Intraocular illumination device and attachment for intraocular illumination

Abstract

This intraocular illumination device comprises: a fiber for guiding light from a light source; and a holder which is disposed between an objective lens of a microscope and an eye during surgery or inspection of the eye and which supports the leading end of the fiber. Provided to the leading end of the fiber is a reflective part on which the light guided through the fiber is reflected toward the interior of the eye.

Description

Intraocular illumination devices, attachments for intraocular illumination

[0001] The present disclosure relates to intraocular illumination devices and attachments for intraocular illumination.

[0002] Conventional intraocular lighting devices used in ophthalmic surgery are inserted into the patient's eye to provide direct illumination. This requires the creation of a port through the sclera into the eye, which poses the risk of infection. Furthermore, because one hand of the surgeon is required to operate the lighting device, surgical instruments can usually only be operated with one hand.

[0003] Japanese Patent Application Laid-Open Publication No. 2005-230558 proposes a technology in which a light source is placed inside a microscope on the opposite side of the objective lens from the eye, and light passing through the objective lens illuminates the inside of the eye from outside the eye. However, with the technology of Japanese Patent Application Laid-Open Publication No. 2005-230558, because the light source is placed on the opposite side of the objective lens from the eye and the light enters the eye through the objective lens, it is difficult to obtain intraocular illumination with a sufficient amount of light and illumination range. Furthermore, because the light source is placed inside the microscope, it is necessary to purchase a new microscope with such a special structure, which has the inconvenience of making it impossible to use existing microscopes.

[0004] What is needed is a technology that can provide extraocular illumination with sufficient light intensity and range, and a technology that can achieve extraocular illumination while utilizing an existing microscope.

[0005] An intraocular lighting device according to one aspect of the present disclosure comprises: a fiber that guides light from a light source; and a holder that is positioned between a microscope objective and the eye during eye surgery or examination and supports the tip of the fiber, wherein the tip of the fiber is provided with a reflector that reflects the light guided through the fiber toward the inside of the eye.

[0006] An intraocular illumination attachment according to one aspect of the present disclosure is an intraocular illumination attachment that is placed between a microscope objective and the eye during eye surgery or examination, and comprises: an illumination unit that is attached to the tip of a fiber that guides light from a light source and includes a mirror that reflects the light guided through the fiber toward the inside of the eye; and a holder that supports the illumination unit.

[0007] FIG. 1 is a schematic diagram showing the positional relationship between an intraocular illumination device according to one embodiment, a microscope objective lens, and an eye. FIG. 2 is an enlarged perspective view of the intraocular illumination device. FIG. 3 is a plan view of the intraocular illumination device as viewed from the eye side. FIG. 4 is a perspective view of an intraocular illumination attachment holder as viewed from the microscope objective lens side. FIG. 5 is a perspective view of the intraocular illumination attachment holder as viewed from the eye side. FIG. 6 is an enlarged perspective view of an illumination unit attached to the tip of a fiber. FIG. 7A is a longitudinal cross-sectional view of the illumination unit. FIG. 7B is a perspective view of the illumination unit. FIG. 8 is a fundus photograph taken when actually observing the fundus using the intraocular illumination device. FIG. 9 is an enlarged perspective view of an intraocular illumination device according to a modified example. FIG. 10 is a plan view of the intraocular illumination device according to a modified example as viewed from the eye side. FIG. 11 is a perspective view of the intraocular illumination attachment holder according to a modified example as viewed from the microscope objective lens side. Fig. 12 is a perspective view of a holder for an intraocular illumination attachment according to one modified example, as viewed from the eye side. Fig. 13 is a schematic diagram showing the positional relationship between an intraocular illumination device according to one modified example, an objective lens of a microscope, and the eye. Fig. 14 is a schematic diagram showing the positional relationship between an intraocular illumination device according to one modified example, an objective lens of a microscope, and the eye. Fig. 15 is a diagram showing specific dimensions of a holder for an intraocular illumination device actually used in the examples. Fig. 16 is a diagram showing specific dimensions of a tubular portion of an illumination unit of an intraocular illumination device actually used in the examples.

[0008] An intraocular illumination device according to a first aspect of the embodiment comprises: a fiber that guides light from a light source; and a holder that is placed between a microscope objective and the eye during eye surgery or examination and supports the tip of the fiber, wherein the tip of the fiber is provided with a reflector that reflects the light guided through the fiber toward the inside of the eye.

[0009] According to this aspect, the tip of the fiber that guides light from the light source is supported by a holder between the microscope objective lens and the eye, and the tip of the fiber is provided with a reflector that reflects the light guided through the fiber toward the inside of the eye, so that light can be irradiated toward the inside of the eye from a position sufficiently close to the eye without going through a lens. Therefore, intraocular illumination with sufficient light intensity and range can be obtained from outside the eye. Furthermore, because the tip of the fiber is supported by the holder so that it does not move, the surgeon can operate surgical instruments with both hands, i.e., bimanual techniques can be practiced.

[0010] An intraocular illumination device according to a second aspect of the embodiment is the intraocular illumination device according to the first aspect, wherein an illumination unit including a mirror that reflects light guided through the fiber toward the inside of the eye is attached to the tip of the fiber, and the reflecting portion is composed of the mirror.

