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WO2019026862A1 - Dispositif de détermination de puissance de lentille intraoculaire et programme de détermination de puissance de lentille intraoculaire - Google Patents

Dispositif de détermination de puissance de lentille intraoculaire et programme de détermination de puissance de lentille intraoculaire Download PDF

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Publication number
WO2019026862A1
WO2019026862A1 PCT/JP2018/028513 JP2018028513W WO2019026862A1 WO 2019026862 A1 WO2019026862 A1 WO 2019026862A1 JP 2018028513 W JP2018028513 W JP 2018028513W WO 2019026862 A1 WO2019026862 A1 WO 2019026862A1
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WIPO (PCT)
Prior art keywords
intraocular lens
lens
anterior segment
eye
power determination
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PCT/JP2018/028513
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English (en)
Japanese (ja)
Inventor
遠藤　雅和
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株式会社ニデック
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Priority to JP2019534513A priority Critical patent/JPWO2019026862A1/ja
Publication of WO2019026862A1 publication Critical patent/WO2019026862A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/107—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining the shape or measuring the curvature of the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses

Definitions

  • the present disclosure relates to an intraocular lens power determination device for determining the power of an intraocular lens to be inserted into an eye to be examined, and an intraocular lens power determination program.
  • an intraocular lens power determination device determines the power (hereinafter, power) of an intraocular lens (hereinafter, IOL) to be inserted into an eye of an eye to be examined after removal of a lens nucleus (Patent Document 1).
  • IOL intraocular lens
  • Patent Document 1 estimation of the predicted anterior chamber depth (the position of the intraocular lens) has been performed to determine the intraocular lens power.
  • the estimated postoperative anterior chamber depth may differ from the actual postoperative anterior chamber depth, and the light passing through the intraocular lens may not be collected on the retina, and appropriate visual acuity may not be obtained. there were.
  • This indication makes it a technical subject to provide an intraocular lens power determination device and an intraocular lens power determination program capable of estimating an appropriate postoperative predicted anterior chamber depth in view of the conventional problems.
  • this indication is characterized by having the following composition.
  • An intraocular lens power determination device for determining the power of an intraocular lens to be inserted into an eye to be examined, which is a cross-sectional imaging means for capturing an anterior segment cross-sectional image of the eye to be examined;
  • Calculation control means for calculating, the calculation control means acquires an anterior segment parameter of the eye to be examined by analyzing the cross-sectional image of the anterior eye, and the intraocular eye from the lens equator position of the eye to be examined
  • the correction amount which is the distance to the lens is calculated using the anterior segment parameters, and the power of the intraocular lens is calculated based on the postoperative anterior chamber depth estimated using the correction amount.
  • An intraocular lens power determination program for use in an intraocular lens power determination device for determining the power of an intraocular lens to be inserted into an eye to be examined, which is executed by the processor of the intraocular lens power determination device
  • a correction amount which is the distance from the position to the intraocular lens, is calculated using the anterior segment parameters, and the dioptric power of the intraocular lens is calculated based on the predicted postoperative anterior chamber depth estimated using the correction amount. Calculating the calculation step to be performed by the intraocular lens power determination device.
  • the intraocular lens diopter determination device (for example, the ophthalmologic imaging device 200) of the present embodiment is a device for determining the diopter of an intraocular lens to be inserted into an eye to be examined.
  • the intraocular lens power determination device includes, for example, a cross-sectional imaging unit (for example, an OCT device 5) and an arithmetic control unit (for example, a control unit 80).
  • the cross-sectional imaging unit captures, for example, an anterior segment cross-sectional image of the subject's eye.
  • the arithmetic control unit calculates, for example, the power of the intraocular lens.
  • the calculation control unit acquires anterior segment parameters of the eye to be examined by analyzing the anterior segment cross-sectional image.
  • the anterior segment parameter is, for example, a parameter indicating the anterior segment shape of the subject's eye.
  • the anterior segment parameters include parameters that indicate the shape of the lens.
  • the anterior segment parameters are, for example, at least one of lens thickness, lens anterior surface curvature, lens posterior surface curvature, lens equatorial position, lens equatorial diameter, anterior chamber depth, corneal thickness, corneal diameter and the like.
