Constant Downforce Assembly for Contact Lens Type Wide-Angle Visualization

Abstract

A contact wide-angle visualization system ("WAVS") for use in an ophthalmic suite with a microscope comprises a constant downforce (CDF) assembly and a contact lens device. The CDF assembly has a proximal end and a distal end. The proximal end connects to the optical head of the microscope via an intervening connecting arm. The contact lens device connects to the distal end of the CDF assembly and includes a contact lens configured to be mounted on the cornea of ​​a patient's eye within the ophthalmic suite. The CDF assembly provides constant downforce to the contact lens device and is self-leveling, thereby maintaining the contact lens device in an orientation substantially parallel to the floor of the ophthalmic suite.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of priority of U.S. Provisional Patent Application No. 63 / 506,713, filed on June 7, 2023, which is hereby incorporated by reference in its entirety.

Background Art

[0002] The present disclosure relates to wide - angle visualization of the internal anatomical structure of a patient's eye. As will be understood by those skilled in the art, for the proper prognosis and diagnosis of retinal tears and other intraocular conditions, physicians often need to use a high - definition optical system. Such a system uses a microscope to magnify the eye to facilitate visualization and may also, if necessary, use a digital camera for image capture. In this way, physicians are provided with a clear real - time view of the retina, macula, vitreous body, and surrounding tissues within the eye.

[0003] During ophthalmic visualization procedures, physicians may need a view of the patient's vitreous chamber that is wider than what is normally achievable using the microscope's lens and visualization hardware. For example, a physician may consider it beneficial to observe the peripheral retinal region when monitoring conditions such as retinal tears or detachments. Wide - angle visualization can be performed using specially constructed optical lenses, which, in some implementations, are placed directly on the patient's cornea ("contact - based"). In other implementations, the lens remains a short distance away from the cornea ("non - contact - based"). In either case, the shape and structure of the lens provide the desired wide - angle view assisted by endoillumination.

Summary of the Invention

Means for Solving the Problems

[0004] Disclosed herein is a contact-type wide-angle visualization system ("WAVS") for use in an ophthalmic suite equipped with a microscope. A contact-type WAVS as conceivable herein includes a constant downforce (CDF) assembly having a proximal and distal end positioned opposite each other. The proximal end of the CDF assembly is connectable to a microscope via an intervening connecting arm, e.g., one or more articulated or translatable arms as described herein. A contact lens device is connectable to the distal end of the CDF assembly, and the contact lens device has a contact lens configured to be mounted on the cornea of ​​a patient's eye within an ophthalmic suite. The CDF assembly provides a predetermined / calibrated constant downforce to the contact lens device and its contact lens at a level sufficient to hold the contact lens on the cornea without corneal distortion. In addition, the CDF assembly is configured to self-level, thereby maintaining the contact lens device in an orientation substantially parallel to the floor of the ophthalmic suite, e.g., within approximately ±5 to 10° of true parallel.

[0005] In one or more embodiments, a gimbal is connected to the distal end of the CDF assembly and the contact lens device, thereby maintaining the substantially parallel orientation of the contact lens, for example by limiting the pitch and / or roll of the contact lens device, and resulting in a better view of the important peripheral retina due to the limited tip / tilt.

[0006] In one or more embodiments, the contact lens device includes a support frame and support frame arms. In this configuration, the support frame is configured to support the contact lens. The support frame arms are connected to the support frame and the CDF assembly. In this particular non-limiting exemplary configuration, the CDF assembly includes a shaft surrounded by a bearing housing that contains instrument bearings, the bearing housing being movable along the longitudinal axis of the shaft in response to forces from the contact lens device resulting from patient movement, for example.

[0007] In possible implementations, one or more constant-load springs may be connected to or surround the shaft. In other implementations, the CDF assembly includes a small gas spring.

[0008] In an alternative configuration, the four-bar mechanism may be operably connected to a low-friction air cylinder in which a piston is located. To ensure an unobstructed view of the anatomical structure of the eye, the longitudinal axis of the piston in such an embodiment may be laterally offset by a short distance from the four-bar mechanism, for example, using short interconnecting components. The end of the piston may be operably connected to the contact lens device summarized above.

