion 5P of the perfusion path 5B is continuously pressed with a substantially constant force while the pump roller 53 rotates from the upstream to the downstream direction of arrow R. In detail, in this embodiment, in the upstream region 60B, the pressed portion 5P is completely crushed and closed by the pump roller 53 and the pressing wall 60 as the pump roller 53 rotates. Therefore, when the peristaltic perfusion pump 50 is driven, the perfusion pressure in the perfusion path 5 changes more appropriately.

[0072] In this embodiment, regardless of the rotation angle of the roller unit 51, at least one of the multiple pump rollers 53 provided on the roller unit 51 presses against the portion to be pressed 5P between itself and the upstream region 60B of the pressing wall 60, completely closing it. In fact, even in the state shown in Figure 5, the pump roller 53 facing the downstream region 60A of the pressing wall 60 gradually moves away from the pressing wall 60 as it rotates, but during this time, the pump roller 53 facing the upstream region 60B of the pressing wall 60 maintains a constant distance from the pressing wall 60, and continues to completely close the portion to be pressed 5P. Therefore, while the roller unit 51 is rotating, there is no period of time when the portion to be pressed 5P is not sufficiently pressed by any of the pump rollers 53 (in this embodiment, a period of time when it is not completely closed). In other words, even when the pump roller 53 located in the downstream region 60A gradually moves away from the pressed portion 5P, the pressed portion 5P continues to be sufficiently pressed by the other pump roller 53 located in the upstream region 60B. Therefore, the ophthalmic surgical apparatus 1 of this embodiment can appropriately suppress the effects of pulsation in the downstream region 60A while appropriately changing the pressure in the perfusion path 5 in the upstream region 60B.

[0073] (Peristaltic-type suction pump / pressure wall section) Referring to Figure 6, the configuration of the suction pump 80 and the pressing wall portion 90 of this embodiment will be described in detail. Figure 6 is a front view of the peristaltic-type suction pump 80 and the pressing wall portion 90 with the cassette 20 mounted on the cassette holding unit 14. For the sake of easier understanding of the explanation, the suction path 6 (6B, 6P) is not shown in Figure 6, and instead the flow of waste liquid passing through the suction path 6 is shown with dashed lines and arrows. In Figure 6, the upper side is the upstream side of the suction path 6 (i.e., the surgical instrument 30 side), and the lower side is the downstream side of the suction path 6 (i.e., the waste liquid container 22 side). As mentioned above, the suction pump 80 changes the suction pressure in the suction path 6 by rotating while pressing the flexible pressed portion 6P (see Figure 3) of the suction path 6 (6B) with the pump roller 83.

[0074] The suction pump 80 of this embodiment, like the peristaltic perfusion pump 50 described above, includes a roller unit 81. The roller unit 81 rotates about a rotation axis O' by an actuator (not shown), such as a motor. The roller unit 81 includes a plurality of pump rollers 83. Each pump roller 83 has a cylindrical contact area on its outer circumference that contacts the pressed portion 6P. The plurality of pump rollers 83 are arranged in the roller unit 81 along a circular arrangement position S' centered on the rotation axis O'. In this embodiment, six pump rollers 83 are arranged at equal intervals along the arrangement position S'. When the roller unit 81 rotates about the rotation axis O', the plurality of pump rollers 83 sequentially contact the pressed portion 6P, moving while pressing the pressed portion 6P. As a result, the suction pressure in the suction path 6 changes. In the example shown in Figure 6, as the roller unit 81 rotates in the direction of arrow R', the suction pressure in the suction path 6 upstream of the roller unit 81 decreases, and waste fluid is aspirated from inside the eye.

[0075] The pressing wall portion 90 is formed in a shape that curves smoothly from the upstream side to the downstream side of the suction path 6B. The pressing wall portion 90 sandwiches the portion to be pressed 6P between itself and the pump roller 83 of the roller unit 81 of the suction pump 80. In detail, the pressing wall portion 90 is positioned opposite the outer circumferential surface of the roller unit 81, thereby forming an arc-shaped position PP' between itself and the roller unit 81 where the portion to be pressed 6P of the suction path 6B is positioned.

