Model eye and model eye unit

Abstract

This model eye is for an ophthalmic laser treatment device and comprises: an optical element holding part that holds an optical element having formed thereto a reflection surface for reflecting, in a direction intersecting the central axis of the model eye, treatment laser light that enters along the central axis; a target holding part that holds a target to be irradiated with the treatment laser light via the optical element; and an adjustment mechanism for adjusting the position of the reflection surface on a plane orthogonal to the central axis with respect to a rotation direction about the target holding part.

Description

Model eye and model eye unit

[0001] The present disclosure relates to a model eye and a model eye unit for an ophthalmic laser treatment device.

[0002] Conventionally, in the field of ophthalmology, when treating tissues of a patient's eye with a treatment laser beam, a contact lens having a reflecting surface for reflecting the treatment laser beam may be used. For example, a contact lens having a reflecting surface may be used for treating fibrous trabeculae or the like present in the anterior chamber angle of the eyeball.

[0003] Here, a function for appropriately assisting the treatment with the treatment laser beam when a contact lens having a reflecting surface is used has been proposed. In Patent Document 1, in the case where an ophthalmic laser treatment device irradiates a patient's eye with a treatment laser beam using a contact lens, an aiming guide for assisting in adjusting the aiming position of the treatment laser beam to an appropriate position is displayed to an operator via a display unit inside the device.

[0004] Further, Patent Document 2 discloses a model eye for a device that photographs the anterior chamber angle of the human eye through a gonioscope, which is an example of the above contact lens. The model eye has the appearance of a plano-convex lens, and the convex surface (lens surface) on the front corresponds to the cornea of the human eye. Further, a simulated iris part and linear feature parts such as fibrous trabeculae are formed on the flat surface on the rear surface, respectively. The model eye can photograph the region including the linear feature parts by applying a gel between the model eye and the gonioscope.

[0005] JP-A-2024-49342 JP-A-2018-187018

[0006] When treatment with a treatment laser beam is performed using a contact lens having a reflecting surface, complicated procedures are required for the operator. That is, the operator always holds the contact lens and observes the tissue reflected on the reflecting surface, and adjusts the aiming position of the treatment laser beam according to the observation result. Therefore, it has not been easy to demonstrate or try the above procedures.

[0007] For example, even if the model eye described in Patent Document 2 is used, the user cannot release their hand from the contact lens, and the position of the contact lens relative to the model eye is completely free. Therefore, it may be difficult for users unfamiliar with the procedure to demonstrate and try it out.

[0008] As a result, even if an auxiliary function, such as the one exemplified in Patent Document 1, is installed in the device, it may be difficult to communicate the effectiveness of that auxiliary function to others.

[0009] A typical object of this disclosure is to provide a model eye that reduces the complexity of the procedure when demonstrating and testing therapeutic laser light treatment when contact lenses having reflective surfaces are used.

[0010] A model eye provided by a typical embodiment of the present disclosure is a model eye for an ophthalmic laser treatment device, comprising: an optical element holding portion for holding an optical element having a reflective surface formed thereon that reflects therapeutic laser light incident along the central axis of the model eye in a direction intersecting the central axis; a target holding portion for holding a target onto which the therapeutic laser light is irradiated via the optical element; and an adjustment mechanism for adjusting the position of the reflective surface on a plane perpendicular to the central axis with respect to a rotational direction around the target holding portion.

[0011] According to the model eye described herein, the complexity of the procedure is reduced when a user demonstrates and tries out treatment using therapeutic laser light when contact lenses with reflective surfaces are used.

[0012] This is an external view of the ophthalmic laser treatment device 1. This is a side view of the optical system of the ophthalmic laser treatment device 1. This is a top view of the optical system of the ophthalmic laser treatment device 1. This is a schematic cross-sectional view of the patient's eye E and the contact lens 26. This is a schematic diagram showing an example of an observation area observed through the reflective surface 27 of the contact lens 26. This is a diagram showing an example of an irradiation plan displayed on the control box 6. This is an explanatory diagram for explaining how to adjust the aiming position of the irradiation spot. This is a diagram showing an example of the operator's field of view during treatment with the ophthalmic laser treatment device of the embodiment. This is a diagram showing an example of a transition of a part of the operator's field of view during treatment with the ophthalmic laser treatment device 1 of the embodiment. This is a diagram showing an example of a transition of a part of the operator's field of view during treatment with the ophthalmic laser treatment device 1 of the embodiment. This is an external view showing the model eye 100A and model eye unit 100 of the embodiment attached to the ophthalmic laser treatment device 1. This is an exploded perspective view of the model eye 100A of the embodiment. This is a partially enlarged view showing the tip portion of the simulated corner portion 133 of the model eye 100A of the embodiment. This is a view showing the trabecular meshwork label 141. This is a view showing the iris label 142. This is a perspective view of the model eye 100A of the embodiment. This is an exploded perspective view of the model eye 200A of the second embodiment. This is a side view of the model eye 300A of the third embodiment. This is an exploded perspective view of the model eye 300A of the third embodiment.

[0013] [Overview] The model eye and model eye unit illustrated in this disclosure are used in conjunction with an ophthalmic laser treatment device (hereinafter sometimes simply referred to as the "treatment device"). Typically, the model eye and the treatment device are independent devices. In the following description of embodiments, "user" refers to the user of the model eye and model eye unit. The user is not limited to the surgeon (physician). For example, a healthcare professional other than a physician, or staff of a business that handles ophthalmic laser treatment devices (manufacturers and distributors), may be the user.

[0014] The model eye comprises at least an optical element holder, a target holder, and an adjustment mechanism. The model eye unit comprises at least a mount in addition to the model eye exemplified in this disclosure.

[0015] The optical element holder holds an optical element having a reflective surface that reflects therapeutic laser light incident along the central axis of the model eye in a direction intersecting the central axis. The optical element holder prevents the optical element from falling out of the model eye even when the user releases their hand. The reflective surface may be formed at a position away from the central axis and may be inclined to reflect therapeutic laser light incident along the central axis toward the central axis. "Incident along the central axis" means that the direction of propagation of the therapeutic laser light may be parallel to or intersecting the direction of the central axis. If intersecting, the angle between the direction of propagation of the therapeutic laser light and the central axis may be, for example, approximately 45° to 65°. However, it is not necessarily limited to this. The optical element may be, for example, a planar mirror equivalent to a contact lens. In this case, the model eye can be manufactured at a lower cost. However, it is not necessarily limited to this, and the optical element may be the contact lens itself.

[0016] The optical element holder may have multiple mounting parts arranged at intervals around a central axis. Alternatively, the optical element holder may detachably hold an optical element with a reflective surface on at least one of the multiple mounting parts. This allows the user to arbitrarily change the number of optical elements depending on the purpose of use. For example, it becomes possible to try procedures using a single reflective surface by attaching only one optical element, or to try procedures using a multi-faceted mirror lens by attaching multiple elements. Therefore, a single model eye can meet a variety of needs.

[0017] Furthermore, the optical element holder may hold the optical element such that multiple reflective surfaces are arranged at equal intervals around the central axis. This allows for a more accurate simulation of the structure of contact lenses with two, three, or four mirrors used in actual treatment.

[0018] If the optical element held by the optical element holder is a contact lens, the optical element holder may also hold the contact lens in a removable manner. In this case, contact lenses already owned by the facility can be reused.

[0019] The target holder holds the target to which therapeutic laser light is irradiated via an optical element. The target is positioned near the central axis, relative to the reflective surface of the optical element. In this case, the center of the target may coincide with the central axis. Furthermore, the target holder is positioned distal to the treatment device relative to the reflective surface of the optical element, with respect to the axial direction of the central axis.

[0020] The target may be detachable from the target holder. The target may be made of paper. Preferably, the target is formed in a rotationally symmetric shape that simulates the tissue of the anterior chamber angle (i.e., the tissue in the region between the iris and the cornea / sclera). Specific shapes of the target include circles, rings, cylinders, truncated cones, and hemispheres. In the case of three-dimensional shapes such as cylinders, truncated cones, and hemispheres, it is preferable that the target be a hollow member with one base open, and that it be held in the target holder so that the concave surface faces the treatment device. In this case, the laser treatment light is irradiated onto the concave surface. The target may have a pattern or shape that corresponds to any of the tissues present in the angle region of the human eye. The target may also have a marker for irradiating the treatment laser light. For example, in the portion corresponding to the trabecular meshwork, lines may be etched at equal intervals in the circumferential direction (for example, lines etched at 400 μm intervals may be formed as markers). Also, in the portion corresponding to the iris, markers may be formed at equal intervals in the circumferential direction. For example, lines divided into 10 sections and letters may be formed as markers.

[0021] The adjustment mechanism is provided to adjust the position of the reflective surface on a plane perpendicular to the central axis with respect to the rotational direction around the target holder. The adjustment mechanism may allow the reflective surface to move in the rotational direction. The adjustment mechanism may be, for example, a bearing mechanism for rotatably connecting the optical element holder to the target holder, with the target holder as the axis, as detailed in the embodiment. The bearing may be a ball bearing, a roller bearing, or simply an opening. When connecting the optical element holder to the target holder, a rotatable configuration may be made using gears or the like. However, the adjustment mechanism is not necessarily limited to this, and various mechanisms can be adopted.

