WO2017102772A1 - Movable ophthalmological diagnostic and/or therapeutic system - Google Patents

Abstract

The invention relates to an ophthalmological diagnostic and/or therapeutic system (1) comprising a main part (2), an articulated arm (4-1, 4-2) connected to said main part (2), a diagnostic and/or therapeutic device (5-1, 5-2), a control device (6) and a movement device (7). The aim of the invention is to disclose an ophthalmological diagnostic and/or therapeutic system (1) which allows simple yet optimally protected movement of such a complex system (1) in different system-standard situations. This problem is solved by virtue of an ophthalmological diagnostic and/or therapeutic system (1) comprising a handle structure (8) that encircles the main part (2) at a distance.

Description

 Mobile ophthalmic diagnostic and / or therapy system

The present invention relates to an ophthalmological diagnosis and / or therapy system with a basic body, a the basic body

subsequent articulated arm, a diagnostic and / or therapeutic device, a control device and a movement device.

Many examinations and therapies in ophthalmology, and in particular surgical procedures, are now carried out with the aid of partially or fully automated systems. For example, eye diseases are first characterized by appropriate diagnostic methods and systems such as optical coherence tomography (OCT) or other ophthalmometric measurements, and then treated by laser-assisted surgical surgical systems. During the therapy, ideally the previously collected measurement data are used and / or further data is determined.

Among the therapies by surgical procedures in ophthalmology, refractive surgery, e.g. for the correction of corneal curvature, to call or the cataract surgery as one of the most commonly performed

A method of therapy in which a patient's clouded eye lens is smashed and removed to replace it with an artificial lens (intraocular lens, IOL).

To reach the goal in cataract surgery, there are various procedures. Thus, the lens can be smashed by means of ultrasound, and an access cut through the cornea be made with the scalpel, through which the shattered lens is aspirated.

The lens can also be pre-cut by means of a therapy laser beam, which is generally a pulsed laser beam, femtosecond lasers being used, and the access section through the cornea can also be cut with the aid of the pulsed laser beam, but the ultrasound is then used smashed and then aspirated, in which case the effect of the ultrasound does not have to be as strong as in the case of a sole disintegration of the eye lens by means of ultrasound. Such a procedure is therefore gentler, but involves additional work steps.

In order to perform the procedure correctly, appropriate examinations, measurements or characterizations of different structures of the eye before, during and after the procedure are necessary or advisable, which can be done by appropriate methods such as optical coherence tomography (OCT), ultrasound or a Scheimpflug camera , Also, the use of a

Operation microscope during the operation hardly to imagine.

However, as can be deduced from the situation described herein, the alternate use of various diagnostic and therapeutic measures in ophthalmology may require the patient to move from one system to another as many prior art ophthalmic systems - and in particular ophthalmic laser therapy systems - are relatively large and are permanently installed. In addition, these systems by their size and immobility "consume" the operating room even when they are not in use.

Therefore, document PCT / EP2015 / 073390 describes an ophthalmic diagnostic and / or therapy system that is much more compact and portable. The compact design of the system is also achieved in that the system comprises a base body and articulated arms, wherein the articulated arms in turn each contain a diagnostic and / or therapeutic device or at least a portion of such a device.

Such an ophthalmological diagnosis and / or therapy system, which usually contains a number of joint arms and possibly also other protruding elements in addition to a compact body, must be protected so that when moving the system, for example by sliding past other objects or through door openings none of the sensitive parts of the system can be damaged by impact or collision. In addition, such an ophthalmological diagnosis and / or therapy system must be able to be moved by different persons: For example, when transporting a person standing behind the system or while a patient is being treated by a doctor sitting in front of the system.

Object of the present invention is therefore an ophthalmological

Describe a diagnosis and / or therapy system, the light and yet optimally protected movement or movement of such a complex

System in different systemic situations.

This object is achieved by an ophthalmological diagnosis and / or therapy system according to claim 1.