[0009] A low-friction air cylinder according to a non-limiting exemplary embodiment is made of glass, such as borosilicate glass, or another low-friction material suitable for the application, and a low-friction piston is movable within the air cylinder.

[0010] The features and advantages of this disclosure described above, as well as other possible features and advantages, will become apparent from the following detailed description of the best mode for carrying out this disclosure, when interpreted in relation to the attached drawings. [Brief explanation of the drawing]

[0011] [Figure 1] This is a schematic diagram of an exemplary ophthalmic suite equipped with a contact wide-angle visualization system ("WAVS") as described herein. [Figure 2A-2B] These show contact-type WAVS when used with articulated and translatable connecting arms. [Figure 3] Figures 1-2B show a contact-type WAVS with a possible structure incorporating linear bearings and a constant-load spring. [Figure 4] Figures 1-3 show a contact-type WAVS with an alternative embodiment incorporating a gas cylinder. [Figure 5]Figures 1-4 show a contact-type WAVS with a possible structure incorporating a 4-bar mechanism and the gas cylinder shown in Figure 4. [Modes for carrying out the invention]

[0012] The attached drawings are not necessarily to scale and present a somewhat simplified depiction of various features of this disclosure as disclosed herein, such as specific dimensions, orientations, locations, and shapes. Details relating to such features will be determined in part by the specific intended use and environment.

[0013] Embodiments of the present disclosure are described herein. However, it will be understood that the embodiments disclosed are merely illustrative and that other embodiments may take various alternative forms. The drawings are not necessarily to scale. Some features may be exaggerated or minimized to illustrate the details of certain components. Accordingly, certain structural and functional details disclosed herein should not be constrained, but rather should be interpreted merely as representative grounds to teach those skilled in the art how to employ the present disclosure in various ways.

[0014] In the following explanation, certain terms may be used for reference purposes only and are therefore not intended to be limiting. For example, terms such as “up” and “down” refer to directions within the referenced drawings. Terms such as “front,” “rear,” “forward,” “backward,” “left,” “right,” “rear,” and “side” describe the orientation and / or location of a part of a component or element within any coordinate system that is consistent, as clarified by referring to the text and related drawings describing the component or element being discussed. Furthermore, terms such as “first,” “second,” and “third” may be used to describe separate components. Such terms may include the words specifically mentioned, their derivatives, and words with similar meanings.

[0015] A typical ophthalmic suite 10 is schematically shown in Figure 1, with similar reference numerals indicating similar components in the drawings. The ophthalmic suite 10 includes an optical system 12 that is capable of visualizing the intraocular anatomical structure 14 of the patient's eye 140, with a portion of the patient's eye projected onto a high-resolution monitor 24 in Figure 1. Both the surgeon and the patient are omitted from Figure 1 for simplicity of explanation, but those skilled in the art will understand that the patient is on a platform 16, for example, on a table or leaning back in a chair, and the surgeon is seated on a stool 160 adjacent to the platform 16. The surgeon then electronically observes the patient's eye 140 in a "heads-up" manner at the magnification provided by the optical system 12, for example, via the NGENUITY® 3D Visualization System, commercially available from Alcon, Inc.

[0016] According to this disclosure, an optical system 12 as considered herein includes a contact wide-angle visualization system ("WAVS") 17. While non-contact approaches to wide-angle observation remain common in the art, it is recognized herein that adequately implementing non-contact alternatives can be challenging. For example, an alternative to a non-contact WAVS involves the use of a lens connected to the optical head 260 of an ophthalmic microscope 26, rather than being fitted to the patient's eye 140. As a result, non-contact alternatives for wide-angle observation are highly sensitive to patient movement and require nearly constant xy-plane translation correction of the microscope 26. The necessary correction is typically driven by a physician's foot pedal input, and similarly, the physician's movement can exacerbate the patient's movement. Furthermore, for proper wide-angle observation, the external / non-contact lens must be positioned very close to the cornea. This results in the external lens frequently striking the corneal surface, thereby causing the transfer of viscoelastic material from the cornea to the lens, and thus requiring frequent cleaning of the lens.

