This application is based upon and claims the benefit of priority from the prior Japanese Patent Application No. 2009-001357 filed on Jan. 7, 2009, the entire contents of which are incorporated herein by reference.
The present invention relates to an ophthalmic laser treatment apparatus for performing photocoagulation treatment or the like by irradiating a laser beam to a patient's eye.
A conventional laser treatment apparatus for performing photocoagulation treatment or the like by irradiating a laser beam to a fundus is configured to irradiate a laser beam as a single spot to an affected part of a patient's eye. For changing a spot position of the laser beam, an operator moves a delivery optical system for delivering the laser beam or moves a reflection mirror by operation of a manipulator to reflect the laser beam toward the eye (for example, see JP 2002-224154 A).
Furthermore, there has been proposed another apparatus using a scanner to cause a single spot of a laser beam scan in a predetermined pattern instead of moving the reflection mirror by the operator (for example, WO 2007/035855 A2 and JP 2008-504075 T2).
However, in the conventional apparatus in JP 2002-224154 A, in the case where a laser beam is to be irradiated to many affected parts, such as retinal photocoagulation, the operator has to move the delivery optical system or the reflection mirror every time an irradiation point of the laser beam is changed. This operation is troublesome and takes a long treatment time.
The apparatus utilizing the scanner can reduce the labor of the operator. However, this apparatus moves a single spot and therefore takes a long treatment time when a laser irradiation time at each spot position is set to be equal to that in JP 2002-224154 A. This results in an increased burden on a patient. If the laser irradiation time at each spot position is shortened and instead output power of the laser beam is increased, the following problems may be caused: operator's past experience could not be fully utilized and thus a coagulation spot could not be appropriately formed; the increased output power in a short irradiation time is liable to cause pain in a patient's eye; and bleeding easily occurs.
The present invention has a purpose to provide an ophthalmic laser treatment apparatus capable of reducing the labor of an operator, shortening a treatment time, and performing treatment under an. irradiation condition making use of the operator's experience.
To achieve the above purpose, the invention provides an ophthalmic laser treatment apparatus for irradiating a laser beam to a patient's eye, comprising: a delivery optical system for forming the laser beam emitted from a laser source into a plurality of spots on a target surface, the delivery optical system including: a diffraction optical element for dividing the laser beam incident thereon into a plurality of diffraction beams in a predetermined spot pattern; a first zoom optical system placed on a side closer to the laser source than the diffraction optical element, the first zoom optical system being configured to change a spot size without changing a spot interval on the target surface; and an objective lens.
According to another aspect, the present invention provides an ophthalmic laser treatment apparatus for irradiating a laser beam to a patient's eye, comprising: a delivery optical system for forming the laser beam emitted from a laser source into a plurality of spots on a target surface, the delivery optical system including: a diffraction optical element for dividing the laser beam incident thereon into a plurality of diffraction beams in a predetermined spot pattern; a first zoom optical system placed on a side closer to the laser source than the diffraction element; a second zoom optical system placed on a side closer to the target surface than the diffraction element; and an objective lens.
A detailed description of a preferred embodiment of the present invention will now be given referring to the accompanying drawings.
The laser treatment apparatus includes a slit lamp 1 in which an observation optical system 10 for a binocular microscope and an illumination optical system 20 are placed, a main unit 50 containing a laser source, an optical fiber 30 for delivering a laser beam from the main unit 50, and a laser delivery optical system 40 for irradiating a laser beam emitted from the optical fiber 30 to an affected part such as a fundus of a patient's eye PE and others. The observation optical system 10, the illumination optical system 20, and the laser delivery optical system 40 are mounted on a movable base 2 which is movable on a table 3. The table 3 is provided with a chin rest 4 for supporting the face of a patient. The movable base 2 is moved with respect to the eye by a joystick 5 to be operated by an operator.
In
A visible light beam emitted from the illumination light source 21 of the illumination optical system 20 passes through a condenser lens 22, a variable aperture 23 for determining the height of the beam, and a variable slit plate 24 for determining the width of the beam. Thus, the beam is formed into a slit-like beam. This slit illumination light passing through the variable slit plate 24 passes through a projection lens 25 and then is reflected by a mirror 26 to illuminate the patient's eye PE. In the case of fundus observation and fundus photocoagulation, a contact lens CL for canceling a corneal refraction power is used.
