Vibrating Surgical Device for Removal of Vitreous and Other Tissue

• US 20140074013A1
• Filed: 09/06/2013
• Published: 03/13/2014
• Est. Priority Date: 09/07/2012
• Status: Active Grant

• Current Assignee: Bausch & Lomb Incorporated (Bausch Health Cos., Inc.)
• Original Assignee: Bausch & Lomb Incorporated (Bausch Health Cos., Inc.)
• Inventors: McCary, Brian D., Goh, Toh Seng, Perkins, James Taylor
• Granted Patent: US 9,498,377 B2
• Time in Patent Office: Days
• US Class Current: 604/22
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32

Abstract

An ophthalmic surgical device 10 includes a housing 12 having a distal end 14 and a proximal end 16. A cannula 18 is attached to the housing distal end 14 and has a distal tip 20 with at least one port 22 in communication with a lumen 19 extending through the cannula 18 and in communication with an aspiration path 24 in the housing 12. A vibration source 26 is held within the housing 12 for vibrating the distal tip 20 for assisting in vitreous and other tissue removal. An aspiration source 152 connected to the aspiration path 24 for applying a negative pressure to the lumen 19 and the at least one port 22 for removing fluids and the vitreous and other tissue from the eye. The vibration source 26 and the aspiration source 152 together create a periodic bi-directional flow of tissue through the port 22 without creating cavitation externally of the distal tip 20.

Claims

1. An ophthalmic surgical device comprising:

a housing having a distal end and a proximal end;

a cannula attached to the housing distal end and having a distal tip with at least one port in communication with a lumen extending through the cannula and in communication with an aspiration path in the housing and wherein a cross-sectional area of the port is less than a cross-sectional area of the lumen;

a vibration source held within the housing for vibrating the distal tip of the cannula for assisting in vitreous and other tissue removal from a patient'"'"'s eye;

an aspiration source connected to the aspiration path for applying a negative pressure to the lumen and the at least one port for removing fluids and the vitreous and other tissue from the eye; and

wherein the vibration source and the aspiration source together create a periodic bi-directional flow of tissue through the port without creating cavitation externally of the distal tip.

2. The device of claim 1 wherein the housing and the vibration source are a part of a phacoemulsification surgical instrument.

3. The device of claim 2 wherein the cannula has a threaded connection for attachment to the phacoemulsification surgical instrument.

4. The device of claim 1 further including a guard device attached to the cannula and extending beyond the cannula distal tip.

5. The device of claim 1 further including a jacket attached to the device and surrounding and extending beyond the cannula distal tip, wherein the jacket includes a port proximate the cannula distal tip.

6. The device of claim 1 wherein the cannula distal tip includes multiple ports in communication with the lumen.

7. The device of claim 6 wherein the multiple ports are formed to a side of a central axis of the cannula.

8. The device of claim 1 wherein the at least one port is formed to a side of the cannula distal tip to assist a surgeon to see the at least one port during surgery and to allow a side of the cannula distal tip opposite the side with the at least one port to contact delicate tissue without damage.

9. The device of claim 1 wherein the at least one port has a cross-sectional area less than approximately 75,000 square microns (μ

m²).

10. The device of claim 1 wherein the at least one port has a smaller cross-sectional area than the lumen.

11. The device of claim 1 wherein the at least one port has a cross-sectional area less than approximately 35,000 square microns (μ

m²).

12. The device of claim 1 wherein the at least one port has a cross-sectional area less than approximately 20,000 square microns (μ

m²).

13. The device of claim 1 wherein the vibration source causes the cannula distal tip to vibrate in one or more of a longitudinal manner, a torsional manner, and a transverse manner.

14. The device of claim 1 wherein the vibration source vibrates the cannula distal tip to vibrate sufficiently to remove a lens fragment.

15. The device of claim 1 wherein the cannula is curved to assist a surgeon to see the at least one port.

16. The device of claim 1 wherein the at least one port has a holding force of less than 1 gram at 735 millimeters of mercury (mmHg) vacuum or less.

17. The device of claim 1 further including an infusion fluid source in communication with the eye and wherein a pressure of infusion fluid into the eye forms a part of the intraocular pressure.

18. The device of claim 17 further including an infusion cannula for insertion into the eye and having a cross-sectional area larger than the cross-sectional area of the lumen.

19. The device of claim 1 wherein the vibration source and the aspiration source together create a desired aspiration flow rate of tissue through the port and the lumen.

20. The device of claim 19 wherein a peak velocity of a volume of tissue from the lumen to an outside of the port is at least equal to an average velocity of tissue through the lumen at the desired aspiration flow rate.

21. The device of claim 1 wherein the cannula is vibrated at approximately 14.4 meters/second multiplied by a ratio of the port cross-sectional area to the lumen cross-sectional area.

22. The device of claim 1 wherein the cannula has an outer diameter of 23 gauge or smaller.

23. The device of claim 1 wherein the port cross-sectional area is less than ⅓

of the lumen cross-sectional area.

24. A cannula for attachment to a surgical instrument capable of vibrating the cannula wherein the surgical instrument also includes an aspiration path, the cannula comprising:

a shaft having a length sufficient to extend across an eye'"'"'s posterior segment without a proximal portion of the cannula or a distal portion of the surgical instrument contacting an entry-site alignment device; and

at least one port formed adjacent a cannula distal tip and to a side of a central axis of the cannula and in communication with a lumen extending through the cannula for communication with the aspiration path, wherein a cross-sectional area of the at least one port is at least one third or less compared to a cross-sectional area of the lumen.

25. The device of claim 24 wherein the surgical instrument is a phacoemulsification surgical instrument.

26. The device of claim 24 wherein the cannula distal tip includes multiple ports in communication with the lumen.

27. The device of claim 24 wherein the shaft length is approximately 31 mm to 33 mm.

28. The device of claim 24 wherein the at least one port has a diameter of 205 μ

m or less.

29. The device of claim 24 wherein the at least one port has a diameter of 155 μ

m or less.

30. The device of claim 24 wherein the at least one port has a diameter of 130 μ

m or less.

31. The device of claim 24 wherein the cannula has an outer diameter of one of 20, 23, 25, and 27 gauge.