[0017] In contrast, the use of a contact approach for wide-angle observation eliminates corneal asphericity from, for example, previous radial keratectomy, astigmatic keratectomy, or permeable keratoplasty, or from corneal lacerations and other factors. At the same time, the contact approach increases the field of view by approximately 10° compared to competing non-contact techniques. However, current alternatives to contact wide-angle observation face their own inherent challenges, including difficulties in positioning and maintaining the contact lens on the cornea by a surgical assistant due to factors such as the patient's head or eye movements. This is true whether such movements are small-amplitude, repetitive movements due to, for example, normal breathing, or more sudden and unexpected movements such as large-amplitude head movements when the patient suddenly sits up or has a seizure due to sleep apnea, or when experiencing a startle reflex such as sneezing, coughing, or otherwise. Therefore, the improvements described in detail below are intended to address these and other safety issues, as well as other potential issues generally associated with contact-type wide-angle observation.

[0018] As is understood in the art and will be described in detail below with reference to the drawings, the contact-type WAVS17 is constructed such that a constant, balanced downforce (arrow DF) is applied to the contact lens 22L when the contact lens 22L is fitted to the patient's eye 140. At the same time, the constant downforce prevents the formation of bubbles or air pockets under the contact lens 22L. Thus, the potential problems of corneal distortion due to excessive downforce and bubble trapping due to insufficient downforce are mitigated by the configuration of the considered contact-type WAVS17 shown in Figure 1, and exemplary embodiments of its constant downforce (CDF) assembly 18 will be described below with reference to Figures 2A-5.

[0019] The optical system 12 shown in Figure 1 includes a digital or analog medical microscope device having a microscope 26, for example, a handle 26H and an eyepiece or eyepiece lens (not shown). In some embodiments, the microscope 26 may be connected to a digital camera 23 to enable a physician or staff member to capture digital pixel images of the eye 140 as needed. Visualization of the eye 140 may be enhanced by real-time video broadcasting via one or more monitors 24, such as medical 4K or other ultra-high-definition organic light-emitting diode (OLED) panels, positioned within easy viewing range for surgeons and other staff members within the ophthalmic suite 10.

[0020] As part of this approach, the optical system 12 shown in Figure 1 is configured to magnify and clearly visualize the intraocular anatomical structures 14 of the eye 140 in real time. For this purpose, the microscope 26 may be suspended from above, connected and / or supported, for example, by a multi-axis robotic arm 25. A contact-type WAVS 17, as described herein, can be attached directly or indirectly to the optical head 260 of the microscope 26 using mechanical engagement elements such as interposing connecting arms 40A or 40B shown in Figures 2A and 2B, respectively. Non-limiting exemplary microscopes 26 include the LuxOR® Revalia® Ophthalmic Microscope from Alcon, Inc. and the OPMI Lumera® 700 from Carl Zeiss Meditec, Inc. Other commercially available microscopes, such as the Aesculap AEOS® Digital Microscope from Aesculap, Inc., do not require the use of an eyepiece.

[0021] To enable the various software-based control modes of this disclosure, the electronic control unit (ECU) 30 is configured to communicate with the microscope 26 and the robot 25 via a network, and such bidirectional communication is shown by the double arrow CC in Figure 1. 25It is shown by. The ECU 30 can be configured to execute computer-readable code or instructions for performing one or more tasks involving the use of the optical system 12. The ECU 30 is schematically shown as a unitary device for simplicity of illustration, but the ECU 30 can include one or more network computer devices together with a relevant computer-readable medium or memory including a non-transitory (e.g., tangible) medium involved in providing data / instructions readable by one or more processors (not shown).

[0022] The memory used for this can take many forms, including but not limited to non-volatile media and volatile media. As understood, non-volatile media can include optical disks and / or magnetic disks and other persistent memories, while volatile media can include dynamic random access memory (DRAM), static RAM (SRAM), etc., and any one or all of these can constitute the main memory. Communication with the microscope 26 and the robot 25 can be achieved via a network connection to the input / output circuit of the ECU 30. Although not shown, other hardware well established in the art, including but not limited to a local oscillator or high-speed clock, signal buffer, digital signal filter, etc., may be included as part of the ECU 30. The ECU 30 can be surrounded by the base 250 of the robot 25 mounted or firmly positioned within the movable cabinet 35 or another suitable structure, such as the floor 11 of the ophthalmic suite 10, to protect the ECU 30 from the intrusion of moisture or debris, cool the ECU 30, and provide the necessary network and power connections. The ECU 30 can communicate with the display monitor 24 via a display signal (CC 24 ) as part of this strategy.