[0022] According to the model eye of this disclosure, the optical element holder holds the optical element, preventing it from falling out of the model eye even when the user releases their hand. Furthermore, since the position of the reflective surface of the optical element relative to the target holder is mechanically restricted, the position of the reflective surface relative to the target can be easily adjusted. Therefore, when demonstrating and testing treatment with therapeutic laser light when contact lenses are used, using the model eye of this disclosure can reduce the complexity of the procedure for the user.

[0023] The adjustment mechanism may allow the position of the reflective surface to be tilted about an axis perpendicular to the central axis relative to the target. When a therapeutic laser beam is directed at a patient's eye using a contact lens with a reflective surface, the operator may tilt the contact lens to adjust the aiming position of the laser beam. Therefore, the model eye of this disclosure allows for the demonstration and trial of the procedure in a manner closer to actual treatment. Such an adjustment mechanism may or may not be limited to a rolling bearing with a self-aligning mechanism.

[0024] The model eye of this disclosure does not require a lens equivalent to a cornea between the optical element and the target. This eliminates the need for gel between the optical element and the target. In other words, even without gel, the user can observe the target reflected on the reflective surface of the optical element through the observation optical system of the treatment device.

[0025] The model eye of this disclosure may further include a mounting portion for attachment to a face support unit that supports the patient's face in a treatment device.

[0026] [Examples] Typical embodiments of the model eye in this disclosure will be described below with reference to the drawings. For the sake of explanation, first, the schematic configuration of the ophthalmic laser treatment device 1 (hereinafter referred to as "treatment device 1") used together with the model eye will be shown. The ophthalmic laser treatment device 1 can irradiate the patient's eye E with therapeutic laser light to perform treatment on the patient's eye E.

[0027] <Overall Configuration of Ophthalmic Laser Treatment Device 1> The configuration of the ophthalmic laser treatment device 1 will be described with reference to Figures 1 to 3. As shown in Figure 1, the ophthalmic laser treatment device 1 of this embodiment comprises a table section 2, a main unit section 3, and a control box 6. The main unit section 3 and the control box 6 are installed on the table section 2.

[0028] The main unit 3 comprises various components, including a laser irradiation optical system 10, an illumination optical system 30, an observation optical system 40, an internal display unit 50, and a control unit 60 (see Figure 2), which will be described later. The main unit 3 also comprises a base unit 4, a joystick unit 5 (operating lever), and a face support unit 8. The face support unit 8 is placed on the base unit 4. A chin rest and a forehead rest are attached to the support column 8a of the face support unit 8. The face support unit 8 supports the patient's face. The base unit 4 is a displacement means equipped with a displacement mechanism, which can move at least a portion of the laser irradiation optical system 10, the observation optical system 40, and the internal display unit 50 in the vertical direction (Y direction in Figure 1), the horizontal direction (X direction in Figure 1), and the front-to-back direction (Z direction in Figure 1). The displacement means changes the positional relationship between the patient's eye and the laser irradiation optical system 10 in the vertical, horizontal, and front-to-back directions. The base unit 4 can further rotate at least a portion of the laser irradiation optical system 10, observation optical system 40, and internal display unit 50 horizontally, using an axis extending vertically as the pivot point. By operating the joystick unit 5, the operator can move or rotate the laser irradiation optical system 10, observation optical system 40, and internal display unit 50, etc., to adjust the observation position of the patient's eye E and the irradiation position of the laser light (treatment laser light and aiming light). In this embodiment, the joystick unit 5 (for example, the upper end of the joystick 5) is provided with operation buttons operated by the operator. In this embodiment, the operation buttons of the joystick unit 5 are used as trigger input means to input a trigger for executing the irradiation of the treatment laser light. Alternatively, a foot switch operated by the operator's foot may be used as a trigger input means to input a trigger for executing the irradiation of the treatment laser light.

[0029] The control box 6 includes an external display unit 7 located outside the observation optical system 40 (see Figure 2). The external display unit 7 can display various images. A touch panel operation unit is provided on the surface of the external display unit 7 of the control box 6. The control box 6 displays various parameters related to treatment on the external display unit 7 and also accepts input of various instructions from the user.

[0030] <Laser Irradiation Optical System> As shown in Figure 2, the laser irradiation optical system 10 of this embodiment includes a therapeutic laser light source 11, an aiming light source 12, an energy adjustment unit 13, a beam splitter 17, a photodetector 18, a safety shutter 19, a collimator lens 21, a dichroic mirror 22, an expander lens 23, a dichroic mirror 24, and an objective lens 25.

[0031] The therapeutic laser light source 11 emits therapeutic laser light for treating the tissue of the patient's eye E. As an example, in the laser light source 11 of this embodiment, a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd:YAG) is used as the laser rod. In addition, a wavelength conversion element (not shown) can convert the infrared laser light (wavelength: 1064 nm) emitted by the laser light source 11 into visible laser light (wavelength: 532 nm).

[0032] The targeting light source 12 emits targeting laser light (hereinafter simply referred to as "targeting light") that indicates the position where the treatment laser light is irradiated (i.e., the position of the irradiation spot). In this embodiment, a light source that emits visible laser light with a wavelength of 635 nm (red) is used as the targeting light source 12. However, it goes without saying that the wavelength of the targeting light can be changed as appropriate.

[0033] The energy adjustment unit 13 adjusts the amount of energy of the therapeutic laser light irradiated onto the tissue of the patient's eye E. In this embodiment, the energy adjustment unit 13 includes a half-wave plate 14 and a polarizer 16. The half-wave plate 14 is rotated by a motor 15 around the optical axis of the therapeutic laser light. The polarizer 16 is positioned at a Brewster angle. The amount of energy of the therapeutic laser light is adjusted by the combination of the half-wave plate 14 and the polarizer 16.

[0034] The beam splitter 17 reflects a portion of the treatment laser light toward the photodetector 18. The photodetector 18 detects the energy of the treatment laser light by receiving the treatment laser light reflected by the beam splitter 17. The safety shutter 19 moves between on and off the optical axis of the treatment laser light by a shutter drive unit (e.g., a solenoid) 20. The safety shutter 19 is positioned on the optical axis of the treatment laser light to block the irradiation of the treatment laser light into the patient's eye E.

[0035] The collimator lens 21 makes the aiming light emitted from the aiming light source 12 into a parallel beam. The dichroic mirror 22 aligns the optical axes of the treatment laser light and the aiming light and combines them. In this embodiment, the dichroic mirror 22 reflects the treatment laser light and transmits the aiming light, thereby combining the treatment laser light and the aiming light.

[0036] The expander lens 23 expands the beam of laser light (treatment laser light and aiming light) combined by the dichroic mirror 22. The laser light expanded by the expander lens 23 is reflected by the dichroic mirror 24 and passes through the objective lens 25. In this embodiment, the laser light that has passed through the objective lens 25 is irradiated onto the tissue of the patient's eye E via a contact lens 26 attached to the patient's eye E. The dichroic mirror 24 reflects light of a wavelength that is less likely to enter the operator's eye after the treatment laser light is reflected by the patient's eye E. The irradiation optical system 10 may also be provided with a configuration for adjusting the spot size of the laser light irradiated onto the tissue.

[0037] <Illumination Optical System> The illumination optical system 30 illuminates the observation area, including the tissue to be treated. The illumination optical system 30 in this embodiment includes a lamp 31, a lens 32, an aperture 33, a lens group 34, and a prism 35. For example, a white light-emitting element can be used for the lamp 31. The illumination optical system 30 may also include a slit plate or the like for illuminating the observation area with slit light.

[0038] <Observation Optical System> As shown in Figures 2 and 3, the observation optical system 40 is an observation means for allowing the operator to observe the patient's eye E, and is equipped with an optical axis L3 (see Figure 3). As shown in Figure 3, the observation optical system 40 of this embodiment is equipped with an optical axis L3R for presenting an observation image to the operator's right eye EoR, and an optical axis L3L for presenting an observation image to the operator's left eye EoL. The observation optical system 30 of this embodiment may also be called binoculars. The observation optical system 40 of this embodiment is equipped with an objective lens 25, a variable magnification optical system 42 (42R, 42L), a protective filter 43 (43R, 43L), a half mirror 47, an erecting prism group 44 (44R, 44L), a field diaphragm 45 (45R, 45L), an eyepiece lens 46 (46R, 46L), etc. The operator can look through the eyepiece 46 to confirm the observation area of ​​the patient's eye E, the spot of the aiming light (in other words, the reflected light (backlight) of the aiming light reflected from the patient's eye E), etc. In this embodiment, the observation surface (object surface) provided in front of the objective lens 41 and the field diaphragm 45 located inside the device are in an optically conjugate positional relationship via the objective lens 41. That is, the observation image of the patient's eye E is formed as an aerial image at the position of the field diaphragm 45. In this embodiment, the magnification of the observation image observed by the operator is changed by the variable magnification optical system 42. The observation optical system 40 is provided with an encoder (not shown) for acquiring the magnification of the observation image by the variable magnification optical system 42.

[0039] <Internal Display Unit> As shown in Figure 2, the internal display unit 50 is provided in the observation optical system 40 and displays images to the operator via the eyepiece lens 46. The internal display unit 50 comprises a display unit 53, a lens 52, and a half mirror 51. Various images are displayed on the display unit 53. In this embodiment, an LCD (with backlight) is used as the display unit 53. In detail, in this embodiment, a color LCD capable of displaying 1600 (H) x 1200 (V) is used as the display unit 53. As shown in Figure 3, the half mirror 51 is positioned on the optical axis L3R. In detail, the half mirror 51 is positioned between the protective filter 43R and the erecting prism group 44R.

