Devices and methods for ocular surgery

• US 10,231,870 B2
• Filed: 05/04/2018
• Issued: 03/19/2019
• Est. Priority Date: 05/04/2017
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Cataract Technology Inc. (Carl-Zeiss-Stiftung)
• Original Assignee: Iantech, Inc. (Carl-Zeiss-Stiftung)
• Inventors: Clauson, Luke W., Schaller, Michael P.
• Primary Examiner(s): Holwerda, Kathleen S
• Assistant Examiner(s): Lauer, Christina C
• Application Number:
  US15/971,387
• Publication Number:
  US 20180318133A1
• Time in Patent Office: 319 Days
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/00763 with rotating or reciprocating cutting elements, e.g. concentric cutting needles atherectomy cutting instruments A61B17/3207; endoscopic cutting instruments A61B17/320016

Abstract

Devices, systems, and methods for performing an ophthalmic procedure in an eye are disclosed. The devices include a hand-held portion and a distal, elongate member coupled to the hand-held portion having a lumen operatively coupled to a vacuum source. A drive mechanism operatively coupled to the elongate member is configured to oscillate the elongate member. When in use, the device is configured to aspirate ocular material from the eye through the lumen. The drive mechanism retracts the elongate member with a retraction speed profile and advances the elongate member with an extension speed profile. The retraction speed profile is different from the extension speed profile.

Claims

1. A device for performing an ophthalmic procedure in an eye, the device comprising:

a hand-held portion;

a distal, elongate member coupled to the hand-held portion, the distal, elongate member comprising an open distal end and a lumen operatively coupled to a vacuum source; and

a drive mechanism operatively coupled to the elongate member and configured to oscillate the elongate member,

wherein a distal portion of the distal, elongate member is sized and configured to extend through an anterior chamber of the eye and to a capsular bag of the eye, and further wherein, in use, the device is configured to aspirate lens material from the capsular bag of the eye through the open distal end and into the lumen, and

the drive mechanism retracts the elongate member in a proximal direction with a retraction speed profile and advances the elongate member in a distal direction with an extension speed profile, and further wherein an average retraction speed of the elongate member from the retraction speed profile is lower than an average extension speed of the elongate member from the extension speed profile.

2. The device of claim 1, wherein the extension speed profile comprises a maximum extension speed and the retraction speed profile comprises a maximum retraction speed, and further wherein the maximum retraction speed is less than the maximum extension speed.

3. The device of claim 2, wherein the maximum retraction speed of the elongate member is below a threshold speed at which cavitation bubbles would be generated in the eye.

4. The device of claim 1, wherein a distal tip of the elongate member is configured to move relative to the hand-held portion from a fully retracted configuration to a fully extended configuration to define a travel distance.

5. The device of claim 4, wherein a pulse of aspiration is drawn through the lumen of the elongate member during at least a portion of the travel distance as the elongate member retracts in the proximal direction.

6. The device of claim 4, wherein the device further comprises a control processor responsive to user input, the control processor for controlling one or more aspects of the drive mechanism.

7. The device of claim 6, wherein at least one of the extension speed profile of the elongate member and the retraction speed profile of the elongate member is adjustable through one or more changes to hardware, the hardware in operable communication with the control processor, and wherein the hardware comprises a portion of a phacoemulsification system.

8. The device of claim 1, wherein the drive mechanism is pneumatic, electromagnetic, piezoelectric, or mechanical.

9. The device of claim 1, wherein the drive mechanism comprises a piezoelectric element configured to oscillate the elongate member according to a voltage frequency that forms a non-sinusoidal motion pattern of the elongate member.

10. The device of claim 9, wherein the voltage frequency sent to the piezoelectric element has a generally non-sinusoidal waveform.

11. The device of claim 9, wherein the voltage frequency sent to the piezoelectric element comprises two or more overlapping sinusoidal waveforms configured to create an interference forming a generally non-sinusoidal waveform.

12. The device of claim 9, wherein the voltage frequency contracts the piezoelectric element slower than the voltage frequency allows the piezoelectric element to expand.

13. The device of claim 1, wherein the drive mechanism comprises a cam mechanism operatively coupled to the elongate member,

wherein a first amount of rotation of the cam mechanism is configured to retract the elongate member in the proximal direction along the retraction speed profile, and

wherein a second amount of rotation of the cam mechanism is configured to advance the elongate member in the distal direction along the extension speed profile.

14. The device of claim 13, wherein the retraction speed profile is at least in part a function of a rotational speed of the cam mechanism.

15. The device of claim 13, wherein the drive mechanism further comprises a spring configured to be compressed by the cam mechanism, wherein the first amount of rotation of the cam mechanism compresses the spring and the second amount of rotation of the cam mechanism releases the spring from compression.

16. The device of claim 15, wherein the extension speed profile is a function of a force of the spring and a mass of the inner elongate member.

17. The device of claim 1, wherein the elongate member comprises a cutting tip defining the open distal end.

18. The device of claim 17, wherein the cutting tip comprises a distal opening from the lumen having a first dimension, the first dimension smaller than a second inner, cross-sectional dimension of the lumen of the elongate member.

19. The device of claim 1, wherein the vacuum source delivers a pulsed vacuum to a distal portion of the lumen of the elongate member.

20. The device of claim 19, wherein the vacuum source is located within a housing of the hand-held portion.

21. The device of claim 19, wherein the drive mechanism repeatedly advances and retracts the elongate member while the vacuum source delivers the pulsed vacuum.

22. The device of claim 19, wherein after the elongate member completes a single cycle of one advancement and one retraction, the vacuum source delivers at least one pulse of vacuum to the distal portion of the lumen.

23. The device of claim 19, wherein as the elongate member passes through a single cycle of one advancement and one retraction, the vacuum source delivers a plurality of pulses of vacuum to the distal portion of the lumen.

24. The device of claim 19, wherein after each pulse of vacuum, the device produces a pulse of positive-pressure regurgitation.

25. The device of claim 19, wherein as the elongate member passes through an oscillation cycle of one advanced and one retraction, the vacuum source delivers at least one pulse of vacuum to the distal portion of the lumen.

26. The device of claim 25, wherein as the elongate member retracts during the oscillation cycle, the vacuum source delivers at least one pulse of vacuum to the distal portion of the lumen.

27. The device of claim 25, wherein as the elongate member advances during the oscillation cycle, the vacuum source delivers at least one pulse of vacuum to the distal portion of the lumen.

28. The device of claim 1, wherein the ocular material comprises at least one of fragmented lens material or emulsified lens material.