CN100479791C - Intravital surgery system for scanning type laser operation of hot forming cornea - Google Patents
Intravital surgery system for scanning type laser operation of hot forming cornea Download PDFInfo
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- CN100479791C CN100479791C CNB2006101188969A CN200610118896A CN100479791C CN 100479791 C CN100479791 C CN 100479791C CN B2006101188969 A CNB2006101188969 A CN B2006101188969A CN 200610118896 A CN200610118896 A CN 200610118896A CN 100479791 C CN100479791 C CN 100479791C
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Abstract
A scanning laser operation system for the thermo-shaping operation of cornea on living body is composed of a scanning laser source, an adaptive locating system, a safte parameter testing system, a therapeutic effect testing system, and a controller.
Description
Technical field
The present invention relates to the system in a kind of biomedical engineering technology field, be specifically related to a kind of live body surgery systems of scanning type laser thermokeratoplasty.
Background technology
Along with people deepen continuously to the understanding of hypermetropia and hypermetropia crowd's continuous growth, the treatment of hypermetropia is just more and more become the focus that ophthalmic industry is paid close attention to.The treatment hypermetropia has several methods at present, comprises excimer laser corneal refractive otomy, Laser in Situ Keratomileusis, laser thermal keratoplasty, transparent crystal excision associating intraocular lens implants, automatic lamellar keratoplasty, keratotomy, Lasso or the like.Wherein, laser thermal keratoplasty is to utilize the laser irradiation cornea, makes the corneal collagen fiber be subjected to thermal contraction, changes corneal diopter with the treatment ametropia.Because laser thermal keratoplasty is to use laser to carry out noninvasive laser therapy to being arranged in the outermost cornea tissue of eye refraction system, though so it the predictability of refraction results and stable aspect curative effect relatively limited, but still be proved to be to treat the safest also one of the most promising method of slight hypermetropia, and be expected to directly benefit from the progress at full speed of laser technology.
Find through literature search prior art, survey article " progress of laser thermal keratoplasty " (Tao Dan in 2004, Du's Chongqing, " Chinese practical ophthalmology magazine ", rolled up o. 11th 848-850 page or leaf in November the 22nd in 2004) mention, at present mainly adopt contactless light beam transmission system to carry out laser thermal keratoplasty, this system can launch the 8 bundle laser that are uniformly distributed in the cornea periphery, equate apart from central diameter simultaneously.Though this system compares early stage contact light beam fiber probe, make laser thermal keratoplasty minimizing consuming time, corneal epithelial wound and corneal infection have been reduced, and improved the degree of accuracy of site of action, but because this system still only can produce limited smooth condensation point, so the retraction ring that forms still has certain unpredictability.Therefore, the relative relatively poor defective of stability that still has therapeutic effect with predictability.In further retrieving, find identical with the present invention or similar theme as yet.
Summary of the invention
The present invention is directed to the deficiency and the defective of the employed system of existing laser thermal keratoplasty, proposed a kind of live body surgery systems of scanning type laser thermokeratoplasty.The present invention can adapt to the demand of hyperopic treatment operation more flexible and efficiently, and increases the stability and the predictability of laser thermal keratoplasty surgical effect.
The present invention is achieved by the following technical solutions, the present invention includes five modules, is respectively: scan laser source, self adaptation navigation system, security parameter test macro, treatment effect test macro, controller.Along beam direction, human eye is directly aimed in the scan laser source; The input of self adaptation navigation system, security parameter test macro and treatment effect test macro is all aimed at human eye, and three's outfan all links to each other with the input of controller.The outfan of controller is connected to the scan laser source.Wherein, the emission and the scanning of laser is responsible in the scan laser source, the self adaptation navigation system is responsible for the self adaptation location to the eye pupil center, the security parameter test macro is responsible for the security sweep parameter (rate of scanning that comprises laser of test scan formula laser thermal keratoplasty, the persistent period of pulse, the rotary speed of probe, degree of depth of focus point or the like), treatment effect test macro is responsible for test scan formula laser thermal keratoplasty at the security sweep parameter (rate of scanning that comprises laser, the persistent period of pulse, the rotary speed of probe, degree of depth of focus point or the like) the treatment effect under, controller is responsible for feedback control.Laser sends via the scan laser source and projects the eye table, realize the ring-type flying-spot scanner of laser at eyeball surface, the pupil center that launching position is determined with reference to the self adaptation navigation system in real time, the security parameter test macro is responsible for real-time detection to scanning type laser thermokeratoplasty security parameter to guarantee safety, treatment effect test macro is responsible for the scanning type laser thermokeratoplasty in the real-time detection that guarantees the treatment effect under the safety prerequisite, the position offset information that both testing results detect with the self adaptation navigation system together, collect feedback by controller, be sent to the scan laser source with real-time control laser parameter.
