CN1664645A - Microscope for operation - Google Patents
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- CN1664645A CN1664645A CN 200510056244 CN200510056244A CN1664645A CN 1664645 A CN1664645 A CN 1664645A CN 200510056244 CN200510056244 CN 200510056244 CN 200510056244 A CN200510056244 A CN 200510056244A CN 1664645 A CN1664645 A CN 1664645A
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Abstract
A microscope for operation is provided with a front lens disposed in front of the eye to be operated for illuminating toward the interior of an eye by the microscope, which is suitable for operation while an operator having operation apparatuses in both hands. The microscope for operation of the invention comprises: an illuminating optical system (61) for illuminating an illuminating light toward the eye to be operated upon, an objective (14) positioned in the body tube to be opposite to the eye (8) be operated, a pair of observing optical systems (60) disposed at opposite sides of an optical axis of the objective for observing the eye be operated. A slit plate (73)is provided in the illuminating optical system and is equiped with a slit hole (73a) for forming a slit illuminating light by the illuminating light and makes the slit hole extending along the vertical direction of the optical axis of the illuminating optical system, furthermore, the projection image of the slit hole on the bottom of the eye is parallel to the planes of the two optical axes of the observing optical systems, thereby, the slit hole can move along the vertical direction of the optical axis of the illuminating optical system and the slit illuminating light is apart from or close to the optical axis of the objective.
Description
The application be that Dec 13, application number in 2002 are 02157420.0 the applying date, denomination of invention divides an application for the application for a patent for invention of " operation microscope ".
Technical field
The present invention relates to utilize the supplementary lens that between the focal position, front side of eyes of being performed the operation and object lens, disposes that illumination light is focused on, simultaneously it is guided into the inside of these eyes of being performed the operation, inside ofeye is thrown light on, observe the operation microscope that carries out intraocular surgery by eyepiece.
Background technology
Always, the microscope of operation usefulness, the stereomicroscopy lens device of the usefulness of for example performing the operation has structure shown in Figure 1.
In Fig. 1, the 1st, pillar, 2 is the 1st arms, 3 is the 2nd arms, the 4th, X-Y inching gear, the 5th, the microscope that operative doctor is used (being also referred to as " microscopie unit "), the 6th, the microscope that the assistant uses, the 7th, foot-switch, the 8th, the eyes of being performed the operation.
Always, when carrying out ophthalmologic operation, operative doctor always as shown in Fig. 2 amplifies like that, the cornea C of the eyes 8 that contact lens 9 and quilt performed the operation is contacted.Then, operative doctor inserts inside ofeyes with the illuminating photoconductive tube of inside ofeye 10, observes by the eyepiece of microscopie unit once again, utilizes operating theater instruments 11 such as scalpel to undergo surgery.Also have, in Fig. 2, symbol 12 expression crystallines, symbol 13 expression vitreous chambers.
In this existing operation microscope, operative doctor must be held photoconductive tube 10 on the other hand and undergo surgery, therefore be difficult to carry out meticulous operation, wish and to undergo surgery by the adept art apparatus 11 of two hands (for example hold the such operating theater instruments of tweezers 11 on the other hand, another hand is held the such operating theater instruments of scissors 11).
Here, as shown in Figure 3, the object lens 14 that the lens barrel portion at microscopie unit that adopts is provided with by between the eyes 8 of performing the operation, and be the structure that disposes supplementary lens in the front portion of the eyes 8 of being performed the operation.So the intraocular of the eyes 8 that can perform the operation by 15 pairs of quilts of supplementary lens throws light on.It is that operative doctor is desirable that surgical operation microscope adopts such structure.
But, like this at object lens 14 and under, following inappropriate situation is arranged by the situation of the structure of configuration supplementary lens 15 between the eyes 8 of performing the operation in employing.
For example, if the focal length F1 of supplementary lens 15 is long, then longer to the distance of the eyes 8 of being performed the operation from the eyepiece of microscopie unit, the doctor is difficult to undergo surgery.
Otherwise,, then might run into the eyes 8 of being performed the operation if the focal length F of supplementary lens 15 is too short.
Again, when being watered physiological saline by the eyes 8 of being performed the operation and wash, physiological saline might splash attached on the supplementary lens 15 in operation.
Also have, if the diameter of supplementary lens 15 is too small, then it has tunnel vision; Otherwise if the diameter of this supplementary lens 15 is excessive, then the influence of supplementary lens 15 causes the interval between operating theater instruments 11 and the operating theater instruments 11 to become big, and in this case, when the hand-held operating theater instruments 11 of two hands underwent surgery, operation was difficult to carry out.Also have, in this Fig. 3, symbol 16 is the insertion position of operating theater instruments 11.
The present invention In view of the foregoing does, and its purpose is, is provided at the front portion configuration supplementary lens of the eyes of being performed the operation, Yi Bian be suitable for utilizing microscope illumination that intraocular is thrown light on, Yi Bian the operation microscope that undergos surgery with the adept art apparatus of two hands.
Summary of the invention
Operation microscope of the present invention the 1st kind, it is characterized in that, the supplementary lens that utilization is disposed between the focal position of eyes of being performed the operation and object lens focuses on the illumination light of microscope illumination, simultaneously it is guided into the interior lighting intraocular of described eyes of being performed the operation, thereby may observe by eyepiece on one side, when carrying out intraocular surgery on one side, the refracting power scope of described supplementary lens is 30D～50D, and promptly the refracting power scope is 30 diopters～50 diopters.
This operation microscope preferably diameter of phi of described supplementary lens (m) is chosen as and makes Φ * P in 0.8～1.0 scope, and wherein P represents the refracting power of described supplementary lens, and its unit is D.