[0023] Referring briefly to FIGS. 2A and 2B, a constant downforce (CDF) assembly 18 contemplated herein is configured to connect to an optical head 260 of a microscope 26 shown in FIG. 1 and described above. As is understood in the art, there are various commercially available options for connecting an external lens to a microscope 26 depending on the structure of the microscope. Generally, the CDF assembly 18 can be attached to the microscope 26 via either an intervening connection arm 40A or 40B of FIGS. 2A and 2B.

[0024] Referring first to FIG. 2A, the connection arm 40A may include a connection ring 41 that is connected to the optical head 260. In this exemplary embodiment, for example, in the RESIGHT® family commercially available from Carl Zeiss Meditec, Inc., opposing tabs 42 disposed at a first end E1 of the connection arm 40A are connected to or formed integrally with the connection ring 41 and joined to the connection arm 40A via a rotary joint 44 so as to form a forked or flared arrangement as shown. Thus, a physician can rotate the connection ring 41 about the optical axis AA and swing the connection arm 40A about the axis of rotation RR of the rotary joint 44, thereby positioning the first end E1 of the connection arm 40A at a desired location within its available range of movement.

[0025] In this embodiment, the second end E2 of the connection arm 40A may include another rotary joint 144 or an attachment mechanism suitable for another use. According to the present disclosure, the CDF assembly 18 is connected to the connection arm 40A, either alone or in conjunction with a high diopter lens (L1) 46. As is understood in the art, such a lens 46 can be about 70 to 90 diopters, which allows a physician to selectively engage or disengage alignment with the optical axis (AA) as needed. Thus, the lens 46 will be positioned between the optical head 260 and the CDF assembly 18 when in use.

[0026] The contact lens device 22 is connectable to the CDF assembly 18 in part, as shown in the figure. The contact lens device 22 includes the contact lens (L2) 22L described above, which is configured such that a portion of it is fitted to the cornea 14C of the eye 140 when the patient is in the ophthalmic suite 10 in Figure 1. As described above, the CDF assembly 18 is configured to provide the contact lens 22L with a constant downforce DF of, for example, about 0.1 to 0.5 pounds per square inch gauge pressure (psig), or a downforce suitable for another application, and to be self-leveling, thereby maintaining the contact lens 22L in an orientation substantially parallel to the floor 11 of the ophthalmic suite 10. As used herein, “substantially parallel” means within about ±5° to 10° of true parallel or within a window suitable for another application of true parallel, but avoiding a true parallel orientation.

[0027] To ensure a desired orientation, the gimbal 36 can be connected to the distal end of the CDF assembly 18 and the contact lens device 22. By using the gimbal 36 to limit the pitch and / or roll of the contact lens device 22, a substantially parallel orientation of the contact lens 22L can be maintained. Figure 2A shows a schematic illustration for simplicity, but those skilled in the art will understand that commercially available gimbals typically include an arrangement of rings connected perpendicular to each other, for example, for camera stability and robot end effector use. Since each component ring of the gimbal 36 can rotate independently of the other rings, the contact lens device 22 can also rotate along multiple axes while maintaining a desired orientation relative to the floor 11 as shown in Figure 1.

[0028] Referring to Figure 2B, an alternatively constructed connecting arm 40B may be a vertically movable rod connected to an angled bracket 48 at its end E1. The angled bracket 48 may then be connected to a body 49, which is then connected to the aforementioned optical head 260 in Figure 1 via a ring 141, for example, as an OCULUS® BIOM® ready set. As is understood in the art, the physician can swing the body 49 and all connected components in and out of the optical axis AA, as indicated by the double arrow BB. Thus, the CDF assembly 18 as described below may be used with different types of connecting arms, including, but not limited to, the connecting arms 40A and 40B in Figures 2A and 2B, respectively. Hereinafter, three possible configurations of the CDF assembly 18 will be described with particular reference to Figures 3-5, and the connecting arms 40A and 40B in Figures 2A and 2B, respectively, will be collectively referred to as 40 in the remaining drawings.

