U.S. patent application number 14/064326 was filed with the patent office on 2014-05-01 for illuminated vitrectomy cutter with adjustable illumination aperture.
This patent application is currently assigned to Alcon Research, Ltd.. The applicant listed for this patent is Alcon Research, Ltd.. Invention is credited to Matthew Edward Bazydlo, Christopher McCollam, Jon-Peter Meckel.
Application Number | 20140121469 14/064326 |
Document ID | / |
Family ID | 50547906 |
Filed Date | 2014-05-01 |
United States Patent
Application |
20140121469 |
Kind Code |
A1 |
Meckel; Jon-Peter ; et
al. |
May 1, 2014 |
ILLUMINATED VITRECTOMY CUTTER WITH ADJUSTABLE ILLUMINATION
APERTURE
Abstract
A vitrector that includes an adjustable illumination aperture is
described. The vitrector may include a probe and a light sleeve
assembly extending along and substantially surrounding the probe.
The light sleeve assembly may include a plurality of optical
fibers. At least a portion of the optical fibers are operable to
provide illumination so as to define an illumination aperture about
the vitrectomy probe. A portion of the optical fibers may be
encapsulated. The light sleeve assembly may be adjustable along a
length of the probe, providing adjustment of the illumination
aperture to increase or decrease an area of illumination provided
thereby.
Inventors: |
Meckel; Jon-Peter; (San Luis
Obispo, CA) ; Bazydlo; Matthew Edward; (Costa Mesa,
CA) ; McCollam; Christopher; (Irvine, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Alcon Research, Ltd. |
Fort Worth |
TX |
US |
|
|
Assignee: |
Alcon Research, Ltd.
Fort Worth
TX
|
Family ID: |
50547906 |
Appl. No.: |
14/064326 |
Filed: |
October 28, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61721216 |
Nov 1, 2012 |
|
|
|
Current U.S.
Class: |
600/249 |
Current CPC
Class: |
A61F 9/00736 20130101;
A61F 2009/00863 20130101; A61F 9/00821 20130101; A61F 2009/00874
20130101 |
Class at
Publication: |
600/249 |
International
Class: |
A61F 9/007 20060101
A61F009/007; A61B 3/00 20060101 A61B003/00 |
Claims
1. An illuminated vitrectomy instrument comprising: a probe; and a
light sleeve assembly extending along and substantially surrounding
the probe and having a position adjustable along a length of the
probe, the light sleeve assembly comprising: a plurality of optical
fibers, at least a portion of the optical fibers operable to
provide illumination, each of the optical fibers comprising an end
face; and an illumination aperture circumjacent at least a portion
of the probe, the illumination aperture defined by the end faces of
the optical fibers and operable to provide an area of illumination,
the area of illumination variable in response to the position of
the light sleeve assembly relative to the probe.
2. The illuminated vitrectomy instrument of claim 1, further
comprising: a nose piece at least partially housing the probe,
wherein a proximal end of the light sleeve assembly is received
within the nose piece and a distal end of the light sleeve assembly
terminates proximally to a distal end of the probe, and wherein a
distance between the distal end of the light sleeve assembly and
the distal end of the probe is altered in response to a change in
the position of the light sleeve assembly relative to the
probe.
3. The illuminated vitrectomy instrument of claim 1, wherein the
position of the light sleeve assembly is manually adjustable.
4. The illuminated vitrectomy instrument of claim 1 further
comprising an actuator coupled to the light sleeve assembly,
wherein the position of the light sleeve assembly with respect to
the probe is adjusted by manipulation of the actuator.
5. The illuminated vitrectomy instrument of claim 1, wherein the
light sleeve assembly further comprises: a sleeve, wherein the
plurality of optical fibers is arranged in an array along an inner
surface of the sleeve; and an encapsulant encapsulating the
plurality of optical fibers.
6. The illuminated vitrectomy instrument of claim 5, wherein the
sleeve is adapted to be connected to a first pole of a generator,
wherein the probe is adapted to be connected to a second pole of
the generator, wherein the encapsulant defines an insulating layer
disposed between the sleeve and the probe, and wherein an
alternating current applied to the sleeve and the probe is operable
to generate an electric field therebetween to produce a diathermy
function when the distal end of the light sleeve assembly is
positioned substantially flush with the end surface of the
probe.
7. The illuminated vitrectomy instrument of claim 1, wherein at
least one of plurality of optical fibers comprises a fiber operable
to propagate laser light.
8. An illuminated vitrectomy cutter assembly, comprising a housing;
a probe having a proximal end received within the housing and
freely extending a distal end; and a light sleeve assembly movable
along the probe between the proximal end and distal end of the
probe, the light sleeve assembly comprising: a first end adjacent
the housing a second end opposite the first end; a plurality of
optical fibers arranged in an array about the probe, at least a
portion of the plurality of optical fibers operable to provide
illumination, each of the optical fibers comprising an end face;
and an illumination aperture formed at the second end of the light
sleeve assembly, the illumination aperture defined by the end faces
of the optical fibers, the illumination aperture operable to
provide collective illumination comprising the individual
illumination from each of the plurality of optical fibers.
