U.S. patent application number 14/450107 was filed with the patent office on 2015-02-05 for occlusion-activated heat supression infusion sleeve.
The applicant listed for this patent is Armand Maaskamp, Ryan Maaskamp, Alex Urich. Invention is credited to Armand Maaskamp, Ryan Maaskamp, Alex Urich.
Application Number | 20150038894 14/450107 |
Document ID | / |
Family ID | 52428304 |
Filed Date | 2015-02-05 |
United States Patent
Application |
20150038894 |
Kind Code |
A1 |
Urich; Alex ; et
al. |
February 5, 2015 |
OCCLUSION-ACTIVATED HEAT SUPRESSION INFUSION SLEEVE
Abstract
Described is a phacoemulsification device for eye surgery that
generally comprises an ultrasonically vibrating aspiration needle
that withdraws ocular material from inside of the eye. The ocular
material withdrawn from the eye is equally replaced with irrigation
fluid provided through irrigation ports in an irrigation sleeve
surrounding the aspiration needle. In the event the aspiration
needle stops withdrawing ocular material, such as if it becomes
occluded with a chunk of ocular material, irrigation fluid is
directed to the outside of the eye via at least one irrigation
aperture to keep the eye cool where the needle is ultrasonically
vibrating.
Inventors: |
Urich; Alex; (Mission Viejo,
CA) ; Maaskamp; Armand; (Napa, CA) ; Maaskamp;
Ryan; (San Francisco, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Urich; Alex
Maaskamp; Armand
Maaskamp; Ryan |
Mission Viejo
Napa
San Francisco |
CA
CA
CA |
US
US
US |
|
|
Family ID: |
52428304 |
Appl. No.: |
14/450107 |
Filed: |
August 1, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61861879 |
Aug 2, 2013 |
|
|
|
Current U.S.
Class: |
604/22 |
Current CPC
Class: |
A61M 2210/0612 20130101;
A61M 2205/3606 20130101; A61B 2017/32007 20170801; A61B 2018/00035
20130101; A61F 9/00745 20130101; A61M 3/0283 20130101; A61M 1/008
20130101; A61M 3/0241 20130101; A61B 17/320068 20130101; A61M
3/0216 20140204; A61B 2017/320084 20130101 |
Class at
Publication: |
604/22 |
International
Class: |
A61F 9/007 20060101
A61F009/007; A61M 3/02 20060101 A61M003/02 |
Claims
1. A phacoemulsification device for eye surgery to an eye
comprising: an ultrasonically vibrating aspiration needle adapted
to withdraw ocular material from inside of said eye; an irrigation
sleeve possessing an irrigation port through which irrigation fluid
is adapted to discharge inside of said eye; and at least one
irrigation aperture extending through said irrigation sleeve, said
irrigation aperture adapted to direct said irrigation fluid through
said irrigation aperture onto the outside of said eye wherein no
part of said irrigation aperture comes into contact with said eye
during said eye surgery.
2. The phacoemulsification device of claim 1 further comprising a
handpiece from which said aspiration needle and said irrigation
sleeve extend, said at least one irrigation aperture is between
said handpiece and said irrigation port of said irrigation sleeve,
said ocular material passes through said handpiece at a first rate
and said irrigation fluid passes through said handpiece at a second
rate.
3. The phacoemulsification device of claim 2 wherein said second
rate is essentially constant and equals said first rate when said
ocular material is withdrawn from said eye freely, said irrigation
fluid that discharges inside of said eye through said irrigation
port always equals said first rate, any reduction in said first
rate increases said irrigation fluid that discharges onto the
outside of said eye via said at least one irrigation aperture.
4. The phacoemulsification device of claim 2 wherein said second
rate is essentially constant and is greater than said first rate
when said ocular material is withdrawn from said eye freely, said
irrigation fluid that discharges inside of said eye through said
irrigation port always equals said first rate, said irrigation
fluid that discharges onto the outside of said eye via said at
least one irrigation aperture increases discharge rate with a
reduction in said first rate.
5. The phacoemulsification device of claim 1 wherein said
irrigation sleeve concentrically surrounds a portion of said
aspiration needle, said irrigation sleeve is spaced apart from said
aspiration needle to form an irrigation pathway, said aspiration
needle extends beyond said irrigation port of said irrigation
sleeve.