Operation microscope of the present invention the 2nd kind, it is characterized in that, the supplementary lens that disposes between the focal position, front side of eyes of being performed the operation and object lens is arranged on the supporting arm that can keep out of the way, support the lens barrel portion of described object lens to be installed on to make on the sliding component that this lens barrel portion moves up and down along optical axis direction, support to be provided with on the main part of this sliding component the base portion of above-mentioned supporting arm slidably.
This above-mentioned microscopical above-mentioned supplementary lens moving up and down and fine motion up and down preferably along with above-mentioned lens barrel portion.
The 3rd kind of operation microscope of the present invention is characterized in that, the supplementary lens between the focal position, front side that is disposed at the eyes of being performed the operation and object lens is arranged on the supporting arm, rotatably is provided for observing the prism that the eyeground periphery is used on this supporting arm.
The 4th kind of operation microscope of the present invention, it is characterized in that, possess: be arranged at lens barrel portion, with the relative object lens of eyes of being performed the operation, between these object lens and described eyes of being performed the operation, illuminating ray is focused on, the inside of the eyes that its guiding is performed the operation simultaneously, the supplementary lens that intraocular is thrown light on; Support this supplementary lens, and can be arranged at the lens barrel portion of operation object lens with keeping out of the way, can make described supplementary lens insert or break away from the supporting arm of the light path between described eyes of being performed the operation and the described object lens.
The microscope of this operation usefulness preferably the refracting power of described supplementary lens in the scope of 30D～50D.
Again, preferably select the diameter of phi (m) of described supplementary lens, make Φ * P in 0.8～1.0 scope.
Also have, coarse adjustment mechanism and the micro-adjusting mechanism that above-mentioned supporting arm is moved up and down preferably is set.
Adopt the 1st kind～the 4th kind of the present invention, set supplementary lens in the front portion of the eyes of being performed the operation, can utilize microscope illumination that intraocular is thrown light on, the adept art apparatus of two hands undergos surgery simultaneously.
Owing to be to have to make the coarse adjustment mechanism that supporting arm moves up and down and the microscope of micro-adjusting mechanism, can from the eyeground of the eyes of being performed the operation near the crystalline on a large scale in the situation of the state observation intraocular of focusing.
And, if adopt such structure, the convex lens that the insertion position of supporting to be used to observe the operating theater instruments of inserting above-mentioned eyes of being performed the operation is used promptly are set on described supporting arm, and make these convex lens can insert or break away from the magnifier supporting mechanism of these convex lens of ground support in the light path between described supplementary lens and the described object lens, then can not insert convex lens between the light path of supplementary lens and object lens yet, can insert the insertion position of the operating theater instruments of the eyes of being performed the operation with the state observation that focuses on by means of assistant's hand.When intraocular is observed, convex lens are kept out of the way out from the light path between supplementary lens and the object lens again.Can also observe the insertion position of operating theater instruments with stable status.
Also have,,, also can under the state that focuses on, observe the insertion position of operating theater instruments even then observing under the situation at the position beyond the eyeground if described convex lens can be moved up and down with respect to described supporting arm.
The 5th kind of operation microscope of the present invention, it is characterized in that, possess: the lamp optical system of the eyes irradiating illumination light of performing the operation to quilt, be arranged at lens barrel portion, with and a pair of viewing optical system of observing the eyes of being performed the operation is set in its both sides by the relative object lens of the eyes of being performed the operation, the optical axis of clamping these object lens; In the described lamp optical system slit plate is set, the slit pore that makes above-mentioned illuminating ray form slit illumination light is set on this slit plate, and make this slit pore on the vertical direction of the optical axis of above-mentioned lamp optical system, extend, and make the projection image of this slit pore on the eyeground be parallel to the face of two optical axises that comprise above-mentioned viewing optical system, above-mentioned slit plate can move on perpendicular to the direction of the optical axis of above-mentioned lamp optical system, so that above-mentioned slit illumination light deviates from respect to the optical axis of above-mentioned object lens or is approaching.
Adopt the 5th kind of invention, can prevent to sneak into viewing optical system, prevent the generation of dazzle from the tail reflected light of crystalline.
Description of drawings
Fig. 1 is the structure diagram of existing operation microscope.
Fig. 2 represents that holding photoconductive tube holds the example that operating theater instruments is carried out the situation of intraocular surgery on the other hand on the other hand.
Fig. 3 represents that two hands hold the example that operating theater instruments is carried out the situation of intraocular surgery.
Fig. 4 represents the general structure of operation microscope of the present invention.
Fig. 5 is the part amplification stereogram of lens barrel portion shown in Figure 4.
Fig. 6 (a) is illustrated in the object lens of lens barrel portion setting and the optical picture of the relation of the optical arrangement between supplementary lens, and the focal length F of expression supplementary lens is 33.3mm, and its diameter of phi is the situation of 33.3mm.
Fig. 6 (b) is illustrated in the object lens of lens barrel portion setting and the optical picture of the relation of the optical arrangement between supplementary lens, and the focal length F of expression supplementary lens is 20mm, and its diameter of phi is the situation of 20mm.
Fig. 7 represents the summary of inner structure shown in Figure 4.
Fig. 8 is the front view (FV) of expression lens barrel portion shown in Figure 5 and the relation of the installation between supporting arm.
Fig. 9 is the key diagram of keeping out of the way state of expression supplementary lens shown in Figure 4.
Figure 10 (a) is the schematic illustration of the observational technique of the front portion that is illustrated in the eyes of the being performed the operation picture when observing the eyes of being performed the operation by eyepiece when setting supplementary lens and when not setting supplementary lens, and expression makes the observational technique of contact lens and the eye contact of the being performed the operation picture so that the front portion of the eyes of being performed the operation is observed.
Figure 10 (b) is the schematic illustration of the observational technique of the front portion that is illustrated in the eyes of the being performed the operation picture when observing the eyes of being performed the operation by eyepiece when setting supplementary lens and when not setting supplementary lens, the observational technique of the picture the when front portion that expression is equipped on the eyes of being performed the operation with supplementary lens is observed.
