Modulated pulsed ultrasonic power delivery system and method

• US 7,316,664 B2
• Filed: 03/12/2003
• Issued: 01/08/2008
• Est. Priority Date: 10/21/2002
• Status: Active Grant

• Current Assignee: Johnson & Johnson Surgical Vision, Inc. (Johnson & Johnson)
• Original Assignee: Advanced Medical Optics Incorporated (Johnson & Johnson)
• Inventors: Rockley, Paul W., Kadziauskas, Kenneth E.
• Primary Examiner(s): Farah; A.
• Application Number:
  US10/387,335
• Publication Number:
  US 20040092922A1
• Time in Patent Office: 1,763 Days
• Field of Search: 604/19, 604/21, 604/22, 604/28, 604/48, 606 4- 6, 606 10- 12, 606/167, 606169-177, 600/437, 600/439, 600/446, 600/452, 601/2
• US Class Current: 604/22
• CPC Class Codes: A61B 2017/00176 Two pulses, e.g. second pulse having an effect different from the first one
• CPC Class Codes: A61B 2017/00194 Means for setting or varying the repetition rate
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: B06B 1/0215 for generating pulses, e.g. bursts of oscillations, envelopes
• CPC Class Codes: B06B 1/023 and stepped in amplitude, e.g. square wave, 2-level signal
• CPC Class Codes: B06B 1/0253 taken directly from the generator circuit
• CPC Class Codes: B06B 1/06 operating with piezoelectric effect or with electrostriction piezoelectric or electrostrictive devices per se H10N30/00
• CPC Class Codes: B06B 2201/76 Medical, dental
• CPC Class Codes: G06F 12/0223 User address space allocation, e.g. contiguous or non contiguous base addressing
• CPC Class Codes: Y02D 10/00 Energy efficient computing, e.g. low power processors, power management or thermal management

Abstract

A method and apparatus for delivering energy during a surgical procedure such as phacoemulsification is provided. The method and apparatus include applying energy during at least one pulsed energy on period, typically sufficient or intended to rapidly induce and beneficially employ transient cavitation. Applying energy during the pulsed energy on period comprises applying energy during a first high energy period, and applying energy during a second nonzero lower energy period.

Claims

1. A method for providing modulated ultrasonic energy to an ocular region during a phacoemulsification procedure, the method comprising:

applying ultrasonic energy to the ocular region using at least one modulated energy period, wherein each modulated energy period comprises;

applying first ultrasonic energy to the ocular region using a relatively high energy pulse for a first period of time; and

subsequently applying second ultrasonic energy to the ocular region after applying first ultrasonic energy, said second ultrasonic energy applied using a relatively low nonzero energy pulse having magnitude lower than said relatively high energy pulse for a second period of time.

2. The method of claim 1, wherein time between said applying first ultrasonic energy and applying second ultrasonic energy is essentially zero.

3. The method of claim 1, said method being applied within an ocular region environment, and wherein applying first ultrasonic energy tends to induce transient cavitation within the ocular region environment.

4. The method of claim 3, further comprising applying third ultrasonic energy subsequent to applying second ultrasonic energy, wherein said third ultrasonic energy comprises an additional low energy pulse having magnitude lower than said relatively high energy pulse, said third ultrasonic energy being applied for a third period of time.

5. The method of claim 4, wherein amplitude of the second ultrasonic energy is substantially identical to amplitude of the third ultrasonic energy.

6. The method of claim 4, wherein amplitude of the second ultrasonic energy materially differs from amplitude of the third ultrasonic energy.

7. The method of claim 3, wherein each modulated energy period is followed by a rest period comprising applying essentially zero power to the ocular region.

8. The method of claim 3, wherein the high energy pulse has a duration of at most approximately four milliseconds.

9. The method of claim 3, wherein the high energy pulse has a duration of at most approximately two milliseconds.

10. The method of claim 3, wherein applying ultrasonic energy to the ocular region further comprises dynamic power application parameter altering capability, wherein power application parameters altered comprise performance of at least one from a group comprising:

high energy pulse timing;

low nonzero low energy pulse timing;

the high energy pulse amplitude; and

the nonzero low energy pulse amplitude.