[0011] An intraocular illumination device according to a third aspect of the embodiment is the intraocular illumination device according to the first aspect, wherein the end face of the tip of the fiber is polished obliquely so as to reflect light guided through the fiber toward the inside of the eye, and the reflecting portion is constituted by the end face of the fiber.

[0012] An intraocular illumination device according to a fourth aspect of the embodiment is the intraocular illumination device according to any one of the first to third aspects, wherein the thickness of the holder is 10 mm or less.

[0013] According to this aspect, the holder can be easily placed in the narrow space between the objective lens of the microscope and the eye.

[0014] An intraocular illumination device according to a fifth aspect of the embodiment is the intraocular illumination device according to any one of the first to fourth aspects, wherein the holder supports a plurality of the tip portions of the fibers.

[0015] According to this aspect, the holder supports a plurality of tip portions of the fibers, thereby increasing the amount and range of light for intraocular illumination.

[0016] An intraocular illumination device according to a sixth aspect of the embodiment is the intraocular illumination device according to the fifth aspect, wherein the plurality of reflecting portions provided on the plurality of tip portions are arranged in the holder at equal intervals along a circumferential direction centered on the optical axis of the microscope.

[0017] According to this aspect, a wide area inside the eye can be uniformly illuminated.

[0018] An intraocular illumination device according to a seventh aspect of the embodiment is the intraocular illumination device according to any one of the first to sixth aspects, wherein the holder is provided with an attachment portion that can be attached to a lens unit of the microscope.

[0019] An intraocular illumination device according to an eighth aspect of the embodiment is the intraocular illumination device according to any one of the first to sixth aspects, wherein the holder is configured integrally with a lens unit of the microscope.

[0020] An intraocular illumination device according to a ninth aspect of the embodiment is the intraocular illumination device according to any one of the first to eighth aspects, wherein the holder has a through hole formed coaxially with the optical axis of the microscope, a groove or hole formed in the holder so as to extend outward from the vicinity of the through hole in a plan view, and the tip of the fiber is inserted into and supported by the groove or hole formed in the holder.

[0021] According to this aspect, the holder has a through-hole formed coaxially with the optical axis of the microscope, which allows a bright field of view to be obtained when observing with the microscope. Furthermore, the tip of the fiber is inserted into a groove or hole formed in the holder and supported, which allows the configuration for supporting the tip of the fiber to be realized with a very simple structure, and makes it possible to reduce the manufacturing cost of the holder.

[0022] An intraocular illumination device according to a tenth aspect of the embodiment is the intraocular illumination device according to the ninth aspect, wherein the tip of the fiber is positionably adjustable along the groove or hole while being supported by the holder.

[0023] According to this aspect, by adjusting the position of the tip of the fiber, it is possible to easily adjust the brightness of the fundus and the condition of the spot (illuminated area).

[0024] An intraocular illumination device according to an eleventh aspect of the embodiment is the intraocular illumination device according to the tenth aspect, wherein the tip of the fiber can be positioned along the groove or hole, thereby allowing the reflecting portion to be brought within 5 mm of the optical axis of the microscope.

[0025] According to this embodiment, the diameter of the pupil (cornea) is usually 10 to 12 mm, whereas the window portion can be placed within 5 mm of the optical axis of the microscope, so that the light emitted from the window portion can be efficiently admitted into the eye through the pupil.

[0026] An intraocular illumination device according to a twelfth aspect of the embodiment is the intraocular illumination device according to any one of the ninth to eleventh aspects, wherein the number of tips of the fibers is four, four grooves or holes are formed in the holder, and the four grooves or holes are formed to extend in directions of 0°, 90°, 180°, and 270°, respectively, in polar coordinates centered on the optical axis of the microscope.

[0027] An intraocular illumination device according to a thirteenth aspect of the embodiment is the intraocular illumination device according to any one of the ninth to eleventh aspects, wherein the number of the tips of the fibers is four, four grooves or holes are formed in the holder, and in polar coordinates centered on the optical axis of the microscope, a first groove or hole is formed to extend in the 0° direction from a 0° position, a second groove or hole is formed to extend in the 180° direction from a 180° position, a third groove or hole is formed to extend in the 0° or 180° direction from a 90° position, and a fourth groove or hole is formed to extend in the 0° or 180° direction from a 270° position.

[0028] An intraocular illumination device according to a fourteenth aspect of the embodiment is the intraocular illumination device according to any one of the first to thirteenth aspects, wherein the numerical aperture (NA) on the exit side of the fiber is 0.55 or less.

[0029] According to this aspect, light with sufficient directionality can be irradiated toward the inside of the eye, and the amount and range of light for intraocular illumination can be increased.

[0030] An intraocular illumination device according to a fifteenth aspect of the embodiment is the intraocular illumination device according to any one of the first to fourteenth aspects, wherein the fiber is branched between the light source and the illumination unit.

[0031] According to this aspect, the number of lighting units can be increased without increasing the number of light sources.

[0032] An intraocular illumination device according to a sixteenth aspect of the embodiment is the intraocular illumination device according to any one of the first to fifteenth aspects, wherein the light source is at least one of a xenon lamp, a halogen lamp, and an LED.

