Ophthalmic endoscope and endoscope attachments for use therewith

[0002] The invention generally relates to ophthalmic surgical equipment in general and ophthalmic endoscopes in particular.

[0003] Ophthalmic surgical procedures typically require that two or even three surgical instruments are simultaneously deployed within the vicinity of a surgical site. The recommended diameter of an ocular surgical opening is about 1 mm which approximately corresponds to the diameter of each instrument and therefore normally two or three ocular surgical openings are required for an ophthalmic surgical procedure, each surgical opening enabling the insertion of a single instrument therethrough.

[0004] In U.S. Pat. No. 4,607,622 to Fritch, there is illustrated and described an ophthalmic endoscope provided with a probe formed with a conduit for accepting instruments, for example, a cutting device- for taking a sample (see Col. 3, lines 16-19) or fiber optics connected to an external laser source for ocular laser intervention However, in order to accommodate the conduit whilst maintaining the same endoscopic ability, the dimensions of the probe are necessarily greater tan those recommended for a surgical opening.

[0005] In accordance with a first aspect of the present invention, there is provided an ophthalmic endoscope for use with an endoscope attachment having a generally tubular body member, the endoscope comprising a rigid probe with an optical axis and a tip, and an attachment interface for releasably engaging the body member of an endoscope attachment slidingly mounted on said probe.

[0006] In accordance with a second aspect of the present invention, there is provided an endoscope attachment for use with an ophthalmic endoscope having a rigid probe with an optical axis and a tip, the endoscope attachment comprising a tubular body member for slidingly mounting on the probe.

[0007] Endoscope attachments of the present invention can be adapted for mounting on either a purpose built ophthalmic endoscope with an attachment interface or a conventional ophthalmic endoscope whereby a hitherto considered passive device is converted into a multi-purpose surgical device useful for a wide range of conventional and newly envisaged intraocular surgical procedures in various tissues of the eye. Mounting of an endoscope attachment on an ophthalmic endoscope's probe enables the imaging of a surgical procedure at high magnifications of up to 50× with an image resolution better than that obtained with an hitherto employed external imaging system i.e. an operating microscope.

[0008] For use with the purpose built ophthalmic endoscope of the present invention, the endoscope attachments preferably have a tubular body member coextensive with the endoscope probe when mounted thereon, the body member having longitudinally directed optic fibers for transmitting illumination light therealong for illumination of a surgical site. The overall width of the probe together with an endoscope attachment mounted thereon is about 1 mm for insertion through a conventional sized ocular surgical opening. In addition, an endoscope attachment can include surgery associated means typically disposed beyond the probe tip when mounted on the probe, the surgery associated means being implemented as an optical element for ocular examination, a surgical tip for ocular surgical intervention or a cauterization tip for ocular cauterization intervention. The ophthalmic endoscope of the present invention can be implemented for selectively displacing the surgical associated means relative to the probe along its optical axis whereby surgical procedures can be performed whilst maintaining the same field of view and image features. The ophthalmic endoscope of the present invention can be implemented for use with a computer controlled XYZ manipulator for facilitating magnifications greater than ×100.

[0009] In order to understand the invention and how it is used, preferred embodiments will now be described by way of non-limiting examples only, with reference to the accompanying drawing in which:

[0010] FIG. 1 is a pictorial view of an ophthalmic endoscope with an endoscope attachment for use therewith in accordance with the present invention;

[0011] FIG. 2 is a front view of the endoscope of FIG. 1;

[0012] FIG. 3A is a longitudinal cross section of the ophthalmic endoscope of FIG. 1 along line A—A;

[0013] FIG. 3B is a close-up view up of an interchangeable dichroic mirror of the ophthalmic endoscope of FIG. 1;

[0014] FIG. 4 is a transverse cross section of the endoscope attachment of FIG. 1 along line B—B;

[0015] FIG. 5 is a pictorial view of the ophthalmic endoscope of FIG. 1 held and manipulated by a computer controlled XYZ manipulator;

[0016] FIGS. 6-9 are partially cut-away side views of the ophthalmic endoscope of FIG. 1 with different endoscope attachments;

[0017] FIG. 10 is a perspective view of a conventional ophthalmic endoscope with an endoscope attachment in accordance with the present invention;

[0018] FIG. 11 is a close-up view showing the mode of attachment of an endoscope attachment to a conventional endoscope attachment; and

[0019] FIGS. 12A-12E are close-up views of various endoscope attachments of the present invention.