[0040] The display light emitted from the display unit 53 travels along the optical axis L5 (see Figure 3). More specifically, the display light emitted from the display unit 53 passes through the lens 52 and is then reflected by the half mirror 51 in the direction of the erecting prism group 44R. In this embodiment, the half mirror 51 is a synthesis means for combining the optical observation image observed by the observation optical system 40 with the image displayed on the display unit 53. In this embodiment, the half mirror 51 makes the optical axis L5 and the optical axis L3R coaxial. The display light reflected by the half mirror 51 travels in the order of the erecting prism group 44R, the field diaphragm 45R, and the eyepiece lens 46R, and is focused on the fundus of the eye of the operator looking through the eyepiece lens 46R. The internal display unit 50 functions as a so-called head-up display (HUD).

[0041] In this embodiment, the display unit 53 and the field diaphragm 45R are in an optically conjugate positional relationship. That is, the display image of the display unit 53 is formed as an aerial image at the position of the field diaphragm 45R. Note that the method of displaying the image to the operator via the eyepiece lens 46 is not limited to the method illustrated in this disclosure. For example, an LCD (liquid crystal panel) without a backlight may be placed as an internal display unit at the position of the field diaphragm 45R (on the optical axis L3R), and the control unit 60 may control the transmittance of each cell constituting the LCD to present information to the operator.

[0042] In this embodiment, the center of the display area in the internal display unit 50 coincides with the observation optical axis of the observation optical system 40. Therefore, the image is displayed in the display area of ​​the internal display unit 50 with reference to the observation optical axis of the observation optical system 40. Consequently, the operator can perform treatment appropriately while recognizing the image presented at an appropriate position in the observation field of view through the eyepiece lens 46.

[0043] Also, in this embodiment, the optical axis of the therapeutic laser light irradiated by the laser irradiation optical system 10 also coincides with the optical axis of the observation optical system 40 and the center of the display area in the internal display unit 50. Therefore, the internal display unit 50 can display an image at an appropriate angle in an appropriate direction centered on the optical axis of the therapeutic laser light. Further, in this embodiment, the optical axis of the aiming light irradiated by the laser irradiation optical system 10 also coincides with the optical axis of the observation optical system 40 and the center of the display area in the internal display unit 50. Therefore, the operator visually recognizes the aiming light at the center of the observation field of view and the center of the display area of the internal display unit 50, so that the adjustment of the irradiation position of the therapeutic laser light based on the aiming light and the display content by the internal display unit 50 becomes easier.

[0044] Although not shown, the observation optical system 40 of this embodiment incorporates an imaging optical system that captures an observation image of the patient's eye E or the like. The imaging optical system includes a half mirror, an imaging lens, and an imaging element. The half mirror is disposed in either the left or right observation optical path provided in the observation optical system 40. The light incident on the half mirror from the observation site or the like through the objective lens 25 is reflected by the half mirror and incident on the imaging element through the imaging lens. As a result, the observation image is captured by the imaging optical system.

[0045] <Control Unit> The control unit 60 controls various operations of the laser treatment apparatus 1. The control unit 60 of this embodiment includes a CPU (processor) 61, a ROM 62, a RAM 63, a non-volatile memory 65, and the like. The CPU 61 controls each part in the laser treatment apparatus 1. Various programs, initial values, etc. are stored in the ROM 62. The RAM 63 temporarily stores various information. The non-volatile memory 65 is a non-transitory storage medium that can retain the stored content even when the power supply is cut off. For example, a USB memory detachably attached to the control unit 60, a flash ROM built into the control unit 60, etc. can be used as the non-volatile memory 65. In this embodiment, the control unit 60 is connected to the base unit 4, the joystick unit 5, the control box 6, the laser light source 11, the aiming light source 12, the motor 15, the photodetector 18, the shutter drive unit 20, the lamp 31, and the display 53, etc.

[0046] <Treatment Methods for the Trabecular Mesh> Referring to Figures 4 and 5, an example of a treatment method for the trabecular meshwork performed by the ophthalmic laser treatment device 1 of this embodiment will be described. In this embodiment, the trabecular meshwork, which is an annular (partially arc-shaped) tissue of the patient's eye E, is given as an example of the treatment target site. For example, selective laser trabeculoplasty (SLT) is a treatment method that irradiates the trabecular meshwork at the angle of the patient's eye E with treatment laser light in order to increase the outflow of aqueous humor from the patient's eye E. In SLT, treatment laser light is irradiated multiple times over the entire circumference or a part of the annular trabecular meshwork.

[0047] As shown in Figure 4, in the treatment of the trabecular meshwork in this embodiment, a contact lens 26 is fitted to the cornea C of the patient's eye E. As an example, the contact lens 26 can be a gonioscope or a Goldmann triangular mirror used to observe the angle A of the patient's eye E. The contact lens 26 is provided with a reflective surface (reflecting mirror) 27. The angle A is observed through the reflective surface 27. Therefore, as shown in Figure 5, in this embodiment, the entire angle A (all around) is not observed simultaneously, but a part of the angle A is observed in a fan shape. The range of the fan-shaped portion of the annular angle A observed through the reflective surface 27 is within an angular range of less than 180 degrees with respect to the center of the annular angle A. Furthermore, the reflective surface 27 of the contact lens 26 reflects the treatment laser light and aiming light in a direction intersecting the optical axis extending from the objective lens 25 (see Figures 2 and 3) toward the patient's eye E, thereby irradiating the trabecular meshwork TM, which is the treatment target site, with the treatment laser light and aiming light. In other words, in this embodiment, treatment of the trabecular meshwork is performed by irradiating the trabecular meshwork TM of the corner A with treatment laser light via the reflective surface 27 in the observation state illustrated in Figure 5.

[0048] The operator adjusts the rotation angle of the contact lens 26 (i.e., the angle in the rotational direction centered on the axis of the contact lens 26), thereby adjusting the reflection direction of the treatment laser light by the reflection surface 27 of the contact lens 26 when viewed from the operator's line-of-sight direction in the observation optical system 40. Further, the operator operates the joystick unit 5 to move the base unit 4, thereby adjusting the aiming position of the treatment laser light and the aiming light with respect to the tissue of the patient's eye E to the treatment spot S. After the adjustment of the aiming position is completed, the operator operates an operation button of the joystick 5 or a foot switch or the like to input an instruction to execute irradiation of the treatment laser light, thereby irradiating the treatment laser light to the spot S. In SLT, in order to make it difficult to cause thermal denaturation of the tissue, the treatment laser light is irradiated with an output (energy and irradiation time) lower than that of argon laser trabeculoplasty (ALT). Therefore, it is difficult for the operator to visually recognize the change in the state of the treatment site (for example, treatment scar, etc.) before and after the surgery. As an SLT technique, there is known a technique in which the spot sizes of the treatment laser light and the aiming light are fixed to a predetermined size (for example, 400 μm, etc.), and the treatment laser light is intermittently irradiated so that a plurality of irradiation spots are adjacent to each other along the trabecular meshwork TM. FIG. 5 schematically shows a part of the state of the technique of intermittently irradiating the treatment laser light so that a plurality of irradiation spots are adjacent to each other. In SLT, it is difficult to visually observe the treatment scar. That is, the irradiated spot (spot S) irradiated with the treatment laser light is not visually recognized by the operator as shown in FIG. 5.

[0049] Referring to Figure 6, an example of a treatment laser light irradiation plan will be described. Figure 6 is a diagram showing an example of an irradiation plan displayed in the control box 6. In this embodiment, the irradiation plan is formulated by operating the control box 6. The irradiation plan determines the irradiation order for multiple irradiation spots to which treatment laser light is to be irradiated when irradiating the patient's eye E with treatment laser light using a contact lens 26 having a reflective surface 27. In the irradiation plan of this embodiment, the irradiation range of the treatment laser light in the annular treatment target area (trabecular meshwork™ in this embodiment) (i.e., the circumferential range in which multiple irradiation spots are arranged), the irradiation spot to which the treatment laser light is irradiated first (the irradiation spot at the position of "START" shown in Figure 6), the number of irradiation spots (the number in the denominator of "Shots" shown in Figure 6), and the irradiation order of the treatment laser light for each irradiation spot (including the irradiation direction. In Figure 6, the circumferential arrow indicates the direction of the irradiation order). In this embodiment, each time the therapeutic laser light is irradiated, the irradiation spot adjacent to the irradiated spot becomes the next irradiation spot to be irradiated with the therapeutic laser light, and "1" is added to the numerator of "Shots" shown in Figure 6. Also, each time the therapeutic laser light is irradiated, the display of the spot corresponding to the irradiated spot (irradiated spot) among the multiple irradiation spots arranged in an arc or ring shape (ring shape in Figure 6) changes to a different display pattern from the other spots. Multiple irradiations of the therapeutic laser light are performed sequentially in a clockwise or counterclockwise direction.

[0050] In this embodiment, the direction in which the treatment area to be irradiated with the therapeutic laser light is actually located, and the direction in which the reflective surface 27 of the contact lens 26 is directed to observe the treatment area, are opposite directions with respect to the optical axis of the observation optical system 40. In this embodiment, the direction in which the therapeutic laser light should be irradiated is indicated by the direction in which the reflective surface 27 is directed. However, the direction in which the therapeutic laser light should be irradiated may also be indicated by the direction in which the treatment area is actually located.