[0076] In the suction path 6B, a certain (partial) region of the smoothly curved pressing wall portion 90 extending from the upstream end 92 toward the downstream side is defined as the upstream region 90A. In this embodiment, as shown in Figure 6, the distance D' between the upstream region 90A and the outer surface of the roller unit 81 (i.e., the circular trajectory traced by the outer ends of each of the multiple pump rollers 83 provided by the roller unit 81) gradually increases as it approaches the upstream side. Therefore, when the pump roller 83 rotates in the direction of arrow R' from the upstream side toward the downstream side, in the upstream region 90A, the pump roller 83 does not rapidly crush the pressed portion 6P of the suction path 6B, but rather crushes it gradually. Thus, a rapid increase in pressure transmitted to the upstream side of the suction path 6 beyond the suction pump 80 is suppressed. As a result, the effect of pulsation by the peristaltic-type suction pump 80 on the patient's eye is appropriately suppressed.

[0077] A certain (partial) region of the pressing wall 90 located downstream of the upstream region 90A is defined as the downstream region 90B. In this embodiment, as shown in Figure 6, the pressing wall 90 is formed such that the curvature of the downstream region 90B is greater than the curvature of the upstream region 90A. In other words, the radius of curvature in the downstream region 90B is smaller than the radius of curvature in the upstream region 90A. Therefore, in the downstream region 90B, as the pump roller 83 rotates from the upstream side to the downstream side in the direction of arrow R', the pressed portion 6P of the suction path 6B is more likely to be continuously and strongly pressed. As a result, the pressure in the suction path 6 changes appropriately as the roller unit 81 rotates.

[0078] In this embodiment, the distance between the downstream region 90B of the pressing wall portion 90 and the outer circumferential surface of the roller unit 81 (i.e., the circular trajectory traced by the outer ends of each of the multiple pump rollers 83 provided by the roller unit 81) is constant. As a result, in the downstream region 90B, the pressed portion 6P of the suction path 6B is continuously pressed with a substantially constant force while the pump roller 83 rotates from the upstream side to the downstream side in the direction of arrow R'. In detail, in this embodiment, in the downstream region 90B, the pressed portion 6P is completely crushed and closed by the pump roller 83 and the pressing wall portion 90 as the pump roller 83 rotates. Therefore, when the suction pump 80 is driven, the suction pressure can be changed more appropriately.

[0079] In this embodiment, regardless of the rotation angle of the roller unit 81, at least one of the multiple pump rollers 83 provided on the roller unit 81 presses the portion to be pressed 6P against the downstream region 90B of the pressing wall 90, completely closing it. In fact, even in the state shown in Figure 6, the pump roller 83 facing the upstream region 90A of the pressing wall 90 is not yet close enough to the pressing wall 90, so the portion to be pressed 6P is not sufficiently pressed. However, during this time, the pump roller 83 facing the downstream region 90B of the pressing wall 90 maintains a constant distance from the pressing wall 90 and continues to completely close the portion to be pressed 6P. Therefore, while the roller unit 81 is rotating, there is no period of time when the portion to be pressed 6P is not sufficiently pressed by any of the pump rollers 83 (in this embodiment, a period of time when it is not completely closed). Therefore, the ophthalmic surgical apparatus 1 of this embodiment can appropriately suppress the effects of pulsation in the upstream region 90A while appropriately changing the suction pressure in the downstream region 90B.

[0080] (Supply of perfusion fluid to the perfusion fluid reservoir chamber) The method for supplying irrigation fluid to the irrigation fluid reservoir chamber 70 will now be described. The ophthalmic surgical apparatus 1 of this embodiment is equipped with a chamber pressure reduction pump (suction pump 80 in this embodiment) and a chamber pressure sensor (irrigation pressure sensor 34 in this embodiment). The chamber pressure reduction pump reduces the pressure inside the irrigation fluid reservoir chamber 70 by discharging gas from inside the irrigation fluid reservoir chamber 70 to the outside. The chamber pressure sensor detects the pressure inside the irrigation fluid reservoir chamber 70. In this embodiment, when the pressure inside the irrigation fluid reservoir chamber 70, reduced by the chamber pressure reduction pump and detected by the chamber pressure sensor, reaches a set value, the discharge of gas from the irrigation fluid reservoir chamber 70 by the chamber pressure reduction pump is stopped, and irrigation fluid is supplied from the irrigation fluid source 17 to the irrigation fluid reservoir chamber 70 through the irrigation path 5. As a result, the target amount of air pockets is more easily formed appropriately inside the irrigation fluid reservoir chamber 70. Therefore, surgery using the ophthalmic surgical apparatus 1 can be performed more appropriately.