[0029] Referring here to Figure 3, the contact lens device 22 described above includes a contact lens 22L, which is configured to be fitted onto the cornea 14C of the patient's eye 140, as shown in Figure 2A. The contact lens 22L may be made of a rigid or semi-rigid gas-permeable material, such as fluorosilicone acrylate, silicone acrylate, or another material suitable for the application that provides the required field of view. The contact lens device 22 is connectable to the distal end of the CDF assembly 180 in the embodiment shown in the CDF assembly 18 shown in Figures 1-2B. For example, the contact lens device 22 may include a support frame 122 and a support frame arm 123. In such an embodiment, the support frame 122 is configured to support the contact lens 22L, for example, around its periphery or outer circumference. A portion of the support frame arm 123 may be welded to the support frame 122, integrally formed with it, or otherwise connected in different implementations, and may also be connected to the CDF assembly 180, removable or permanent in different implementations.

[0030] In the non-limiting embodiment of Figure 3, the CDF assembly 180 is shown connected to a connecting arm 40, for example, either connecting arm 40A or 40B in Figures 2A and 2B, respectively. The CDF assembly 180 of the illustrated structure includes a cylindrical rod or shaft 50 surrounded by a bearing housing 52. The bearing housing 52, which contains instrument-quality ball bearings 54, is movable in parallel along the longitudinal axis (LL) of the shaft 50. As is understood in the art, linear ball bearings are used to minimize friction and ensure controlled and smooth linear motion in linear motion systems such as the illustrated bearing housing 52 and the contact lens device 22L connected thereto. Such motion may be caused by the movement of the patient's eye 140 and / or the patient's head in Figure 2A. Linear instrument bearings are commercially available, for example, the Thomson® family of linear bearings from Regal Rexnord Corporation (Belot, WI.). The bearing housing 52 moves parallel to the longitudinal axis (LL) of the shaft 50 via a ball track (not shown) in which the instrument ball bearing 54 is captured.

[0031] The vertical movement of the contact lens device 22L in Figure 3 can be optimized in one or more embodiments using a suitable damping mechanism. For example, in some implementations, one or more constant-force springs 55 may be connected to and / or surround the shaft 50. As understood in the art, a constant-force spring is configured to maintain a consistent force output when extended and compressed. In this application, the constant-force spring 55 is compressed as the bearing housing 52 moves toward the optical head 260 of the microscope (see Figure 1). When the patient returns to a resting position, the compressed constant-force spring 55 slowly releases their stored energy, thus precisely controlling the downward speed of the contact lens device 22L.

[0032] Referring here to Figure 4, the desired constant downforce and self-leveling advantages of the contact-type WAVS 17 of Figure 1 can be achieved in other ways within the scope of this disclosure. For example, the CDF assembly 280 may include a miniature gas spring 60 for providing precise downforce and controlling vertical movement (double arrows VV). As is understood in the art, miniature gas springs are often designed to provide precise and controlled movement in areas where space is limited. Generally, a miniature gas spring 60 as considered herein may include a gas-filled cylinder 62 and a low-friction piston 64 that moves parallel within the cylinder 62.

[0033] In this application, such translation occurs in response to the movement of the patient's eye 140 (Figure 2A) or the patient's head (not shown). By changing the pressure acting on the piston 64, a smooth, almost frictionless linear motion is obtained. The gas spring 60 may be configured to slow the movement of the piston 64 when force is applied by the patient's eye 140 and / or the patient's head. For optimal low-friction performance, damping and additional resistance of the movement of the contact lens device 22 and the connected wide-angle contact lens (L2) 22L may be implemented.

[0034] Referring to Figure 5, in yet another possible embodiment, the contact-type WAVS17 of Figure 1 may include a CDF assembly 380 with a four-bar mechanism 70. The four-bar mechanism 70 as discussed herein and as understood in the art includes first, second, third, and fourth link mechanisms or bars 70A, 70B, 70C, and 70D interconnected by rotary joints J1, J2, J3, and J4 as shown. Thus, this arrangement configuration provides vertical movement and holds the contact lens device 22 substantially parallel to the floor 11 in Figure 1, within a small tolerance of true parallelism, as permitted by, for example, the gimbal 36 in Figure 2A or other suitable structure.

