JP6531508B2 - Laser treatment device - Google Patents

Description

  The present disclosure relates to a laser treatment apparatus that irradiates treatment laser light to an affected part of a patient's eye.

  There is known a laser treatment apparatus which causes an operator to observe a patient's eye and applies a treatment laser beam to an affected part of the patient's eye. For example, in the laser treatment apparatus disclosed in Patent Document 1, the color information range related to the selected laser wavelength is displayed in the observation field of the eyepiece for observing the observation image.

Japanese Patent Application Laid-Open No. 11-276500

  In the case where the observation image of the patient's eye and the display of a mode different from the observation image (color information in Patent Document 1) are presented in the visual field of the operator, the observation image may be difficult to see by the presentation information. In addition, the presented image may be difficult to see by the observation image.

  An object of the present disclosure is to provide a laser treatment apparatus that allows an operator to preferably view both an observation image of a patient's eye and a display regarding irradiation conditions.

In order to solve the above-mentioned subject, the present invention is characterized by having the following composition.
A laser treatment apparatus for irradiating a treatment laser beam to the affected part of the patient's eye, and illuminating means for projecting illumination light to the observed region of the patient's eye, and presentation means for presenting an observation image of the observation site, said presentation Display means for displaying a parameter relating to the irradiation condition of the treatment laser light on the observation image presented by the means, the display means considering the illumination area of the observation site illuminated by the illumination means And a display position of the parameter to be displayed on the observation image is determined.

  According to the present disclosure, it is possible to provide a laser treatment apparatus capable of suitably visualizing an observation image of a patient's eye and a display regarding irradiation conditions.

It is a schematic block diagram of the control system and optical system of the laser treatment apparatus of this embodiment. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. It is an observation image and parameters to be presented to the operator. It is explanatory drawing regarding the display position of a parameter. It is explanatory drawing regarding the display position of a parameter. It is a figure explaining the example of a change of the display position of a parameter. It is a figure for comparison.

  Hereinafter, typical embodiments of the present disclosure will be described using the drawings. As an example of an ophthalmologic apparatus for observing a patient's eye for surgery, examination, or diagnosis, in the present embodiment, a secondary cataract, iris dissection, laser vitrectomy, secondary cataract, selective laser trabeculoplasty ( A laser treatment apparatus is described in which surgery such as Selective Laser Trabeculoplasty (SLT) is performed using a giant pulse.

  FIG. 1 is a schematic configuration diagram of a control system and an optical system of the laser treatment apparatus 1 of the present embodiment. The laser treatment apparatus 1 of the present embodiment includes a laser irradiation optical system 10, an aiming optical system 20, an illumination optical system 30, an observation optical system 40, a display optical system 50, and a control unit 60 as an example.

<Laser irradiation optical system>
The laser irradiation optical system 10 of this embodiment is an irradiation means of a treatment laser beam, and is used to irradiate a treatment laser beam to a site to be treated. The laser irradiation optical system 10 of the present embodiment includes a laser light source 11, an energy adjustment unit 13, a shift adjustment unit 15, a dichroic mirror 22, an expander lens group 23, a dichroic mirror 24, and an objective lens 25. The laser irradiation optical system 10 also has an optical axis L1. The laser light source 11 emits a treatment laser beam for treating the tissue of the patient's eye Ep. In the present embodiment, a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd: YAG) is used as the laser rod of the laser light source 11. A wavelength conversion element (not shown) can convert infrared laser light (wavelength: 1064 nm) emitted from the laser light source 11 into visible laser light (wavelength: 532 nm). In addition, you may use another kind of solid laser, gas laser, a semiconductor laser etc. as a treatment laser beam.

  The energy adjusting unit 13 of the present embodiment is an energy adjusting means that adjusts the emission energy of the treatment laser light, and is used to adjust the energy of the treatment laser light emitted from the laser treatment apparatus 1. The energy adjustment unit 13 of the present embodiment attenuates the treatment laser light emitted from the laser light source 11. The energy adjusting unit 13 of the present embodiment includes a half wave plate and a polarizing plate. The half-wave plate and the polarizing plate are disposed on the optical axis L1, and the motor 14 is connected to the half-wave plate. The controller 60 can adjust the energy of the treatment laser light by rotating the half-wave plate. The shift adjustment unit 15 can shift the focusing position of the treatment laser beam to a distance or near position with respect to the focusing position of the aiming beam (hereinafter referred to as a focus shift). The motor 16 is connected to the shift adjustment unit 15, and the control unit 60 can adjust the focus shift position. The focusing position of the aiming beam and the focusing position of the treatment laser beam may be at the same position.

<Aiming optical system>
The aiming optical system 20 of the present embodiment is an aiming means for irradiating the area to be treated with aiming light, and is used to aim at the area to be treated. The aiming optical system 20 of the present embodiment has an optical axis L2. The aiming optical system 20 of the present embodiment shares the optical path from the dichroic mirror 22 to the objective lens 25 with the laser irradiation optical system 10. An aiming light source 12, a collimator lens 21, and an aperture 27 are disposed in the optical path of the laser irradiation optical system 10 branched from the dichroic mirror 22. The aiming light emitted from the aiming light source 12 is separated into two light beams by the aperture 27 and then condensed by the end of the objective lens 25.