[0033] According to this embodiment, a xenon lamp, halogen lamp, or LED already installed in the operating room or examination room can be used as the light source, which is convenient as there is no need to prepare a new light source.

[0034] An intraocular illumination attachment according to a seventeenth aspect of the embodiment is an intraocular illumination attachment that is placed between a microscope objective and the eye during eye surgery or examination, and comprises: an illumination unit that is attached to the tip of a fiber that guides light from a light source and includes a mirror that reflects the light guided through the fiber toward the inside of the eye; and a holder that supports the illumination unit.

[0035] According to this aspect, the endoocular illumination attachment is placed between the microscope objective and the eye during ocular surgery or examination, i.e., it is placed outside the microscope, making it possible to achieve endoocular illumination from outside the eye while utilizing an existing microscope. Furthermore, the illumination unit, which includes a mirror that reflects light guided through a fiber toward the inside of the eye, is supported by a holder between the microscope objective and the eye, making it possible to irradiate light toward the inside of the eye from a position sufficiently close to the eye without using a lens. Therefore, endoocular illumination with sufficient light intensity and range can be achieved from outside the eye. Furthermore, because the illumination unit is supported by the holder so as not to move, the surgeon can operate surgical instruments with both hands, i.e., it is possible to practice bimanual techniques.

[0036] An intraocular illumination attachment according to an eighteenth aspect of the embodiment is the intraocular illumination attachment according to the seventeenth aspect, wherein the holder has a thickness of 10 mm or less.

[0037] According to this aspect, the holder can be easily placed in the narrow space between the objective lens of the microscope and the eye.

[0038] An intraocular illumination attachment according to a nineteenth aspect of the embodiment is the intraocular illumination attachment according to the seventeenth or eighteenth aspect, wherein the holder supports a plurality of the illumination units.

[0039] According to this aspect, the holder supports a plurality of illumination units, thereby increasing the amount and range of light for intraocular illumination.

[0040] An intraocular illumination attachment according to a twentieth aspect of the embodiment is the intraocular illumination attachment according to the nineteenth aspect, wherein the plurality of illumination units are arranged so that the window portions through which light reflected by the mirror exits are aligned at equal intervals in a circumferential direction centered on the optical axis of the microscope.

[0041] According to this aspect, a wide area inside the eye can be uniformly illuminated.

[0042] An intraocular illumination attachment according to a twenty-first aspect of the embodiment is an intraocular illumination attachment according to any one of the seventeenth to twentieth aspects, wherein the holder is provided with an attachment portion that can be attached to a lens unit of the microscope.

[0043] According to this aspect, the holder can be easily fixed so as not to move relative to the lens unit.

[0044] An intraocular illumination attachment according to a 22nd aspect of the embodiment is an intraocular illumination attachment according to any one of the 17th to 21st aspects, wherein the holder has a through hole formed coaxially with the optical axis of the microscope, and a groove or hole formed in the holder so as to extend outward from the vicinity of the through hole in a planar view, and the illumination unit attached to the tip of the fiber is inserted into and supported by the groove or hole formed in the holder.

[0045] According to this aspect, the holder has a through-hole formed coaxially with the optical axis of the microscope, so that a bright field of view can be obtained when observing with the microscope. Furthermore, the illumination unit is inserted into a groove or hole formed in the holder and supported, so that the configuration for supporting the illumination unit can be realized with a very simple structure, and it is possible to reduce the manufacturing cost of the holder.

[0046] An intraocular illumination attachment according to a twenty-third aspect of the embodiment is the intraocular illumination attachment according to the twenty-second aspect, wherein the illumination unit attached to the tip of the fiber is positionably adjustable along the groove or hole while supported by the holder.

[0047] According to this aspect, by adjusting the position of the illumination unit, it is possible to easily adjust the brightness of the fundus and the condition of the spot (illuminated area).

[0048] An intraocular illumination attachment according to a twenty-fourth aspect of the embodiment is the intraocular illumination attachment according to the twenty-third aspect, wherein the illumination unit attached to the tip of the fiber can be positioned along the groove or hole, so that the window portion through which light reflected by the mirror exits can be brought within 5 mm of the optical axis of the microscope.

[0049] According to this embodiment, the diameter of the pupil of the eye is usually 10 to 12 mm, but the window portion can be placed within 5 mm of the optical axis of the microscope, so that the light emitted from the window portion can be efficiently admitted into the eye through the pupil.

[0050] An intraocular illumination attachment according to a 25th aspect of the embodiment is an intraocular illumination attachment according to any one of the 22nd to 24th aspects, wherein the number of illumination units is four, four grooves or holes are formed in the holder, and the four grooves or holes are formed to extend in the directions of 0°, 90°, 180°, and 270°, respectively, in polar coordinates centered on the optical axis of the microscope.

[0051] An intraocular illumination attachment according to a 26th aspect of the embodiment is an intraocular illumination attachment according to any one of the 22nd to 24th aspects, wherein the number of illumination units is four, four grooves or holes are formed in the holder, and in polar coordinates centered on the optical axis of the microscope, a first groove or hole is formed to extend in the 0° direction from the 0° position, a second groove or hole is formed to extend in the 180° direction from the 180° position, a third groove or hole is formed to extend in the 0° or 180° direction from the 90° position, and a fourth groove or hole is formed to extend in the 0° or 180° direction from the 270° position.