The main unit 50 includes a treatment laser source 51 and an aiming laser source 52 such as a semiconductor laser to generate a red aiming beam. The laser source 51 emits a laser beam having a visible wavelength (e.g., a wavelength of 532 nm) suitable for photocoagulation treatment. The laser beam emitted from the laser source 51 is partly reflected by a beam splitter 53 and the output of the laser beam is monitored by an output sensor 54. The laser beam passing through the beam splitter 53 is made coaxial with the aiming beam from the aiming laser source 52 and caused to enter the optical fiber 30 through a condensing lens 56.
The laser beam and the aiming beam emitted from the main unit 50 are transmitted to the laser delivery optical system 40 through the fiber 30. The fiber 30 used in this embodiment shown in
The laser delivery optical system 40 includes a diffractive optical element (hereinafter, “DOE”) 44 for forming a plurality of spots in a predetermined pattern on a target surface FO (the fundus). On both sides of the DOE 44, a first zoom optical system 41 is placed on a side closer to the laser source 51 which is an incident side of the DOE 44 and a second zoom optical system 45 is placed on a side closer to the target surface FO which is an emission side of the DOE 44. The laser beam (and the aiming beam) passing through the second zoom optical system 45 is reflected by a dichroic mirror 48 disposed on an illumination optical axis of the illumination optical system 20 toward the eye PE through the projection lens 25 and the mirror 26 used in common with the illumination optical system 20. The laser delivery optical system 40 uses the projection lens 25 as an objective lens. Furthermore, an emission end face of the fiber 30 is conjugated with the target surface FO with respect to the lens 25. The dichroic mirror 48 has a property of reflecting most of the laser beam from the laser source 51, reflecting a certain amount of the red aiming beam, and transmitting a certain amount of white light from the illumination light source 21.
The first zoom optical system 41 includes a convex lens 42a and a concave lens 42b movable in an optical axis direction. The convex lens 42a serves as a variator lens (serves to change the size of an image). Movement of the convex lens 42a changes the size of spots to be formed on the target surface FO. The concave lens 42b serves as a compensator lens (movable synchronously with the variator lens and serves to compensate deviation of a focal point on the target surface FO). The concave lens 42b is moved in the optical axis direction synchronously with the convex lens 41a in order to cause almost parallel light to enter the DOE 44. The convex lens 42a and the concave lens 42b are moved in the optical axis direction synchronously with a drive unit 43 having a motor and a moving mechanism. For the lenses 42a and 42b, a known cam mechanism for zoom lens barrel utilizable in a photographic camera and others may be used. The use of such cam mechanism enables synchronous movement of the convex lens 42a and the 42b by manual operation.
The second zoom optical system 45 includes a convex lens 46a and a concave lens 46b which will be moved in the optical axis direction. The parallel light passing through the first zoom optical system 41 is incident on the convex lens 46a, forming a magnified image of an emission end face (core) of the fiber 30 serving as a subject plane on a focal plane of the convex lens 46a. In the configuration that the DOE 44 is placed between the first zoom optical system 41 and the second zoom optical system 45, multiple spots are formed on the focal plane of the convex lens 46a according to a diffraction angle of the DOE 44. The concave lens 46b serves to magnify the spots formed on the focal plane of the convex lens 46a by the DOE 44 and the convex lens 42a. The convex lens 46a is moved synchronously with the concave lens 46b to focus on the target surface FO. In the second zoom optical system 45, the convex lens 46a functions as a compensator lens and the concave lens 46b functions as a variator lens. The convex lens 46a and the concave lens 46b are synchronously moved in the optical axis direction by a drive unit 47 having a motor and a moving mechanism. For the lenses 46a and 46b, a known cam mechanism for zoom lens barrel may be used as in the first zoom optical system 41. The second zoom optical system 45 may also be configured to move each constituent lens by manual operation instead of using the drive unit 47.
