US20010001829A1 - Corneal surgical apparatus - Google Patents
Corneal surgical apparatus Download PDFInfo
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- US20010001829A1 US20010001829A1 US09/753,568 US75356801A US2001001829A1 US 20010001829 A1 US20010001829 A1 US 20010001829A1 US 75356801 A US75356801 A US 75356801A US 2001001829 A1 US2001001829 A1 US 2001001829A1
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- shaft
- transmitting member
- surgical apparatus
- central axis
- cornea
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
Definitions
- the present invention relates to a corneal surgical apparatus for incising the cornea of an eye of a patient in a layered form at the time of a keratorefrative surgery or the like.
- a LASIK surgery laser in situ keratomileusis
- a flap is formed by incising a portion with a thickness of about 0.15 mm from the corneal epithelium to the corneal stroma with a part of the cornea remaining connected like a hinge, ablating the corneal stroma in a refractive correction amount by an excimer laser light, and returning the flap to its original position.
- a corneal surgical apparatus called microkeratome is used for incising the cornea in a layered form.
- a corneal surgical apparatus one comprising a suction ring to be vacuum-fixed to a part of the cornea from a corneal ring portion to the surface of the conjunctiva, a cornea applanating member for applanating the cornea flatly, and a blade movable toward the hinge while being oscillated laterally so as to incise the flattened cornea into a layer form with a substantially uniform thickness, is known.
- FIG. 13A As a mechanism for the blade lateral oscillation, as shown in FIG. 13A, one comprising a rotation shaft 301 to be rotated by a driving device such as a motor, an eccentric pin 302 provided at the tip end of the shaft 301 , a transmitting member 304 having a vertical groove 303 to be engaged with the pin 302 is proposed.
- the transmitting member 304 having a blade 300 fixed thereto is held movably in the lateral direction (right and left direction, that is, the direction perpendicular to the paper surface in FIG. 13) in a receiving groove formed in a blade holder 305 and a holder block 306 .
- the displacement amount of the transmitting member 304 to be displaced vertically and laterally (in the up and down, and right and left directions) according to the circumferential movement of the pin 302 corresponds to the eccentric amount of the pin 302 , but as to the vertical direction, since the transmitting member 304 is held by the blade holder 305 and the holder block 306 in the vertical direction, the transmitting member 304 (and the blade 300 ) is displaced (vertical oscillation) for the gap with respect to each member.
- an object of the present invention is to provide a corneal surgical apparatus capable of forming a good flap by preventing “rampage” of a blade. Effects of the apparatus include efficient generation of lateral oscillation, restraint of the cost rise according to high accuracy of the mechanism, and high durability.
- the invention is characterized by the following features.
- a corneal surgical apparatus for incising a cornea of a patient's eye in a layered form comprising:
- a suction ring unit having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft;
- cornea applanating means that applanates the cornea within the opening into a substantially flat form
- a first oscillation transmitting member having a part with which the eccentric pin is engaged
- a second oscillation transmitting member having a part with which a part of the first oscillation transmitting member is engaged
- a holder that holds the first and second oscillation transmitting members to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft
- a corneal surgical apparatus according to (1), wherein the first oscillation transmitting member includes:
- the second oscillation transmitting member includes a pin receiving part with which the pin part of the first oscillation transmitting member is engaged.
- a corneal surgical apparatus wherein the first oscillation transmitting member includes a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion, and
- the holder includes a bearing part that rotatably supports the shaft part and that has a part with which the shaft part is engaged, the holder holding the first oscillation transmitting member to be rockable in the lateral direction.
- a corneal surgical apparatus wherein the shaft part of the first oscillation transmitting member includes two shaft parts respectively located on an upper part and a lower part of the first oscillation transmitting member, and
- the bearing part includes two bearing parts respectively supporting the two shaft parts.
- a corneal surgical apparatus according to (5), wherein the shaft part of the first oscillation transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
- a corneal surgical apparatus according to (1), wherein the eccentric pin is provided on an axis non-perpendicularly intersecting the rotational central axis of the shaft.
- a corneal surgical apparatus according to (1), further comprising:
- a corneal surgical apparatus according to (1), further comprising:
- a corneal surgical apparatus for incising a cornea of a patient's eye in a layered form comprising:
- a suction ring unit having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft;
- cornea applanating means that applanates the cornea within the opening into a substantially flat form
- a rock transmitting member having a part with which the eccentric pin is engaged and a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion;
- a holder that holds the rock transmitting members to be rockable in a lateral direction which is perpendicular to the rotational central axis of the shaft, the holder having a bearing part rotatably supporting the shaft part of the rock transmitting member, the bearing part having a part with which the shaft part is engaged,
- a corneal surgical apparatus according to (14), wherein the shaft part of the rock transmitting member includes two shaft parts respectively located on an upper part and a lower part of the rock transmitting member, and
- the bearing part includes two bearing parts respectively supporting the two shaft parts.
- a corneal surgical apparatus according to (14), wherein the shaft part of the rock transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
- a corneal surgical apparatus according to (16), wherein the rotational central axis of the shaft part of the rock transmitting member perpendicularly intersects the rotational central axis of the shaft.
- a corneal surgical apparatus according to (17), wherein the eccentric pin is provided on an axis passing through an intersecting point at which the rotational central axis of the shaft part intersects the rotational central axis of the shaft.
- a corneal surgical apparatus according to (14), further comprising:
- a corneal surgical apparatus according to (14), further comprising:
- a corneal surgical apparatus for incising a cornea of a patient's eye in a layered form comprising:
- a suction ring unit having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being provided on an axis non-parallel to and non-perpendicular to a rotational central axis of the shaft;
- cornea applanating means that applanates the cornea within the opening into a substantially flat form
- a holder that holds the transmitting member to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft
- a corneal surgical apparatus according to (22), further comprising:
- a corneal surgical apparatus according to (22), further comprising:
- FIG. 1 is a cross-sectional view of an apparatus according to a first embodiment and a schematic diagram of a control system.
- FIG. 2 is an enlarged explanatory diagram of a cutting unit and a suction unit of the apparatus according to the first embodiment.
- FIG. 3 is a cross-sectional view taken on the line A-A of FIG. 2, illustrating the cutting unit of the apparatus according to the first embodiment.
- FIG. 4 is a cross-sectional view taken on the line B-B of FIG. 2, illustrating the cutting unit of the apparatus according to the first embodiment.
- FIGS. 5A and 5B are explanatory diagrams for the movement of two oscillation transmitting members and a blade in the apparatus according to the first embodiment.
- FIG. 6 is an explanatory diagram for the difference of the blade positions in the conventional apparatus and the apparatus according to the first embodiment.
- FIG. 7 is a diagram of a modified embodiment of the cutting unit of the apparatus according to the first embodiment.
- FIG. 8 is a cross-sectional view of an apparatus according to a second embodiment and a schematic diagram of a control system.
- FIG. 9 is an enlarged explanatory diagram of a cutting unit and a suction unit of the apparatus according to the second embodiment.
- FIG. 10 is a cross-sectional view taken on the line C-C of FIG. 9, illustrating the cutting unit of the apparatus according to the second embodiment.
- FIG. 11 is an explanatory diagram for conversion of the motion in the apparatus according to the second embodiment.
- FIG. 12 is a diagram of a modified embodiment of the cutting unit of the apparatus according to the second embodiment.
- FIGS. 13A and 13B are explanatory diagrams for the configuration of a cutting unit, and the movement of a transmitting member and a blade in a conventional mechanism.
- FIG. 1 is a cross-sectional view of a corneal surgical apparatus according to a first embodiment and a schematic diagram of a control system.
- Reference numeral 1 denotes a main body of the apparatus, and numeral 1 a denotes a grip portion to be held by an operator during a surgery.
- a suction unit 3 for fixation to the patient's eye, and a cutting unit 2 having a blade 20 for incising the cornea, to be moved rectilinearly above the suction unit 3 are provided on the front side (left side in the figure) of the main body 1 .
