Apparatus and method for auto-titrating a laser

This invention, generally, regards the laser system. Especially, this invention regards the laser system for operation. Especially and, this invention regards the system and its manner for the automatic increase of the laser in order to use for the operation of the eye.<br /> This application, insisting the priority sequence of the original of the American patent modulo 119th provision and American temporary patent application number 60/818002 which is applied on 2006 June 30th, the entire contents accessing, is installed in this bill.

Many ophthalmology operation behavior, is done for example vis-a-vis, the eye of patient such as retina. These behavior need that spot of light is irradiated to the part where the eye chooses, of usually, spot this light is offered by the laser which possesses the spot size of desire. Utilization of the microscope operation which light ray dynamic medical therapy (photo-dynamic therapy), ray crotch lining (LASIK), includes laser sukurarosutomi (laser sclerlostomy), tissue cylinder band incision technique (trabeculectomy), and nervous (neural) operation, operation and spinal cord (spinal chord) operation of the glenoid mirror apparent bottom the (arthroscopic) to example of the operation behavior which utilizes the laser, uses the general endoscope is included.

Usually, it can direct to the part which the retina of the patient chooses optical spot of the laser, in one ophthalmology operation behavior which is named retina solidification, accumulates energy, causes the solidification of the local cell. That kind of optical solidification means, for example, in order to cover vascular it is easy neutron leakage, in order to break abnormal vascular, or, it can be used in order to cover the rift of the retina. At the time of preparing that kind of laser means and the other laser means, as for the surgeon, usually, shooting several laser shots for investigating on the retina, as for the te it does not become because of the operation effect which it makes purpose not to increase laser power. The surgeon starts, to usually, configurating the laser low power configuration. As for him or her, laser power, or shows the fact that it exceeds level in the level which the behavior which is made purpose needs, until the cell effect (for example, solidification) of desire is observed, laser power it augments gradually. The surgeon, after that, configurating laser power lastly, deals with the field where it makes purpose.

Because the laser for the operation which presently exists or the laser system for operation do not have the capacity which progresses the laser for operation automatically, the procedure which progresses the laser is done in the manual operation by the surgeon. If feature of the procedure which progresses the laser, is automated is in substituting, because as for the surgeon, it is possible, to be opened from the addition configuration procedure which is necessary for the configuration of power of the laser for the surgery vis-a-vis operation behavior, you can do the improvement of efficiency of operation behavior and the improvement of the flow.

<p> Therefore, the device in order to progress the laser for operation automatically and the necessity for its manner exist. This device and manner until recently problem of the laser for operation of technology which progresses the laser for operation in the manual operation at the time of preparing for operation behavior, it is something which or can decrease remove. </p>