9. The illuminated vitrectomy cutter assembly of claim 8, wherein
the collective illumination of the plurality of optical fibers
defines an area of illumination, and wherein the area of
illumination is adjusted in response to movement of the light
sleeve assembly along the probe.
10. The illuminated vitrectomy cutter assembly of claim 8 further
comprising a nose piece coupled to the housing, the nose piece
adapted to receive a proximal end of the light sleeve assembly.
11. The illuminated vitrectomy cutter assembly of claim 8, wherein
the light sleeve assembly further comprises: a sleeve, wherein the
plurality of optical fibers is arranged in a array along an inner
surface of the sleeve; and an encapsulant substantially
encapsulating the plurality of optical fibers along at least a
portion of the sleeve.
12. The illuminated vitrectomy cutter assembly of claim 10, wherein
the sleeve is adapted to be connected to a first pole of a
generator, wherein the probe is adapted to be connected to a second
pole of a generator, wherein the encapsulant defines an insulating
layer disposed between the sleeve and the probe, and wherein, upon
application of an alternating current to the sleeve and the probe,
an electric field is generated between the sleeve and the probe to
produce a diathermy function when the second end of the light
sleeve assembly is positioned substantially flush with an end
surface of the probe.
13. The illuminated vitrectomy cutter assembly of claim 8, wherein
at least one of the plurality of optical fibers comprises a fiber
capable operable to propagate laser light.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 61/721,216, filed Nov. 1, 2012, the contents which
are incorporated herein by reference.
TECHNICAL FIELD
[0002] The present disclosure relates generally to the field of
vitrectomy cutters, and more particularly, to illuminated
vitrectomy cutters with adjustable illumination apertures for
providing adjustment of an area of illumination provided about the
cutter tip.
BACKGROUND
[0003] Vitrectomy cutters generally are used during ophthalmic
surgeries such as vitreoretinal surgeries that involve the surgical
removal of the vitreous in the eye. The vitreous includes a clear,
colorless, gel-like substance that fills the eye from the iris to
the retina. During some surgeries to correct impaired vision, a
vitrectomy cutter generally can be used to cut and remove portions
of the vitreous as needed to correct the visual impairment.
[0004] Vitrectomy cutters can include a hollow, reciprocating probe
having an opening or port at the cutting end of the probe, and can
be connected to a vacuum for drawing fluid and tissue away from the
surgical site. During a vitreo-retinal surgery, the internal
portions of the eye where the incision/correction is being
performed may require illumination, especially where the incision
is of a reduced or minimal size to enable the surgeon to clearly
see and accurately remove portions of the vitreous in order to
correct the visual impairment. In the past, separate illumination
probes have been used to provide focused illumination of the eye at
the surgical site. Additionally, some vitrectomy cutters with
illumination capability have been developed. However, these
existing vitrectomy cutters provide fixed illumination, while in
use a surgeon may need to vary or otherwise change or adapt the
area of illumination during the surgical procedure.
[0005] Accordingly, there is a need for an illuminated vitrectomy
instrument that is capable of providing adjustment of an
illumination aperture to increase or decrease an area of
illumination provided thereby.
SUMMARY
[0006] According to one aspect, the present disclosure generally
relates to an illuminated vitrectomy instrument that may include a
probe and a light sleeve assembly. The light sleeve assembly may
extend along and substantially surrounding the probe and have a
position adjustable along a length of the probe. The light sleeve
assembly may include a plurality of optical fibers. At least a
portion of the optical fibers may be operable to provide
illumination. Also, each of the optical fibers includes an end
face. The light sleeve assembly may also include an illumination
aperture. The illumination aperture is defined by end faces of the
optical fibers and is operable to provide an area of illumination.
The area of illumination may be varied in response to the position
of the light sleeve assembly relative to the probe.
[0007] Another aspect of the disclosure encompasses an illuminated
vitrectomy cutter assembly including a housing, a probe having a
proximal end received within the housing and a freely extending
distal end, and a light sleeve assembly. The light sleeve assembly
may be movable along the probe between the proximal end and distal
end of the probe. The light sleeve assembly also includes a first
end adjacent to the housing; a second end opposite the first end;
and a plurality of optical fibers arranged in an array about the
probe. At least a portion of the plurality of optical fibers may be
operable to provide illumination. Also, each of the optical fibers
includes an end face. The light sleeve assembly may also include an
illumination aperture formed at the second end thereof. The
illumination aperture is defined by the end faces of the optical
fibers, and the illumination aperture is operable to provide
collective illumination of the plurality of optical fibers. The
collective illumination includes the individual illumination from
each of the plurality of optical fibers.