  • the arithmetic control unit may calculate the correction amount of the predicted anterior chamber depth after surgery using the anterior segment parameter.
  • the correction amount is, for example, the distance from the lens equator position of the subject's eye to the intraocular lens.
  • the calculation control unit may estimate the postoperative predicted anterior chamber depth using the calculated correction amount, and may calculate the intraocular lens power based on the estimated postoperative estimated anterior chamber depth. As a result, it is possible to estimate an appropriate postoperative predicted anterior chamber depth based on the correction amount corresponding to the anterior segment shape of the subject's eye, and to calculate an intraocular lens power that is appropriate for the subject.
  • the arithmetic control unit may specify the equatorial position of the lens by analyzing the anterior segment cross-sectional image, for example. Then, the calculation control unit may estimate the postoperative predicted anterior chamber depth by adding the correction amount to the distance from the cornea of the subject's eye to the equatorial position of the lens.
  • the calculation control unit may calculate the correction amount by substituting the anterior segment parameter into the relational expression between the correction amount and the anterior segment parameter.
  • this relational expression may be created based on clinical data of a patient who has inserted an intraocular lens in the past.
  • the relational expression may be a regression expression obtained from a regression analysis result of an actual correction value and an anterior segment parameter.
  • the regression equation may be obtained by a multiple regression analysis result using a plurality of anterior segment parameters.
  • the anterior segment parameter may be a parameter newly generated from a combination of a plurality of parameters.
  • the anterior segment parameter may be a parameter generated from a combination of the distance (offset amount) from the lens front surface position to the lens equator position and the lens thickness.
  • the anterior segment parameter may be the ratio of the offset amount to the lens thickness.
  • the operation control unit may estimate the predicted anterior chamber depth after surgery using an IOL parameter specific to each IOL.
  • the IOL parameter is, for example, at least one of A constant, IOL total length, thickness, front and back surface curvature, material, elastic modulus, optical part diameter, and loop angle.
  • the calculation control unit can estimate the postoperative predicted anterior chamber depth suitable for the model of the IOL by using the IOL parameter for estimating the postoperative predicted anterior chamber depth.
  • the calculation control unit may execute an intraocular lens power determination program stored in a storage unit (for example, the memory 85) or the like.
  • the intraocular lens power determination program includes, for example, a cross-sectional imaging step, an acquisition step, and a calculation step.
  • the cross-sectional imaging step is, for example, a step of imaging an anterior segment cross-sectional image of the eye to be examined.
  • the acquiring step is, for example, a step of acquiring anterior segment parameters of the subject's eye by analyzing the anterior segment cross-sectional image.
  • the calculation step calculates a correction amount, which is the distance from the lens equatorial position of the eye to be examined to the intraocular lens, using the anterior segment parameters, and based on the predicted postoperative anterior chamber depth estimated using the correction amount. This is a step of calculating the power of the intraocular lens.
  • FIG. 1 is a schematic configuration view showing an optical system of an ophthalmologic photographing apparatus 200 according to the present embodiment.
  • the following optical system is incorporated in a housing (not shown).
  • the housing is three-dimensionally moved relative to the eye E via the operation member (for example, a joystick) by the drive of a known alignment moving mechanism.
  • the optical axis direction of the subject's eye (eye E) is Z direction
  • the horizontal direction is X direction
  • the vertical direction is Y direction.
  • the surface direction of the fundus may be considered as the XY direction.
  • an ophthalmologic imaging apparatus 200 including the optical coherence tomography device (OCT device) 5 and the cornea shape measuring device 300 will be described as an example.
  • the OCT device 5 is used as an anterior segment imaging device for capturing a cross-sectional image of the eye to be examined E.
  • the OCT device 5 may be used to measure the axial length of the eye E.
  • the cornea shape measuring device 300 is used to measure the cornea shape.
  • the OCT device 5 will be described by exemplifying an optical coherence tomography device for capturing an anterior segment tomographic image (cross-sectional image).
  • the OCT device 5 includes an interference optical system (OCT optical system) 100.
  • the OCT optical system 100 irradiates the eye E with measurement light.