6. The phacoemulsification device of claim 5 further comprising an
irrigation sleeve hub disposed between said aspiration port and
said handpiece wherein said irrigation sleeve hub possesses a hub
diameter that is greater than a sleeve diameter of said irrigation
sleeve, said at least one irrigation aperture located at said
irrigation sleeve hub.
7. The phacoemulsification device of claim 1 wherein said ocular
material passes through said aspiration needle at a first rate
whereby if said first rate becomes essentially zero, then said
irrigation aperture directs said irrigation fluid through said
irrigation aperture onto the outside of said eye.
8. The phacoemulsification device of claim 1 wherein said
irrigation aperture does not get closer than at least one-eighth of
an inch from said eye during an eye surgery.
9. An eye surgery method comprising: providing a
phacoemulsification device comprising a hollow irrigation sleeve
through which irrigation fluid flows, said irrigation sleeve
possessing at least one irrigation port and at least one irrigation
aperture, and a hollow aspiration needle possessing an aspiration
port at the distal end of said aspiration needle; inserting said
distal end of said aspiration needle and said irrigation port into
an eye; ultrasonically vibrating said aspiration needle; aspirating
ocular material from inside of said eye through said aspiration
port at an aspiration flow rate; discharging said irrigation fluid
through said irrigation port into said eye at an irrigation port
flow rate, wherein said irrigation port flow rate essentially
equals said aspiration flow rate; directing said irrigation fluid
through said irrigation aperture towards the outside of said eye at
an aperture irrigation flow rate, said irrigation aperture does not
come into contact with said eye.
10. The eye surgery method of claim 9 wherein said aperture
irrigation flow rate is zero when said ocular material flows freely
through said aspiration port during said aspirating step, but said
aperture irrigation flow rate increases when said aspirating flow
rate decreases.
11. The eye surgery method of claim 10 wherein said aperture
irrigation flow rate is inversely proportional to said aspiration
flow rate.
12. The eye surgery method of claim 9 wherein said aperture
irrigation flow rate is greater than zero when said ocular material
flows freely through said aspiration port during said aspirating
step, but said aperture irrigation flow rate increases when said
aspirating flow rate decreases.
13. The eye surgery method of claim 12 wherein said aperture
irrigation flow rate changes at a rate that is inversely
proportional to said aspiration flow rate.
14. The eye surgery method of claim 9 further providing a handpiece
from which said aspiration needle and said irrigation sleeve
extend, said at least one aperture is between said handpiece and
said irrigation port.
15. The eye surgery method of claim 9 wherein said irrigation
sleeve concentrically surrounds a portion of said aspiration
needle, said irrigation sleeve is spaced apart from said aspiration
needle to form an irrigation pathway, said aspiration needle
extends beyond where said irrigation sleeve terminates.
16. The eye surgery method of claim 15 further comprising an
irrigation sleeve hub disposed at the distal end of said handpiece
wherein said irrigation sleeve hub is closer to said aspiration
port than said handpiece, wherein said irrigation sleeve hub
possesses a hub diameter that is greater than a sleeve diameter of
said irrigation sleeve, said at least one irrigation aperture
located at said irrigation sleeve hub.
17. The eye surgery method of claim 9 wherein said irrigation
aperture remains at least one-eighth of an inch from said eye
during said aspirating step, said discharging step, and said
directing step.
18. The eye surgery method of claim 9 wherein said directing step
only occurs if said aspiration flow rate essentially goes to
zero.
19. A phacoemulsification device comprising: a handpiece; an
aspiration needle extending from said handpiece, said aspiration
needle possessing an aspiration port at the distal end of said
aspiration needle; an irrigation sleeve concentrically surrounding
a portion of said aspiration needle, said irrigation sleeve spaced
apart from said aspiration needle forming an irrigation pathway,
said aspiration needle extending distally beyond said irrigation
sleeve; an irrigation port passing through said irrigation sleeve,
said irrigation port less than one-half of an inch from said
aspiration port; means for directing irrigation fluid to the
outside of an eye.
20. The phacoemulsification device of claim 19 wherein said means
for directing irrigation fluid is an irrigation aperture passing
through said irrigation sleeve greater than one-half of an inch
from said aspiration port.
