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WO1990008500A1 - Appareil medical pour examiner et traiter l'×il - Google Patents

Appareil medical pour examiner et traiter l'×il Download PDF

Info

Publication number
WO1990008500A1
WO1990008500A1 PCT/EP1989/001349 EP8901349W WO9008500A1 WO 1990008500 A1 WO1990008500 A1 WO 1990008500A1 EP 8901349 W EP8901349 W EP 8901349W WO 9008500 A1 WO9008500 A1 WO 9008500A1
Authority
WO
WIPO (PCT)
Prior art keywords
eye
scanner system
medical device
radiation
optical deflection
Prior art date
Application number
PCT/EP1989/001349
Other languages
German (de)
English (en)
Inventor
Erich Weimel
Stefan Pieger
Original Assignee
Aesculap Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap Ag filed Critical Aesculap Ag
Publication of WO1990008500A1 publication Critical patent/WO1990008500A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0075—Apparatus for testing the eyes; Instruments for examining the eyes provided with adjusting devices, e.g. operated by control lever
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A61B3/1225—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes using coherent radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00897—Scanning mechanisms or algorithms

Definitions

  • the invention relates to a medical device for examining and treating the eye with an observation device directed into the patient's eye, as well as a lamp and a laser, which send radiation for illuminating or treating the eye into the eye via an optical deflecting device.
  • a lamp in particular a so-called slit lamp, directs an illuminating radiation into the inside of the eye via an optical deflection element and illuminates a specific area of the eye in such a way that it is monitored by an observation device the inside of the eye can be examined.
  • a generally invisible treatment radiation generated by a laser can be directed into the eye and act there on the tissue, for example in order to achieve coagulation of the tissue.
  • the illuminating and treatment radiation falling into the eye is usually directed into the eye in the direction of observation via an optical deflecting element, for example a semitransparent mirror, so that the observing physician enters the eye in the direction of the radiation falling into the eye sees.
  • an optical deflecting element for example a semitransparent mirror
  • the device can gegen ⁇ above to be examined eye in its distance, -in his "lateral position and possibly also adjust its height. It is also known, the deflection elements that allow lighting and radiation treatment in the The eye is steered in such a way that different areas of the eye can be exposed to the illumination and treatment radiation 7. It has been found in known devices that the accuracy and, in particular, the speed with which different areas of the eye with which radiation can be applied is insufficient.
  • optical deflection device is an electrically controllable scanner system with deflection along two perpendicularly
  • Such scanner or scanning systems make it possible to direct a light beam striking them with a high deflection frequency and high deflection accuracy to every point on a surface.
  • Such scanner systems are known per se and are used, for example, for the optical scanning of printing types, for the exposure of light-sensitive lacquers on a surface or for marking assembly positions on electrical circuit boards.
  • the scanner systems used in a completely different context improve the operation and use of a medical eye examination device in a particularly advantageous manner, since the scanner systems, which are generally very low-inertia and small in size, not only have excellent reproducibility and an extraordinarily rapid change of the eye area to be irradiated, but also have a very small and robust structure, so that a device which is less susceptible to faults and works reliably can be created.
  • a control is assigned to the scanner system, which separately controls optical deflection systems for the deflection along each of the two axes, if each deflection system can be driven by the control to oscillate around a zero position and if the zero position of each deflection element is permanently adjustable.
  • the desired result can then be achieved solely by an appropriate choice of the zero positions, the oscillation frequencies and phase relationships of these deflecting movements, it being additionally possible to first control the shape and position of the irradiated surface solely by the visible illuminating radiation and only then by Switch on the laser beam for the invisible laser radiation.
  • the scanner system comprises two separate deflecting mirrors which can be pivoted about mutually perpendicular axes and at which the radiation is reflected one after the other.
  • the scanner system comprises a deflecting mirror that can be pivoted about two mutually perpendicular axes.
  • the drive of the scanner system is held on a swivel arm which is mounted on the device so as to be rotatable about a vertical axis, for example passing through the eye to be examined.
  • a first drive motor of the scanner system is held in a device-fixed manner, that an optical deflection element is arranged on a holder that can be rotated by the first drive motor, and that a second drive motor is held on this holder which pivots the optical deflection element about an axis of rotation extending perpendicular to the axis of rotation of the holder.