<p> Execution configuration of the laser device and its manner which use the laser for operation, in this inventing progress automatically, substantially, satisfies these necessity and the like. The laser as for one execution configuration of manner in order automatic increase to do, at the same time it offers the algorithm which can configurate the laser, one or on the basis of multiple user entries makes the above-mentioned algorithm run and it offers the 1st user entry which can emit the above-mentioned laser with the pattern which at the same time is decided answering the condition which was observed, it makes emission the above-mentioned laser halt, and the above-mentioned algorithm decide one or makes the multiple laser parameter values and it offers the 2nd user entry which can make the above-mentioned laser configurate the above-mentioned one or on the basis of the multiple laser parameter values, the above-mentioned laser emitsWhen halting, last laser power value is entry to the above-mentioned algorithm, the above-mentioned algorithm the above-mentioned one or it possesses the step which decides the multiple laser parameter values on the basis of the above-mentioned last laser power value. This manner automatically or through other user entry furthermore, with automatic progressive algorithm, the laser to includes the fact that it moves the charge (for operation) mode (set). Once, when it becomes charge mode, the user for example like the surgeon can run operation behavior making use of the laser which is configurated automatically. At the same time as for the surgeon, that way, quickly efficient, when it is configurated to the power configuration which the laser configurates him or her beforehand automatically, it can move to the run of the operation which is made purpose. </p><p> A certain advantage in one execution configuration of this invention which exceeds preferential technology, that way, automates the procedure of progression and the part of configuration, the flow and efficiency of operation behavior it is the capacity which improves with that. For example, the surgeon chooses the inclination of the progression which is configurated beforehand, it seems like the normal using foot switch in order to control the manipulation of the laser for ophthalmology operation with the surgeon of ophthalmology, to activate the laser pulse string which is configurated beforehand by operating it is possible the control switch. As for the surgeon, observing the effect where the top of the cell which was irradiated by the beam of the laser is desirable, foot switch (or, other control unit) release it is possible to do. The time specification (interval) of control unit release seems like laser power and the pulse duration for the operation behavior which is intended on the basis of the standard where one for operation is beforehand configurated, in order to configurate the specified laser operation parameter, it can be used by the laser system for operation. Depending on the standard which the surgeon configurates beforehand, perhaps the operation parameter which is configurated by one execution configuration of this invention, it is lower whether, or it is higher whether, it is corresponding vis-a-vis the configuration at the time of release of the control unit. </p><p> Execution configuration of this invention can have the device in order to progress the laser for operation automatically. This device has the memory which operation possibly is joined in treatment module and this treatment module. Here, memory makes several functions run which are explained to treatment module at least here, it possesses computer feasibility software instruction. As for execution configuration of the device in order to progress the laser for operation automatically, furthermore, responding to the signal from treatment module, it has the hardware which can run several functions which are explained at least here. </p><p> Execution configuration of this invention can be implemented in the laser system for optional ophthalmology operation which is known in this trader. Especially, it can be implemented by the system for eye light/write (registered trade mark) laser operation which is produced karuhuarunia bank, by the arukon maniyuhuakuchiyaringu corporation of arbor in. Execution configuration of this invention can be installed in the machine or the system for that kind of operation for using with operation of ophthalmology or other things. The device in order to progress the laser which you follow the instruction of this invention automatically and use of the other things for manner, being known in this trader, are expected probably will be inside the range of this invention. </p>

More complete understanding of this invention and its advantage, considering the drawing of attachment collectively, it probably will be obtained by accessing the below-mentioned demonstration. Regarding drawing, the similar reference mark, has shown similar feature.

The execution configuration where this invention is desirable, is explained by drawing, the similar code, similar or accesses the part in each drawing which corresponds and is used.

Each execution configuration of this invention has the device and manner in order to progress laser such as laser for operation, and for example the laser for operation which are progressed automatically automatically, these, laser parameter of the specification which for example is used for user such as surgeon, with operation behavior, concretely offer the capacity which is configurated automatically laser power, on the basis of the actual effect and specified configuration (progression) program. Execution configuration of this invention, can include the device in order to progress the laser and the laser which for operation are progressed automatically automatically, and the manner in order to configurate the laser.

Execution configuration of this invention offers the capacity which automates the process which is progressed until recently by hand of technology to the surgeon. At the time of this processing, the surgeon, emitting the test shot, tries around the retina and burns and creates. Here, burning changes until you can see the effect of the desire like the thing where the part where for example influence of the retina is received becomes white, gradually and almost does not cause influence in visual sense of the patient at the time of laser power configurating which augments. Once when you can see the effect which is made white, the surgeon laser power knows that it is higher than the power which is desired vis-a-vis retina operation. He or her, suitableness, can configurate to a lower set vis-a-vis the operation result which designates laser power, as purpose. This operation result is something which does not have the times when the influence (for example damage) which is not intended in the retina of the patient is caused. For example, as for the surgeon, just a certain coefficient (for example 20%) can choose the fact that power is made low. Usually, as for the retina in test position becoming white, laser power configuration, displays the fact that it is higher than desirable laser power vis-a-vis operation behavior.