- a feed motor 11 for rectilinearly moving the cutting unit 2 in the incising direction is fixed in the main body 1 , with a feed screw 13 having a threaded portion corresponding in length to the rectilinear movement of the cutting unit 2 , attached to the rotation shaft of the motor 11 .
- An oscillating motor 12 for imparting lateral oscillation to the blade, and a connecting member 17 to be connected with the cutting unit 2 at its tip portion are fixed to an attaching member 14 to be screwed into the threaded portion of the screw 13 .
- a rotation shaft 15 mounted on the rotation shaft of the motor 12 is held by the connecting member 17 rotatably.
- An eccentric pin 16 is embedded on the tip of the shaft 15 at a position offset from the rotation center (rotation central axis), projecting therefrom.
- the cutting unit 2 moves forward or backward with the motor 12 and the connecting member 17 mounted on the attaching member 14 according to the forward or reverse rotation of the motor 11 .
- FIG. 2 is an enlarged explanatory diagram of the cutting unit 2 and the suction unit 3 of the apparatus according to the first embodiment.
- FIG. 3 is a cross-sectional view taken on the line A-A of FIG. 2
- FIG. 4 is a cross-sectional view taken on the line B-B of FIG. 2.
- the cutting unit 2 comprises the blade 20 , a blade holder 21 a, a holder block 21 b, a first oscillation transmitting member 22 , and a second oscillation transmitting member 23 .
- a rotation hole in which the shaft 15 is inserted is provided in the holder block 21 b so that the tip portion of the connecting member 17 is fixed thereto.
- a metal blade having a blade edge of stainless steel, or steel, or an ore blade having a blade edge of diamond or sapphire is used as the blade 20 .
- the blade 20 is held between the blade holder 21 a and the holder block 21 b laterally oscillatably with an appropriate angle with respect to the horizontal plane.
- a shallow recess 210 a is formed at a portion, where the blade 20 is to be placed, at the blade holder 21 a side.
- the lateral width of the recess 210 a is provided larger than the oscillation width of the lateral oscillation of the blade 20 .
- the first transmitting member 22 is held laterally movably in an oscillating space 210 c formed in the holder block 21 b. Further, a vertical groove 22 a to be engaged with the pin 16 is formed in the first transmitting member 22 .
- a lateral force is applied to the first transmitting member 22 according to the circumferential movement of the pin 16 engaged with the vertical groove 22 a. Accordingly, the first transmitting member 22 oscillates laterally.
- the second transmitting member 23 is held laterally movably in an oscillating space 210 b formed in the holder block 21 b. Further, a vertical groove 23 a to be engaged with a pin part 22 b provided below the first transmitting member 22 is formed in the second transmitting member 23 .
- the first transmitting member 22 is oscillated laterally by the rotation of the shaft 15 (circumferential movement of the pin 16 )
- the lateral oscillation provides a lateral force to the second transmitting member 23 via the pin part 22 b and the vertical groove 23 a. Accordingly, the second transmitting member 23 oscillates laterally, and further, the blade 20 fixed to the second transmitting member 23 oscillates laterally as well.
- the first transmitting member 22 moves reciprocally in the lateral direction (X direction) (this will be referred to as a first lateral oscillation) as well as moves reciprocally in the vertical direction (Y direction) (this will be referred to as a first vertical oscillation) according to the circumferential movement of the pin 16 according to the rotation of the shaft 15 (according to split of the force generated by the circumferential movement of the pin 16 into the pushing force for pushing the side surface of the vertical groove 22 a and the friction force functioning in the vertical direction on the side surface of the vertical groove 22 a ) as shown in FIG. 5A.
- the dashed line D 1 in the figure denotes the locus of the movement of the point P, which is the center of the pin part 22 b.
- the second transmitting member 23 moves reciprocally in the lateral direction (X direction) (this will be referred to as a second lateral oscillation) as well as slightly moves reciprocally in the vertical direction (Y direction) (this will be referred to as a second vertical oscillation) according to the movement of the pin part 22 b of the first transmitting member 22 as shown in FIG. 5B.
- the dashed line D 2 in the figure denotes the locus of the movement of the point Q, which is the center of the blade 20 .
- the displacement amount in the lateral direction according to the first vertical oscillation is based on the distance of the gap between the first transmitting member 22 and the holder block 21 b.
- the displacement amount in the vertical direction according to the second vertical oscillation is much smaller than that of the first vertical oscillation because the circumferential movement of the pin 16 is converted to the first lateral oscillation already, thereby generating the second lateral oscillation (the displacement amount in the lateral direction of the first lateral oscillation and the second lateral oscillation is same, and it corresponds to the eccentric amount of the pin 16 ).
- the displacement amount difference in the vertical direction according to the second vertical oscillation derived from the gap at the time of generating the first lateral oscillation and the gap at the time of generating the second vertical oscillation is small because the displacement amount itself is extremely small.
- the locus D 2 has a smaller displacement amount in the vertical direction compared with the locus D 1 . That is, the second transmitting member 23 has a smaller displacement amount in the vertical oscillation at the time of the lateral oscillation with respect to the first transmitting member 22 . Accordingly, the “rampage” can be restrained at the time of the lateral oscillation.
- the second transmitting member 23 can be made smaller than the conventional transmitting member 404 (see FIG. 7). Accordingly, the rotation torque applied on the blade 20 is smaller than the conventional configuration, and thus the blade 20 can efficiently be oscillated laterally so that the “rampage” can be smaller.
- a cornea applanating part 24 is fixed to the holder block 21 b by an attaching member 24 a so as to be provided on the front side (left side in the figure) of the blade 20 .
- the cornea applanating part 24 moves according to the movement of the cutting unit 2 for applanating the cornea of the patient's eye flatly preceding incision with the blade 20 . Since the blade 20 incises the cornea thus applanated flatly by the applanating part 24 , a flap of a uniform layer is formed.
- the distance between the edge of the blade 20 attached to the blade holder 21 a and the lower surface of the applanating part 24 is about 150 ⁇ m so that the cornea can be incised with this thickness in a layered form.
- the suction unit 3 comprises a fixing member 30 , a suction ring 31 , and a suction pipe 32 .
- the suction ring 31 is fixed to the main body 1 by the fixing member 30 .
- the suction ring 31 having a substantially cylindrical shape with a U-shaped cross-section, comprises a circular recess 31 a to be contacted with the patient's eye and an opening 31 b concentric with the recess 31 a.
- the cornea of the patient's eye projects upward from the opening 31 b so that the lower end portion of the suction ring 31 and the opening end portion of the opening 31 b are contacted so as to provide a space S for suction.
- the suction pipe 32 is embedded in the suction ring 31 , and connected with a vacuum tube (not illustrated) elongating to a pump 41 .
- a suction path 32 a provided inside the suction pipe 32 communicates with the recess 31 a.
- the suction ring 31 is vacuum-fixed to the patient's eye. In this fixation, as the operator holds the grip portion 1 a, positioning of the opening 31 b can be facilitated, and the apparatus can be held stably.
- a pipe for pressure detection (not illustrated) is embedded in the suction ring 31 at a position facing to the suction pipe 32 .
- the pipe for pressure detection is connected with a pressure detector 33 via a tube (not illustrated).
- the pressure detector 33 detects the air pressure in the space S sucked by the pump 41 via the pipe for pressure detection.
- a control unit 40 controls the operation of the motor 11 , the motor 12 , and the pump 41 based on the air pressure detected by the pressure detector 33 .
- the operator After installation of the suction ring 31 , the operator operates the pump 41 so as to suck the air in the space S between the suction ring 31 and the patient's eye while keeping the position and the posture of the main body 1 for thereby reducing the air pressure (to the negative pressure).
- the air pressure in the space S is reduced to a certain value (when it reaches a sufficiently negative pressure)
- the operation of the pump 41 is controlled by the control unit 40 so as to maintain the air pressure. Accordingly, the suction ring 31 is vacuum-fixed onto the patient's eye.