Figure 10 (c) is the schematic illustration of the observational technique of the front portion that is illustrated in the eyes of the being performed the operation picture when observing the eyes of being performed the operation by eyepiece when setting supplementary lens and when not setting supplementary lens, the observational technique of the picture when expression is inserted lens unit and observed.
Figure 11 relates to the figure of the variation of embodiment 1, is the synoptic diagram that is used to illustrate the image space at the Vitrea position different with the retina of the eyes of performing the operation.
Figure 12 relates to the figure of the variation of embodiment 1, is the vitreum that is used to illustrate in the eyes of removing operation, the synoptic diagram of the amphiblestroid image space of the eyes of performing the operation under the situation of filling gas or air within the eye.
Figure 13 is expressed as to observe position shown in Figure 11, and the stereographic map of the example of coarse adjustment mechanism is set in the lens barrel portion of the object lens of operation microscope shown in Figure 5.
Figure 14 is the sectional view of the marriage relation of the rectangular blocks of expression coarse adjustment mechanism shown in Figure 13 and sliding panel.
Figure 15 is the stereographic map of the lens barrel portion structure of embodiment 2.
Figure 16 (a) is the key diagram of picture that is formed at the ejaculation pupil of the picture of injecting pupil of the observing system on the cornea C and irradiation system, the picture of the observation pupil of expression observing system and the overlapping state of picture of the irradiation pupil of irradiation system.
Figure 16 (b) is the key diagram of picture that is formed at the irradiation pupil of the picture of observation pupil of the observing system on the cornea C and irradiation system, the state that the picture of the observation pupil of expression observing system separates with the picture of the irradiation pupil of irradiation system.
Figure 17 is illustrated on the bar-shaped arm shown in Figure 15 linear motor is installed, and makes the stereographic map of the lens barrel portion of the mechanism that supplementary lens can finely tune.
Figure 18 relates to the figure of embodiment 3, is the state of magnifier is inserted in expression when observing the insertion position of operating theater instruments in the front of supplementary lens synoptic diagram.
Figure 19 is to be illustrated in when observing the eyeground and is the synoptic diagram of image space at the insertion position of the operating theater instruments when not inserting magnifier.
Figure 20 is that expression makes when observing the eyeground and is the synoptic diagram of the image space at insertion position of the operating theater instruments when the inserting magnifier state consistent with the eyeground.
When Figure 21 is illustrated in the sight glass body region and be the synoptic diagram of image space at the insertion position of the operating theater instruments when not inserting magnifier.
When Figure 22 is illustrated in the sight glass body region and be to insert magnifier, change the interval of magnifier and supplementary lens, make the synoptic diagram of the image space at insertion position of the operating theater instruments state consistent with the vitreum position.
Figure 23 is the stereographic map of structure of lens barrel portion of the object lens of expression embodiment 3.
Figure 24 is that the part of magnifier supporting mechanism shown in Figure 23 is amplified key diagram.
Figure 25 represents the structure of optical system of the operation microscope of embodiment 4.
Figure 26 is for explanation is provided with illuminator to the in-problem synoptic diagram of structure that the eyes of performing the operation throw light on operation microscope, is the longitudinal diagram that the expression intraocular is full of the operation eye of fluid conditions.
Figure 27 is for explanation is provided with the eyes structure in-problem synoptic diagram that throw light on of illuminator to operation on operation microscope, is the longitudinal diagram that the in-problem operation eye when making air filling intraocular behind the vitreum of intraocular is removed in expression.
Figure 28 has been expressed as to solve existing problems shown in Figure 27, the eyeground of the eyes of operation is carried out the longitudinal diagram of the operation eye of illumination condition with slit illumination light.
Figure 29 is the figure of the position relation between two optical axises of projection image and a pair of viewing optical system of expression slit pore shown in Figure 25, is the schematic illustration of the mobile status of the slit illumination light on the eyeground when arrow directions X shown in Figure 26 is observed the eyes of performing the operation by object lens.
Figure 30 relates to the sectional view of the supplementary lens part-structure of embodiment 5.
Concrete example
Fig. 4 represents the outside drawing of operation microscope of the present invention.In Fig. 4, the structural detail identical with the structural detail that illustrates in the example of prior art is marked with identical symbol and describes.
The microscope 5 that operative doctor is used has lens barrel portion 20, negater portion 21, supporting arm 22 as shown in Figure 4.Fig. 5 is the part amplification stereogram of this lens barrel portion 20.
On the support rack 27 pivoted lever 35 is set again.Supporting arm 22 can be the center rotation with revolving shaft 25 by means of pivoted lever 35.For example when observing the eyes 8 performed the operation anterior, when wanting to use contact lens 9 to undergo surgery etc., can it be stood up, keep out of the way from the front portion of the eyes 8 of being performed the operation and to come.Also have, symbol 36 is when being used to keep using and the solenoid shape spring of the state in when keeping out of the way.
In lens barrel portion 20, shown in Fig. 6 (a) and (b), be the center with the optical axis O of object lens 14, on symmetric position, be provided with a pair of zoom lens 37, on the eccentric position that departs from optical axis O, be provided with illuminating prism 38 simultaneously.
The front side focal distance f of object lens 14 is for example 200mm here.Supplementary lens 15 here its focal length F is more than the 20mm, and below the 33.3mm, in other words, its refracting power (inverse of focal length F) is 30D (diopter)～50D scope.
The vertex distance that supplementary lens 15 is disposed at digression film C as shown in Figure 6 is the place of H1.The vertex distance that the rear side focal position of this supplementary lens 15 is positioned at digression film C is the place of H2.