[0051] As an example, in this embodiment, the operator specifies either the "full circumference" mode or the "half circumference" mode to specify both the planned irradiation area and the number of planned irradiation spots. Specifically, in this embodiment, a "full circumference" mode is provided in advance, which irradiates multiple spots with treatment laser light around the entire circumference of angle A, and a "half circumference" mode is provided, which irradiates multiple spots with treatment laser light around half the circumference of angle A. The default value for the number of planned irradiation spots in the "full circumference" mode is set to 100. The default value for the number of planned irradiation spots in the "half circumference" mode is set to 50. When the operator specifies the "full circumference" mode, the control unit 60 sets the area around the entire circumference of angle A as the planned irradiation area and sets "100" as the number of planned irradiation spots. In the example shown in Figure 6, the "full circumference" mode is specified. When the operator specifies the "half circumference" mode, the control unit 60 sets the area around half the circumference of angle A as the planned irradiation area and sets "50" as the number of planned irradiation spots. In this embodiment, when the operator selects the "half-circumference" mode, they specify the detailed position of the irradiation area at angle A by operating the touch panel or other means to specify the "upper half, lower half, right half, left half," etc. of angle A. The control unit 60 sets the irradiation area based on the input results.

[0052] Needless to say, the method for receiving the specification of the irradiation area and the number of irradiation spots can be changed. For example, the laser treatment device 1 may have modes other than the "full circumference" mode and the "half circumference" mode prepared in advance. The control unit 60 may receive an angle specification (within a range of 360 degrees or less) from the operator and set the area corresponding to the specified angle as the irradiation area. The control unit 60 may have the operator directly input the number of irradiation spots and set the number of irradiation spots that was input, regardless of the selected mode. The control unit 60 may change the number of irradiation spots predetermined for each mode according to the operator's instructions. The control unit 60 may have the operator input the distance between two adjacent spots and calculate the number of irradiation spots according to the parameters of the irradiation area (for example, the circumferential length of the treatment target area) and the input distance between spots.

[0053] Referring to Figure 7, a method for adjusting the aiming position of the irradiation spot will be described. In this embodiment, there are two methods for adjusting the aiming position of the irradiation spot of the treatment laser light: adjusting the positional relationship between the patient's eye E and the laser irradiation optical system 10 by operating the joystick unit 5, and performing at least one of the rotational operation and / or movement operation of the reflective surface 27 of the contact lens 26. Figure 7(A) shows the state after the most recent irradiation of the treatment laser light has been completed. In the state shown in Figure 7(A), the position of the irradiated spot SS, where irradiation of the treatment laser light has been completed, and the position of the aiming light AI coincide. The operator needs to adjust the position of the aiming light AI (i.e., the aiming position of the irradiation spot) from the state shown in Figure 7(A) to the position of the next irradiation spot (in the example shown in Figure 7, the position to the right of the position of the irradiated spot SS).

[0054] Figure 7(B) shows the state in which the aiming position has been adjusted to the position of the next irradiation spot by operating the joystick unit 5 (i.e., with the angle of the reflective surface 27 of the contact lens 26 fixed) from the state shown in Figure 7(A). In Figure 7(B), the positions of the irradiated spot SS and the treatment target area (trabecular meshwork TM in this embodiment) at the time of completion of the treatment laser beam are schematically shown by dotted lines. However, in reality, there is no treatment mark at the irradiated spot SS at the time of completion of the previous irradiation, so it is difficult to accurately adjust the aiming position by operating the joystick unit 5.

[0055] Furthermore, Figure 7(C) shows the state in which the aiming position has been adjusted to the position of the next irradiation spot by rotating the reflective surface 27 of the contact lens 26 (i.e., without operating the joystick unit 5) from the state shown in Figure 7(A). In Figure 7(C) as well, the positions of the irradiated spot SS and the treatment target area at the time of completion of the treatment laser beam are schematically shown by dotted lines. However, in reality, even in Figure 7(C), there is no treatment mark on the irradiated spot SS at the time of completion of the previous irradiation, and it is difficult to accurately adjust the aiming position by rotating the reflective surface 27. In this disclosure, a guide is displayed on the internal display unit 50 to assist the operator in adjusting the aiming position.

[0056] <Example> Referring to Figures 8 to 10, the treatment control process performed by the ophthalmic laser treatment device 1 of the example will be described. In the example, the case in which treatment is performed using a contact lens that is not a partially rotating lens will be illustrated. The adjustment pattern for the aiming position of the treatment laser light performed in the example is a pattern in which the relative position of the ophthalmic laser treatment device 1 with respect to the eye under examination is mainly moved when adjusting the aiming position for each of the multiple irradiation spots contained within one irradiation section (hereinafter referred to as the "movement adjustment pattern"). However, in the movement adjustment pattern, in addition to moving the relative position of the ophthalmic laser treatment device 1 with respect to the eye under examination, the contact lens may also be rotated. The irradiation section in the example is the angular range of an arc-shaped region (fan-shaped region) in which the irradiation of treatment laser light (i.e., irradiation of treatment laser light for each of the specified number of irradiation spots) is scheduled to be performed a specified number of times M (M≧2) based on the spot spacing guide 90. In the example as well, the center of the display area in the internal display unit 50, the observation optical axis of the observation optical system 40, the optical axis of the treatment laser light, and the optical axis of the aiming light all coincide at the center O. In other words, the operator visually identifies the targeting light spot AI at the center of the observation field of view and the center of the display area of ​​the internal display unit 50. The treatment laser light is directed at the same spot as the targeting light spot AI.

[0057] First, with reference to Figure 8, an example of the operator's field of view during treatment with the ophthalmic laser treatment device 1 of the embodiment will be described. Similar to the fourth embodiment, the ophthalmic laser treatment device 1 of the embodiment also allows the operator to understand the spacing between multiple irradiation spots by displaying the spot spacing guide 90 on the internal display unit 50. The spot spacing guide 90 shows the operator the appropriate spacing between multiple irradiation spots to which the treatment laser light is to be irradiated.

[0058] As shown in Figure 8, the ophthalmic laser treatment device 1 of the embodiment adjusts the intervals between multiple indicators included in the spot spacing guide 90 to match the appropriate intervals between multiple irradiation spots. Therefore, the operator can easily adjust the intervals between irradiation spots of the treatment laser light to the appropriate interval by matching the distance traveled when moving the targeting position of the treatment laser light from the previous irradiation spot to the next irradiation spot with the intervals between the multiple indicators included in the spot spacing guide 90. Thus, treatment can be performed more appropriately according to the treatment plan.

[0059] In the embodiment, the ophthalmic laser treatment device 1 displays the spot spacing guide 90 in the display area of ​​the internal display unit 50 at a position spaced apart from the targeting position of the treatment laser light (in Figure 8, the position where the targeting light AI is projected) (in Figure 8, a position slightly above). The ophthalmic laser treatment device 1 displays the end of each of the multiple indicators included in the spot spacing guide 90 on the targeting position side of the treatment laser light (in Figure 8, the lower end of each of the multiple indicators) along a curve that approximates the curve of the treatment area of ​​the patient's eye E (in this embodiment, the trabecular meshwork), which is arc-shaped or annular. In the embodiment, since the spot spacing guide 90 is displayed at a position different from the targeting position of the treatment laser light (the position where the targeting light AI is projected) (i.e., the spot spacing guide 90 does not overlap with the targeting position), the operator can set the irradiation position of the treatment laser light after appropriately understanding the condition of the tissue at the targeting position. Furthermore, by arranging the targeting end of each of the multiple indicators along a curve (arc-shaped), the distance between the targeting end of each of the multiple indicators (the lower end in Figure 8) and the arc-shaped treatment area becomes smaller when the spot spacing guide 90 is positioned appropriately for the next targeting position. As a result, the operator can more easily adjust the next targeting position of the treatment laser beam by referring to the spot spacing guide 90. In the example shown in Figure 8, the spot spacing guide 90 is displayed on the opposite side of the iris from the treatment area (trabecular meshwork in this embodiment). However, the spot spacing guide may also be displayed on the iris side of the treatment area.

[0060] The shape of the curve of the treatment area in the patient's eye E does not vary significantly from eye to eye, although there are some differences depending on the patient's eye. Therefore, the targeting end of each of the multiple indicators may be displayed along a predetermined curve based on the average shape of the treatment area. As an example, in this embodiment, an experiment is performed in advance to observe a portion of a model eye that mimics the trabecular meshwork (simulated trabecular meshwork) under predetermined conditions. A program for displaying the targeting end of each of the multiple indicators along the shape of the simulated trabecular meshwork observed in the experiment is stored in the non-volatile memory 65 in advance. Details of the process for displaying the targeting end of each of the multiple indicators will be described later.

[0061] The ophthalmic laser treatment device 1 displays a next-target indicator 90A in the spot spacing guide 90 at a position corresponding to the optical axis of the treatment laser beam, for aligning the position of the next irradiation spot. Each time the treatment laser beam is irradiated, the ophthalmic laser treatment device 1 moves one appropriate interval between multiple irradiation spots in the opposite direction to the treatment progression direction defined in the irradiation plan. The ophthalmic laser treatment device 1 also moves the position of the next-target indicator 90A within the spot spacing guide 90 in the progression direction defined in the irradiation plan by one appropriate interval between multiple irradiation spots. As a result, the position of the next-target indicator 90A is maintained at a position corresponding to the target position. The operator can further easily adjust the next target position by considering the position of the next-target indicator 90A on the optical axis of the treatment laser beam (which also coincides with the optical axis of the targeting light if a targeting light is irradiated) and aligning the position on the tissue to be irradiated with the next treatment laser beam.