  • Fig. 1 is a schematic view of a medical
  • FIG. 2 shows a view of the scanner system used in the device of FIG. 1.
  • the medical device shown in the drawing comprises a base plate 1, on which two swivel arms 3 and 4 are mounted rotatably about a vertical axis 2 by means of a cross table, not shown in the drawing, which can be displaced in the horizontal plane.
  • the first swivel arm 3 carries on a vertical holder 5 an observation device 6 with an objective 7 and an eyepiece 8, through which a doctor can look into the eye 9 of a patient.
  • the eye is located approximately on the vertical axis 2.
  • the other swivel arm 4 carries a housing 10, from which a holder 11 protrudes, which carries at its free end an optical deflection element in the form of a semi-transparent mirror 12.
  • This mirror 12 deflects radiation 13 coming vertically from above at right angles into the eye 9 to be examined.
  • the mirror 12 is located in front of the objective 7, so that the observing doctor looks through the semitransparent mirror 12 into the eye 9.
  • the radiation 13 comes from an illumination lamp, not shown in the drawing, preferably a so-called slit lamp, which emits visible light.
  • an illumination lamp not shown in the drawing
  • invisible radiation from a treatment laser is also reflected in the beam path in a manner not shown in the drawing, so that this treatment radiation is directed collinearly with the illuminating radiation via the mirror 12 into the eye 9.
  • the holder 11 carrying the mirror 12 is rotatably supported about its longitudinal axis in the housing 10, in which there is a first scanner motor 14 held on the housing, the elongated shaft 15 of which supports the holder 11.
  • a second scanner motor 16 which is preferably located directly in the extension of the shaft 15 and whose motor shaft 18 is perpendicular to the motor shaft 15, is arranged on the side opposite the holder 11 via a holder 17, which is shown only schematically in FIG of the first scanner motor 14 is arranged.
  • the second motor shaft 18 is connected via a linkage 19 'that of the motor shaft 18, for example via an eccentric parallel to its longitudinal direction and is movable up, hinged to the mirror 12, in turn, to the holder 11 about an axis perpendicular of on the longitudinal axis Holder 11 • standing axis is pivotally mounted; this axis of rotation of the mirror is perpendicular to the drawing plane in the illustration in FIG. 2.
  • Both scanner motors 14 and 16 are connected via control lines 20 and 21 to a controller 22 which supplies the control motors separately with different control signals.
  • These control signals can cause permanent rotation of the scanner motor by a certain angle, on the other hand, these signals can cause oscillating rotary movements of each motor, which are superimposed on the permanent rotation. These movements are transmitted to the mirror 12, which, due to the permanent rotation of the motors, directs the radiation 13 striking it into different areas of the eye 9 and thus accordingly
  • the radiation in the eye carries out oscillations along two mutually perpendicular axes, the radiation sweeping over differently shaped areas, for example circles, ellipses or rectangles, in accordance with the respective frequency of these oscillations and the phase relationships thereof.
  • the observing physician can change the extent, shape and size of the swept area on the control by appropriate choice of the frequencies and the phase relationships as well as by the choice of the amplitude of the oscillating movement of the two scanner motors.
  • the position of the surface can be influenced by changing the zero position, this is preferably done by a ball 24, which can be freely rotated about two perpendicular axes on a joy stick-like lever 23, and the rotary pulse generator arranged in the lever 23 when it is rotated actuated, the signals of which are also fed to the control and are used to change the zero positions along the two pivot axes of the mirror.
  • the joystick-like lever 23 itself can be used to operate the cross table, not shown in the drawing, with which the relative position of the two swivel arms 3 and 4 relative to the eye 9 can be varied.
  • the scanner magnets are very inert and therefore extremely fast to move, so that the mirror 12 can be oscillated at high frequencies around the two axes of rotation. This makes it possible to allow the radiation in the eye 9 to sweep over an area so quickly that the eye of the observing doctor sees the area illuminated evenly, so that the movements of the essentially point-focused light beam can no longer be resolved in time.
  • the mechanical arrangement of the scanner motors in the housing 10 and the holder 11 as well as the linkage 19 is shown essentially schematically in the exemplary embodiment. It is of course possible here to find other mechanical configurations with which fixed with the help of two separately controllable scanner motors Angle adjustments and oscillating movements about the two mutually perpendicular axes are transmitted to the deflecting mirror 12. In a modified exemplary embodiment, it would also be possible to use two mirrors connected directly in series instead of one mirror 12, each about an axis

