CATARACT REMOVAL DEVICE AND INTEGRATED TIP

• US 20140081151A1
• Filed: 09/17/2013
• Published: 03/20/2014
• Est. Priority Date: 09/18/2012
• Status: Active Grant

• Current Assignee: Liviu B. Saimovici
• Original Assignee: Liviu B. Saimovici
• Inventors: Saimovici, Liviu B.
• Granted Patent: US 10,052,227 B2
• Time in Patent Office: Days
• US Class Current: 600/478
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320073 probe
• CPC Class Codes: A61B 2017/32008 preventing clogging of suction channel
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• 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 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/00 Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems catheters A61M25/00; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; devices for taking samples of blood A61B5/15; filters implantable into blood vessels A61F2/01
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently

Abstract

The present invention is directed to an apparatus and method for assisted removal of the cortex, capsule polishing and destruction and/or removal of other intraocular structures. More particularly, the present invention is directed to a surgical apparatus configurable for removal of the cortex and the polishing of the capsule during cataract extraction surgery.

Claims

1. An ophthalmic surgical instrument for use at a surgical site, comprising:

an endpiece configured to be operable with a handpiece having at least one axis, said endpiece configured to oscillate about the at least one axis;

wherein the endpiece is configured with at least one polishing surface and at least one emulsification surface;

wherein said emulsification surface is configured to emulsify intraocular structures; and

wherein said primary polishing surface is configured to polish the lens capsule of the eye.

2. The ophthalmic instrument of claim 1,

wherein the endpiece is further configured with an inlet positioned to direct material present at the surgical site into an interior channel configured within the endpiece, the inlet being recessed from the surface of the endpiece and configured with a plurality of structures to prevent complete occlusion by, and ensuing damage to, the capsule, iris or other eye tissues.

3. The ophthalmic instrument of claim 1, wherein said endpiece is configured to oscillate so as to induce cavitation within a fluid present in the surgical site.

4. The ophthalmic instrument of claim 2, wherein said apparatus has the ability to selectively extract material from the eye.

5. The ophthalmic instrument of claim 1, wherein the endpiece having at least one of said polishing surface and emulsification surface is configured to selectively oscillate along three axis.

6. The ophthalmic instrument of claim 5, wherein at least one of said polishing surfaces and emulsification surfaces has the ability to rotate around a central axis of the endpiece.

7. The ophthalmic instrument of claim 6, wherein at least a portion of the endpiece is configured to oscillate at a variable power setting.

8. The ophthalmic instrument of claim 7, wherein the endpiece is selectively removable from the handpiece.

11. The ophthalmic apparatus of claim 1 further including;

a selectable power source for generating the oscillation energy.

12. The ophthalmic instrument of claim 11 wherein the endpiece is equipped with a plurality of emulsification and polishing surfaces, each surface configured to be selectably oscillated independently of any other surface.

13. The ophthalmic instrument of claim 1, wherein at least one polishing surface of the endpiece is equipped with a compressible, porous material and further configured to abrade the interior of a capsular bag.

14. The ophthalmic instrument of claim 11, wherein the endpiece further includes a sheath surrounding the endpiece, the sheath being equipped with at least one outlet to introduce material to, or remove material from, the eye.

15. The ophthalmic instrument of claim 14, wherein the endpiece is formed of a solid resilient material.

16. The ophthalmic instrument of claim 11, wherein the endpiece further includes a fiber-optic imaging instrument configured to transmit images from the surgical site to the operator of the surgical instrument.

17. The ophthalmic instrument of claim 13, wherein the volume of the porous material is configurable based on user action.

22. The ophthalmic instrument of claim 11, wherein the endpiece is configured to articulate in three dimensions about a longitudinal axis of the handpiece.

23. The ophthalmic surgical instrument of claim 2, wherein the endpiece is configured with a means for altering geometry of the inlet.

24. The ophthalmic surgical instrument of claim 1, wherein the endpiece is formed of a flexible material.

25. The ophthalmic surgical instrument of claim 16 wherein the fiber-optic imaging instrument includes a fiber optic cable equipped to transmit images to a monitor.

