DEVICES AND METHODS FOR THE REMOVAL OF LENTICULAR TISSUE

• US 20160074220A1
• Filed: 09/17/2015
• Published: 03/17/2016
• Est. Priority Date: 09/17/2014
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Cataract Technology Inc. (Carl-Zeiss-Stiftung)
• Original Assignee: Iantech, Inc. (Carl-Zeiss-Stiftung)
• Inventors: Clauson, Luke W., Lari, David R., IANCHULEV, Tsontcho Alexandrov, IANCHULEV, Pravoslava Tsontchev, GUGUCHKOVA, Maria Tsontchev, Schaller, Michael Paul
• Granted Patent: US 9,775,743 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/00763 with rotating or reciprocating cutting elements, e.g. concentric cutting needles atherectomy cutting instruments A61B17/3207; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61F 9/00825 for photodisruption

Abstract

An exemplary surgical device includes a shaft with a lumen defined therethrough and an element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen; wherein motion from the stored position to the deployed position causes a first leg of the element to advance distally relative to the distal end of the shaft, and causes a second leg of the element to move proximally relative to the distal end of the shaft.

Claims

1. A surgical device, comprising:

a shaft with a lumen defined therethrough; and

an element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen;

wherein motion from the stored position to the deployed position causes a first leg of the element to advance distally relative to the distal end of the shaft, and causes a second leg of the element to move proximally relative to the distal end of the shaft.

2. The surgical device of claim 1, wherein all but a tip portion of the element is positioned within the lumen.

3. The surgical device of claim 1, wherein in the deployed position the majority of the element positioned outside the lumen is located to one side of the longitudinal axis of the lumen.

4. The surgical device of claim 1, wherein the element is composed of superelastic metal.

5. The surgical device of claim 4, wherein the element undergoes superelastic shape change during the transition of the element from the stored position to the deployed position as a result of increased temperature at the element.

6. The surgical device of claim 1, wherein the element undergoes shape change during the transition of the element from the stored position to the deployed position as a result of the extension of the element out of the lumen.

7. The surgical device of claim 1, wherein the element is a wire.

8. The surgical device of claim 1, wherein the element is a strap.

9. The surgical device of claim 1, wherein the element is a continuous structure that in the deployed position forms a substantially closed shape, with both first and second legs of the element extending out of the distal end of the lumen;

wherein, in proximity to the distal end of the lumen, the first leg bends back more than 120 degrees in the deployed position.

10. The surgical device of claim 1, wherein in the deployed position, the element forms a generally-closed, curved, and atraumatic shape.

11. The surgical device of claim 1, wherein in the deployed position, the element forms a substantially closed shape that defines a plane, wherein the longitudinal axis of the shaft lies in that plane.

12. The surgical device of claim 1, wherein the device further comprises a handle attached to the proximal end of the shaft, wherein the element is rotatable in response to actuation of at least one control on the handle.

13. The surgical device of claim 12, wherein the element is rotatable relative to the handle while the element is between the stored position and the deployed position.

14. The surgical device of claim 12, wherein the control is a slider coupled to both the element and to a cam that converts linear motion of the slider into rotary motion of the element.

15. The surgical device of claim 12, wherein the element is a continuous structure that in the deployed position forms a substantially closed shape, with both first and second legs of the element extending out of the distal end of the lumen;

wherein the handle includes a separate control associated with each leg of the element.

16. The surgical device of claim 1, further comprising a retrieval bag attached to the element.

17. The surgical device of claim 1, wherein in the deployed position, the element forms a substantially closed shape that is curved and is non-planar.

18. A device for surgery on a human eye, the human eye including a capsular bag, a lens inside the capsular bag, and a cornea , comprising:

a tube with a lumen defined therethrough; and

a sectioning element configured to change between at least a first shape and a second shape, the second shape having a perimeter, and the sectioning element extending from the distal end of the lumen;

wherein the first shape is sized to insert through a capsulorhexis on the anterior surface of the capsular bag, the diameter of is the capsulorhexis less than the diameter of the lens;

wherein the sectioning element is movable from the first shape to the second shape to move between the lens and the capsular bag, such that when the sectioning element has the second shape, the sectioning element includes at least a portion of the lens within its perimeter; and

wherein the sectioning element is movable to a third shape from the second shape to apply cutting force to the lens.

19. The device of claim 18, wherein the sectioning element is movable from the first shape to the second shape to move between the lens and the capsular bag while applying force to the capsular bag below a threshold amount associated with damage to the capsular bag.

20. A device for eye surgery, comprising:

a shaft with a lumen defined therethrough;

an inner rotating element positioned at least partially in the lumen;

an outer rotating element positioned at least partially in the lumen, and positioned radially between the inner rotating element and the shaft;

a first plurality of straps extending distally from the distal end of the outer rotating element, each of the first plurality of straps circumferentially spaced from one another;

a second plurality of straps extending distally from the distal end of the inner rotating element, each of the second plurality of straps circumferentially spaced from one another; and

a tip connected to the distal end of each of the straps;

wherein the first plurality of straps and second plurality of straps are movable from a closed position to an open position; and

wherein at least one of the first plurality of straps and second plurality of straps is rotatable relative to the other in the open position.

21. The device of claim 20, wherein the elements collectively form a cage, wherein the cage is movable from a larger configuration to a smaller configuration to capture tissue.

22. The device of claim 20, wherein the first plurality of straps and second plurality of straps are fabricated from superelastic material.

23. A surgical method for treating an eye with a cornea, capsular bag, and lens within the capsular bag, comprising:

incising the cornea;

creating an capsulorhexis in the anterior surface of the capsular bag;

inserting a shaft, having a lumen therethrough, through the incision in the cornea toward the capsulorhexis;

extending a wire out of the distal end of the lumen, wherein the extending causes the wire to bend away from the axis of the shaft through the capsulorhexis, expand to a size greater than the capsulorhexis, and capture at least a part of the lens.

24. The method of claim 23, further comprising tensioning the wire, wherein the tensioning fragments the lens.

25. The method of claim 23, wherein the incising the cornea is performed at an edge of the cornea, and wherein the inserting a shaft further comprises placing the shaft generally parallel to and spaced apart from the circle defined by the edge of the capsulorhexis.

26. The method of claim 23, further comprising rotating the wire to capture at least a part of the lens.

27. The method of claim 26, further comprising rotating the wire during the extending.

28. The method of claim 23, further comprising at least one additional wire, the wires forming a cage, wherein the extending further comprises opening the cage;

further comprising tensioning the wires to capture a lens fragment.

29. The method of claim 23, wherein at least the inserting and extending are performed under robotic control.