Vitrectomy probe with adjustable cutter port size

• US 9,517,161 B2
• Filed: 03/13/2012
• Issued: 12/13/2016
• Est. Priority Date: 12/20/2011
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Alcon Research Limited (Nestle SA)
• Inventors: Underwood, John R., Flowers, Matthew Braden, Auld, Jack Robert, Huculak, John Christopher
• Primary Examiner(s): Anderson, Gregory
• Assistant Examiner(s): SIMPSON, SARAH A
• Application Number:
  US13/419,061
• Publication Number:
  US 20130158579A1
• Time in Patent Office: 1,736 Days
• Field of Search: 606/166, 606/170, 606/171, 606/172
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/00544 pneumatically
• 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

Vitrectomy probes and system related thereto are disclosed herein. The disclosure describes various example vitrectomy probes having an adjustable cutting port size. Various example features are described for adjusting the size of the cutting port. Further, the disclosure provides examples for adjusting the size of the cutter port while the vitrectomy probe is in operation.

Claims

1. A vitrectomy probe comprising:

a housing;

a cutter extending longitudinally from a first end of the housing, the cutter comprising;

an outer cutting member coupled to the housing, the outer cutting member comprising;

an aperture comprising a distal edge and a proximal edge;

an inner cutting member comprising a distal edge and slideable within the outer cutting member, the inner cutting member slideable between a retracted position and an extended position; and

an adjustable port;

an oscillator operable to reciprocate the inner cutting member;

a stroke limiter selectively moveable relative to the housing over an operating range, the stroke limiter stoppable at a plurality of positions along the operating range to define an engagement position, the inner cutting member adapted to contact the stroke limiter at the engagement position to define a fully retracted position of the inner cutting member, the distal edge of the inner cutting member being disposed adjacent to the aperture between the distal edge of the aperture and the proximal edge of the aperture when the inner cutting member is at the fully retracted position, a size of the adjustable port defined by a distance between the distal edge of the aperture and the distal edge of the inner cutting member;

a biasing member disposed between a portion of the stroke limiter and a portion of the housing;

a first chamber formed in the housing, wherein the stroke limiter is disposed within the first chamber; and

a first diaphragm disposed within and dividing the first chamber into a first chamber portion and a second chamber portion, an outer periphery of the first diaphragm coupled to the housing and an interior periphery of the first diaphragm coupled to the housing,

wherein the stroke limiter is longitudinally moveable with the first diaphragm to any of the plurality of positions along the operating range, the first diaphragm moveable in response to pneumatic pressure in the second chamber portion of the first chamber, the pneumatic pressure alterable to a selected pressure to move the stroke limiter to a desired position of the plurality of positions.

2. The vitrectomy probe of claim 1, wherein the stoke limiter is displaceable along a longitudinal axis of the vitrectomy probe in response to a fluidic pressure.

3. The vitrectomy probe of claim 1, wherein the biasing member is a spring.

4. The vitrectomy probe of claim 3, wherein the spring is a coil spring.

5. The vitrectomy probe of claim 4, wherein the inner cutting member extends through a longitudinal passage defined by the coil spring.

6. The vitrectomy probe of claim 1, wherein the inner cutting member further comprises:

a hollow coupling wherein a portion of the hollow coupling is operable to contact the stroke limiter at the engagement position.

7. The vitrectomy probe of claim 6 further comprising a central passage extending through the inner cutting member, the central passage adapted to allow passage of aspirated materials during operation of the vitrectomy probe.

8. The vitrectomy probe of claim 1,

wherein the biasing member is operable to apply a biasing force in a direction opposite displacement of the stroke limiter.

9. The vitrectomy probe of claim 1, wherein the stroke limiter comprises a hollow cylindrical portion defining an interior passage, and

wherein the inner cutting member extends through the interior passage.

10. The vitrectomy probe of claim 1 further comprising a second chamber formed in the housing, wherein the oscillator comprises a second diaphragm disposed in the second chamber, an outer periphery of the second diaphragm coupled to the housing and an inner periphery of the second diaphragm coupled to the inner cutting member.