Such an ophthalmological diagnosis and / or therapy system comprises first a main body and a the main body or a

Extension of the body subsequent articulated arm.

The main body is advantageously covered by a housing. The

Extension of the body can be realized for example by an axle or a holder. The articulated arm, which is usually movable, preferably adjoins the main body upwards.

The ophthalmic diagnostic and / or therapy system further comprises a diagnostic and / or therapeutic device. This can be made in one piece or contain several parts, possibly also spatially separated parts.

Examples of a diagnostic device are a surgical microscope, a

Scheimpflug camera, an ultrasound device or an optical coherence tomography system (OCT). A corresponding therapy device is

For example, a laser system that uses laser radiation for therapeutic purposes, such as for cutting an eye tissue by means of photodisruption, or in turn an ultrasound system for smashing tissue by means of

Ultrasound or an X-ray system for irradiation of tissue by means of

X-rays. In this case, the articulated arm comprises the diagnostic and / or therapeutic device or at least a part of the diagnostic and / or therapeutic device. By appropriate positioning of the articulated arm this diagnostic and / or

Therapy device can be used on the patient.

In addition, the ophthalmologic diagnosis and / or therapy system comprises a control device. The control device can also be designed in one piece or in several parts. The control device is set up to control the diagnosis and / or therapy device, but if necessary also to control further components of the ophthalmological diagnosis and / or therapy system, such as a beam deflecting device advantageously included in the ophthalmic diagnosis and / or therapy system or an adjustable one

Beam focusing optics. For this purpose, appropriate supply and

Communication paths between the controller and the components of the ophthalmic diagnostic and / or therapy system available.

Finally, the ophthalmic diagnostic and / or therapy system comprises a movement device. By means of the movement device, the diagnostic and / or therapy system can be changed in its position, for example, moved in the operating room or even spent in another room. This is preferably done by a person who manually shifts the system.

The fact that such an ophthalmic diagnostic and / or therapy system comprises an articulated arm also implies that it may comprise several articulated arms. In the presence of a plurality of articulated arms, these can be designed to be coupled together, for example by means of a coupling device. Thus, for example, one of the articulated arms may include a diagnostic device or a part of a diagnostic device and another of the articulated arms may contain a therapy device or a part of a therapy device.

According to the invention now includes the ophthalmic diagnostic and / or

Therapy system surrounding the main body handle structure. The circumferential handle structure extends at a distance to the body around it. there can in an advantageous embodiment, the encircling handle structure for

Main body be variably spaced, the distance between the handle structure and body can therefore vary. Such a handle structure revolving around the main body allows optimum operation when the ophthalmological diagnosis and / or therapy system is to be moved. It also forms an outer protective structure around the main body: Before it can strike against an obstacle during a movement, this is intercepted by the encircling handle structure.

Preferably, in an ophthalmological diagnosis and / or therapy system according to the invention, the articulated arm can thus be placed in a transport and / or

Resting position can be spent that he is in a plan view of the diagnostic and / or therapy system within the area encompassed by the rotating handle structure surface. The positions of the largest "protruding" of a spent in transport or rest position articulated arm also determine the respective distance of the rotating handle structure to the body.

Thus, the circumferential handle structure also provides appropriate protection for the articulated arm against collisions during transport, during which the

Articulated arm is in a transport position, or in a rest position of the articulated arm, that is, with the ophthalmological diagnosis and / or

Therapy system.

The transport position preferably has an additional

Fixation possibility for the articulated arm on a filing structure, so that the articulated arm does not move unintentionally during transport.

In a further preferred embodiment of the invention

ophtalmological diagnosis and / or therapy system, the circumferential handle structure runs around the main body at different heights. The height is a measure of the distance of the handle structure to a ground plane on which the ophthalmological diagnosis and / or therapy system is set up. The height at which the encircling grip structure is arranged around the base body is adapted at different positions of the base body to the position of an operator of the ophthalmological diagnosis and / or therapy system who wants to grasp the system on the grip structure at this point. Thus, the handle structure in places where the operator is in front of the device, at a greater height than at locations where the operator usually sits in front of the device. In this way, the ophthalmological diagnosis and / or therapy system can be optimally operated with regard to its movement.

