Methods and Apparatus for Integrated Cataract Surgery

• US 20090137993A1
• Filed: 09/18/2008
• Published: 05/28/2009
• Est. Priority Date: 09/18/2007
• Status: Abandoned Application

• Current Assignee: Alcon LenSx, Inc. (Alcon Incorporated)
• Original Assignee: Alcon LenSx, Inc. (Alcon Incorporated)
• Inventors: Kurtz, Ronald M.
• Application Number:
  US12/233,401
• Publication Number:
  US 20090137993A1
• Time in Patent Office: Days
• US Class Current: 606/6
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00887 Cataract
• 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 9/008 using laser
• CPC Class Codes: A61F 9/00825 for photodisruption

Abstract

Techniques, apparatus and systems for cataract surgery. Implementation of the described techniques, apparatus and systems includes a method for cataract eye surgery is presented, including: determining a surgical target region in a lens of the eye and applying laser pulses to photodisrupt a portion of the determined target region before making an incision on a capsule of the lens within an integrated surgical procedure. The laser pulses can be applied before making an incision on a cornea of the eye. In some cases, the target region includes the nucleus of the lens. The integrated surgical procedure involves using the same pulsed laser source for three functions: for photodisrupting the target region, for making an incision on the capsule of the lens and for making an incision on the cornea of the eye.

Claims

1. A method for cataract eye surgery, comprising:

determining a surgical target region in a lens of the eye; and

applying laser pulses to photodisrupt a portion of the determined target region

before making an incision on a capsule of the lens, within an integrated surgical procedure.

2. The method of claim 1, wherein the applying laser pulses step is performed before making an incision on a cornea of the eye.

3. The method of claim 1, wherein the target region includes a nucleus of the lens.

4. The method of claim 1, wherein the integrated surgical procedure comprises:

using a pulsed laser source for photodisrupting the target region;

using the same laser source for making an incision on the capsule of the lens; and

using the same laser source for making an incision on the cornea of the eye.

5. The method of claim 4, wherein the incisions are one of

a multi-plane incision, a valved incision, a self-sealing incision a partial incision, and a full-thickness incision.

6. The method of claim 4, wherein the making of the capsular incision comprises:

creating an essentially closed loop of bubbles to define a capsular lid,

spacing the bubbles along the loop to make the removal of the capsular lid easy.

7. The method of claim 4, wherein the integrated surgical procedure comprises:

removing photodisrupted material through the capsular incision and the corneal incision.

8. The method of claim 4, wherein the integrated surgical procedure comprises:

inserting an intra ocular lens into the lens capsule through the existing corneal and capsular incisions.

9. The method according to claim 8, wherein the integrated surgical procedure comprises:

inflating the lens capsule during the insertion of the intra ocular lens; and

placing a haptic portion of the intraocular lens to optimize at least one of a centration and an anterior-posterior localization of an optic portion of the intraocular lens.

10. A method according to claim 8, wherein the integrated surgical procedure comprises:

deflating the lens capsule following the insertion of the intra ocular lens, thereby bringing an anterior portion and a posterior portion of the capsule closer to the intraocular lens in a controlled manner to optimize a centration and an anterior-posterior localization of the intraocular lens.

11. The method of claim 1, wherein the photodisruption comprises:

determining a boundary of the target region;

focusing the laser pulses on a posterior region of the target region; and

focusing the laser pulses on a region anterior to the posterior region of the target region.

12. The method of claim 1, further comprising:

inserting a trochar into the corneal and the capsular incisions.

13. The method of claim 12, wherein:

the trochar is inserted to create an essentially watertight contact with at least one of the cornea and the capsule.

14. The method of claim 12, wherein the integrated surgical procedure comprises at least one of:

inserting surgical tools through the trochar;

managing the eye-fluids during a period of the surgery through the trochar; and

inserting the intra ocular lens into the capsule through the trochar.

15. The method of claim 1, wherein the integrated surgical procedure comprises

maintaining a shape of a portion of the eye by infusing a physiologically suitable viscoelastic fluid into a volume of the eye.

16. The method of claim 15, wherein the maintaining the shape of an eye-portion comprises:

infusing a viscoelastic fluid into the lens in relation to the removal of a photodisrupted nucleus through the capsular incision.

17. The method of claim 1, wherein the integrated surgical procedure further comprises:

optically accessing a peripheral area of the lens via an angled mirror.

18. A method for performing cataract surgery, comprising:

directing a beam of laser pulses with an integrated surgical device to fragment a portion of a lens for removal before making any physical incision on the eye;

performing a partial or full thickness capsular incision to access the fragmented lens portion with the integrated surgical device;

removing the fragmented lens portion from the eye through the incision; and

inserting an intraocular lens into the eye through the incision to a position of the removed fragmented lens portion.

19. The method as in claim 18, further comprising:

placing removable trochars to traverse a corneal incision and the capsule incisions to maintain an essentially watertight seal.

20. An eye-surgical device, comprising:

a multi-purpose pulsed laser, configured;

to be directed at a lens of an eye to fragment a portion of the lens before making a physical incision on the eye; and

to perform a corneal incision and a capsular incision to access the fragmented lens portion with the multi-purpose laser; and

an aspiration device, configured

to remove the fragmented lens portion from the eye through the corneal incision and the capsular incision.