<Illumination optical system>
The illumination optical system 30 of the present embodiment is an illumination unit that projects illumination light to the observation site, and is used to illuminate the observation site including the tissue to be treated. The illumination optical system 30 of the present embodiment includes a lamp 31, a condenser lens 32, an illumination field stop 33, a projection lens 34, and a prism 35. The illumination optical system 30 has an optical axis L3. For example, a white light emitting element or the like may be used as the lamp 31. The optical axis L3 penetrates the inside of the aperture region of the illumination field stop 33. The illumination field stop 33 is provided at a position that is optically conjugate to the observation site via the projection lens 34. That is, in the present embodiment, the illumination field stop 33 can suppress the illumination range of the illumination light at the observation site. In other words, the illumination optical system 30 of the present embodiment forms an image of the opening of the illumination field stop 33 and an image of the light shielding portion on the observation site. The control unit 60 has a function as a light control unit of the illumination light projected to the observation site, and can adjust the amount of light emitted from the lamp 31 in the present embodiment.

  The illumination optical system 30 of the present embodiment includes an adjustment unit that adjusts the illumination area of the illumination light projected to the observation site. In the present embodiment, the aperture shape of the illumination field stop 33 is deformed as the adjustment means. In the present embodiment, the drive means 36 is connected to the illumination field stop 33, and the control unit 60 can deform the opening shape of the illumination field stop 33. In this embodiment, three deformation mechanisms are combined to form an adjustment means. FIGS. 2A to 2C show how the aperture diameter of the illumination field stop 33 is deformed by the first deformation mechanism. FIGS. 3A to 3C show a state in which the shape of the opening of the illumination field stop 33 is deformed from a circular shape to a slit shape by the second deformation mechanism. FIGS. 4A to 4C show how the slit angle (the direction in which the long axis of the slit shape is directed) is changed by the third deformation mechanism. The laser treatment apparatus 1 of the present embodiment can deform the opening shape of the illumination field stop 33 by combining the three deformation mechanisms described above. By this, for example, when projecting a slit-shaped light (hereinafter referred to as slit light), the slit width, the slit length, and the slit angle can be deformed. Each of the first to third deformation mechanisms can deform the aperture shape of the illumination field stop 33 in multiple steps. For the mechanism of the illumination field stop 33, see, for example, Japanese Patent Application Laid-Open No. 6-142047. The method of deforming the aperture shape of the illumination field stop 33 is not limited to the method in which the control unit 60 controls the drive means 36. For example, the opening shape of the illumination field stop 33 may be changed by the operator manually operating a knob, a dial or the like connected to the illumination field stop 33. In this case, the control unit 60 may receive the output signal of the detector provided in the illumination field stop 33 and detect the opening shape of the illumination field stop 33.

  In addition, although the shape of the illumination field stop 33 of this embodiment is a symmetrical shape centering | focusing on the optical axis L3, it may be an asymmetrical shape. In addition, the opening of the illumination field stop 33 may not be located on the optical axis L3. In addition, the deformation | transformation method of the opening shape of the illumination field stop 33 is not restricted to this. For example, the illumination optical system 30 may change only the slit angle. In addition, as illumination light, light separated at the observation site may be projected.

  The illumination optical system 30 of the present embodiment can deform the shape of the illumination light projected to the observation site into a circular shape, a substantially square shape, and a substantially rectangular shape (slit light) by the adjustment means described above. Thereby, the observation site can be suitably observed. For example, by projecting slit light to the observation site, unnecessary reflections (flares, ghosts) generated in the cornea of the patient's eye Ep can be suppressed, and the observation site (for example, the lens) can be suitably observed. The control unit 60 of the present embodiment can detect the opening shape (in other words, the illumination shape) of the illumination field stop 33 using the control signal to the drive means 36. The illumination field stop 33 may deform the aperture shape by a manual operation by the user. The illumination field stop 33 may include a detector, and may output a signal regarding the aperture shape of the illumination field stop 33 to the control unit 60.

<Observation optical system>
The observation optical system 40 of the present embodiment is an observation means for observing the observation site, and is used by the operator to observe the observation site of the patient's eye E. The observation optical system 40 of the present embodiment is incorporated in the microscope 41. The observation optical system 40 of the present embodiment includes a variable magnification optical system 42, a beam splitter 51, an imaging lens 44, an erecting prism group 45, a field stop 46, and an eyepiece lens 47. The observation optical system 40 also has an optical axis L4. The dichroic mirror 24 and the objective lens 25 are shared by the laser irradiation optical system 10 and the observation optical system 40. The variable magnification optical system 42 is used to change the observation magnification. For example, as the variable magnification optical system 42, a rotating drum or the like in which a plurality of lenses having different refractive powers are combined may be used. The observation optical system 40 may not include the variable magnification optical system 42.