In a simple embodiment of the ophthalmic diagnosis and / or therapy system, the circumferential handle structure is formed by a closed handle ring which extends around the base body and is secured thereto. Such attachment can be done for example by at regular intervals extending from the handle ring to the main body or to a housing of the body transverse bars.

The handle ring does not necessarily have to have a symmetrical structure, but can also show a completely irregular shape in a plan view, and preferably also does not form a plane, but is thus the structure of

adapted to its protective function as well as its transport function optimally: So it is usually shaped in three dimensions.

Furthermore, the movement device of a preferred ophthalmological diagnosis and / or therapy system according to the invention comprises rollers and / or wheels. Preferably, these are designed so that they allow a change of direction. Thus, for example, they can be movable in all directions of a plane by means of a corresponding ball bearing or else be adjustable in their direction by a steering device.

This makes it possible to push or pull the ophthalmological diagnosis and / or therapy system from any direction, as soon as the movement device is released from a lock, which they are preferably for protection against unwanted Has movement. It is also preferably possible to drive in the movement of the ophthalmological diagnosis and / or therapy system curves.

Preferably, the articulated arm of an ophthalmological diagnosis and / or therapy system according to the invention has a plurality of rotatable or pivotable joints. This allows free movement of the articulated arm in three-dimensional space, i.e., a diagnostic and / or therapeutic device contained on the articulated arm can be positioned in any position of a three-dimensional diagnostic and / or therapy space.

To support the free movement of the arms in three-dimensional space, the articulated arm of the ophthalmic diagnostic and / or

Therapy system preferably a weight compensation device. These

makes it possible to avoid tilting of the system even in extreme positions of the articulated arm.

The main body of an ophthalmological diagnosis and / or therapy system according to the invention preferably contains the control device or at least a part of the control device and / or a part of the diagnostic and / or

Therapy device.

Preferably, the diagnostic and / or therapy device contains a

at least one laser system according to the invention ophthalmic diagnostic and / or therapeutic system.

Advantageously, a laser system of the therapy device of the ophthalmological diagnosis and / or therapy system, which contains a laser source which generates a pulsed laser radiation. Here, a laser system is particularly preferred that generates a femtosecond laser radiation.

Such femtosecond laser radiation may be focused with a beam focusing optic at a desired position in the tissue and by means of a beam deflecting device, such as one or more scanners operate the different spatial directions x, y, and z, be distracted in the three-dimensional diagnostic and / or therapy room.

The present invention will now be explained with reference to exemplary embodiments. It shows:

- Fig. 1 shows a first embodiment of the invention

ophthalmological diagnosis and / or therapy system in a side view.

- Fig. 2: a second embodiment of the invention

ophthalmic diagnosis and / or therapy system in a plan view.

 - Fig. 3 shows a third embodiment of the invention

ophthalmic diagnosis and / or therapy system in a plan view.

 - Fig. 4 shows a fourth embodiment of the invention

ophthalmological diagnosis and / or therapy system in a side view.

In Fig. 1 is a first embodiment of the invention

ophthalmic diagnosis and / or therapy system 1 shown in a side view. This ophthalmologic diagnosis and / or therapy system 1 contains a basic body 2 which is mounted on a movement device 7 which has rollers. For this basic body 2 protrude out two axes 3-1, 3-2, on each of which an articulated arm 4-1, 4-2 is arranged. The first articulated arm 4-1 contains a surgical microscope 5-1, while a laser applicator head 5-2 is arranged on the second articulated arm 4-2, from which in use a focused pulsed laser radiation, which is located in a base body 2 (here not shown) laser source - in this case a femtosecond laser - is generated and passed through a beam guiding system to the laser applicator head 5-2. The

Beam guiding system includes a beam deflecting device and a

Beam focusing optics. The components of this ophthalmic diagnostic and / or therapy system 1 are controlled by a control device 6.

