JP3144615B2 - Ophthalmic surgery device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ophthalmic surgical foot switch and an ophthalmic surgical apparatus having the same.

[0002]

2. Description of the Related Art An ophthalmic surgical foot switch is used in a photocoagulation device, a perfusion suction device, an ultrasonic cataract surgery device, and the like. When using this type of device, a hand switch is used for switching the output of ultrasonic oscillation, the suction flow rate of the perfusate, etc., because the probe is held in the hand. For example, an ultrasonic cataract surgical device amplifies and transmits ultrasonic vibration to a tip attached to the tip of a probe to crush and emulsify the nucleus of the lens,
The crushed nucleus is removed by suction through a tube through a suction port provided in the chip together with the perfusate supplied to the eye. The output of ultrasonic oscillation can be freely adjusted by adjusting the foot switch (linear control function).

[0003]

However, since the linear control function provided in the conventional foot switch has only one direction of adjustment by adjusting the depression, the output of the ultrasonic oscillation as described above is provided. When a linear control is used, the suction pressure and the suction flow rate can only be adjusted by switches provided on the operation section of the apparatus main body. For this reason, when it is desired to adjust the suction pressure or the suction flow rate during the operation, the surgeon once interrupts the operation and operates the switch of the main unit to reset the setting, or instructs the assistant or the like to set the switch of the main unit. There is a drawback that the suction pressure or the suction flow rate cannot be adjusted immediately according to the condition of the eye to be operated. In addition, such adjustment must be made frequently depending on the operation site, and there is a disadvantage that the efficiency of the operation is low.

SUMMARY OF THE INVENTION In view of the above-described drawbacks of the conventional apparatus, it is an object of the present invention to provide an ophthalmic surgery foot switch capable of obtaining a plurality of control signals by a foot switch and an ophthalmic surgery apparatus including the same.

[0005]

Means for Solving the Problems To solve the above problems, the apparatus of the present invention is characterized by having the following configuration. (1) Perfusion solution supply for supplying perfusion solution in the perfusion bottle to the eye
Ophthalmic surgery device with means, suction flow or suction
Variable pressure to aspirate perfusate with waste in the eye
The power of the suction means and the emulsifying means is variable,
Emulsifying means for crushing and emulsifying the tissue of
A first operation mechanism for depressing the mounting portion,
(1) first detecting means for detecting the amount of depression of the operating mechanism;
Move the footrest on a plane including the plane of the footrest.
A second operating mechanism for detecting the movement by the second operating mechanism
A foot switch having a second detection means for detecting
Mode, perfusion / aspiration mode, perfusion / aspiration / emulsification mode
Mode selection means for selecting a mode from the above, the suction means and
And selecting a mode selecting means from among the emulsifying means and
Set to operate in addition to perfusion based on detection by the detection means
Selection means for selecting the alignment and detection by the second detection means.
Control of the suction pressure or the suction flow rate by the suction means based on
And control means for performing the following.

(2) Supplying the perfusate in the perfusion bottle into the eye
Ophthalmic surgery apparatus with a perfusate supply means
The volume or suction pressure is variable and the perfusate is flushed with waste in the eye.
The power of the suction means and the power of the emulsification means are variable
An emulsifying means for crushing and emulsifying intraocular tissues;
First operation for depressing the footrest with respect to the part
A first mechanism for detecting a depression amount of the first operating mechanism;
Sensing means and the footrest on a plane including the plane of the footrest.
A second operating mechanism for moving the
Switch having a second detecting means for detecting a moving movement
And the detection results of the first detection means and the second detection means
Operation of the suction means and the emulsification means operating on the basis of
Selecting means for selecting a combination of
And

[0007]

[0008]

[0009]

An embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram showing a schematic configuration of the apparatus. Reference numeral 1 denotes a perfusion bottle for storing a perfusion solution such as a physiological saline solution, and the height of the perfusion bottle 1 is adjusted so as to supply the perfusion solution to the patient's eye 2 at an appropriate speed. Reference numeral 3 denotes a perfusion tube for guiding the perfusate falling from the perfusion bottle 1 to the patient's eye. A perfusion control valve 4 is provided in the middle of the perfusion tube 3, and the opening and closing of the perfusion control valve 4 controls the outflow of perfusate.