[0081] In detail, as shown in Figure 2, in this embodiment, the perfusion path 5 between the perfusion fluid reservoir chamber 70 and the perfusion fluid source 17 is closed by a peristaltic perfusion pump 50 or the like, the perfusion valve 24 is closed, and the vent valve 25 is open, and the gas in the perfusion fluid reservoir chamber 70 is discharged to the outside by a suction pump 80. In this case, the gas in the perfusion fluid reservoir chamber 70 is discharged to the outside by a configuration (perfusion valve 24, vent valve 25, and suction pump 80, etc.) used for supplying perfusion fluid, adjusting suction pressure, and suppressing adverse effects due to surge phenomena, thus eliminating the need to separately provide a configuration in the ophthalmic surgical apparatus 1 to reduce the pressure inside the chamber. Therefore, an appropriate amount of air is formed in the perfusion fluid reservoir chamber 70 while keeping the configuration of the ophthalmic surgical apparatus 1 from becoming overly complex. Furthermore, the ophthalmic surgical apparatus 1 may be equipped with a separate fluid source valve for opening and closing the path between the irrigation fluid reservoir chamber 70 and the irrigation fluid source 17, in addition to the peristaltic irrigation pump 50.

[0082] Furthermore, in this embodiment, the perfusion pressure in the perfusion path 5 is appropriately detected by the perfusion pressure sensor 34. Moreover, when supplying perfusion fluid into the perfusion fluid reservoir chamber 70, the perfusion pressure sensor 34 functions as a chamber pressure sensor that detects the pressure inside the perfusion fluid reservoir chamber 70. Therefore, there is no need to separately provide a dedicated sensor for detecting the pressure inside the perfusion fluid reservoir chamber 70. Thus, an appropriate amount of air pocket is formed inside the perfusion fluid reservoir chamber 70 while keeping the configuration of the ophthalmic surgical apparatus 1 from becoming overly complex.

[0083] (Automatic supply of perfusion fluid to the perfusion fluid reservoir chamber) Referring to Figure 7, the automatic supply process performed by the ophthalmic surgical apparatus 1 of this embodiment will be described. In the automatic supply process, an appropriate amount of air pockets are automatically formed in the irrigation fluid reservoir chamber 70. When an instruction to start forming air pockets in the irrigation fluid reservoir chamber 70 is input to the ophthalmic surgical apparatus 1, the CPU 41 of the ophthalmic surgical apparatus 1 executes the automatic supply process illustrated in Figure 7 according to the control program stored in the non-volatile memory 44.

[0084] First, the CPU 41 closes the perfusion path 5 between the perfusion fluid reservoir chamber 70 and the perfusion fluid source 17 (S1). As described above, the ophthalmic surgical apparatus 1 of this embodiment can close the perfusion path between the perfusion fluid reservoir chamber 70 and the perfusion fluid source 17 by stopping the rotation of the peristaltic perfusion pump 50. However, the ophthalmic surgical apparatus 1 may also be provided with a fluid source valve separate from the peristaltic perfusion pump 50 for opening and closing the path between the perfusion fluid reservoir chamber 70 and the perfusion fluid source 17.

[0085] CPU 41 closes the perfusion valve 24 (S2) and opens the vent valve 25 (S3). As a result, as shown in Figure 2, the only fluid flow path connected to the perfusion fluid reservoir chamber 70 is the one extending from the perfusion fluid reservoir chamber 70 through the vent path 7 to the suction pump 80.

[0086] Next, the CPU 41 drives the suction pump 80 (chamber pressure reduction pump) to begin discharging the gas from the perfusion fluid reservoir chamber 70 to the outside (S4). As a result, the pressure inside the perfusion fluid reservoir chamber 70 gradually decreases.

