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CN118845353B - A femtosecond laser cataract surgery instrument and application method - Google Patents

A femtosecond laser cataract surgery instrument and application method
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Publication number
CN118845353B
CN118845353BCN202410998342.0ACN202410998342ACN118845353BCN 118845353 BCN118845353 BCN 118845353BCN 202410998342 ACN202410998342 ACN 202410998342ACN 118845353 BCN118845353 BCN 118845353B
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femtosecond laser
reflector
suction
opening
suction head
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CN118845353A (en
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喻建锋
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Affiliated Hospital of Nantong University
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Affiliated Hospital of Nantong University
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Abstract

Translated fromChinese

本发明涉及飞秒激光白内障手术器械及应用方法,包括支座,支座上设置有飞秒激光发生器,还包括吸管,吸管的尾端设置有操作柄并连接有负压发生器,吸管的前端设置有开口朝下的弧形的吸头;吸头的上表面设置有开孔,开孔处设置有第一反射镜,支座上设置有指示当前飞秒激光发生器的焦点位置的焦点指示单元,操作柄上设置有控制飞秒激光发生器以及负压发生器运行的控制单元;无需应用超声能量,清理比较彻底,不会形成大规模碎片以致于碎片难以清理,对不同情况患者的晶状体适应性好,不需要对碎核精度进行复杂计算,而且对吸头的改进会非常小,成本能控制在可接受范围,解决了当前飞秒激光白内障手术中遇到的行业性难题。

The invention relates to a femtosecond laser cataract surgical instrument and an application method. The instrument comprises a support, a femtosecond laser generator is arranged on the support, and a suction pipe, an operating handle is arranged at the tail end of the suction pipe and is connected to a negative pressure generator, and an arc-shaped suction head with an opening facing downward is arranged at the front end of the suction pipe; an opening is arranged on the upper surface of the suction head, a first reflecting mirror is arranged at the opening, a focus indicating unit indicating the current focus position of the femtosecond laser generator is arranged on the support, and a control unit for controlling the operation of the femtosecond laser generator and the negative pressure generator is arranged on the operating handle; ultrasonic energy does not need to be applied, cleaning is relatively thorough, large-scale fragments are not formed so that the fragments are difficult to clean, the instrument has good adaptability to the lenses of patients in different conditions, does not need to perform complex calculations on the precision of nuclear fragmentation, and the improvement of the suction head is very small, the cost can be controlled within an acceptable range, and the industry problems encountered in the current femtosecond laser cataract surgery are solved.