  The beam splitter 51 is installed on the optical axis L4. The beam splitter 51 of this embodiment is an optical path combining means, and combines the optical path of the display optical system 50 and the optical path of the observation optical system 40. Details of the display optical system 50 will be described later. The field stop 46 is provided at a position conjugate with the observation site via the lens of the observation optical system 40. The field stop 46 masks unnecessary areas of the observation image. The field stop 46 of the present embodiment masks the peripheral portion of the observation image. The eyepiece lens 47 of this embodiment is a presentation means for presenting the observation image of the observation site to the operator, and is used for the operator to look through with the operator's eye Eo. The observation optical system 40 of the present embodiment has diopter adjustment means. The diopter adjusting means moves the eyepiece lens 47 along the optical axis L4. By the diopter adjusting means, the field stop 46 and the fundus of the operator's eye Eo can be brought into an optically conjugate positional relationship.

<Display optical system>
The display optical system 50 according to the present embodiment is used as a display unit that displays information related to the operation of the laser treatment apparatus 1 to display irradiation conditions (information) of treatment laser light to the operator. The display optical system 50 of the present embodiment shares a member from the beam splitter 51 to the eyepiece lens 47 with the observation optical system 40. A display unit 53 and a collimator lens 52 are provided in the light path of the display optical system 50 branched from the observation optical system 40. The display optical system 50 has an optical axis L5. The beam splitter 51 joins the display optical system 50 to the observation optical system 40. The beam splitter 51 makes the optical axis L5 coaxial with the optical axis L4. The display unit 53 has a display surface 53a. The display surface 53a is disposed at a position conjugate with the field stop 46 via a lens (collimator lens 52, imaging lens 44).

  The control unit 60 of the present embodiment displays parameters relating to the irradiation condition of the treatment laser light on the display surface 53a. Specifically, a display relating to the type of laser light emitted to the patient's eye Ep is parameter Sa, a display relating to the energy of laser light emitted to the patient eye Ep as the parameter Sb, a display relating to the number of bursts as the parameter Sc, and a focus shift The display regarding the position is displayed on the display surface 53a as a parameter Sd (see FIG. 7). The information displayed on the display surface 53a is presented within the field of view of the operator's eye Eo looking through the eyepiece 47 (see FIG. 5). The display contents of each parameter are successively updated when the operator makes a change on the operation panel or the like. Further, when the operator looks through the eyepiece lens 47, the parameter S is displayed in a predetermined direction on the display surface 53a so that the parameter S 'can be visually recognized as an erect image.

  Details of each parameter displayed on the display surface 53a will be described. The laser treatment apparatus 1 of the present embodiment can irradiate the patient's eye Ep with the treatment laser light at 1064 nm and the treatment laser light at 532 nm. In the place of the parameter Sa, a display corresponding to the wavelength of the treatment laser light to be irradiated to the patient's eye Ep is displayed. As one example, when irradiating the treatment laser light of wavelength 1064 nm, “YAG” is displayed at the position of the parameter Sa (see FIG. 7). When the treatment laser light having a wavelength of 532 nm is irradiated, “SLT” is displayed in the place of the parameter Sa.

  The energy adjusting unit 13 of the present embodiment can adjust the energy of the treatment laser light in the range of 0.3 mJ to 10.0 mJ. At the location of the parameter Sa, a display corresponding to the energy value of the treatment laser light emitted by the laser treatment apparatus 1 is displayed. As one example, when irradiating 2.0 mJ of treatment laser light, the characters “E: 2.0” are displayed at the location of the parameter Sb (see FIG. 7).

  When the trigger switch 67 is pressed, the laser treatment apparatus 1 of the present embodiment can intermittently emit treatment laser light (referred to as a burst). In the present embodiment, the number of bursts can be adjusted between 1 and 3 times. In the place of the parameter Sc, a display corresponding to the number of bursts is displayed. As an example, in the case where the number of bursts is three, the characters “B: 3” are displayed in the place of the parameter Sc (see FIG. 7).

  The shift adjustment unit 15 of the present embodiment can adjust the focus shift position in the range of −500 μm to +500 μm. A display corresponding to the focus shift position is displayed at the position of the parameter Sd. As an example, when the focus shift position is +125 μm, the character “P125” is displayed at the position of the parameter Sd (see FIG. 7).

  The display mode of the parameters is not limited to characters. For example, parameters may be expressed by icons and indicators. Further, the types of parameters to be displayed on the display surface 53a are not limited to the parameters Sa to Sd. For example, the cumulative number of times of irradiation of the treatment laser light after the power of the laser treatment apparatus 1 is turned on may be displayed. Further, the type of parameter displayed on the display surface 53a may be selectable by the preference of the operator. For example, only the parameter Sa may be displayed on the display surface 53a. Also, the display position of the parameter may be selectable according to the preference of the operator. It is preferable to store the settings (settings) selected by the operator in the non-volatile memory 65. Here, it is more preferable to store the setting for each operator.