Illuminating ray P is sent by not shown light source, as shown in Figure 6, becomes divergent beams by supplementary lens 14.This illuminating ray P is focused on by supplementary lens 15 thereafter and forms focused beam, and the cornea C of the eyes 8 of being performed the operation by quilt is introduced into intraocular, and intraocular is thrown light on.Fan She reflection ray is by nearby temporary transient form the in the air picture of supplementary lens 15 at the focal position, front side of object lens 14 u0 within the eye.Thereafter, this reflected light is introduced into eyepiece shown in Figure 4 30 by object lens 14, zoom lens 37, negater portion 21.Thereby operative doctor can be observed intraocular by eyepiece 30.
The relative position relation of the eyes 8 that the object lens 14 when these Fig. 6 (a) and (b) are represented to observe retina 8a, supplementary lens 15, quilt are performed the operation, just make the rear side focal position of this supplementary lens 15 consistent, and focus on the retina 8a of the eyes 8 of being performed the operation with the front side focal position u0 of object lens 14.
In that contact lens 9 is contacted with the eyes 8 of being performed the operation, when observing, can observe the erect image S1 of the eyeground 8a shown in Figure 10 (a) by 30 pairs of intraoculars of eyepiece.In case the front portion at the eyes 8 of being performed the operation sets supplementary lens 15, when observing by 15 pairs of intraoculars of supplementary lens, shown in Figure 10 (b), can observe reverse up and down reversed image S2.Therefore, if lever 21C is switched in operation,, just can shown in Figure 10 (c), observe forward as S1 by supplementary lens 15 with the light path that lens unit 21A inserts object lens 14.
Again, symbol 15a represents the edge of supplementary lens 15, in the outside of supplementary lens 15, can see the picture of the eyes 8 of being performed the operation by object lens 14.Under the situation shown in Figure 10 (b), the forward of front portion that can observe the eyes 8 of being performed the operation is as S1 '.Under the situation shown in Figure 10 (c), can observe the reverse picture S2 ' of the front portion of the eyes 8 of being performed the operation.
Also have, here, this Figure 10 be illustrated in the operating theater instruments 11 that can see by object lens 14 in supplementary lens 15 outsides rearward end situation.
The refracting power of supplementary lens 15 (inverse of focal length F) is got more than the 30D, and it be the reasons are as follows.
If the refracting power of supplementary lens 15 is then elongated to the distance of object lens 14 from the eyes 8 of being performed the operation less than 30D.In other words, promptly oversize to the distance of eyepiece 30 from the eyes 8 of being performed the operation, then be difficult to undergo surgery.
Again, the refracting power of supplementary lens 15 (inverse of focal length F) is got below the 50D, and it be the reasons are as follows.
If the refracting power of supplementary lens 15 is then too short to the distance of supplementary lens 15 from the eyes 8 of being performed the operation greater than 50D, the danger that touches the eyes 8 of being performed the operation increases.Again, when in when operation physiological saline being injected the eyes 8 of being performed the operation and cleans the eyes 8 of being performed the operation, physiological saline splashes and is attached to supplementary lens 15 and can causes and observe difficulty.
Also have, the diameter of phi of supplementary lens 15 is chosen as and makes Φ * P in 0.8～1.0 scope, and P is refracting power (unit is D), and it be the reasons are as follows.
If the diameter of phi of supplementary lens 15 is too little, then the visual field is corresponding narrow.Otherwise if the diameter of phi of supplementary lens 15 is too big, then the interval of operating theater instruments 11 and supplementary lens 15 is narrow.Therefore when two hand handle art apparatuses 11 underwent surgery, operating theater instruments 11 can not reach the eyeground affected part.
If select the diameter of supplementary lens 15 like this, the refracting power of supplementary lens 15 (inverse of focal length F) is set in the scope of 30D～50D, Φ * P is in 0.8～1.0 scope, then set supplementary lens 15 in the front portion of the eyes 8 of being performed the operation, on one side intraocular is thrown light on one side two hands when holding operating theater instruments 11 and undergoing surgery, operation is just carried out easily.
Variation
Shown in the synoptic diagram of Figure 11, when supplementary lens 15 being disposed on the position that by the vertex distance of the cornea C of the eyes 8 of being performed the operation is H1, as mentioned above, the picture of retina 8a images in from being on the position u1 of H2 by the vertex distance of the cornea C of the eyes 8 of being performed the operation.
In contrast to this, the picture of Vitrea position 8b then images on the position u2 that the vertex distance of digression film C is H3.On the other hand, carrying out under the situation such as Vitrea operation, having and remove vitreum and by the situation of injecting gas in the eyes 8 of performing the operation.Under these circumstances, as shown in figure 12, the vertex distance that the picture of retina 8a images in from the cornea C of the eyes 8 of being performed the operation is on the position u3 of H4.
Under situation about undergoing surgery, undergo surgery while be necessary to observe such position, but just make the focus f of object lens 14 consistent with position u1, fine motion adjusting knob 31 ' is operated, be under the state that focuses on, to observe these positions.
Why like this, to be because the fine motion distance on the above-below direction of supplementary lens 15 is to the maximum about 10mm.If therefore the image space of the operative site of the eyes 8 of operation departs from greater than this numerical value, then under the state that focuses on, can not observe these positions.
Therefore, for example, as shown in figure 11, holding arms 3 is upwards carried, and object lens 14 are risen, so that focal position, the front side u0 of object lens 14 is approximately consistent with the position u2 that the picture of Vitrea position 8b forms.
So, in the operation microscope of structure shown in Figure 5, support the supporting arm 22 of supplementary lens 15 to rise overally as one with object lens 14, therefore the distance from the cornea C of the eyes 8 of operation to supplementary lens 15 changes.Therefore utilize fine motion adjusting screw 31 to regulate, so that the distance from the summit of the cornea C of the eyes 8 of operation to supplementary lens 15 equals distance H 1.But, be limited owing to can carry out the scope that fine motion regulates supplementary lens 15, therefore with operation microscope shown in Figure 5 can not be under the state of focusing the position of sight glass body.
