Vitrectomy probe

• US 10,639,197 B2
• Filed: 10/25/2017
• Issued: 05/05/2020
• Est. Priority Date: 06/19/2017
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Alcon Incorporated
• Inventors: Lopez, Jose Luis, McCawley, Matthew Douglas, McDonell, Brian William, Ryan, Timothy C., Underwood, John R., Valencia, Salomon, Auld, Jack Robert
• Primary Examiner(s): Anderson, Gregory A
• Application Number:
  US15/793,353
• Publication Number:
  US 20180360660A1
• Time in Patent Office: 923 Days
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• 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

In some embodiments, a vitrectomy probe may include an inner cutting tube reciprocating in an outer tube. The outer tube includes a side port and the inner tube includes a distal cutting port, and, in some embodiments, an additional side port. In some embodiments, the inner tube may also include a flat upper edge that cuts across the outer tube side port. In some embodiments, a diaphragm drives the inner tube and may have an open-stroke side with a lower hardness material than a closed-stroke side. In some embodiments, an aspiration tube coupled to the vitrectomy probe may include a first aspiration tubing and a second aspiration tubing with a lower hardness than the first aspiration tubing. In some embodiments, the vitrectomy probe may be coupled to pneumatic tubing that is stepped or tapered.

Claims

1. A vitrectomy probe, comprising:

an outer cutting tube with an outer port side opening;

an inner cutting tube, positioned inside the outer cutting tube, wherein the inner cutting tube has an open distal end having a cutting edge;

wherein the inner cutting tube further comprises a distal side port with a distal side port cutting edge positioned on the distal side port such that as the inner cutting tube retracts inside the outer cutting tube, tissue entering the outer port side opening also enters the distal side port of the inner cutting tube to be cut by the distal side port cutting edge as the inner cutting tube is retracted in the outer cutting tube;

a diaphragm coupled to the inner cutting tube, wherein the diaphragm is located inside a drive chamber and the diaphragm is configured to move back and forth inside the drive chamber as air is alternately supplied and vented on either side of the diaphragm in the drive chamber;

wherein movement of the diaphragm causes the inner cutting tube to oscillate inside the outer cutting tube such that the open distal end of the inner cutting tube moves back and forth across the outer port side opening to cut tissue entering the outer port side opening;

wherein the diaphragm comprises an open-stroke side with a first contact surface that contacts an inner drive chamber wall when the inner cutting tube is in a retracted position;

wherein the diaphragm comprises an closed-stroke side with a second contact surface that contacts an opposing inner drive chamber wall when the inner cutting tube is in an extended position; and

wherein the first contact surface comprises a material with a lower hardness than the second contact surface.

2. The vitrectomy probe of claim 1, wherein the first contact surface comprises silicone and the second contact surface comprises polycarbonate or polysulfone.

3. The vitrectomy probe of claim 1, wherein the outer cutting tube has a beveled closed end with a degree of bevel approximately in a range of 20 to 80 degrees as measured from the beveled closed end to an extended back surface line of the outer cutting tube that is opposite the outer port side opening.

4. The vitrectomy probe of claim 3, wherein a port edge tip to retinal (PTRD) distance is approximately in a range of 0.004 to 0.009 inches and a port edge to distal probe tip measurement (PTTD) is approximately in a range of 0.005 to 0.010 inches with approximately a 60 degree bevel as measured from the beveled closed end to an extended back surface line of the outer cutting tube that is opposite the outer port side opening.

5. The vitrectomy probe of claim 1, further comprising an aspiration tubing coupled to the inner cutting tube to apply a vacuum to the inner cutting tube and wherein the aspiration tubing comprises a first aspiration tubing with a first aspiration tubing hardness, configured to be coupled to a surgical console, and a second aspiration tubing coupled to the first aspiration tubing and the vitrectomy probe, wherein the second aspiration tubing has a second aspiration tubing hardness that is less than the first aspiration tubing hardness.

6. The vitrectomy probe of claim 5, wherein the first aspiration tubing has an inner diameter of approximately 0.060 inches and the first aspiration tubing hardness of approximately 80 Shore A and the second aspiration tubing has an inner diameter of approximately 0.060 inches and the second aspiration tubing hardness of approximately 40 Shore A;

wherein the first aspiration tubing is approximately 79 inches long and wherein the second aspiration tubing is approximately 5 inches long and is coupled to the vitrectomy probe on a distal end and coupled to the first aspiration tubing on a proximal end.

