DEVICES AND METHODS FOR CUTTING LENTICULAR TISSUE

• US 20170312125A1
• Filed: 03/16/2017
• Published: 11/02/2017
• 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., Ianchulev, Pravoslava Tsontcheva, Guguchkova, Maria Tsontcheva, Schaller, Michael Paul, Ianchulev, Tsontcho Alexandrov, Lari, David R.
• Granted Patent: US 10,478,334 B2
• Time in Patent Office: Days
• 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 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 2230/0008 elliptical or oval
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts
• 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 9/00754 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 an element positionable within a shaft having a lumen defined therethrough with the 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. The element forming a closed loop which is positioned around the lens while the lens is within a capsular bag. The closed loop is reduced in size to form a cut in the lens.

Claims

1-95. -95. (canceled)

96. A method of cutting a lens positioned in a capsular bag, comprising:

positioning an element of a device with the element positioned above a lens in a first configuration, the lens being within a capsular bag and having a posterior surface, an anterior surface and an axis, the lens also having a circumference that separates the anterior surface from the posterior surface, the element extending through a lumen in a shaft;

extending the element out of the lumen in the shaft from the first configuration to a second configuration, the element advancing between the lens and the capsular bag as the element moves toward the second configuration, the device forming a closed loop in the second configuration with the closed loop having an open area;

positioning the element around the whole lens with the element in the second configuration; and

tensioning the element to cut the whole lens.

143. The method of claim 96, wherein:

the extending is carried out with the closed loop formed by the device increasing in size during the extending, when the element is in the first configuration the closed loop is in a collapsed condition which is smaller than an unbiased shape of the closed loop.

144. The method of claim 143, wherein:

the extending is carried out with the closed loop expanding toward the unbiased shape to advance the closed loop between the capsular bag and the lens.

146. The method of claim 96, wherein:

the extending is carried out with the closed loop formed by the device advancing between the capsular bag and lens due to natural expansion of the closed loop.

97-142. -142. (canceled)

145. (canceled)

147-267. -267. (canceled)

268. A method of cutting a whole lens within a capsular bag, comprising:

positioning a cutting element of a device above the whole lens with the element in a first configuration, at least a portion of the element positioned in a lumen of a shaft when in the first configuration;

expanding the element out of the lumen so that a larger portion of the element extends out of the lumen to form a substantially closed loop with an open area, the open area of the substantially closed loop increasing as the element extends further out of the lumen;

advancing the substantially closed loop between the capsular bag and an anterior surface of the lens as the element expands from the first configuration towards an unbiased configuration;

positioning the open area of the substantially closed loop around a portion of the lens between a posterior portion of the capsular bag and a posterior surface of the lens; and

tensioning the element so that the whole lens is cut.

269. The method of claim 268, wherein:

the substantially closed loop expands towards the unbiased configuration to advance between the capsular bag and the anterior surface of the whole lens while the whole lens is within the capsular bag.

270. The method of claim 268, wherein:

the substantially closed loop is in a collapsed condition when the element is in the first configuration, the collapsed condition being smaller in area than the unbiased configuration of the substantially closed loop.

271. The method of claim 268, wherein:

the substantially closed loop is formed by the element and a distal portion of the shaft.

272. A method of cutting a lens within a capsular bag, the lens having a posterior surface, an anterior surface, an axis, and a circumference separating the anterior surface from the posterior surface, the method comprising:

positioning a first portion of an element of a device above the anterior surface of the lens with the element in a first configuration, a second portion of the element extending through a lumen in a shaft of the device;

extending the second portion of the element out of the lumen in the shaft so that the element changes in size toward a second configuration, the element advancing between the posterior portion of the lens and the capsular bag as the element moves toward the second configuration, the device forming a substantially closed loop as the element expands towards the second configuration with the closed loop having an open area; and

tensioning the element to cut the lens.

273. The method of claim 272, wherein:

when the element is extended from the lumen in the shaft and moves towards the second configuration, the substantially closed loop increases in area as the extending progresses.

274. The method of claim 272, wherein:

as the element moves toward the second configuration, the substantially closed loop formed by the device increases in size as the element advances between the anterior portion of the lens and the capsular bag.

275. The method of claim 272, wherein:

as the second portion of the element extends out of the lumen in the shaft, the element extends around the anterior surface and the posterior surface of the lens; and

the cutting results in cutting through the anterior surface and the posterior surface of the lens.

276. The method of claim 272, wherein:

the substantially closed loop expands towards an unbiased shape as the element expands towards the second configuration.

277. The method of claim 272, wherein:

the substantially closed loop expands toward the unbiased shape to advance between the capsular bag and the posterior surface of lens.

278. The method of claim 272, wherein:

the substantially closed loop formed by the device advances between the capsular bag and the anterior surface of the lens due to natural expansion of the closed loop.

279. The method of claim 272, wherein

a length of the element extending from the lumen increases in order to increase the open area of the substantially closed loop.

280. The method of claim 272, wherein:

the element is positioned over the lens while the lens is whole within the capsular bag.

281. A method of cutting a lens within a capsular bag of an eye, comprising:

introducing a cutting element into an anterior chamber of an eye, the cutting element being positioned in a first configuration with at least a portion of the cutting element positioned within a lumen, said cutting element being movable from the first configuration to a second, expanded configuration as the portion of the cutting element is extended from the lumen, at least part of the cutting element forming a closed loop having an open area as the cutting element is moved to the second configuration;

positioning the cutting element in the first configuration, through an opening in the capsular bag, over an anterior surface of the lens with the lens being whole and inside the capsular bag;

extending the portion of the cutting element from the lumen to move the cutting element from the first configuration toward the second configuration, the open area increasing in size as the portion of the cutting element is extended further from the lumen, the cutting element advancing between the capsular bag and the anterior surface of the lens as the cutting element moves toward the second configuration, the closed loop expanding toward an unbiased shape as the closed loop advances between the capsular bag and the anterior surface of the lens;

positioning the cutting element in the second configuration around a portion of the lens between a posterior portion of the capsular bag and a posterior surface of the lens; and

tensioning the cutting element so that the whole lens is fully sectioned into at least two fragments.

282. The method of claim 281, wherein:

the closed loop is formed by the cutting element and the shaft which comprises the lumen.