Description

Femtosecond laser cataract surgical instrument and application method
Technical Field
The invention relates to the technical field of ophthalmic surgical instruments, in particular to a femtosecond laser cataract surgical instrument and an application method thereof.
Background
The working principle of the femtosecond cataract surgery is that the femtosecond laser is used for cutting the cornea to form an incision, then the continuous manual annular capsulorhexis is carried out on the lens capsule, the anterior capsule is removed, the split nucleus is formed into small blocks and is subjected to ultrasonic emulsification suction, and finally the artificial lens is implanted from the incision;
In actual clinical operation, as the broken cores still need to be subjected to ultrasonic energy to a certain extent, certain damage can be brought to human eyes, and the number of the broken cores is large after ultrasonic breaking, so that more broken residues are easy to occur; the technology of completely relying on femtosecond laser for nucleus disruption in the current research is clinically difficult due to the difference of the situations of lens nuclei of patients (each patient needs to have a targeted accurate nucleus disruption scheme after multiple detection and needs to carry out femtosecond laser debugging);
Chinese patent application No. CN201610092343.4 provides a femto-second laser cataract emulsification treatment system, by integrating a femto-second laser generator inside a suction head, to realize the suction of the middle broken core, but the theoretical idea is difficult to implement on the ground, mainly because the femto-second laser needs to have higher focusing precision and a relatively stable output environment, integrating it on the suction head has too high requirement for precision control, the manufacturing cost of the equipment can be very high, and a low-cost femto-second laser cataract surgical instrument and application method capable of reducing the differential interference of the lens core of a patient and completely relying on femto-second laser to break the core are needed.
Disclosure of Invention
The technical problem to be solved by the invention is to provide a femtosecond laser cataract surgery instrument and an application method of the femtosecond laser cataract surgery instrument aiming at the defects in the prior art.
The technical scheme adopted for solving the technical problems is as follows:
The femtosecond laser cataract surgical instrument comprises a support, wherein a femtosecond laser generator is arranged on the support, the femtosecond laser cataract surgical instrument further comprises a suction pipe, an operating handle is arranged at the tail end of the suction pipe and is connected with a negative pressure generator, an arc suction head with a downward opening is arranged at the front end of the suction pipe, an opening is arranged on the upper surface of the suction head, a first reflecting mirror is arranged at the opening and is used for reflecting femtosecond laser beams entering through the opening into an inner hole of the suction head to break nuclei, meanwhile, the lower end of the first reflecting mirror stretches into the inner hole of the suction head and forms a suction gap with the inner wall of the inner hole, a focus indicating unit for indicating the focus position of the current femtosecond laser generator is arranged on the support, the focus indicating unit comprises a plurality of obliquely downward indicating beam generators, the intersection points of the beams emitted by the indicating beam generators are focuses of the femtosecond laser generators, and a control unit for controlling the operation of the femtosecond laser generators and the negative pressure generator is arranged on the operating handle.
The invention discloses a femtosecond laser cataract surgery instrument, wherein the front end of an inner hole of a suction head is provided with a second reflecting mirror, the direction of a first reflecting mirror reflecting a femtosecond laser beam faces to the second reflecting mirror, and the direction of the second reflecting mirror reflecting the femtosecond laser beam faces to an aspiration gap.
The femtosecond laser cataract surgery instrument provided by the invention has the advantages that the first reflecting mirror is in a support leg triangle shape, a right-angle side of the first reflecting mirror seals the opening, the other right-angle side is close to the second reflecting mirror, a reflecting coating is arranged on the bevel edge, and the lower end part of the first reflecting mirror and the inner wall of the inner hole form the suction gap.
The invention relates to a femtosecond laser cataract surgery instrument, wherein the second reflecting mirror is a plane mirror and is obliquely and fixedly arranged at the bending position of an inner hole of a suction head.
The femtosecond laser cataract surgery instrument of the present invention, wherein the upper surface of the first mirror is lower than the edge of the opening.
The femtosecond laser cataract surgery instrument provided by the invention, wherein the edge of the opening is provided with a conical surface.
The invention discloses a femtosecond laser cataract surgery instrument, wherein the focus indication unit comprises a bracket for fixing a plurality of indication beam generators, and a manipulator for adjusting deflection and lifting of the bracket is arranged on the bracket.
A method for applying a femtosecond laser cataract surgery instrument, which is applied to the femtosecond laser cataract surgery instrument, wherein the method comprises the following steps:
After the femtosecond laser generator finishes the pre-splitting operation of the crystalline lens, the focus of the femtosecond laser generator moves to a first position close to the edge of the crystalline lens;
Extending the suction tube into the cornea through the opening of the cornea, and moving the suction tube by taking the first position as the center, wherein the operation of sucking broken nuclei for a plurality of times in the moving process;
sucking the lens fragments after pre-splitting, moving to a focus position indicated by the opening and focus indicating unit, controlling the operation of the femtosecond laser generator by the control unit, reflecting the emitted laser beam by the first reflecting mirror, and then crushing the lens fragments sucked into the inner hole of the suction head, wherein substances after crushing the cores are sucked away by the suction gap;