- the operator After completion of the fixation of the apparatus, the operator operates a foot switch 42 for rotation drive of the motor 11 and the motor 12 .
- the control unit 40 controls for rotation drive of the motor 11 and the motor 12 .
- the control unit 40 controls the drive of the motor 12 by the input of a drive command signal by the foot switch 42 so as to oscillate the blade 20 laterally by a fixed or variable oscillation frequency.
- the control unit 40 controls the rotation of the motor 11 according to a fixed or variable feeding speed so as to rectilinearly move the cutting section 2 in the hinge direction.
- the shaft 15 slides in the advancing direction integrally with the cutting unit 2 while making a rotational motion for imparting lateral oscillation to the blade 20 .
- the motor 11 is rotated reversely so as to return the cutting unit 2 to its initial position.
- the rotation of the motor 12 is stopped according to the independent control of the motors so that the blade 20 can be taken out from the flap while avoiding the unnecessary oscillation of the blade 20 . Accordingly, the possibility of cut off of the thus formed flap can be reduced.
- the first transmitting member 22 comprising the vertical groove 22 a to be engaged with the pin 16 and the pin part 22 b
- the second transmitting member 23 comprising the vertical groove 23 a to be engaged with the pin part 22 b of the first transmitting member 22
- the blade 20 is fixed to the second transmitting member 23
- the blade is fixed to the third transmitting member. That is, although the rotation of the rotation shaft is converted to the lateral oscillation of the blade by the conversion by twice, but the conversion needs to be at least twice and can be increased to three times or four times.
- FIG. 8 is a cross-sectional view of an apparatus according to the second embodiment and a schematic diagram of a control system.
- FIG. 9 is an enlarged cross-sectional view of a cutting unit 2 and a suction unit 3 .
- FIG. 10 is a cross-sectional view taken on the line C-C of FIG. 9. The same numerals are applied to the same components as in the first embodiment.
- the cutting unit 2 comprises the blade 20 , the blade holder 21 a, the holder block 21 b, a bearing part 21 c, a rock (swing) transmitting member 25 , and a lateral oscillation transmitting member 26 .
- a rotation hole in which the shaft 15 is inserted is provided in the blade holder 21 a so that the tip portion of the connected member 17 is fixed thereto.
- the rock transmitting member 25 is pivoted by the holder block 21 b and the bearing part 21 c rotatably (rockably) with two upper and lower rotation shaft parts 25 c as the rotation central axes in the oscillation space 210 c formed in the holder block 21 b (that is, the rock transmitting member 25 is pivoted rockably in the lateral direction, centering the axial line L elongating in the vertical direction). Further, a vertical groove 25 a to be engaged with the pin 16 is formed in the rock transmitting member 25 .
- the shaft 15 is rotated according to the rotation drive of the motor 12 , a force in the lateral direction is applied on the rock transmitting member 25 by the circumferential movement of the pin 16 engaged with the vertical groove 25 a. Accordingly the rock transmitting member 25 is rocked.
- the lateral oscillation transmitting member 26 is held movably in the lateral direction in the oscillation space 210 b formed in the holder block 21 b.
- a pin receiving part 26 a to be engaged with the a pin part 25 b provided at a lower portion of the rock transmitting member 25 is formed in the lateral oscillation transmitting member 26 .
- the projecting portion of the pin 16 provided eccentrically in the shaft 15 moves circumferentially, centering the rotation central axis of the shaft 15 .
- the force generated by the circumferential movement of the pin 16 can be split in the vertical and lateral directions, that is, the force in the vertical direction functioning on the side surface of the vertical groove 25 a in the up and down direction as the friction force, and the force in the lateral direction pushing the side surface of the vertical groove 25 a in the lateral direction as the pushing force.
- the rock transmitting member 25 rocks with the shaft parts 25 c as the rotation center.
- the pin part 25 b formed in the lower portion thereof is rocked in the lateral direction with substantially no displacement in the vertical direction. Since the pin part 25 b rocking in the lateral direction applies a force on the side surface of the pin receiving part 26 a, the lateral oscillation transmitting member 26 oscillates in the lateral direction with the oscillation space 210 b as the guide. At the time, by providing a substantially spherical tip end shape to the pin part 25 b, a force can be applied efficiently to the pin receiving part 26 a so that the lateral oscillation can be provided smoothly. Since the blade 20 is fixed to the lateral oscillation transmitting member 26 , it oscillates according to the lateral oscillation of the lateral oscillation transmitting member 26 .
- the pin 16 can be attached to the shaft 15 , elongating parallel in the rotation central axis direction of the shaft 15 (as in the conventional apparatus shown in FIG. 13A), but the pin 16 is provided tilting with respect to the rotation central axis direction of the shaft 15 in this embodiment. That is, the pin 16 is provided eccentrically, elongating passing through the intersection of the axial line L passing through the rotation center of the rock of the rock transmitting member 25 and the rotation central axis of the shaft 15 .
- the rocking angle of the pin 16 in the lateral direction and the rocking angle of the rock transmitting member 25 in the lateral direction coincide, the contacting property of the pin 16 engaged with the vertical groove 25 a is improved and thus the rotational motion can be converted smoothly and efficiently to the lateral rock.
- the shape of the vertical groove 25 a and the tip end portion shape of the pin 16 to be engaged therewith can be a simple shape (linear shape) so that the production of components can be facilitated.
- rock of the pin part 25 b is converted to the linear lateral oscillation of the lateral oscillation transmitting member 26 in this embodiment, it is also possible to fix the pin part 25 b and the lateral oscillation transmitting member 26 , rock the lateral oscillation transmitting member 25 , and have arc-like oscillation of the blade 20 . Moreover, as shown in FIG. 12, the rock transmitting member 25 can be eliminated.
- the rock transmitting member 25 needs to rock with oscillation with a lateral direction component for oscillating the blade 20 in the lateral direction, and therefor, the axial line L to be the center of the rock should be provided at a position offset from the rotation central axis of the shaft 15 .
- the axial line L to be the center of the rock is in the same plane as the rotation central axis of the shaft 15 , and further, it is preferable that the axial line L as the rocking center is disposed in the plane in the vertical direction passing through the rotation central axis of the shaft 15 with respect to the lateral direction for oscillating the blade 20 , and the rock transmitting member 25 is rocked with the axial line L as the center.
- the conversion efficiency of the oscillation in the lateral direction can be most efficient by providing the axial line L orthogonal to the rotation central axis of the shaft 15 as in this embodiment.
- the vertical groove 25 a formed in the rock transmitting member 25 can be provided at the grip portion 1 a side with respect tot he rotation center of the shaft parts 25 c. Furthermore, by changing the distance of the vertical groove 25 a and the distance of the pin 25 b from the rotation center of the shaft parts 25 c, respectively, the width of the lateral oscillation of the blade 20 with respect to the eccentric amount of the pin 16 can be adjusted freely (it is also possible to enlarge the oscillation width with a small eccentric amount).
- a good flap can be formed by preventing the “rampage” of the blade.
- the lateral oscillation of the blade can be generated efficiently, the cost rise according to the high accuracy of the mechanism can be restrained, and the durability of the mechanism is improved so as to prolong the life cycle.
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Abstract
A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form includes: a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea; a rotatable shaft; an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft; and a cutting unit movable in an incising direction above the suction ring unit. The cutting unit including: cornea applanating means that applanates the cornea within the opening into a substantially flat form; a blade that incises the cornea; a first oscillation transmitting member having a part with which the eccentric pin is engaged; a second oscillation transmitting member having a part with which a part of the first oscillation transmitting member is engaged; and a holder that holds the first and second oscillation transmitting members to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft. Movement of the second oscillation transmitting member in the lateral direction causes the blade to be moved in the same direction.
Description
- 1. Field of the Invention
- The present invention relates to a corneal surgical apparatus for incising the cornea of an eye of a patient in a layered form at the time of a keratorefrative surgery or the like.