  In the present embodiment, an LCD (Liquid Crystal Display) is used for the display unit 53. As the display unit 53, an organic EL display, a dot matrix LED, or the like may be used. In addition, the display unit 53 may be configured by combining an opening formed in an icon shape or an indicator shape with one or more light sources. Also, the liquid crystal panel may be disposed at the position of the field stop 46. In the present embodiment, the control unit 60 displays the parameter S in red.

<Interrelationship of each optical system>
The mutual relationship of each optical system of the laser therapeutic apparatus 1 of this embodiment is demonstrated. In the present embodiment, the optical axis L3 and the optical axis L4 intersect at the observation site. Further, in the present embodiment, the illumination field stop 33, the observation site, the field stop 46, the display surface 53a, and the fundus of the operator's eye Eo are in an optically conjugate relationship (for reference, each optical axis in FIG. The conjugate position is marked with an X)). By this, when observing the observation site, the operator displays the observation image of the observation site, the illumination area of the illumination optical system 30 (in other words, the projection image of the light blocking portion of the field stop 46) and the display unit 53 And visible information. The observation optical system 40 may not have the field stop 46.
<Control unit>
The control unit 60 is an example of a control unit that controls the operation of the laser treatment apparatus 1. The control unit 60 of the present embodiment includes a CPU 61 (processor), a ROM 62, a RAM 63, a non-volatile memory 65, and the like. The CPU 61 is responsible for control of each part in the laser treatment apparatus 1. The ROM 62 stores various programs, initial values and the like. The RAM 63 temporarily stores various information. The non-volatile memory 65 is a non-transitory storage medium capable of retaining stored contents even when the supply of power is shut off. For example, a USB memory removably mounted on the control unit 60, a flash ROM built in the control unit 60, or the like can be used as the non-volatile memory 65. The non-volatile memory 65 may be used as storage means for storing parameters relating to the irradiation of the treatment laser light. As the storage means, the RAM 63, the ROM 62, or another state holding medium (for example, dip SW or the like) may be used.

  The laser light source 11, the motor 14, the motor 16, the aiming light source 12, the display unit 53, the display unit 66, the trigger switch 67, the buzzer 68, and the like are connected to the control unit 60 of the present embodiment. The control unit 60 of the present embodiment is a display control unit of the display unit 53. The display unit 66 displays the operating conditions and the like of the laser treatment apparatus 1. The parameter S described later is also displayed on the display unit 66. The control unit 60 of the present embodiment has a function as a display control unit that controls the display of the display unit 66. The display unit 66 may have a touch panel function and may double as display means and input means. The trigger switch 67 is operated by the operator in order to input the irradiation execution instruction of the treatment laser light.

<Display of observation image in area>
The display of the parameter regarding the irradiation conditions of a treatment laser beam is demonstrated. FIG. 9 is illustrated for comparison with the display of the present embodiment. An observation image IMG and parameters S ′ (Sa ′ to Sd ′) are presented in the field of view of the operator looking through the eyepiece 47. The observation image IMG corresponds to the observation site. The observation image IMG includes an illumination area U corresponding to the opening of the illumination field stop 33, and a light blocking area N corresponding to a projection image of the light blocking portion of the illumination field stop 33. The parameter S ′ is a display regarding the irradiation condition (information) of the treatment laser light. The parameter S ′ indicates that it is a projection image of the parameter S displayed on the display surface 53 a of the display unit 53.

  In FIG. 9, the parameter Sb 'and the parameter Sc' overlap the illumination area U. As a result, the information on the observation site in the illumination area U is missing. In addition, the information on the observation site in the illumination area U is difficult to see with the parameter S '. As a result, for example, it takes time for the operator to take a look off the eyepiece lens 47 and check the display on the display unit 66, for example. In addition, since the illumination area U is bright, the brightness in the illumination area U and the brightness of the parameter S '(parameter Sb', parameter Sc ') are close to each other, and the parameter S' tends to be difficult to visually recognize. As a result, for example, the operator operates the operation member or the like to temporarily reduce the amount of illumination light. If the display of the parameter S 'is too bright, only the parameter S' may be noticeable, making it difficult to visually recognize the observation image IMG.

  FIG. 5 is a view of an observation image presented by the laser treatment apparatus 1 of the present embodiment. In FIG. 9 illustrated for comparison, the parameter S 'is displayed in the illumination area U. However, in the present embodiment, the parameter S' is displayed outside the illumination area U as shown in FIG. The control unit 60 of the present embodiment determines the display position of the parameter S ′ in the observation image IMG in consideration of the illumination area U to the observation site (a method of determining the display position will be described later). Specifically, the control unit 60 causes the parameter to be displayed at the position where the image of the light shielding portion of the illumination field stop 33 is formed in the region of the observation image IMG. Thereby, the operator can appropriately view both the observation image IMG and the parameter S '. Further, the control unit 60 of the present embodiment determines the brightness of the parameter S 'in consideration of the illumination light amount. Thereby, for example, the operator can suitably observe the observation image IMG even if the parameter S 'is displayed.