  • the OCT optical system 100 detects a state of interference between the measurement light reflected from the anterior segment (for example, a cornea, a lens, etc.) and the reference light by a light receiving element (detector 120).
  • the OCT optical system 100 includes an irradiation position change unit (for example, an optical scanner 108) that changes the irradiation position of the measurement light in the anterior segment to change the imaging position on the anterior segment.
  • the control unit 80 controls the operation of the irradiation position changing unit based on the set imaging position information, and acquires a tomographic image based on the light reception signal from the detector 120.
  • the OCT optical system 100 has an apparatus configuration of so-called ophthalmic optical coherence tomography (OCT).
  • OCT optical system 100 splits the light emitted from the measurement light source 102 into a measurement light (sample light) and a reference light by a coupler (light splitter) 104. Then, the OCT optical system 100 guides the measurement light to the anterior segment by the measurement optical system 106, and guides the reference light to the reference optical system 110. After that, the detector (light receiving element) 120 receives interference light by combining the measurement light reflected by the anterior segment and the reference light.
  • OCT ophthalmic optical coherence tomography
  • the light emitted from the light source 102 is divided by the coupler 104 into a measurement light beam and a reference light beam. Then, the measurement light flux is emitted into the air after passing through the optical fiber. The luminous flux is collected on the anterior segment via the optical scanner 108 and other optical members of the measurement optical system 106. Then, the light reflected by the anterior segment is returned to the optical fiber through the same light path.
  • the optical scanner 108 scans the measurement light in the X and Y directions (transverse direction) on the eye E.
  • the light scanner 108 is, for example, two galvanometer mirrors, and the reflection angle thereof is arbitrarily adjusted by the drive mechanism 109.
  • the light scanner 108 may be configured to deflect light.
  • a reflection mirror galvano mirror, polygon mirror, resonant scanner
  • AOM acousto-optic element
  • the reference optical system 110 generates reference light that is combined with the reflected light obtained by the reflection of the measurement light at the eye E.
  • the reference optical system 110 may be a Michelson type or a Mach-Zehnder type.
  • the reference optical system 110 is formed by, for example, a reflective optical system (for example, a reference mirror), and the light from the coupler 104 is returned to the coupler 104 again by being reflected by the reflective optical system and guided to the detector 120.
  • the reference optical system 110 is formed by transmission optical system (for example, an optical fiber) and is guided to the detector 120 by transmitting the light from the coupler 104 without returning it.
  • the reference optical system 110 is configured to change the optical path length difference between the measurement light and the reference light by moving the optical member in the reference light path. For example, the reference mirror is moved in the optical axis direction.
  • a configuration for changing the optical path length difference may be disposed in the measurement optical path of the measurement optical system 106.
  • the detector 120 detects an interference state between the measurement light and the reference light.
  • the spectral intensity of the interference light is detected by the detector 120, and a depth profile (A scan signal) in a predetermined range is acquired by Fourier transformation on the spectral intensity data.
  • the control unit 80 can acquire a tomogram by scanning the measurement light in the predetermined transverse direction on the anterior segment by the light scanner 108. That is, an anterior segment tomogram of the eye to be examined is taken.
  • a tomographic image an anterior segment tomographic image
  • the light is scanned one-dimensionally with respect to the anterior segment to obtain a tomogram as B scan).
  • the acquired anterior segment tomographic image is stored in the memory 85 connected to the control unit 80.
  • Fourier-domain OCT includes Spectral-domain OCT (SD-OCT) and Swept-source OCT (SS-OCT). Also, it may be Time-domain OCT (TD-OCT).
  • SD-OCT Spectral-domain OCT
  • SS-OCT Swept-source OCT
  • TD-OCT Time-domain OCT
  • a low coherent light source (broadband light source) is used as the light source 102, and the detector 120 is provided with a spectroscopic optical system (spectrometer) that disperses interference light into each frequency component (each wavelength component).
  • the spectrometer comprises, for example, a diffraction grating and a line sensor.
  • a wavelength scanning light source (wavelength variable light source) that changes the emission wavelength at high speed in time is used as the light source 102, and a single light receiving element is provided as the detector 120, for example.
  • the light source 102 includes, for example, a light source, a fiber ring resonator, and a wavelength selection filter.