[0008] The various aspects may include one or more of the following
features. A nose piece may be included that at least partially
houses the probe. A proximal end of the light sleeve assembly may
be received within the nose piece, and a distal end of the light
sleeve assembly may terminate proximally to a distal end of the
probe. A distance between the distal end of the light sleeve
assembly and the distal end of the probe may be altered in response
to a change in the position of the light sleeve assembly relative
to the probe. The position of the light sleeve assembly may be
manually adjustable. An actuator may be coupled to the light sleeve
assembly. The position of the light sleeve assembly with respect to
the probe may be adjusted by manipulation of the actuator.
[0009] The light sleeve assembly may further include a sleeve. The
plurality of optical fibers may be arranged in an array along an
inner surface of the sleeve. The light sleeve assembly may also
include an encapsulant encapsulating the plurality of optical
fibers. The sleeve may be adapted to be connected to a first pole
of a generator. The probe may be adapted to be connected to a
second pole of the generator. The encapsulant may define an
insulating layer disposed between the sleeve and the probe. An
alternating current applied to the sleeve and the probe may be
operable to generate an electric field therebetween to produce a
diathermy function when the distal end of the light sleeve assembly
is positioned substantially flush with the end surface of the
probe. At least one of plurality of optical fibers may be a fiber
operable to propagate laser light.
[0010] The various aspects may also include one or more of the
following features. The collective illumination of the plurality of
optical fibers may define an area of illumination, and the area of
illumination may be adjusted in response to movement of the light
sleeve assembly along the probe. A nose piece may be coupled to the
housing. The nose piece may be adapted to receive a proximal end of
the light sleeve assembly. The light sleeve assembly may also
include a sleeve. The plurality of optical fibers may be arranged
in an array along an inner surface of the sleeve. The light sleeve
assembly may also include an encapsulant substantially
encapsulating the plurality of optical fibers along at least a
portion of the sleeve. The sleeve may be adapted to be connected to
a first pole of a generator. The probe may be adapted to be
connected to a second pole of a generator. The encapsulant may
define an insulating layer disposed between the sleeve and the
probe. Upon application of an alternating current to the sleeve and
the probe, an electric field is generated between the sleeve and
the probe to produce a diathermy function when the second end of
the light sleeve assembly is positioned substantially flush with an
end surface of the probe. At least one of the plurality of optical
fibers may be a fiber capable operable to propagate laser
light.
[0011] The details of one or more implementations of the present
disclosure are set forth in the accompanying drawings and the
description below. Other features, objects, and advantages will be
apparent from the description and drawings, and from the
claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1A is a side view of an example illuminated vitrectomy
cutter assembly.
[0013] FIG. 1B is a side view of an example light sleeve
assembly.
[0014] FIG. 1C is a partial cross-sectional view of a distal end of
an example vitrectomy cutter probe.
[0015] FIG. 2 is a perspective view of a distal end of an example
light sleeve assembly.
[0016] FIG. 3A is detailed view of a distal end of an example
vitrectomy cutter probe.
[0017] FIGS. 3B and 3C are side views of the distal end of the
vitrectomy cutter probe with the light sleeve assembly disposed at
different positions relative to the vitrectomy cutter probe.
[0018] FIGS. 4A to 4B are side views depicting a movement of the
light sleeve assembly with respect to the distal end of the
vitrectomy cutter probe.
[0019] FIGS. 5A to 5B illustrate an example actuator adapted
operable to extend or retract the light sleeve assembly relative to
the vitrectomy cutter probe at different positions.
[0020] FIG. 6A is a detailed view of a proximal end of an example
light sleeve assembly showing a transition area of a plurality of
optical fibers.
[0021] FIG. 6B is a detailed view of a proximal end of an example
light sleeve assembly, illustrating the sheath and encapsulated
array of optical fibers thereof.
[0022] FIG. 6C is a top view of the vitrectomy instrument shown in
FIG. 6B.
[0023] FIG. 6D is a schematic view of an example vitrector coupled
to a surgical console.
[0024] FIG. 6E is a detail view of a portion of an example
vitrectomy instrument illustrating a proximal end of a light sleeve
assembly retracted into a housing of the vitrectomy instrument
showing the plurality of optical fibers in a slackened
configuration.
[0025] FIGS. 7A to 7B are perspective views illustrating an example
vitrectomy cutter assembly with a diathermy function.
[0026] FIGS. 8A to 8B are perspective views illustrating an example
vitrectomy cutter assembly with an endolaser function.
[0027] Those skilled in the art will appreciate and understand
that, according to common practice, the various features of the
drawings discussed below are not necessarily drawn to scale, and
that dimensions of various features and elements of the drawings
may be expanded or reduced to more clearly illustrate the example
implementations of the present disclosure.