21. The phacoemulsification device of claim 19 wherein said means
for directing irrigation fluid is between said handpiece and said
irrigation port, said aspiration needle is adapted to withdraw
ocular material from said eye at a first rate, said irrigation
sleeve is adapted to provide said irrigation fluid inside of said
eye via said irrigation port at a second rate, said means for
directing irrigation fluid to the outside of said eye is adapted to
direct said irrigation fluid at a third rate, wherein said first
rate equals said second rate, and said third rate is at least zero
when said first rate is at a maximum flow rate and said third rate
is proportional to said first rate.
22. The phacoemulsification device of claim 19 wherein said
aspiration needle withdraws ocular material from said eye at an
aspiration flow rate during a phacoemulsification procedure, but
when said aspiration flow rate is zero during said
phacoemulsification procedure, said means for directing irrigation
fluid to the outside of said eye directs fluid at a flow rate
greater than zero.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority to and the benefit of U.S.
provisional Patent Application No. 61/861,879, entitled:
Occlusion-Activated heat Suppression Infusion Sleeve, filed on Aug.
2, 2013 the entire disclosure of which is hereby incorporated by
reference.
FIELD OF THE INVENTION
[0002] The present invention is directed to a phacoemulsification
device with cooling aperture ports that is useful in providing
cooling to an eye during cataract surgery.
BACKGROUND OF THE INVENTION
[0003] A cataract is the clouding of the eye's natural lens. The
lens is mostly made up of water and protein. As we age, these
proteins change and clump together obscuring the lens. Correcting
this change is generally done by removing the cataract lens and
replacing it with a clear lens implant. One way of correcting the
effects of cataracts is through Phacoemulsification eye
surgery.
[0004] Phacoemulsification is a surgery technique on an eye wherein
the internal lens is emulsified with a phacoemulsification, or
phaco for short, needle tip driven to vibrate ultrasonically by an
ultrasonic producing mechanism in the phaco handpiece. The
ultrasonic vibration of the phaco needle creates a significant
temperature rise of the needle. The temperature rise occurs
essentially instantaneously. The emulsified lens material (mostly
fluid) is aspirated from the eye through the phaco needle and
replaced with an irrigation fluid made up of a balanced salt
solution. Intraocular pressure (IOP) is maintained in the eye while
the phaco needle is aspirating ocular material from the eye by
constantly infusing saline solution into the eye. This constant
replenishment of fluids in the eye is critical to avoid collapse of
the anterior chamber of the eye. The irrigation fluid is also the
only fluid that cools the heating effects of the vibrating phaco
needle, thus preventing burning of eye tissue at the incision site.
On occasion, large chunks of ocular material clog the phaco needle,
which interrupts the aspiration flow, which in turn causes
interruption in the irrigation flow. Though the irrigation flow is
interrupted, the phaco needle may still be vibrating causing
localized heating and potential localized burning of the eye.
[0005] It is to improvements in dealing with localized heating of
the eye when aspiration flow is interrupted that embodiments of the
present invention are directed.
SUMMARY OF THE INVENTION
[0006] The present invention is directed to a phacoemulsification
device with cooling aperture ports that is useful in providing
cooling to the incision site of an eye during cataract surgery.