Described scan laser source comprises lasing light emitter and incidental focusing system, cooling system and scanning system; directly realize the rotary scanning of laser; and can be directly at laser before the outgoing of laser emitting mouth; just directly realize the cooling protection of beams focusing optimization and device, the feedback control of the controlled device of laser parameter.Lasing light emitter is responsible for the emission of laser beam, and focusing system is responsible for the focusing of laser beam, and cooling system is responsible for the cooling of laser beam, and scanning system is responsible for the scanning of laser beam.Scan laser source emitted laser bundle directly is mapped to eyeball surface.
Described self adaptation navigation system is responsible for the self adaptation location to the eye pupil center, and its result delivers to controller.
Described security parameter test macro comprises hot camera, scopometer.Hot camera is responsible for the real-time detection of corneal tissue temperature, and scopometer is responsible for the real-time detection that corneal is organized turbidity.During the work of security parameter test macro, accept to show detected information from eye, hot camera is accepted the cornea tissue temperature information, and is sent to controller, and scopometer is accepted cornea tissue turbidity information, and is sent to controller.
Described treatment effect test macro comprises that corneal topography system, corrugated differ instrument.Corneal topography system is responsible for detecting in real time with corneal topography diagram form corneal diopter, and the corrugated differs instrument and is responsible for differing form corneal diopter with the corrugated and detects in real time.During the work of treatment effect test macro, acceptance is shown detected corneal diopter information from eye, and corneal topography system shows information, and is sent to controller with the corneal topography diagram form, the corrugated differs instrument information is shown with the corrugated form that differs, and is sent to controller.
Described controller is collected the testing result of the test macro of the test macro of security parameter and treatment effect, through with the secure threshold of prior setting with treat and will adjust signal after expected value is compared and deliver to the scan laser source, laser parameter is carried out feedback control.If hot camera detects the too high or scopometer of corneal temperature and detects corneal opacity degree and begin to rise, then controller feedback negative signal is to the scan laser source, makes it reduce scanning rotating speed or reduces laser intensity, otherwise then improve the scanning rotating speed or increase laser intensity.Simultaneously, described controller is collected the testing result of self adaptation navigation system, through the laser scanning center with laser direction is adjusted signal after the cornea practical center is compared and delivers to the scan laser source, the laser direction parameter is carried out feedback control.If find laser scanning misalignment cornea practical center, then adjust beam direction so that both conform to again.
The light condensation point that existing laser thermal keratoplasty system is produced is arranged generally two kinds on Liang Quan and three circles.And behind application the present invention, the laser light condensation point will form fine and close set point array by the scanning of ring-type flying spot formula.
The advantage of the live body surgery systems of this kind scan laser thermokeratoplasty is: being heated of (1) cornea is almost simultaneously, can reduce the generation of asymmetric astigmatic phenomenon significantly; (2) adjust frequency and the interval of scanning, can realize the best accumulated of heat effect; (3) can form the more stable contraction endless belt of stress, improve the stability of cornea hot forming surgical effect; (4) can detect diopter change effect in real time and come the correspondingly number of turns of decision scanning in real time, improve the predictability of cornea hot forming surgical effect; (5) the self adaptation location can increase the accuracy of operation.
Description of drawings
Fig. 1 is a structural representation block diagram of the present invention
The specific embodiment
Below in conjunction with accompanying drawing embodiments of the invention are elaborated: present embodiment has provided detailed embodiment and process being to implement under the prerequisite with the technical solution of the present invention, but protection scope of the present invention is not limited to following embodiment.
As shown in Figure 1, present embodiment comprises five modules, is respectively: test macro, the controller of the test macro of scan laser source, self adaptation navigation system, security parameter, treatment effect.Along beam direction, human eye is directly aimed in the scan laser source; The input of self adaptation navigation system, security parameter test macro and treatment effect test macro is all aimed at human eye, and three's outfan all links to each other with the input of controller.The outfan of controller is connected to the scan laser source.
