Laser system for intraocular tissue removal

• US 4,694,828 A
• Filed: 04/21/1986
• Issued: 09/22/1987
• Est. Priority Date: 04/21/1986
• Status: Expired due to Term

• Current Assignee: Photomed International, Inc.
• Original Assignee: Daniel M. Eichenbaum
• Inventors: Eichenbaum, Daniel M.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Hindenburg, Max F.
• Application Number:
  US06/854,134
• Time in Patent Office: 519 Days
• Field of Search: 128/4-8, 128/303.1, 128/395-398
• US Class Current: 606/6
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61F 2009/00874 Vitreous
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 9/008 using laser

Abstract

A laser system for intraocular tissue removal including a handpiece and a nose cone assembly releasably coupled to the handpiece. The handpiece and nose cone assembly have mating passageways for aspiration and irrigation, and the handpiece supports a laser energy transmitting tube that is releasably received in the nose cone assembly. The nose cone assembly comprises an outer housing, an inner housing located inside the outer housing, and an aspiration tube located inside the inner housing. The outer and inner housings and the aspiration tube have coaxially aligned lateral openings defining a photovaporization chamber. The distal end of the laser energy transmitting tube is located adjacent the photovaporization chamber. In use, tissue to be removed is aspirated into the photovaporization chamber where it is vaporized by the laser energy and then conducted along the aspiration tube. Irrigation fluid flows between the outer and inner housings and then out the end of the outer housing to cool the photovaporization chamber and replace the tissue volume removed from the eye. Preferably, the laser energy transmitting means is a fiber optic rod with a lens fused on the end to direct the laser energy into the photovaporization chamber and thus prevent it from being scattered into the eye. Nose cone assemblies of different configurations can be releasably coupled to the handpiece and exchanged during surgery.

Claims

1. A needle probe for removing tissue comprising:

an outer housing having first and second ends and inner and outer surfaces, said outer housing having means defining a first aperture on a first side of said housing adjacent said second end, and means defining a second aperture substantially at said second end;

an inner housing located inside said outer housing, said inner housing having first and second ends, first and second opposite sides, and inner and outer surfaces, said inner housing having means defining an inner housing aperture positioned substantially coaxially with said means defining said first aperture in said outer housing, and on said first side of said inner housing, which side is laterally adjacent to said first side of said outer housing;

the volume bounded by said means defining said coaxial first and inner housing apertures in said outer and inner housings defining a photovaporization zone;

said inner surface of said outer housing and said outer surface of said inner housing defining an irrigation passageway for irrigating liquid, which liquid flows through said passageway from said first ends of said outer and inner housings and exits the probe through said second aperture in said outer housing, said irrigation passageway being connectable to an irrigation generator;

a laser tube positioned inside said inner housing and laterally adjacent to said first side of said inner housing, said laser tube having first and second ends, said first end being connectable to a laser generator and said second end being located adjacent said photovaporization zone to deliver laser energy into said zone; and

an aspiration tube having first and second ends, and first and second opposite sides, said aspiration tube being positioned inside said inner housing with said second side of said aspiration tube being laterally adjacent to said second side of said inner housing, said aspiration tube having means defining an aspiration aperture on said first side of said aspiration tube adjacent said second end, said means defining said aspiration aperture being positioned substantially coaxially with said means defining said first aperture of said outer housing and said means defining said inner housing aperture of said inner housing, said first end of said aspiration tube being connectable to an aspiration generator.

2. The probe of claim 1, wherein

said laser tube includes fiber optic means adapted to transmit laser energy, said fiber optic means having a distal end, said distal end being in the proximity of said second end of said laser tube.

3. The probe of claim 2, wherein

said fiber optic means includes a lens at its distal end.

4. The probe of claim 3, wherein

said fiber optic means has a diameter of about 200 microns.

5. The probe of claim 1, wherein

said first side of said aspiration tube engages said laser tube.

6. The probe of claim 5, wherein

said first side of said aspiration tube has a groove therein recovering a portion of said laser tube therein.