DETAILED DESCRIPTION
[0028] The drawings illustrate various example implementations of a
vitrectomy instrument (interchangeably referred to as "vitrector")
having illumination capability that provides the ability of
selectively adjusting an area of illumination provided about a
distal end or cutting tip of the vitrector.
[0029] FIGS. 1A through 1B illustrate and example vitrector 100.
The vitrector 100 may include a housing 110 having a nose piece 115
extending therefrom. The vitrector 100 may also include a hollow
vitrectomy probe or needle (referred to hereinafter as "probe") 120
having an outer cutting member 121. A proximal end of the outer
cutting member 121 may be received within or otherwise coupled to
housing 110. A distal end 123 of the outer cutting member 121
includes a cutting tip 125. As shown in FIG. 1C, in some
implementations, the probe 120 may also include an inner cutting
member slideable within the outer cutting member 121. The inner
cutting member 200 may have a cutting edge 202. As material is
drawn into a port 127 formed in the outer cutting member 121, the
edge 202 of the inner cutting member 200 along with an edge 204
defining the port 127 cooperate to sever material (e.g., tissue)
drawn into the port 127 as the inner cutting member 200 is
reciprocated within the outer cutting member 121. The severed
material along with other fluids and material drawn through the
port 127 may be aspirated away through a lumen 206 defined by the
inner cutting member 200.
[0030] The housing 110 may house at least a portion of a drive
mechanism. The drive mechanism is operable to reciprocate the inner
cutting member 200 within and relative to the outer cutting member
121. The housing 110 may also provide one or more ports. For
example, the one or more ports may provide a connection between the
vitrector 100 and a vacuum source for aspiration. In some
implementations, another port may be used to provide pressurized
air, for example, to operate the drive mechanism. In other
implementations, a port may provide electrical power fir the drive
mechanism. The housing 110 may also include a tactile indicator
126. The tactile indicator 126 may provides a tactile indication to
a user, such as a surgeon or other medical professional, regarding
a side on which of the outer cutting member 121 the port 127 is
located.
[0031] The nose piece 115 extends from the housing 110 and couples
the probe 120 to the housing 110. In some instances, a length of
the probe 120 may be approximately 1.5 mm to 27 mm. However, in
other implementations, the probe may have a larger or smaller
length. Various outer diameter vitrectomy probes may also be used.
For example, in some instances, the probes may be 20 gauge, 23
gauge, 25 gauge, or 27 gauge. In other instances, the probe may
have any a size larger or smaller than those indicated.
[0032] Referring to FIGS. 1A and 1B, the vitrector 100 may also
include a light sleeve assembly 130. The light sleeve assembly 130
includes a proximal end 145 adjacent the housing 110 and a distal
end 146 spaced from the proximal end. The light sleeve assembly 130
may be received onto and substantially surrounds the probe 120. The
distal end 146 of the light sleeve assembly 130 is disposed
proximate the distal end 123 of the probe 120. Additionally, the
proximal end 145 of the light sleeve assembly 130 may be slidably
received within the nose piece 115. Thus, the light sleeve assembly
130 is configured to be slideable on and relative to the probe
120.
[0033] FIG. 2 illustrates a cross-section view of the distal end
146 of an example light sleeve assembly 130. The light sleeve
assembly 130 defines a central bore 218 into which the probe 120 is
received. The light sleeve assembly 130 may include a plurality of
optical fibers 210 arranged in a substantially circular array about
the light sleeve assembly 130. The distal end surfaces 226 of the
plurality of optical fibers 210 define an illumination aperture
220. Light sleeve assembly 130 may also include an outer sleeve
212. In some implementations, the outer sleeve 212 may be formed
from a rigid material. For example, in some instances, the outer
sleeve 212 may be formed from a metal, a polymer, or any other
suitable material. The optical fibers 210 may be arranged in a
circular array along an inner surface of the sleeve 212. In some
implementations, the light sleeve assembly 130 may include other
types of fibers. For example, in some implementations, the light
sleeve assembly 130 may include one or more fibers operable to
transmit other types of radiation. For example, fibers that
transmit laser light, ultraviolet light, infrared light, or any
other type of light may also be included. Further, in some
implementations, the light sleeve assembly 130 may also include one
or more spacers disposed between fibers. The spacers are operable
to separate adjacent fibers a desired amount.
[0034] The optical fibers 210 extend substantially along the length
of the probe 120, with proximal ends of some or all of the optical
fibers generally being received within the housing 110. One or more
of the optical fibers 210 may be coupled to an illumination source.