11. A vitrectomy probe comprising:

a housing;

a cutter extending longitudinally from a first end of the housing, the cutter comprising;

an outer cutting member coupled to the housing, the outer cutting member comprising;

an aperture comprising a distal edge and a proximal edge;

an inner cutting member comprising a distal edge and slideable within the outer cutting member, the inner cutting member slideable between a retracted position and an extended position; and

an adjustable port;

an oscillator operable to reciprocate the inner cutting member;

a stroke limiter selectively moveable relative to the housing over an operating range, the stroke limiter stoppable at a plurality of positions along the operating range to define an engagement position, the inner cutting member adapted to contact the stroke limiter at the engagement position to define a fully retracted position of the inner cutting member, the distal edge of the inner cutting member being disposed adjacent to the aperture between the distal edge of the aperture and the proximal edge of the aperture when the inner cutting member is at the fully retracted position, a size of the adjustable port defined by a distance between the distal edge of the aperture and the distal edge of the inner cutting member;

a biasing member disposed between a portion of the stroke limiter and a portion of the housing;

a chamber formed in the housing, wherein the stroke limiter is disposed within the chamber; and

a diaphragm moveable in response to fluidic pressure, wherein the stroke limiter is coupled to the diaphragm, wherein the diaphragm is coupled to the housing along an outer periphery thereof and along an inner periphery thereof.

12. The vitrectomy probe of claim 11, wherein the fluidic pressure is pneumatic pressure.

13. The vitrectomy probe of claim 11, wherein the stroke limiter is coupled to the diaphragm at a location between the inner periphery and the outer periphery.

14. A vitrectomy probe comprising:

a housing;

a cutter extending longitudinally from a first end of the housing, the cutter comprising;

an outer cutting member coupled to the housing, the outer cutting member comprising;

an aperture comprising a distal edge and a proximal edge;

an inner cutting member comprising a distal edge and slideable within the outer cutting member, the inner cutting member slideable between a retracted position and an extended position; and

an adjustable port;

an oscillator operable to reciprocate the inner cutting member;

a stroke limiter selectively moveable relative to the housing over an operating range, the stroke limiter stoppable at a plurality of positions along the operating range to define an engagement position, the inner cutting member adapted to contact the stroke limiter at the engagement position to define a fully retracted position of the inner cutting member, the distal edge of the inner cutting member being disposed adjacent to the aperture between the distal edge of the aperture and the proximal edge of the aperture when the inner cutting member is at the fully retracted position, a size of the adjustable port defined by a distance between the distal edge of the aperture and the distal edge of the inner cutting member;

a biasing member disposed between a portion of the stroke limiter and a portion of the housing; and

a chamber formed in the housing, wherein the oscillator comprises a diaphragm disposed in the chamber, an outer periphery of the diaphragm coupled to the housing and an inner periphery of the diaphragm coupled to the inner cutting member, wherein the diaphragm divides the chamber into a first chamber portion and a second chamber portion, and

wherein the diaphragm is oscillatable in response to fluidic pressure alternately applied to the first chamber portion and the second chamber portion.

15. A vitrectomy probe comprising:

a housing;

a cutter extending from a first end of the housing, the cutter comprising;

a hollow outer cutting member coupled to the housing, the outer cutting member comprising an open end and a closed end;

a hollow inner cutting member slideable within the outer cutting member, the inner cutting member comprising open opposing ends and a first cutting surface at a first end thereof; and

an opening formed in the outer cutting member proximate an end thereof, the opening having a second cutting surface cooperative with the first cutting surface to dissect materials that enter the opening, the opening and the first cutting surface defining a port, a size of the port defined by a location of the first cutting surface relative to the opening when the inner cutting member is in a fully retracted position;

a first pneumatic chamber formed in the housing;

a first diaphragm coupled to the inner cutting member and dividing the first pneumatic chamber into a first chamber portion and a second chamber portion, the first chamber portion in fluid communication with a first passageway and the second chamber portion in fluid communication with a second passageway, the first passageway and the second passageway adapted to transmit a first pneumatic pressure to the first chamber portion and the second chamber portion, respectively, in an alternating sequence to oscillate the first diaphragm and the inner cutting member between the fully retracted position and a fully extended position;

a second pneumatic chamber formed in the housing;

a second diaphragm dividing the second pneumatic chamber into a third chamber portion and a fourth chamber portion;

a stroke limiter coupled to the second diaphragm and moveable therewith;

a biasing element disposed in the third chamber portion; and

a third passageway in communication with the fourth chamber portion, the third passageway adapted to transmit a second pneumatic pressure to the fourth chamber portion to displace the second diaphragm an amount proportional to the second pneumatic pressure,

wherein an outer periphery and an inner periphery of the second diaphragm are coupled to the housing, wherein the inner periphery defines an opening in the second diaphragm.

16. The vitrectomy probe of claim 15, wherein the stroke limiter is moveable to a selected location by variation of the second pneumatic pressure.