- 2. Description of the Related Art
- In recent years, attention has been focused on a LASIK surgery (laser in situ keratomileusis) for the keratorefractive surgery wherein a flap is formed by incising a portion with a thickness of about 0.15 mm from the corneal epithelium to the corneal stroma with a part of the cornea remaining connected like a hinge, ablating the corneal stroma in a refractive correction amount by an excimer laser light, and returning the flap to its original position. In the LASIK surgery, a corneal surgical apparatus called microkeratome is used for incising the cornea in a layered form.
- As a corneal surgical apparatus, one comprising a suction ring to be vacuum-fixed to a part of the cornea from a corneal ring portion to the surface of the conjunctiva, a cornea applanating member for applanating the cornea flatly, and a blade movable toward the hinge while being oscillated laterally so as to incise the flattened cornea into a layer form with a substantially uniform thickness, is known.
- As a mechanism for the blade lateral oscillation, as shown in FIG. 13A, one comprising a
rotation shaft 301 to be rotated by a driving device such as a motor, aneccentric pin 302 provided at the tip end of theshaft 301, a transmittingmember 304 having avertical groove 303 to be engaged with thepin 302 is proposed. The transmittingmember 304 having ablade 300 fixed thereto is held movably in the lateral direction (right and left direction, that is, the direction perpendicular to the paper surface in FIG. 13) in a receiving groove formed in ablade holder 305 and aholder block 306. When theshaft 301 is rotated by drive of the motor, force is applied on the transmittingmember 304 in the lateral direction according to the circumferential movement (circular motion) of thepin 302 engaged with thevertical groove 303. Accordingly, the transmittingmember 304 oscillated laterally (moved in the right and left direction), and further, theblade 300 fixed to the transmittingmember 304 is oscillated laterally as well. - However, according to the conventional mechanism, as shown in FIG. 13B, by the circumferential movement of the
pin 302, not only the force in the lateral direction but also force in the vertical direction (up and down direction) is applied to the transmittingmember 304. That is, since thepin 302 with the circumferential movement comes in contact with the wall of thevertical groove 303 so that force is applied on the transmittingmember 304 in the vertical direction due to the friction force generated by the contact, the transmittingmember 304 is oscillated laterally while being moved also in the vertical direction. Therefore, if theshaft 301 is rotated at a high speed, the transmittingmember 304 and theblade 300 generate vertical oscillation (up and down movement) called “rampage” in addition to the lateral oscillation. - The “rampage” hinders stable incision as well as generates a loss in terms of the efficiency of converting the rotational motion to the lateral oscillation. Moreover, since the corner part of the transmitting
member 304 is contacted with ablade holder 305 and theholder block 306 frequently so as to be applied with a large force, the parts are worn out rapidly so that the life cycle thereof is shortened. - The displacement amount of the transmitting
member 304 to be displaced vertically and laterally (in the up and down, and right and left directions) according to the circumferential movement of thepin 302 corresponds to the eccentric amount of thepin 302, but as to the vertical direction, since the transmittingmember 304 is held by theblade holder 305 and theholder block 306 in the vertical direction, the transmitting member 304 (and the blade 300) is displaced (vertical oscillation) for the gap with respect to each member. Therefore, accurate production without a gap among the transmittingmember 304, theblade holder 305 and theholder block 306 would prevent the vertical oscillation (that is, “rampage”), however, much labor is required for meeting the demand particularly in mass production so as to increase the cost. - In view of the above-mentioned problems, an object of the present invention is to provide a corneal surgical apparatus capable of forming a good flap by preventing “rampage” of a blade. Effects of the apparatus include efficient generation of lateral oscillation, restraint of the cost rise according to high accuracy of the mechanism, and high durability.
- In order to solve the above-mentioned problems, the invention is characterized by the following features.
- (1) A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
- a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
- a rotatable shaft;
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft; and
- a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
- cornea applanating means that applanates the cornea within the opening into a substantially flat form;
- a blade that incises the cornea;
- a first oscillation transmitting member having a part with which the eccentric pin is engaged;
- a second oscillation transmitting member having a part with which a part of the first oscillation transmitting member is engaged; and
- a holder that holds the first and second oscillation transmitting members to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft,
- wherein movement of the second oscillation transmitting member in the lateral direction causes the blade to be moved in the same direction.
- (2) A corneal surgical apparatus according to (1), wherein the blade is fixed to the second oscillation transmitting member.
- (3) A corneal surgical apparatus according to (1), wherein the first oscillation transmitting member includes:
- a vertical groove elongating in a direction perpendicular to both of the lateral direction and the rotational central axis of the shaft, the eccentric pin being engaged with the vertical groove; and
- a pin part extending toward the second oscillation transmitting member;
- wherein the second oscillation transmitting member includes a pin receiving part with which the pin part of the first oscillation transmitting member is engaged.
- (4) A corneal surgical apparatus according to (1), wherein the holder holds the first and second oscillation transmitting member to be movable linearly in the lateral direction.
- (5) A corneal surgical apparatus according to (1), wherein the first oscillation transmitting member includes a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion, and
- wherein the holder includes a bearing part that rotatably supports the shaft part and that has a part with which the shaft part is engaged, the holder holding the first oscillation transmitting member to be rockable in the lateral direction.
- (6) A corneal surgical apparatus according to (5), wherein the holder holds the second oscillation transmitting member to be movable linearly in the lateral direction.
- (7) A corneal surgical apparatus according to (5), wherein the shaft part of the first oscillation transmitting member includes two shaft parts respectively located on an upper part and a lower part of the first oscillation transmitting member, and
- wherein the bearing part includes two bearing parts respectively supporting the two shaft parts.
- (8) A corneal surgical apparatus according to (5), wherein the shaft part of the first oscillation transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
- (9) A corneal surgical apparatus according to (8), wherein the rotational central axis of the shaft part of the first oscillation transmitting member intersects the rotational central axis of the shaft perpendicularly.
- (10) A corneal surgical apparatus according to (9), wherein the eccentric pin is provided on an axis passing through an intersecting point at which the rotational central axis of the shaft part intersects the rotational central axis of the shaft.
- (11) A corneal surgical apparatus according to (1), wherein the eccentric pin is provided on an axis non-perpendicularly intersecting the rotational central axis of the shaft.
- (12) A corneal surgical apparatus according to (1), further comprising:
- a drive unit that rotates the shaft.
- (13) A corneal surgical apparatus according to (1), further comprising:
- a drive unit that moves the cutting unit in the incising direction.
- (14) A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
- a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
- a rotatable shaft;
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft; and
- a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
- cornea applanating means that applanates the cornea within the opening into a substantially flat form;
- a blade that incises the cornea;
- a rock transmitting member having a part with which the eccentric pin is engaged and a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion; and
- a holder that holds the rock transmitting members to be rockable in a lateral direction which is perpendicular to the rotational central axis of the shaft, the holder having a bearing part rotatably supporting the shaft part of the rock transmitting member, the bearing part having a part with which the shaft part is engaged,
- wherein movement of the rock transmitting member in the lateral direction causes the blade to be moved in the same direction.
- (15) A corneal surgical apparatus according to (14), wherein the shaft part of the rock transmitting member includes two shaft parts respectively located on an upper part and a lower part of the rock transmitting member, and
- wherein the bearing part includes two bearing parts respectively supporting the two shaft parts.
- (16) A corneal surgical apparatus according to (14), wherein the shaft part of the rock transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
- (17) A corneal surgical apparatus according to (16), wherein the rotational central axis of the shaft part of the rock transmitting member perpendicularly intersects the rotational central axis of the shaft.
- (18) A corneal surgical apparatus according to (17), wherein the eccentric pin is provided on an axis passing through an intersecting point at which the rotational central axis of the shaft part intersects the rotational central axis of the shaft.
- (19) A corneal surgical apparatus according to (14), wherein the eccentric pin is provided on an axis which non-perpendicularly intersects the rotational central axis of the shaft.