[0087] The CPU 41 determines whether the pressure inside the perfusion fluid reservoir chamber 70, as detected by the perfusion pressure sensor 34 (chamber pressure sensor), has reached a set value (S5). If the pressure inside the perfusion fluid reservoir chamber 70 has not reached the set value (S5: NO), the determination in S5 is repeated, and the system enters a standby state, and the discharge of gas from the perfusion fluid reservoir chamber 70 continues. When the pressure inside the perfusion fluid reservoir chamber 70 reaches the set value (S5: YES), the CPU 41 stops the discharge of gas from the perfusion fluid reservoir chamber 70 by the suction pump 80 (chamber pressure reduction pump) and closes the vent valve 25 (S6). Next, the CPU 41 starts supplying perfusion fluid from the perfusion fluid source 17 to the perfusion fluid reservoir chamber 70 (S7). The CPU 41 determines whether the pressure inside the perfusion fluid reservoir chamber 70, as detected by the perfusion pressure sensor 34 (chamber pressure sensor), has reached a set value (different from the set value in S5) necessary to complete the supply of perfusion fluid to the perfusion fluid reservoir chamber 70. When the set value is reached (S8:YES), the supply of irrigation fluid to the irrigation fluid reservoir chamber 70 is stopped, and the process ends. As a result, an appropriate amount of air pocket is automatically formed in the irrigation fluid reservoir chamber 70 without the user having to operate the ophthalmic surgical device 1 themselves.

[0088] The settings used in S5 can be changed according to instructions entered by the user. As mentioned above, it is desirable that the amount of air pockets in the perfusion fluid reservoir chamber 70 be adjusted to an appropriate amount according to various factors that affect the perfusion pressure (for example, the material and dimensions of the perfusion path 5). By changing the pressure setting value when forming air pockets in the perfusion fluid reservoir chamber 70, the amount of air pockets is changed, making it easier to perform surgery more appropriately.

[0089] 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 possible to implement only some of the technologies exemplified in the above embodiments. For example, it is possible to adopt only one of the technologies related to the peristaltic perfusion pump 50 and the pressing wall portion 60, or the technology utilizing the perfusion fluid reservoir chamber 70, in the ophthalmic surgical apparatus 1. Furthermore, the ophthalmic surgical apparatus 1 of the above embodiments is used by attaching the cassette 20. However, at least some of the technologies exemplified in the above embodiments can also be applied to ophthalmic surgical apparatuses that do not utilize the cassette 20. In this case, at least some of the configurations of the cassette 20 of the above embodiments may be provided in the main body of the ophthalmic surgical apparatus.

[0090] In the above embodiment, a suction pump 80 or the like is used to reduce the pressure inside the perfusion fluid reservoir chamber 70. However, it is also possible to change the method for reducing the pressure inside the perfusion fluid reservoir chamber 70. For example, with the portion of the perfusion path 5 extending from the perfusion fluid reservoir chamber 70 toward the surgical instrument 30 side closed, the gas inside the perfusion fluid reservoir chamber 70 may be discharged to the outside by rotating the peristaltic perfusion pump 50 in the opposite direction to the direction that increases the perfusion pressure. In other words, the peristaltic perfusion pump 50 may function as a chamber pressure reduction pump. Even in this case, it is not necessary to separately provide a configuration for reducing the pressure inside the chamber in the ophthalmic surgical apparatus 1. However, it is also possible to use a chamber pressure reduction pump that discharges the gas inside the perfusion fluid reservoir chamber 70 to the outside separately from the suction pump 80 and the peristaltic perfusion pump 50.

[0091] The ophthalmic surgical apparatus 1 of the above embodiment can automatically form an appropriate amount of air pockets in the irrigation fluid reservoir chamber 70 by performing an automatic supply process (see Figure 7). However, it is also possible for the user to manually form air pockets in the irrigation fluid reservoir chamber 70 by operating a chamber pressure reduction pump or the like after determining whether the pressure in the irrigation fluid reservoir chamber 70 has reached a set value. [Explanation of symbols]

[0092] 1 Ophthalmic surgery equipment 5 Perfusion pathways 6. Suction route 7. Venting Paths 14 Cassette holding unit 17 Irrigation fluid source 20 Ophthalmic surgery cassettes (cassettes) 24 Perfusion valve 25 Vent Valves 30 Surgical instruments 34 Perfusion pressure sensor 40 Control Unit 41 CPU 50 Peristaltic perfusion pumps 51 Roller Unit 53 Pump Roller 60 Pressing wall section 60A Downstream area 60B Upstream area 70 Perfusion fluid reservoir chamber O Rotation axis S location

Claims

1. An ophthalmic surgical device that supplies irrigation fluid from an irrigation fluid source into the eye of a patient, and aspirates waste fluid containing the patient's eye tissue and the irrigation fluid from inside the eye, A perfusion path that passes the perfusion fluid supplied from the perfusion fluid source through the surgical instrument, A peristaltic perfusion pump is provided in the perfusion path and rotates the flexible perfusion path while pressing it with a plurality of pump rollers, thereby changing the pressure within the perfusion path. The perfusion pathway includes a perfusion fluid reservoir chamber located in the path between the peristaltic perfusion pump and the surgical instrument, which stores the perfusion fluid in a sealed state with gas inside, An ophthalmic surgical apparatus characterized by being equipped with the following features.