the focus of the femtosecond laser generator moves to a second position close to the edge of the crystalline lens nucleus, the suction tube moves by taking the second position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator moves to a third position close to the edge of the crystalline lens nucleus, the suction tube moves by taking the third position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator moves to a fourth position close to the center of the crystalline lens nucleus, the suction tube moves by taking the fourth position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator moves to a fifth position close to the edge of the crystalline lens nucleus, the suction tube moves by taking the fifth position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process.
After the femtosecond laser generator finishes the operation of pre-splitting the nucleus of the crystalline lens, the focus of the femtosecond laser generator moves to a first position close to the edge of the nucleus of the crystalline lens; the method comprises the steps of stretching a suction tube into a cornea through an opening of the suction head, taking a first position as a center, carrying out a plurality of times of suction and crushing operations in the moving process, moving a lens fragment after presplitting to a focus position indicated by an opening and focus indication unit, controlling a femtosecond laser generator to operate through a control unit, reflecting a laser beam emitted by the control unit through a first reflecting mirror, crushing the lens fragment sucked into an inner hole of the suction head, sucking away substances after the crushing through a suction gap, moving a focus of the femtosecond laser generator to a second position close to the edge of the lens core, moving the suction tube to the second position as the center, carrying out a plurality of times of suction and crushing operations in the moving process, moving the focus of the femtosecond laser generator to a third position close to the edge of the lens core, carrying out a plurality of times of suction and crushing operations in the moving process to a fourth position close to the center of the lens core, and carrying out a plurality of times of suction and crushing operations in the moving the focus of the femtosecond laser generator to a fifth position close to the edge of the lens core;
By adopting the method, the damage caused by ultrasonic energy is avoided without applying ultrasonic energy, the fragments are difficult to clean because the fragments are thoroughly cleaned and cannot be formed in large scale, the adaptability to the lens of the patient in different conditions is good, the complex calculation on the precision of the broken nucleus of the lens of the patient in different conditions is not needed, the improvement on the suction head is very small, and the cost can be controlled in an acceptable range, so that the industrial problem encountered in the current femtosecond laser cataract operation is solved.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the present invention will be further described with reference to the accompanying drawings and embodiments, in which the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained by those skilled in the art without inventive effort:
FIG. 1 is a schematic view of a femtosecond laser cataract surgery instrument according to the preferred embodiment of the present invention;
FIG. 2 is an enlarged cross-sectional view of a suction head of a femtosecond laser cataract surgery instrument in accordance with a preferred embodiment of the present invention;
FIG. 3 is a schematic view of the focal position distribution of a femtosecond laser cataract surgery instrument in a preferred embodiment of the invention;
Fig. 4 is a flowchart of a method of applying the femtosecond laser cataract surgery instrument of the preferred embodiment of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the following description will be made in detail with reference to the technical solutions in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by a person skilled in the art without any inventive effort, are intended to be within the scope of the present invention, based on the embodiments of the present invention.
The invention relates to a femtosecond laser cataract surgery instrument of a preferred embodiment, as shown in fig. 1, and referring to fig. 2 and 3, which comprises a support 1, wherein a femtosecond laser generator 2 is arranged on the support 1, a suction pipe 3 is also arranged on the support 1, the tail end of the suction pipe 3 is provided with an operating handle 30 and is connected with a negative pressure generator 4, the front end of the suction pipe 3 is provided with an arc suction head 5 with a downward opening, the upper surface of the suction head 5 is provided with an opening 50, a first reflecting mirror 51 is arranged at the opening 50 and is used for reflecting a femtosecond laser beam entering from the opening 50 into an inner hole of the suction head 5 for nucleus breaking, the lower end of the first reflecting mirror 51 extends into the inner hole of the suction head 5 and forms a suction gap 52 with the inner wall of the inner hole, the support 1 is provided with a focus indicating unit 6 for indicating the focus position of the current femtosecond laser generator 2, the focus indicating unit 6 comprises a plurality of indicating beam generators 60 which are inclined downwards, and the intersection point of the beams emitted by the indicating beam generators 60 is the focus of the femtosecond laser generator 2, and the control unit 31 for controlling the operation of the negative pressure generator 4 is arranged on the operating handle 30;
After the femtosecond laser generator 2 completes the operation of pre-cleaving the lens (cornea opening, femtosecond laser capsulotomy, capsulorhexis, pre-cleaving the lens are performed in the prior art, which is not described in detail), the focal point of the femtosecond laser generator 2 is moved to a first position 80 near the edge of the lens core;
Sucking the pre-cleaved lens fragments, moving to a focus position indicated by the opening 50 and the focus indication unit 6, controlling the operation of the femtosecond laser generator 2 by the control unit 31, and crushing the lens fragments sucked into the inner hole of the suction head 5 after the emitted laser beams are reflected by the first reflecting mirror 51, wherein the crushed substances are sucked away by the suction gap 52;