Until recently when as for the laser system for operation of technology, in the surgeon, adjusting power gradually, next, you can see the influence of the cell, in order power to configurate to the manipulation value of desire by hand, it requires that the laser for operation is progressed by hand. Execution configuration of this invention, to however, in order the progressive algorithm to which the surgeon can configurate the parameter of the laser for operation automatically, with guidance of the surgeon, to decide beforehand, automates the feature of progressive procedure. For example, one execution configuration of this invention, impulse rate, pulse duration, the laser power growth, one inside early power and largest laser power or the how many, offers the automatic progressive function which allows the fact that the surgeon configurates beforehand. As for the surgeon, in addition, power configuration (namely, it is possible to configurate beforehand as a function laser power which is used in operation behavior) for operation (in regard to manipulation) of the laser, for example last progression power configuration (desirable cell influence being seen, power configuration where surgeon stops test shot). For example, perhaps the power configuration for operation, 20% than last progression power configuration it is lower configurated. It seems the known way in this trader, other parameter configuration, it is possible to be decided beforehand, with the execution configuration of automatic progressive algorithm of this invention, vis-a-vis automatic setting.

Once when the surgeon configurates automatic progressive function beforehand, execution configuration of this invention runs that function, in order to configurate the laser parameter for operation for operating automatically on the basis of the entry by the surgeon, operates. While preparing operation, laser or laser function the surgeon does the entry that the button and the scope icon where the manipulation which operates is possible, you operate the control interface like the foot switch or optional other control mechanism. In a certain execution configuration, for example, as for the surgeon, operating the foot switch, it is possible to emit the laser. According to the execution configuration of this invention, as for the surgeon, between progressive mode (as for this mode, laser for operation/through control interface on control unit, it can be activated,), operating the foot switch, it can emit the laser. This way, being able to send the progression program (for example, power growth and pulse duration etc) which is configurated beforehand, one or it shoots the multiple test shots on the retina of the patient. Once, when the cell effect where the surgeon displays the laser power configuration of desire, makes purpose is observed, he or her can halt the operation of the laser, (for example, the foot switch release is done, (separating,)). This, the automatic progression program, following the laser parameter which is chosen, to the standard to which the automatic progression program is beforehand configurated laser power, concretely, brings the fact that it configurates to the configuration for operation which is chosen, automatically. The surgeon laser test emission (progression) the specification of the time when it is the point in time when you stop (the duration when the surgeon emits the laser test shot), is first entry in order to decide the laser configuration for operation on the basis of the laser operation parameter. Once, when the automatic progression program configurates laser parameter to the value for the operation, as for the laser for operation, it is possible, as for the surgeon, to move automatically in disposal mode, it is possible to do without suspending operation behavior.

Drawing 1 the laser of this invention is the figure which shows one example of the device in order automatic increase to do and the laser control unit for operation which one execution configuration of manner can be implemented. Laser 10, user interface 12, each control knob and/or button 14, probe port 16, illumination port 20, on/off key has 22, and urgent cutoff button 24. These means are only one example, the laser for operation/as for the laser control unit, it is possible to have possessed other control interface and the port perhaps it is useful in these optional combinations and the ophthalmology laser system. User interface 12, it seems the known way in this trader, displaying, it chooses the function of laser system, 10 at the same time it includes the scope of touch sensor type in order to allow the fact that control/you adjust parameter in the user, it can be graphical user interface. Other various control means and the port which are shown in drawing 1, can offer clear function to this trader of the laser system for ophthalmology.