Example illumination sources may include an ultraviolet ("UV")
source, an infrared ("IR") source, or other desired light or
radiation source. While "light" is discussed herein, the scope of
the disclosure is not intended to be limited to visible light. On
the contrary and as indicated above, other types of radiation, such
as UV and IR radiation, may be transmitted through and emitted from
one or more of the optical fibers 210. The term "light" is intended
to encompass any type of radiation for use with the optical fibers
210. Further, in some instances, the optical fibers 210 may be
multi-mode end-emitting fibers. However, in other implementations,
other types of light-emitting optical fibers may be used.
[0035] Light from an illumination source may be conveyed through
one or more of the optical fibers 210 and emitted from distal ends
211 thereof. As explained above, the end surfaces 226 of the
optical fibers at distal ends 211 thereof collectively define the
illumination aperture 220. In some implementations, the optical
fibers may have a diameter in the range of 25 .mu.m to 75 .mu.m. In
some particular implementations, the optical fibers 210 may have a
diameter within the range of about 40 .mu.m to 50 .mu.m. In still
other implementations, one or more of the optical fibers 210 may
have a diameter that is larger or smaller than the diameters
described. In some implementations, the light sleeve assembly 130
may have a plurality of optical fibers 210 that are all the same
size. In other implementations, the light sleeve assembly 130 may
have optical fibers 210 of varying sizes.
[0036] Additionally, the light sleeve assembly 130 may include an
encapsulant 214 that substantially encapsulates the optical fibers
210 along at least a portion of the length of the sleeve 212. The
encapsulant 214 may be formed of a polymer, such as a resin. In
other instances, the encapsulant 214 may include other material,
such as a rubber, a tape, or any other desired encapsulant or
sealing materials, or any combination of two or more of these
materials.
[0037] In some instances, the sleeve 212, optical fibers 210, and
encapsulant 214 may be polished together to form an end face 222 at
the distal end 146 of the light sleeve assembly 130. In some
implementations, the end face 222 may be planar, as shown in the
example light sleeve assembly 130 of FIG. 1B. In some instances,
the end face 222 may be perpendicular to the longitudinal axis 224
of the light sleeve assembly 130 as also illustrated in FIG. 1B. In
other instances, the end face 22 may be formed at an angle relative
to the longitudinal axis 224. In other instances, the end face 222
may not be planar. Rather, in some instances, the distal end 146
may have an end face that has an irregular profile. For example,
the end face 222 may be wavy or be faceted, or have any other
desired shape or profile. In some instances, the sleeve 212,
optical fibers 210, and encapsulant 214 extend along substantially
the entire length of the light sleeve assembly 130, with an inner
surface 216 of the encapsulant 214 defining the bore 218 that is
configured to receive the probe 120.
[0038] Referring again FIGS. 23B, 3C, and 413, each of the optical
fibers 210 includes an end surface 226. Also, at least a portion of
the optical fibers 210 are operable to provide illumination via the
end surfaces 226. As explained above, the end surfaces 226
providing illumination collectively define the illumination
aperture 220. As also explained above, the light sleeve assembly
130 includes an end face 222. Thus, the illumination aperture 220
may be defined within the end face 222.
[0039] The illumination aperture 220 may be defined in any desired
configuration. For example, in some implementations, the
illumination aperture 220 may have a semi-circular shape. In other
implementations, the illumination aperture 220 may have a
continuous circular shape. In still others, the illumination
aperture 220 may have an arc length of any desired length. Further,
one or more optical fibers 210 providing illumination may be
separated from one or more additional optical fibers 210 also
providing illumination by one or more spacers. Thus, the
illumination aperture 220 may be configured into any desired area
or pattern about the probe 120. Further, the cross-sectional shape
of the light sleeve assembly 130 is not limited to a circular
shape. Rather, the light sleeve assembly 130 may have any shape
and, particularly, may have a shape associated with the shape of
the probe 120 to which the light sleeve assembly 130 is
coupled.
[0040] Referring to FIGS. 3A, 3B, and 3C, the light sleeve assembly
130 may be movable along the probe 120. As the light sleeve
assembly 130 is extended (i.e., moved in a direction of arrow 230)
or retracted (i.e., moved in a direction of arrow 232) along the
probe 120, a position of the illumination aperture 220 is adjusted
with respect to the cutting tip 125 of probe 120. Movement of the
light sleeve assembly 130 relative to the probe 120 adjusts a size
of an illumination area 221 provided by the illumination aperture
220, as shown in FIGS. 3B, 3C, and 4B. For example, a user may
desire that an area of a retina be illuminated. Thus, the
illumination area 221 may be a portion of the retina for which
illumination is desired. A user may adjust the size of the
illumination area 221 by sliding the light sleeve assembly 130
relative to the probe 120. The lux (i.e., luminous flux per unit
area) of the illumination from the illumination aperture 220 may
also be altered based on the position of the light sleeve assembly
130 relative to the probe 120. Thus, the illumination aperture 220
may be adjusted with respect to the cutting tip 125 of the probe
120 to vary the illumination provided about the cutting tip 125
through the illumination aperture 220.