<Determination of display position of parameter>
The display position of parameter S 'which control part 60 determines using Drawing 5-Drawing 8 is explained. The control unit 60 of the present embodiment acquires information on the opening shape of the illumination field stop 33 from the non-volatile memory 65. Specifically, in the non-volatile memory 65, parameters used for control of the drive means 36 and parameters related to the aperture shape of the illumination field stop 33 are associated and stored in advance as table data. The control unit 60 calls, from the non-volatile memory 65, data relating to the aperture shape of the illumination field stop 33 corresponding to the control data used for control of the drive means 36. Then, the control unit 60 determines the display position of the parameter S using the data regarding the opening shape of the illumination field stop 33 that has been called. Here, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U. That is, in the present embodiment, the adjustment unit of the illumination optical system 30, the non-volatile memory 65, and the control unit 60 constitute an area detection unit that detects the illumination area U adjusted by the adjustment unit. Then, the control unit 60 determines the display position of the parameter based on the illumination area U detected by the area detection unit.

  FIG. 6 is a diagram for explaining the area of the display surface 53a. In FIG. 6, when the display surface 53a is projected to the position of the field stop 46, the area overlapping with the illumination area U is denoted by (U), the area overlapping (light blocking) with the field stop 46 is indicated by the light shielding area P. An area where it is determined that the parameter S can be displayed is shown as a displayable area M. The control unit 60 according to the present embodiment determines an area that does not overlap with the illumination area (U) and does not overlap with the light shielding area P as a displayable area M in which parameters can be displayed. When the control unit 60 reads out data relating to the aperture shape of the illumination field stop 33 from the non-volatile memory 65, the control unit 60 determines the distribution of the illumination area (U) on the display surface 53a using the data. At this time, the control unit 60 considers the magnification of the observation optical system 40 when distributing the illumination area (U). In detail, using the signal of the detector provided in the variable magnification optical system 42, the magnification of the observation optical system 40 is considered. The control unit 60 calls up the shape data of the field stop 46 stored in advance in the non-volatile memory 65, and determines the distribution of the light blocking area P on the display surface 53a. Then, the control unit 60 determines, as the displayable area M, an area not overlapping the illumination area (U) and the light shielding area P in the area of the display surface 53a.

  FIG. 7 shows that the control unit 60 displays the parameters S (Sa to Sd) in the displayable area M described above. The control unit 60 of the present embodiment determines the display positions of a plurality of types of parameters in consideration of the distribution of the displayable area M. In detail, in consideration of the shape of the illumination area U, the control unit 60 may display a part of the plurality of parameters at a position separated from the position at which the other parameter is displayed. More specifically, the control unit 60 may divide the four types of parameters into two groups for layout. The control unit 60 arranges the parameter Sa and the parameter Sb in the displayable area M at the upper side of the sheet of FIG. 6, and arranges the parameter Sa and the parameter Sb in the displayable area M at the lower side of the sheet of FIG. There is. As a result, since the parameter S is presented in the vicinity of the illumination area U, the movement of the sight line of the operator can be suppressed. Note that the control unit 60 of the present embodiment determines the brightness of the parameter S displayed on the display surface 53 a in consideration of the lighting amount of the lamp 31. For example, the control unit 60 increases the display light amount of the parameter S as the illumination light amount increases. By this, the operator can suitably view the parameter S 'regardless of the amount of illumination light.

  As described above, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U, and displays the parameter S on the display surface 53a. When the operator looks through the eyepiece lens 47, the observation image IMG and the parameter S 'are displayed in the field of the operator's eye Eo in the manner shown in FIG. Needless to say, if the observation optical system 40 does not have the field stop 46, the parameter S 'can be displayed also in the area indicated by the light shielding area P in FIG.

<Example of transformation of display position>
FIG. 8 is a diagram showing a modification of the display position of the parameter S '. In FIG. 8A, the control unit 60 displays the parameter S ′ outside the illumination area U in consideration of the slit-shaped illumination area U extending in the vertical direction in the drawing. Unlike in FIG. 5, the control unit 60 has a layout in which four types of parameters S (Sa to Sb) are arranged in the vertical direction of the drawing without being separated. That is, the control unit 60 determines the display position of the parameter S ′ in consideration of the distribution of the illumination area U in the area of the observation image IMG. In FIG. 8B, the control unit 60 displays the parameter S ′ outside the illumination area U in consideration of the slit-shaped illumination area U extending from the upper right direction to the lower left direction in the drawing. The control unit 60 divides the four types of parameters S (Sa to Sb) into two groups and lays out the same as in FIG. In both FIG. 5 and FIG. 8, the layout is in the order of the parameter Sa ′, the parameter Sb ′, the parameter Sb ′, and the parameter Sc ′ from the upper side to the lower side of the sheet. As a result, even if the control unit 60 changes the display position of the parameter S 'in consideration of the distribution of the illumination area U, the operator can easily search for the parameter S' to be confirmed.