  • the wavelength selection filter for example, a combination of a diffraction grating and a polygon mirror, and one using a Fabry-Perot etalon can be mentioned.
  • the cornea shape measuring device 300 is roughly divided into a kerat projection optical system 50, an alignment projection optical system 40, and an anterior segment front imaging optical system 30.
  • the kerat projection optical system 50 has a ring-shaped light source 51 disposed around the measurement optical axis L1 and projects a ring index on the cornea to be examined to measure the corneal shape (curvature, astigmatism axis angle, etc.) Used for the light source 51, for example, an LED that emits infrared light or visible light is used.
  • the projection optical system 50 at least three or more point light sources may be disposed on the same circumference around the optical axis L1, and may be an intermittent ring light source. Furthermore, it may be a placido index projection optical system that projects a plurality of ring indices.
  • the projection optical system 50 is an optical system that projects a ring index on the subject's eye cornea Ec, and the ring index is also used as the Mayer ring.
  • the light source 41 of the projection optical system 40 doubles as an anterior segment illumination that illuminates the anterior segment with an infrared ray from an oblique direction.
  • an optical system for projecting parallel light onto the cornea Ec may be further provided, and the front and back alignment may be performed in combination with finite light by the projection optical system 40.
  • the anterior segment front imaging optical system 30 is used to capture (acquire) an anterior segment front image.
  • the anterior eye front imaging optical system 30 includes a dichroic mirror 33, an objective lens 47, a dichroic mirror 62, a filter 34, an imaging lens 37, and a two-dimensional imaging device 35, and is for imaging a frontal eye image of an eye to be examined. Used for The two-dimensional imaging device 35 is disposed at a position substantially conjugate with the anterior eye of the subject's eye.
  • Reflected light in the anterior segment by the projection optical system 40 and the projection optical system 50 described above is imaged on the two-dimensional imaging device 35 through the dichroic mirror 33, the objective lens 47, the dichroic mirror 62, the filter 34, and the imaging lens 37. Ru.
  • the light source 1 is a fixation lamp. Further, for example, a part of the anterior segment reflected light acquired by the reflection at the anterior segment of the light emitted from the light source 1 is reflected by the dichroic mirror 33 and an image is formed by the anterior segment front imaging optical system 30 Be done.
  • the control unit 80 controls the entire apparatus and calculates measurement results.
  • the control unit 80 is connected to each member of the OCT device 5, each member of the cornea shape measuring device 300, the monitor 70, the operation unit 84, the memory 85, and the like.
  • a general-purpose interface such as a mouse may be used as the operation input unit, or in addition, a touch panel may be used.
  • the memory 85 stores, in addition to various control programs, an analysis program for the controller 80 to analyze the anterior segment image.
  • ⁇ Control action> The operation and control operation when determining the intraocular lens dioptric power in the device having the above configuration will be described.
  • the examiner moves the device up, down, left, right and back and forth using the operation means such as a joystick (not shown) while looking at the alignment state of the eye to be examined displayed on the monitor 70, Put in the positional relationship of. In this case, the examiner causes the fixation target to fixate on the subject's eye.
  • the examiner aligns the reticle LC electronically displayed on the monitor 70 with the ring indicators Q1 and Q2 by the light source 41 so as to align the top, bottom, left, and right.
  • alignment is performed in the X and Y directions so that the optical axis L1 of the present apparatus passes through the apex of the cornea of the subject's eye.
  • the examiner performs front-to-back alignment so that the ring index Q1 is in focus.
  • the controller 80 When alignment with the anterior segment is completed, the controller 80 causes the anterior segment front imaging optical system 30 to image the anterior segment of the eye to be examined. In addition, the control unit 80 captures a cross-sectional image 500 of the eye to be examined by the OCT optical system 100 based on a preset scanning pattern (see FIG. 3). The acquired anterior segment image and cross-sectional image are stored in the memory 85 or the like.
  • the control unit 80 calculates the corneal shape of the subject's eye based on the ring index images Q1 and Q2 in the anterior segment image 400 stored in the memory 85.
  • the corneal shape is, for example, the corneal curvature radius of the front of the cornea in the strong and weak meridian directions, the astigmatic axis angle of the cornea, and the like.
