DEVICES AND METHODS FOR THE REMOVAL OF LENTICULAR TISSUE

• US 20190269557A1
• Filed: 05/17/2019
• Published: 09/05/2019
• Est. Priority Date: 09/17/2014
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Cataract Technology Inc. (Carl-Zeiss-Stiftung)
• Original Assignee: Carl Zeiss Meditec Cataract Technology Inc. (Carl-Zeiss-Stiftung)
• Inventors: Clauson, Luke W., Guguchkova, Maria Tsontcheva
• Granted Patent: US 10,463,536 B2
• Time in Patent Office: Days
• 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
• 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 device for cutting a lens within a capsular bag of an eye, comprising:

an elongate member comprising at least one lumen and a distal portion;

a cutting element capable of being configured into a first, retracted configuration with at least a portion of said cutting element being positioned within the at least one lumen, wherein the first, retracted configuration of the cutting element and the distal portion of the elongate member are both sized for insertion into an anterior chamber of the eye through an incision and into the capsular bag,

wherein said cutting element comprises a first leg and a second leg, and further wherein, after insertion of the cutting element into the capsular bag, at least one of the first and second legs of the cutting element is configured to move relative to a distal end of the elongate member to expand the cutting element from the first, retracted configuration toward a second, expanded configuration having an open area, wherein a first portion of the open area is distal of the distal end of the elongate member and a second portion of the open area is proximal of the distal end of the elongate member;

wherein the second, expanded configuration of the cutting element is sized and shaped to permit advancement of the cutting element between the capsular bag and an anterior surface of the lens and further advancement of the cutting element between the capsular bag and a posterior surface of the lens to capture a first portion of the lens within the open area; and

an actuator operatively coupled to the cutting element, for tensioning the cutting element to reduce the size of the open area and cut the lens.

2. The device of claim 1, wherein at least a portion of the second, expanded configuration of the cutting element comprises a preset shape.

3. The device of claim 2, wherein the preset shape of the second, expanded configuration of the cutting element accommodates a cross-sectional shape of the lens.

4. The device of claim 1, wherein, with the cutting element in the first, retracted configuration, all but a tip portion of the cutting element is positioned within the at least one lumen.

5. The device of claim 4, wherein the tip portion comprises a portion of at least one of the first and second legs.

6. The device of claim 1, wherein, with the cutting element in the second, expanded configuration, a majority of the cutting element positioned outside the at least one lumen is off-set from a longitudinal axis of the at least one lumen.

7. The device of claim 1, wherein, with the cutting element in the second, expanded configuration, a majority of the open area of the cutting element is off-set to one side of a longitudinal axis of the at least one lumen.

8. The device of claim 2, wherein the cutting element undergoes shape-change toward the preset shape during expansion of the cutting element from the first, retracted configuration toward the second, expanded configuration.

9. The device of claim 1, wherein the cutting element comprises a nitinol wire or strap.

10. The device of claim 1, wherein the cutting element is coated with a material to reduce friction.

11. The device of claim 10, wherein the coating comprises a hydrophobic material.

12. The device of claim 2, wherein the preset shape includes an approximately closed, non-planar loop comprising both the first and second legs of the cutting element.

13. The device of claim 1, wherein the second leg bends more than 120 degrees relative to a longitudinal axis of the distal portion of the elongate element when the cutting element is in the second, expanded configuration.

14. The device of claim 1, wherein the actuator comprises at least one of a slider and a spring.

15. The device of claim 2, wherein the preset shape is similar in size and shape to a cross-section of the lens.

16. The device of claim 15, wherein the cross-section is parallel to a transverse plane extending from an anterior surface of the lens to a posterior surface of the lens.

17. The device of claim 15, wherein the preset shape comprises a longer axis that corresponds in length to a major axis of the cross-section of the lens, and a shorter axis that corresponds in length to a minor axis of the cross-section of the lens.

18. The device of claim 1, wherein a first inner perimeter of the cutting element defining the open area is larger than a second perimeter of a cross-sectional portion of the lens when the cutting element is in the second, expanded configuration.

19. The device of claim 1, wherein the open area of the cutting element when in the second, expanded configuration has a diameter larger than a diameter of a capsulorhexis in the capsular bag.

20. The device of claim 1, wherein, when the cutting element is tensioned, the open area of the cutting element reduces to cut the lens.

21. The device of claim 1, wherein the cutting element is configured to be advanced between the capsular bag and an anterior surface of the lens as the cutting element expands toward the second, expanded configuration.

22. The device of claim 1, wherein the portion of the cutting element positioned within the at least one lumen in the first, retracted configuration comprises at least a portion of the first and second legs of the cutting element.

23. The device of claim 1, further comprising at least a second cutting element comprising a first arm and a second arm, at least one of the first and second arms is configured to move relative to the distal end of the elongate element to expand the second cutting element to a shape having a second open area;

and

wherein the second cutting element is sized and shaped to permit advancement of the second cutting element between the capsular bag and the posterior surface of the lens to capture a second portion of the lens within the second open area.

24. The device of claim 23, wherein the second cutting element expands to the shape having the second open area as the cutting element expands from the first configuration toward the second, expanded configuration.

25. The device of claim 23, wherein the second cutting element is capable of advancement between the capsular bag and the posterior surface of the lens to capture the second portion of the lens within the second open area as the cutting element is advanced between the capsular bag and the posterior surface of the lens to capture the first portion of the lens within the open area.

26. The device of claim 23, wherein the actuator is operatively coupled to the second cutting element and is capable of tensioning both the cutting element and the second cutting element to cut the lens.

27. The device of claim 1, wherein the elongate member comprises a shaft, wherein, when the device is in use, the shaft extends proximally outside of the anterior chamber of the eye.

28. The device of claim 1, wherein said actuator tensions the cutting element to reduce the size of the open area by proximally retracting a portion of at least one of the first and second legs.

29. The device of claim 1, wherein said actuator tensions the cutting element to reduce the size of the open area by proximally retracting a portion of both of the first and second legs.

30. The device of claim 1, wherein tensioning of the actuator sections the lens into at least two pieces.