Therefore, as shown in figure 13, setting can be carried out the coarse adjustment mechanism 40 of coarse adjustment to supporting arm 22 in the position that upper and lower moves up.This coarse adjustment mechanism 40 has rectangular blocks 41 and sliding panel 42.Sliding panel 42 is mounted slidably on rectangular blocks 41.
Interval setting with 10mm makes its detent of locating 43 on above-below direction as shown in figure 14 on this rectangular blocks 41.Be formed with on the sliding panel 42 and support tube 44.On this support tube 44 locating bar 45 is set.On this locating bar 45, its head is provided with knob 46.This locating bar 45 is provided with flange portion 47.Between the top of flange portion 47 and support tube 44 spring 48 that saves up strength is set.Locating bar 45 utilizes this spring 48 that saves up strength to prop up at its front end on the direction of rectangular blocks 41 and saves up strength.Support rack 27 is installed on this sliding panel 42.
Figure 14 represents that this locating bar 45 is embedded in the state of the detent 43 of reference position.The locating bar 45 side shifting 10mm that here can make progress, side shifting 20mm downwards from this reference position.Also have, in Figure 13,49 are arranged on the landing of using with the landing that stops support rack 27 on the rectangular blocks 41 stops pin 49,50th, the gathering sill when landing stops pin 49 to move up and down.
As shown in figure 11, when the Vitrea position 8b of the eyes 8 of observing for example operation, make focal position, the front side u0 of object lens 14 change into u2 from position u1.So supplementary lens 15 rises, supplementary lens 15 changes with the distance of the cornea C of the eyes 8 of operation, and the amount of its variation only is equivalent to the variable in distance of position u1 to position u2.Therefore, the knob 46 of pulling coarse adjustment mechanism 40 descends supporting arm 22, and its slippage is equivalent to the relative position variable quantity of the eyes 8 of this supplementary lens 15 and operation, and the position relation of cornea C and supplementary lens 15 returns to original state.Thereafter, operation fine motion adjusting knob 31 ' focuses on Vitrea position 8b.
Like this,, then can observe and utilize the position that fine motion adjusting knob 31 ' can not observed scope if adopt this coarse adjustment mechanism 40, promptly from the retina 8a on eyeground near crystalline 12, to such an extent as to the vast scope nearby of cornea C.
Also have, in this variation, utilize manual methods that coarse adjustment mechanism 40 is operated, but can adopt such structure again, promptly on rectangular blocks 41, linear graduation is set, the driving mechanism of sliding panel 42 is set simultaneously, drives sliding panel 42 automatically it is compensated, only move up and down the supplementary lens 15 that causes structure with respect to the variable in distance share of the eyes 8 of operation with compensation object lens 14.
Figure 15 be lens barrel portion 20 is adopted can be with respect to fine motion main part 20A fine motion up and down up and down, in the other end of the supporting arm 22 of supplementary lens 13 revolution base portion 20B is set simultaneously, this revolution base portion 20B is installed on pivotally the structure of main part 20A.
Supporting sliding panel 20C on the main part 20A slidably as sliding component.This sliding panel 20C can move up at upper and lower by means of the driving mechanism that is provided with in main part 20A (diagram is omitted).Lens barrel portion 20 is integrally formed on this sliding panel 20C.Also have, supplementary lens 15 is supported frame 15A and supports.
Under the situation of such structure, has advantage described below.
The ejaculation pupil of injecting pupil and illuminator of the observing system of the microscope 5 that operative doctor is used is positioned near the object lens 14.This pupil image 20A ', 20B ' that injects pupil and ejaculation pupil is imaged near the front side focus of supplementary lens 15 by supplementary lens 15.
Here, shown in Figure 16 (a), if the picture 20B ' of the ejaculation pupil of the picture 20A ' of the entrance pupil of observing system and irradiation system is overlapping on cornea C, then illuminating ray is subjected to scattering in cornea C and sneaks into observing system, produces dazzle.But, if make the entrance pupil and near the conjugation of ejaculation pupil of observing system with respect to supplementary lens 15 and eye's cornea C.If the focal position, front side of supplementary lens 15 is positioned near the cornea C, then shown in Figure 16 (b), on cornea C, the separating of the picture 20A ' of the entrance pupil of observing system and the ejaculation pupil of illuminator as 20B.Just can prevent observing system generation dazzle.
But under the situation of normal eyes, the picture of retina 8a is formed on the focus face of rear side focal position F2 of supplementary lens 15.If focal position, the front side u0 of object lens 14 overlaps with the focus face of this rear side focal position F2, then can rely on microscopic examination to arrive distinct picture.
But, under the situation of cataract patient,, often before operation on vitreous, extract crystalline 12 in order to improve the visual readability on eyeground, 8 one-tenth of eyes that the quilt of this anhydrous crystalline is performed the operation the farsightedness of the degree of depth.In this case, the picture of the retina 8a that supplementary lens 15 forms is formed at than the rear side focal position F2 of supplementary lens 15 more on the position u4 near a side of object lens 14 as shown in figure 17.Again, look-out station is not limited to the eyeground, also sight glass body cavity 13 often.
That is to say that when the eyes to degree of depth long sight, degree of depth myopia underwent surgery, the conjugate position of observed object was not the infinite distance.And for example top described, the conjugate position of observed object neither the infinite distance when the look-out station of change eyes, under the situation of carrying out such operation, wants the place observed during facing to operation, and mobile object lens 14 are focused again on optical axis.