11. The method of claim 3, further comprising engaging the method at a first desired time when energy application is desired and disengaging the method at a second desired time when energy application is not desired.

12. The method of claim 11, wherein said engaging and disengaging is accomplished by means of a switch.

13. An apparatus comprising:

a handpiece having a needle, said handpiece ultrasonically vibrating said needle;

a power source for providing pulsed electrical power to the handpiece;

an input device enabling an operator to select an amplitude of electrical pulses;

a fluid system configured to provide fluid from the handpiece; and

a controller controlling power supplied to the handpiece during a surgical procedure conducted in a surgical environment, said controller controlling power supplied by applying power during at least one modulated pulsed energy period, said modulated pulsed energy period comprising a relatively high energy pulse sufficient to induce transient cavitation within the surgical environment, followed by a relatively low energy nonzero amplitude pulse, said relatively low energy nonzero amplitude pulse having magnitude less than the relatively high energy pulse.

14. The apparatus of claim 13, said relatively high energy pulse being separated in time by zero from said relatively low energy nonzero amplitude pulse.

15. The apparatus of claim 13, wherein said control means further enables application of de minimis power between modulated pulse energy periods.

16. The apparatus of claim 13, wherein said controller further provides a subsequent relatively low energy nonzero amplitude pulse.

17. The apparatus of claim 16, wherein amplitude of said subsequent relatively low energy nonzero amplitude pulse materially differs from amplitude of said relatively low energy nonzero amplitude pulse.

18. The apparatus of claim 16, wherein amplitude of said subsequent relatively low energy nonzero amplitude pulse is substantially identical to amplitude of said relatively low energy nonzero amplitude pulse.

19. The apparatus of claim 13, wherein the relatively high energy pulse produced by the control means has a duration of at most approximately four milliseconds.

20. The apparatus of claim 13, wherein the relatively high energy pulse produced by the control means has a duration of at most approximately two milliseconds.

21. The apparatus of claim 13, wherein operation of the apparatus is engaged at a first desired time when energy application is desired and operation of the apparatus is disengaged at a second desired time when energy application is not desired.

22. The apparatus of claim 21, wherein said engagement/disengagement occurs using a switch.

23. An apparatus comprising:

a handpiece having a needle, said handpiece ultrasonically vibrating said needle;

a power source providing pulsed electrical power to the handpiece;

an input device enabling an operator to select an amplitude of electrical pulses;

a fluid system configured to provide fluid from the handpiece; and

a controller controlling power supplied to the handpiece, said controller controlling power supplied by applying power for a higher energy period of relatively higher energy ultrasonic power application followed by applying power during a nonzero lower energy period of nonzero ultrasonic energy having magnitude lower than the relatively higher energy ultrasonic power.

24. The apparatus of claim 23, wherein the lower energy period comprises applying power at the amplitude selected using the input device.

25. The apparatus of claim 23, the apparatus having the ability to operate within an ocular environment, wherein power supplied by the controller induces transient cavitation within the ocular environment thereby enabling cutting of ocular tissue.

26. The apparatus of claim 25, wherein said controller controls power by further applying power for a further nonzero lower energy period.

27. The apparatus of claim 25, further comprising engaging the controller at a first desired time when energy application is desired and disengaging the controller at a second desired time when energy application is not desired.

28. The apparatus of claim 27, wherein said engaging and disengaging occurs using a switch.

29. A method for providing modulated ultrasonic energy to an ocular region during a phacoemulsification procedure, the method comprising:

applying ultrasonic energy to the ocular region using at least one modulated energy period, wherein each modulated energy period comprises;

applying first ultrasonic energy to the ocular region using a relatively low energy pulse for a first period of time; and

subsequently applying second ultrasonic energy to the ocular region after applying first ultrasonic energy, said second ultrasonic energy applied using a relatively high nonzero energy pulse having magnitude higher than said relatively low energy pulse for a second period of time.