The DOE 44 is an optical element formed of a light-transmitting body, such as glass, quartz, or resin, formed with microgrooves for generating diffraction. The microgrooves of the DOE 44 can give a diffraction phenomenon of an arbitral pattern to the light passing through the DOE 44. The DOE 44 in this embodiment is designed to divide a laser beam incident thereon into a plurality of diffraction beams in a predetermined spot pattern and form a plurality of spots (multiple spots) having the same shape and arranged in the predetermined pattern on the target surface. For instance, as shown in
A control section 60 installed in the main unit 50 is connected to the laser source 51, the aiming laser source 52, the output sensor 54, the drive units 43 and 47, a footswitch 8 for inputting a trigger signal of laser irradiation, a controller 61, and others. The control section 60 controls output power of the laser beam, duration of the laser beam, and switching ON/OFF of the aiming beam. The controller 61 is provided with a switch 61a for changing the spot size of the laser beam, a switch 61b for setting an irradiation range of the laser beam (the total dimension of the multiple spots), and further various switches such as a switch for setting surgical parameters such as the output power (an energy amount) and irradiation time of the laser beam, and a switch for adjusting an illumination light amount. The controller 61 is provided with a display (an indicator) 64 for indicating surgical conditions set with the switches. The control section 60 controls driving of the drive units 43 and 47 to change the emission condition, the spot size, etc. of the laser beam from the laser source 51 based on the parameters set by the controller 61.
Next, the principle of changing the size and the irradiation range of the spots to be irradiated on the target surface is explained.
Diffraction beams divided by the DOE 44 form for example nine spots S having the same size and the same shape as shown in
In other words, when the magnification β4 by the second zoom optical system 45 is changed, the magnification M of each spot S is determined based on both of the magnification β1 by the first zoom optical system 41 and the magnification β4 by the second zoom optical system 45. For instance, in the case where the spot size of each spot S remains unchanged and only the total irradiation range is to be changed, the magnification β1 by the first zoom optical system 41 is adjusted according to the magnification β4 by the second zoom optical system 45 so that the magnification M of each spot S is constant.
As shown in
d=f3×tan θ [Expression 3]
Since the DOE 44 is designed to have a plurality of diffraction angles θ, a plurality of spots are formed on the focal plane A according to the diffraction angles θ.
The convex lens 46a of the second zoom optical system 45 serves to magnify the multiple spots formed on the focal plane A of the convex lens 46a. The convex lens 46a is moved synchronously with the concave lens 46b to focus on the target surface FO. When each interval between the spots formed on the focal plane A of the convex lens 46a is “d”, each interval “D” of the spots on the target surface FO and the magnification β4 by the second zoom optical system 45 have the following relation.
D=d×β4 [Expression 4]
Specifically, the interval D is determined based on the magnification β4 by the second zoom optical system 45.
a to 5C are explanatory views showing the case of changing only the spot interval D without changing the spot size φ on the target surface FO.
As in the above examples in which the spot size φ is constant and only the spot interval D is changed, the magnification β4 by the second zoom optical system 45 is changed according to magnification (reduction) of the spot interval D. Also, the magnification β1 by the first zoom optical system 41 is changed according to the magnification β4 to make the magnification M of each spot size φ constant.
As the above examples, when the sport interval D is fixed and only the spot size φ is changed, the magnification β4 is not changed and only the magnification β1 is changed. When the spot size φ is to be displayed on the display (the indicator) 64, the spot size φ is calculated by the control section 60 based on the magnifications β1 and β4.
Operations of the laser treatment apparatus during surgical operation will be explained below. Herein, the explanation is given to the case of performing photocoagulation treatment on a fundus. For photocoagulation treatment, an operator determines the irradiation time, the output power, and others of the laser beam with various switches not shown on the controller 61. The irradiation time and the output power are also displayed on the display 64. The laser output power displayed on the display 64 appears as a value of total laser output power and also as a value of output power per one spot so as to make use of operator's experience. For instance, when the laser output power at one spot is set to 0.1 W, the control section 60 drives the laser source 51 to output laser power at 0.9 W in total based on the number of diffraction beams divided by the DOE 44 (the number of spots is set to 9).