In this case, then as described above if supporting arm 22 is set in lens barrel portion 20, when lens barrel portion 20 was moved up and down, supplementary lens 15 moved up and down together with lens barrel portion 20 on above-below direction.Thereby supplementary lens 15 changes with respect to the position of cornea C, and shown in 16 (a), the picture 20A ' of the entrance pupil of the observing system on cornea C and the picture 20B ' of the ejaculation pupil of illuminator thicken.Consequently, when observing, sneak into dazzle with microscope.But shown in this embodiment 2, if supporting arm 22 is installed on main part 22A pivotally, even then operation foot control 7 moves up and down lens barrel portion 20, supplementary lens 15 is with respect to still being kept motionless by the position of operation eyes 8.So the released state of the picture 20B ' of the entrance pupil of picture 20A ' and the illuminator of the observation pupil of the observing system on cornea C is maintained, can prevent that dazzle from sneaking into observing system.
At this moment, shown in dotted line, also can adopt the inside that the revolution micro switch 20D that detects revolution base portion 20B is arranged at main part 20A, when connection foot control 6 moves up and down lens barrel portion 20, make supplementary lens fine motion up and down, so that the ejaculation pupil of the observation pupil of observing system and illuminator keeps the structure of conjugate relation with respect to supplementary lens 15 and cornea C.
That is to say, as shown in figure 17, the excellent arm 20E that installs is divided into two on revolution base portion 20B.Then, the side at this rod arm 20E installs linear motor 20F.Again at another square rod arm of the last installation of output shaft (movable link) 20G of this linear motor 20F 20E.Take then when micro switch 20D connects, to drive linear motor 20F, make the structure of supporting arm fine motion about in the of 22.
Below with reference to Figure 11 its relational expression is described.
In this Figure 11, make supplementary lens 15 with respect to object lens fine motion about in the of 14, and make it satisfy following formula to get final product.
H
1＝P
-1+2·(P
2·H
0)
-1·[1+{1+(4P’/P
2·H
0)}
1/2]
-1
H
4’＝H
0+P
-1+P
-2·〔(H
1+(1/P’)-(1/P)〕
H wherein
0Focal length (m) for object lens 14; P is the refracting power (inverse of focal length F (m of unit)) of supplementary lens 15, and P ' is the refracting power of eyes, H
4Be 15 distance from object lens 14 to supplementary lens.
Take such structure, can be on cornea C the looking like 20B ' and be separated more brightly of the ejaculation pupil of the picture 20A ' of the observation pupil of observing system and illuminator, can prevent that dazzle from sneaking into viewing optical system.
Figure 18 represents the insertion position 16 of operating theater instruments 11 and the key diagram of the position relation of supplementary lens 15.Operating theater instruments 11 in the distance of decision from the summit of cornea C to supplementary lens 15 so that after dazzle is unlikely to take place, the eyes 8 that insertion is performed the operation after the state of the picture that forms the retina 8a that can observe the eyeground.
But, as shown in figure 19, inserts position 16 and be positioned near the rear side focus face of supplementary lens 15, so its conjugate points is approximately at infinity, can not utilize object lens 14 to make its imaging.On the other hand, focal position, the front side u0 of object lens 14 is consistent with position u1, therefore when observing insertion position 16 by object lens 14, can not observe and insert position 16.
Thereby the operative doctor eyes leave eyepiece 30, do not pass through supplementary lens 15, and spy on insertion position 16 from the limit.But, when being inserted into insertion position 16, operating theater instruments 11 make eyes leave eyepiece 30 one by one like this, and then operation can make the people be unable to stand.
Therefore, when for example operating theater instruments 11 is inserted, insert magnifier 51 as shown in figure 20 on the light path of the viewing optical system of supplementary lens 15, make the picture that inserts position 16 consistent with focal position, the front side u0 of object lens 14, that observes this insertion position 16 on one side looks like to insert operating theater instruments 11.
Again, for example, when Vitrea position 8b was undergone surgery, focal position, the front side u0 that makes object lens 14 that must adapt with it became position u2 from position u1 as shown in figure 21.If but make focal position, the front side u0 of object lens 14 become position u2 like this from position u1, then as shown in figure 22, must change the distance relation of magnifier 51 and supplementary lens 15, so that insert focal position, the front side u0 that the picture 16 ' at position 16 is formed at these object lens 14.
Therefore, as Figure 23, shown in Figure 24, adopt magnifier supporting mechanism is arranged at structure on the arm.This magnifier supporting mechanism is roughly by being arranged at finger plate 52 on the supporting arm 22 pivotally, being arranged at the linear motor 53 of this finger plate 52 and the magnifier 55 that is arranged on the output shaft 54 of this linear motor 53 constitutes.55a is the convex lens of this magnifier 55.Linear motor 53 has the function that magnifier 55 is moved up and down.Spacer block (spacer) 56 is set between support plate 23 and the finger plate 52.
Like this, finger plate 52 is set on supporting arm 22, when wanting to observe insertion position 16, adopts the structure that magnifier 55 is inserted on the light path that constitutes optical systems, then can support magnifier 55 with stable status.Even when changing focal position, the front side u0 of object lens 14, also can utilize to make magnifier 55 under the state of focusing, observe insertion position 16 easily in the method that upper and lower moves up again.
Figure 25 is the overall pattern of operative doctor with the optical system of microscope 5.
In this Figure 25, the 60th, viewing optical system, the 61st, lamp optical system.The optical axis O that a pair of viewing optical system 60 clips object lens 14 is provided with in its both sides, and the structure of this a pair of viewing optical system 60 is known, therefore only is marked with symbol on figure, lists its title below, and describes it in detail omission.
In this Figure 25, the 62nd, zoom-lens system; The 63rd, beam splitter, the 64th, imaging len, the 65th, erect image prism, the 66th, the wide adjustment prism of eye, the 67th, visual field aperture.Also have, zoom-lens system 62 is made of zoom lens 37,37a, 37b.
