Method for controlling fluid flow to and from an eye during ophthalmic surgery

• US 20040097870A1
• Filed: 10/24/2003
• Published: 05/20/2004
• Est. Priority Date: 07/31/2001
• Status: Active Grant

• Current Assignee: Johnson & Johnson Surgical Vision, Inc. (Johnson & Johnson)
• Original Assignee: Kenneth E. Kadziauskas, Mark S. Cole
• Inventors: Kadziauskas, Kenneth E., Cole, Mark S.
• Granted Patent: US 6,899,694 B2
• Time in Patent Office: Days
• US Class Current: 604/35
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/85 with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants for negative pressure wound therapy A61M1/92, A61M1/94; combined with tracheal tubes A61M16/0463; dental instruments with combined rinsing and aspirating A61C17/0208

Abstract

A method and apparatus provided for controlling fluid control to and from an eye or a phacoemulsification handpiece. The handpiece includes an ultrasonically driven, hollow, sleeved needle and the method includes inserting the needle and sleeve into an eye for phacoemulsification of eye tissue and introducing fluid into the eye through an annulus established between the sleeve and the needle. Aspiration of fragmented tissue and fluid from the eye is conducted through the hollow needle. An initial irrigation fluid pressure is determined and the irrigation fluid flow and aspiration fluid flow are adjusted based upon the initial determination. Thereafter continued determination of irrigation fluid pressure is utilized to continuously adjust irrigation fluid flow and/or aspiration fluid flow.

Claims

1. A method for controlling fluid flow to and from an eye during ophthalmic surgery, said method composing the steps of:

introducing irrigation fluid into an eye;

determining initial irrigation fluid pressure;

adjusting irrigation fluid flow based on the determined initial irrigation fluid pressure;

continuously determining irrigation fluid pressure after the initial determination; and

continuously adjusting irrigation fluid flow based on the continuous determination of irrigation fluid pressure.

4. The method according to claim 1 further comprising the step of using a positive displacement pump to introduce the irrigation fluid and the step of adjusting irrigation fluid flow includes adjusting pump speed.

5. The method according to any one of claims 1, 2 or 3 where the step of initially determining irrigation fluid pressure and continuously measuring irrigation fluid pressure includes determining in-line irrigation pressure.

8. The method according to any one of claims 1, 2 or 3 further comprising the step of using a change in irrigation fluid pressure to provide an indication of wound leaking.

2. A method for controlling fluid flow to and from an eye during ophthalmic surgery, said method composing the steps of:

introducing irrigation fluid into an eye;

determining initial irrigation fluid pressure;

adjusting aspiration fluid flow based on the determined initial irrigation fluid pressure;

continuously determining irrigation fluid pressure after the initial determination; and

continuously adjusting aspiration fluid flow based on the continuous determination of irrigation fluid pressure.

6. The method according to claim 2 wherein the step of adjusting aspiration fluid flow includes setting a maximum aspiration vacuum pressure as a function of determined irrigation fluid pressure.

7. The method according to claim 6 wherein the function is linear.

3. A method for controlling fluid flow to and from an eye during ophthalmic surgery, said method composing the steps of:

introducing irrigation fluid into an eye;

determining initial irrigation fluid pressure;

adjusting maximum vacuum setting based on the determined initial irrigation fluid pressure;

continuously determining irrigation fluid pressure after the initial determination; and

continuously adjusting maximum vacuum setting based on the continuous determination of irrigation fluid pressure.

9. A method for controlling fluid flow to and from a phacoemulsification handpiece, the handpiece including an ultrasonically driven, hollow needle, said method comprising the steps of:

inserting the needle into an eye for phacoemulsification of eye tissue;

introducing irrigation fluid into the eye;

aspirating fluid from the eye through the hollow needle;

determining initial irrigation fluid pressure;

adjusting irrigation fluid flow and aspiration fluid flow based on the determined initial irrigation fluid pressure;

continuously determining irrigation fluid pressure after the initial determination; and

continuously adjusting irrigation fluid flow and aspiration fluid flow based on the continuous determination of irrigation fluid pressure in order to accommodate changes in needle incision size and wound stretching during eye surgery.

10. The method according to claim 9 further comprising the step of using a positive displacement pump to introduce the irrigation fluid and the step of adjusting irrigation fluid flow includes adjusting pump speed.

11. The method according to claim 10 wherein the steps of initially determining irrigation fluid pressure and continuously measuring irrigation fluid pressure including determining in-line irrigation pressure.

12. The method according to claim 9 wherein the step of adjusting aspiration fluid flow includes setting a maximum aspiration vacuum pressure as a function of determined irrigation fluid pressure.

13. The method according to claim 12 wherein the function is linear.

14. The method according to claim 9 further comprising the step of using a change in irrigation fluid pressure to provide an indication of wound leaking.

19. The method according to claim 12 wherein the function is linear.

20. The method according to claim 9 further comprising the step of using a change in irrigation fluid pressure to provide an indication of wound leaking.

15. Apparatus for controlling fluid flow to and from an eye, said apparatus comprising:

a supply of irrigation fluid;

a positive displacement pump for introducing irrigation fluid from said supply of irrigation fluid into an eye;

a vacuum source for aspirating fluid from the eye through a hollow needle;

a pressure sensor for determining pressure of irrigation fluid introduced into the eye; and

a control system for adjusting irrigation fluid and aspiration fluid flow rates in response to determined irrigation fluid pressure.

16. The apparatus according to claim 15 wherein said pressure sensor is disposed in a line interconnection, said positive displacement pump and the needle.

17. The apparatus according to claim 15 where said pressure sensor is disposed in the eye.

18. The apparatus according to claim 15 wherein said control system includes an indicator for enabling monitoring by a surgeon of wound constriction consistency based upon irrigation fluid pressure.

22. The apparatus according to claim 15 wherein said pressure sensor is disposed in a line interconnection, said positive displacement pump and the needle.

21. Apparatus for controlling fluid flow to and from an eye, said apparatus comprising:

a supply of irrigation fluid;

a positive displacement pump for introducing irrigation fluid from said supply of irrigation fluid into an eye;

a vacuum source for aspirating fluid from the eye through a hollow needle;

a pressure sensor for determining pressure of irrigation fluid introduced into the eye; and

a control system for adjusting irrigation fluid and aspiration fluid flow rates in response to determined irrigation fluid pressure.