[0062] Of the multiple indicators in the spot spacing guide 90, all indicators other than the next targeting indicator 90A are either the irradiated indicator 90B, which corresponds to a spot where the treatment laser light has already been irradiated, or the unirradiated indicator 90C, which corresponds to a spot where the treatment laser light will be irradiated at a later date. The ophthalmic laser treatment device 1 displays each of the next targeting indicator 90A, the irradiated indicator 90B, and the unirradiated indicator 90C in a different manner (i.e., in a manner that can be identified by the operator). Therefore, the operator can easily grasp the positional relationship between the next targeting indicator 90A, the irradiated indicator 90B, and the unirradiated indicator 90C, making it easier to proceed with treatment more smoothly.

[0063] Each time the ophthalmic laser treatment device 1 is irradiated with treatment laser light, it moves the entire spot spacing guide 90 in the opposite direction to the direction of travel determined in the irradiation plan by the appropriate spacing of multiple irradiation spots. The operator can further easily adjust the aiming position by adjusting the aiming position each time so that the positions of the multiple indicators that move each time the treatment laser light is irradiated are at a constant position on the observation image observed through the observation optical system 40. As described above, the embodiment illustrates the case in which treatment is performed using a contact lens that does not have spacing indicators 28 and is not a partially rotating lens. Even in this case, the operator can appropriately adjust each of the multiple aiming positions by appropriately adjusting the positional relationship between the characteristic parts present in the tissue included in the observation image and the multiple indicators of the spot spacing guide 90. For example, the operator can identify a feature area on the observed image and, each time the spot spacing guide 90 moves by the appropriate interval of one irradiation spot (i.e., each time the treatment laser light is irradiated), issue a movement instruction to the device so that a specific indicator among multiple indicators (for example, the leftmost indicator, or the second indicator from the left) aligns with the identified feature area. In other words, if the spot spacing guide 90 includes multiple indicators, each of the multiple targeting positions is appropriately adjusted by aligning at least one of the indicators (a specific indicator) with the feature area.

[0064] In this embodiment, the ophthalmic laser treatment device 1 displays one of the elements of each of the multiple indicators included in the spot spacing guide 90 in a straight line. In this embodiment, the ophthalmic laser treatment device 1 displays the multiple indicators 90A, 90B, and 90C included in the spot spacing guide 90 in a straight line along a virtual straight-line angular reference line AL (which is not actually displayed on the internal display unit 50). In this embodiment, the centroid of each of the multiple indicators is displayed in a straight line along the angular reference line AL. Each time the treatment laser light is irradiated, the ophthalmic laser treatment device 1 moves the spot spacing guide 90 along the straight-line direction in which the elements of the multiple indicators are arranged. In this case, the operator can perform the treatment more appropriately by matching the direction in which the elements of the multiple indicators are arranged with the direction in which the targeting position of the treatment laser light is moved to the next irradiation spot. For example, the reflective surface of a contact lens may include edges perpendicular to the direction extending outward from the central axis of the lens. In this case, the operator can adjust the aiming position of the treatment laser beam along the direction of the edge of the contact lens by aligning the direction of the edge of the contact lens as seen in the observation image with the direction of the straight line formed by the elements of the multiple indicators. Furthermore, even if the contact lens that was in contact with the patient's eye comes off, the operator can easily restore the position and orientation of the contact lens by aligning the direction of the edge of the contact lens as seen in the observation image with the direction of the straight line formed by the elements of the multiple indicators.

[0065] In detail, in this embodiment, each of the multiple indicators is perpendicular to the angle reference line AL, and the center (centroid) of each indicator is positioned on the angle reference line AL. When the multiple indicators of the spot spacing guide 90 are positioned appropriately for the next irradiation spot, each indicator of the spot spacing guide 90 extends from the angle reference line AL to near the treatment site (trabecular meshwork) in this embodiment. As a result, the positional relationship between the spot spacing guide 90 and the treatment site (for example, the positional relationship between a specific indicator and a characteristic site in the tissue) becomes easier to understand. Furthermore, the lengths of each of the multiple indicators of the spot spacing guide 90 are symmetrical with respect to the angle reference line AL. Therefore, the operator can easily understand the direction in which each element of the multiple indicators is positioned (i.e., the direction in which the angle reference line AL extends), making it easier to adjust the angle of the reflective surface of the contact lens to an appropriate angle. For example, it is possible to set the angle of the reflective surface to an appropriate angle by adjusting the angle of the reflective surface of the contact lens so that the direction of the angle reference line AL is tangent to the annular or arc-shaped treatment site. Furthermore, the multiple indicators of the spot spacing guide 90 do not necessarily have to extend from the angle reference line AL to near the treatment site. The indicators displayed near the treatment site may have an appropriate width to accommodate individual differences in the curve of the treatment site.

[0066] The ophthalmic laser treatment device 1 of this embodiment displays an outer peripheral guide 75 on the internal display unit 50 as a targeting guide. The outer peripheral guide 75 includes a next targeting guide 75A, an irradiation completion guide 75B, and an unirradiated guide 75C. The outer peripheral guide 75 indicates at least one of the rotation angle of the contact lens's reflective surface (i.e., the direction in which the reflective surface 27 is positioned relative to the central axis of the contact lens 26) and the direction in which the irradiation spot to be irradiated with the treatment laser light is located (the direction in which the irradiation spot is located in the observation image using the contact lens 26). The outer peripheral guide 75 is displayed along the outer edge of the observation field of view by the operator via the observation optical system 40. As mentioned above, the observation optical axis by the observation optical system 40 and the center of the display area of ​​the internal display unit 50 coincide. Therefore, by displaying the outer peripheral guide 75 along the outer edge of the observation field of view with respect to the center of the display area of ​​the internal display unit 50, the operator can easily grasp the appropriate direction.

[0067] In detail, in this embodiment, multiple outer peripheral guides 75 are arranged in an arc or ring shape along the outer periphery of the observation field. Furthermore, when the control unit 60 moves one outer peripheral guide 75, it moves it along the arc or ring line that follows the outer periphery of the observation field. The center of the arc or ring line on which the outer peripheral guide 75 is displayed (in other words, the center of the outer peripheral guide 75, or the center of curvature of the outer peripheral guide 75) coincides with the observation optical axis of the observation optical system 40. Therefore, the operator can appropriately grasp the direction indicated by the outer peripheral guide 75.

[0068] The next targeting guide 75A indicates the appropriate direction for the irradiation spot to be next treated with the laser light, from among the multiple irradiation spots defined in the irradiation plan. Each time the treatment laser light is irradiated, the control unit 60 moves the position of the next targeting guide 75A to a position corresponding to the irradiation spot adjacent to the direction of travel defined in the irradiation plan. For example, in the case of an irradiation plan that irradiates 100 times clockwise around the entire circumference of the trabecular meshwork TM, the next targeting guide 75A should be moved 3.6 degrees relative to the center O. Therefore, the operator can appropriately determine the direction of the irradiation spot to which the targeting position will be adjusted next by the next targeting guide moving along the outer edge of the observation field of view.

[0069] The irradiation completion guide 75B indicates the direction of the irradiation spot where irradiation with the therapeutic laser light has already been completed, among the multiple irradiation spots specified in the irradiation plan. Each time irradiation with the therapeutic laser light is completed, the control unit 60 changes the next targeting guide 75A, which was displayed until immediately before irradiation, to the irradiation completion guide 75B. Therefore, the operator can understand the direction in which irradiation with the therapeutic laser light has been completed and appropriately adjust the next targeting position using the next targeting guide 75A. It also becomes easier to understand the progress of the treatment.

[0070] The unirradiated guide 75C indicates the direction of the irradiation spot that is scheduled to be irradiated with treatment laser light at a later date, among the multiple irradiation spots defined in the irradiation plan. Each time the irradiation of treatment laser light is completed, the control unit 60 changes the unirradiated guide 75C, which was displayed in the direction of the irradiation spot for the next irradiation sequence defined in the irradiation plan, to the next targeting guide 75A, thereby transitioning to the next targeting guide 75A. In this case, the operator can also understand the direction of the irradiation spot that is scheduled to be irradiated with treatment laser light at a later date, and appropriately adjust the next targeting position using the next targeting guide 75A. It also becomes easier to understand the progress of the treatment.

[0071] Furthermore, the ophthalmic laser treatment device 1 of the embodiment displays the total number of irradiation spots specified in the irradiation plan. In the example shown in Figure 8, the number in the denominator of "SHOTS" represents the total number of irradiation spots. The number of irradiation spots for which treatment has been completed (i.e., the total number of irradiation spots for which irradiation with the treatment laser light has been completed and the number of irradiation spots for which irradiation was skipped) is also displayed. In the example shown in Figure 8, the number in the numerator of "SHOTS" represents the number of irradiation spots for which treatment has been completed. Each time irradiation with the treatment laser light or irradiation is skipped, "1" is added to the numerator of "SHOTS". In addition, in the example shown in Figure 8, the type of aiming light AI being used and the energy of the treatment laser light are also displayed.

