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WO1991005515A1 - Laser ophtalmique a couplage par faisceau de fibres - Google Patents

Laser ophtalmique a couplage par faisceau de fibres Download PDF

Info

Publication number
WO1991005515A1
WO1991005515A1 PCT/AU1990/000500 AU9000500W WO9105515A1 WO 1991005515 A1 WO1991005515 A1 WO 1991005515A1 AU 9000500 W AU9000500 W AU 9000500W WO 9105515 A1 WO9105515 A1 WO 9105515A1
Authority
WO
WIPO (PCT)
Prior art keywords
eye
patient
laser beam
unit
fibre bundle
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/AU1990/000500
Other languages
English (en)
Inventor
John Leonard Hughes
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Australian Electro Optics Pty Ltd
Original Assignee
Australian Electro Optics Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Australian Electro Optics Pty Ltd filed Critical Australian Electro Optics Pty Ltd
Publication of WO1991005515A1 publication Critical patent/WO1991005515A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • 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
    • A61F9/008—Methods or devices for eye surgery using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2205—Characteristics of fibres
    • A61B2018/2211—Plurality of fibres
    • 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
    • A61F2009/0035—Devices for immobilising a patient's head with respect to the instrument
    • A61F2009/0043—Devices for immobilising a patient's head with respect to the instrument by supporting the instrument on the patient's head, e.g. head bands
    • 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
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00863—Retina
    • 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
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/0087—Lens
    • 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
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00872—Cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00885—Methods or devices for eye surgery using laser for treating a particular disease
    • A61F2009/00887—Cataract

Definitions

  • This invention relates to a fibre bundle coupled, opthalmic laser system consisting of a head module which can be attached to the patient's head, said head module being fibre bundle coupled to an optical module containing a source of white light, laser beam sources, beam splitter arrays and an opto-electronic camera, said optical module being connected to a computer module which controls the operation of said system, the preferred computer module being that of an artificial neural computer, said computer module in turn being connected to a display monitor, the remaining module being the control module which is operated by the opthalmologist.
  • the invention has application in opthalmology.
  • Prior art laser opthalmic systems consisted of a slit lamp- microscope assembly in which the laser beam generator was added in a manner which minimised departures from the pre-laser art of opthalmology.
  • These prior art laser opthalmic systems placed a severe strain, particularly on elderly patients in that their heads had to be strapped into a rigid frame some times for hours at a time whilst the opthalmologist repeatedly fired what was essentially a single shot laser beam into the eye, also placing undue strain on the opthalmologist in the process.
  • these prior art laser opthalmic systems using powerful pulsed lasers emitting outside the visible region required a low power visible laser beam to align the high power beam within the eye of the patient due to both wavelength and power differences of the
  • the present invention overcomes the severe defects of prior art laser opthalmic systems in that it eliminates the need for patients to be strapped into the rigid framework of the system as a whole by providing a compact, portable head module which can be ⁇ o attached to the patient's head allowing, for example, elderly patients to remain in bed whilst undergoing treatment. Furthermore, by fibre coupling said portable head to the other modules, the opthalmologist can be remotely sited, looking after one or more patients simultaneously via computer control which
  • the invention can be taught to perform the work of the opthaimologists who then only needs to oversee the actual treatment procedures.
  • the module contains what is essentially an electro-optics eye itself in the form of the coherently packed output aperture of a bundle of single mode optical fibres which act as both a transmitter of light into the eye and a means of collecting the reflected light in such a manner that an image of the internal structure of the patient's eye can be displayed at a remote site where it can be viewed by the opthalmologist and assessed by a neural network controlled artificial intelligence unit which learns the art of opthalmology with experience.
  • the invention can be used by a single opthalmologist to treat several patients simultaneously.
  • Another object of the invention is to provide a coherently packed, single mode fibre bundle to optically link the two sections of the invention together, to transmit ordinary light and laser light
  • Another object of the invention is to allow a laser beam passed along said fibre bundle to said eye to be focused precisely onto any 5 selected portion of the displayed internal image of said eye. It is an object of the invention to allow for the collection into the end of the fibre bundle over the patient's eye sufficient light scattered from said eye that is necessary to form the image of the internal structure of said eye.
  • Another object of the invention is to provide laser light of a wavelength appropriate to the various operations that have to be performed on both the internal and/or external areas of the said human eye.
  • Figure 1 shows the layout of the invention with the portable head module attached to the patient's head and fibre bundle coupled to the remotely sited optical, computer, display and control module of the invention.
  • numeral 1 indicates the patient's eye whilst numeral 2 indicates the pupil of said eye through which both the laser beam and the white light viewing beam indicated by numerals 3 and 4 respectively enter eye 1.
  • numeral 5 indicates the light 5 energy reflected and scattered from within eye 1 and off its outside surface, into the concave surface indicated by numeral 6 of the fibre bundle of the invention indicated by numeral 7.
  • numeral 8 indicates the casing of the head module of the invention which is strapped around the patient's head to
  • Numeral 10 indicates a micro lens array to couple the fibre cores, when the said fibre core diameters are less than the fibre cladding thickness, into a collimated beam in the case of incoherent light and into a phase locked beam in the case of laser light.
  • the micro lens array 10 may be dispensed with.
  • Numeral 11 indicates a source of white light to illuminate eye 1 in full colour whilst numeral 12 indicates a light beam splitter to direct part of said white light incident from 11 into fibre bundle 7.
  • Numeral 13 indicates a partial reflector to direct laser light from the beam splitters indicated by numeral 14, 15 and the fully reflecting mirror indicated by numeral 16 from laser sources indicated by numerals 17, 18 and 19 respectively into fibre bundle 7.
  • Numeral 20 indicates an opto-electronic camera which views 0 the eye via reflected and scattered light 5 via fibre bundle 7.
  • numeral 21 indicates a computer module in a preferred format of an artificial neural computer.
  • Numeral 22 indicates a display monitor which allows the internal structure of eye 1 to be viewed by the opthalmologist in the detail necessary for 5 the most intricate operation to then be performed.
  • Numeral 23 indicates a control unit which allows the opthalmologist to override computer module 21 when performing the eye surgery.
  • artificial neural computers have the ability to learn and remember the procedures of the best opthalmoiogists both individually and as a group and the invention, after the due learning processes, will be able to perform eye operations itself as it has
  • numeral 24 indicates a movable joint which allows relative movement between fibre bundle 7 and housing 8.
  • Numerals 25 indicates the positioners which adjust output surface 6 of fibre bundle 7 relative to eye 1 via pupil 2.
  • Numeral 26 indicates an ⁇ o optical fibre or wire coupler which conveys the information from computer module 21 to positioners 25 to accurately adjust surface 6 relative to eye 1.
  • surface 6 of fibre bundle 7 acts as a coherent and incoherent optical transmitter and receiver unit.
  • the invention has application for opthalmic operations from a remote site on one or more patients whilst the patient lies in bed rather than being strapped onto a fixed head rest for hours at a time in some instances.
  • the system allows for a full screen, full colour display of the internal structures of the patient's eye with a detailed record being made of all operating procedures together with their results.
  • the invention can be used to disperse secondary cataracts, re- attach retinas, seal blood vessels, treat tumors, and also profile the outside of the eye ball with ultra violet light by replacing light source 11 with an ultra violet laser 11 , 1 to profile eye 1 , and laser sources 17, 18 and 19 as illuminators, and for aiming the UV beam from generator 11.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ophthalmology & Optometry (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Optics & Photonics (AREA)
  • General Health & Medical Sciences (AREA)
  • Otolaryngology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Electromagnetism (AREA)
  • Vascular Medicine (AREA)
  • Radiation-Therapy Devices (AREA)
  • Laser Surgery Devices (AREA)