Laser is issued to the eye table via the scan laser source, realizes the ring-type flying-spot scanner of laser at eyeball surface.Simultaneously, determine pupil center in real time by the self adaptation navigation system, carry out the real-time detection of security parameter by the test macro of security parameter, and treat the real-time detection of effect by the test macro of treatment effect, testing result is collected by controller and is fed back to the scan laser source, with real-time control laser parameter.
Described scan laser source comprises lasing light emitter and incidental focusing system, cooling system and scanning system; directly realize the rotary scanning of laser; and can be directly at laser before the outgoing of laser emitting mouth, the direct cooling protection of realization beams focusing optimization and device just.
The lasing light emitter in described scan laser source is the laser instrument of suitable wavelength, the laser of emission suitable wavelength, and corneal hot forming art wavelength is generally about 2.0 μ m.
The focusing system in described scan laser source is just finished beams focusing before laser emitting, comprise first order concentrating element and second level concentrating element.First order concentrating element in the focusing system in described scan laser source, purpose is that divergent beams are focused to directional light.Second level concentrating element in the focusing system in described scan laser source, purpose is that directional light is further focused on the cornea.The focometry of second level concentrating element is fairly simple, under the situation that instrument lacks even can estimate by the range estimation spot size.By the focal length and the required cornea inner focusing degree of depth of laser thermal keratoplasty of second level concentrating element, determine the distance between second level concentrating element and the human eye then.
Described first order concentrating element and second level concentrating element are lens.
The cooling system in described scan laser source is implemented cooling in real time to lasing light emitter.
The scanning system in described scan laser source realizes the ring-type flying-spot scanner of laser at eyeball surface by the deflection of scan laser source internal mechanical element.
Described self adaptation navigation system is responsible for intelligent personalized operation real-time positioning is carried out at the eye pupil center, and its result delivers to controller.This self adaptation navigation system can be the commercial system that has the eye tracking technology, also software development voluntarily.Owing to be the cutting of flying spot formula equally, so can directly use the self adaptation location technology of existing Laser in Situ Keratomileusis.
Described controller is collected the feedback information of security parameter test macro, treatment effect test macro and self adaptation navigation system, with the real-time control eyeball speed of rotation.
Described security parameter test macro and treatment effect test macro carry out security parameter test and the test of treatment effect respectively, and its result delivers to controller.
Described security parameter test macro comprises hot camera, scopometer.
Hot camera in the described security parameter test macro is the ordinary hot camera, and purpose is that the test scan parameter can cause required corneal temperature (55 ° of C-65 ° of C, promptly can guarantee to condense and can not cause the temperature range of degeneration and damage) in what scope.If there is not ready-made hot camera, can substitute with two kinds of methods: a kind of method is the general digital camera that installs infrared filter additional, carry out postmortem analysis but so just can only obtain infrared photograph, and can't correspond to actual temp in real time intuitively, and resolution is lower; Another kind method is to use thermocouple temperature sensor to replace, and shortcoming is for invasive.
Turbidity in the described security parameter test macro is counted common scopometer, and purpose is that the test scan parameter can not cause the excessive turbidity of anterior corneal surface to rise in what scope.If there is not common scopometer, this partial function also can be realized via the change that detects the light scattering direction.Ultimate principle is to utilize a reference laser source after electronics (penetrating) beam splitter is drawn together bundle, focuses on again, shines anterior corneal surface at last, and it detects at the scattered light of the cornea front and rear surfaces light sensitive diode by two places.The reason that need carry out this measurement is: the astigmatism of human eye derives from corneal astigmatism and ophthalmic astigmatism two parts, and the former is the largest portion of a total astigmatism, comprises cornea front and back astigmatism; And the corneal astigmatism more complicated, be the major issue of judging the cornea refractive surgery effect.
Described treatment effect test macro comprises that corneal topography system, corrugated differ instrument.
Corneal topography system in the described treatment effect test macro is common corneal topography system, and purpose is the corneal curature variation amount after the test treatment.The full name of corneal topography is computer assisted corneal topography analytical system, and it is the pseudocolour picture that forms after the Computer Processing in fact, reflection full-shape film front surface curvature form.Its advantage is the corneal form to carry out real-time observation, therefore except can carrying out postoperative evaluation to the scanning type laser thermokeratoplasty result who decides parameter, also can in the operation process of scanning type laser thermokeratoplasty, constantly provide information, instruct the operation process in real time.
