JP6549099B2 - 白内障手術における軸アラインメントのためのレーザ基準 - Google Patents
白内障手術における軸アラインメントのためのレーザ基準 Download PDFInfo
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/20—Surgical microscopes characterised by non-optical aspects
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/20—Surgical microscopes characterised by non-optical aspects
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- A—HUMAN NECESSITIES
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
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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
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- 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
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
- A61F9/00754—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments for cutting or perforating the anterior lens capsule, e.g. capsulotomes
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- 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
- A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
- A61F9/00834—Inlays; Onlays; Intraocular lenses [IOL]
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/363—Use of fiducial points
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
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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
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00878—Planning
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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
- A61F9/008—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
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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
- A61F9/008—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
- A61F2009/00889—Capsulotomy
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Description
Claims (23)
- 器械であって、前記器械は、
レーザビームを生じさせるレーザと、
前記レーザビームを患者の眼上に走査して前記眼の解剖学的構造上に基準を作るためのスキャナと、
マーカを有する植え込み型器具と、
前記レーザ及び前記スキャナに作動的に結合されたプロセッサと、
を備え、
前記プロセッサは、前記植え込み型器具を前記患者の前記眼内に植え込む方法のステップのそれぞれを実施するための命令を格納した有形の媒体を含み、
前記方法は、
前記基準を前記眼の解剖学的構造上に作るステップと、
前記植え込み型器具の前記マーカが前記基準と整列するように前記植え込み型器具を前記眼に対して配置するステップと、
を含み、
前記基準および前記マーカはそれぞれ相補的な形状を有しており、前記基準および前記マーカの一方は空洞の輪郭形状を有し、前記基準および前記マーカの他方は、前記空洞の輪郭形状に対応しかつ前記空洞の輪郭形状内に適合する、埋められた形状を有しており、
前記基準を前記眼の解剖学的構造上に作る前記ステップは、2つの基準を前記眼の前記解剖学的構造上に作るステップを有し、
前記2つの基準は軸を画定する線を定めるように配置されており、
前記植え込み型器具は2つの前記マーカを有し、前記植え込み型器具は、前記2つのマーカが前記2つの基準と位置合わせされたときに、前記眼と位置合わせされるように構成されている
ことを特徴とする器械。 - 前記器械は患者インターフェースを更に備え、
前記眼は、吸引により前記眼に結合された前記患者インターフェースで保持され、
前記基準は、前記眼が前記患者インターフェースで保持されている時に作られる
ことを特徴とする請求項1記載の器械。 - 前記器械はカメラ又は手術用顕微鏡を更に備え、
前記植え込み型器具は、眼内レンズを有し、
前記マーカ及び前記基準は、前記眼内レンズが配置されたときにユーザに提供されるカメラ画像又は手術用顕微鏡画像により、当該ユーザに可視である
ことを特徴とする請求項1記載の器械。 - 前記器械が前記眼の乱視の治療軸を入力するためのユーザ入力部
を更に備え、
前記スキャナは、前記眼の瞳孔を横切って延びる前記治療軸を定めるよう前記眼の解剖学的構造上に第1の基準及び第2の基準を作るよう構成されており、
前記マーカは、眼内レンズのレンズ軸を定めるよう前記植え込み型器具の互いに反対側に配置された第1のマーカ及び第2のマーカを有し、
前記マーカ及び前記基準は、前記治療軸と前記レンズ軸のアラインメントを決定するようユーザに可視である
