Ophthalmic microsurgical tools, systems, and methods of use

Patent metadata

Field	Value
Publication number	US-11638660-B2
Application number	US-201916431560-A
Country	US
Kind code	B2
Filing date	Jun 4, 2019
Priority date	Jun 5, 2018
Publication date	May 2, 2023
Grant date	May 2, 2023

Abstract

A system for extracting lens material from an eye including an instrument having a first aspiration pump driven by a drive mechanism having a motor, and an elongate member sized and configured to extend through an anterior chamber to a capsular bag of the eye. The elongate member configured to be oscillated by the drive mechanism includes an inner lumen fluidly coupled to the first aspiration pump and defining at least a portion of an aspiration waste line, and an open distal end having a distal cutting tip. The system can further include a fluid system remote from the surgical instrument including a second aspiration pump and a fluid line configured to deliver background aspiration from the second aspiration pump to the inner lumen of the elongate member to aspirate the lens material from the eye towards the inner lumen. Related devices, systems, and methods are also provided.

First claim

What is claimed is:

1. A system for extracting lens material from an eye, the system comprising:
a surgical instrument comprising:
a drive mechanism having a motor;
a first aspiration pump driven by the drive mechanism, wherein the first aspiration pump is a piston pump;
an elongate member sized and configured to extend through an anterior chamber of the eye and to a capsular bag of the eye, the elongate member comprising:
an inner lumen fluidly coupled to the first aspiration pump and defining at least a portion of an aspiration waste line of the surgical instrument; and
an open distal end having a distal cutting tip; and

an anti-surge valve located within the aspiration waste line that is configured to passively close when flow upstream of the anti-surge valve is above a threshold value and is configured to passively open when flow upstream of the anti-surge valve is below the threshold value,
wherein the elongate member is configured to be oscillated by the drive mechanism; and

a fluid system remote from the surgical instrument.

2. The system of claim 1 , wherein the first aspiration pump is configured to create discontinuous, pulsatile aspiration through the inner lumen to aspirate the lens material from the eye into the inner lumen.

3. The system of claim 1 , wherein the fluid system further comprises an irrigation line fluidly coupling a source of irrigation fluid of the fluid system to the surgical instrument.

4. The system of claim 3 , wherein the irrigation line of the fluid system comprises a valve configured to control irrigation fluid flow through the irrigation line of the fluid system.

5. The system of claim 4 , further comprising an input on a housing of the surgical instrument.

6. The system of claim 5 , wherein the input is a multi-way trigger configured to activate different functions of the surgical instrument depending on degree of trigger depression.

7. The system of claim 6 , wherein a first degree of trigger depression opens the valve of the irrigation line of the fluid system placing the surgical instrument into an irrigation-only mode.

8. The system of claim 7 , wherein a second degree of trigger depression places the surgical instrument in an irrigation-continuous aspiration mode.

9. The system of claim 8 , wherein a third degree of trigger depression activates the first aspiration pump and oscillation of the elongate member placing the surgical instrument in an irrigation-pulsed aspiration-cutting mode.

10. The system of claim 9 , wherein trigger depression beyond the third degree of trigger depression increases at least one of oscillation frequency and aspiration flow rate.

11. The system of claim 5 , wherein the input incorporates a sensing mechanism selected from the group consisting of capacitive sensor, optical sensor, magnetic sensor, electromagnetic sensor, and Hall-Effect sensor.

12. The system of claim 1 , wherein the surgical instrument comprises a hand-held portion comprising a proximal, reusable portion releasably coupleable to a distal, disposable portion.

13. The system of claim 12 , wherein a rotatable coupler is configured for releasably operatively coupling rotation of the motor to the distal, disposable portion.

14. The system of claim 12 , wherein the proximal, reusable portion is configured to remain outside of the eye.

15. The system of claim 1 , wherein the first aspiration pump comprises a plurality of pistons, each of the plurality of pistons being housed within a respective cylinder, each of the cylinders fluidly coupled to the inner lumen of the elongate member.

16. The system of claim 15 , wherein the drive mechanism further comprises a rotational cam assembly capable of being rotated by the motor via a rotatable coupler, wherein rotation of said rotational cam assembly causes the plurality of pistons to generate pulses of discontinuous negative pressure within the inner lumen.

17. The system of claim 16 , wherein aspiration created by the first aspiration pump is selectively modifiable by a user.

18. The system of claim 17 , wherein the surgical instrument further comprises a piston hard stop configured to limit proximal travel of the plurality of pistons within their respective cylinders.

19. The system of claim 18 , wherein the piston hard stop is configured to toggle between a high vacuum position and a low vacuum position.

20. The system of claim 19 , wherein when in the high vacuum position, the piston hard stop is retracted proximally relative to the cylinders allowing for maximum proximal travel of each piston within its respective cylinder.

21. The system of claim 19 , wherein when in the low vacuum position, the piston hard stop is advanced distally relative to the cylinders limiting proximal travel of the each piston within its respective cylinder to less than a maximum proximal travel.

22. The system of claim 18 , wherein the piston hard stop is configured to toggle between a continuous aspiration position and a pulsatile aspiration position.

23. The system of claim 22 , wherein when in the continuous aspiration position, the piston hard stop is advanced distally relative to the cylinders limiting proximal travel of each piston within its respective cylinder and relative to the rotational cam assembly of the drive mechanism.

24. The system of claim 22 , wherein when in the pulsatile aspiration position, the piston hard stop is retracted proximally relative to the cylinders allowing full proximal travel of each piston within its respective cylinder and relative to the rotational cam assembly of the drive mechanism.

25. The system of claim 1 , wherein when the anti-surge valve is closed fluid flow through the aspiration waste line is limited when the anti-surge valve is open fluid flow through the aspiration waste line is allowed.

26. The system of claim 25 , wherein the threshold value is 40 milliliter (ml)/minute.

27. The system of claim 1 , wherein the anti-surge valve is a diaphragm valve, an umbrella valve, or a mushroom valve.

28. The system of claim 1 , wherein the anti-surge valve further comprises a filter.

29. A device for extracting lens material from an eye, the device comprising:
a drive mechanism having a motor;
an aspiration pump driven by the drive mechanism that is selectively modifiable by a user, the aspiration pump being a piston pump comprising a plurality of pistons housed within respective cylinders;
an elongate member configured to be oscillated by the drive mechanism, the elongate member sized and configured to extend through an anterior chamber of the eye and to a lens within a capsular bag of the eye, the elongate member comprising:
an inner lumen fluidly coupled to the aspiration pump and defining at least a portion of an aspiration waste line; and
an open distal end having a distal cutting tip,

wherein aspiration created by the aspiration pump and delivered through the inner lumen to aspirate the lens material from the eye into the inner lumen is selectively modifiable between continuous aspiration and discontinuous, pulsatile aspiration, wherein proximal travel of the plurality of pistons within their respective cylinders determines whether the aspiration created is continuous aspiration or discontinuous, pulsatile aspiration.

30. The device of claim 29 , wherein the drive mechanism further comprises a rotationa

Assignees

• Zeiss Carl Meditec Inc

Inventors

• Balkenbush Casey
• Bentley Peter
• Clauson Luke W
• Newell Matthew
• Schaller Michael

Classifications

• F04B49/12

  by varying the length of stroke of the working members · CPC title

• F04B43/1253

  by using two or more rollers as squeezing elements, the rollers moving on an arc of a circle during squeezing · CPC title

• F04B23/02

  having reservoirs · CPC title

• F04B9/042

  the means being cams · CPC title

• F04B5/02

  with double-acting pistons · CPC title