Lamp optical system 61 is made of lighting source 70, collector lens 71, illumination visual field aperture 72, slit plate 73.Slit plate 73 has slit pore 73a.This slit plate 73 can insert or withdraw from the illumination path of this lamp optical system 61, and this slit plate 73 is formed on the structure that can move on the direction vertical with lighting optical axis O1 when inserting illumination path.Slit pore 73a as shown in figure 25, with the lighting optical axis O1 direction vertical with the movable direction of slit plate 73 on, and the 73b of projection image on the eyeground of this slit pore 73a (being slit illumination light P3), the face NP with two optical axis O2, O2 comprising a pair of viewing optical system 60 extends in parallel as shown in figure 29.In this Figure 29, this projection image is represented by dotted lines, and represents that this projection image is formed on the eyeground.
Focal position, the front side u0 conjugation of illumination visual field aperture 72 and object lens, focal position, the front side u0 of these object lens 14 here with the retina 8a conjugation on eyeground.
By the eyeground of the eyes 8 of being performed the operation, as shown in figure 26, illuminating ray P is drawn towards the eyeground by supplementary lens 15, cornea C, crystalline 12, is thrown light in the eyeground of the eyes 8 of being performed the operation.The reflected light P1 on this eyeground 8 is drawn towards supplementary lens 15 by crystalline 12, cornea C, images in focal position, the front side u0 of object lens 14 aloft by this supplementary lens 15.
As shown in figure 26, when vitreum is full of body fluid, refringence on the boundary surface of crystalline 12 and body fluid is little, so illuminating ray P is little at the reflectivity of the back of crystalline 12 12a, and the ratio of light path of sneaking into viewing optical system 60 from the diffuse light of the back 12a of crystalline 12 is little.
But as shown in figure 27, after removing vitreum, in the eyes 8 of operation under the situation of filling gass or air, illuminating ray P is subjected to scattering at the back of crystalline 12 12a position 12b is overlapping with the part from the reflected light P1 on eyeground.Thereby the part of the diffuse light P2 that the position 12b of illuminating ray P causes is sneaked into the light path of viewing optical system 60, therefore produces dazzle when observing by 30 pairs of eyeground of eyepiece.
Therefore slit plate 73 is inserted the light path of lamp optical system 61, as shown in figure 28, slit illumination light P3 is thrown light on by cornea C, 12 pairs of eyeground of crystalline.
Adopt such structure, as shown in figure 28, can be subjected to the reflected light P1 that position 12b and the eyeground of scattering of the back 12a of crystalline 12 the comes position 12c by the back 12a of crystalline 12 to slit illumination light P3 and separate.Thereby, can prevent on the observation optical path of viewing optical system 60 generation of the dazzle that the P2 that diffuses owing to the back 12b of crystalline 12 causes.
Also have, as shown in figure 25, slit plate 73 can be moved on perpendicular to the direction of lighting optical axis O1.So on the direction shown in the arrow of Figure 28, travelling slit light can be observed whole eyeground 8a.
Figure 29 is the synoptic diagram of the eyes of the operation seen by object lens 14 from the direction of arrow X shown in Figure 26.As shown in figure 29, if make the 73b of projection image of the slit pore 73a on the 8a of eyeground, just make slit plate 73 removable on direction perpendicular to lighting optical axis O1, then the 73b of projection image (slit illumination light P3) is shown in dotted line, keep the parallel relation with the NP face, on the direction that deviates near the optical axis O of object lens 14, can move simultaneously.Here, if the 73b of projection image with dashed lines is described when to be expression by object lens 14 can see the 8b of projection image on the 8a of eyeground the relation of the position of the position of the 8b of projection image and zoom lens 37.
Embodiment 5
Figure 30 represents the variation of the support frame 15A of supplementary lens 15.Here, the support frame 15A of supplementary lens 15 goes up and inserts logical inner core 15B.Can load prism 15C on the inner core 15B.This prism 15C can unload.
This prism 15C makes optical axis O bending, is used in to observe retina 8a peripheral part (peripheral part on eyeground).Form locking groove 15D in the bottom of this prism 15C, make front end prop up this locking groove 15D,, just can observation post wish the eyeground peripheral part of observing by making prism 15C rotation as the tweezers of operating theater instruments 11.
Also have, the observation field angle of supplementary lens 15 here is about about 40 °.Therefore preferably make the drift angle that forms by prism 15C in about 10 °～20 ° scope.
More than embodiment is illustrated, but under the little situation of the pupil diameter of patient's eyes, observe the obstruction that light beam, illuminating bundle are subjected to pupil easily.For fear of such situation takes place, also can adopt the structure of the device that the interval that optically reduces to observe pupil, illumination pupil is set on operation microscope.
Operation microscope of the present invention is suitable at the front portion of the eyes of being performed the operation configuration supplementary lens owing to have structure as mentioned above, and two hands are held the situation use that operating theater instruments undergos surgery when utilizing microscope illumination that intraocular is thrown light on.