[0007] Certain embodiments of the present invention can therefore
comprise a phacoemulsification device comprising: a handpiece; an
aspiration needle extending from the handpiece, the aspiration
needle adapted to pull a volume of lens material at a particular
rate from an eye via an aspiration port located at the distal end
of the aspiration needle; an irrigation sleeve that surrounds a
portion of the aspiration needle, the irrigation sleeve is spaced
apart from the aspiration needle to provide an irrigation pathway
where through liquid is adapted to flow; at least one irrigation
port extending through the irrigation sleeve and providing an exit
for the liquid to pass from the irrigation pathway outside of the
phacoemulsification device, the irrigation port adapted to replace
the volume of lens material with the liquid at the particular rate
into the eye to maintain a balanced intraocular pressure in the
eye, a portion of the aspiration needle, a portion of the
irrigation sleeve, and the at least one irrigation port are adapted
to be inserted inside of the eye; at least one aperture forming an
outlet from the irrigation pathway and the phacoemulsification
device through which a portion of the liquid can flow, the at least
one aperture when in use is not adapted to be inserted inside of
the eye, the aperture adapted to direct fluid towards the eye at an
accelerated rate if the aspiration needle pulls less than the
volume of lens material at the particular rate. In these
embodiments, the aperture is adapted to direct the fluid towards
the eye at a decelerated rate while the aspiration needle pulls the
volume of lens material at the particular rate. In these
embodiments, there can further be an irrigation sleeve hub disposed
between the aspiration port and the handpiece wherein the
irrigation sleeve hub possesses a hub diameter that is greater than
a sleeve diameter of the irrigation sleeve, the at least one
irrigation port located at the irrigation sleeve hub. Furthermore,
the fluid that flows through the irrigation pathway is adapted to
flow essentially at a continuous rate prior to reaching the
aperture and the irrigation port whereby if the particular rate of
the volume of the liquid slows through the irrigation port more of
the liquid is adapted to flow through the aperture in order to
maintain the continuous rate.
[0008] Other embodiments of the present invention can therefore
comprise a method for using a phacoemulsification device for eye
surgery comprising the steps of: providing the phacoemulsification
device comprising a handpiece through which extends an irrigation
sleeve and an aspiration needle, the aspiration needle extending
distally from the irrigation sleeve surrounding a portion of the
aspiration needle, the irrigation sleeve extending from the
handpiece towards but not including the distal end of the
aspiration needle wherein an inner surface of the irrigation sleeve
and an outer surface of the aspiration needle are spaced apart
through which irrigation fluid can flow, an irrigation port
extending through the phacoemulsification device into the infusion
sleeve, at least one aperture extending into the infusion sleeve,
and a fluid source that provides the irrigation fluid to flow there
from at essentially a constant supply pressure though the infusion
sleeve; inserting the aspiration needle to at least include the
irrigation port into an eye; after the inserting step, aspirating
lens material from the eye through the aspiration needle at an
aspiration flow rate; replacing the lens material with a sufficient
amount of the irrigation fluid to maintain essentially constant
intraocular pressure in the eye, the sufficient amount of the
irrigation fluid flows through the infusion sleeve and through the
irrigation port at essentially the aspiration flow rate; directing
the irrigation fluid through the at least one aperture towards the
eye when the aspiration flow rate at least slows down, the at least
one aperture is not inserted in the eye. In this embodiment, the
directing step occurs when the aspiration flow rate stops.
Optionally, the aspiration flow rate at least slows down due to an
occlusion of the lens material in the aspiration needle. In another
embodiment, a portion of the irrigation fluid is always diverted
through the at least one aperture to the eye, but the irrigation
fluid is accelerated toward the eye when the aspiration flow rate
at least slows down. This embodiment further contemplates providing
a hub interposed between the handpiece and the irrigation sleeve
wherein the aperture extends there through. It is further
contemplated that the constant supply pressure is essentially
identical as the lens pressure. Another embodiment contemplates the
aperture extends through the irrigation sleeve.
[0009] Yet, other embodiments of the present invention can
therefore comprise a phacoemulsification device comprising: a
handpiece; an aspiration needle extending from the handpiece, the
aspiration needle is hollow and is adapted to remove lens material
there through by way of a suction device; an irrigation sleeve
surrounding a portion of the aspiration needle, a distal end of the
aspiration needle is not surrounded by the irrigation sleeve; a
conduit spaced between the irrigation sleeve and the aspiration
needle wherein irrigation fluid is capable of flowing through the
conduit; at least one irrigation port in the irrigation sleeve
adapted to provide an outlet for the irrigation fluid from the
conduit to outside of the phacoemulsification device, the
aspiration needle adapted to be inserted into an eye up to at least
past the irrigation port, wherein constant pressure can be
maintained in the eye via volumetric replacement of the removed
lens material by flowing the irrigation fluid through the
irrigation port; at least one aperture located between the
handpiece and the irrigation port, the at least one aperture
providing a passage from the conduit to outside of the
phacoemulsification device, the at least one aperture not adapted
to be inside of the eye, the aperture adapted to direct the
irrigation fluid to the eye at an accelerated rate when flow of the
irrigation fluid via the irrigation port is reduced. This
embodiment further contemplates that the at least one aperture is
adapted to direct the irrigation fluid towards the eye at a
decelerated rate when flow of the irrigation fluid via the
irrigation port is not reduced during eye surgery. This embodiment
further contemplates that the irrigation fluid is received from a
fluid source at essentially a constant source pressure, wherein
when the aspiration port becomes blocked, the irrigation port stops
flowing the irrigation fluid into the eye and the at least one
aperture increases the fluid flow at the constant source pressure.
