Apparatus and method for laser cyclo-photocoagulation

• US 5,533,998 A
• Filed: 12/12/1994
• Issued: 07/09/1996
• Est. Priority Date: 12/21/1993
• Status: Expired due to Fees

• Current Assignee: Carl-Zeiss-Stiftung
• Original Assignee: Carl-Zeiss-Stiftung
• Inventors: Freese, Manfred, Reimer, Peter, Lasser, Theo
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): HARRIS, SONYA C
• Application Number:
  US08/354,404
• Time in Patent Office: 575 Days
• Field of Search: 606/4, 606/5, 606/6, 606/10, 606/11, 606/12, 606/14, 606/15, 606/16, 606/17, 128/660.06, 128/660.09, 607/97
• US Class Current: 606/4
• CPC Class Codes: A61F 2009/0052 the instrument being supported on the patient's eye
• CPC Class Codes: A61F 2009/00865 Sclera
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00821 for coagulation
• CPC Class Codes: A61F 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008

Abstract

A laser cyclo-photocoagulation in the eye is monitored on-line by means of an ultrasonic biomicroscope, i.e., visual representations of the treated field, inclusive of the effects obtained in the tissue, are provided continuously on a display placed at the disposal of the attending doctor. The doctor decides, by means of the generated ultrasonic images, on the course of the further treatment. The choice is possible between different operating modes of the ultrasonic biomicroscope.

Claims

1. Apparatus for laser cyclo-photocoagulation comprising:

fiber applicator means (3, 33,

     40) for applying laser radiation for cyclo-photocoagulation, an ultrasonic head (4b, 40b) of an ultrasonic biomicroscope for monitoring said laser cyclo-photocoagulation,

holding means for holding said fiber applicator means and said ultrasonic head in a defined relative orientation to each other, so that a treatment site for laser cyclo-photocoagulation and said fiber applicator means (3, 33,

     40) lie in an observation plane of said ultrasonic biomicroscope in any possible irradiation position,

and display means (12) connected with said ultrasonic biomicroscope for displaying a visual representation of said treatment site.

2. Apparatus according to claim 1, further comprising fixing and filling means (2, 30) for placement on an eye for fixing said eye in a defined position and for filling with a liquid.

3. Apparatus according to claim 1, further comprising image processing means (11) connected to said display means (12) for processing and representing images of investigated tissue, connected to follow said ultrasonic head (4b, 40b) of said ultrasonic biomicroscope, said image processing means including selection means for selecting between at least two operating modes of said ultrasonic biomicroscope.

4. Apparatus according to claim 3, wherein said two operating modes of said ultrasonic microscope comprise operating modes of A-image technique and B-image technique of said ultrasonic biomicroscope and include representations of said two operating modes on said display means (12).

5. Apparatus according to claim 4, in which said fiber applicator means (3, 33, 40) has a distal end and said ultrasonic head (4b, 40b) is oriented relative to said distal end of said fiber applicator means (3, 33, 40) such that said treatment site in said eye is visible on said display means (12) in said B-image technique mode of said ultrasonic biomicroscope.

6. Apparatus according to claim 5, in which said display means (12) provides in the B-image technique mode of said ultrasonic biomicroscope a differential representation of a section of said eye being worked on, with super-posed images of different treatment stages.

7. Apparatus according to claim 1, in which said fiber applicator means (3, 33, 40) is coded to provide an optimum discernment on said display means (12).

8. Apparatus according to claim 7, in which said fiber applicator means (3, 33, 40) is provided with a coating having integrated scattering elements that effect a diffuse scattering of ultrasonic waves emitted by said ultrasonic head (4b, 40b).

9. Apparatus according to claim 1, further comprising laser diode irradiation means (6) providing an irradiation source for said fiber applicator means (3, 33, 40).

10. Apparatus according to claim 1, further comprising laser radiation means for providing laser radiation having laser wavelengths that lie in a region of 0.5 μ

m-1.7 μ

m.

11. Apparatus according to claim 2, in which said fiber applicator means (3, 33, 40) has a distal end that is positioned by said fixing means (2, 30) circularly relative to said eye (1, 100).

12. Apparatus according to claim 11, wherein said fixing means (2, 30) comprises an outer cylinder (20a) and an inner cylinder (20b) that is rotatable relative to said outer cylinder, said outer cylinder (20a) assumes a fixed relative position to said eye (1, 100), said inner cylinder (20b) is rotatable relative to said fixed relative position, and said distal end of said fiber applicator means (3, 33, 40) is firmly connected to said inner cylinder (20b).

13. Apparatus according to claim 1, in which said fiber applicator means (3, 33, 40) has a distal end, further comprising a mechanical coupling (35) connected to said fiber applicator means and said ultrasonic head for establishing said defined relative orientation between said distal end of said fiber applicator means (3, 33, 40) and said ultrasonic head (40b) of said ultrasonic biomicroscope.

14. Method for laser cyclophotocoagulation, comprising the steps of:

monitoring a course of treatment in an eye (1,

     100) on a display (12) of an ultrasonic biomicroscope, an ultrasonic head of said ultrasonic biomicroscope being aligned towards a treatment site, and

utilizing information acquired by means of said ultrasonic biomicroscope for regulation of applied laser irradiation during said course of treatment.

15. Method according to claim 14, in which said acquired information is directly utilized by means of a control circuit or regulating circuit for regulation of said applied laser radiation.

16. Method according to claim 14, further comprising adjusting a fiber applicator (3, 33, 40) relative to said ultrasonic head (4b, 40b) so that a distal end of said fiber applicator (3, 33, 40) and a treatment site are simultaneously visible in an ultrasonic image in a B-image technique mode,

laying down at least one sectional line through a region to be treated in said eye (1, 100), along which line a one-dimensional representation is possible in an A-image technique mode, and

utilizing behavior with time, in said course of treatment, of signal amplitude in a representation of said A-image technique mode in said region of treatment for regulation of applied laser power.