  The display position of the parameter S 'shown in FIGS. 5 and 8 is merely an example. The control unit 60 may determine the display position of the parameter S 'in accordance with the distribution (shape, area, position) of the illumination area U in the area of the observation image IMG. For example, the display position of the parameter S 'may be determined according to the slit length of the slit light, the slit width, and the slit angle. Further, even when the illumination area is divided into a plurality of areas, the parameter S 'may be displayed at a position not overlapping with each illumination area. The parameter S ′ may not strictly avoid the illumination area U. That is, the parameter S ′ may overlap with part of the illumination area U. The overlap between the parameter S ′ and the illumination area U may be reduced by determining the display position of the parameter S ′ in consideration of the illumination area U by the control unit 60. Also, the display mode of each parameter S 'may be changed according to the distribution of the illumination area U. For example, when the distribution of the illumination area U is large in the area of the observation image IMG, the control unit 60 may reduce the display area of each parameter S '. Also, the number of characters of each parameter S 'may be reduced. For example, although the parameter Sb 'is displayed as "E: 2.0" in FIG. 5, this display may be abbreviated as "2.0". In addition, the control unit 60 may increase or decrease the type of the parameter S ‘to be displayed according to the change in the distribution ratio of the illumination area U.

<How to use>
An example of the operation of the laser treatment apparatus 1 will be described. When the operator turns on the laser treatment apparatus 1, test irradiation is performed several seconds later. The test irradiation is performed with the safety shutter inserted on the optical axis L1 of the laser irradiation optical system 10, and the treatment laser light emitted from the laser light source 11 is a beam splitter installed on the optical axis L1. It reflects and is incident on the light detector. The control unit 60 calculates the energy of the treatment laser light from the light reception amount detected by the light detector, and performs display on the parameter Sa of the display surface 53a. The test irradiation is performed each time the energy is set by the operation unit, and the display of the parameter Sa is updated each time. Also, when the irradiation mode of the treatment laser light is changed, the display of the test irradiation and the parameter Sa is updated.

  Thereafter, the operator operates the input switch or the like of the control panel to set irradiation conditions such as the irradiation mode, the laser output amount, the number of irradiation pulses, and the like according to the treatment purpose of the patient eye Ep. When the setting is completed, the operator places the patient's eye Ep at a predetermined position. After the operator sits in position and prevents movement, he looks through the eyepiece lens 47. The observation image IMG and each parameter S 'of the aspect shown in FIG. 5 are displayed in the visual field of the operator. The operator operates the joystick or the like so that the slit light projected by the illumination optical system 30 comes on the patient's eye Ep while looking through the eyepiece lens, and moves the slit delivery of the laser treatment apparatus 1.

  After adjusting the light amount of the slit light and the focus, the operator sets the contact lens 26 in the patient's eye Ep and observes the observation site of the patient's eye Ep while looking into the eyepiece lens 47 again. Further, at the time of laser irradiation, the switch provided on the joystick is operated to set the laser output amount. When the laser output amount is set, the control unit 60 controls the energy adjustment unit 13, the display unit 53, the display unit 66, and the like based on the set conditions. The display of the parameter Sb 'is updated (changed) along with the change of the laser output amount. The display of other parameters (Sa ', Sc', Sd ') is updated (changed) each time the corresponding setting is changed.

  The aiming light emitted from the aiming light source 12 is split into two and then enters the patient's eye Ep. The focal position of the therapeutic laser light is shifted in the direction of the optical axis from the intersection of the two aiming beams by the distance displayed as the parameter Sd ′. The operator refers the laser focal position to the affected area with reference to this intersection. Perform alignment by operating the joystick etc. to align.

  When alignment by the aiming light is completed, the operator presses the trigger switch 67 to emit a trigger signal. When receiving the trigger signal, the control unit 60 drives and controls the actuator to retract the safety shutter of the laser irradiation optical system 10 from the laser optical axis (optical axis L1) and emits a treatment laser beam.

  The treatment laser light is emitted from the laser light source 11 and then irradiated to the patient's eye Ep through the dichroic mirror 24 to cause tissue destruction due to plasma generation in the affected part of the patient's eye Ep. The control unit 60 causes the treatment laser light to be emitted for the number of irradiations based on the number of irradiations displayed in the parameter Sc '.