26. The ophthalmic surgical instrument of claim 1, wherein the endpiece is equipped with a series of ridges, divots, ports or small communications or openings into the channel or other structures designed to dislodge intraocular tissue and prevent the complete occlusion of the inlet by membranous tissues such as lens capsule and iris, while preventing damage to the intraocular tissues.

27. An ophthalmic surgical instrument of claim 1:

Wherein the endpiece is a fiber optic imaging instrument configured to oscillate.

28. The ophthalmic instrument of claim 27;

Wherein the endpiece is configured to transmit images to a display, wherein the images are synchronized with the oscillation of the fiber optic imagining instrument so as to produce a stable image.

29. The ophthalmic instrument of claim 28 wherein,

the endpiece is configured to illuminate the surgical site.

30. The ophthalmic instrument of claim 27 wherein,

the endpiece is configured to illuminate the surgical site.

9. A method of operating an ophthalmic instrument having at least one source of vibration energy, and at least one device configured to provide negative pressure and an endpiece having a proximal end and a distal end, the endpiece configured with at least a polishing surface, an emulsification surface and an aspiration inlet coextensive with a channel configured within the endpiece, wherein the inlet is recessed from the surface to prevent complete occlusion by intraocular tissues, said method comprising the steps of:

(a) inserting the surgical apparatus into the eye;

(b) engaging the source of vibration;

(c) selecting a vibration power, wherein the vibration power is related to the amplitude and frequency of the vibration;

(d) bringing emulsification surface of the endpiece into direct contact with lens cortex in order to emulsify the lens cortex;

(e) drawing the pieces of cortex into the inlet;

(f) moving the instrument to a new location and repeating steps (a)-(e) within the eye until the cortex is removed;

(g) rotating the endpiece to bring the polishing surface into contact with the capsule;

(h) polishing the capsule by oscillating the endpiece and drawing epithelial cells and small pieces of the cortex that still remain attached to the capsule into the inlet; and

(i) moving the endpiece to a new location within the eye to contact other capsule tissue and repeating step (h) until the lens capsule is polished.

10. A method of operating an ophthalmic instrument having at least one source of vibration energy, and at least one device configured to provide negative pressure and an endpiece having a proximal end and a distal end, the endpiece configured with at least a polishing surface, an emulsification surface and an aspiration inlet coextensive with a channel configured within the endpiece, wherein the inlet is recessed from the surface to prevent complete occlusion by intraocular tissues, said method comprising the steps of:

(a) inserting the surgical apparatus into the eye;

(b) engaging the source of oscillation;

(c) selecting a oscillation power, wherein the vibration power is related to the amplitude and frequency of the vibration;

(d) bringing emulsification surface in close proximity to lens cortex in order to emulsify the lens cortex;

(e) drawing the pieces of cortex into the inlet;

(f) moving the instrument to a new location and repeating steps (a)-(e) within the eye until the cortex is removed;

(g) rotating the endpiece to bring the polishing surface into close proximity with the capsule;

(h) polishing the capsule by oscillating the endpiece and drawing epithelial cells and small pieces of the cortex that still remain attached to the capsule into the inlet; and

(i) moving the endpiece to a new location within the eye to contact other capsule tissue and repeating step (h) until the lens capsule is polished.

18. A method according to claim 10 further comprising the step of

introducing a fluid into the eye cavity through the surgical instrument.

19. The method of operating the ophthalmic surgical instrument of claim 18, wherein the fluid has a viscosity greater than saline fluid.

20. The method of operating the ophthalmic surgical instrument of claim 19, wherein the fluid is a viscoelastic fluid.

21. A method of claim 10 wherein the ophthalmic surgical instrument further includes a fluid pump configured to provide fluid at a plurality of pressure settings or cycles, said method further comprising the steps of:

(a) selecting a pressure setting,

(b) introducing a fluid into the eye through the surgical apparatus;

(c) selecting a varying fluid pressure and velocity cycle;

(d) directing the instrument to a desired location; and

(e) moving the instrument to a different location.