INSTRUMENT SYSTEM AND PROCEDURE FOR PHACOEMULSIFICATION

• US 20140052113A1
• Filed: 02/26/2013
• Published: 02/20/2014
• Est. Priority Date: 08/17/2012
• Status: Abandoned Application

• Current Assignee: Carl Zeiss Meditec AG (Carl-Zeiss-Stiftung)
• Original Assignee: Carl Zeiss Meditec AG (Carl-Zeiss-Stiftung)
• Inventors: Kuehnert, Juergen, Bischoff, Mark
• Application Number:
  US13/776,744
• Publication Number:
  US 20140052113A1
• Time in Patent Office: Days
• US Class Current: 606/6
• CPC Class Codes: A61F 2009/0087 Lens
• 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

An instrument system for phacoemulsification includes a femto- or picosecond laser device configured to dissect a lens of a patient'"'"'s eye into lens fragments, open an anterior capsule of the lens of the eye, and make an incision in the eyeball so as to provide access to the lens of the eye. The system also includes device for fragmenting and aspirating the lens fragments through the access incision. A monitoring device is provided for monitoring results achieved by the phacoemulsification. A control device is configured to control the femto- or picosecond laser device and the device for fragmenting and aspirating the lens fragments, subject to parameters of the eye to be treated or of given surgical steps.

Claims

1. An instrument system for phacoemulsification, comprising:

a femto- or picosecond laser device configured to

dissect a lens of a patient'"'"'s eye into lens fragments,

open an anterior capsule of the lens of the eye, and

make an incision in the eyeball so as to provide access to the lens of the eye;

a device for fragmenting and aspirating the lens fragments through the access incision;

a monitoring device provided for monitoring results achieved by the phacoemulsification; and

a control device configured to control the femto- or picosecond laser device and the device for fragmenting and aspirating the lens fragments, subject to parameters of the eye to be treated or of given surgical steps.

2. The instrument system according to claim 1, wherein the monitoring device and the device for fragmenting and aspirating the lens fragments are spatially combined as one modular unit, and wherein the femto- or picosecond laser device is spatially separated from the modular unit that includes the monitoring device and the device for fragmenting and aspirating the lens fragments.

3. The instrument system according to claim 1, wherein the device for fragmenting and aspirating the lens fragments and the femto- or picosecond laser device are spatially combined as one modular unit, and wherein the monitoring device is spatially separated from the modular unit that includes the device for fragmenting and aspirating the lens fragments and the femto- or picosecond laser device.

4. The instrument system according to claim 1, wherein a control is provided for the femto- or picosecond laser device for making the access incision, the access incision extending from an anterior chamber of the eye into a cornea of the eye, without dividing the cornea completely outwards, wherein the cornea at this location exhibits a residual thickness of preferably 20 μ

m to 80 μ

m.

5. The instrument system according to claim 4, wherein a control is provided for the femto- or picosecond laser device for making a marker incision in a surface of the cornea in a region of the unopened access incision, and

devices are available in the treatment area for the device for disintegrating and aspirating the lens fragments for the complete division of the cornea and hence for the opening of the access incision, guided by the marker incision.

6. The instrument system according to claim 1, wherein the device for disintegrating and aspirating the lens fragments includes an ablating laser device for disintegration of the lens fragments using the laser device.

7. The instrument system according to claim 1, wherein the device for disintegrating and aspirating the lens fragments is equipped with devices for irrigation and aspiration, including an aspiration canal and an irrigation canal.

8. The instrument system according to claim 7, further comprising a measurement device for measuring an irrigation and aspiration pressure during the aspiration of the lens fragments, and

a control for the ablating laser device for the purposes of disintegrating the lens fragments subject to the irrigation and aspiration pressure, wherein an optical fiber is configured to emit the laser energy into the lens fragments to be disintegrated.

9. The instrument system according to claim 8, wherein the aspiration canal and the irrigation canal are combined in one modular unit,

wherein an exit opening of the irrigation canal and a light radiating surface of the optical fiber are arranged in an area of an entry opening of the aspiration canal, and

wherein the optical fiber is movable relative to the aspiration canal in a direction of the emission, the light radiating surface being configured to be displaced as far as the lens fragments to be disintegrated.

10. The instrument system according to claim 8, wherein the aspiration canal and the irrigation canal and separate modular units, designed for separate introduction into the eye, are arranged, whereby the light radiating surface of the optical fiber is disposed within the exit opening of the irrigation canal and the light radiating surface of the optical fiber is configured to be displaced as far as the lens fragments to be disintegrated together with the exit opening of the irrigation canal.

11. The instrument system according to claim 1, wherein the femto- or picosecond laser device includes a laser radiation source with pulse lengths of between 100 fs and 1000 fs, pulse energies of between 0.1 μ

J and 10 μ

J, and repetition frequencies of between 50 kHz and 500 kHz or with a source for laser radiation with pulse lengths of between 1 ps and 20 ps, pulse energies of between 1 μ

J and 200 μ

J, and repetition frequencies of between 25 kHz and 150 kHz, and wherein the device for fragmenting and aspirating the lens fragments includes a laser radiation source with a wavelength of about 2.9 μ

m.

12. The instrument system according to claim 1, wherein the laser radiation source of the ablating laser device is adjustable so as to emit laser radiation with such a number of pulses as to cause the formation of cavitation bubbles in a region of the lens fragments, and, by means of these cavitation bubbles, to bring about the disintegration of the lens fragments, which impede the aspiration due to their size.

13. The instrument system according to claim 2, further comprising a patient cradle for positioning a patient, initially in the femto- or picosecond laser device treatment area and subsequently in the treatment area for the modular unit including the monitoring device and the device for fragmenting and aspirating the lens fragments.

14. The instrument system according to claim 13, wherein the treatment area for the femto- or picosecond laser device and the treatment area for the modular unit including the monitoring device and the device for fragmenting and aspirating the lens fragments are located in separate areas, which differ in terms of their sterility requirements, whereby, in the area which is allocated to the modular unit, the requirements for a sterile operating room are fulfilled, while the sterility requirements in the area with the femto- or picosecond laser device are less stringent.

15. The instrument system according to claim 1, wherein the monitoring device is designed as a microscope.

16. A method of phacoemulsification comprising:

a) dissecting a lens tissue of an eye into lens fragments, opening an anterior capsule of the lens of the eye (capsulorhexis), and placing an access incision in the eyeball using a femto- or picosecond laser device, and

b) subsequently aspirating the lens fragments through the access incision, whereby disintegration of the lens fragments which impede the aspiration due to their size takes place prior to the aspiration.

17. The method according to claim 16, wherein the disintegration of the lens fragments using an ablating laser device is optionally performed prior to the aspiration.

18. The method according to claim 16, wherein the disintegration of the lens fragments is performed subject to a pressure within a capsular sac of the eye, which is measured during the aspiration of the lens fragments and an introduction of an irrigation fluid, and the laser energy is emitted immediately into the lens fragments, which lead to an increase in the irrigation and aspiration pressure by impeding their aspiration due to their size.

19. The method according to claim 16, wherein an access incision is made, which extends from the anterior chamber of the eye into the cornea, whereby the cornea is not completely divided through to the surface, but a residual corneal thickness of preferably 20 μ

m to 80 μ

m remains.

20. The method according to claim 19, wherein a marker incision is made in a surface of the cornea in a region of the unopened access incision, and

a complete opening of the access incision is guided by the marker incision.

21. The method according to claim 16, wherein the a) and b) are performed in separate areas, the areas differing in terms of their sterility requirements.