<Others>
In the present embodiment, the eyepiece lens 47 is used as a presenting unit that presents an observation image of an observation site to which illumination light is projected, but the presenting unit is not limited to this. It is only necessary to present the observation image to the operator. For example, a monitor connected to the laser treatment apparatus 1 may be used as the presentation means. In this case, for example, the imaging element is disposed in the optical path separated from the observation optical system 40, the observation site is photographed, and the observation image IMG is displayed on the monitor connected to the laser treatment apparatus 1 using the output signal of the imaging element. do it. In the observation image IMG displayed on the monitor, the parameter S relating to the irradiation condition of the treatment laser light may be displayed in the area of the observation image IMG in the same manner as in the present embodiment. Here, instead of the eyepiece lens 47 and the display optical system 50, the laser treatment apparatus 1 may be provided with an EVF (Electronic View Finder).

  Alternatively, the observation image IMG may be photographed by the observation optical system 40, and the control unit 60 may detect the illumination area U using image processing. The control unit 60 performs image processing and detects the illumination area U from the observation image. Then, in consideration of the detected illumination area U, the display position of the parameter is determined. For example, the illumination area U may be detected by performing image processing using the luminance information of the observation image. In the same manner as in the above-described embodiment, a composite image may be generated on the observation image IMG and outside the detected illumination area U by combining the parameter S related to the irradiation condition of the treatment laser light. By detecting the illumination area by image processing, it is considered that the illumination area U can be accurately detected with a simple configuration. The amount of illumination light may be detected using image processing.

  Moreover, the change (change) of the display mode of parameter S 'which a display means changes is not restricted to brightness. For example, the display color of the parameter S 'may be changed in conjunction with the change of the operating condition of the laser treatment apparatus 1. For example, when a color filter is inserted on the optical axis L3 of the illumination optical system 30, there is a possibility that the hue of the observation image IMG approaches the hue of the parameter S 'and the parameter S' becomes difficult to see. In such a case, the control unit 60 may determine the display color of the parameter S 'in consideration of the hue of the entire observation image IMG or the region of interest. As one example, the control unit 60 may display the parameter in green in the color observation mode (illuminated in white) and may display the parameter in red in the red free observation mode (illuminated in green).

  In addition, although this embodiment demonstrated using the laser treatment apparatus 1, the application scope of this technique is not limited to the laser treatment apparatus 1. FIG. For example, it may be applied to a slit lamp microscope (slit lamp). In addition, the present invention may be applied to a mydriatic type fundus camera that requires delicate observation. The present invention may be applied to other devices for observing the anterior segment, devices for observing the fundus, and the like. With such an apparatus, the technology relating to the display of the parameter S 'disclosed in the present embodiment can be applied when displaying the parameters related to the operating conditions of the apparatus. In addition, since observation with a chromatic color has a large amount of information, the appearance and taste of the observed image is often important. The application of the present technology is considered to be particularly suitable when observing the observation site in a chromatic manner.

<Operation and effect>
The laser treatment apparatus 1 of this embodiment irradiates treatment laser light to the affected part of a patient's eye. The laser treatment apparatus 1 includes illumination means for projecting illumination light to the observation site of the patient's eye Ep, presentation means for presenting the observation image IMG of the observation site to which illumination light is projected, and the area of the observation image IMG. , And display means for displaying a parameter S 'related to the irradiation condition of the treatment laser light, the display means, in consideration of the illumination area U of the illumination means, the display position of the parameter S' in the observation image IMG decide. Thereby, the operator (operator) can suitably view the observation image IMG of the patient's eye Ep and the display (parameter S ') on the irradiation condition. For example, it is possible to suppress the inconvenience that the parameter S ′ overlaps the illumination area U and the information of the observation site is lost to make observation difficult. In addition, it is possible to suppress the inconvenience that the parameter S ′ overlaps the illumination area U and the brightness of the illumination area U makes it difficult for the operator to visually recognize the parameter S ′. Therefore, the operator can easily treat the affected area promptly.

  Further, the illumination means of the laser treatment apparatus 1 of the present embodiment includes the illumination field stop 33 having an opening and a light shielding portion at a position conjugate to the observation site, and an image of the opening at the observation site (illumination area U) An image of the light shielding portion (light shielding region N) is formed. The display means displays the parameter S 'at the position where the image of the light shielding portion is formed in the area of the observation image IMG. Thus, for example, the contrast between the parameter S 'and the background of the parameter S' can be easily obtained, and the operator can easily view the display content of the parameter '. Further, the control unit 60 can easily detect (detect) the illumination area, and can display the parameter S 'with a simple configuration.

  Further, the parameter S ′ of the laser treatment apparatus 1 according to the present embodiment includes a plurality of parameters (Sa ′ to Sb ′) of different types, and the display unit takes into consideration the shape of the illumination area U. Some of the parameters may be displayed at positions away from the positions at which other parameters are displayed. Thereby, for example, a plurality of parameters can be displayed while maintaining the number of characters of the parameter S 'or the size of the characters. Therefore, the parameter S 'can be displayed to the operator without impairing the presentation information. In addition, it is easy to display the parameter S 'in the vicinity of the illumination area U which can be considered as the area of interest of the operator. This makes it possible to brightly present the observation site and reduce the movement of the sight line from the illumination area U (the area of interest) which is the gaze target of the operator. Therefore, the operator can easily treat the affected area promptly.

