MEDICAL TOOLS WITH ASPIRATION TIPS SUITABLE FOR CATARACT SURGERIES AND RELATED METHODS

• US 20150005753A1
• Filed: 09/11/2014
• Published: 01/01/2015
• Est. Priority Date: 03/05/2012
• Status: Active Grant

• Current Assignee: Keith A Walter, Jr.
• Original Assignee: Wake Forest University Health Sciences
• Inventors: Walter, Keith Andrew
• Granted Patent: US 10,213,533 B2
• 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 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/00834 Inlays; Onlays; Intraocular lenses [IOL]
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• CPC Class Codes: A61M 3/0283 with at least two inner passageways, a first one for irrigating and a second for evacuating suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92

Abstract

Devices and methods for cataract surgery include a tip with reciprocating door to chop, fragment or reduce size of large nuclear lens fragments and/or cortex fragments in a capsule bag to facilitate aspiration.

Claims

1. A method of performing cataract surgery, comprising:

performing a phacoemulsification or laser disintegration procedure on an eye of a patient;

inserting, in vivo, a tip of an aspiration tool that is in fluid communication with an aspiration channel into a posterior capsule bag of a patient, wherein the tip comprises an open leading end that defines an aspiration port and one or both of (i) a longitudinally translatable door that is configured to retract and extend to at least partially cover the aspiration port or (ii) first and second cooperating members that form the leading end of the tip and allow the leading end of the tip to open from a first configuration with a first size of the aspiration port to a second configuration with a second larger size of the aspiration port;

aspirating nuclear lens and/or cortex fragments into the aspiration channel using the aspiration port; and

manually and/or automatically directing (a) the door to reciprocate in a longitudinal direction over the aspiration port or (b) the tip to successively open from the first configuration to the second configuration to thereby reduce a size of at least one nuclear lens fragment and/or cortex fragment to inhibit one or more nuclear lens fragments and/or one or more cortex fragments from blocking the aspiration port and/or the aspiration channel.

2. The method of claim 1, wherein the tip has the door and the method is carried out to manually and/or automatically directing the door to reciprocate, and wherein the door comprises at least one aspiration port that is smaller than the aspiration port defined by the open leading end, the method comprising manually or automatically directing the door to reciprocate in a longitudinal direction to at least partially cover the aspiration port defined by the open leading end of the tip.

3. The method of claim 2, further comprising after the directing step, manually or automatically closing the door over the aspiration port defined by the open leading end and then, with the door closed, aspirating cortical material or nuclear lens fragments through the aspiration port in the door.

4. The method of claim 1, wherein the tip comprises external surface texture, the method comprising polishing the posterior and/or anterior capsule using the textured external surface.

5. The method of claim 1, wherein the tip has a textured external portion and a smooth surface portion, the method comprising rotating the tip so that the textured surface faces cortical tissue after the inserting step for capsular polishing.

6. The method of claim 1, wherein the tip has the door, and wherein the manually and/or automatically directing step is carried out to direct the door to reciprocate so that a leading end of the door moves successively back and forth a distance between about 0.5 mm and about 2 mm to thereby chop nuclear lens and/or cortex fragments to reduce the size of loose nuclear lens and/or cortex fragments proximate the aspiration port.

7. The method of any of claim 1, wherein the tip has the door, and wherein the manually and/or automatically directing step is carried out to direct the door to reciprocate wherein the door is flexible and can reciprocate manually and/or automatically before, during or after the aspirating.

8. The method of claim 1, wherein the tip has the door and the method is carried out to manually and/or automatically directing the door to reciprocate, and wherein the door includes at least one aspiration port that is smaller than the leading end aspiration port, the method further comprising aspirating cortex material through the smaller aspiration port when the door resides over the leading end aspiration port.

9. The method of claim 1, wherein the tip has the door and the method is carried out to manually and/or automatically directing the door to reciprocate, and wherein the door has a pair of laterally opposing outer side edges that slidably engage a respective side door frame in the tool tip during the directing step for controlled longitudinal reciprocal movement.

10. The method of claim 1, wherein the tip comprises at least one irrigation port, the method comprising flowing irrigation fluid out of the at least one irrigation port during the aspirating.

11. The method of claim 1, wherein the tip comprises a front irrigation port residing adjacent and to a side or under or over the aspiration port defined by the open leading end, the method further comprising flowing irrigation fluid out of the front irrigation port during the aspirating.

12. The method of claim 1, wherein the tool has the tip with the first and second members that open and the method is carried out to manually and/or automatically direct the tip to open from the first configuration to the second configuration, and wherein the tool further comprises a sleeve that slidably cooperates with the first and second members of the tip to allow the tip to extend forward of the sleeve a distance sufficient to allow the first and second members to travel apart to open from the first configuration with the first size of the aspiration port to the second configuration with the second larger size of the aspiration port, and wherein cooperating first and second members attach together to form the first configuration with the first size of the aspiration port and separate to move apart to open to the second configuration with the second larger size aspiration port.