[0072] The treatment flow using the spot spacing guide 90 will be explained using the examples shown in Figures 9 and 10. In Figures 9 and 10, in order to facilitate understanding of the display transitions of the spot spacing guide 90, the portion of the operator's field of view other than the vicinity of the spot spacing guide 90 displayed on the internal display unit 50 is omitted. Figures 9 and 10 show an example in which adjacent irradiation in a clockwise direction is performed on the actual trabecular meshwork region from the bottom (Figure 9) to the lower left (Figure 10), based on an irradiation plan set in advance by the operator. In Figures 9 and 10, the lower trabecular meshwork is reflected by the reflective surface of the contact lens and enters the operator's field of view. Therefore, in Figures 9 and 10, the top and bottom are inverted, and the lower trabecular meshwork is reflected. On the reflective surface in Figures 9 and 10, if the treatment for the irradiation spot progresses from right to left (i.e., counterclockwise), then in the actual lower trabecular meshwork, the treatment for the irradiation spot progresses from right to left (i.e., clockwise).

[0073] First, as shown in Figure 9(a), the control unit 60 determines the angle of the spot spacing guide 90 to be displayed on the internal display unit 50 according to the progress of the irradiation plan, and displays the spot spacing guide 90 at the determined angle. The spot spacing guide 90 shown in Figure 9 is a guide for performing a specified number of irradiations, 10 times (i.e., a maximum of 10 times), on the lower region of the actual fiber trabecular meshwork™. The indicators of the spot spacing guide 90 shown in Figure 9(a) are arranged horizontally to treat the lower region of the fiber trabecular meshwork™. The control unit 60 displays the next targeting indicator 90A in the spot spacing guide 90 in an identifiable manner for aligning the targeting position of the next treatment laser beam. In the example shown in Figure 9(a), the control unit 60 first displays the next targeting indicator 90A at the position of the indicator located at the opposite end of the treatment progression direction defined in the irradiation plan (in Figure 9(a), the indicator located at the right end). Of the multiple indicators on the spot spacing guide 90, the indicators other than those that overlap with the next targeting indicator 90A are designated as un-irradiated indicators, corresponding to at least a portion of the spots that will be irradiated with the treatment laser light after the next time. Furthermore, the control unit 60 displays the multiple indicators on the spot spacing guide 90 so that the next targeting indicator 90A corresponds to the position on the optical axis of the treatment laser light irradiated by the laser irradiation optical system 10. As mentioned above, the position where the next targeting indicator 90A is displayed does not need to perfectly coincide with the optical axis of the treatment laser light. In other words, the next targeting indicator 90A only needs to be displayed at a position corresponding to the targeting position of the treatment laser light so that the operator can recognize the targeting position where the treatment laser light will be irradiated.

[0074] The operator adjusts the rotation angle of the contact lens and at least one of the relative positions of the patient's eye E and the laser irradiation optical system 10, which are changed by the joystick unit 5, so that the position of the next targeting indicator 90A included in the spot spacing guide 90 corresponds to the irradiation spot of the first treatment laser beam in the treatment area of ​​the patient's eye E (trabecular meshwork in this embodiment). If there are any characteristic areas in the tissue of the patient's eye E included in the observed image, it is desirable for the operator to understand the positional relationship between at least one of the multiple indicators in the spot spacing guide 90 (a specific indicator) and the characteristic area of ​​the tissue. In this case, in subsequent treatment procedures, the operator can smoothly proceed with treatment for each of the multiple irradiation spots by adjusting the positional relationship between the specific indicator and the characteristic area of ​​the tissue to the same positional relationship. As shown in Figure 9(b), the operator inputs a command to perform irradiation of the treatment laser beam with the position of the next targeting indicator 90A aligned to the position corresponding to the irradiation spot of the first treatment laser beam in the treatment area of ​​the patient's eye E (trabecular meshwork in this embodiment). As a result, the treatment laser beam is irradiated onto the spot S through which the optical axis of the laser irradiation optical system 10 passes.

[0075] As shown in Figure 9(c), once the irradiation of the treatment laser light is complete, the control unit 60 moves all the indicators on the spot spacing guide 90 in the opposite direction to the treatment progression direction defined in the irradiation plan (clockwise, or leftward in Figure 9) by the appropriate interval of one irradiation spot. The control unit 60 also moves the position of the next targeting indicator 90A in the direction of progression defined in the irradiation plan by the appropriate interval of one irradiation spot. As a result, the position of the next targeting indicator 90A is maintained at the position corresponding to the targeting position. Furthermore, the control unit 60 changes the indicator that the next targeting indicator 90A was superimposed on during the previous irradiation of the treatment laser light to an indicator that has already been irradiated. As shown in Figure 9(d), the operator can adjust the targeting position of the next treatment laser light by mainly operating the joystick unit 5 and moving the tissue visible in the observation image in the treatment progression direction defined in the irradiation plan by the interval of each of the multiple indicators on the spot spacing guide 90. Furthermore, the operator can adjust the targeting position of the next treatment laser beam by adjusting the positional relationship between at least one of several indicators (a specific indicator) and the characteristic tissue area to the same positional relationship as the previous time. Therefore, the targeting position is easily adjusted appropriately. The operator inputs the instruction to perform irradiation of the treatment laser beam with the position of the next targeting indicator 90A aligned to the position corresponding to the targeting position of the next treatment laser beam (as shown in Figure 9(d)).

[0076] As shown in Figure 9(e), once the irradiation of the second irradiation spot with the therapeutic laser light is complete, the control unit 60 moves all the indicators on the spot spacing guide 90 further in the opposite direction of travel determined in the irradiation plan by the appropriate spacing of one irradiation spot. The control unit 60 also moves the position of the next targeting indicator 90A in the direction of travel determined in the irradiation plan by the appropriate spacing of one irradiation spot. As a result, the position of the next targeting indicator 90A is maintained at the position corresponding to the targeting position. The operator inputs the instruction to perform irradiation of the therapeutic laser light with the position of the next targeting indicator 90A aligned with the position corresponding to the next irradiation spot of the therapeutic laser light (as shown in Figure 9(f)). The above procedure is repeated until the irradiation of the therapeutic laser light to all of the multiple spots (10 spots in the example shown in Figures 9 and 10) within one irradiation area is complete. As mentioned above, the irradiation area is the angular range of an arc-shaped region where treatment laser light is to be irradiated a specified number of times M times (M≧2, in this embodiment M=10) based on the spot spacing guide 90.

[0077] When the prescribed number of treatment laser beam irradiations (M irradiations) for one irradiation area (10 irradiations in the example shown in Figures 9 and 10) are completed, the state shown in Figure 10(a) is reached. The control unit 60 automatically rotates the entire index of the spot spacing guide 90 in the direction of travel by the angle of one irradiation area. The control unit 60 also displays the next targeting index 90A at a position that overlaps with the index located at the opposite end of the treatment direction determined in the irradiation plan. Furthermore, the control unit 60 sets all the indexes of the spot spacing guide 90 other than the position where the next targeting index 90A overlaps as unirradiated indexes. The control unit 60 displays the indexes of the spot spacing guide 90 and the next targeting index 90A so that the next targeting index 90A corresponds to the position on the optical axis of the treatment laser beam irradiated by the laser irradiation optical system 10. As a result, the observed image is in the state shown in Figure 10(b). The operator rotates the reflective surface of the contact lens clockwise, in the direction of treatment (see Figure 10(c)). As mentioned above, the treatment laser light is then repeatedly applied to all of the multiple spots within the new irradiation area.

[0078] Furthermore, in the embodiment, the ophthalmic laser treatment device 1 can also receive a user instruction to rotate the entire spot spacing guide 90 before the irradiation of the treatment laser light to all of the multiple irradiation spots within the irradiation area being treated is completed (i.e., in the middle of treatment to the irradiation spots within the irradiation area). When an instruction to rotate the entire spot spacing guide 90 is received before the treatment to all of the multiple irradiation spots within the irradiation area being treated is completed, the ophthalmic laser treatment device 1 rotates the entire spot spacing guide 90 by an angle corresponding to the range of treatment that has progressed within the irradiation area that was being treated. Therefore, even if the treatment in each irradiation area is not yet complete, the operator can rotate the entire spot spacing guide 90 and then move on to treatment in the next irradiation area.

[0079] As described above, in this embodiment as well, a spot spacing guide 90, which allows the user to understand the appropriate spacing between multiple irradiation spots, is displayed on the internal display unit 50 according to the progress of the irradiation plan. Therefore, the operator can check the spot spacing guide 90 while observing the patient's eye E through the eyepiece 46 (i.e., without taking their eye off the eyepiece 46), and adjust the multiple targeting positions of the treatment laser beam by referring to the confirmed spot spacing guide 90.

[0080] Furthermore, the control unit 60 changes the spacing between multiple indicators of the spot spacing guide 90 displayed on the internal display unit 50 according to the magnification of the observation optical system 40. Therefore, even if the observation magnification is changed, the spot spacing guide 90 corresponding to the appropriate spacing of the multiple irradiation spots is displayed on the internal display unit 50.

[0081] <Model Eye Unit> Next, the model eye unit 100 in this embodiment will be described with reference to Figures 11 to 14. In this description, the person using the model eye unit 100 will be referred to as the "user". The user is not limited to the surgeon (physician). For example, a medical professional other than a physician, or staff of a business (manufacturer and distributor) that handles the ophthalmic laser treatment device 1, may be the user.