  Further, the laser treatment apparatus 1 of the present embodiment includes an adjustment unit for adjusting the illumination area U by the illumination unit, and an area detection unit for detecting the illumination area U adjusted by the adjustment unit, and a display unit The display position of the parameter S 'is determined based on the illumination area U detected by the area detection unit. Thereby, even if the illumination area U changes, the parameter S 'can be displayed at a suitable position on the observation image IMG. Therefore, the operator can easily observe the parameter S 'while being able to observe the observation site in the various shapes of the illumination area U.

  Moreover, the presentation means of the laser treatment apparatus 1 of this embodiment is provided with the magnification change means which carries out magnification change of the observation site | part and forms observation image IMG. The display means may detect the amount of magnification change of the magnification change means, and determine the display position of the parameter S 'based on the amount of magnification change. Thus, for example, the display position of the parameter S 'can be determined more accurately.

  In addition, as a modified example of the laser treatment apparatus 1 of the present embodiment, the display unit may detect the illumination area U from the observation image IMG and determine the display position of the parameter S ′ in consideration of the illumination area U. . By this, for example, even if the illumination light is unintentionally refracted by the contact lens 26, the detection error of the distribution of the illumination area U on the observation image IMG is detected because the illumination area U is detected from the observation image IMG by image processing. Is less likely to occur. Therefore, it is easy to display parameter S 'to a suitable position.

  Moreover, the display means of the laser treatment apparatus 1 of this embodiment displays parameter S 'on the observation image IMG and the outer side of the detected illumination area U. FIG. This allows the operator to view the parameter S 'without impairing the visibility of the observation image IMG. Also, the parameter S 'can be arranged with high accuracy.

  Moreover, the illumination means of the laser treatment apparatus 1 of the present embodiment is provided with a light amount adjustment means for adjusting the light projection light amount (illumination light amount) of the illumination light, and the display means is an observation image IMG according to the light projection light amount. The brightness of the display of the parameter to be displayed is determined. As a result, the operator can easily view the parameter S 'regardless of the amount of light emitted from the illumination light. For example, an event in which the parameter S 'is too bright for the observation image IMG to make observation difficult is suppressed. Moreover, the phenomenon in which the observation image IMG is too bright for the parameter S ′ and the parameter S ′ becomes difficult to visually recognize is suppressed.

  Further, the laser treatment apparatus 1 of the present embodiment has an eyepiece unit (eyepiece lens 47) and an observation optical system 40 for observing the observation region, and the presenting means is in the observation field of view by the eyepiece unit. Present the observation image IMG. Thereby, for example, even when the operator looks through the eyepiece and performs precise (or delicate) observation, the observation image IMG and the parameter S 'can be suitably viewed. Thus, the operability of the laser treatment apparatus 1 is improved. Moreover, it is hard to produce observation errors.

  The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is shown not by the above description but by the scope of claims, and is intended to include all modifications within the scope of claims and equivalents thereof.

1: Laser treatment apparatus 30: illumination optical system 40: observation optical system 47: eyepiece lens 50: display optical system 53: display unit 60: control unit

Claims (5)

A laser treatment apparatus for irradiating a treatment laser beam to an affected area of a patient's eye, comprising:
Illumination means for projecting illumination light onto the observation site of the patient's eye;
And presentation means for presenting an observation image of the observation site,
Display means for displaying parameters relating to irradiation conditions of the treatment laser light on the observation image presented by the presentation means ;
Equipped with
The laser treatment apparatus according to claim 1, wherein the display means determines a display position of the parameter to be displayed on the observation image in consideration of an illumination area of the observation site illuminated by the illumination means. The laser treatment apparatus according to claim 1, wherein
The illumination means includes an illumination field stop having an opening and a light blocking portion at a position conjugate to the observation portion, and forms an image of the opening and an image of the light blocking portion at the observation portion.
The display means displays the parameter on a light shielding area by the light shielding portion in the area of the observation image.
Laser treatment apparatus characterized in that. A laser treatment apparatus according to claim 1 or 2, wherein
The parameters include a plurality of parameters of different types,
The display means displays a part of the plurality of parameters at a position apart from the position at which another parameter is displayed, in consideration of the shape of the illumination area.
Laser treatment apparatus characterized in that. It is a laser treatment apparatus of any one of Claims 1-3,
Adjusting means for adjusting the illumination area by the illumination means;
An area detection unit that detects the illumination area adjusted by the adjustment unit;
The display means determines the display position of the parameter to be displayed on the observation image based on the illumination area detected by the area detection unit.
Laser treatment apparatus characterized in that. It is a laser treatment apparatus of any one of Claims 1-4, Comprising:
The presenting means includes a scaling means for scaling the observation site to form the observation image.
The display means detects the amount of magnification change of the magnification change means, and determines the display position of the parameter based on the amount of magnification change.
Laser treatment apparatus characterized in that .

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