- (20) A corneal surgical apparatus according to (14), further comprising:
- a drive unit that rotates the shaft.
- (21) A corneal surgical apparatus according to (14), further comprising:
- a drive unit that moves the cutting unit in the incising direction.
- (22) A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
- a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
- a rotatable shaft;
- an eccentric pin projecting from a distal end of the shaft, the eccentric pin being provided on an axis non-parallel to and non-perpendicular to a rotational central axis of the shaft; and
- a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
- cornea applanating means that applanates the cornea within the opening into a substantially flat form;
- a blade that incises the cornea;
- a transmitting member having a part with which the eccentric pin is engaged; and
- a holder that holds the transmitting member to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft,
- wherein movement of the transmitting member in the lateral direction causes the blade to be moved in the same direction.
- (23) A corneal surgical apparatus according to (22), wherein the eccentric pin is provided on an axis that non-perpendicularly intersects the rotational central axis of the shaft.
- (24) A corneal surgical apparatus according to (22), further comprising:
- a drive unit that rotates the shaft.
- (25) A corneal surgical apparatus according to (22), further comprising:
- a drive unit that moves the cutting unit in the incising direction.
- The present disclosure relates to the subject matter contained in Japanese patent application Nos. Hei. 11-55696 (filed on Mar. 3, 1999) and Hei. 11-90337 (filed on Mar. 31, 1999), which are expressly incorporated herein by reference in their entireties.
- FIG. 1 is a cross-sectional view of an apparatus according to a first embodiment and a schematic diagram of a control system.
- FIG. 2 is an enlarged explanatory diagram of a cutting unit and a suction unit of the apparatus according to the first embodiment.
- FIG. 3 is a cross-sectional view taken on the line A-A of FIG. 2, illustrating the cutting unit of the apparatus according to the first embodiment.
- FIG. 4 is a cross-sectional view taken on the line B-B of FIG. 2, illustrating the cutting unit of the apparatus according to the first embodiment.
- FIGS. 5A and 5B are explanatory diagrams for the movement of two oscillation transmitting members and a blade in the apparatus according to the first embodiment.
- FIG. 6 is an explanatory diagram for the difference of the blade positions in the conventional apparatus and the apparatus according to the first embodiment.
- FIG. 7 is a diagram of a modified embodiment of the cutting unit of the apparatus according to the first embodiment.
- FIG. 8 is a cross-sectional view of an apparatus according to a second embodiment and a schematic diagram of a control system.
- FIG. 9 is an enlarged explanatory diagram of a cutting unit and a suction unit of the apparatus according to the second embodiment.
- FIG. 10 is a cross-sectional view taken on the line C-C of FIG. 9, illustrating the cutting unit of the apparatus according to the second embodiment.
- FIG. 11 is an explanatory diagram for conversion of the motion in the apparatus according to the second embodiment.
- FIG. 12 is a diagram of a modified embodiment of the cutting unit of the apparatus according to the second embodiment.
- FIGS. 13A and 13B are explanatory diagrams for the configuration of a cutting unit, and the movement of a transmitting member and a blade in a conventional mechanism.
- Hereinafter an embodiment of the invention will be explained with reference to the drawings. FIG. 1 is a cross-sectional view of a corneal surgical apparatus according to a first embodiment and a schematic diagram of a control system.
- Reference numeral1 denotes a main body of the apparatus, and numeral 1 a denotes a grip portion to be held by an operator during a surgery. A
suction unit 3 for fixation to the patient's eye, and acutting unit 2 having ablade 20 for incising the cornea, to be moved rectilinearly above thesuction unit 3 are provided on the front side (left side in the figure) of the main body 1. - A
feed motor 11 for rectilinearly moving thecutting unit 2 in the incising direction is fixed in the main body 1, with afeed screw 13 having a threaded portion corresponding in length to the rectilinear movement of thecutting unit 2, attached to the rotation shaft of themotor 11. Anoscillating motor 12 for imparting lateral oscillation to the blade, and a connectingmember 17 to be connected with thecutting unit 2 at its tip portion are fixed to an attachingmember 14 to be screwed into the threaded portion of thescrew 13. Arotation shaft 15 mounted on the rotation shaft of themotor 12 is held by the connectingmember 17 rotatably. Aneccentric pin 16 is embedded on the tip of theshaft 15 at a position offset from the rotation center (rotation central axis), projecting therefrom. Thecutting unit 2 moves forward or backward with themotor 12 and the connectingmember 17 mounted on the attachingmember 14 according to the forward or reverse rotation of themotor 11. - Next, the configuration of the
cutting unit 2 and thesuction unit 3 will be explained with reference to FIGS. 2, 3 and 4. FIG. 2 is an enlarged explanatory diagram of thecutting unit 2 and thesuction unit 3 of the apparatus according to the first embodiment. FIG. 3 is a cross-sectional view taken on the line A-A of FIG. 2, and FIG. 4 is a cross-sectional view taken on the line B-B of FIG. 2. - The
cutting unit 2 comprises theblade 20, ablade holder 21 a, aholder block 21 b, a firstoscillation transmitting member 22, and a secondoscillation transmitting member 23. A rotation hole in which theshaft 15 is inserted is provided in theholder block 21 b so that the tip portion of the connectingmember 17 is fixed thereto. - A metal blade having a blade edge of stainless steel, or steel, or an ore blade having a blade edge of diamond or sapphire is used as the
blade 20. Theblade 20 is held between theblade holder 21 a and theholder block 21 b laterally oscillatably with an appropriate angle with respect to the horizontal plane. Ashallow recess 210 a is formed at a portion, where theblade 20 is to be placed, at theblade holder 21 a side. The lateral width of therecess 210 a is provided larger than the oscillation width of the lateral oscillation of theblade 20. - The first transmitting
member 22 is held laterally movably in anoscillating space 210 c formed in theholder block 21 b. Further, avertical groove 22 a to be engaged with thepin 16 is formed in the first transmittingmember 22. When theshaft 15 is rotated by the rotation drive of themotor 12, a lateral force is applied to the first transmittingmember 22 according to the circumferential movement of thepin 16 engaged with thevertical groove 22 a. Accordingly, the first transmittingmember 22 oscillates laterally. - The second transmitting
member 23 is held laterally movably in anoscillating space 210 b formed in theholder block 21 b. Further, avertical groove 23 a to be engaged with apin part 22 b provided below the first transmittingmember 22 is formed in the second transmittingmember 23. When the first transmittingmember 22 is oscillated laterally by the rotation of the shaft 15 (circumferential movement of the pin 16), the lateral oscillation provides a lateral force to the second transmittingmember 23 via thepin part 22 b and thevertical groove 23 a. Accordingly, the second transmittingmember 23 oscillates laterally, and further, theblade 20 fixed to the second transmittingmember 23 oscillates laterally as well. - The movement of the first transmitting
member 22, the second transmittingmember 23, and theblade 20 will be explained with reference to FIGS. 5A and 5B. - The first transmitting
member 22 moves reciprocally in the lateral direction (X direction) (this will be referred to as a first lateral oscillation) as well as moves reciprocally in the vertical direction (Y direction) (this will be referred to as a first vertical oscillation) according to the circumferential movement of thepin 16 according to the rotation of the shaft 15 (according to split of the force generated by the circumferential movement of thepin 16 into the pushing force for pushing the side surface of thevertical groove 22 a and the friction force functioning in the vertical direction on the side surface of thevertical groove 22 a) as shown in FIG. 5A. The dashed line D1 in the figure denotes the locus of the movement of the point P, which is the center of thepin part 22 b. - The second transmitting
member 23 moves reciprocally in the lateral direction (X direction) (this will be referred to as a second lateral oscillation) as well as slightly moves reciprocally in the vertical direction (Y direction) (this will be referred to as a second vertical oscillation) according to the movement of thepin part 22 b of the first transmittingmember 22 as shown in FIG. 5B. The dashed line D2 in the figure denotes the locus of the movement of the point Q, which is the center of theblade 20. - The displacement amount in the lateral direction according to the first vertical oscillation is based on the distance of the gap between the first transmitting