Abstract

L'invention se rapporte à un système ophtalmique commandé par ordinateur et fonctionnant à laser, dans lequel l'oeil (1) est traité à travers la pupille (2) par le rayon laser (3), pendant que sa structure est éclairée par de la lumière ordinaire (4) et enregistrée par l'intermédiaire d'une lumière diffusée (5) recueillie par l'ouverture (6) d'un faisceau de fibres optiques monomode à polissage cohérent (7), tous ces composants étant enfermés dans une unité portative (8) qui s'adapte par ajustage étroit autour de l'oeil (9) du patient. Un faisceau de fibres (7) relie l'unité de tête (8) à une unité située à distance, commandée par l'ophtalmologiste et contenant des lasers (17, 18 et 19) et une source de lumière blanche (11), un ordinateur neuronal (21), un moniteur d'affichage (22) et un module de commande (23), qui permet à l'ophtalmologiste de se substituer au signal de commande produit par l'ordinateur en cas de nécessité.
PCT/AU1990/000500 1989-10-19 1990-10-19 Laser ophtalmique a couplage par faisceau de fibres Ceased WO1991005515A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AUPJ693289 1989-10-19
AUPJ6932 1989-10-19

Publications (1)

Publication Number Publication Date
WO1991005515A1 true WO1991005515A1 (fr) 1991-05-02

Family

ID=3774286

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AU1990/000500 Ceased WO1991005515A1 (fr) 1989-10-19 1990-10-19 Laser ophtalmique a couplage par faisceau de fibres

Country Status (1)