Laser 10 has joined, furthermore, mutually operational, at the same time, it has joined to the control facility of the control unit of laser 10 for operation operational, treatment module it can have 50 and related memory 52. Treatment module 50 and related memory 52 makes laser emit 10, configuration of laser 10 and alteration the other function which it is related to the laser 10 which is well known in this trader, stores manipulation instruction and at the same time can run. As for treatment module 50 and related memory 52, especially, manner of this invention which is stated in this bill/the computer which can make functional at least how many of algorithm the laser run (treatment module) the feasibility software/you store manipulation instruction and at the same time you can run. As for that kind of instruction, the hard code, and/or, it is possible, to be the manipulation instruction which is stored in memory 52 at least it can correspond to several it is stated in this bill steps or function.

Treatment module 50, one central processing unit, or, can be the many central processing unit. That kind of central processing unit the signal (analog and/or digital) may be the optional device which is manipulated the microprocessor, the micro controller, the digital signal processor, the micro-computer and the central processing unit, field programmable gate array, the programmable logic device, the state machine, the logic circuit, the analog circuit and the digital circuit, and/or, hard coding of the circuit and/or on the basis of manipulation instruction. Memory 52, one memory unit and the many memory unit, and/or, may be the circuit which is installed in treatment module. Memory 52, ridoonri memory, random access memory, volatile storage, non-volatile memory, static memory, dynamic memory, flash memory and cache memory, and/or, may be the optional device which stores digital information. Treatment module 50, the state machine, the analog circuit and the digital circuit and/or through the logic circuit, when one among functions or implementing the how many, to the dot memory 52 and/or the memory element which stores the manipulation instruction which corresponds, whether the state machine, the analog circuit and the digital circuit and/or in the circuit which includes the logic circuit or may be installed outside, should consider. Furthermore, at least it corresponds several from drawing 1 it is stated in 4 steps and/or to function the instruction which is coded hard and/or manipulation instruction, to store the memory element, to the dot that it runs treatment module, should consider.

As for the one of this traders, user interface 12 probably will be, generally, recognizes the fact that it corresponds to the optional user interface inside the operation system for ophthalmology which uses the laser for operation. Especially, as for user interface 12, it inputs to the execution configuration of the automatic progressive procedure where this invention is beforehand decided,/in order to program, for example it seems like the surgeon, with the user it can be used. For example, for example as for the user, graphical user interface through the other control means of 12 and laser 10, laser starting power, pulse duration, impulse interval, the power step growth, largest approved laser power, last progression power configuration (, at the time of release of the foot switch) from the power configuration offset and single/multi shot pattern etc for operation can be input.

Drawing 2 is the enlarged drawing of one execution configuration of user interface 12 of this invention. In user interface 12, as for the user, for example, laser power 30, pulse duration 32 or you can adjust by touching to the screen in impulse interval 34, the respective functional label. User interface 12, next, for example, the graphical slider which can use because the user adjusts parameter by crossing the scope, making his/her finger slide with the manner which is well informed in this trader, (not to illustrate) it is possible to present. For example as for the surgeon, that way, other function (, largest laser power and power offset proportion etc for operation) with in the same way, it is possible to decide progressive procedure beforehand, making use of the function which is shown in drawing 2. The progression program which presently or past is stored being chosen, through user interface 12, after that, with the surgeon, for example it can be activated the laser emission foot switch or other means by operating. The progression program being chosen with the surgeon, by configurating laser 10 to progressive mode, it can be able to do the preparation for activating. As for configurating laser 10 to progressive mode, for example, by for example choosing progressive button 40 in user interface 12, or, you can do by choosing that kind of mode by operating the dedicated progressive mode switch 29 in drawing 1. Progressive mode switch 29 is the software switch or the optional other that kind of control switch on laser 10 for operation.