The focus of the femtosecond laser generator 2 moves to a second position 81 close to the edge of the crystalline lens nucleus, the suction tube moves by taking the second position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator 2 moves to a third position 82 near the edge of the crystalline lens nucleus, the suction tube moves by taking the third position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator 2 moves to a fourth position 83 near the center of the crystalline lens nucleus, the suction tube moves by taking the fourth position as the center, and the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
the focal point of the femtosecond laser generator 2 moves to a fifth position 84 near the edge of the crystalline lens nucleus, the suction tube moves by taking the fifth position as the center, and the nucleus breaking sucking operation is performed for a plurality of times during the movement;
By adopting the method, the damage caused by ultrasonic energy is avoided without applying ultrasonic energy, the fragments are difficult to clean because the fragments are thoroughly cleaned and cannot be formed in large scale, the adaptability to the lens of the patient in different conditions is good, the complex calculation on the precision of the broken nucleus of the lens of the patient in different conditions is not needed, the improvement on the suction head is very small, and the cost can be controlled in an acceptable range, so that the industrial problem encountered in the current femtosecond laser cataract surgery is solved;
It should be noted that the above five positions may be increased or decreased according to actual needs, and the positions may also be sequentially adjusted;
Preferably, the front end of the inner hole of the suction head 5 is provided with a second reflecting mirror 53, the direction of the first reflecting mirror 51 reflecting the femtosecond laser beam faces the second reflecting mirror 53, and the direction of the second reflecting mirror 53 reflecting the femtosecond laser beam faces the suction gap 52.
Preferably, the first reflecting mirror 51 is in a triangular shape with legs, wherein a right-angle side closes the opening 50, the other right-angle side is close to the second reflecting mirror 53, a reflecting coating is arranged on the inclined side, a suction gap 52 is formed between the lower end part of the first reflecting mirror 51 and the inner wall of the inner hole, the structure is simple, the layout is reasonable, the production cost can be effectively reduced, preferably, the upper surface of the first reflecting mirror is lower than the edge of the opening, the edge of the opening is provided with a conical surface which is convenient to rapidly align with the indication intersection point of the focus indication unit 6, in addition, the suction gap 52 is designed so that the suction force at the suction gap is larger than the suction force at the front end opening of the suction head 5, namely, the main crushed cores and the parts with the effect of fragments are transferred into the suction head, the damage to the eyes is reduced, and preferably, the cutter can be arranged at the lower end part of the first reflecting mirror 51 to assist in physical crushed cores.
Preferably, the focus indication unit comprises a bracket 9 for fixing a plurality of indication beam generators, a manipulator 10 for adjusting deflection and lifting of the bracket is arranged on the support 1, when the femtosecond laser generator 2 moves, the manipulator 10 adjusts deflection and lifting of the bracket 9 to quickly adjust the indication intersection point position of the focus indication unit 6, and the manipulator 10 adopts the prior art and is not repeated.
A method for applying a femtosecond laser cataract surgery instrument to the femtosecond laser cataract surgery instrument as described above, as shown in fig. 4, and referring to fig. 3, the method comprises the following steps:
S01, after the femtosecond laser generator finishes the pre-splitting operation of the crystalline lens, the focus of the femtosecond laser generator moves to a first position close to the edge of the crystalline lens;
S02, extending a suction tube into the cornea through an opening of the cornea, and moving the suction tube by taking the first position as a center, wherein the operation of sucking broken nuclei for a plurality of times is performed in the moving process;
sucking the lens fragments after pre-splitting, moving to a focus position indicated by the opening and focus indicating unit, controlling the operation of the femtosecond laser generator by the control unit, reflecting the emitted laser beam by the first reflecting mirror, and then crushing the lens fragments sucked into the inner hole of the suction head, wherein substances after crushing the cores are sucked away by the suction gap;
s03, moving a focus of the femtosecond laser generator to a second position close to the edge of the crystalline lens nucleus, and moving the suction tube by taking the second position as a center, wherein the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
S04, moving a focus of the femtosecond laser generator to a third position close to the edge of the crystalline lens nucleus, and moving a suction tube by taking the third position as a center, wherein the nucleus breaking sucking operation is performed for a plurality of times in the moving process;
S05, moving a focus of the femtosecond laser generator to a fourth position close to the center of the crystalline lens nucleus, and moving a suction tube by taking the fourth position as the center, wherein the operation of sucking the crushed nucleus is performed for a plurality of times in the moving process;
S06, moving the focus of the femtosecond laser generator to a fifth position close to the edge of the crystalline lens nucleus, and moving the suction tube by taking the fifth position as the center, wherein the nucleus breaking sucking operation is performed for a plurality of times in the moving process.
By adopting the method, the damage caused by ultrasonic energy is avoided without applying ultrasonic energy, the fragments are difficult to clean because the fragments are thoroughly cleaned and cannot be formed in large scale, the adaptability to the lens of the patient in different conditions is good, the complex calculation on the precision of the broken nucleus of the lens of the patient in different conditions is not needed, the improvement on the suction head is very small, and the cost can be controlled in an acceptable range, so that the industrial problem encountered in the current femtosecond laser cataract operation is solved.
It will be understood that modifications and variations will be apparent to those skilled in the art from the foregoing description, and it is intended that all such modifications and variations be included within the scope of the following claims.