Country Link
WO (1) WO1991005515A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998019642A1 (fr) * 1996-11-05 1998-05-14 Meridian Ag Dispositif d'examen optique et/ou de traitement de l'oeil humain
US5779696A (en) * 1990-07-23 1998-07-14 Sunrise Technologies International, Inc. Method and apparatus for performing corneal reshaping to correct ocular refractive errors
DE10021278A1 (de) * 2000-02-23 2001-09-06 Asclepion Meditec Ag Handstück zur Abstrahlung von Licht auf eine Hautfläche bei einer medizinischen oder kosmetischen Hautbehandlung
US7780654B2 (en) 2000-02-23 2010-08-24 Asclepion Laser Technologies Gmbh Device for radiating light onto a skin surface during a medical or cosmetic skin treatment
EP3045138A1 (fr) * 2005-01-10 2016-07-20 Optimedica Corporation Procédé et appareil pour trépanation à plasma à motifs de capsule lentille et phaco-segmentation tridimensionnelle

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2692384A (en) * 1983-02-28 1984-09-10 Bank One Texas, N A Process and apparatus for controlling the photocoagulation of biological tissue
WO1985001445A1 (fr) * 1983-10-06 1985-04-11 Sonomo Corporation Procede et dispositif de cicatrisation au laser
AU5757686A (en) * 1985-05-17 1986-11-20 Laser Holdings Limited Optical therapeutic and surgical system
US4732148A (en) * 1983-11-17 1988-03-22 Lri L.P. Method for performing ophthalmic laser surgery
WO1990009141A2 (fr) * 1989-02-06 1990-08-23 Phoenix Laser Systems, Inc. Procede et appareil de chirurgie de precision a laser

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU2692384A (en) * 1983-02-28 1984-09-10 Bank One Texas, N A Process and apparatus for controlling the photocoagulation of biological tissue
WO1985001445A1 (fr) * 1983-10-06 1985-04-11 Sonomo Corporation Procede et dispositif de cicatrisation au laser
US4732148A (en) * 1983-11-17 1988-03-22 Lri L.P. Method for performing ophthalmic laser surgery
AU5757686A (en) * 1985-05-17 1986-11-20 Laser Holdings Limited Optical therapeutic and surgical system
WO1990009141A2 (fr) * 1989-02-06 1990-08-23 Phoenix Laser Systems, Inc. Procede et appareil de chirurgie de precision a laser

Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5779696A (en) * 1990-07-23 1998-07-14 Sunrise Technologies International, Inc. Method and apparatus for performing corneal reshaping to correct ocular refractive errors
WO1998019642A1 (fr) * 1996-11-05 1998-05-14 Meridian Ag Dispositif d'examen optique et/ou de traitement de l'oeil humain
DE10021278A1 (de) * 2000-02-23 2001-09-06 Asclepion Meditec Ag Handstück zur Abstrahlung von Licht auf eine Hautfläche bei einer medizinischen oder kosmetischen Hautbehandlung
DE10021278B4 (de) * 2000-02-23 2004-09-30 Asclepion-Meditec Ag Handstück zur Abstrahlung von Licht auf eine Hautfläche bei einer medizinischen oder kosmetischen Hautbehandlung
US7780654B2 (en) 2000-02-23 2010-08-24 Asclepion Laser Technologies Gmbh Device for radiating light onto a skin surface during a medical or cosmetic skin treatment
US9480601B2 (en) 2005-01-10 2016-11-01 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US9750640B2 (en) 2005-01-10 2017-09-05 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US9474648B2 (en) 2005-01-10 2016-10-25 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
EP3045138A1 (fr) * 2005-01-10 2016-07-20 Optimedica Corporation Procédé et appareil pour trépanation à plasma à motifs de capsule lentille et phaco-segmentation tridimensionnelle
US9693904B2 (en) 2005-01-10 2017-07-04 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US9693903B2 (en) 2005-01-10 2017-07-04 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US9693905B2 (en) 2005-01-10 2017-07-04 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US9474649B2 (en) 2005-01-10 2016-10-25 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
US10130510B2 (en) 2005-01-10 2018-11-20 Optimedica Corporation Apparatus for patterned plasma-mediated laser ophthalmic surgery
EP3459486A1 (fr) * 2005-01-10 2019-03-27 Optimedica Corporation Procédé et appareil pour trépanation à plasma à motifs de capsule lentille et phaco-segmentation tridimensionnelle
US10874553B2 (en) 2005-01-10 2020-12-29 Amo Development, Llc Apparatus for patterned plasma-mediated laser ophthalmic surgery
US11364147B2 (en) 2005-01-10 2022-06-21 Amo Development, Llc Apparatus for patterned plasma-mediated laser ophthalmic surgery
US11998486B2 (en) 2005-01-10 2024-06-04 Amo Development, Llc Apparatus for patterned plasma-mediated laser ophthalmic surgery
US12102565B2 (en) 2005-01-10 2024-10-01 Amo Development, Llc Apparatus for patterned plasma-mediated laser ophthalmic surgery

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