It is that common corrugated differs instrument that corrugated in the described treatment effect test macro differs instrument, and purpose is the degree of improvement that human eye dioptric system corrugated differed after test was treated.It is that Ray Of Light is injected ophthalmic that the corrugated differs instrument, return from retinal reflex then, actual direction that reflects from eyes by light relatively and the difference between the ideal orientation just can be measured eye and look totally differing of photosystem, and with the form demonstration of 3-D view.Human eye differs and is divided into two kinds of low order and high-orders, is not having under the interferential situation of low order aberration (referring to myopia, hypermetropia, astigmatism), and human eyesight also has only 1.0-2.0.If higher order aberratons (refer to coma, shadow dizzy etc.) is got rid of the human extraordinary vision that just can reach 3.0-4.0 in the lump.Perfect Wavefront aberration instrument can be measured low order simultaneously and differ with high-order and differ.Differ instrument about the corrugated, existing at present a lot of sophisticated business equipment.
During parameter test system safe in utilization, the laser beam of suitable wavelength (about 2.0 μ m) is sent by the scan laser source, converge via first order condenser lens and to be collimated light beam, focus on eyeball surface via second level condenser lens again, by the deflection of scan laser source internal mechanical element, realize the ring-type flying-spot scanner of laser at eyeball surface.Simultaneously, hot camera and scopometer are realized the real-time detection of security parameter.
When using treatment effect test macro, the laser beam of suitable wavelength (about 2.0 μ m) is sent by the scan laser source, converge via first order concentrating element and to be collimated light beam, focus on eyeball surface via second level concentrating element again, by the deflection of scan laser source internal mechanical element, realize the ring-type flying-spot scanner of laser at eyeball surface.Simultaneously, corneal topography system and corrugated differ the real-time detection that instrument is realized the treatment effect.
Hot camera, scopometer, corneal topography system, corrugated in security parameter test macro and the treatment effect test macro differs that instrument also can be worked simultaneously or selects as required, realizes corresponding monitoring function.
By the laser thermo keratoplasty operation that present embodiment carried out, astigmatic phenomenon can reduce, and effect is more stable, and predictability is more arranged, and accuracy is also higher.
Claims (10)
1, a kind of live body surgery systems of scanning type laser thermokeratoplasty, it is characterized in that, comprise: the scan laser source, the self adaptation navigation system, the security parameter test macro, treatment effect test macro, controller, along beam direction, human eye is directly aimed in the scan laser source, the self adaptation navigation system, the input of security parameter test macro and treatment effect test macro is all aimed at human eye, three's outfan all links to each other with the input of controller, the outfan of controller is connected to the scan laser source, wherein, the emission and the scanning of laser is responsible in the scan laser source, the self adaptation navigation system is responsible for the self adaptation location to the eye pupil center, the security parameter test macro is responsible for real-time detection to scanning type laser thermokeratoplasty security parameter to guarantee safety, treatment effect test macro is responsible for the real-time detection to the treatment effect of scanning type laser thermokeratoplasty under assurance safety prerequisite, and controller is responsible for feedback control; Laser is issued to the eye table via the scan laser source, realize the ring-type flying-spot scanner of laser at eyeball surface, the pupil center that launching position is determined with reference to the self adaptation navigation system in real time, carry out the real-time detection of security parameter by the security parameter test macro, and treat the real-time detection of effect by treatment effect test macro, the position offset information that both testing results detect with the self adaptation navigation system is collected feedback by controller together, is sent to the scan laser source with real-time control laser parameter.
2; the live body surgery systems of scanning type laser thermokeratoplasty according to claim 1; it is characterized in that; described scan laser source; comprise lasing light emitter and incidental focusing system thereof; cooling system and scanning system; directly realize the rotary scanning of laser; and directly realize the cooling protection of beams focusing optimization and device before the outgoing of laser emitting mouth at laser; the feedback control of the controlled device of laser parameter; lasing light emitter is responsible for the emission of laser beam; focusing system is responsible for the focusing of laser beam; cooling system is responsible for the cooling of laser beam, and scanning system is responsible for the scanning of laser beam, and scan laser source emitted laser bundle directly is mapped to eyeball surface.
3, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 2, it is characterized in that, the focusing system in described scan laser source, before laser emitting, just finish beams focusing, comprise first order concentrating element and second level concentrating element, first order concentrating element in the focusing system in described scan laser source is focused to directional light with divergent beams, and second level concentrating element further focuses on directional light on the cornea; By the focal length and the required cornea inner focusing degree of depth of laser thermal keratoplasty of second level concentrating element, determine the distance between second level concentrating element and the human eye then.
4, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 3 is characterized in that, described first order concentrating element and second level concentrating element are lens.
5, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 2, it is characterized in that, the scanning system in described scan laser source by the deflection of scan laser source internal mechanical element, realizes the ring-type flying-spot scanner of laser at eyeball surface.
6, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 2 is characterized in that, the lasing light emitter in described scan laser source is a laser instrument, launches the laser of 2.0 mum wavelengths.
7, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 1, it is characterized in that, described security parameter test macro comprises hot camera, scopometer, hot camera is responsible for the real-time detection of corneal tissue temperature, scopometer is responsible for the real-time detection that corneal is organized turbidity, hot camera is accepted the cornea tissue temperature information and is sent to controller, and scopometer is accepted cornea tissue turbidity information and is sent to controller.
8, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 7, it is characterized in that, hot camera in the described security parameter test macro is the ordinary hot camera, or installs the digital camera of infrared filter additional, or thermocouple temperature sensor.
9, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 1, it is characterized in that, described treatment effect test macro comprises that corneal topography system, corrugated differ instrument, corneal topography system is responsible for detecting in real time with corneal topography diagram form corneal diopter, the corrugated differs instrument and is responsible for differing form corneal diopter with the corrugated and detects in real time, corneal topography system shows information and is sent to controller that the corrugated differs instrument information is differed the form demonstration and is sent to controller with the corrugated with the corneal topography diagram form.
10, the live body surgery systems of scanning type laser thermokeratoplasty according to claim 7, it is characterized in that, described controller, collect the testing result of test macro with the test macro of treatment effect of security parameter, through with will adjust signal after the secure threshold of prior setting and treatment expected value are compared and deliver to the scan laser source, laser parameter is carried out feedback control, if hot camera detects the too high or scopometer of corneal temperature and detects corneal opacity degree and begin to rise, then controller feedback negative signal is to the scan laser source, make it reduce scanning rotating speed or reduction laser intensity, otherwise then improve the scanning rotating speed or increase laser intensity; Simultaneously, described controller is collected the testing result of self adaptation navigation system, through the laser scanning center with laser direction is adjusted signal after the cornea practical center is compared and delivers to the scan laser source, the laser direction parameter is carried out feedback control, if find laser scanning misalignment cornea practical center, then adjust beam direction so that both conform to again.
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| Application Number | Priority Date | Filing Date | Title |
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| CNB2006101188969A CN100479791C (en) | 2006-11-30 | 2006-11-30 | Intravital surgery system for scanning type laser operation of hot forming cornea |
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| Application Number | Priority Date | Filing Date | Title |
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| CNB2006101188969A CN100479791C (en) | 2006-11-30 | 2006-11-30 | Intravital surgery system for scanning type laser operation of hot forming cornea |
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| CN1957867A CN1957867A (en) | 2007-05-09 |
| CN100479791C true CN100479791C (en) | 2009-04-22 |
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| CNB2006101188969A Expired - Fee Related CN100479791C (en) | 2006-11-30 | 2006-11-30 | Intravital surgery system for scanning type laser operation of hot forming cornea |
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Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102481205B (en) * | 2009-12-07 | 2015-02-18 | 视乐有限公司 | Device for ophthalmic laser surgery |
| CN104873325B (en) * | 2015-05-21 | 2017-06-09 | 中国科学院光电研究院 | A kind of device and method for detecting corneal laser ablation threshold |
| CN105030413B (en) * | 2015-06-03 | 2017-03-22 | 中国科学院光电研究院 | Device for detecting laser cutting threshold value of cornea |
| ES2958658T3 (en) | 2017-10-13 | 2024-02-13 | Alcon Inc | Laser pulse modulation for corneal laser treatments |
| WO2020125435A1 (en) * | 2018-12-18 | 2020-06-25 | 深圳先进技术研究院 | Terahertz thermokeratoplasty system and method |
| CN109481142B (en) * | 2018-12-18 | 2023-08-22 | 深圳先进技术研究院 | Terahertz cornea thermal forming system and method |
| CN110507341A (en) * | 2019-08-27 | 2019-11-29 | 北京永新医疗设备有限公司 | Medical laser positioning system and image position method |
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2006
- 2006-11-30 CN CNB2006101188969A patent/CN100479791C/en not_active Expired - Fee Related
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