30. The method of claim 29, wherein time between said applying first ultrasonic energy and applying second ultrasonic energy is essentially zero.

31. The method of claim 29, said method being applied within an ocular region environment, and wherein applying first ultrasonic energy tends to induce transient cavitation within the ocular region environment.

32. The method of claim 31, further comprising applying third ultrasonic energy subsequent to applying second ultrasonic energy, wherein said third ultrasonic energy comprises an additional low energy pulse having magnitude lower than said relatively high energy pulse, said third ultrasonic energy being applied for a third period of time.

33. The method of claim 32, wherein amplitude of the second ultrasonic energy is substantially identical to amplitude of the third ultrasonic energy.

34. The method of claim 32, wherein amplitude of the second ultrasonic energy materially differs from amplitude of the third ultrasonic energy.

35. The method of claim 31, wherein each modulated energy period is followed by a rest period comprising applying essentially zero power to the ocular region.

36. The method of claim 31, wherein the high energy pulse has a duration of at most approximately four milliseconds.

37. The method of claim 31, wherein the high energy pulse has a duration of at most approximately two milliseconds.

38. The method of claim 31, wherein applying ultrasonic energy to the ocular region further comprises dynamic power application parameter altering capability, wherein power application parameters altered comprise performance of at least one from a group comprising:

high energy pulse timing;

low nonzero low energy pulse timing;

the high energy pulse amplitude; and

the nonzero low energy pulse amplitude.

39. The method of claim 31, further comprising engaging the method at a first desired time when energy application is desired and disengaging the method at a second desired time when energy application is not desired.

40. The method of claim 39, wherein said engaging and disengaging is accomplished by means of a switch.

41. A method for providing modulated ultrasonic energy to an ocular region during a phacoemulsification procedure, the method comprising:

applying ultrasonic energy to the ocular region using at least one modulated energy period, wherein each modulated energy period comprises;

applying first ultrasonic energy using a relatively low energy pulse for a first period of time; and

subsequently applying second ultrasonic energy to the ocular region using a relatively high energy pulse after applying first ultrasonic energy;

wherein applying first ultrasonic energy and subsequently applying second ultrasonic energy induces transient cavitation in fluid within the ocular region.

42. The method of claim 41, wherein time between said applying first ultrasonic energy and applying second ultrasonic energy is essentially zero.

43. The method of claim 41, said method being applied within an ocular region environment, and wherein applying first ultrasonic energy tends to induce transient cavitation within the ocular region environment.

44. The method of claim 43, further comprising applying third ultrasonic energy subsequent to applying second ultrasonic energy, wherein said third ultrasonic energy comprises an additional low energy pulse having magnitude lower than said relatively high energy pulse, said third ultrasonic energy being applied for a third period of time.

45. The method of claim 44, wherein amplitude of the second ultrasonic energy is substantially identical to amplitude of the third ultrasonic energy.

46. The method of claim 44, wherein amplitude of the second ultrasonic energy materially differs from amplitude of the third ultrasonic energy.

47. The method of claim 43, wherein each modulated energy period is followed by a rest period comprising applying essentially zero power to the ocular region.

48. The method of claim 43, wherein the high energy pulse has a duration of at most approximately four milliseconds.

49. The method of claim 43, wherein the high energy pulse has a duration of at most approximately two milliseconds.

50. The method of claim 43, wherein applying ultrasonic energy to the ocular region further comprises dynamic power application parameter altering capability, wherein power application parameters altered comprise performance of at least one from a group comprising:

high energy pulse timing;

low nonzero low energy pulse timing;

the high energy pulse amplitude; and

the nonzero low energy pulse amplitude.

51. The method of claim 43, further comprising engaging the method at a first desired time when energy application is desired and disengaging the method at a second desired time when energy application is not desired.

52. The method of claim 51, wherein said engaging and disengaging is accomplished by means of a switch.