7. The vitrectomy probe of claim 1, wherein the outer port side opening has a proximal port edge angle approximately in a range of 40 to 60 degrees and a distal port edge angle approximately in a range of 35 to 55 degrees.

8. The vitrectomy probe of claim 1, further comprising a pneumatic drive line coupling the vitrectomy probe to a surgical console, the pneumatic drive line having an internal bore configured to deliver the air to the vitrectomy probe, the internal bore having a non-uniform cross-section along a length of the pneumatic drive line, wherein the pneumatic drive line comprises a first segment and a second segment, the first segment defining a first passageway having a first diameter and the second segment defining a second passageway having a second diameter, the first diameter being different than the second diameter.

9. A vitrectomy probe, comprising:

an outer cutting tube with an outer port side opening and a beveled closed end;

an inner cutting tube, positioned inside the outer cutting tube, wherein the inner cutting tube has an open distal end having a cutting edge and a distal side port with a distal side port cutting edge positioned on the distal side port such that as the inner cutting tube retracts inside the outer cutting tube, tissue entering the outer port side opening also enters the distal side port of the inner cutting tube to be cut by the distal side port cutting edge as the inner cutting tube is retracted in the outer cutting tube;

a diaphragm coupled to the inner cutting tube, wherein the diaphragm is located inside a drive chamber and the diaphragm is configured to move back and forth inside the drive chamber as air is alternately supplied and vented on either side of the diaphragm in the drive chamber;

wherein movement of the diaphragm causes the inner cutting tube to oscillate inside the outer cutting tube such that the open distal end of the inner cutting tube moves back and forth across the outer port side opening to cut tissue entering the outer port side opening; and

wherein the inner cutting tube comprises a flat upper edge, approximately perpendicular to an inner tube longitudinal axis, on the portion of the inner cutting tube that cuts across the outer port side opening;

wherein movement of the diaphragm causes the inner cutting tube to oscillate inside the outer cutting tube such that the open distal end of the inner cutting tube moves back and forth across the outer port side opening to cut tissue entering the outer port side opening;

wherein the diaphragm comprises an open-stroke side with a first contact surface that contacts an inner drive chamber wall when the inner cutting tube is in a retracted position;

wherein the diaphragm comprises an closed-stroke side with a second contact surface that contacts an opposing inner drive chamber wall when the inner cutting tube is in an extended position; and

wherein the first contact surface comprises a material with a lower hardness than the second contact surface.

10. The vitrectomy probe of claim 9, wherein the outer port side opening has a proximal port edge angle approximately in a range of 40 to 60 degrees and a distal port edge angle approximately in a range of 35 to 55 degrees.

11. The vitrectomy probe of claim 9, further comprising an aspiration tubing coupled to the inner cutting tube to apply a vacuum to the inner cutting tube;

and wherein the aspiration tubing comprises a first aspiration tubing with a first aspiration tubing hardness, configured to be coupled to a surgical console, and a second aspiration tubing coupled to the first aspiration tubing and the vitrectomy probe, wherein the second aspiration tubing has a second aspiration tubing hardness that is less than the first aspiration tubing hardness.

12. The vitrectomy probe of claim 11, wherein the first aspiration tubing has an inner diameter of approximately 0.060 inches and the first aspiration tubing hardness of approximately 80 Shore A and the second aspiration tubing has an inner diameter of approximately 0.060 inches and the second aspiration tubing hardness of approximately 40 Shore A;

and

wherein the first aspiration tubing is approximately 79 inches long and wherein the second aspiration tubing is approximately 5 inches long and is coupled to the vitrectomy probe on a distal end and coupled to the first aspiration tubing on a proximal end.

13. The vitrectomy probe of claim 9, further comprising a pneumatic drive line coupling the vitrectomy probe to a surgical console, the pneumatic drive line having an internal bore configured to deliver the air to the vitrectomy probe, the internal bore having a non-uniform cross-section along a length of the pneumatic drive line, wherein the pneumatic drive line comprises a first segment and a second segment, the first segment defining a first passageway having a first diameter and the second segment defining a second passageway having a second diameter, the first diameter being different than the second diameter.

14. The vitrectomy probe of claim 9, wherein a port edge tip to retinal (PTRD) distance for the outer port side opening is approximately in a range of 0.004 to 0.009 inches and a port edge to distal probe tip measurement (PTTD) for the outer port side opening is approximately in a range of 0.005 to 0.010 inches with approximately a 60 degree bevel as measured from the beveled closed end to an extended back surface line of the outer cutting tube that is opposite the outer port side opening.