  • the control unit 80 calculates the corneal shape based on the size and shape of the ring index images Q1 and Q2.
  • control unit 80 analyzes a cross-sectional image captured using the OCT device 5. For example, the control unit 80 detects the position of the cornea, the lens, and the like by edge detection of the cross-sectional image, and measures the corneal thickness, the anterior chamber depth, and the lens thickness based on the position. Further, the control unit 80 performs circular approximation (or elliptic approximation, conic curve approximation, etc.) of the detected anterior surface or posterior surface of the lens and the radius of curvature of the posterior surface of the cornea, curvature of the anterior surface of the lens, and posterior surface of the lens based on this approximate curve. Measure the curvature etc.
  • the control unit 80 calculates the intraocular lens power by partially diverting the known SRK / T equation, Binkhorst equation or the like. For example, the above measurement data is substituted into the SRK / T equation, the Binkhorst equation, and the like.
  • the intraocular lens diopter power is calculated using the corneal curvature radius, axial length, post-operative predicted anterior chamber depth (details will be described later), and the like.
  • the predicted postoperative anterior chamber depth ELP pred is calculated by adding the central corneal thickness CCT, the anterior chamber depth ACD, the offset amount X, and the correction amount ⁇ , as shown in FIG. Ru. Therefore, the predicted postoperative anterior chamber depth ELP pred can be expressed as the following equation (2).
  • the offset amount X is the distance from the position of the front surface of the lens to the equatorial position (maximum diameter portion of the lens) EPP.
  • the equator position is a position where the front surface of the lens and the rear surface of the lens intersect.
  • the correction amount ⁇ is the distance from the equatorial position of the lens to the IOL.
  • the correction amount ⁇ is affected by the movement of the IOL to the posterior capsule side or the anterior chamber side by receiving pressure from the lens capsule.
  • the post-operative predicted anterior chamber depth may be defined from the back of the cornea, but in this case, it is the distance from the front of the cornea to the IOL.
  • the distance (quartz of the equatorial lens) h indicates the distance from the optical axis L1 to the intersection point of the approximate circle on the front surface of the lens and the approximate circle on the rear surface of the lens.
  • the distance X1 indicates the distance from the lens front surface curvature center O4 in the optical axis L1 to the back surface of the lens.
  • the distance X1 ' indicates the distance from the intersection of the approximate circle on the front of the lens and the approximate circle on the rear of the lens to the rear surface of the lens.
  • the distance X2 indicates the distance from the lens back surface curvature center O3 in the optical axis L1 to the front surface of the lens.
  • the distance X indicates the distance from the intersection of the approximate circle on the front of the lens and the approximate circle on the rear of the lens to the front of the lens, and is an offset amount.
  • control unit 80 calculates the offset amount X by substituting the numerical values for the lens front surface curvature radius R 3 , the lens back surface curvature radius R 4 , and the lens thickness LT in Expression (4). Each numerical value is obtained by analyzing a tomographic image.
  • the control unit 80 obtains the correction amount ⁇ based on an anterior segment parameter indicating the shape of the anterior segment.
  • the anterior segment parameters are, for example, parameters related to the shape of the crystalline lens.
  • the anterior segment parameters are, for example, at least one of lens thickness, lens anterior surface curvature, lens posterior surface curvature, lens equatorial position, lens equatorial diameter, anterior chamber depth, corneal thickness, corneal diameter and the like.
  • the control unit 80 calculates the correction amount ⁇ using a relational expression between the correction amount ⁇ and the anterior segment parameter.
  • This relational expression is acquired, for example, using clinical data of a patient who has inserted an intraocular lens in the past.
  • the control unit 80 obtains a measured value of the postoperative anterior chamber depth ELP by analyzing a cross-sectional image of the patient into which the intraocular lens is inserted, and based on the measured value of the postoperative anterior chamber depth ELP, the measured value of the correction amount ⁇ .
  • the actual value of the correction amount ⁇ is calculated by subtracting the distance (CCT + ACD + X) from the corneal apex K to the equatorial position EPP measured before the operation from the actual value of the postoperative anterior chamber depth ELP. Then, regression analysis is performed using the measured correction amount ⁇ and the anterior segment shape parameter, and a relational expression is derived from the result. In this embodiment, multiple regression analysis is used.