member 22 and theholder block 21 b. In contrast, the displacement amount in the vertical direction according to the second vertical oscillation is much smaller than that of the first vertical oscillation because the circumferential movement of thepin 16 is converted to the first lateral oscillation already, thereby generating the second lateral oscillation (the displacement amount in the lateral direction of the first lateral oscillation and the second lateral oscillation is same, and it corresponds to the eccentric amount of the pin 16). Moreover, the displacement amount difference in the vertical direction according to the second vertical oscillation derived from the gap at the time of generating the first lateral oscillation and the gap at the time of generating the second vertical oscillation is small because the displacement amount itself is extremely small. - As mentioned above, the locus D2 has a smaller displacement amount in the vertical direction compared with the locus D1. That is, the second transmitting
member 23 has a smaller displacement amount in the vertical oscillation at the time of the lateral oscillation with respect to the first transmittingmember 22. Accordingly, the “rampage” can be restrained at the time of the lateral oscillation. - Furthermore, as shown in FIG. 6, according to the conventional apparatus configuration, the position of a
blade 400 in the up and down direction is limited due to the radius (diameter) of arotation shaft 401, the circumferential movement of aneccentric pin 402, and the displacement amount in the vertical direction (vertical groove 403). In contrast, according to an apparatus of the invention, since the position of theblade 20 in the up and down direction is limited onto to the displacement amount in the vertical direction (vertical groove 23 a), and further, the displacement amount in the vertical direction is smaller than the conventional configuration, the point of action for transmitting the lateral oscillation to the second transmittingmember 23 can be provided adjacent to theblade 20, to which the load is applied. Therefore, the second transmittingmember 23 can be made smaller than the conventional transmitting member 404 (see FIG. 7). Accordingly, the rotation torque applied on theblade 20 is smaller than the conventional configuration, and thus theblade 20 can efficiently be oscillated laterally so that the “rampage” can be smaller. - In FIG. 2, a cornea
applanating part 24 is fixed to theholder block 21 b by an attachingmember 24 a so as to be provided on the front side (left side in the figure) of theblade 20. The corneaapplanating part 24 moves according to the movement of thecutting unit 2 for applanating the cornea of the patient's eye flatly preceding incision with theblade 20. Since theblade 20 incises the cornea thus applanated flatly by theapplanating part 24, a flap of a uniform layer is formed. The distance between the edge of theblade 20 attached to theblade holder 21 a and the lower surface of theapplanating part 24 is about 150 μm so that the cornea can be incised with this thickness in a layered form. - The
suction unit 3 comprises a fixingmember 30, asuction ring 31, and asuction pipe 32. Thesuction ring 31 is fixed to the main body 1 by the fixingmember 30. Thesuction ring 31 having a substantially cylindrical shape with a U-shaped cross-section, comprises acircular recess 31 a to be contacted with the patient's eye and anopening 31 b concentric with therecess 31 a. When thesuction ring 31 is set on the patient's eye for surgery, the cornea of the patient's eye projects upward from theopening 31 b so that the lower end portion of thesuction ring 31 and the opening end portion of theopening 31 b are contacted so as to provide a space S for suction. - The
suction pipe 32 is embedded in thesuction ring 31, and connected with a vacuum tube (not illustrated) elongating to apump 41. Asuction path 32 a provided inside thesuction pipe 32 communicates with therecess 31 a. According to suction and discharge of the air in the space S by thepump 41 via thesuction path 32 a, thesuction ring 31 is vacuum-fixed to the patient's eye. In this fixation, as the operator holds the grip portion 1 a, positioning of theopening 31 b can be facilitated, and the apparatus can be held stably. - In addition, a pipe for pressure detection (not illustrated) is embedded in the
suction ring 31 at a position facing to thesuction pipe 32. The pipe for pressure detection is connected with apressure detector 33 via a tube (not illustrated). Thepressure detector 33 detects the air pressure in the space S sucked by thepump 41 via the pipe for pressure detection. Acontrol unit 40 controls the operation of themotor 11, themotor 12, and thepump 41 based on the air pressure detected by thepressure detector 33. - Hereinafter the operation of the apparatus with the above-mentioned configuration will be described. While confirming the state of inclination of the suction ring31 (main body 1) and the position of the pupillary center based on a mark applied on the cornea of the patient's eye with an instrument such as a marker, the operator positions the center of the
opening 31 b with respect to the pupillary center and disposes thesuction ring 31 on the patient's eye. - After installation of the
suction ring 31, the operator operates thepump 41 so as to suck the air in the space S between thesuction ring 31 and the patient's eye while keeping the position and the posture of the main body 1 for thereby reducing the air pressure (to the negative pressure). When the air pressure in the space S is reduced to a certain value (when it reaches a sufficiently negative pressure), the operation of thepump 41 is controlled by thecontrol unit 40 so as to maintain the air pressure. Accordingly, thesuction ring 31 is vacuum-fixed onto the patient's eye. - After completion of the fixation of the apparatus, the operator operates a
foot switch 42 for rotation drive of themotor 11 and themotor 12. Thecontrol unit 40 controls for rotation drive of themotor 11 and themotor 12. Thecontrol unit 40 controls the drive of themotor 12 by the input of a drive command signal by thefoot switch 42 so as to oscillate theblade 20 laterally by a fixed or variable oscillation frequency. Further, thecontrol unit 40 controls the rotation of themotor 11 according to a fixed or variable feeding speed so as to rectilinearly move thecutting section 2 in the hinge direction. At the time, theshaft 15 slides in the advancing direction integrally with thecutting unit 2 while making a rotational motion for imparting lateral oscillation to theblade 20. - After being converted to the lateral oscillation of the first transmitting
member 22, the rotational motion of theshaft 15 is converted to the lateral oscillation of the second transmitting member so as to provide the rectilinear oscillation to theblade 20, and thus the “rampage” caused by the vertical oscillation can be restrained so as to form a good flap stably. - When the edge of the
blade 20 has incised the cornea with the hinge portion left so as to complete the flap formation, themotor 11 is rotated reversely so as to return thecutting unit 2 to its initial position. At the time, the rotation of themotor 12 is stopped according to the independent control of the motors so that theblade 20 can be taken out from the flap while avoiding the unnecessary oscillation of theblade 20. Accordingly, the possibility of cut off of the thus formed flap can be reduced. - After the return of the
cutting unit 2 to the initial position, air is introduced into the space S so as to release the suction for removing the apparatus (suction ring 31). Subsequently, the corneal stroma is ablated for the refractive correction amount, and then the flap is returned to its original position so as to finish the surgery. - Although the first transmitting
member 22 comprising thevertical groove 22 a to be engaged with thepin 16 and thepin part 22 b, and the second transmittingmember 23 comprising thevertical groove 23 a to be engaged with thepin part 22 b of the first transmitting member 22 (in this case, theblade 20 is fixed to the second transmitting member 23) are used in this embodiment for converting the rotation of the shaft 15 (circumferential movement of the pin 16) to the lateral oscillation of theblade 20, it is also possible to further provide a pin part similar to thepin part 22 b in the second transmitting member and a third oscillation transmitting member comprising a vertical groove to be engaged with the pin part of the second transmitting member. In this case, the blade is fixed to the third transmitting member. That is, although the rotation of the rotation shaft is converted to the lateral oscillation of the blade by the conversion by twice, but the conversion needs to be at least twice and can be increased to three times or four times. - Another embodiment of the invention will be explained with reference to the drawings. FIG. 8 is a cross-sectional view of an apparatus according to the second embodiment and a schematic diagram of a control system. FIG. 9 is an enlarged cross-sectional view of a
cutting unit 2 and asuction unit 3. FIG. 10 is a cross-sectional view taken on the line C-C of FIG. 9. The same numerals are applied to the same components as in the first embodiment. - The
cutting unit 2 comprises theblade 20, theblade holder 21 a, theholder block 21 b, a bearingpart 21 c, a rock (swing) transmittingmember 25, and a lateraloscillation transmitting member 26. A rotation hole in which theshaft 15 is inserted is provided in theblade holder 21 a so that the tip portion of the connectedmember 17 is fixed thereto. - The
