System and method for pulsed ultrasonic power delivery employing cavitation effects

• US 10,245,179 B2
• Filed: 01/07/2015
• Issued: 04/02/2019
• Est. Priority Date: 10/21/2002
• Status: Active Grant

• Current Assignee: Johnson & Johnson Surgical Vision, Inc. (Johnson & Johnson)
• Original Assignee: Johnson & Johnson Surgical Vision, Inc. (Johnson & Johnson)
• Inventors: Kadziauskas, Kenneth E., Rockley, Paul W., Schafer, Mark
• Primary Examiner(s): Tanner, Jocelin
• Application Number:
  US14/591,703
• Publication Number:
  US 20150216726A1
• Time in Patent Office: 1,546 Days
• CPC Class Codes: A61B 2017/00176 Two pulses, e.g. second pulse having an effect different from the first one
• CPC Class Codes: A61B 2017/00194 Means for setting or varying the repetition rate
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: B06B 1/0215 for generating pulses, e.g. bursts of oscillations, envelopes
• CPC Class Codes: B06B 1/023 and stepped in amplitude, e.g. square wave, 2-level signal
• CPC Class Codes: B06B 1/0253 taken directly from the generator circuit
• CPC Class Codes: B06B 2201/76 Medical, dental

Abstract

A method and apparatus for delivering energy during a surgical procedure such as phacoemulsification is provided. The method and apparatus include applying energy during at least one pulsed energy on period, comprising applying energy during a series of short burst periods, the short burst periods interspersed by short rest periods. The method and apparatus further comprise delivering minimal energy during a long off period, the long off period comprising a relatively long period when minimal energy is applied, wherein one long off period follows each pulsed energy on period. The short burst periods and the short rest periods are relatively brief in duration as compared with the long off period.

Claims

1. An apparatus comprising:

a handpiece having a needle, the handpiece configured to ultrasonically vibrate;

a power source configured to provide pulsed electrical power to the handpiece;

a footswitch in communication with the handpiece, wherein the footswitch is configured to enable an operator to select an amplitude of an ultrasonic vibration and select between multiple separate and unrelated pulse timing operation sets when positioned in different footswitch zones while performing an ocular surgical procedure;

a sensor; and

a controller configured to control ultrasonic power supplied from the power source to the handpiece during the ocular surgical procedure according to a pulse timing operation set determined based on pulse timing settings selected by the operator, footswitch position within the different footswitch zones, and occlusion status by applying ultrasonic energy to an ocular region during at least one pulsed energy on period followed by a long off period, wherein the controller is configured to apply ultrasonic energy to the ocular region during the at least one pulsed energy on period in a series of short burst periods, said short burst periods interspersed by short rest periods, and short rest periods having minimal power application;

wherein the controller is further configured to dynamically alter, without operator intervention, at least two selected from the group consisting of pulse amplitude, the long off period, the at least one pulsed energy on period, the short burst periods, and the short rest periods during the ocular surgical procedure in response to a change in flow or vacuum sensed by the sensor.

2. An apparatus comprising:

a handpiece having a needle, the handpiece configured to ultrasonically vibrate;

a power source configured to provide pulsed electrical power to the handpiece;

a footswitch in communication with the handpiece, wherein the footswitch is configured to provide operator control according to multiple separate and unrelated pulse timing operation sets when positioned in different footswitch zones while performing an ocular surgical procedure;

a sensor; and

a controller configured to control ultrasonic power supplied from the power source to the handpiece during the ocular surgical procedure according to a pulse timing operation set determined based on pulse timing settings selected by an operator, footswitch position within the different footswitch zones, and occlusion status by applying ultrasonic energy to an ocular region during at least one pulsed energy on period, wherein the controller is configured to apply energy during the at least one pulsed energy on period during a series of short burst periods, said short burst periods interspersed by short rest periods where minimal energy is applied; and

the controller is further configured to refrain from delivering ultrasonic energy during a long off period, the long off period comprising a relatively long period when minimal energy is applied, wherein one long off period follows each pulsed energy period;

wherein said short burst periods and said short rest periods are relatively brief in duration as compared with said long off period, and the controller is further configured to dynamically alter, without operator intervention, at least two selected from the group consisting of the at least one pulsed energy on period, the short burst periods, the short rest periods, and the long off period during the ocular surgical procedure in response to a change in flow or vacuum sensed by the sensor.

3. The apparatus of claim 2, wherein the short burst period is at most approximately ten milliseconds and the short rest period is at most approximately twenty-five milliseconds.

4. The apparatus of claim 2, wherein the energy applied during the at least one pulsed energy on period and series of short burst periods is of approximately the same magnitude.

5. The apparatus of claim 2, wherein multiple pulsed energy on periods are interspersed with multiple long off periods.

6. The apparatus of claim 2, further comprising applying ultrasonic energy during at least one additional pulsed energy on period, wherein applying ultrasonic energy during the additional pulsed energy on period comprises:

applying ultrasonic energy during an additional series of short burst periods, said additional series of short burst periods interspersed by additional short rest periods wherein minimal energy is applied; and

refraining from delivering ultrasonic energy during an additional long off period, the additional long off period comprising an additional relatively long period when minimal energy is applied, wherein one additional long off period follows each additional energy on period;

wherein said additional short burst periods and said additional series of short burst periods are relatively brief in duration as compared with said additional long off period.

7. The apparatus of claim 2, wherein the long off period is at least about twenty milliseconds.

8. The apparatus of claim 2, wherein the footswitch is configured to enable an operator to select an amplitude of the ultrasonic vibration.