  • the multiple regression analysis is, for example, an analysis method that predicts one variable with a plurality of variables. Multiple regression analysis can be performed by general statistical software or the like. By performing multiple regression analysis using a plurality of clinical data, it is possible to obtain a regression equation of the correction amount ⁇ as in the following equation (5).
  • the equation (5) is an example of a regression equation of the correction amount ⁇ .
  • the anterior chamber depth ACD, the lens front surface curvature R 3 , and the ratio of the offset amount X to the lens thickness (X / LT) are used as the anterior segment parameters.
  • other anterior segment parameters may be used in the regression equation.
  • X / LT it is possible to take into consideration the change in the ratio of the lens thickness and the offset amount X depending on the size of the lens to the correction amount ⁇ .
  • a combination of a plurality of parameters may be used as the anterior segment parameter.
  • control unit 80 calculates the correction amount ⁇ by substituting the anterior chamber depth ACD, the lens front surface curvature R 3 , the offset amount X, and the lens thickness LT into Expression (5).
  • control unit 80 substitutes the offset amount X and the correction amount ⁇ calculated by the equations (4) and (5), the central corneal thickness CCT obtained by analyzing the tomographic image, and the anterior chamber depth ACD into the equation (2). Then, the predicted anterior chamber depth ELP pred after surgery is calculated. The control unit 80 calculates the intraocular lens power by substituting the post-operative estimated anterior chamber depth ELP pred estimated in this manner, for example, into AD ′ of Expression (1).
  • the intraocular lens power determination device of the present embodiment calculates the correction amount ⁇ based on the anterior segment parameter. Since the correction amount ⁇ varies depending on the shape of the anterior segment of the subject's eye etc., it is possible to estimate an appropriate postoperative predicted anterior chamber depth ELP pred by calculating the correction amount ⁇ based on the anterior segment parameters. . By this, it is possible to select the power of the intraocular lens suitable for the subject eye.
  • the IOL parameter (model information) is, for example, at least one of A constant, IOL total length, thickness, front and back surface curvature, material, elastic modulus, optical part diameter, and loop angle.
  • a constant is a constant set for each model of IOL based on clinical data.
  • the coefficients of the variables in the equation for obtaining the correction amount ⁇ may be set individually for each model of the intraocular lens as in the equation (5).
  • the control unit 80 may change the regression equation for obtaining the correction amount ⁇ for each model of the intraocular lens. By this, it is possible to obtain a correction amount ⁇ suitable for each model.
  • the relational expression for obtaining the correction amount ⁇ as in the expression (5) may be created by the control unit 80, or may be created in advance by an external computer or the like and recorded in the memory 85 or the like.
  • the equatorial position is a position where the front surface of the lens intersects the rear surface of the lens, but the equatorial position may be estimated by another calculation method.
  • an optical coherence tomography device for imaging an anterior segment tomographic image acquires a three-dimensional shape image by acquiring an anterior segment tomographic image at a plurality of scanning positions.
  • the OCT device 5 is an anterior segment imaging device that acquires a three-dimensional cross-sectional image (three-dimensional anterior segment data) of the anterior segment
  • the control unit 80 acquires the three acquired by the anterior segment imaging device.
  • the offset distance from the front surface of the lens to the contact point of the chin strip and the lens may be three-dimensionally determined based on the two-dimensional cross-sectional image. In this case, the average of the lens front surface curvature and the lens back surface curvature for each meridian direction in the three-dimensional anterior segment data may be calculated, and the ELP may be calculated based on this.
  • an anterior segment imaging device for capturing an anterior segment sectional image an optical coherence tomography device for capturing an anterior segment tomographic image (sectional image) has been exemplified, but the present invention is not limited to this.
  • a projection optical system for projecting light emitted from a light source toward the anterior eye of the subject's eye to form a light cutting surface on the anterior eye, and before being acquired by scattering in the anterior eye of the light cutting surface It is sufficient to have a light receiving optical system having a detector for receiving light including scattered light in the eye, and to form an anterior segment cross-sectional image based on a detection signal from the detector. That is, the present invention can also be applied to an apparatus or the like that projects slit light onto the anterior segment of an optometry eye and obtains an anterior segment cross-sectional image with a Shine Pluck Camera.