[0082] As shown in Figure 11, the model eye unit 100 according to the embodiment includes a model eye 100A and a mount 100B. The mount 100B attaches the model eye 100A to the face support unit 8 of the ophthalmic laser treatment device 1. As will be described in detail later, the height at which the mount 100B is attached and the left-right position of the model eye 100A on the mount 100B are adjustable. This allows the model eye 100A to be positioned in a desired position in the up, down, left, and right directions.

[0083] <Model Eye> In this embodiment, the model eye 100A has a part corresponding to a contact lens and a part corresponding to a patient's eye integrated into one. Details will be explained with reference to Figures 12 to 14. The model eye 100A is formed substantially symmetrically with respect to axis AX2.

[0084] Figure 12 shows the exploded view illustrating the configuration of the model eye 100A of the first embodiment. The model eye 100A is broadly divided into an optical element holder 110, a bearing 120, and a target holder 130. The optical element holder 110 holds a mirror 111, which corresponds to a contact lens. The target holder 130 has a simulated goniosacral angle 133, which corresponds to a patient's eye.

[0085] The optical element holder 110 includes a mirror 111 and an operating section 112. The mirror 111 is a flat plate mirror with a reflective surface formed thereon. The operating section 112 is a cylindrical member. The mirror 111 is held inside the operating section 112. In other words, the mirror 111 is fixed to the operating section 112 so as not to fall out due to its own weight or the like. Similar to the reflective surface of an actual contact lens, the mirror 111 is positioned away from the central axis of the operating section 112 and tilted with respect to the central axis of the operating section 112. That is, the mirror 111 is tilted so that the normal to the reflective surface of the mirror 111 intersects with the central axis of the operating section 112. The tilt value (angle) of the mirror 111 is appropriately determined according to the expected angle of incidence of the treatment laser light and the positional relationship between the position of the mirror 111 and the mounting position of the target in the target holder 130. The operating section 112 is held by the user when changing the position of the mirror 111 relative to the target held by the target holding section 130. In this embodiment, a portion of the outer circumference of the operating section 112 that is held by the user is knurled.

[0086] In this embodiment, the model eye 100A has only one reflective surface by holding the mirror 111, but it is not necessarily limited to this. The operating unit 112 may hold multiple mirrors at different positions around the central axis. For example, two mirrors may be held at 180° intervals, or four mirrors may be held at 90° intervals.

[0087] The bearing 120 is an example of an adjustment mechanism. In this embodiment, a rolling bearing with a self-aligning mechanism is used for the bearing 120. The member supported by the bearing 120 is not only rotatable around the rotation axis of the bearing 120, but the rotation axis of the bearing can also be eccentric (in other words, the rotation axis can be tilted).

[0088] The target holding portion 130 has a bearing fixing portion 131, a base portion 132, and a simulated corner portion 133.

[0089] The base portion 132 is a disc-shaped member. The back surface of the base portion 132 is fixed to the mount portion 100B. The bearing fixing portion 131 is a hollow cylindrical member whose outer diameter is approximately the same as (i.e., the same as or slightly smaller than) the inner diameter of the bearing 120. A flange with a diameter larger than the inner ring diameter of the bearing 120 is formed at the tip of the bearing fixing portion 131. The other end of the bearing fixing portion 131, which does not have a flange, is fixed to the base portion 132. The bearing fixing portion 131 is inserted into the inner ring of the bearing 120 and fixed to the base portion 132. As a result, the bearing 120 is sandwiched between the flange and the base portion 132 and supports the target holding portion 130.

[0090] The simulated corner portion 133 is a component to which the target 140 is attached and detached. In a trial or demonstration of treatment using the model eye 100A, the target 140 is irradiated with treatment laser light. As shown in Figure 12, the simulated corner portion 133 is formed in a cylindrical shape. The outer diameter of the simulated corner portion 133 is approximately the same as (i.e., the same as or slightly smaller than) the inner diameter of the bearing fixing portion 131. A recess for holding the target 140 is formed at the tip of the simulated corner portion 133. In this embodiment, the recess is formed by a side surface parallel to the axial direction of the simulated corner portion 133 and a bottom surface perpendicular to it. The recess of the simulated corner portion 133 is positioned distal to the laser treatment device 1 with respect to the axial direction of axis AX2, compared to the reflective surface of the mirror 111.

[0091] Here, in this embodiment, the target attached to the simulated corner portion 133 will be described with reference to Figure 13. As shown in Figure 13A, a trabecular meshwork label 141 and an iris label 142 are attached to the recess at the tip of the simulated corner portion 133 as targets formed with patterns and shapes corresponding to the tissue present in the corner region of the human eye. The target is a disposable part and is replaceable. The trabecular meshwork label 141 and the iris label 142 are attached, for example, by adhesive tape. As shown in Figure 13B, the trabecular meshwork label 141 is an annular piece of paper formed by connecting the short sides of rectangular pieces of paper. The trabecular meshwork label 141 is placed on the side surface of the recess. The trabecular meshwork label 141 has a striped pattern TM2 that simulates a trabecular meshwork printed on it. Instead of stripes, a colored band may be printed. As shown in Figure 13C, the iris label 142 is a circular piece of paper. The iris label 142 is placed on the bottom surface of the recess. The iris label 142 has a pattern printed on it that mimics the iris. As shown in Figure 13A, in this embodiment, when each is attached to a recess, the trabecular meshwork label 141 is positioned perpendicular to the iris label 142. This allows the angle region of the human eye to be simulated in three dimensions.

[0092] Incidentally, when using contact lenses to irradiate a patient's eye with therapeutic laser light, a gel is applied between the contact lens and the cornea to adjust the refractive index. In contrast, the model eye 100A in this embodiment does not have an optical element equivalent to the cornea, so gel is not required when using the model eye 100A.

[0093] <Mounting Section> Returning to Figure 11, the configuration of the mounting section 100B will be explained. The mounting section 100B includes a sliding mechanism 160 and a detachable mechanism 170.

[0094] The sliding mechanism 160 includes two shafts 161 and a sliding member 162. The two shafts 161 are arranged parallel to each other with a gap between them in the vertical direction, and their longitudinal direction is aligned with the left-right direction. A model eye 100A is fixed to the sliding member 162. The sliding member 162 is guided by the shafts 161 and is movable in the left-right direction. This allows the user to freely move the model eye 100A in the left-right direction.

[0095] The detachable mechanism 170 is positioned one on each side of the slide mechanism 160. The detachable mechanism 170 is connected to two shafts 161. The detachable mechanism 170 is detachably attached to the support column 8a of the face support unit 8. The detachable mechanism 170 has, for example, a mechanism for tightening the support column 8a from the left and right directions. By tightening the support column 8a with a spring, screw, or the like provided as a tightening mechanism, the detachable mechanism 170 is fixed to the support column 8a. This allows the model eye 100A to be attached to the face support unit 8. In this embodiment, the detachable mechanism 170 can be fixed at any height in a section of the support column 8a where the thickness is uniform. The user can change the height of the model eye 100A by changing the height at which the detachable mechanism 170 is attached.

[0096] The model eye 100A is used after the positional relationship between the main body 3 of the ophthalmic laser treatment device 1 and the model eye 100A has been adjusted so that the optical axis extending from the objective lens 25 of the ophthalmic laser treatment device 1 substantially coincides with the axis AX2 of the model eye 100A.

[0097] The method of using the model eye 100A will be explained with reference to Figure 14. The model eye 100A has a target holding part 130, including a simulated gonioscopy area 133, fixed to the mount part 100B, and an optical element holding part 110 that can rotate and tilt via a bearing 120. With the positional relationship between the main body 3 of the ophthalmic laser treatment device 1 and the model eye 100A adjusted, the optical element holding part 110 is rotated and tilted to position the mirror 111 on the path of the light ray indicated by LC in Figure 14. As a result, the reflected image of the target (in this embodiment, the trabecular meshwork label 141 and the iris label 142) attached to the simulated gonioscopy area 133 is projected onto the reflective surface of the mirror 111 in the optical element holding part 110. The user can observe the reflected image through the eyepiece lens 46 of the ophthalmic laser treatment device 1, just as during actual treatment. In addition, when the targeting light is shone on the target, the reflected image of the targeting light is also projected. Therefore, the user can adjust the aiming position of the treatment laser beam relative to the target while understanding the position of the target and the aiming light reflected on the reflective surface. Furthermore, the treatment laser beam can be irradiated onto the aiming position on the target.

[0098] Furthermore, the above-described treatment control process (see Figures 8 to 10) can be performed using the model eye 100A of this embodiment instead of the patient's eye and contact lenses. In this case, a reflection image similar to that shown in Figures 8, 9, and 10 is observed in the observation field. However, instead of the trabecular meshwork™, a striped pattern™2 that mimics the trabecular meshwork™ formed on the trabecular meshwork label 141 of the model eye 100A is observed.

[0099] <Spacer for Tilt Lock> In this embodiment, there is a clearance between the back surface of the operating section 112 and the sliding member 162 necessary for the tilting of the operating section 112. A spacer (not shown) that fills this clearance may be attached to the model eye unit 100. The spacer is, for example, a plate-shaped member with a thickness corresponding to the clearance. By inserting the spacer from the side of the model eye unit 100, the central axis of the operating section 112 is fixed (i.e., tilting is restricted). However, even with the spacer inserted, the operating section 112 can rotate around its axis. This restricts tilting, which makes it difficult to intuitively understand which way the observation field of view is moving from the reflected image, making it easier for inexperienced users to handle the model eye 100A.