[0041] As depicted in FIG. 3A, a region "x" defines a distance
between the distal end 146 of the light sleeve assembly 130 and the
distal end 123 of the probe 120 and, particularly, the cutting tip
125. The light sleeve assembly 130 may be adjusted to any position
within this distance "x" to cause alteration of the size of the
illumination area 221, as shown in FIGS. 3B and 3C. Light sleeve
assembly 130 is adjustable along a length of the vitrectomy needle
120 to provide adjustment of the illumination aperture 220 to
increase or decrease the area of illumination 221 provided thereby.
During the course of a surgical procedure, such as a vitreoretinal
surgical procedure, a surgeon may desire different levels of
illumination at any given time. For example, a surgeon may desire
different levels of illumination in different regions of the eye,
or a surgeon may desire adjusting an amount of illumination in any
particular region of the eye. By adjusting the illumination area
121 by varying the position of the illumination aperture 220 within
the region "x" relative to the port 127, the illumination provided
via the illumination aperture 220 may be tailored to specific needs
of a user, such as a surgeon performing the surgical procedure.
[0042] Referring to FIGS. 4A-4B, in some implementations, the light
sleeve assembly 130 (and, consequently, the illumination aperture
220) may be moved along the probe 120 by manually sliding the light
sleeve assembly 130 to one or more positions along the probe 120.
The light sleeve assembly 130 may be adjusted to any desired
position along the probe 120 within a range of positions. This
allows a user to position the illumination aperture 220 at desired
positions along the probe 120 and with respect to the cutting tip
125 thereof. As a result, an amount of illumination provided via
the illumination aperture 220 and directed to an illumination area
221 may be varied. For example, in some instances where a focused
light (or smaller, more directed area of illumination) is
desirable, the light sleeve assembly 130 may be moved closer to the
distal end 123 of the probe 120. For example, in some
implementations, the light sleeve assembly 130 may be moved to
within 1 to 15 mm or closer of the cutting tip 125. In some
implementations, the distal end 146 of the light sleeve assembly
130 may be extended to a position that is substantially flush with
or partially extending past an end surface of the cutting tip 125.
In other cases where a diffused illumination or an enlarged area of
illumination is desirable (for peripheral viewing, for example),
the light sleeve assembly 130 may be moved farther away from the
distal end 123 of the probe 120 so as to allow greater spreading of
the illumination from the illumination aperture 220.
[0043] In some implementations, the light sleeve assembly 130 and,
correspondingly, the illumination aperture 220 may be moved along
the probe 120 with the use of an actuator coupled to the light
sleeve assembly 130. A position of the illumination aperture 220
relative to a distal end 123 of the probe 120 may be adjusted by
manipulation of the actuator. FIGS. 5A and 5B illustrate an example
vitrector 100 having an actuator 445 coupled to the light sleeve
assembly 130 to adjust the position of the light sleeve assembly
130. The actuator 445 may be actuated by a finger of a user, such
as a thumb. The actuator 445 may extend through a slot formed in a
forward projecting portion 446 of the nose piece 115. The actuator
445 may be moved within a slot relative to the forward projection
portion 446 and to extend or retract the light sleeve assembly 130
along the probe 120. The actuator 445 may be adhesively,
mechanically, or otherwise coupled to the light sleeve assembly
130, or may engage the light sleeve assembly 130 in a frictional
engagement. Accordingly, as the actuator 445 is moved in the
direction of arrow 230 or the direction of arrow 232, the light
sleeve assembly 130 is moved in kind. By manipulation of the
actuator 445, the light sleeve assembly 130 is moved accordingly
along the probe 120. As a result, a position of the illumination
aperture 220 along the probe 120 is adjusted. Other types of
actuators (for example, pneumatic, hydraulic, electrical, or other)
may also be utilized. Further, the actuator of may be operable to
adjust a position of the light sleeve assembly 130 without manual
manipulation of the light sleeve assembly 130. Further, the
actuator, whether manual or otherwise, may be utilized to adjust a
position of the light sleeve assembly 130 relative to the probe 120
without removing the probe 120 from the eye.