Drawing 3 depends on one execution configuration of this invention, power of the progression program/the algorithm which a certain beforehand is decided (electricity) it is the figure which shows anti- time profile. In the example in graph 100, for example, the starting laser power of 200mW, the pulse duration of 200ms, the impulse interval of 200ms, the power step growth of 30mW, the largest approved power of 500mW, and, - the surgeon chooses the laser power configuration offset for operation from last progressive power which is 20%, (namely, once the surgeon, to observe the cell effect of desire, for example release doing the foot switch or the other operation device, when it halts the laser test shot, as for progressive procedure 20% it is lower than the laser power in laser power for operation, the release of the foot switch automaticallyIt configurates). As for the surgeon, through user interface 12 in laser 10, it is possible, desires to program these progression configurations, if is, to retain for accessing after it is possible that progression configuration.

Way you express already, as for the surgeon, it is possible to activate automatic progressive mode by pushing the foot switch, the button or the virtual button for example in the control unit of laser 10. As shown in drawing 3, for example because the surgeon emits laser 10 in point A, the operation system (, the foot switch) pushing, the automatic progressive sequence/algorithm being activated, following to automatic progressive algorithm/the program, it controls the emission of laser 10. From point A to point B, laser power in every 200ms augments at the increment of 30mW, each impulse has the duration of 200ms. In point B, as for the surgeon, release doing the operation device, emission of the laser stops. Power configuration for last operation is configurated as compared to point B (shown in point C with the progressive algorithm of this invention,) 20% low automatically. Once, when power is adjusted the value for operation, as for laser 10, further entry from the surgeon dying mode for operation (namely, automatic progressive mode ends, as for the laser charge (ready) with it becomes) automatically moving, as for laser 10 preparation of operation is prepared. At the same time as for the surgeon, that way, quickly efficient, when it is configurated to the power configuration which laser 10 configurates him or her beforehand and the parameter configuration to which optional other things are beforehand configurated automatically, it can move to the run of the operation which is made purpose. When you think, if the surgeon, power configuration for automatic setting operation is inadequate vis-a-vis operation, he or her iterates the above-mentioned procedure, or can adjust power by hand.

As for drawing 4, it is the flowchart which demonstrates the step in one execution configuration of manner of this invention. In step 200, the user, as mentioned, programs the automatic progression program, or chooses. Or, the user, as mentioned, programs the automatic progression program and at the same time chooses. As for step 200, in addition, as the user, mentioned, it can include the fact that laser 10 for operation is set to progressive mode. In step 210, the user running the automatic progression program which is chosen, by pushing the operation system for example like the foot switch, emits laser 10 (one in order to progress laser 10 or the multiple test shots). The automatic progressive sequence being activated, following to the progression program which is chosen, it controls the emission of laser 10. In step 220, when the cell reaction of the desire in test shot position is observed, the user stops emission of laser 10, for example by release doing the operation system. In step 230, entry of the surgeon (halt of the laser) responding, the automatic progression program, following to the standard of the automatic progression program which is decided beforehand, it corresponds to the automatic progression program which is chosen it configurates the laser parameter which is chosen automatically. In step 240, as for laser 10, automatically or through the entry of the other user with the automatic progression program, charge (for operation) moving to mode, as for the surgeon, it can run operation behavior in step 250. At the same time as for the surgeon, that way, quickly efficient, when it is configurated to the power configuration which laser 10 configurates him or her beforehand and the parameter configuration to which optional other things are beforehand configurated automatically, it can move to the run of the operation which is made purpose. While mentioning, several or to include all steps it is possible the execution configuration of manner of this invention.