The other end of the perfusion tube 3 is a crushing hand pipe.
5A and a perfusion suction handpiece 5B. The crushing handpiece 5A is provided with a chip having a suction port.
The nucleus of the lens is crushed and emulsified by the tip using ultrasonic vibration , and the crushed nucleus is aspirated together with the perfusate. The output of the ultrasonic oscillator disposed inside the crushing handpiece 5A is adjusted by the control of the control unit 8.

The perfusion suction handpiece 5B has a tip having a suction port, and sucks the cortex and the like remaining after the removal of the lens nucleus together with the perfusion solution. The handpiece 5A for crushing and the handpiece 5B for perfusion suction are selected according to the operation stage, the operation method and the like, and are used by being reconnected. 6 is a handpiece for crushing
This is a suction tube for discharging the waste and the perfusate sucked by the space 5A (or the perfusion suction handpiece 5B). A suction pump 7 for generating a suction pressure is provided behind the suction tube 6, and the drive of the suction pump 7 is controlled by a control unit 8. The sucked waste is a waste liquid bag 9
Is discharged and dumped.

Reference numeral 10 denotes a pressure sensor, and 11 denotes a solenoid valve.
The pressure sensor 10 and the solenoid valve 11 are connected to the suction tube 6 via a connection 12. The pressure sensor 10 constantly detects the suction pressure, and when the suction pressure rises above a set value, the electromagnetic valve 11 is opened under the control of the control unit 8 to flow air and reduce the suction pressure. The upper limit of the suction pressure is set by a switch operation of the input unit described later. 13 is a perfusion mode
An input unit provided with various switches for setting a mode such as a mode, a suction mode, an ultrasonic emulsification mode, and setting a suction flow rate and a suction pressure. 14 is a foot switch. The foot switch 14 can control the operation of perfusion, suction and ultrasonic emulsification according to the depressed position as shown in FIG. 2 by the mode setting set by the input unit 13.

FIG. 3 is a view of the foot switch 14 viewed from the side, FIG. 4 is a view of the foot switch 14 from above, FIG. 5 is a view of FIG. . Foot switch 1
For 4, perfusion, suction,
A step operation mechanism for variably adjusting the ultrasonic output while switching each operation of the ultrasonic emulsification, a lateral operation mechanism for variably adjusting the suction pressure or the suction flow rate by a lateral operation different from the stepping direction, and a suction flow. A description will be given separately of a reflux mechanism for temporarily backflowing.

(Stepping mechanism) 20 is a base portion, 21
Is a step portion. The rear (left side in the figure) of the step portion 21 is connected to the base portion 20 by a shaft 22, and the step portion 21 is rotatable about the shaft 22 in the direction of arrow B in FIG. A spring 2 is provided between the step portion 21 and the base portion 20.
When no force is applied to the step portion 21, the state shown in FIG. 3 is maintained. Reference numeral 24 denotes a stepping amount transmitting member having a gear portion 24a.
1. Reference numeral 25 denotes a rotary potentiometer fixed to the base portion 20, and a rotary shaft of the potentiometer 25 is provided with a gear 26 meshing with the gear portion 24a of the stepping amount transmitting member 24. I have. When a force is applied to the step portion 21, the step amount transmitting member 24 rotates about the shaft 22. This rotation is performed by the gear portion 24a and the gear 26.
The potentiometer 25 detects the amount of depression of the foot switch.

Reference numeral 27 denotes a solenoid. Solenoid 27
Is fixed to the shaft 22 by the mounting member 28, and rotates about the shaft 22 as the center of rotation together with the step portion 21. 27a is a pin of the solenoid 27, and a weight 27
b and the weight 27b and the solenoid 27
A spring (not shown) is sandwiched between the main bodies. As shown in FIG. 6, a voltage is applied to the solenoid 27 at the position positions 1, 2, and 3 detected by the potentiometer 25,
The solenoid 27 draws and drives the pin 27a. When the pin 27a is pulled in, vibration is caused by the movement of the weight 27b, and the surgeon recognizes the switching of the position.