[0035] In one or more embodiments, the four-bar mechanism 70 may be operably connected to a low-friction air cylinder 75 supplied by regulated pneumatic pressure (not shown) to maintain a constant downforce, e.g., about 0.1–0.5 psig or a constant downforce suitable for a different patient and application. The low-friction air cylinder 75 then has a low-friction piston 76 located inside it. The longitudinal axis (LL2) of the piston 76 may be laterally offset from the four-bar mechanism 70, for example, via an interconnecting component 77 connected to the low-friction air cylinder 75, as shown. The contact lens device 22 is then connected to the end 78 of the piston 76 of the low-friction air cylinder 75 so that the air cylinder 75 brings the constant downforce described above to the contact lens (L2) 22L. At the same time, the optional four-bar mechanism 70 maintains a desired substantially parallel orientation to the floor 11 in Figure 1, along with the upward or downward movement of the contact lens device 22 in response to a given patient movement—without allowing a truly parallel orientation. Therefore, the low-friction air cylinder 75 in this case counteracts the vertically guided load, including the contact lens device 22, its support frame 122, and its support arm 123.

[0036] Low-friction air cylinders, such as the Airpel-AB® air cylinders commercially available from Airpot® Corporation (Norwalk, CT), are constructed to provide smooth, efficient, and essentially frictionless linear motion and are therefore usable within the scope of this disclosure. With respect to minimum friction, this can be achieved by constructing the cylinder 75 from a material having a low coefficient of friction, such as borosilicate glass, along with process steps such as machining. The low-friction air cylinder 75 and the low-friction piston 76 located inside it are used in conjunction with the illustrated four-bar mechanism to smoothly and efficiently apply a desired constant downforce.

[0037] As will be understood by those skilled in the art in light of the foregoing disclosure, the solution presented above ensures a constant downforce on the contact lens 22L in a precise manner that guarantees no distortion of the cornea. This occurs without any air bubbles being observed on the back side of the contact lens 22L. The contact lens 22L is maintained in an orientation substantially parallel (but not perfectly parallel) to the floor 11 of the ophthalmic suite in Figure 1, as opposed to the plane of the iris. A slight tolerance for non-parallelism, for example, made possible by the gimbal in Figure 2A, ensures this orientation. The patient's head can then be moved up and down by breathing with the lowest possible friction along the axis of such vertical movement, with respect to both static friction ("stiction") and Coulomb friction. The embodiments described above may be either autoclavable or disposable in different configurations, thereby facilitating a wider adoption of the teachings. These and other incidental advantages will be readily understood by those skilled in the art in light of the foregoing disclosure.

[0038] While detailed descriptions and drawings support and illustrate this disclosure, the scope of this disclosure is defined solely by the claims. Although several best modes and other embodiments for carrying out the claimed disclosure have been described in detail, various alternative designs and embodiments exist for carrying out the disclosure as defined in the attached claims.

[0039] Furthermore, the features of the embodiments shown in the drawings or the various embodiments referred to in this description should not necessarily be understood as independent embodiments. Rather, each of the features described in one example of an embodiment may be combined with one or more other desirable features from other embodiments, resulting in other embodiments that are not described in words or not described by reference to the drawings. Accordingly, such other embodiments are included within the framework of the appended claims.

Claims

1. A contact-type wide-angle visualization system ("WAVS") for use in an ophthalmic suite with a microscope, wherein the contact-type WAVS is A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to connect to the optical head of the microscope via an intervening connecting arm, A contact lens device comprising a contact lens that is connectable to the distal end of the CDF assembly and configured to be fitted to the cornea of ​​a patient's eye within the ophthalmic suite, wherein the CDF assembly is configured to (i) provide a constant downforce to the contact lens device and (ii) self-level, thereby maintaining the contact lens device in an orientation substantially parallel to the floor of the ophthalmic suite. Contact-type WAVS, including

2. The contact-type WAVS according to claim 1, further comprising a gimbal connected to the distal end of the CDF assembly and the contact lens device, the gimbal maintaining the substantially parallel orientation by limiting the pitch and / or roll of the contact lens device.