rock transmitting member 25 is pivoted by theholder block 21 b and the bearingpart 21 c rotatably (rockably) with two upper and lowerrotation shaft parts 25 c as the rotation central axes in theoscillation space 210 c formed in theholder block 21 b (that is, therock transmitting member 25 is pivoted rockably in the lateral direction, centering the axial line L elongating in the vertical direction). Further, avertical groove 25 a to be engaged with thepin 16 is formed in therock transmitting member 25. When theshaft 15 is rotated according to the rotation drive of themotor 12, a force in the lateral direction is applied on therock transmitting member 25 by the circumferential movement of thepin 16 engaged with thevertical groove 25 a. Accordingly therock transmitting member 25 is rocked. - The lateral
oscillation transmitting member 26 is held movably in the lateral direction in theoscillation space 210 b formed in theholder block 21 b. Apin receiving part 26 a to be engaged with the apin part 25 b provided at a lower portion of therock transmitting member 25 is formed in the lateraloscillation transmitting member 26. When therock transmitting member 25 is rocked in the lateral direction with theshaft parts 25 c as the rotation center by the rotation of the shaft 15 (circumferential movement of the pin 16), a force in the lateral direction is applied on the lateraloscillation transmitting member 26 via thepin part 25 b and thepin receiving part 26 a according to the rock. Accordingly, the lateraloscillation transmitting member 26 oscillates laterally, and further, theblade 20 fixed to theoscillation transmitting member 26 oscillates laterally as well. - The movement of the
pin 16, therock transmitting member 25, the lateraloscillation transmitting member 26, and theblade 20 will be explained with reference to FIG. 11. - When the
shaft 15 is rotated by themotor 12, the projecting portion of thepin 16 provided eccentrically in theshaft 15 moves circumferentially, centering the rotation central axis of theshaft 15. The force generated by the circumferential movement of thepin 16 can be split in the vertical and lateral directions, that is, the force in the vertical direction functioning on the side surface of thevertical groove 25 a in the up and down direction as the friction force, and the force in the lateral direction pushing the side surface of thevertical groove 25 a in the lateral direction as the pushing force. According to the force applied on the side surface of thevertical groove 25 a, therock transmitting member 25 rocks with theshaft parts 25 c as the rotation center. Since theshaft parts 25 c are held sufficiently by theholder block 21 b and the bearingpart 21 c with respect to the force in the vertical direction generated by thepin 16, the “rampage” in the vertical direction an be restrained so that the rotational motion of theshaft 15 can be converted efficiently to the rock of therock transmitting member 25. - According to the rock of the
rock transmitting member 25 in the lateral direction, thepin part 25 b formed in the lower portion thereof is rocked in the lateral direction with substantially no displacement in the vertical direction. Since thepin part 25 b rocking in the lateral direction applies a force on the side surface of thepin receiving part 26 a, the lateraloscillation transmitting member 26 oscillates in the lateral direction with theoscillation space 210 b as the guide. At the time, by providing a substantially spherical tip end shape to thepin part 25 b, a force can be applied efficiently to thepin receiving part 26 a so that the lateral oscillation can be provided smoothly. Since theblade 20 is fixed to the lateraloscillation transmitting member 26, it oscillates according to the lateral oscillation of the lateraloscillation transmitting member 26. - According to the configuration, after being converted to the rock with the
shaft parts 25 c of therock transmitting member 25 as the rotation center, the rotational motion of theshaft 15 applies rectilinear oscillation to theblade 20 in the lateral direction. Since the force according to the circumferential movement of thepin 16 in the vertical direction is supported by theshaft parts 25 c, the “rampage” by the vertical oscillation can be restrained so that a good flap can be formed stably. Moreover, since the sliding portion is only in the peripheral part of theshaft parts 25 c, worn out of the oscillating portion can be restrained so as to prolong the life cycle of the parts. - The
pin 16 can be attached to theshaft 15, elongating parallel in the rotation central axis direction of the shaft 15 (as in the conventional apparatus shown in FIG. 13A), but thepin 16 is provided tilting with respect to the rotation central axis direction of theshaft 15 in this embodiment. That is, thepin 16 is provided eccentrically, elongating passing through the intersection of the axial line L passing through the rotation center of the rock of therock transmitting member 25 and the rotation central axis of theshaft 15. According to the configuration, since the rocking angle of thepin 16 in the lateral direction and the rocking angle of therock transmitting member 25 in the lateral direction coincide, the contacting property of thepin 16 engaged with thevertical groove 25 a is improved and thus the rotational motion can be converted smoothly and efficiently to the lateral rock. Moreover, the shape of thevertical groove 25 a and the tip end portion shape of thepin 16 to be engaged therewith can be a simple shape (linear shape) so that the production of components can be facilitated. - Furthermore, although the rock of the
pin part 25 b is converted to the linear lateral oscillation of the lateraloscillation transmitting member 26 in this embodiment, it is also possible to fix thepin part 25 b and the lateraloscillation transmitting member 26, rock the lateraloscillation transmitting member 25, and have arc-like oscillation of theblade 20. Moreover, as shown in FIG. 12, therock transmitting member 25 can be eliminated. - Furthermore, the
rock transmitting member 25 needs to rock with oscillation with a lateral direction component for oscillating theblade 20 in the lateral direction, and therefor, the axial line L to be the center of the rock should be provided at a position offset from the rotation central axis of theshaft 15. For the efficient conversion of the rotation of theshaft 15 into the oscillation of the lateral direction component, it is preferable that the axial line L to be the center of the rock is in the same plane as the rotation central axis of theshaft 15, and further, it is preferable that the axial line L as the rocking center is disposed in the plane in the vertical direction passing through the rotation central axis of theshaft 15 with respect to the lateral direction for oscillating theblade 20, and therock transmitting member 25 is rocked with the axial line L as the center. The conversion efficiency of the oscillation in the lateral direction can be most efficient by providing the axial line L orthogonal to the rotation central axis of theshaft 15 as in this embodiment. - Moreover, the
vertical groove 25 a formed in therock transmitting member 25 can be provided at the grip portion 1 a side with respect tot he rotation center of theshaft parts 25 c. Furthermore, by changing the distance of thevertical groove 25 a and the distance of thepin 25 b from the rotation center of theshaft parts 25 c, respectively, the width of the lateral oscillation of theblade 20 with respect to the eccentric amount of thepin 16 can be adjusted freely (it is also possible to enlarge the oscillation width with a small eccentric amount). - Moreover, although explanation has been given with the
motor 12 for rotating theshaft 15 in this embodiment, an air turbine can be used as well. Furthermore, as the mechanism for feeding the blade, a mechanism for incising the cornea by rotational movement of the blade as disclosed in JP-A-11-19115 and JP-A-11-99167 filed by the present inventor can be adopted as well. - As heretofore explained according to the invention, a good flap can be formed by preventing the “rampage” of the blade.
- Moreover, the lateral oscillation of the blade can be generated efficiently, the cost rise according to the high accuracy of the mechanism can be restrained, and the durability of the mechanism is improved so as to prolong the life cycle.
Claims (25)
1. A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
a rotatable shaft;
an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft; and
a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
cornea applanating means that applanates the cornea within the opening into a substantially flat form;
a blade that incises the cornea;
a first oscillation transmitting member having a part with which the eccentric pin is engaged;
a second oscillation transmitting member having a part with which a part of the first oscillation transmitting member is engaged; and
a holder that holds the first and second oscillation transmitting members to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft,
wherein movement of the second oscillation transmitting member in the lateral direction causes the blade to be moved in the same direction.