[0020] In FIGS. 1-3, an ophthalmic endoscope 1 is adapted for use with an endoscope attachment 2 and for connection to a display 3, an external light source 4, an external laser source 6 and an external DC power source 7. The endoscope 1 has a handpiece 8 and a rigid probe 9 having a tip 11 and defining an optical axis 12 on which a CCD 13 is disposed for imaging a surgical site on the display 3.

[0021] The handpiece 8 has an attachment interface 14 constituted by a major socket 16 from whose center the probe 9 extends and a minor socket 17, the major socket 16 being adapted for securely engaging a proximal end 18A of a tubular sleeve-like body member 18 of the endoscope attachment 2 and the minor socket 17 being adapted to receive a rearwardly directed tang 19 of the endoscope attachment 2. The endoscope attachment's body member 18 is shaped and dimensioned for tight sliding along the probe 9 and contains a fiber optic annulus 21 (see FIG. 4) which is coupled via a pin 22 received in a socket 23 connected to the external light source 4 for transmitting illumination light therealong for illuminating an eye's interior.

[0022] The handpiece 8 has a dichroic flip flop mirror 24 under the control of a hand operated external lever 26 for selectively enabling laser light from the external laser source 6 to be transmitted along the probe 9 when disposed along the optical axis 12. The flip flop mirror 24 is releasably held in a carriage 27 slidably mounted on tracks 28 such that the flip flop mirror 24 is interchangeable whereby different lasers can be employed The handpiece 8 has a cog 29 driven by a motor 31 under the control of a hand operated rocker switch 32 for engaging a rack 33 formed on the tang's underside for selectively displacing the endoscope attachment 2 relative to the probe 9 along a stroke of about 3 mm whereby surgical procedures can be performed whilst maintaining the same field of view and image features.

[0023] The ophthalmic endoscope 1 has a sensing unit 34 for use with a computer controlled XYZ manipulator 35 (see FIG. 5) supporting the handpiece 8 by means of a support rod 36. The sensing unit 34 has a sensor 37 reciprocatingly extendable in a direction parallel to the optical axis 12 between a fully retracted position when it is substantially flush with the handpiece's front surface and a fully protruding position when it is substantially coextensive with the probe tip 11. The sensor 37 is initially fully extended by a motor 38 on depressing a pushbutton 39 and thereafter its tip 37A is continuously urging against a portion of an eye wall A adjacent an ocular surgical opening B through which a surgical procedure is performed. During such a procedure, the XYZ manipulator 35 utilizes the distance of the sensor's tip 37A from its fully retracted position as sensed by the sensing unit 34 for manipulating the endoscope 1 relative to the ocular surgical opening B in a manner similar to a ball and socket like universal socket.

[0024] The ophthalmic endoscope 1 is adapted for use with a number of different endoscope attachments 2, the simplest attachment 40 (see FIG. 6) thereof being similar to the endoscope attachment 2 except without the tang 19 suitable for ocular examination and ocular laser intervention. Other attachments with a tang enabling selective displacement relative to the and including surgical associated means at their distal ends are as follows: An endoscope attachment 41 thereto (see FIG. 7) with an optical element 42 disposed along the optical axis 12 on its mounting suitable for ocular examination and ocular laser intervention. An endoscope attachment 43 (see FIG. 8) with a surgical tip 44 extending beyond the probe tip 11 in a bayonet-like fashion on its mounting suitable for ocular surgical intervention. An endoscope attachment 46 (see FIG. 9) with a cauterization tip 47 coupled to an electrical coupling 48 (see FIG. 2) connected to the external DC power source 8 extending beyond the probe tip 11 in a bayonet-like fashion suitable for ocular cauterization intervention.

[0025] In FIG. 10, an endoscope attachment 49 with a surgical blade 51 or an endoscope attachment 52 with an optical element 53 can be slidably mounted on aconventional ophthalmic endoscope 54, each endoscope attachment 49 and 52 having a slit 56 transverse to its longitudinal axis whereby it secured to the endoscope's probe by means of an elastic member 57 circumscribing the probe surface exposed through the slit 56 and the probe's outer surface (see FIG. 11).

[0026] Various modifications and changes may be made in the configuration described above that come within the spirit of the invention. The invention embraces all such changes and modifications coming within the scope of the appended claims. For example, different modes of attachment between the endoscope attachments and the endoscopes can be employed. In addition, the probe 9 may include the fiber optic annulus 21. Also, a surgical tip can include a pin point shaped blade (see FIG. 12A), a crescent shaped blade (see FIG. 12B) and a round point shaped blade (see FIG. 12C) whilst an optical element can include a convex lens 16 for focusing purposes (see FIG. 12D) or a prism 18 for refracting purposes (see FIG. 12E).