3. The aforementioned contact lens device is A support frame configured to support the contact lens, The support frame and the support frame arm connected to the CDF assembly A contact-type WAVS according to claim 1, including the above.

4. The contact type WAVS according to claim 1, wherein the CDF assembly includes a shaft surrounded by a bearing housing which includes a device bearing inside, and the bearing housing is movable in parallel along the longitudinal axis of the shaft.

5. The contact-type WAVS according to claim 4, further comprising one or more constant-load springs connected to or surrounding the shaft.

6. The contact-type WAVS according to claim 1, wherein the CDF assembly includes a small gas spring.

7. The contact type WAVS according to claim 1, wherein the CDF assembly includes a four-bar mechanism operably connected to a low-friction air cylinder, the low-friction air cylinder having a low-friction piston disposed therein, the longitudinal axis of the piston being laterally offset from the four-bar mechanism.

8. The end of the piston is operably connected to the contact lens device, as described in claim 7.

9. The contact-type WAVS according to claim 8, wherein the low-friction air cylinder is made of borosilicate glass.

10. The contact-type WAVS according to claim 1, further comprising the intervening connecting arm.

11. A contact-type wide-angle visualization system ("WAVS") for use in an ophthalmic suite with a microscope, wherein the contact-type WAVS is A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to connect to the optical head of the microscope via an intervening connecting arm, A contact lens device comprising: a contact lens connectable to the distal end of the CDF assembly and configured to be mounted on the cornea of ​​a patient's eye within the ophthalmic suite; a support frame configured to support the contact lens; and a support frame arm connected to the support frame and the CDF assembly, A gimbal connected to the distal end of the CDF assembly and the contact lens device, wherein the CDF assembly is configured to provide a constant downforce to the contact lens device and to self-level, thereby maintaining the contact lens device in an orientation substantially parallel to the floor of the ophthalmic suite, and the gimbal maintains the substantially parallel orientation by limiting the pitch and / or roll of the contact lens device. Contact-type WAVS, including

12. The contact type WAVS according to claim 11, wherein the CDF assembly includes a shaft surrounded by a bearing housing which includes a device bearing inside, and the bearing housing is movable in parallel along the longitudinal axis of the shaft.

13. The contact-type WAVS according to claim 12, further comprising one or more constant-load springs connected to or surrounding the shaft.

14. The contact-type WAVS according to claim 11, wherein the CDF assembly includes a small gas spring.

15. The contact type WAVS according to claim 11, wherein the CDF assembly includes a four-bar mechanism operably connected to a low-friction air cylinder.

16. The contact-type WAVS according to claim 15, wherein the low-friction air cylinder has a piston disposed inside it, the longitudinal axis of the piston is offset laterally from the four-bar mechanism, and the end of the piston is operably connected to the contact lens device.

17. It is a system, A connecting arm configured to connect to the optical head of a microscope, A contact-type wide-angle visualization system ("WAVS") for use in an ophthalmic suite with a microscope, wherein the contact-type WAVS is A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to connect to a connecting arm, the CDF assembly includes a shaft surrounded by a bearing housing which includes a device bearing inside, the bearing housing being movable parallel to the longitudinal axis of the shaft, and one or more constant-load springs connected to or surrounding the shaft, and A contact lens device comprising a contact lens connectable to the distal end of the CDF assembly and configured to be fitted to the cornea of ​​a patient's eye within the ophthalmic suite, wherein the CDF assembly is configured to provide a constant downforce to the contact lens device and to self-level, thereby maintaining the contact lens device in an orientation substantially parallel to the floor of the ophthalmic suite. Including contact-type WAVS and A system that includes this.

18. The system according to claim 17, further comprising a gimbal connected to the distal end of the CDF assembly and the contact lens device, the gimbal maintaining the substantially parallel orientation by limiting the pitch and / or roll of the contact lens device.

19. The system according to claim 17, wherein the contact lens device includes a support frame configured to support the contact lens.

20. The system according to claim 19, wherein the contact lens device includes a support frame and a support frame arm connected to the CDF assembly.

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