Devices and methods for the removal of lenticular tissue

• US 9,775,743 B2
• Filed: 09/17/2015
• Issued: 10/03/2017
• Est. Priority Date: 09/17/2014
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Cataract Technology Inc. (Carl-Zeiss-Stiftung)
• Original Assignee: Iantech, Inc. (Carl-Zeiss-Stiftung)
• Inventors: Clauson, Luke W., Guguchkova, Maria Tsontcheva
• Primary Examiner(s): Aleman, Sarah W
• Assistant Examiner(s): Highland, Rachel S
• Application Number:
  US14/857,518
• Publication Number:
  US 20160074220A1
• Time in Patent Office: 747 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 for prostheses A61F2210/0014
• 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 method of cutting a lens within a capsular bag of an eye, comprising:

introducing a cutting element of a device into an anterior chamber of the eye, wherein at least a portion of said cutting element is positioned in a first, retracted configuration within a lumen of a shaft, and wherein a first leg of the cutting element is configured to advance distally relative to a distal end of the shaft and a second leg of the cutting element is configured to move proximally relative to the distal end of the shaft to expand the cutting element from the first configuration to a second, expanded configuration having an open area;

positioning the cutting element in the first configuration over an anterior surface of the lens with the lens inside the capsular bag;

expanding the cutting element from the first configuration to the second configuration, wherein the cutting element advances between the capsular bag and the anterior surface of the lens as the cutting element moves toward the second configuration;

positioning the cutting element in the second configuration around a portion of the lens between a posterior portion of the capsular bag and the lens to capture the portion of the lens within the open area; and

tensioning the cutting element so that the lens is fully sectioned into at least two fragments.

2. The method of claim 1, wherein during said tensioning the cutting element, a posterior surface of the lens and the anterior surface of the lens are both cut.

3. The method of claim 1, wherein at least one of said positioning the cutting element between the capsular bag and the lens and said tensioning the cutting element comprises engaging a posterior surface of the lens and the anterior surface of the lens with the cutting element.

4. The method of claim 1, wherein said positioning the cutting element comprises rotating the cutting element to traverse a space between the capsular bag and the lens.

5. The method of claim 1, further comprising performing phacoemulsification on one or more of the at least two fragments.

6. The method of claim 1, wherein the second configuration comprises at least a first portion having a first, smaller radius of curvature and a second portion having a second, larger radius of curvature.

7. The method of claim 1, further comprising:

repositioning the cutting element around at least one of the at least two fragments; and

retensioning the cutting element to further fully section at least one of the at least two fragments to produce more lens fragments.

8. The method of claim 1, wherein the expanding is with the first leg being a distal leg and the second leg being a proximal leg, and wherein the distal leg advances distally and the proximal leg moves proximally when the cutting element expands from the first configuration to the second configuration.

9. The method of claim 1, wherein the introducing is with the second configuration being similar in shape to a cross-sectional shape of the lens.

10. The method of claim 1, further comprising removing an anterior portion of the capsular bag to form an opening in the capsular bag, wherein the cutting element is positioned over the anterior surface of the lens after the opening has been formed in the capsular bag.

11. The method of claim 10, wherein the expanding is carried out with the open area of the second configuration having a dimension larger than the opening in the capsular bag.

12. The method of claim 1, wherein the introducing is with a hand-held instrument comprising the shaft.

13. The method of claim 1, wherein the expanding is with the second configuration being an approximate closed loop.

14. The method of claim 13, wherein the second configuration comprises a closed loop formed of the cutting element and a distal portion of the shaft.

15. The method of claim 1, wherein the introducing is with all but a tip portion of the cutting element positioned within the lumen with the cutting element in the first, retracted configuration.

16. The method of claim 1, wherein the positioning in the second, expanded configuration, is with a majority of the cutting element positioned outside the lumen and to one side of a longitudinal axis of the lumen.

17. The method of claim 1, wherein the second configuration of the cutting element comprises the first leg bending back more than 120 degrees relative to a longitudinal axis of the shaft.

18. The method of claim 1, wherein the cutting element in the second, expanded configuration comprises a preset shape.

19. The method of claim 18, wherein the cutting element comprises a superelastic or metal alloy material.