A (lateral operating mechanism) 30 is a foot plate on which an operator places his or her foot. At the front right end (from the surgeon) of the foot plate 30, a footrest 30a for contacting the surgeon's foot is formed to protrude. The foot plate 30 is rotatably supported with respect to the stepping portion 21 by a shaft 31. The surgeon puts the foot on the foot plate 30, touches the side of the foot to the foot abutment portion 30a, and places the foot plate 30 on the foot plate 30. Rightward from the operator indicated by the two-dot chain line (arrow C in FIG. 4)
Direction).

Reference numeral 32 denotes a return spring for returning the foot plate 30 to the initial position. One end of the return spring 32 is a pin 3
3, the other end is fixed to the step portion 21 by a pin 34. The return spring 32 has a biasing force in the direction of arrow D in FIG.
When the pin 34 comes into contact with the restricting portion 35 provided on the step portion 21, the “0” is returned to the position indicated by the solid line, and the leftward deflection is restricted.

A rotation transmitting plate 40 having a shaft 31 as a center of rotation is fixed to the lower surface of the foot plate 30. The rotation transmission plate 40 has a gear portion 40a. Reference numeral 41 denotes a rotary potentiometer fixed to the inside of the step portion 21 by a fixing member (not shown). A gear 42 meshing with the gear portion 40a of the rotation transmitting plate 40 is mounted on the shaft of the potentiometer 41. It is. With these configurations, the potentiometer 41
Detects the amount of lateral deflection of the foot plate 30.

The (reflux mechanism) 50 is a leaf spring fixed to the front side of the base section 20 via a spacer (not shown). At the front end of the leaf spring 50, a reflux pedal 51 to which an operator touches the left side of the foot is fixed. Further, in front of the reflux pedal 51, a switch terminal of a reflux switch 52 held by the base portion 20 is attached. When the operator operates the foot of the reflux switch 52, the reflux pedal 51 is moved outward (left side).
It is energized when pressed. The reflux pedal 51 to which the reflux switch 52 is energized returns to the non-energized position by the action of the leaf spring 50 when the operator's foot is released.

The potentiometer 25, the solenoid 27, the potentiometer 41 and the reflux switch 52 of the stepping operation mechanism, the lateral operation mechanism and the reflux mechanism are respectively connected to the control unit 8 via a communication cable 55. Connected to

Next, in the apparatus having the above configuration,
The operation will be described focusing on the operation of the foot switch 14. Here, an explanation will be given of an example of an ultrasonic phacoemulsification performed using the crushing handpiece 5A. In this case, the mode is set to a perfusion / aspiration / ultrasonic emulsification mode. In the perfusion / aspiration / ultrasonic emulsification mode, when the foot switch 14 is in the position 3, the ultrasonic output is controlled within a set range by adjusting the foot switch.
Can be

Step portion 2 detected by potentiometer 25
The signal of the depression amount of 1 is subjected to predetermined processing and sent to the control unit 8. The control unit 8 controls the operation of each drive mechanism as follows based on the signal of the depression amount. As shown in FIG. 6, when the depressed amount reaches each of the positions 1, 2, and 3, the solenoid 26 is driven to make the operator recognize the switching.

Further, the control unit 8 opens the perfusion control valve 4 at the position 1 to put the perfusate in the injection state,
When the pressure reaches, the suction pump is driven to start suction. When the position 3 is further reached, ultrasonic vibration is generated in the crushing handpiece 5A. In position 3, the amount of depression further depends on the detected amount of potentiometer 25 ,
The ultrasonic output of the crushing handpiece 5A changes. In this way, the operator can switch the start / stop of perfusion, suction, and ultrasonic emulsification and variably adjust the ultrasonic output by depressing the foot switch. When the suction pump is operated at the position 2 or higher, either the suction pressure or the suction flow rate can be adjusted by laterally operating the foot plate 30. The selection of the suction pressure and the suction flow rate is switched by a mode switch of the suction pressure linear mode and the suction flow rate linear mode provided in the input unit 13.

When the foot plate 30 is shaken in the horizontal direction, the amount of the shake is detected by the potentiometer 41, and a detection signal of the potentiometer 41 is input to the control unit 8. The control unit 8 changes the suction pressure or the suction flow rate to the upper limit of the set value according to the shake amount. When the suction pressure linear mode is selected, the suction flow rate is constant at the set value, and when the suction flow rate linear mode is selected, the suction pressure upper limit is constant at the set value. Further, when the suction pump at the position 2 or higher is operated, the reflux switch 52 is turned on by swinging the reflux pedal 51 outward, and the control unit 8 having received this signal drives the suction pump 7 in the reverse direction to flow the suction flow. Reverse the flow temporarily. In this way, the surgeon adjusts the ultrasonic output by depressing the foot switch,
The suction pressure or the suction flow rate can be freely adjusted by operating the door 30 in the lateral direction.