7. The probe of claim 1, wherein

said first side of said aspiration tube forms the bottom of said photovaporization zone.

8. The probe of claim 1, wherein

said first aperture in said outer housing has a maximum length of about 2.5 mm and a maximum width of about 1.0 mm.

9. The probe of claim 8, wherein

said first aperture is oval.

10. The probe of claim 8, wherein

said aspiration aperture in said aspiration tube has a diameter of about 0.30 mm.

11. The probe of claim 8, wherein

said outer housing has an outside diameter of about 1.65 mm;

said inner housing has an outside diameter of about 1.3 mm; and

said laser tube has an outside diameter of about 0.5 mm.

12. A needle probe for removing tissue comprising:

first and second members including

a handpiece having an aspiration passageway, an irrigation passageway and a laser energy passageway, and

a nose cone assembly having an aspiration passageway, an irrigation passageway, and a laser energy passageway; and

means for releasably coupling said first and second members, said means including at least one male member extending axially outward from said first member, and at least one correspondingly mating female receptacle extending axially within said second member, said male member being releasably coupled with said female receptacle,

said nose cone assembly including

an outer housing having means defining a first lateral aperture spaced from its distal end and means defining an aperture at its distal end,

an inner housing located inside said outer housing, having means defining a second lateral aperture coaxially aligned with said means defining said first lateral aperture, and being spaced from said outer housing to define said nose cone assembly irrigation passageway therebetween, and

an aspiration tube located inside said inner housing, forming said nose cone assembly aspiration passageway, and having means defining a third lateral aperture coaxially aligned with said means defining said first and second lateral apertures,

the volume bounded by said coaxially aligned means for defining said first, second and third lateral apertures defining a photovaporization zone, said nose cone assembly laser energy passageway extending into said inner housing and having a distal end located adjacent said photovaporization zone.

13. The probe of claim 12, wherein

said handpiece is said first member, and has two male members extending axially outward from said aspiration passageway and said irrigation passageway.

14. The needle probe of claim 12, wherein,

said handpiece further includes laser transmitting means located in said laser energy passageway for transmitting laser energy, said laser transmitting means being releasably received in said laser energy passageway in said nose cone assembly.

15. The needle probe of claim 14, wherein

said laser transmitting means includes fiber optic means, said fiber optic means having a distal end.

16. The needle probe of claim 15, wherein

said fiber optic means includes a lens at its distal end.

17. The needle probe of claim 16, wherein

said fiber optic means is about 200 microns in diameter.

18. The needle probe of claim 14, and further comprising

an irrigation generator, an aspiration generator, and a laser energy generator;

means for connecting said irrigation generator and aspiration generator to said irrigation and aspiration passageways in said handpiece; and

means for connecting said laser energy generator to said laser transmitting means.

19. A needle probe for removing tissue comprising:

a handpiece having irrigation and aspiration passageways therein and a laser energy trasmitting optical fiber coupled thereto;

means for generating a vacuum coupled to said aspiration passageway;

means for generating irrigation fluid flow coupled to said irrigation passageway;

means for generating laser energy coupled to said optical fiber;

a nose cone assembly having irrigation and aspiration passageways; and

means for coupling said irrigation and aspiration passageways in said handpiece and in said nose cone assembly,

said nose cone assembly including

an outer housing having means defining a first lateral aperture spaced from its distal end and means defining an aperture at its distal end,

an inner housing located inside said outer housing, having means defining a second lateral aperture coaxially aligned with said means defining said first lateral aperture, and being spaced from said outer housing to define said irrigation passageway therebetween, and

an aspiration tube located inside said inner housing, forming said aspiration passageway, and having means defining a third lateral aperture coaxially aligned with said means defining said first and second lateral apertures,

the volume bounded by said coaxially aligned means for defining said first, second and third lateral apertures defining a photovaporization zone therebetween, said optical fiber extending into said inner housing and having a distal end located adjacent said photovaporization zone.

20. The probe of claim 19, and further comprising

a lens located at said distal end of said optical fiber for focusing the laser energy into said photovaporization zone.