  • the present invention is also applicable to an apparatus for acquiring a three-dimensional shape image of the anterior segment by rotating the Shine Pluck camera or moving it in the horizontal or vertical direction.
  • it is possible to obtain the three-dimensional shape image of the anterior segment with high accuracy by performing the shift correction for each predetermined rotation angle, and the accuracy of the measurement value obtained from the three-dimensional shape image is improved.
  • the positional deviation in the direction perpendicular to the imaging surface (slit cross section) is detected, and the deviation correction processing is performed based on the detection result.
  • the anterior segment cross-sectional image was optically acquired, it is not limited to this.
  • any configuration may be used as long as a cross-sectional image of the anterior segment is acquired by detecting reflection information from the anterior segment using an ultrasound probe for B scan.
  • IOL calculation formulas such as SRK / T formula and Binkhors formula which are known, were used as a calculation method of IOL frequency, it is not limited to this.
  • the IOL power is calculated by the ray tracing method using the postoperative predicted anterior chamber depth ELP, the corneal thickness CCT, the axial length measurement result AL, the corneal curvature radius of the anterior corneal surface, and the corneal curvature radius of the posterior corneal surface.
  • IOL powers are calculated by simulating reflection and refraction of light, so the IOL powers can be calculated with high accuracy also by the theoretical formula IOL.
  • machine learning may be used to calculate the IOL.
  • the cornea curvature radius at the front of the cornea is calculated using the cornea shape measuring device 300, and the cornea curvature radius at the back of the cornea is calculated using the OCT device 5, but It is not limited.
  • the radius of curvature of the cornea on the anterior-posterior surface of the cornea may be calculated by the OCT device 5.
  • the radius of curvature of the cornea on the anterior and posterior surfaces of the cornea may be treated as the same measurement value. That is, the corneal curvature radius at the front of the cornea calculated by the corneal shape measuring device 300 may be used as the corneal curvature radius at the anterior and posterior surfaces of the cornea.
  • corneal topography can also be used as the corneal shape measuring device 300.
  • the radius of curvature of the anterior surface of the cornea is calculated, the radius of curvature of the anterior surface of the cornea is calculated from the entire shape of the cornea, so the radius of curvature of the anterior surface of the cornea is accurately calculated. For this reason, when calculating an IOL frequency, it leads to the improvement of the accuracy of IOL frequency calculation.
  • the control unit 80 performs an OCT
  • the offset amount X may be determined based on positional information of the ciliary body in the anterior segment cross-sectional image acquired by the device 5. For example, the ciliary body (ciliary tip) is detected from the acquired anterior segment tomographic image (an anterior segment cross-sectional image), and the position of the chin zonule is predicted from the detected ciliary body position. Then, the position of the contact portion between the chin band and the lens may be detected from the predicted chin position.
  • control The unit 80 processes the contact portion in the anterior segment cross-sectional image acquired by the OCT device 5 to obtain the offset amount X. For example, when a chin zonule is photographed in the anterior segment tomogram (cross-sectional image), the position of the contact portion between the chin zonule and the lens may be detected from the acquired anterior segment tomogram. .
  • an anterior segment imaging device for example, an ultrasound B probe, an anterior segment OCT
  • control The unit 80 processes the contact portion in the anterior segment cross-sectional image acquired by the OCT device 5 to obtain the offset amount X. For example, when a chin zonule is photographed in the anterior segment tomogram (cross-sectional image), the position of the contact portion between the chin zonule and the lens may be detected from the acquired anterior segment tomogram. .
  • an IOL frequency calculation program for performing the functions of the above embodiments is supplied to a system or apparatus via a network or various storage media. Then, a computer (for example, a CPU or the like) of a system or an apparatus can read and execute a program.
  • Equation (6) is a equation for calculating the correction amount ⁇ using an anterior segment parameter different from the equation (5) described above.
  • Formula (6) is also calculated
  • DIA is a lens diameter (a lens equatorial diameter).
  • anterior segment parameters generated from the combination of the lens equatorial diameter and the lens thickness are used.