[0044] As shown in FIGS. 1B, 4A, 5A, 5B, the proximal end 145 of
the light sleeve assembly 130 may be slidably received within the
nose piece 115, with the light sleeve assembly 130 extending along
the probe 120. Referring to FIGS. 6A, 6B, and 6C, the optical
fibers 210 exit the proximal end 145 of the sleeve 212 of the light
sleeve assembly 130 at a transition area 504. Within the transition
zone 504, the optical fibers 210 may be encapsulated in an
encapsulant 505. As shown in FIG. 6A, the optical fibers 210 are
gather to a side of the probe 120, and the probe 120 extends
proximally beyond the transition area 504 of the optical fibers
210. Beyond the transition area 504, the optical fibers 210 may be
arranged into a fiber bundle 160. The fiber bundle 160 may be
disposed within a protective sheath 515. The protective sheath 515
is operable to protect the optical fibers 210 and as well as
provide strain relief to the optical fibers 210. In some instances,
the protective sheath 515 may be formed from an elastomeric
material. However, the protective sheath 515 may be formed from any
suitable material. The encapsulant 505 may also encapsulate at
least a portion of the optical fibers 210 that extend into and
through the protective sheath 515.
[0045] In some implementations, the fiber bundle 160 may extend to
and be coupled with a light source. In some implementations, as
shown in FIG. 6D, light source 600 may be disposed remote from the
vitrector 100. For example, the light source 600 may be provided in
a surgical console 610 to which the vitrector 100 is coupled. In
other implementations, the fiber bundle 160 may be coupled to one
or more secondary optical fibers 620 which connect to or extend
from the light source 600. In still other implementations, the
light source may be contained within or otherwise coupled to the
housing 110 of the vitrector 100. As explained above, the light
source may reside at a surgical console 610, and light generated by
the light source 600 may be provided to the vitrector 100 and
delivered via the secondary optical fibers 620 and/or fiber bundle
160 to optical fibers 210 for illuminating the surgical site.
[0046] In some implementations, the fiber bundle 160 may be
extendable from and retractable into the housing 110 in response to
movement of the light sleeve assembly 130 along the probe 120, as
depicted in FIGS. 6B (extended configuration) and 6E (retracted
configuration). Thus, in some instances, the housing 110 may
include space to accommodate at least a portion of the fiber bundle
160. Also, the fiber bundle 160 may include slack 170, i.e., a
length of the fiber bundle 160 inside the housing 110 so as to
allow a desired amount of movement of the light sleeve assembly
130, as shown in FIG. 6E. Consequently, movement of the light
sleeve assembly 130 relative to the probe 120 is made possible by
having the light sleeve assembly 130 moveable within and relative
to the nose piece 115 and providing a sufficient length of the
fiber bundle 160 to allow sliding of the light sleeve assembly 130
along the probe 120 to the distal end thereof.
[0047] FIG. 6E depicts the proximal end 145 of the light sleeve
assembly 130 in a first position in which the fiber bundle 160 is
in a slackened configuration. In some implementations, when the
light sleeve assembly 130 is moved to this first position, the
distal end 146 of the light sleeve assembly 130 is spaced away from
the distal end 123 of the probe 120. For example, FIG. 3B shows the
light sleeve assembly 130 displaced proximally from the distal end
123 of the probe 120. The light sleeve assembly 130 is movable to a
second position in which the light sleeve assembly 130 is in an
extended configuration. In the extended configuration, the distal
end 146 of the light sleeve assembly 130 is positioned closer to
the distal end 123 of the probe 120. The fiber bundle 160 in this
second position is in a less slackened condition. In some
instances, the second position, the fiber bundle 160 may be
substantially taut. In other instances, the fiber bundle 160 may
have a lessened amount of slack than in the first position. FIG. 3C
shows an example light sleeve assembly 130 disposed closer to the
distal end 123 of the probe 120.
[0048] In still other implementations, the vitrector 100 may
incorporate a wet field diathermy capability. In some instances, a
vitrectomy procedure may result in bleeding of vessels about the
retina. Diathermy is the application of electricity (typically high
frequency alternating current) to induce heat. The induced heat may
be utilized to cauterizing vessels to stop bleeding. The diathermy
capability may be implemented with a metal used to form or included
in the sleeve 212 and the metal forming probe 120. The close
proximity between the sleeve 212 and the probe 120, particularly
when the light sleeve assembly 130 is extended such that the end
face 222 of the light sleeve assembly 130 is substantially flush
with the end surface 240 of probe 120 (as shown, for example, in
FIG. 7B), generates an electrical field as a result of application
of the high frequency alternating current. An electric field effect
is generated between the probe 120 the sleeve 212 with the
encapsulant 214 acting as an insulator for diathermy operations.
The generated electrical field induces heating of material, such as
tissues and more particularly blood vessels, located adjacent to
the distal end 123 of the probe 120. In the context of bleeding
vessels, the generated heat cauterizes the vessels, thereby
stopping the bleeding.