9. An apparatus comprising:

a handpiece having a needle, the handpiece configured to ultrasonically vibrate;

a power source configured to provide pulsed electrical power to the handpiece;

a footswitch in communication with the handpiece, wherein the footswitch is configured to provide operator control according to multiple separate and unrelated pulse timing operation sets when positioned in different footswitch zones while performing an ocular surgical procedure;

a sensor; and

a controller configured to control ultrasonic power supplied from the power source to the handpiece during the ocular surgical procedure based on pulse timing settings selected by the operator, footswitch position within the different footswitch zones, and occlusion status, said controller configured to deliver pulses of ultrasonic energy during an on period comprising at least one relatively short burst of energy followed by a pause for at least one relatively short period; and

wherein the controller is further configured to pause for a relatively long off period after said on period and prior to commencing any subsequent on period, wherein the controller being configured to pause for each relatively short period and for the relatively long off period comprises the controller being configured to apply minimal energy therein;

wherein each relatively long off period occurs after each on period and occurs in the absence of external energy level reduction activities, and

wherein the controller is further configured to dynamically alter, without operator intervention, at least two selected from the group consisting of the on period, the at least one relatively short burst of energy, the pause of the at least one relatively short period, and the relatively long off period during the ocular surgical procedure in response to a change in flow or vacuum sensed by the sensor.

10. The apparatus of claim 9, wherein said relatively long off period is longer in duration than the at least one relatively short period and the at least one relatively short burst of energy.

11. The apparatus of claim 10, wherein the at least one relatively short burst period is at most approximately ten milliseconds and the at least one relatively short period is at most approximately twenty-five milliseconds.

12. The apparatus of claim 9, wherein the energy applied during each at least one relatively short burst period is approximately the same magnitude.

13. The apparatus of claim 9, wherein multiple on periods are employed interspersed with multiple relatively long off periods.

14. The apparatus of claim 9, wherein one of a power application parameters altered comprises amplitude of energy applied during the at least one relatively short burst of energy.

15. The apparatus of claim 9, wherein the relatively long off period is at least about twenty milliseconds.

16. An apparatus comprising:

a handpiece having a needle, the handpiece configured to ultrasonically vibrate;

a power source configured to provide pulsed electrical power to the handpiece;

a footswitch in communication with the handpiece, wherein the footswitch is configured to provide operator control according to multiple separate and unrelated pulse timing operation sets when positioned in different footswitch zones while performing an ocular surgical procedure;

a sensor; and

a controller configured to control ultrasonic power supplied from the power source to the handpiece during the ocular surgical procedure according to a pulse timing operation set determined based on pulse timing settings selected by the operator, footswitch position within the different footswitch zones, and occlusion status, said controller configured to apply ultrasonic energy to an ocular region during at least one pulsed energy on period followed by a long off period, wherein the controller is configured to apply ultrasonic energy in a series of short burst periods, said short burst periods interspersed by short rest periods, and short rest periods having minimal power application,

wherein the controller is further configured to dynamically alter, without operator intervention, at least two selected from the group consisting of pulse amplitude, the at least one pulsed energy on period, the long off period, the short burst periods, and the short rest periods during the ocular surgical procedure in response to a change in flow or vacuum sensed by the sensor.

17. The apparatus of claim 16, wherein the energy applied during the at least one pulsed energy on period and series of short burst periods is of approximately the same magnitude.

18. The apparatus of claim 16, further comprising an input device configured to enable an operator to select an amplitude of an ultrasonic vibration.

19. An apparatus comprising:

a handpiece having a needle, the handpiece configured to ultrasonically vibrate;

a power source configured to provide pulsed electrical power to the handpiece;

a footswitch in communication with the handpiece, wherein the footswitch is configured to provide operator control according to multiple separate and unrelated pulse timing operation sets when positioned in different footswitch zones while performing an ocular surgical procedure;

a sensor; and

a controller configured to control ultrasonic power supplied from the power source to the handpiece during the ocular surgical procedure based on pulse timing settings selected by the operator, footswitch position within the different footswitch zones, and occlusion status, said controller configured to deliver at least one at least one relatively short burst of energy, pause for at least one relatively short period during an on period, and pause for a relatively long off period after said on period and prior to commencing any subsequent on period, wherein pausing for each at least one relatively short period for the relatively long off period comprises applying minimal energy therein;

wherein the relatively long off period comprises a relatively long period when minimal energy is applied, wherein one long off period follows each pulsed energy on period,

wherein the controller is further configured to dynamically alter, without operator intervention, at least two selected from the group consisting of the pulsed energy on period, the relatively short burst, the at least one relatively short period; and

the long off period during the ocular surgical procedure in response to a change in flow or vacuum sensed by the sensor.

20. The apparatus of claim 19, wherein the relatively short burst of energy is at most approximately ten milliseconds and the at least one relatively short period is at most approximately twenty-five milliseconds.

21. The apparatus of claim 19, wherein the relatively long off period is at least about twenty milliseconds.

22. The apparatus of claim 19, wherein the energy applied during the on period and the relatively short burst of energy is of approximately the same magnitude.

23. The apparatus of claim 19, wherein multiple on periods are interspersed with multiple long off periods.

24. The apparatus of claim 19, wherein energy pulse delivery further comprises applying ultrasonic energy during at least one additional pulsed energy on period, wherein applying ultrasonic energy during the at least one additional pulsed energy on period comprises:

applying ultrasonic energy during an additional series of short burst periods, said additional series of short burst periods interspersed by additional short rest periods wherein minimal energy is applied; and

refraining from delivering ultrasonic energy during an additional long off period, the additional long off period comprising an additional relatively long period when minimal energy is applied, wherein one additional long off period follows each additional pulsed energy on period;

wherein said additional short burst periods and said additional short rest periods are relatively brief in duration as compared with said additional long off period.