Further execution configuration of this invention can have the device for the laser for automatic progression operation. As shown in drawing 5, device 400 treatment module can have with 402 and memory 404.<br /> Treatment module 402, one central processing unit, or, can be the many central processing unit. That kind of central processing unit the signal (analog and/or digital) may be the optional device which is manipulated the microprocessor, the micro controller, the digital signal processor, the micro-computer and the central processing unit, field programmable gate array, the programmable logic device, the state machine, the logic circuit, the analog circuit and the digital circuit, and/or, hard coding of the circuit and/or on the basis of manipulation instruction. Memory 404, one memory unit and the many memory unit, and/or, may be the circuit which is installed in treatment module. Memory 404, ridoonri memory, random access memory, volatile storage, non-volatile memory, static memory, dynamic memory, flash memory and cache memory, and/or, may be the optional device which stores digital information. Treatment module 402, the state machine, the analog circuit and the digital circuit and/or through the logic circuit, when one among functions or implementing the how many, to the dot memory 404 and/or the memory element which stores the manipulation instruction which corresponds, whether the state machine, the analog circuit and the digital circuit and/or in the circuit which includes the logic circuit or may be installed outside, should consider. Furthermore, at least it corresponds several from drawing 1 it is stated in 4 steps and/or to function the instruction which is coded hard and/or manipulation instruction, to store memory 404, to the dot that it runs treatment module 402, should consider.

Accessing the desirable execution configuration where there is this invention, it was explained, but this invention should consider to the dot that it is possible to be materialized with the forma or the deformation example of specification of other things, without mind of this invention or leaving from basic feature. As for the execution configuration which it mentions, therefore, that it is the demonstration in all viewpoints you can think, those which restrict the range of this invention which is shown by the patent claim of attachment you cannot think. In order to be used here, substantial (substantially) and the word which (approximately) with is said approximately the allowance which is accepted industrially that the word which corresponds and/or two entries (item) vis-a-vis the relationship between, is had. That kind of as for the allowance which is accepted industrially, from under 1% there is 50% range, is not the case that it is restricted to these, but component value, frequency of integrated circuit process fluctuation, temperature fluctuation and increase and decrease, and/or, thermal noise corresponds. Relationship between that kind of entries from 2 from the difference of 3 percent reaches to the big difference. In addition, in order to be used here, joined (coupled to) and/or join (coupling) with the word which is said, direct join between entries, and/or, a certain entry includes the indirect join between the entries which lie between, for example (, as for a certain entry, as for restriction it does not make these, but the part and the element, the circuit, and/or, module is included). Here, the entry which lies between vis-a-vis indirect join, alteration the information of the signal, but electric current level and voltage level of the signal, and/or, it is good alteration power level. Furthermore, in order to be used here, when it has joined to the other element, inference join (inferred coupling) (namely, one element inference (inference) with), it joined (coupled to) with in the same way, it includes the direct between two entries and indirect join. And furthermore, in order to be used here, it is possible to do, (operable to) with as for the word which is said, a certain entry one or has the join, entry and output etc of multiple electricity, one or we display the fact that the function to which multiple corresponds is run, furthermore, one or are possible to include the inference join with the multiple other entries. And furthermore, in order to be used here, with there is a relation, (associated with) with the word which is said the direct of the entry which is separated and/or includes indirect join, and/or, includes the fact that one entry is padded in other entry. In order to be used here, it compares desirably (compares favorably) with as for the word which is said, two or the comparison in between entry and the signal etc above that, displays the fact that desirable relation is had. For example, when it is the relation which the notion that where is desirable signal 1 is larger than signal 2, size of signal 1 it is larger than size of signal 2 when or size of signal 2 when it is smaller than size of signal 1, desirable comparison is achieved.

This invention was explained, accessing the general field of laser ophthalmology operation, but it can apply the instruction which is included in this bill, equally to the system for optional operation where it is desired that it controls laser subsystem.

<figref num="1">The laser of this invention it is the figure which shows one example of the device in order automatic increase to do and the laser control unit for operation which one execution configuration of its manner can be implemented. </figref><figref num="2">It is the enlarged drawing of one execution configuration of user interface 12 of this invention. </figref><figref num="3">It depends on one execution configuration of this invention, power of the progressive procedure which a certain beforehand is decided (electricity) it is the figure which shows anti- time profile. </figref><figref num="4">It is the flowchart which demonstrates the step in one execution configuration of manner of this invention. </figref><figref num="5">The laser of this invention it is the functional block figure of one execution configuration of the device in order automatic increase to do.</figref>