  • the ratio of lens thickness to lens equatorial diameter is used. This allows the geometrical features of the lens to be represented by the ratio of thickness to diameter.
  • the control unit 80 calculates the correction amount ⁇ based on the shape feature of the crystalline lens, so that, even if the shape of the crystalline lens is different for each subject's eye, it is possible to predict the postoperative condition suitable for each subject's eye You can determine the chamber depth.

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Abstract

L'invention concerne un dispositif de détermination de puissance de lentille intraoculaire et un programme de détermination de puissance de lentille intraoculaire capable d'estimer une profondeur de chambre antérieure post-opératoire prédite appropriée. Le dispositif de détermination de puissance de lentille intraoculaire pour déterminer une puissance d'une lentille intraoculaire à insérer dans l'œil d'un patient comprend: un moyen de photographie de section transversale pour prendre une image en coupe transversale du segment oculaire antérieur de l'œil du patient; et un moyen de commande arithmétique pour calculer la puissance de la lentille intraoculaire. Le moyen de commande arithmétique acquiert un paramètre de segment oculaire antérieur de l'œil du patient par analyse de l'image en coupe transversale du segment oculaire antérieur, calcule une quantité de correction, qui est une distance d'une position équatoriale du cristallin de l'œil du patient à la lentille intraoculaire, en utilisant le paramètre de segment oculaire antérieur, et calcule la puissance de la lentille intraoculaire sur la base d'une profondeur de chambre antérieure post-opératoire prédite estimée à l'aide de la quantité de correction.
PCT/JP2018/028513 2017-07-31 2018-07-30 Dispositif de détermination de puissance de lentille intraoculaire et programme de détermination de puissance de lentille intraoculaire WO2019026862A1 (fr)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210186322A1 (en) * 2019-12-13 2021-06-24 Nidek Co., Ltd. Ophthalmologic measurement apparatus, ophthalmologic measurement system, and ophthalmologic measurement program
CN113440099A (zh) * 2021-06-07 2021-09-28 天津市索维电子技术有限公司 一种人眼视光综合检查装置和方法
WO2023155509A1 (fr) * 2022-02-15 2023-08-24 北京百度网讯科技有限公司 Procédé et appareil de prédiction de données, dispositif électronique et support de stockage

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US20050117117A1 (en) * 2003-12-02 2005-06-02 Dan Bourla Intraoperative biometry
US20090164007A1 (en) * 2007-12-19 2009-06-25 Wf Systems Llc Devices and methods for measuring axial distances
JP2013094410A (ja) * 2011-10-31 2013-05-20 Nidek Co Ltd 眼内レンズ度数決定装置及びプログラム
JP2017505698A (ja) * 2014-02-03 2017-02-23 シャマス，ハンナ 眼内レンズ度数を決定するシステムおよび方法
JP2018033807A (ja) * 2016-09-01 2018-03-08 株式会社ニデック 眼内レンズ度数決定装置、および眼内レンズ度数決定プログラム

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050117117A1 (en) * 2003-12-02 2005-06-02 Dan Bourla Intraoperative biometry
US20090164007A1 (en) * 2007-12-19 2009-06-25 Wf Systems Llc Devices and methods for measuring axial distances
JP2013094410A (ja) * 2011-10-31 2013-05-20 Nidek Co Ltd 眼内レンズ度数決定装置及びプログラム
JP2017505698A (ja) * 2014-02-03 2017-02-23 シャマス，ハンナ 眼内レンズ度数を決定するシステムおよび方法
JP2018033807A (ja) * 2016-09-01 2018-03-08 株式会社ニデック 眼内レンズ度数決定装置、および眼内レンズ度数決定プログラム

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210186322A1 (en) * 2019-12-13 2021-06-24 Nidek Co., Ltd. Ophthalmologic measurement apparatus, ophthalmologic measurement system, and ophthalmologic measurement program
CN113440099A (zh) * 2021-06-07 2021-09-28 天津市索维电子技术有限公司 一种人眼视光综合检查装置和方法
WO2023155509A1 (fr) * 2022-02-15 2023-08-24 北京百度网讯科技有限公司 Procédé et appareil de prédiction de données, dispositif électronique et support de stockage

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