[0052] An intraocular illumination attachment according to a twenty-seventh aspect of the embodiment is the intraocular illumination attachment according to any one of the seventeenth to twenty-sixth aspects, wherein the intraocular illumination attachment is disposable.

[0053] According to this aspect, although the intraocular illumination attachment is easily soiled because it is placed between the objective lens of the microscope and the eye during eye surgery or examination, it is extremely hygienic and convenient because it is disposable.

[0054] An intraocular illumination attachment according to a twenty-eighth aspect of the embodiment is the intraocular illumination attachment according to any one of the seventeenth to twenty-seventh aspects, wherein the numerical aperture (NA) on the exit side of the fiber is 0.55 or less.

[0055] According to this aspect, light with sufficient directionality can be irradiated toward the inside of the eye, and the amount and range of light for intraocular illumination can be increased.

[0056] An intraocular illumination attachment according to a twenty-ninth aspect of the embodiment is the intraocular illumination attachment according to any one of the seventeenth to twenty-eighth aspects, wherein the fiber is branched between the light source 15 and the illumination unit.

[0057] According to this aspect, the number of lighting units can be increased without increasing the number of light sources.

[0058] An intraocular illumination attachment according to a thirtieth aspect of the embodiment is the intraocular illumination attachment according to any one of the seventeenth to twenty-ninth aspects, wherein the light source is at least one of a xenon lamp, a halogen lamp, and an LED.

[0059] According to this embodiment, a xenon lamp, halogen lamp, or LED already installed in the operating room or examination room can be used as the light source, which is convenient as there is no need to prepare a new light source.

[0060] An intraocular illumination device according to a thirty-first aspect of the embodiment includes the intraocular illumination attachment according to any one of the seventeenth to thirtieth aspects and the fiber.

[0061] An ophthalmic surgical or inspection microscope according to a thirty-second aspect of the embodiment comprises an intraocular illumination device according to any one of the first to sixteenth and thirty-first aspects.

[0062] Hereinafter, specific examples of the embodiments will be described in detail with reference to the accompanying drawings. In each drawing, components having equivalent functions are designated by the same reference numerals, and detailed description of the components having the same reference numerals will not be repeated.

[0063] Fig. 1 is a schematic diagram showing the positional relationship between an intraocular illumination device 1 according to one embodiment, a microscope objective lens 31, and an eye 20. Fig. 2 is an enlarged perspective view of the intraocular illumination device 1. Fig. 3 is a plan view of the intraocular illumination device 1 as seen from the eye 20 side.

[0064] As shown in FIGS. 1 to 3, the intraocular illumination device 1 has a fiber (optical fiber) 13 that guides light from a light source 15 , and an intraocular illumination attachment 10 that is attached to the tip of the fiber 13 .

[0065] Of these, the intraocular illumination attachment 10 is, as shown in Figure 1, placed between the objective lens 31 of the microscope and the eye 20 during surgery or examination of the eye 20. Since the intraocular illumination attachment 10 is placed between the objective lens 31 and the eye 20 and is prone to becoming dirty, it may be disposable for hygienic reasons. The objective lens 31 of the microscope is housed in the lens unit 30.

[0066] As shown in FIGS. 1 to 3, the intraocular illumination attachment 10 has an illumination unit 11 attached to the tip of a fiber 13 and a holder 12 that supports the illumination unit 11.

[0067] First, the structure of the illumination unit 11 will be described. Fig. 6 is an enlarged perspective view of the illumination unit 11 attached to the tip of the fiber 13. Fig. 7A is a vertical cross-sectional view of the illumination unit 11, and Fig. 7B is a perspective view of the illumination unit 11.

[0068] 6, 7A, and 7B, the lighting unit 11 has a cylindrical portion 110 having a tip cut at an angle (for example, at a 45° angle) and a mirror 111 attached so as to cover an opening exposed at the cut surface of the cylindrical portion 110. The cylindrical portion 110 is made of, for example, brass. A window portion 112 is formed on the outer peripheral surface of the cylindrical portion 110 so as to correspond to the reflective surface of the mirror 111.

[0069] 6 , the tip of fiber 13 is inserted from the proximal end of tube portion 110 and fixed to tube portion 110. Light emitted from the tip of fiber 13 is reflected at a 90° angle by the reflecting surface of mirror 111 and then emitted to the outside through window portion 112. That is, in this embodiment, the reflecting portion that is provided at the tip of fiber 13 and reflects the light guided through fiber 13 toward the inside of eye 20 is composed of mirror 111 of illumination unit 11.

[0070] Next, a description will be given of the structure of the holder 12. Fig. 4 is a perspective view of the holder 12 as seen from the objective lens 31 side of the microscope. Fig. 5 is a perspective view of the holder 12 as seen from the eye 20 side.