[0049] To provide a diathermy capability, metal incorporated into
or forming the sleeve 212 may be connected to a first pole of a
generator, with the probe 120 connected to a second pole of a
generator. Again, the encapsulant 214 surrounding the optical
fibers may be used as an insulating material. For example, the
encapsulant 214 may be formed form a material having sufficient
dielectric strength to serve as an insulator. An electric field is
generated between the two poles such that the vitrector 100 is
operable to provide a diathermy function. For example, as explained
above, the diathermy capability may be operable when the light
sleeve assembly 130 is positioned substantially flush with the end
surface 240 of the probe 120. The generated electric field induces
heat within tissues disposed adjacent the distal end 123 of the
probe 120. The generated heat may be utilized to cauterization
tissues. For example, blood vessels within the eye, particularly
bleeding vessels about the retina, may be cauterized to stop
bleeding. Inclusion of a diathermy capability with the vitrector
100 avoids the need to exchange the vitrector 100 with a diathermy
probe when diathermy is needed. Eliminating this exchange reduces
time required to perform a surgical procedure and eliminates
potential injury to ocular tissues that may be associated with
withdrawing and inserting instruments from and into the eye. Thus,
when diathermy is needed, the light sleeve assembly 130 may be
positioned as described. When diathermy is not desired, the light
sleeve assembly 130 may be located at another position or positions
to provide illumination as described above.
[0050] In some implementations, the vitrector 100 may incorporate
an endolaser capability. An endolaser treatment involves the use of
laser radiation, for example in the context of retinal surgical
procedures, to seal tears in the retina. The vitrector 100 may
incorporate endolaser functionality by replacing one or more of the
optical fibers 210 used to provide illumination with one or more
optical fibers having properties suitable for transmitting laser
light. FIGS. 8A-8B show an example vitrector 100 operable to
provide endolaser capability with an optical fiber 805 provided
among the optical fibers 210. In operation, the distal end 146 of
the light sleeve assembly 130 may to be positioned substantially
flush with the end surface 240 of the probe 120. A flush
arrangement of the light sleeve assembly 130 and the end surface
240 avoids laser vignetting by the probe 120. Also, the inclusion
of an endolaser capability with the vitrector 100 eliminates the
need to remove the vitrector 100 in order to insert a separate
endolaser probe, thereby reducing risks associated with surgical
procedures, such as one or the risks explained above.
[0051] At least one optical fiber 805 with properties appropriate
for endolaser may be added to the array of optical fibers 210.
While the remaining optical fibers 210 in the array continue to
provide illumination, the optical fiber 805 may be coupled to a
laser source. For example, the optical fiber 805 may have a distal
end that is terminated with a connector appropriate for a laser
source. The optical fiber 805 may extend along the length of the
probe 120 in a manner similar to the remaining optical fibers 210.
When endolaser functionality is required, the light sleeve assembly
130 may be moved to a position flush with the end surface 240 and
the optical fiber 805 activated for the transmission of laser light
from the distal end of the optical fiber 805. Consequently, at
times, the vitrector 100 may be utilized to provide illumination,
for example, as described above, while, at other times, the
vitrector 100 may be utilized to provide endolaser
functionality.
[0052] In still other implementations, the vitrector 100 may
incorporate a wet field diathermy capability and an endolaser
capability, while also including an illumination capability. A
user, such as a surgeon, may select a type of vitrector 100, such
as a vitrector having an illumination capability, a vitrector with
illumination and one or more of an endolaser or diathermy
capability, based on the therapy(ies) that is/are believed to be
needed during a surgical procedure.
[0053] In some instances, application of illumination, diathermy,
or endolaser functionality may be implemented by actuation of a
corresponding control on a surgical console to which the vitrector
is coupled. For example, where a diathermy capability may be
desired, a user may position the light sleeve assembly 130 such
that the distal end 146 thereof is substantially flush with the end
face 240 of the probe 120. The user may then actuate a diathermy
control of the surgical console to provide the diathermy function
of the vitrector 100. When the endolaser control of the surgical
console is actuated, the endolaser function is provided by the
vitrector 100. As explained above, in some instances, a user may
align the distal end 146 of the light sleeve assembly 130 with the
end face 240 of the probe 120 in order to eliminate vignetting of
the emitted laser light.
[0054] The foregoing description generally illustrates and
describes various implementations of the present disclosure. It
will, however, be understood by those skilled in the art that
various changes and modifications can be made to one or more of the
features described herein without departing from the spirit and
scope of the disclosure, and that it is intended that all matter
contained in the above description or shown in the accompanying
drawings shall be interpreted as being illustrative, and not to be
taken in a limiting sense. Furthermore the scope of the present
disclosure shall be construed to cover various modifications,
combinations, additions, alterations, etc., above and to the
above-described embodiments, which shall be considered to be within
the scope of the present disclosure. Accordingly, various features
and characteristics of the present disclosure as discussed herein
may be selectively interchanged and applied to other illustrated
and non-illustrated examples of the present disclosure, and
numerous variations, modifications, and additions further can be
made thereto without departing from the spirit and scope of the
present disclosure as set forth in the appended claims.
* * * * *