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Physics & Mathematics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

Un appareil pour examiner et traiter l'÷il comprend un dispositif d'observation (6) qui est dirigé dans l'÷il (9) du patient, une lampe et un laser qui dirigent un rayonnement, via un dispositif de déflection optique (12), dans l'÷il afin d'éclairer et de traiter ce dernier. Dans le but d'assurer un déplacement rapide et précis de la région irradiée de l'÷il, le dispositif de déflection optique se présente sous la forme d'un système scanner à commande électrique (11 ... 19) et à déflection le long de deux axes mutuellement perpendiculaires.
PCT/EP1989/001349 1989-01-27 1989-11-11 Appareil medical pour examiner et traiter l'×il WO1990008500A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19893902410 DE3902410A1 (de) 1989-01-27 1989-01-27 Medizinisches geraet zur untersuchung und behandlung des auges
DEP3902410.5 1989-01-27

Publications (1)

Publication Number Publication Date
WO1990008500A1 true WO1990008500A1 (fr) 1990-08-09

Family

ID=6372915

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1989/001349 WO1990008500A1 (fr) 1989-01-27 1989-11-11 Appareil medical pour examiner et traiter l'×il

Country Status (2)

Country Link
DE (1) DE3902410A1 (fr)
WO (1) WO1990008500A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998000078A1 (fr) * 1996-07-01 1998-01-08 Life Science Resources Limited Appareil medical de guidage au laser

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6425860B1 (en) 1995-08-16 2002-07-30 Grigory Sadkhin Therapeutic and diagnostic method and apparatus
US6705727B1 (en) * 2002-12-30 2004-03-16 Bausch & Lomb Incorporated Mechanism for rotationally moving a mirror

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2143052A (en) * 1983-07-06 1985-01-30 Lasers For Medicine Inc Laser ophthalmic surgical system
US4520816A (en) * 1983-01-12 1985-06-04 Schachar Ronald A Method and apparatus for delivering laser energy for ophthalmic use
EP0228778A1 (fr) * 1985-10-18 1987-07-15 Kowa Company, Ltd. Système de coagulation à laser
WO1987005205A1 (fr) * 1986-03-08 1987-09-11 G. Rodenstock Instrumente Gmbh Installation a laser pour l'examen et le traitement de l'oeil
EP0279589A1 (fr) * 1987-02-17 1988-08-24 Eye Research Institute Of Retina Foundation Alignement/stabilisateur pour le fond d'oeil

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS52111295A (en) * 1976-03-15 1977-09-17 Mochida Pharm Co Ltd Operational laser optical device under microscope
US4737628A (en) * 1984-02-07 1988-04-12 International Technical Associates Method and system for controlled and selective removal of material

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4520816A (en) * 1983-01-12 1985-06-04 Schachar Ronald A Method and apparatus for delivering laser energy for ophthalmic use
GB2143052A (en) * 1983-07-06 1985-01-30 Lasers For Medicine Inc Laser ophthalmic surgical system
EP0228778A1 (fr) * 1985-10-18 1987-07-15 Kowa Company, Ltd. Système de coagulation à laser
WO1987005205A1 (fr) * 1986-03-08 1987-09-11 G. Rodenstock Instrumente Gmbh Installation a laser pour l'examen et le traitement de l'oeil
EP0279589A1 (fr) * 1987-02-17 1988-08-24 Eye Research Institute Of Retina Foundation Alignement/stabilisateur pour le fond d'oeil

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998000078A1 (fr) * 1996-07-01 1998-01-08 Life Science Resources Limited Appareil medical de guidage au laser

Also Published As

Publication number Publication date
DE3902410A1 (de) 1990-08-02

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