Claims (1)
1. an operation microscope is characterized in that possessing
The lamp optical system of the eyes irradiating illumination light of performing the operation to quilt, be arranged at lens barrel portion, the object lens relative with the eyes of being performed the operation, the optical axis of clamping these object lens are arranged on its both sides, and a pair of viewing optical system of observing described eyes of being performed the operation;
In the described lamp optical system slit plate is set, the slit pore that makes described illuminating ray form slit illumination light is set on this slit plate, and make this slit pore on the vertical direction of the optical axis of described lamp optical system, extend, and make the projection image of this slit pore on the eyeground be parallel to the face of two optical axises that comprise described viewing optical system, described slit plate can move on perpendicular to the direction of the optical axis of described lamp optical system, so that described slit illumination light deviates from respect to the optical axis of described object lens or is approaching.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2002085092 | 2002-03-26 | ||
| JP2002085092A JP4068371B2 (en) | 2001-06-13 | 2002-03-26 | Surgical microscope |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 02157420 Division CN1447146A (en) | 2002-03-26 | 2002-12-13 | Operation microscope |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2006100681728A Division CN100388044C (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1664645A true CN1664645A (en) | 2005-09-07 |
Family
ID=28449240
Family Applications (4)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200510056244 Pending CN1664645A (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
| CNB2006100681728A Expired - Fee Related CN100388044C (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
| CN 02157420 Pending CN1447146A (en) | 2002-03-26 | 2002-12-13 | Operation microscope |
| CNB2005100562438A Expired - Fee Related CN1327263C (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
Family Applications After (3)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2006100681728A Expired - Fee Related CN100388044C (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
| CN 02157420 Pending CN1447146A (en) | 2002-03-26 | 2002-12-13 | Operation microscope |
| CNB2005100562438A Expired - Fee Related CN1327263C (en) | 2002-03-26 | 2002-12-13 | Microscope for operation |
Country Status (2)
| Country | Link |
|---|---|
| CN (4) | CN1664645A (en) |
| HK (2) | HK1082549A1 (en) |
Families Citing this family (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN100340892C (en) * | 2004-05-29 | 2007-10-03 | 王水良 | Medical optical guage |
| CN102551656A (en) * | 2012-02-24 | 2012-07-11 | 河南省眼科研究所 | Construction method for aqueous medium required for observation of living in-vivo eye tissue of rat under microscope water mirror |
| US9999350B2 (en) * | 2014-09-25 | 2018-06-19 | Novartis Ag | Reduced glare surgical microscope and associated devices, systems, and methods |
| US9693686B2 (en) * | 2015-04-30 | 2017-07-04 | Novartis Ag | Ophthalmic visualization devices, systems, and methods |
| US9877648B2 (en) * | 2015-09-18 | 2018-01-30 | Novartis Ag | Contact lens mounting speculum for vitreoretinal surgery |
| CN105361852A (en) * | 2015-12-09 | 2016-03-02 | 重庆康华瑞明科技股份有限公司 | Animal ophthalmofundoscope |
| CN105476723B (en) * | 2016-01-30 | 2018-05-11 | 李传青 | A kind of ophthalmology Integrated Checkout diagnostic equipment |
| JP6975168B2 (en) * | 2016-11-22 | 2021-12-01 | ソニー・オリンパスメディカルソリューションズ株式会社 | Microscope system and control method |
| EP3381399B1 (en) * | 2017-03-27 | 2022-03-16 | Leica Microsystems K.K. | Method for controlling the movement of a vitreoretinal viewing system in an ophthalmic surgical microscope, microscope and motion controller for a microscope |
| CN111665618A (en) * | 2020-06-01 | 2020-09-15 | 陈晞凯 | Multi-position stereoscopic vision multi-wavelength video ophthalmic surgery microscope |
| CN115486810B (en) * | 2022-11-16 | 2023-03-10 | 图湃(北京)医疗科技有限公司 | Ophthalmoscope module and operating microscope |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3001244A1 (en) * | 1979-01-16 | 1980-07-24 | Canon Kk | FOCUSING SYSTEM FOR A BASIC EYE CAMERA |
| US4601550A (en) * | 1983-08-08 | 1986-07-22 | Tokyo Kogaku Kikai Kabushiki Kaisha | Stereo-microscope with a common objective lens system |
| JP2966514B2 (en) * | 1990-11-19 | 1999-10-25 | オリンパス光学工業株式会社 | Microscope with focusing mechanism |
| DE9415219U1 (en) * | 1994-09-22 | 1994-11-24 | Oculus Optikgeräte GmbH, 35582 Wetzlar | Attachment device for a microscope |
| US5793524A (en) * | 1997-08-04 | 1998-08-11 | Luloh; K. Peter | Device for non-contact wide-angle viewing of fundus during vitrectomy |
| JPH11169383A (en) * | 1997-12-10 | 1999-06-29 | Topcon Corp | Microscope for operation |
| ATE274833T1 (en) * | 1998-11-24 | 2004-09-15 | Welch Allyn Inc | EYE EXAMINATION DEVICE TO VIEW THE RETINA THROUGH AN UNDILATED PUPILL |
| DE29905969U1 (en) * | 1999-04-08 | 1999-07-08 | Oculus Optikgeräte GmbH, 35582 Wetzlar | Stereoscopic microscope |
| DE20017891U1 (en) * | 2000-10-18 | 2001-02-08 | Oculus Optikgeräte GmbH, 35582 Wetzlar | Microscope for non-contact wide-angle observation |
| DE20021955U1 (en) * | 2000-12-23 | 2001-03-15 | Oculus Optikgeräte GmbH, 35582 Wetzlar | Microscope for wide-angle observation, especially for eye operations |
-
2002
- 2002-12-13 CN CN 200510056244 patent/CN1664645A/en active Pending
- 2002-12-13 CN CNB2006100681728A patent/CN100388044C/en not_active Expired - Fee Related
- 2002-12-13 CN CN 02157420 patent/CN1447146A/en active Pending
- 2002-12-13 CN CNB2005100562438A patent/CN1327263C/en not_active Expired - Fee Related
-
2006
- 2006-03-13 HK HK06103153A patent/HK1082549A1/en not_active IP Right Cessation
- 2006-11-28 HK HK06113026A patent/HK1092539A1/en not_active IP Right Cessation
Also Published As
| Publication number | Publication date |
|---|---|
| CN1327263C (en) | 2007-07-18 |
| CN1447146A (en) | 2003-10-08 |
| CN1667447A (en) | 2005-09-14 |
| CN100388044C (en) | 2008-05-14 |
| HK1082549A1 (en) | 2006-06-09 |
| CN1834719A (en) | 2006-09-20 |
| HK1092539A1 (en) | 2007-02-09 |
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