In the above description, the operation when the ultrasonic emulsification mode is selected by the input unit 13 and the crushing handpiece 5A is used has been described.
In the case of selecting at 3 and using the perfusion suction handpiece 5B for residual cortical suction instead of the crushing handpiece 5A, both the suction pressure and the suction flow rate can be adjusted by the foot switch. The input unit 13 determines which of the stepping operation and the lateral operation is used for the variable adjustment of the suction pressure and the variable adjustment of the suction flow rate.
Select with the switch.

In the above embodiment, the operation signal by the stepping operation and the lateral operation of the foot switch is not limited to the output of the ultrasonic oscillation, the suction pressure, or the adjustment signal of the suction flow rate shown in the embodiment. For example, it can be used for giving signals of various surgical devices such as setting of coagulation conditions of a photocoagulation device. Although the foot plate 30 is rotated in the lateral direction, it may be moved in the X and Y axis directions.

[0027]

As described above, according to the present invention,
The output of the ultrasonic oscillation, the suction pressure, or the suction flow rate can be variably adjusted by operating the foot switch, and these setting conditions can be quickly changed to a state suitable for the operation, so that an efficient operation can be performed. .

[Brief description of the drawings]

FIG. 1 is a diagram showing a schematic configuration of an apparatus according to an embodiment.

FIG. 2 is a diagram illustrating the operation of perfusion, suction, and ultrasonic emulsification depending on the depressed position of a foot switch.

FIG. 3 is a side view of a foot switch of the device according to the embodiment.

FIG. 4 is a top view of a foot switch of the device according to the embodiment.

FIG. 5 is a view taken in the direction of arrow A in FIG. 4;

FIG. 6 is a diagram illustrating switching of a position position by depressing a foot switch.

[Explanation of symbols]

 8 Control unit 14 Foot switch 21 Stepping unit 25 Potentiometer 30 Foot plate 41 Potentiometer

Claims (2)

(57) [Claims] 1. A method for perfusing a perfusion solution in a perfusion bottle into an eye.
In an ophthalmic surgery apparatus with liquid supply means,
The suction pressure is variable, and the perfusate is sucked together with waste in the eye.
The power of the suction means for pulling and the power of the emulsification means are variable.
And emulsifying means for crushing and emulsifying intraocular tissue
First operating mechanism for depressing the footrest on the other hand
And a first detection means for detecting a stepping amount of the first operation mechanism.
The step and the footrest are transferred on a plane including the plane of the footrest.
A second operating mechanism for moving, and a transfer by the second operating mechanism.
A foot switch having second detection means for detecting movement;
Perfusion mode, perfusion / aspiration mode, perfusion / aspiration / emulsification mode
Mode selection means for selecting a mode from the modes,
Mode selection means from the drawing means and the emulsification means.
Operate in addition to perfusion based on the detection of the selection first detection means
Selecting means for selecting a power combination, and the second detecting means
Suction pressure or suction flow by the suction means based on the detection of
And control means for controlling the amount.
Ophthalmic surgery device. 2. Perfusion in which a perfusion solution in a perfusion bottle is supplied into the eye.
In an ophthalmic surgery apparatus with liquid supply means,
The suction pressure is variable, and the perfusate is sucked together with waste in the eye.
The power of the suction means for pulling and the power of the emulsification means are variable.
And emulsifying means for crushing and emulsifying intraocular tissue
First operating mechanism for depressing the footrest on the other hand
And a first detection means for detecting a stepping amount of the first operation mechanism.
The step and the footrest are transferred on a plane including the plane of the footrest.
A second operating mechanism for moving, and a transfer by the second operating mechanism.
A foot switch having second detection means for detecting movement;
Based on the detection results of the first detection means and the second detection means
Set of operation of the suction means and the emulsification means operating
Selecting means for selecting a combination.
Eye surgery device.