The ophthalmological diagnosis and / or therapy system further includes a handle structure 8 surrounding the base body 2, which is designed as a closed grip ring, which runs at a distance from the base body 2 and through a plurality Cross struts or mounting webs 15 is attached to a housing of the base body 2.

In this first embodiment, the two articulated arms 4-1, 4-2 are each in a rest position. They are thus at a movement of

ophthalmological diagnosis and / or therapy system 1 by the encircling handle structure 8, so the closed handle ring, protected. The closed handle ring extends at different heights H-1, H-2 over a ground plane 14 around the base body 2 around. Where a first operator 13-1 of the

ophthalmic diagnostic and / or therapy system 1 preferably operates standing, the handle ring 8 is in a favorable for a standing person first height H-1 above the ground level 14, while the handle ring 8 at another location at which a second operator 13-2 of the ophthalmological diagnosis and / or therapy system 1 preferably operates while sitting, in a favorable for a seated person second height H-2 above the ground plane 14 is located. In this case, the first height H1 is greater than the second height H-2. From both operators 13-1, 13-2, the ophthalmic diagnosis and / or therapy system 1 can thus be optimally operated.

Fig. 2 shows a second embodiment of the invention

ophthalmic diagnostic and / or therapy system 1 in a plan view. In this system 1, only one articulated arm 4-2 is shown, which contains the laser applicator head 5-2 and which is in a transport position. For this purpose, the articulated arm 4-2 is detachably fixed on a storage structure 10 and a maximum "folded" over the base body 2, so that it does not substantially in the plan view of the

Base 2 protrudes.

Nevertheless, there is the possibility of a collision of the articulated arm 4-2 during the movement of the ophthalmological diagnosis and / or therapy system 1, if not the encircling handle ring 8 the articulated arm 4-2 by circulating around the body in a selected distance from the main body. 2 would protect. The area formed by the circumferential grip ring 8 thus forms a protective area. Good is evident in Fig. 2 also that the distance of the circumferential handle ring 8 to the base body 2 is not necessarily fixed is, but is usually adapted to the movement possibilities or stowage possibilities of the articulated arms 4-1, 4-2, as well as others if necessary

protruding parts of the ophthalmic diagnostic and / or therapy system 1. The distance which the encircling grip ring 8 has to the base body 2 at the respective position is determined by a corresponding shaping of the

circumferential gripping rings and by the length and shape of the mounting webs 15, so the cross braces, by means of which the circumferential handle ring 8 is attached to the base body 2.

A third embodiment of the ophthalmic invention

Diagnosis and / or therapy system 1 shows the Fig. 3 in a plan view. In this example, the shape of the circumferential grip ring 8 is strongly related to the shape of the

Base body 2 adapted and makes it clear that the handle ring 8 does not necessarily have to have an annular or oval shape, but rather may form any self-contained structure. By means of such a shaping, the ophthalmological diagnosis and / or therapy system 1 according to the invention can be made even more compact without losing the protective function generated by the encircling grip ring 8, since the circumferential grip ring 8 has a greater distance to the base body 2 precisely where this is for protection of the articulated arm 4-2 and the articulated arms 4-1, 4-2 is really necessary.

4, in turn, shows a fourth exemplary embodiment of the ophthalmic diagnosis and / or therapy system 1 according to the invention in a side view. This example corresponds to the first embodiment, however, the ophthalmologic diagnosis and / or therapy system 1 is in a working position.