[0071] 4 and 5, the holder 12 has a generally circular disk shape. The thickness T of the holder 12 (the length in the direction of the optical axis A of the microscope) may be, for example, 10 mm or less, 9 mm or less, or 8 mm or less. When the thickness of the holder 12 is sufficiently thin, the holder 12 can be easily placed in the narrow space between the objective lens 23 of the microscope and the eye 20 during surgery or examination of the eye 20. The diameter W0 of the holder 12 may be, for example, 40 to 50 mm. The material of the holder 12 is, for example, resin.

[0072] 4 and 5, the holder 12 is provided with a mounting portion 14 that can be attached to the lens unit 30 of the microscope. In the example shown, the mounting portion 14 has a substantially cylindrical shape and is provided on the surface of the holder 12 coaxially with the optical axis A of the microscope. The diameter of the mounting portion 14 is, for example, 20 to 25 mm, and the height of the mounting portion 14 is, for example, 10 to 15 mm.

[0073] Threaded holes are formed on the outer circumferential surface of the mounting portion 14. As shown in Fig. 1, when the lens unit 30 of the microscope is inserted inside the mounting portion 14, the screws inserted into the threaded holes are tightened, thereby fixing the holder 12 so that it does not move relative to the lens unit 30.

[0074] 3 and 4, a through-hole 121 is formed in the holder 12 so as to be coaxial with the optical axis A of the microscope. This prevents the holder 12 from blocking the periphery of the optical axis A of the microscope, allowing a bright field of view to be obtained when observing with the microscope.

[0075] As shown in FIGS. 3 to 5 , the holder 12 is formed with a groove or hole 122 extending outward from the vicinity of the through-hole 121 in a plan view. Here, the "groove or hole" refers to a structure that has a groove shape (open cross-sectional contour) near the through-hole 121 but becomes a hole shape (closed cross-sectional contour) away from the through-hole 121. The diameter of the groove or hole 122 is approximately the same as the diameter of the cylindrical portion 110 of the illumination unit 11, and the illumination unit 11 attached to the tip of the fiber 13 is supported by being inserted into the groove or hole 122 formed in the holder 12. This allows the configuration for supporting the illumination unit 11 to be realized with a very simple structure, thereby reducing the manufacturing cost of the holder 12.

[0076] Furthermore, by moving the fiber 13 in its axial direction, the position of the illumination unit 11 attached to the tip of the fiber 13 can be adjusted along the groove or hole 122 while being supported by the holder 12. By adjusting the position of the illumination unit 11, it is possible to easily adjust the brightness of the fundus and the condition of the spot (illuminated area).

[0077] The illumination unit 11 attached to the tip of the fiber 13 can be positioned along the groove or hole 122, so that the window 112, through which light reflected by the mirror 111 emerges, can be brought close to the optical axis A of the microscope. Referring to FIG. 3, the distance D between the optical axis A of the microscope and the window 112 may be within 5 mm, for example. The diameter of the iris 21 of the eye 20 is usually 10 to 12 mm, and by bringing the window 112 within 5 mm of the optical axis A of the microscope, it is possible to efficiently allow the light emerging from the window 112 to enter the eye 20 through the iris 21.

[0078] 4 and 5 , small grooves 122a for restricting rotation may be formed adjacent to the groove or hole 122 for inserting the illumination unit 11. A protrusion (not shown) corresponding to the small groove 122a may be provided on the outer peripheral surface of the cylindrical portion 110 of the illumination unit 11, and when inserting the cylindrical portion 110 of the illumination unit 11 into the groove or hole 122 of the holder 12, the protrusion of the cylindrical portion 110 may be inserted along the small groove 122a, thereby preventing the illumination unit 11 from rotating around the axis of the fiber 13 and making it possible to fix the direction of the light emitted from the window portion 112 so as not to move.

[0079] The holder 12 may have only one groove or hole 122 formed therein so as to support only one lighting unit 11, or may have multiple grooves or holes 122 formed therein so as to support multiple lighting units 11.

[0080] 2 and 3, four grooves or holes 122 are formed in the holder 12 so as to support four illumination units 11, but this is not limiting, and for example, six or eight grooves or holes may be formed in the holder 12 so as to support six or eight illumination units 11. By having the holder 12 support a plurality of illumination units 11, it is possible to increase the amount of light and range of intraocular illumination.

[0081] 2 and 3 , the multiple illumination units 11 may be arranged so that the window portions 112 through which light reflected by the mirrors 111 exit are aligned at equal intervals in the circumferential direction centered on the optical axis A of the microscope. In the illustrated example, the four illumination units 11 are respectively arranged at positions of 0°, 90°, 180°, and 270° in polar coordinates centered on the optical axis A of the microscope. By arranging the window portions 112 through which light exits at equal intervals in the circumferential direction, it becomes possible to uniformly illuminate a wide area inside the eye.

[0082] 2 to 5, in the present embodiment, four grooves or holes 122 are formed in the holder 12 so as to extend in the directions of 0°, 90°, 180°, and 270° in polar coordinates centered on the optical axis A of the microscope. Four fibers 13, each having an illumination unit 11 attached to its tip, are inserted into the grooves or holes 122 from the mutually different directions of 0°, 90°, 180°, and 270° and are supported.

