DEVICES AND METHODS FOR OCULAR SURGERY

• US 20180318132A1
• Filed: 05/03/2018
• Published: 11/08/2018
• Est. Priority Date: 05/04/2017
• 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., Schaller, Michael P., Chamness, Scott, Reese, Brendan
• Granted Patent: US 11,278,450 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61F 2009/00887 Cataract
• 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

Abstract

Devices, systems, and methods for performing an ophthalmic procedure in an eye are disclosed. The devices include a hand-held portion and a distal, elongate member coupled to the hand-held portion having a lumen operatively coupled to a vacuum source. A drive mechanism operatively coupled to the elongate member is configured to oscillate the elongate member. When in use, the device is configured to aspirate ocular material from the eye through the lumen. The drive mechanism retracts the elongate member with a retraction speed profile and advances the elongate member with an extension speed profile. The retraction speed profile is different from the extension speed profile.

Claims

1-65. -65. (canceled)

66. A method for performing an ophthalmic procedure in an eye, the method comprising:

inserting a distal portion of a device into an anterior chamber of the eye, the device further comprising;

a hand-held portion comprising a vacuum source configured to create pulses of discontinuous negative pressure and to create pulses of discontinuous positive pressure, the pulses of discontinuous negative pressure interspersed by the pulses of discontinuous positive pressure and having a frequency; and

a distal, elongate member coupled to the hand-held portion and forming part of the distal portion, the elongate member having an internal lumen and an opening at a distal end region of the elongate shaft;

accessing a lens of the eye with the distal portion of the device; and

activating the device to create the pulses of discontinuous negative pressure through the internal lumen of the elongate member to aspirate a first amount of material into the internal lumen through the opening at the frequency, and to create the pulses of discontinuous positive pressure interspersed with the pulses of discontinuous negative pressure to expel, from the internal lumen through the opening, a second amount of material at the frequency, wherein the second amount is substantially less than the first amount.

67. A device for performing an ophthalmic procedure in an eye, the device comprising:

a hand-held portion;

a distal, elongate member coupled to the hand-held portion, the distal, elongate member comprising a lumen and an opening at a distal end region of the elongate member; and

a vacuum source in fluid communication with the opening at the distal end region of the elongate member,

wherein the vacuum source is configured to deliver pulses of discontinuous negative pressure to the distal end region of the lumen.

68. The device of claim 67, wherein the vacuum source comprises a pump positioned within an interior of the hand-held portion.

69. The device of claim 68, wherein the pump comprises:

at least one pumping chamber having an inlet opening and an outlet opening, the inlet opening in fluid communication with the lumen of the elongate member;

a piston positioned within the at least one pumping chamber; and

a drive mechanism configured to oscillate the piston within the at least one pumping chamber to create the pulses of discontinuous negative pressure.

70. The device of claim 67, wherein the negative pressure is from 10 inHg up to about 30 inHg.

71. The device of claim 67, wherein the pulses of discontinuous negative pressure have a cycling frequency of between about 1 Hz and about 100 Hz.

72. The device of claim 67, wherein a first pulse of negative pressure draws a first amount of fluid from the lumen of the elongate member into at least one pumping chamber positioned within the hand-held portion through an inlet opening, and wherein a first pulse of positive pressure within the at least one pumping chamber expels the first amount of fluid from the at least one pumping chamber through an outlet opening.

73. The device of claim 72, wherein a volume of the first amount of fluid is between about 0.1 mL up to about 1.0 mL.

74. The device of claim 72, wherein movement of a piston in a first direction within the at least one pumping chamber creates the first pulse of negative pressure, and wherein movement of the piston in a second, opposite direction creates the first pulse of positive pressure.

75. The device of claim 74, further comprising a compliant valve positioned within the inlet opening.

76. The device of claim 75, wherein movement of the piston a second distance in the second, opposite direction seals the inlet opening and transmits an amount of the first pulse of positive pressure through the compliant valve to the lumen of the elongate member.

77. The device of claim 76, wherein the amount transmitted causes a second amount of fluid to be expelled out the opening at the distal end region of the elongate member.

78. The device of claim 72, wherein the outlet opening is regulated by a valve.

79. The device of claim 78, wherein the valve is a ball type check valve.

80. The device of claim 78, wherein the outlet opening is in fluid communication with an evacuation chamber.

81. The device of claim 67, wherein the device further comprises a drive mechanism operatively coupled to the elongate member and configured to oscillate the elongate member.

82. The device of claim 81, wherein in use, the drive mechanism is capable of retracting the elongate member in a proximal direction with a retraction speed profile and advancing the elongate member in a distal direction with an extension speed profile, and further wherein the retraction speed profile is different from the extension speed profile.

83. The device of claim 82, wherein an average retraction speed of the elongate member from the retraction speed profile is lower than an average extension speed of the elongate member from the extension speed profile.

84. The device of claim 81, wherein the drive mechanism operatively coupled to the elongate member is configured to asymmetrically oscillate the elongate member.

85. The device of claim 84, wherein the extension speed profile comprises a maximum extension speed and the retraction speed profile comprises a maximum retraction speed, and further wherein the maximum retraction speed is less than the maximum extension speed.

86. The device of claim 82, wherein the maximum retraction speed of the elongate member is below a threshold speed at which cavitation bubbles would be generated in the eye.

87. The device of claim 82, wherein a distal tip of the elongate member is configured to move relative to the hand-held portion from a fully retracted configuration to a fully extended configuration to define a travel distance.