The articulated arms 4-1, 4-2, of which a first articulated arm 4-1 a

Surgical microscope 5-1 and a second articulated arm 4-2 part of a

Laser system comprises - namely the laser applicator head 5-2 as well as a part of a beam guidance system from a in the main body 2 of the ophthalmic diagnosis and / or therapy system 1 laser source (not shown) to the laser applicator head 5-2 -, are in positions where they are to

Therapy of an eye of a patient can be used on a couch (also not shown here) can be positioned next to the ophthalmic diagnostic and / or therapy system 1.

In such a working position, the articulated arms 4-1, 4-2 can of course be moved beyond the handle structure 8 which is encircled by the base body 2. Turning or pivot axes 9-1, 9-2, 9-3, 9-4, 9-5, 9-6, 9-7, 9-8 are further shown in FIG first articulated arm 4-1 and the second

Can move articulated arm 4-2.

Also, the two articulated arms 4-1, 4-2 can be connected to each other, that two parts of a coupling structure 12, the first part of the

Surgical microscope of the first articulated arm 4-1 is arranged and the second part of which is arranged on the laser applicator head 5-2 of the second articulated arm, are brought together.

So that the ophthalmological diagnosis and / or therapy system 1 retains its stability in every position of the articulated arms 4-1, 4-2 and does not tip over, the articulated arms 4-1, 4-2 have weight compensation structures 11.

The above-mentioned and explained in various embodiments features of the invention are not only in the exemplary combinations, but also in other combinations or alone, without departing from the scope of the present invention.

Claims

claims 1 . Ophthalmological diagnostic and / or therapy system (1) comprising  a base body (2),  - a the main body (2) or an extension (3-1, 3-2) of Basic body (2) subsequent articulated arm (4-1, 4-2),  a diagnosis and / or therapy device (5-1, 5-2),  - wherein the articulated arm (4-1, 4-2) comprises the diagnostic and / or therapeutic device (5-1, 5-2) or a part of the diagnostic and / or therapeutic device (5-1, 5-2), a control device (6), set up to control the diagnosis and / or therapy device (5-1, 5-2),  a movement device (7), characterized in that the ophthalmological diagnostic and / or Therapy system (1) comprises a around the main body (2) at a distance encircling handle structure (8). 2. ophthalmological diagnosis and / or therapy system (1) according to claim 1, characterized in that the articulated arm (4-1, 4-2) can be brought into such a transport and / or rest position that he is in a plan view the diagnostic and / or therapy system (1) within that of the circulating Handle structure (8) covered area is located. 3. ophthalmological diagnosis and / or therapy system (1) according to claim 1 or 2, characterized in that the circumferential handle structure (8) over different heights (H-1, H-2) extends. 4. Ophthalmological diagnostic and / or therapy system according to one of claims 1 to 3, characterized in that the circumferential handle structure (8) is formed by a closed handle ring. 5. ophthalmological diagnosis and / or therapy system (1) according to one of claims 1 to 4, characterized in that the movement device (7) comprises rollers and / or wheels. 6. ophthalmological diagnosis and / or therapy system (1) according to one of claims 1 to 5, characterized in that the articulated arm (4-1, 4-2) a plurality of pivotable or pivotable joints (9-1, 9-2 , 9-3, 9-4, 9-5, 9-6, 9-7, 9-8). 7. ophthalmological diagnosis and / or therapy system (1) according to one of claims 1 to 6, characterized in that the articulated arm (4-1, 4-2) comprises a weight compensation device (1 1). 8. ophthalmological diagnosis and / or therapy system (1) according to one of claims 1 to 7, characterized in that the basic body (2) the Control device (6) or a part of the control device (6) and / or a part of the diagnostic and / or therapy device (5-1, 5-2). 9. ophthalmological diagnosis and / or therapy system (1) according to one of claims 1 to 8, characterized in that the diagnostic and / or Therapy device (5-1, 5-2) contains at least one laser system. 10. Ophthalmic diagnostic and / or therapy system (1) according to claim 9, characterized in that the laser system of the therapy device (5-2) contains a laser source, which comprises a pulsed laser radiation, preferably a Femtosecond laser radiation generated.