[0083] As shown in FIG. 1 , the holder 12 is placed between the objective lens 31 of the microscope and the eye 20, and the illumination unit 11 attached to the tip of the fiber 13 is inserted into and supported by a groove or hole 122 in the holder 12. With the window 112 of the illumination unit 11 oriented toward the inside of the eye 20 (see FIG. 3 ), light L emitted from the tip of the fiber 13 is reflected by the mirror 111 of the illumination unit 11 toward the inside of the eye 20. The illuminance of the light L irradiated from the illumination unit 11 toward the inside of the eye 20 can be set appropriately depending on the microscope used; for example, the central illuminance at the fundus may be 10,000 to 100,000 lx. The definition of illuminance is in accordance with JIS Z9110:2010.

[0084] The numerical aperture (NA) on the exit side of the fiber 13 may be 0.55 or less, 0.50 or less, 0.45 or less, or 0.40 or less. Here, the numerical aperture (NA) is a value expressed as n sin θ, where 2θ is the angle of the apex of the largest conical ray of light emitted from the core of the fiber 13 and n is the refractive index of the medium in which the fiber 13 exists, and is defined as such in JIS C6820:2018. The small numerical aperture (NA) of the fiber 13 allows light to be irradiated toward the inside of the eye with sufficient directionality, thereby making it possible to increase the amount and range of light for intraocular illumination.

[0085] 1 , when the holder 12 supports a plurality of lighting units 11, the fiber 13 may be branched into a plurality of fibers between the light source 15 and each lighting unit 11. For example, when the holder 12 supports four lighting units 11, one fiber 13 extending from one light source 15 may be branched into four fibers and then connected to the four lighting units 11, or one fiber 13 extending from one light source 15 may be branched into two fibers and then connected to two lighting units 11, and another fiber 13 extending from another light source 15 may also be branched into two fibers and then connected to the remaining two lighting units 11. By branching the fiber 13 between the light source 15 and the lighting unit 11, it is possible to increase the number of lighting units 11 without increasing the number of light sources 15.

[0086] The light source 15 may be at least one of a xenon lamp, a halogen lamp, and an LED (light-emitting diode). In this case, a xenon lamp, a halogen lamp, or an LED already installed in the operating room or examination room can be used as the light source 15, which is convenient as there is no need to prepare a new light source.

[0087] According to the present embodiment as described above, the intraocular illumination attachment 10 is placed between the objective lens 31 of the microscope and the eye 20 during surgery or examination of the eye 20, i.e., it is placed outside the microscope, so that intraocular illumination from outside the eye can be achieved while utilizing an existing microscope.

[0088] Furthermore, according to this embodiment, the illumination unit 11, which includes the mirror 111 that reflects the light guided through the fiber 13 toward the inside of the eye, is supported by the holder 12 between the objective lens 31 of the microscope and the eye 20, so that light can be irradiated toward the inside of the eye from a position sufficiently close to the eye 20 without going through a lens. Therefore, intraocular illumination with a sufficient amount of light and range can be obtained from outside the eye.

[0089] Furthermore, according to this embodiment, the lighting unit 11 is supported by the holder 12 so that it does not move, allowing the surgeon to operate the surgical instruments with both hands, i.e., to practice bimanual techniques.

[0090] In the above-described embodiment, the holder 12 is provided with an attachment portion 14, and the holder 12 is fixed via the attachment portion 14 so as not to move relative to the lens unit 30 of the microscope. However, this is not limited to such an embodiment. For example, the holder 12 may not be provided with an attachment portion 14, and a support jig (e.g., a stand with a clamp) not shown may be used to support the holder 12 so as not to move relative to the lens unit 30.

[0091] As a modified example, the holder 12 may be configured as one unit with the lens unit 30 of the microscope (not detachable from the lens unit 30), as shown in Fig. 14. In the example shown in Fig. 14, the holder 12 is disposed adjacent to the outside of the lens unit 30, but this is not limiting, and the holder 12 may be disposed inside the lens unit 30 as long as it is located between the objective lens 31 and the eye 20.

[0092] Furthermore, in the above-described embodiment, as shown in Figures 2 to 5, four grooves or holes 122 are formed in the holder 12 so as to extend in the directions of 0°, 90°, 180°, and 270° in polar coordinates centered on the optical axis A of the microscope, and four fibers 13 having illumination units 11 attached to their tips are inserted into the grooves or holes 122 from the mutually different directions of 0°, 90°, 180°, and 270° and supported, respectively, but the present invention is not limited to such an embodiment.

[0093] Fig. 9 is an enlarged perspective view of an intraocular illumination device 1 according to one modified example, and Fig. 10 is a plan view of the intraocular illumination device 1 as viewed from the eye 20 side. Fig. 11 is a perspective view of the holder 12 of the intraocular illumination attachment 10 according to one modified example as viewed from the microscope objective lens 31 side. Fig. 12 is a perspective view of the holder 12 of the intraocular illumination attachment 10 according to one modified example as viewed from the eye 20 side.

