Cataract Posterior/Wedge Chopper

• US 20170007452A1
• Filed: 12/29/2015
• Published: 01/12/2017
• Est. Priority Date: 07/08/2015
• Status: Active Grant

• Current Assignee: Michael Jerome Design, LLC
• Original Assignee: Michael Jerome Design, LLC
• Inventors: Depenbusch, Michael Jerome
• Granted Patent: US 10,166,144 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• 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

Abstract

Disclosed here is an apparatus and method for cataract surgery. The apparatus is an instrument referred to as a chopper that allows the reduction or elimination of ultrasound and/or laser energy introduced into the eye during cataract surgery. The chopper instrument is bent at an angle, such as an angle less than 110 degrees or less than 90 degrees, to provide a posterior (to anterior) chopping, and a wedge compression of the cataract. The bend in the chopper instrument, among other features, introduces refined vector forces that help in breaking/chopping the cataract with ease. The apparatus allows laser free/ultrasound free cataract extraction in dense cataracts. The chopper apparatus, a vacuum-tip and the proper vacuum settings, when used for performing a cataract surgery by a surgeon, allows the surgeon to break up the nucleus into small enough fragments that a true ultrasound-free/laser-free small incision cataract surgery can be accomplished with ease.

Claims

1. A chopper apparatus for performing a cataract surgery, the apparatus comprising:

a chopping member that that is elongated and bent near a distal end of the chopping member, the chopping member comprising;

a wedge portion comprising a bend in the chopping member,

an arm portion extending proximally from a first side of the wedge of the chopping member, the arm portion terminating in a handle portion configured to be held by a user when performing the cataract surgery on a patient,

a forearm portion extending proximally from a second side of the wedge of the chopping member, the forearm terminating at the distal end of the chopping member, the distal end being configured to be placed into an eye of a patient by a user when performing the cataract surgery, and

wherein the bend of the wedge portion comprises an angle of 110 degrees or less between the arm portion and the forearm portion of the chopping member.

2. The chopper apparatus of claim 1, wherein the distal end of the chopping member comprises a blunt rounded tip.

3. The chopper apparatus of claim 1, further comprising:

an inside edge at the wedge portion of the chopping member, the inside edge extending on either side of the wedge along the arm portion and the forearm portion of the chopping member, the inside edge facing into the bend of the chopping member; and

an outside surface of the chopping member extending along the arm portion, forearm portion, and wedge portion that is smooth and faces outward from the bend of the chopper member.

4. The chopper apparatus of claim 3, wherein the inside edge is a sharp edge for cutting tissue of the cataract.

5. The chopper apparatus of claim 3, wherein the inside edge is a sharp edge, and the outside surface is a rounded surface, the sharp edge extending from the rounded surface to form a continuous line.

6. The chopper apparatus of claim 3, wherein the inside edge is a sharp edge, and the outside surface is a rounded surface having a lip formed on either side of the sharp edge that reach toward a tip of the sharp edge.

7. The chopper apparatus of claim 3, wherein the inside edge is a sharp edge and the outside surface is a flat surface extending laterally out from either side of the sharp edge.

8. The chopper apparatus of claim 3, wherein the distal end of the forearm portion is a blunt end, and wherein the inside edge extends the length of the forearm portion to the blunt end of the forearm portion.

9. The chopper apparatus of claim 1, further comprising a paddle portion along a wedge wherein the paddle portion comprises increasing a surface area of the wedge.

10. The chopper apparatus of claim 1, further comprising a wedge paddle formed at the wedge portion of the chopping member, the wedge paddle extending laterally on either side of the chopping member to form a scoop design for scooping a cataract in the eye of the patient.

11. The chopper apparatus of claim 10, wherein the wedge paddle extends along the forearm portion of the chopping member to the distal end of the chopping member, the wedge paddle increasing a surface area of the forearm portion.

12. The chopper apparatus of claim 10, wherein the wedge paddle extends along part of the arm portion of the chopping member, the wedge paddle increasing a surface area of the arm portion.

13. The chopper apparatus of claim 10, wherein the wedge paddle extends along both the forearm portion of the chopping member and the arm portion of the chopping member, the wedge paddle increasing a surface area of the arm and forearm portions.

14. The chopper apparatus of claim 1, wherein the bend of the wedge portion comprises an angle of 90 degrees or less between the arm portion and the forearm portion of the chopping member.

15. The chopper apparatus of claim 1, wherein the bend of the wedge portion comprises an angle of 70 degrees or less between the arm portion and the forearm portion of the chopping member.

16. A method for performing an ultrasound and laser free cataract surgery using a chopper apparatus that is elongated and comprises a bend of 110 degrees or less near a distal end, the chopper apparatus including an arm extending proximally from the bend and a forearm extending distally from the bend, the method comprising:

placing a chopper apparatus into an eye of a patient to access a cataract;

rotating the chopper apparatus such that a tip of the chopper apparatus at the distal end points toward a posterior pole of the cataract;

positioning the chopper apparatus around a nucleus of the cataract such that an equator of the nucleus is straddled at the bend between the forearm and the arm of the chopper apparatus with the forearm positioned at a posterior of the nucleus;

fragmenting the nucleus of the cataract into a plurality of fragments for removal from the eye with a vacuum tip that is positioned near a center of an anterior surface of the nucleus of the cataract, the fragmentation performed by repeatedly;

pulling the chopper apparatus through the cataract such that the forearm of the chopper apparatus is moved anteriorly and horizontally toward a vacuum tip, the vacuum tip positioned near a center of an anterior surface of the nucleus of the cataract, the pulling motion causing a posterior to anterior chopping of the nucleus of the cataract; and

moving the chopper apparatus and the vacuum tip back apart.

17. The method of claim 16, further comprising removing from the eye a fragment from a plurality of fragments of the nucleus using the vacuum tip.

18. The method of claim 16, further comprising repeating the posterior to anterior chopping of the nucleus a plurality of times to cause formation of 5 to 8 fragments of the nucleus.

19. The method of claim 16, further comprising fixating and freeing the fragments from one another and simultaneously micro-chopping and feeding the fragments directly into the vacuum tip for removal from the eye, the micro-chopping performed without laser or ultrasound.

20. The method of claim 16, wherein the pulling of the chopper apparatus further comprises pulling the chopper apparatus such that the forearm of the chopper apparatus moves toward a center of the vacuum tip until the chopper apparatus and the vacuum tip are almost touching each other, wherein moving the chopper apparatus comprises moving the chopper apparatus in a horizontal and anterior direction, and wherein the method further comprises rotating the nucleus to repeat the pulling and moving steps.

21. The method of claim 16, wherein the posterior to anterior chopping of the nucleus creates vector forces on the nucleus that point anteriorly against the vacuum tip to break the nucleus of the cataract into fragments.

22. The method of claim 16, wherein the positioning step comprises positioning the chopper apparatus with the tip tilted slightly posteriorly from the horizontal and pointing toward an incision.