CATARACT EXTRACTION METHOD AND INSTRUMENTATION

• US 20190015252A1
• Filed: 07/17/2017
• Published: 01/17/2019
• Est. Priority Date: 07/17/2017
• Status: Active Application

• Current Assignee: Alfredo Tranjan, Fabio Henrique Cacho Casanova, Francisco Seixas Soares, Jonathan Lake
• Original Assignee: Alfredo Tranjan, Fabio Henrique Cacho Casanova, Francisco Seixas Soares, Jonathan Lake
• Inventors: Lake, Jonathan, Casanova, Fabio Henrique Cacho, Soares, Francisco Seixas, Tranjan, Alfredo
• Application Number:
  US15/651,214
• Publication Number:
  US 20190015252A1
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320072 Working tips with special features, e.g. extending parts
• CPC Class Codes: A61B 2017/32008 preventing clogging of suction channel
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00887 Cataract
• 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 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00825 for photodisruption

Abstract

A tip for a phacoemulsification handpiece, including a tubular structure having an elongate portion with generally parallel sides and a flared end portion extending outwardly from the elongate portion and presenting a mouth that is larger in diameter than a lumen diameter of the elongate portion. The tip may include a plurality of internally extending structures coupled to an interior of the tubular structure. A method of surgically removing a crystalline lens of an eye, including evaluating the crystalline lens to determine the level of nuclear sclerosis, sectioning at least a central portion of the crystalline lens into a plurality of lens fragments by application of femtosecond laser energy and aspirating the lens fragments from the eye using a phaco-aspiration tip coupled to a source of suction. The method may include application of pulsed vacuum to aspirate lens fragments.

Claims

1. A tip for a phacoemulsification handpiece, comprising:

a tubular structure including an elongate portion having generally parallel sides and a flared end portion extending outwardly from the elongate portion and presenting a mouth that is larger in diameter than a lumen diameter of the elongate portion;

a plurality of internally extending structures coupled to an interior of the tubular structure;

wherein the tubular structure is coupled to the phacoemulsification handpiece which in turn is coupled to a source of suction by which fragments of a crystalline lens may be drawn into the lumen of the tubular structure.

2. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the internally extending structures comprise spikes or blades.

3. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the flared end portion is frustoconical in shape.

4. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the mouth defines an inner diameter of approximately 1200 μ

m.

5. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the internally extending structures are located within the flared end portion.

6. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the internally extending structures extend internally a distance between 100 and 400 μ

m

7. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the internally extending structures are located proximate a junction between the flared end portion and the elongate portion having generally parallel sides.

8. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the internally extending structures are located within the elongate portion having generally parallel sides.

9. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the source of vacuum is structured to supply vacuum in a pulsed fashion.

10. The tip for a phacoemulsification handpiece as claimed in claim 1, wherein the tubular structure defines an inner diameter of approximately 900 μ

m.

11. A method of surgically removing a crystalline lens of an eye, the method comprising:

evaluating the crystalline lens to determine a level of nuclear sclerosis;

sectioning at least a central portion of the crystalline lens into a plurality of lens fragments by application of femtosecond laser energy;

aspirating the lens fragments from the eye using a phaco-aspiration tip coupled to a source of suction;

selecting or making the phaco-aspiration tip to include an elongate tube defining a flared end portion and a parallel side tubular portion.

12. The method as claimed in claim 11, further comprising engaging internally extending structures of the phaco-aspiration tip with the lens fragments.

13. The method as claimed in claim 11, further comprising applying no ultrasound energy to the eye during aspiration.

14. The method as claimed in claim 11, further comprising applying aspiration suction in a pulsed fashion.

15. The method as claimed in claim 11, further comprising sectioning the crystalline lens so that the lens fragments comprise cuboids.

16. The method as claimed in claim 15, further comprising making the cuboids to have it dimension of approximately 300 μ

m.

17. The method as claimed in claim 11, further comprising applying at least one further femtosecond laser pulse centrally within at least some of the lens fragments when the level of nuclear sclerosis exceeds a preselected value.

18. The method as claimed in claim 17, further comprising applying the at least one further femtosecond laser pulse when the preselected value for the level of nuclear sclerosis exceeds 2+.

19. The method as claimed in claim 11, further comprising applying additional femtosecond laser energy to at least some of the lens fragments thereby facilitating disruption of the lens fragments and aspiration of the lens fragments to which additional femtosecond laser energy is applied.

20. The method as claimed in claim 11, further comprising sectioning at least a portion of a lens nucleus by the application of femtosecond laser energy.

21. The method as claimed in claim 11, further comprising sectioning substantially an entirety of the crystalline lens by the application of femtosecond laser energy.