Vitreoretinal instruments for fluid aspiration

Patent metadata

Field	Value
Publication number	US-11033427-B2
Application number	US-201815926302-A
Country	US
Kind code	B2
Filing date	Mar 20, 2018
Priority date	Apr 13, 2017
Publication date	Jun 15, 2021
Grant date	Jun 15, 2021

Abstract

Vitreoretinal instruments and methods related thereto are disclosed herein. The disclosure describes various example vitreoretinal instruments having various aspirating port configurations. A vitreoretinal instrument may include a handle and a cannula coupled to the handle. The cannula may include a straight portion and a curved portion. The curved portion may be configurable between a straight configuration and a curved configuration. The curved configuration may include a first curved portion having a curvature defined by a first radius. The curved configuration may include a second curved portion having a curvature defined by a second radius different from the first radius. The curved portion may further include one or more ports formed in the curved portion.

First claim

What is claimed is:

1. A vitreoretinal instrument for use in removing subretinal fluid, comprising:
a handle; and
a cannula coupled to the handle, the cannula comprising:
a straight portion;
a curvable portion configurable between a straight configuration and a curved configuration, the curvable portion comprising an outer curvature and an inner curvature when the curvable portion is configured in the curved configuration, the curved configuration comprising:
a first curved portion having a curvature defined by a first radius, wherein the curvature of the first curved portion angles a distal end of the curvable portion along a choroid; and
a second curved portion having a curvature defined by a second radius, wherein the second radius is different from the first radius and wherein the curvature of the second curved portion conforms to a shape of the choroid;

one or more ports formed in the curvable portion;
an outer tube, wherein an entire outer tube is straight, and wherein the cannula is extendable and retractable within the outer tube, and wherein a shape of the curvable portion is variable between the curved configuration as the cannula is extended from the outer tube and the straight configuration as the cannula is retracted into the outer tube; and
a mechanism on the handle to extend and retract the cannula from the outer tube;
wherein the one or more ports comprise a plurality of lateral ports formed only along a length of a portion of the curvable portion and only along the outer curvature of the curved configuration;
wherein an amount by which the curvable portion curves varies with an amount by which the curvable portion extends from the outer tube;
wherein a distal end of the cannula defines a first portion of a longitudinal axis, wherein the straight portion defines a second portion of the longitudinal axis, and wherein an angle defined between the first portion of the longitudinal axis and the second portion of the longitudinal axis is variable in response to extension of the cannula from the outer tube or retraction of the cannula into the outer tube.

2. The vitreoretinal instrument of claim 1 , wherein the one or more ports further comprises a tip port formed at a distal tip of the curvable portion.

3. The vitreoretinal instrument of claim 1 , wherein the plurality of lateral ports are arranged in two or more rows.

4. The vitreoretinal instrument of claim 3 , wherein the two or more rows are arranged symmetrically relative to a plane defined by a longitudinal axis of the curvable portion.

5. The vitreoretinal instrument of claim 3 , wherein the plurality of lateral ports progressively decrease in size with increasing distance away from a distal tip of the curvable portion.

6. The vitreoretinal instrument of claim 1 , wherein at least one of the plurality of lateral ports is oval in shape.

7. The vitreoretinal instrument of claim 1 , wherein the second radius is larger than the first radius, and wherein the second curved portion is located closer to a distal tip of the curvable portion than the first curved portion.

8. The vitreoretinal instrument of claim 1 , wherein the first radius and the second radius are adjustable.

9. The vitreoretinal instrument of claim 1 , wherein the curvable portion comprises at least one elastic material selected from a group consisting of a thermoplastic elastomer and a shape memory alloy.

10. The vitreoretinal instrument of claim 1 , further comprising a vacuum source and a tubing fluidly coupled to the vacuum source and the one or more ports, wherein the tubing extends into the handle, and wherein the handle comprises a compression valve moveable between a first position in which the tubing is placed into an open configuration and a second position in which the tubing is placed into a closed configuration.

11. The vitreoretinal instrument of claim 1 , wherein the curvature of the first curved portion adjusts the angle of the distal end of the curvable portion to be within a range of approximately 88 degrees to 92 degrees and wherein the second radius is within a range of about 8 millimeters (mm) to 10 mm.

12. The vitreoretinal instrument of claim 1 , further comprising an optical fiber extending through a lumen of the cannula to provide intraocular illumination through the cannula.

13. The vitreoretinal instrument of claim 12 , wherein the cannula comprises a light transmitting window and the optical fiber is operatively coupled to the light transmitting window to provide intraocular illumination through the window.

14. A method for operating a vitreoretinal instrument in order to remove subretinal fluid, the method comprising:
providing the vitreoretinal instrument, the vitreoretinal instrument comprising:
a handle; and
a cannula coupled to the handle, the handle comprising:
a straight portion;
a curvable portion configurable between a straight configuration and a curved configuration, the curvable portion comprising an outer curvature and an inner curvature when the curvable portion is configured in the curved configuration, the curved configuration comprising:
a first curved portion having a curvature defined by a first radius, wherein the curvature of the first curved portion angles a distal end of the curvable portion along a choroid; and
a second curved portion having a curvature defined by a second radius, wherein the second radius is different from the first radius and wherein the curvature of the second curved portion conforms to a shape of the choroid; and

one or more ports formed in the curvable portion;

positioning the vitreoretinal instrument in a subretinal space of an eye such that the curvable portion is at least partially in the subretinal space; and
aspirating fluid from the subretinal space through at least the one or more ports;
wherein the one or more ports comprises a plurality of lateral ports formed only along a length of a portion of the curvable portion and only along the outer curvature of the curved configuration;
wherein the cannula is extendable and retractable within an outer tube of the vitreoretinal instrument, wherein the entire outer tube is straight, and wherein a shape of the curvable portion is variable between the curved configuration as the cannula is extended from the outer tube and the straight configuration as the cannula is retracted into the outer tube;
wherein the method further comprises extending and retracting the cannula from the outer tube through a mechanism on the handle;
wherein an amount by which the curvable portion curves varies with an amount by which the curvable portion extends from the outer tube; and
wherein a distal end of the cannula defines a first portion of a longitudinal axis, wherein the straight portion defines a second portion of the longitudinal axis, and wherein an angle defined between the first portion of the longitudinal axis and the second portion of the longitudinal axis is variable in response to extension of the cannula from the outer tube or retraction of the cannula into the outer tube.

15. The method of claim 14 , wherein the plurality of lateral ports are arranged in two or more rows and wherein the lateral ports progressively decrease in size with increasing distance from the tip port.

16. The method of claim 14 wherein the one or more ports further comprises a tip port formed in a distal tip of the curvable portion.

17. The method of claim 14 , wherein the curvature of the first curved portion adjusts the angle of the distal end of the curvable portion to be within a range of approximately 88 degrees to 92 degrees

Assignees

• Novartis Ag
• Alcon Inc

Inventors

• Charles Steven T
• Grueebler Reto
• Schaller Philipp

Classifications

• A61M2205/587

  Lighting arrangements · CPC title

• A61M2205/0266

  Shape memory materials · CPC title

• A61M1/774

  Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently · CPC title

• A61M1/7415

  by deformation of the fluid passage · CPC title

• A61M2210/0612

  Eyes · CPC title