The operator further sets the spot size φ with the switch 61a for spot size change and also sets the spot interval D (which also may be set as a range of nine spots S corresponding to the irradiation range of the laser beam) with the switch 61b. The spot size φ and the spot interval D are displayed on the display 64. When the spot interval D is set, the control section 60 determines the magnification β4 based on a set signal representing the spot interval D, and controls the drive unit 47 to drive the second zoom optical system 45. The control section 60 also determines the magnification β1 by the first zoom optical system 41 based on drive information (the magnification β4) of the second zoom optical system 45 and the set signal representing the spot size φ, and controls the drive unit 43 to drive the first zoom optical system 41 to adjust the spot size φ to the set value. For instance, under the above conditions in
The operator observes, through the observation optical system 10, an affected part of the fundus illuminated by illumination light from the illumination optical system 20. When the aiming laser source 52 is turned on, the aiming beam from the aiming laser source 52 is guided into the laser delivery optical system 40 through the fiber 30, and passes through the first zoom optical system 41, the DOE 44, the second zoom optical system 45, and the projection lens 25, thereby forming nine spots as illustrated in
When the operator makes alignment to the affected part while observing the nine spots formed by the aiming beam, the operator performs laser irradiation by use of the footswitch 8. Upon receipt of the trigger signal of the laser irradiation from the footswitch 8, the control section 60 drives the laser source 51 to emit the laser beam. The laser beam from the laser source 51 is guided into the delivery optical system 40 through the optical fiber 30 and passes through the first zoom optical system 41, the DOE 44, the second zoom optical system 45, and the objection lens 25. Thus, the laser beams divided into nine spots are irradiated at once to the fundus for the set irradiation time. Consequently, nine coagulation spots are simultaneously formed. In treatment for forming many coagulation spots as in retinal photocoagulation treatment, the laser beams of nine spots are irradiated at once to the fundus. This can save the operator time and labor for alignment and shorten the treatment time. Since the treatment is enabled under the same irradiation time and laser output power as in the laser irradiation performed individually for each spot. Thus, the treatment can be conducted appropriately based on the operator's experience.
The above embodiment exhibits the example of using the DOE 44 to form the patterns in which nine spots are arranged in a grid form. An alternative is to provide a plurality of DOEs configured to form different arrangement patterns of multiple spots to enable selection of a multi-spot irradiation pattern, so that more appropriate treatment is performed according to conditions of the affected part.
The DOEs 101a to 101e are rotatably held in the turret plate 100 by holders 104a to 104e respectively. Each of the holders 104a to 104e is rotated synchronously with rotation of a sun gear 105 by the motor 106. When one of the DOEs 101a to 101e placed on the optical axis of the laser delivery optical system 40 is rotated about the optical axis, the multi-spot pattern to be irradiated to the eye PE is also rotated. The motor 106 is driven by the control section 60 based on a signal from a rotation-angle designating switch provided on the controller 61. The rotation of each of the DOEs 101a to 101e about the optical axis may also be performed by manual rotation of each DOE or the sun gear 105 by the operator to rotate the multi-spot pattern.
respectively.
When the opening 102 is placed on the optical path (that is, when the DOEs are placed out of the optical path), the laser beam from the laser delivery optical system 40 is formed in a single spot. This enables treatment using a single spot as with the conventional apparatus. The aforementioned configuration having the DOE 44 in
In the above method, when the spot diameter and the irradiation range are to be changed, the first zoom optical system 41 and the second zoom optical system 45 are electrically driven. Alternatively, the first and second zoom optical systems 41 and 45 may be moved by manual operation of a rotating knob or the like by the operator. In this case, a sensor is preferably provided to detect a movement position of each lens of the first and second zoom optical systems 41 and 45 or an operation position of the rotating knob. Accordingly, the magnifications by the first and second zoom optical systems 41 and 45 respectively are detected. Based on the detected magnifications, information on the spot size φ and the spot interval D (or the irradiation range) are displayed on the display 64. This enables the operator to perform appropriate laser irradiation while observing the spot size φ and the spot interval D.
In the embodiment of
While the above embodiment of the present invention has been shown and described, it is to be understood that this disclosure is for the purpose of illustration and that various changes and modifications may be made without departing from the scope of the invention as set forth in the appended claims.
Number | Date | Country | Kind |
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2009-001357 | Jan 2009 | JP | national |