[0094] In the embodiment shown in Figures 9 to 12, the holder 12 has a substantially rectangular parallelepiped shape. The thickness T of the holder 12 (the length in the direction of the optical axis A of the microscope) may be, for example, 10 mm or less, 9 mm or less, or 8 mm or less. When the holder 12 is sufficiently thin, the holder 12 can be easily placed in the narrow space between the objective lens 23 of the microscope and the eye 20 during surgery or examination of the eye 20. The length W1 of the holder 12 in the long side direction may be, for example, 40 to 50 mm, and the length W2 of the holder 12 in the short side direction may be, for example, 20 to 30 mm. The material of the holder 12 is, for example, resin.

[0095] As shown in FIGS. 10 and 12, the holder 12 is formed with four grooves or holes 1221 to 1224 for supporting the four lighting units 11.

[0096] In polar coordinates centered on the optical axis A of the microscope, if the long side direction of the holder 12 is the direction of 0° and 180° and the short side direction of the holder 12 is the direction of 90° and 270°, the first groove or hole 1221 is formed so as to extend in the 0° direction from the 0° position, and the second groove or hole 1222 is formed so as to extend in the 180° direction from the 180° position.

[0097] On the other hand, the third groove or hole 1223 is formed to extend in the 180° direction from the 90° position (i.e., parallel to the first groove or hole 1221), and the fourth groove or hole 1224 is formed to extend in the 0° direction from the 270° position (i.e., parallel to the second groove or hole 1222).

[0098] Therefore, as shown in Figure 9, of the four fibers 13 with lighting units 11 attached to their tips, two fibers 13 are inserted and supported into the first and fourth grooves or holes 1221, 1224 from the same 0° direction, and the remaining two fibers 13 are inserted and supported into the second and third grooves or holes 1222, 1223 from the same 180° direction.

[0099] According to this aspect of the modified example, the fiber 13 only needs to be routed in two directions, 0° and 180°, and there is no need to route it in four directions. This allows the wiring of the fiber 13 to be compact, and prevents the presence of the fiber 13 from being a hindrance during eye surgery or examination.

[0100] Furthermore, according to this aspect of the modified example, it is possible to reduce the length W2 of the short side of the holder 12. This allows the length W2 of the short side of the holder 12 to be large enough to fit into the hollow between the patient's eyebrow and cheek, making it easier to place the holder 12 in the narrow space between the microscope objective lens 31 and the eye 20 during surgery or examination of the eye 20.

[0101] 9 to 12, the rotation-regulating small groove 1224a formed adjacent to the fourth groove or hole 1224 may have a sector-shaped cross section. In this case, with the illumination unit 11 attached to the tip of the fiber 13 inserted and supported in the fourth groove or hole 1224, the illumination unit 11 can be rotated by a small angle (for example, 5° to 10°) around the axis of the fiber 13. As shown in Fig. 10, this allows the direction of the light L emitted from the window 112 of the illumination unit 11 to be adjusted, thereby adjusting the brightness of the fundus and the condition of the spot (illuminated area).

[0102] Similarly, a small groove (not shown) for restricting rotation formed adjacent to the third groove or hole 1223 may also have a sector-shaped cross section. In this case, with the illumination unit 11 attached to the tip of the fiber 13 inserted and supported in the third groove or hole 1223, the illumination unit 11 can be rotated by a small angle (for example, 5° to 10°) around the axis of the fiber 13. As shown in Fig. 10, this allows the direction of the light L emitted from the window 112 of the illumination unit 11 to be adjusted, thereby adjusting the brightness of the fundus and the condition of the spot (illuminated area).

[0103] In the embodiments shown in Figures 9 to 12, the third groove or hole 1223 may be formed to extend in the 0° direction from the 90° position (i.e., parallel to the second groove or hole 1222), and the fourth groove or hole 1224 may be formed to extend in the 180° direction from the 270° position (i.e., parallel to the first groove or hole 1221).

[0104] The present inventors actually performed fundus observations on a simulated eye and a pig's eye using the intraocular illumination device 1 according to the above-described embodiment. The holder 12 of the intraocular illumination device 1 used was manufactured using a 3D printer, with its specific dimensions as shown in FIG. 15 . The tubular portion 110 of the illumination unit 11 of the intraocular illumination device 1 used was manufactured from brass, with its specific dimensions as shown in FIG. 16 . During fundus observation, the distance from the cornea 21 to the bottom of the holder 12 was 10 mm. FIG. 8 shows a fundus photograph taken during fundus observation on an actual simulated eye (eyeball diameter: 24 mm, cornea diameter: 12 mm). As shown in FIG. 8 , it was confirmed that the use of the intraocular illumination device 1 according to this embodiment enables extraocular illumination with sufficient light intensity and range while using an existing microscope, enabling fundus observations sufficient for surgery.

[0105] In the above-described embodiment, the reflecting portion provided at the tip of fiber 13 and reflecting the light guided through fiber 13 toward the inside of eye 20 is composed of mirror 111 of illumination unit 11, but the present invention is not limited to this. For example, as shown in Fig. 13, end surface 131 at the tip of fiber 13 may be polished at an angle so as to reflect the light guided through fiber 13 toward the inside of eye 20. In this case, the reflecting portion provided at the tip of fiber 13 and reflecting the light guided through fiber 13 toward the inside of eye 20 is composed of end surface 131 at the tip of fiber 13.