17. The vitrectomy probe of claim 15 further comprising an interior assembly, the interior assembly comprising:

the inner cutting member;

a tubular member; and

a hollow coupling disposed between and joining the inner cutting member and the tubular member, the interior assembly extending through an aperture formed in the first diaphragm and an aperture formed in the second diaphragm, and the interior assembly defining a continuous central passage adapted to pass aspirated materials during operation of the vitrectomy probe.

18. The vitrectomy probe of claim 15, wherein the stroke limiter comprises a first contact surface, wherein the hollow coupling comprises a second contact surface, and wherein contact of the first contact surface with the second contact surface defines the fully retracted position of the inner cutting member.

19. The vitrectomy probe of claim 15, wherein an alteration to the second pneumatic pressure alters a position of the stroke limiter to cause a change in the size of the port by altering the fully retracted position of the inner cutting member.

20. The vitrectomy probe of claim 15, wherein the biasing member is a spring.

21. The vitrectomy probe of claim 20, wherein the spring is a coil spring.

22. The vitrectomy probe of claim 21, wherein the inner cutting member extends through a longitudinal passage defined by the coil spring.

23. The vitrectomy probe of claim 15, wherein the stroke limiter is coupled to the second diaphragm at a location between the inner periphery and the outer periphery.

24. The vitrectomy probe of claim 15, wherein the biasing member is disposed in the third chamber portion between the housing and the stroke limiter, the biasing member adapted to apply a biasing force on the stroke limiter counter to the second pneumatic pressure.

25. A vitrectomy probe comprising:

a housing;

a cutter extending from a first end of the housing, the cutter comprising;

a hollow outer cutting member coupled to the housing, the outer cutting member comprising;

an open end;

a closed end;

a sidewall; and

an opening in the sidewall, the opening including a first cutting surface;

a hollow inner cutting member slideable within the outer cutting member, the inner cutting member comprising;

open opposing ends; and

a second cutting surface at a first end thereof; and

an adjustable port, the first cutting surface cooperative with the second cutting surface to dissect materials that enter the opening, a distance extending between the first cutting surface and the second cutting surface defining a size of the adjustable port when the inner cutting member is in a fully retracted position;

a first pneumatic chamber formed in the housing;

a first diaphragm coupled to the inner cutting member and dividing the first pneumatic chamber into a first chamber portion and a second chamber portion, the first chamber portion in fluid communication with a first passageway and the second chamber portion in fluid communication with a second passageway, the first passageway and the second passageway adapted to transmit a first pneumatic pressure to the first chamber portion and the second chamber portion, respectively, in an alternating sequence to oscillate the first diaphragm and the inner cutting member between the fully retracted position and a fully extended position;

a second pneumatic chamber formed in the housing;

a second diaphragm dividing the second pneumatic chamber into a third chamber portion and a fourth chamber portion;

a stroke limiter coupled to the second diaphragm and selectively moveable therewith relative to the housing over an operating range, the stroke limiter stoppable at a plurality of positions along the operating range to define an engagement position, the inner cutting member adapted to contact the stroke limiter at the engagement position to define the fully retracted position of the inner cutting member, the first cutting surface is disposed laterally adjacent to the opening when the inner cutting member is at the fully retracted position, and a size of the adjustable port defined by a distance between the first cutting surface and the second cutting surface;

a biasing element disposed in the third chamber portion; and

a third passageway in communication with the fourth chamber portion, the third passageway adapted to transmit a second pneumatic pressure to the fourth chamber portion to displace the second diaphragm an amount proportional to the second pneumatic pressure,

wherein an outer periphery and an inner periphery of the second diaphragm are coupled to the housing.

26. The vitrectomy probe of claim 25, wherein the stroke limiter is moveable to a selected location by variation of the second pneumatic pressure.

27. The vitrectomy probe of claim 25, wherein the inner cutting member comprises:

a hollow coupling, wherein the inner cutting member extending through an aperture formed in the first diaphragm and an aperture formed in the second diaphragm, and wherein the inner cutting member defines a continuous central passage adapted to pass aspirated materials during operation of the vitrectomy probe.

28. The vitrectomy probe of claim 27, wherein the stroke limiter comprises a first contact surface, wherein the hollow coupling comprises a second contact surface, and wherein contact of the first contact surface with the second contact surface defines the fully retracted position of the inner cutting member.

29. The vitrectomy probe of claim 25, wherein an alteration to the second pneumatic pressure alters a position of the stroke limiter to cause a change in the size of the adjustable port.

30. The vitrectomy probe of claim 25, wherein the biasing member is a spring.

31. The vitrectomy probe of claim 30, wherein the spring is a coil spring.