Claims (6)

Translated fromChinese
1.一种飞秒激光白内障手术器械,包括支座,所述支座上设置有飞秒激光发生器,其特征在于,还包括吸管,所述吸管的尾端设置有操作柄并连接有负压发生器,所述吸管的前端设置有开口朝下的弧形的吸头;所述吸头的上表面设置有开孔,所述开孔处设置有第一反射镜,所述第一反射镜用于将开孔进入的飞秒激光束反射至所述吸头的内孔内进行碎核,同时所述第一反射镜的下端伸入所述吸头的内孔内并与内孔的内壁形成抽吸间隙;所述支座上设置有指示当前飞秒激光发生器的焦点位置的焦点指示单元,所述焦点指示单元包括多束斜向下的指示光束发生器,多个所述指示光束发生器发出光束的交点为飞秒激光发生器的焦点;所述操作柄上设置有控制所述飞秒激光发生器以及所述负压发生器运行的控制单元;所述吸头的内孔的前端设置有第二反射镜,所述第一反射镜反射飞秒激光束的方向朝向所述第二反射镜,所述第二反射镜反射飞秒激光束的方向朝向所述抽吸间隙。1. A femtosecond laser cataract surgical instrument, comprising a support, on which a femtosecond laser generator is arranged, characterized in that it also comprises a suction tube, the tail end of the suction tube is provided with an operating handle and is connected to a negative pressure generator, the front end of the suction tube is provided with an arc-shaped suction head with an opening facing downward; the upper surface of the suction head is provided with an opening, and a first reflector is provided at the opening, the first reflector is used to reflect the femtosecond laser beam entering through the opening into the inner hole of the suction head for nuclear fragmentation, and at the same time, the lower end of the first reflector extends into the inner hole of the suction head and forms a suction gap with the inner wall of the inner hole; The support is provided with a focus indication unit for indicating the current focus position of the femtosecond laser generator, and the focus indication unit includes a plurality of indicator beam generators that are obliquely downward, and the intersection of the beams emitted by the plurality of indicator beam generators is the focus of the femtosecond laser generator; the operating handle is provided with a control unit for controlling the operation of the femtosecond laser generator and the negative pressure generator; the front end of the inner hole of the suction head is provided with a second reflector, the first reflector reflects the direction of the femtosecond laser beam toward the second reflector, and the second reflector reflects the direction of the femtosecond laser beam toward the suction gap.2.根据权利要求1所述的飞秒激光白内障手术器械,其特征在于,所述第一反射镜呈支脚三角形状,且其中一直角边封闭所述开孔,另一直角边靠近所述第二反射镜,斜边设置有反射涂层;所述第一反射镜的下端端部与所述内孔的内壁形成所述抽吸间隙。2. The femtosecond laser cataract surgical instrument according to claim 1 is characterized in that the first reflector is in the shape of a triangular leg, and one of the right-angled sides closes the opening, the other right-angled side is close to the second reflector, and the hypotenuse is provided with a reflective coating; the lower end of the first reflector and the inner wall of the inner hole form the suction gap.3.根据权利要求2所述的飞秒激光白内障手术器械,其特征在于,所述第二反射镜为平面镜且斜向固定设置在所述吸头的内孔的弯折处。3. The femtosecond laser cataract surgical instrument according to claim 2 is characterized in that the second reflector is a plane mirror and is obliquely fixed at the bend of the inner hole of the suction head.4.根据权利要求2所述的飞秒激光白内障手术器械,其特征在于,所述第一反射镜的上表面低于所述开孔的边缘。4 . The femtosecond laser cataract surgical instrument according to claim 2 , wherein the upper surface of the first reflector is lower than the edge of the opening.5.根据权利要求4所述的飞秒激光白内障手术器械,其特征在于,所述开孔的边缘设置有锥面。5 . The femtosecond laser cataract surgical instrument according to claim 4 , wherein a conical surface is provided at the edge of the opening.6.根据权利要求1所述的飞秒激光白内障手术器械,其特征在于,所述焦点指示单元包括固定多个指示光束发生器的支架,所述支座上设置有调节所述支架偏转以及升降的机械手。6. The femtosecond laser cataract surgical instrument according to claim 1 is characterized in that the focus indication unit includes a bracket for fixing a plurality of indication beam generators, and a manipulator for adjusting the deflection and lifting of the bracket is provided on the bracket.
CN202410998342.0A2024-07-242024-07-24 A femtosecond laser cataract surgery instrument and application methodActiveCN118845353B (en)

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