[0106] The inventors of the present invention used laser processing to polish the end face of the tip of a multimode fiber (SI-MMF400, NA 0.39) with an SMA connector manufactured by Thorlabs at an angle, thereby producing a first sample with an end face angle of 55.7° and a second sample with an end face angle of 55.1°. Here, the end face angle refers to the angle between the end face 131 and a plane perpendicular to the optical axis of the fiber 13. When the inventors confirmed the state of light emission from the tip of the fiber 13, they found that in both the first and second samples, approximately 65% ​​of the light guided through the fiber 13 was reflected by the end face 131 and emitted downward, thereby enabling intraocular illumination from outside the eye with sufficient light intensity and range.

[0107] The above description of the embodiment and the disclosure of the drawings are merely examples for explaining the invention described in the claims, and the invention described in the claims is not limited by the above description of the embodiment or the disclosure of the drawings. The components of the above embodiment can be combined in any manner without departing from the spirit of the invention.

Claims

1. An optical fiber for guiding light from a light source, A holder that is disposed between the objective lens of a microscope and the eye during eye surgery or examination and supports the tip of the optical fiber, Comprising: A through-hole is formed in the holder coaxially with the optical axis of the microscope, and a groove or hole is formed so as to extend outward from the vicinity of the through-hole in a plan view. The tip of the optical fiber is inserted into and supported by the groove or hole formed in the holder. A reflecting portion is provided at the tip of the optical fiber for reflecting the light guided through the optical fiber toward the inside of the eye. An intraocular lighting device.

2. An illumination unit including a mirror for reflecting the light guided through the optical fiber toward the inside of the eye is attached to the tip of the optical fiber. The intraocular lighting device according to claim 1, wherein the reflecting portion is constituted by the mirror.

3. The end face of the tip of the optical fiber is obliquely polished so as to reflect the light guided through the optical fiber toward the inside of the eye. The intraocular lighting device according to claim 1, wherein the reflecting portion is constituted by the end face of the optical fiber.

4. The intraocular lighting device according to any one of claims 1 to 3, wherein the thickness of the holder is 10 mm or less.

5. The intraocular lighting device according to any one of claims 1 to 3, wherein the holder supports a plurality of tips of the optical fiber.

6. The intraocular lighting device according to claim 5, wherein the plurality of reflecting portions provided at the plurality of tips are arranged at equal intervals along the circumferential direction centered on the optical axis of the microscope within the holder.

7. The intraocular lighting device according to any one of claims 1 to 3, wherein the holder is provided with an attachment portion that can be attached to the lens unit of the microscope.

8. The intraocular lighting device according to any one of claims 1 to 3, wherein the holder is integrally formed with the lens unit of the microscope.

9. The intraocular lighting device according to any one of claims 1 to 3, wherein the tip of the optical fiber is position-adjustable along the groove or hole while being supported by the holder.

10. The intraocular lighting device according to claim 9, wherein by adjusting the position of the tip of the optical fiber along the groove or hole, the reflecting portion can be brought close to within a range of 5 mm from the optical axis of the microscope.

11. The number of the tip portions of the fiber is four, and four grooves or holes are formed in the holder. In polar coordinates centered on the optical axis of the microscope, the four grooves or holes are respectively formed so as to extend in the directions of 0°, 90°, 180°, and 270°. The intraocular lighting device according to any one of claims 1 to 3.

12. The number of the tip portions of the fiber is four, and four grooves or holes are formed in the holder. In polar coordinates centered on the optical axis of the microscope, the first groove or hole is formed so as to extend from the position of 0° in the direction of 0°, the second groove or hole is formed so as to extend from the position of 180° in the direction of 180°, the third groove or hole is formed so as to extend from the position of 90° in the direction of 0° or 180°, and the fourth groove or hole is formed so as to extend from the position of 270° in the direction of 0° or 180°. The intraocular lighting device according to any one of claims 1 to 3.

13. The NA on the emission side of the fiber is 0.55 or less. The intraocular lighting device according to any one of claims 1 to 3.

14. The fiber is branched between the light source and the lighting unit. The intraocular lighting device according to any one of claims 1 to 3.

15. The light source is at least one of a xenon lamp, a halogen lamp, and an LED. The intraocular lighting device according to any one of claims 1 to 3.

16. An intraocular lighting attachment disposed between the objective lens of a microscope and an eye during eye surgery or examination, A lighting unit including a mirror attached to the tip of a fiber that guides light from a light source and reflects the light guided through the fiber toward the inside of the eye, A holder that supports the lighting unit, Comprising, A through hole is formed coaxially with the optical axis of the microscope in the holder, and a groove or a hole is formed so as to extend outward from the vicinity of the through hole in a plan view. The lighting unit attached to the tip of the fiber is inserted and supported in the groove or the hole formed in the holder. An intraocular lighting attachment.

17. The intraocular lighting attachment is disposable. The intraocular lighting attachment according to claim 16.

18. An intraocular lighting device comprising the intraocular lighting attachment according to claim 16 or 17 and the fiber.

19. An ophthalmic surgical or examination microscope equipped with the intraocular lighting device according to any one of claims 1 to 3.