ことを特徴とする請求項1記載の器械。 - 前記第1の基準及び前記第2の基準は、前記眼の瞳孔から離れた角膜上に配置され、
前記第1のマーカ、前記第2のマーカ、前記第1の基準及び前記第2の基準は、前記ユーザに可視である像の状態で表示される
ことを特徴とする請求項4記載の器械。 - 前記器械が患者支持体を更に含み、
前記眼の構造が、前記患者が前記患者支持体上に載せられた時に測定され、
前記基準は、測定された前記眼の前記構造の向きに応じて前記眼の解剖学的構造上に作られる
ことを特徴とする請求項1記載の器械。 - 測定された前記眼の前記構造は、前記眼の角膜、前記眼の虹彩又は前記眼の水晶体、のうちの1つ又は2つ以上を含み、
前記向きは、前記角膜の乱視軸の角度、前記眼の瞳孔周りの前記虹彩の回転角度又は前記眼の前記水晶体の乱視軸、のうちの1つ又は2つ以上から成る
ことを特徴とする請求項6記載の器械。 - 前記植え込み型器具は、人工眼内レンズを有する
ことを特徴とする請求項1記載の器械。 - 前記人工眼内レンズは、トーリック眼内レンズを有する
ことを特徴とする請求項8記載の器械。 - 前記2つのマーカが前記2つの基準と位置合わせされたときに、前記植え込み型器具の視力矯正軸が前記眼の収差軸と位置合わせされるように、前記植え込み型器具は構成されている
ことを特徴とする請求項1記載の器械。 - 前記眼の前記収差軸は、乱視軸を有する
ことを特徴とする請求項10記載の器械。 - 前記眼の前記収差軸は、高次収差の軸を有し、
前記植え込み型器具は、コーマ、トレフォイル又は球面収差、のうちの1つ又は2つ以上を含む前記眼の高次収差を矯正する
ことを特徴とする請求項10記載の器械。 - 前記眼の前記解剖学的構造上に置かれた前記基準は、ドット、線、三角形、矢印、十字、台形、長方形、正方形、シェブロン、五角形、六角形、円、楕円形、又は弧、のうちの1つ又は2つ以上を含む形状を有する
ことを特徴とする請求項1記載の器械。 - 前記植え込み型器具の前記マーカは、ドット、線、三角形、矢印、十字、台形、長方形、正方形、シェブロン、五角形、六角形、円、楕円形、又は弧、のうちの1つ又は2つ以上を含む形状を有する
ことを特徴とする請求項1記載の器械。 - 前記基準は、前記解剖学的構造を前記レーザビームでマーク付けすることによって、前記眼の前記解剖学的構造上に作られる
ことを特徴とする請求項1記載の器械。 - 前記解剖学的構造は、角膜縁、角膜、強膜、水晶体曩、虹彩、支質、又は水晶体核、のうちの1つ又は2つ以上の内部構造を有し、
当該内部構造は、前記植え込み型器具が配置されたときにユーザに可視である
ことを特徴とする請求項1記載の器械。 - 前記基準は、少なくとも、前記角膜の辺縁又は前記角膜縁上に作られる
ことを特徴とする請求項16記載の器械。 - 前記眼の前記解剖学的構造上に作られた前記2つの基準は、第1の基準及び第2の基準を有する
ことを特徴とする請求項17記載の器械。 - 前記第1の基準の形状は、前記第2の基準の形状とは異なっている
ことを特徴とする請求項18記載の器械。 - 前記第1の基準の形状は、前記第2の基準の形状と同一である
ことを特徴とする請求項18記載の器械。 - 前記軸は、前記眼の乱視軸と平行である
ことを特徴とする請求項1記載の器械。 - 前記軸は、前記眼の乱視軸に対して、整列されているか、横切る方向であるか、或いは、垂直である
ことを特徴とする請求項1記載の器械。 - 前記器械は患者インターフェースを更に備え、
前記基準は、前記眼を前記患者インターフェースに結合する前に、前記解剖学的構造上に作られる
ことを特徴とする請求項1記載の器械。
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US201361813172P | 2013-04-17 | 2013-04-17 | |
US61/813,172 | 2013-04-17 | ||
PCT/US2014/034508 WO2014172545A1 (en) | 2013-04-17 | 2014-04-17 | Laser fiducials for axis alignment in cataract surgery |
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JP2016518927A JP2016518927A (ja) | 2016-06-30 |
JP2016518927A5 JP2016518927A5 (ja) | 2017-04-27 |
JP6549099B2 true JP6549099B2 (ja) | 2019-07-24 |
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US (3) | US10219945B2 (ja) |
EP (2) | EP2986258B1 (ja) |
JP (1) | JP6549099B2 (ja) |
CN (2) | CN105491981B (ja) |
AU (2) | AU2014253904B2 (ja) |
CA (1) | CA2909684C (ja) |
WO (1) | WO2014172545A1 (ja) |
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PT3145459T (pt) | 2015-08-07 | 2019-03-21 | Wavelight Gmbh | Marcas corneanas em cirurgia corretora de visão |
EP3359987B1 (en) | 2015-10-05 | 2024-02-28 | AcuFocus, Inc. | Methods of molding intraocular lenses |
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EP2986258A1 (en) | 2016-02-24 |
CA2909684C (en) | 2021-11-16 |
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AU2014253904A1 (en) | 2015-11-12 |
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CA2909684A1 (en) | 2014-10-23 |
US20230000673A1 (en) | 2023-01-05 |
US10219945B2 (en) | 2019-03-05 |
CN108309465B (zh) | 2022-04-15 |
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