2. A corneal surgical apparatus according to , wherein the blade is fixed to the second oscillation transmitting member.
claim 1
3. A corneal surgical apparatus according to , wherein the first oscillation transmitting member includes:
claim 1
a vertical groove elongating in a direction perpendicular to both of the lateral direction and the rotational central axis of the shaft, the eccentric pin being engaged with the vertical groove; and
a pin part extending toward the second oscillation transmitting member;
wherein the second oscillation transmitting member includes a pin receiving part with which the pin part of the first oscillation transmitting member is engaged.
4. A corneal surgical apparatus according to , wherein the holder holds the first and second oscillation transmitting member to be movable linearly in the lateral direction.
claim 1
5. A corneal surgical apparatus according to , wherein the first oscillation transmitting member includes a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion, and
claim 1
wherein the holder includes a bearing part that rotatably supports the shaft part and that has a part with which the shaft part is engaged, the holder holding the first oscillation transmitting member to be rockable in the lateral direction.
6. A corneal surgical apparatus according to , wherein the holder holds the second oscillation transmitting member to be movable linearly in the lateral direction.
claim 5
7. A corneal surgical apparatus according to , wherein the shaft part of the first oscillation transmitting member includes two shaft parts respectively located on an upper part and a lower part of the first oscillation transmitting member, and
claim 5
wherein the bearing part includes two bearing parts respectively supporting the two shaft parts.
8. A corneal surgical apparatus according to , wherein the shaft part of the first oscillation transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
claim 5
9. A corneal surgical apparatus according to , wherein the rotational central axis of the shaft part of the first oscillation transmitting member intersects the rotational central axis of the shaft perpendicularly.
claim 8
10. A corneal surgical apparatus according to , wherein the eccentric pin is provided on an axis passing through an intersecting point at which the rotational central axis of the shaft part intersects the rotational central axis of the shaft.
claim 9
11. A corneal surgical apparatus according to , wherein the eccentric pin is provided on an axis non-perpendicularly intersecting the rotational central axis of the shaft.
claim 1
12. A corneal surgical apparatus according to , further comprising:
claim 1
a drive unit that rotates the shaft.
13. A corneal surgical apparatus according to , further comprising:
claim 1
a drive unit that moves the cutting unit in the incising direction.
14. A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
a rotatable shaft;
an eccentric pin projecting from a distal end of the shaft, the eccentric pin being located at a position offset from a rotational central axis of the shaft; and
a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
cornea applanating means that applanates the cornea within the opening into a substantially flat form;
a blade that incises the cornea;
a rock transmitting member having a part with which the eccentric pin is engaged and a shaft part rotatable about an axis different in location from the rotational central axis of the shaft, the shaft part having at least one of a recess and a protrusion; and
a holder that holds the rock transmitting members to be rockable in a lateral direction which is perpendicular to the rotational central axis of the shaft, the holder having a bearing part rotatably supporting the shaft part of the rock transmitting member, the bearing part having a part with which the shaft part is engaged,
wherein movement of the rock transmitting member in the lateral direction causes the blade to be moved in the same direction.
15. A corneal surgical apparatus according to , wherein the shaft part of the rock transmitting member includes two shaft parts respectively located on an upper part and a lower part of the rock transmitting member, and
claim 14
wherein the bearing part includes two bearing parts respectively supporting the two shaft parts.
16. A corneal surgical apparatus according to , wherein the shaft part of the rock transmitting member is rotatable about an axis intersecting the rotational central axis of the shaft.
claim 14
17. A corneal surgical apparatus according to , wherein the rotational central axis of the shaft part of the rock transmitting member perpendicularly intersects the rotational central axis of the shaft.
claim 16
18. A corneal surgical apparatus according to , wherein the eccentric pin is provided on an axis passing through an intersecting point at which the rotational central axis of the shaft part intersects the rotational central axis of the shaft.
claim 17
19. A corneal surgical apparatus according to , wherein the eccentric pin is provided on an axis which non-perpendicularly intersects the rotational central axis of the shaft.
claim 14
20. A corneal surgical apparatus according to , further comprising:
claim 14
a drive unit that rotates the shaft.
21. A corneal surgical apparatus according to , further comprising:
claim 14
a drive unit that moves the cutting unit in the incising direction.
22. A corneal surgical apparatus for incising a cornea of a patient's eye in a layered form, comprising:
a suction ring unit, having a circular opening, that is to be vacuum-fixed onto a peripheral part of the cornea;
a rotatable shaft;
an eccentric pin projecting from a distal end of the shaft, the eccentric pin being provided on an axis non-parallel to and non-perpendicular to a rotational central axis of the shaft; and
a cutting unit movable in an incising direction above the suction ring unit, the cutting unit including:
cornea applanating means that applanates the cornea within the opening into a substantially flat form;
a blade that incises the cornea;
a transmitting member having a part with which the eccentric pin is engaged; and
a holder that holds the transmitting member to be movable in a lateral direction which is perpendicular to the rotational central axis of the shaft,
wherein movement of the transmitting member in the lateral direction causes the blade to be moved in the same direction.
23. A corneal surgical apparatus according to , wherein the eccentric pin is provided on an axis that non-perpendicularly intersects the rotational central axis of the shaft.
claim 22
24. A corneal surgical apparatus according to , further comprising:
claim 22
a drive unit that rotates the shaft.
25. A corneal surgical apparatus according to , further comprising:
claim 22
a drive unit that moves the cutting unit in the incising direction.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/753,568 US6344046B2 (en) | 1999-03-03 | 2001-01-04 | Corneal surgical apparatus |
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP05569699A JP4021091B2 (en) | 1999-03-03 | 1999-03-03 | Cornea surgery device |
JP11-55696 | 1999-03-03 | ||
JPP.HEI.11-55696 | 1999-03-03 | ||
JP11090337A JP2000279437A (en) | 1999-03-31 | 1999-03-31 | Cornea operation device |
JP11-90337 | 1999-03-31 | ||
US09/517,188 US6203555B1 (en) | 1999-03-03 | 2000-03-02 | Corneal surgical apparatus |
US09/753,568 US6344046B2 (en) | 1999-03-03 | 2001-01-04 | Corneal surgical apparatus |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/517,188 Division US6203555B1 (en) | 1999-03-03 | 2000-03-02 | Corneal surgical apparatus |
Publications (2)
Publication Number | Publication Date |
---|---|
US20010001829A1 true US20010001829A1 (en) | 2001-05-24 |
US6344046B2 US6344046B2 (en) | 2002-02-05 |
Family
ID=26396603
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/517,188 Expired - Fee Related US6203555B1 (en) | 1999-03-03 | 2000-03-02 | Corneal surgical apparatus |
US09/753,568 Expired - Lifetime US6344046B2 (en) | 1999-03-03 | 2001-01-04 | Corneal surgical apparatus |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/517,188 Expired - Fee Related US6203555B1 (en) | 1999-03-03 | 2000-03-02 | Corneal surgical apparatus |
Country Status (3)
Country | Link |
---|---|
US (2) | US6203555B1 (en) |
EP (1) | EP1033120B1 (en) |
DE (1) | DE60022413T2 (en) |
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- 2000-03-01 DE DE60022413T patent/DE60022413T2/en not_active Expired - Lifetime
- 2000-03-01 EP EP00104284A patent/EP1033120B1/en not_active Expired - Lifetime
- 2000-03-02 US US09/517,188 patent/US6203555B1/en not_active Expired - Fee Related
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Also Published As
Publication number | Publication date |
---|---|
US6344046B2 (en) | 2002-02-05 |
DE60022413T2 (en) | 2006-01-19 |
EP1033120A3 (en) | 2002-01-02 |
US6203555B1 (en) | 2001-03-20 |
EP1033120A2 (en) | 2000-09-06 |
DE60022413D1 (en) | 2005-10-13 |
EP1033120B1 (en) | 2005-09-07 |
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