13. An aspiration tool for use in combination with a surgical system for cataracts after a phacoemulsification and/or laser disintegration procedure, comprising:

a tip having an open leading end that defines an aspiration port, the tip sized and configured for removing cortical and/or nuclear lens fragments, tissue and/or fibers; and

at least one of;

(a) a translatable door in communication with the first aspiration port configured to extend and retract about the first aspiration port, wherein, in the extended position, the door travels forward to at least partially occlude the aspiration port;

or

(b) cooperating pair first and second members that attach together to form a first configuration with a first size of the aspiration port and that move apart to open to a second configuration with a second larger size of the aspiration port.

14. The tool of claim 13, wherein the open leading end, when viewed from the side, has a tapered or angled profile.

15. The tool of claim 13, wherein the open leading end of the tip has an external planar bottom surface.

16. The tool of claim 13, wherein the tool comprises the translatable door, and wherein the first aspiration port has a wall with a perimeter that has spaced apart sides with guides, channels or rails that engage outer side edges of the door to allow the door to slidably translate up and down.

17. The tool of claim 13, wherein the tool comprises the translatable door, and wherein the door is has a planar bottom end that is sized and configured to close against a surface of the leading end of the tip.

18. The tool of claim 13, wherein the tool comprises the translatable door, wherein the door has at least one aspiration port extending therethrough, the door aspiration port having a size that is smaller than the aspiration port defined by the open leading end, and wherein the aspiration port defined by the open leading end has a width that is between about 1 mm to about 1.5 mm across and a height that is between about 0.7 to about 1 mm.

19. The tool of claim 13, wherein at least a portion of the leading end of the tip comprises a textured exterior surface.

20. The tool of claim 19, wherein the textured surface extends about at least a portion of a perimeter of the door and/or an external wall of the leading end of the tip adjacent the perimeter of the door.

21. The tool of any of claim 13, wherein the tool comprises the translatable door, the tool further comprising a user control in communication with the door, wherein the door is configured to oscillate or reciprocate over the aspiration port responsive to input with the user control, and wherein the user control comprises at least one of an electronic or manual control.

22. The tool of claim 13, wherein the tool comprises the translatable door, and wherein the door is flexible and extends to be flat across the aspiration port when partially and/or fully closed.

23. The tool of claim 13, wherein the tool comprises the translatable door, and wherein the door has a pair of laterally opposing outer side edges that each slidably engage a respective side door frame in the tool tip during longitudinal reciprocal movement.

24. The tool of claim 13, wherein the leading end of the tip comprises a front irrigation port that resides adjacent and to a side or under or over the aspiration port defined by the open leading end to thereby allow irrigation fluid to flow forward out of the front irrigation port during aspiration.

25. The tool of claim 13, wherein the tool comprises the translatable door, and wherein the tip comprises an elongate primary body defining an interior aspiration channel with a pair of spaced apart longitudinally extending guides, channels or rails that extend downward in a distal end thereof to define first and second sides of a door frame for slidably engaging respective outer spaced apart sides of the door.

26. The tool of claim 25, wherein the door has a longitudinally extending shaft or extension that cooperates with the longitudinally extending guides, channels or rails and a user control to translate the door between extended and retracted positions.

27. The tool of claim 13, wherein the door is configured to be flat across the aspiration port to close the aspiration port, and wherein the door includes an aspiration port that resides over the first aspiration port when the door is in an extended configuration.

28. The tool of claim 13, wherein the tool has a sleeve that slidably cooperates with the tip to allow the tip to extend forward of the sleeve a distance sufficient to allow the first and second cooperating members of the tip to open from the first configuration with the first size of the aspiration port to the second configuration with the second larger size of the aspiration port.

29. The tool of claim 13, wherein the first and second cooperating members have an outer wall that encases an open longitudinally extending aspiration channel.

30. An ophthalmic irrigation/aspiration tool, comprising:

an aspiration cannula, the cannula having a hub configured to attach to a hand piece and an open end opposite the hub; and

a tip adapted to enter a capsular bag of an eye of a patient, the tip residing over the open end of the aspiration cannula, wherein the tip comprises a leading open end that forms a primary aspiration port, and wherein the tip comprises at least one of;

(a) a longitudinally translating door that is sized and configured to oscillate and/or reciprocate over the primary aspiration port to thereby chop and/or crush nuclear lens fragments in an eye of a patient;

or

(b) cooperating first and second members that attach together to form a first configuration with a first size of the aspiration port and that move apart to open to a second configuration with a second larger size of the aspiration port.