[0100] <Second Embodiment> Next, a model eye 200A according to the second embodiment will be described. An exploded perspective view of the model eye 200A is shown in Figure 15. In Figure 15, components identical to those in the first embodiment are denoted by the same reference numerals and their descriptions are omitted. The model eye 200A comprises at least an operating section 210, a bearing 120, and a target holding section 230. The model eye 200A differs from the model eye 100A according to the above embodiment mainly in its optical elements and target, and this point will be explained in detail.

[0101] In the second embodiment, the operating unit 210 holds a goniolens 201 as an optical element. The target holding unit 230 holds a plano-convex lens-shaped member as a target 202 (see Patent Document 2). The goniolens 201 and the target 202 are detachable from the model eye 200A. The goniolens 201 is suitable for irradiating the irrigation angle of the human eye with therapeutic laser light and for observing the irrigation angle, and has one or more reflective surfaces that reflect the therapeutic laser light.

[0102] Target 202 has the appearance of a plano-convex lens, with the front convex surface (lens surface) corresponding to the cornea of ​​the human eye. Furthermore, a pattern simulating the iris is formed on the rear flat surface. In addition, a pattern (striped pattern) simulating the trabecular meshwork is formed on the edge of the lens.

[0103] Model eye 200A is used after applying a gel for adjusting the refractive index between the goniolens 201 and the target 202.

[0104] In the second embodiment, the operating section 210 is separable into a holding section 211 that holds the goniol lens 201 and a first bearing fixing section 212 that is fixed to the outer ring of the bearing 120. In this embodiment, the holding section 211 and the first bearing fixing section 212 can be freely connected and disconnected by engaging a claw 213 formed on the first bearing fixing section 212 with a notch 214 formed on the holding section 211. Separating the holding section 211 from the bearing fixing section 212 makes it easier for the user to apply the gel. In the second embodiment, a screw hole is formed on the side of the holding section 211 for fixing the goniol lens 201 by tightening it from the side with a screw. Of course, the method of fixing is not necessarily limited to this.

[0105] In the second embodiment, the target holding portion 230 includes a second bearing fixing portion 231, a base portion 232, a spring retainer 233, a spring 234, and a base 235.

[0106] Furthermore, the base portion 232 is fixed to the mounting portion 100B. A spring retainer 233 is attached to the back surface of the base portion 232. The second bearing fixing portion 231 is a hollow cylindrical member whose outer diameter is approximately the same as (i.e., the same as or slightly smaller than) the inner diameter of the bearing 120. Similar to the first embodiment, the second bearing fixing portion 231 is inserted into the inner ring of the bearing 120 and fixed to the base portion 232. In this way, the target holding portion 230 is supported by the inner ring of the bearing 120.

[0107] The target 202 is attached to and detached from the tip of the base 235. The inner diameter of the base 235 is approximately the same as (i.e., the same or slightly smaller than) that of the second bearing fixing portion 231. As shown in Figure 15, a spring 234 is positioned between the base 235 and the spring retainer 233. The spring 234 allows the target 202 to move away from the lens 201 when the lens 201 and target 202 come into contact, preventing excessive force from being applied. This allows the rotation and tilt of the operating portion 210 to be smooth.

[0108] The model eye 200A according to the second embodiment can also be used for demonstrating or trying out the procedure, similar to the first embodiment. In addition, the application of gel, which is necessary when actually irradiating a patient's eye with treatment laser light, can also be demonstrated and tried out on the model eye 200A.

[0109] <Third Embodiment> Next, the model eye 300A according to the third embodiment will be described with reference to Figures 16 and 17. A side view of the model eye 300A is shown in Figure 16. An exploded perspective view of the model eye 300A is shown in Figure 17. In Figures 16 and 17, components that are the same or similar as those in the first and second embodiments are denoted by the same reference numerals, and their descriptions are omitted as appropriate.

[0110] The model eye 300A comprises at least an operating section 310, a bearing 320 (see Figure 17), and a simulated corner section 333. In this embodiment, the mirror 301 is detachable from the holding section 311, and the number of mirrors installed can be arbitrarily changed from one to four. This allows for various requests to be met, such as installing only one mirror to try a procedure with a single reflective surface, as in the first embodiment, or installing all four mirrors to try a procedure using a four-sided mirror lens.

[0111] The operating section 310 is the part that holds multiple mirrors 301 as optical elements, and the user grasps it and performs at least a rotational operation. Similar to the operating section 210 of the second embodiment, the operating section 310 is separable into a holding section 311 that directly holds the mirrors 301 and a bearing fixing section 312 that is fixed to the outer ring of the bearing 320. In the third embodiment, threads are formed on the base end of the holding section 311 and the bearing fixing section 312, and the two members are joined together via the threads. When replacing the target 140, the replacement work is made easier by removing the holding section 311.

[0112] The holding portion 311 is a cylindrical member, and four recesses 311a (mounting portion in the third embodiment) for attaching the mirror 301 are formed on its inner surface at 90° intervals around the central axis AX2 of the model eye 300A. A mirror 301, which consists of a mirror body 301a and a mounting bracket, can be detachably attached to each recess 311a. In the third embodiment, the mirror 301 is attached to the recess 311a by fixing the mirror 301 with a screw 313 through a through hole formed on the side surface of the holding portion 311. In this way, the holding portion 311 holds up to four mirrors 301 at different positions around the central axis.

[0113] The bearing 320 functions as an adjustment mechanism, similar to the bearing 120 in the first and second embodiments. The operating section 310 is rotatably supported. The bearing 320 may also be a rolling bearing with a self-aligning mechanism, similar to the first and second embodiments. This allows the operating section 310 to be tiltably supported.

[0114] The simulated corner portion 333 in the third embodiment is a cylindrical member on which the target 140 is attached and detached, similar to the simulated corner portion 133 in the first embodiment. However, the simulated corner portion 333 in this embodiment also serves the functions of the target holding portions 130, 230 and the base portions 132, 232 in the first and second embodiments. That is, the base end of the simulated corner portion 333 is directly fixed to the mounting portion 100B. Multiple steps are formed on the outer circumference of the simulated corner portion 333 such that the diameter gradually decreases from the base end to the tip.

[0115] The bearing fixing portion 335 is a ring-shaped member with an internal thread formed on its inner circumference. On the other hand, an external thread is formed on the outer circumference of the middle step 333a on the side surface of the simulated corner portion 333. After the inner ring of the bearing 320 is mounted on the simulated corner portion 333, the bearing fixing portion 335 is screwed onto the thread of the simulated corner portion 333 and tightened. As a result, the bearing 320 is fixed to the simulated corner portion 333 by being sandwiched between the base end of the bearing fixing portion 335 and one of the steps formed on the simulated corner portion 333.

[0116] According to the model eye 300A of the third embodiment, since the mirror 301 is detachable, the user can change the number of mirrors according to the purpose. For example, if only one mirror 301 is installed, a basic procedure using a single reflective surface can be tried, similar to the first embodiment. On the other hand, if all four mirrors 301 are installed at 90° intervals, a procedure in which the target is observed and irradiated from four different directions can be demonstrated or tried, similar to treatment using an actual four-sided mirror lens. In this way, the model eye 300A of this embodiment can handle multiple procedures with a single unit.

[0117] While embodiments of the technology disclosed herein have been described in detail above, these are merely illustrative and do not limit the scope of the claims. The technologies described in the claims include various modifications and changes to the embodiments illustrated above.

[0118] While embodiments of this disclosure have been described above, this disclosure is not limited to the embodiments described above, and various modifications are possible without departing from the spirit of the claims.

[0119] For example, the adjustment mechanism is not limited to bearings; it may also have a ball joint mechanism that allows for rotation and tilting. Furthermore, it may include a click mechanism that provides a tactile click during operation.

[0120] 100 Model eye unit 100A Main body 110 Optical element holder 133 Target holder 120 Bearing AX Central axis

Claims

1. A model eye for an ophthalmic laser treatment device, comprising: an optical element holding portion for holding an optical element having a reflective surface formed thereon that reflects therapeutic laser light incident along the central axis of the model eye in a direction intersecting the central axis; a target holding portion for holding a target onto which the therapeutic laser light is irradiated via the optical element; and an adjustment mechanism for adjusting the position of the reflective surface on a plane perpendicular to the central axis with respect to a rotational direction around the target holding portion.

2. The model eye according to claim 1, wherein the adjustment mechanism is capable of tilting the position of the reflective surface about an axis perpendicular to the central axis relative to the position of the reflective surface with respect to the target holding portion.

3. The model eye according to claim 2, wherein the adjustment mechanism is a rolling bearing with a self-aligning mechanism.

4. The model eye according to any one of claims 1 to 3, wherein a lens corresponding to the cornea is not provided between the optical element and the target.

5. The model eye according to any one of claims 1 to 4, wherein the optical element holding portion has a plurality of mounting portions arranged at intervals around the central axis, and the optical element on which the reflective surface is formed is detachably held by at least one of the plurality of mounting portions.

6. The model eye according to any one of claims 1 to 4, wherein the optical element holding portion holds the optical element such that the plurality of reflective surfaces are arranged at equal intervals around the central axis.

7. The model eye according to any one of claims 1 to 3, wherein the optical element is a contact lens having the reflective surface, and the optical element holding portion holds the contact lens in a removable manner.

8. A model eye unit comprising a model eye according to any one of claims 1 to 7, and a mounting portion for attaching the model eye to a face support unit that supports the patient's face in the ophthalmic laser treatment apparatus.

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