2. An ophthalmic surgical apparatus according to claim 1, The amount of gas sealed inside the perfusion fluid reservoir chamber can be adjusted. A chamber pressure reduction pump that reduces the pressure inside the perfusion fluid reservoir chamber by discharging the gas inside the perfusion fluid reservoir chamber to the outside, A chamber pressure sensor for detecting the pressure inside the perfusion fluid reservoir chamber, Furthermore, An ophthalmic surgical apparatus characterized in that, when the pressure in the perfusion fluid reservoir chamber, which has been reduced by the chamber pressure reduction pump and detected by the chamber pressure sensor, reaches a set value, the discharge of gas from the perfusion fluid reservoir chamber by the chamber pressure reduction pump is stopped, and the perfusion fluid is supplied from the perfusion fluid source to the perfusion fluid reservoir chamber through the perfusion path.

3. An ophthalmic surgical apparatus according to claim 2, A suction path through which the waste fluid aspirated from the eye via the surgical instrument passes, A suction pump provided in the suction path, which changes the suction pressure for aspirating the waste liquid from inside the eye, A vent path connecting the perfusion fluid reservoir chamber and the surgical instrument in the perfusion path, and the surgical instrument and the suction pump in the suction path, A vent valve that opens and closes the aforementioned vent path, A perfusion valve is provided between the connection point of the venting path and the surgical instrument in the perfusion path, and opens and closes the perfusion path. Furthermore, An ophthalmic surgical apparatus characterized in that, with the perfusion path between the perfusion fluid reservoir chamber and the perfusion fluid source closed, the perfusion valve closed, and the vent valve open, the gas in the perfusion fluid reservoir chamber is discharged to the outside by the suction pump, thereby causing the suction pump to function as a chamber pressure reduction pump.

4. An ophthalmic surgical apparatus according to claim 2 or 3, The perfusion pathway further includes a perfusion pressure sensor, which is provided between the peristaltic perfusion pump and the surgical instrument and detects the pressure of the perfusion fluid supplied into the eye. An ophthalmic surgical apparatus characterized in that the perfusion pressure sensor also serves as the chamber pressure sensor.

5. An ophthalmic surgical apparatus according to any one of claims 2 to 4, The device further comprises a control unit that controls the ophthalmic surgical apparatus, The control unit, The chamber pressure reduction pump discharges the gas from the perfusion fluid reservoir chamber to the outside until the pressure inside the perfusion fluid reservoir chamber, as detected by the chamber pressure sensor, reaches the set value. An ophthalmic surgical apparatus characterized in that, when the pressure detected by the chamber pressure sensor reaches the set value, the discharge of gas from the perfusion fluid reservoir chamber by the chamber pressure reduction pump is stopped, and the perfusion fluid is supplied from the perfusion fluid source to the perfusion fluid reservoir chamber through the perfusion path.

6. An ophthalmic surgical apparatus according to claim 5, An ophthalmic surgical apparatus characterized in that the set value of the pressure in the perfusion fluid reservoir chamber can be changed.

7. An ophthalmic surgical cassette that is detachably attached to an ophthalmic surgical device that supplies irrigation fluid from an irrigation fluid source into the patient's eye by supplying it to surgical instruments through an irrigation pathway, and aspirates waste tissue from the patient's eye and waste liquid containing the irrigation fluid from the eye, The aforementioned ophthalmic surgical device is The system includes a peristaltic perfusion pump that changes the pressure within the perfusion path by rotating a flexible portion of the perfusion path while pressing it with a plurality of pump rollers. The aforementioned ophthalmic surgery cassette is An ophthalmic surgical cassette characterized by having an irrigation fluid reservoir chamber provided in the perfusion pathway between the peristaltic perfusion pump and the surgical instrument, which stores the irrigation fluid in a sealed state with gas inside.

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