It is further contemplated that an irrigation sleeve hub is
disposed between the aspiration port and the handpiece wherein the
irrigation sleeve hub possesses a hub diameter that is greater than
a sleeve diameter of the irrigation sleeve, the at least one
irrigation port located at the irrigation sleeve hub. It is further
contemplated that the at least one aperture is smaller than the
irrigation port.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1A illustratively depicts an embodiment of a
phacoemulsification device consistent with embodiments of the
present invention.
[0011] FIG. 1B illustratively depicts an embodiment of a front view
of a phacoemulsification device consistent with embodiments of the
present invention.
[0012] FIG. 2 depicts a system block diagram of a
phacoemulsification system, consistent with embodiments of the
present invention.
[0013] FIG. 3 illustratively depicts a cross section of a
phacoemulsification device consistent with embodiments of the
present invention.
[0014] FIGS. 4A and 4B illustratively depict a cross section of a
phacoemulsification device in operation consistent with embodiments
of the present invention.
[0015] FIG. 5 depicts a block diagram of a method of use of an
embodiment of the phacoemulsification device consistent with
embodiments of the present invention.
[0016] FIGS. 6A-6E depict alternative aperture embodiments
consistent with embodiments of the present invention.
DETAILED DESCRIPTION
[0017] Initially, this disclosure is by way of example only, not by
limitation. Thus, although the instrumentalities described herein
are for the convenience of explanation, shown and described with
respect to exemplary embodiments, it will be appreciated that the
principles herein may be applied equally in other types of
situations involving eye surgery.
[0018] To illustrate an exemplary environment in which preferred
embodiments of the present invention can be practiced, FIG. 1A
depicts an embodiment of a phacoemulsification device 100
consistent with embodiments of the present invention. As shown the
phacoemulsification device 100 generally comprises a handpiece 114,
a hollow aspiration needle 106 extending from the handpiece 114, an
irrigation sleeve 104 that surrounds a portion of the aspiration
needle 106 (also known as a phacoemulsification needle), at least
one irrigation port 102 extending through the irrigation sleeve
104, a hub 112, and at least one irrigation aperture 110 in the hub
112. FIG. 1B depicts a front view of FIG. 1A as viewed if one were
looking down the hollow aspiration needle 106 through the
aspiration port 108. As shown here, the irrigation sleeve 104
concentrically surrounds a portion of the aspiration needle 106
(the end of the aspiration needle 106 extends beyond the irrigation
sleeve 104 depicted in FIG. 1A, for example). Also noted in the
depiction of the present embodiment, which is non-limiting, the
irrigation apertures 110 are equally dispersed around the hub 112.
The hub 112, in this embodiment, concentrically surrounds a portion
of the irrigation sleeve 104.
[0019] With reference to FIG. 2 in conjunction with FIG. 1, shown
therein is a block diagram of a phacoemulsification system
embodiment 148. As shown, the phacoemulsification system 148
includes an infusion bottle 150 of balanced salt solution generally
positioned between 100 cm to 130 cm above the eye 202 (or to a
level that gravitationally provides balanced intraocular pressure
(IOP) in the eye 202 which is generally between 10 mm Hg and 20 mm
Hg and averages to 15.5 mm Hg in a human eye. During a cataract
surgery, a surgeon tries to keep the IOP above 20 mm Hg, especially
after a vacuum surge). Osmotically balanced salt solution is
compatible with the ocular fluid in the eye 202. The system 148
further provides a pinch valve 152 that opens and closes an
infusion/irrigation pathway 158 to the eye 202. An aspiration pump
154 is adapted to suck emulsified lens material (ocular material)
from the eye 202 through the aspiration port 108 at the distal end
(tip) of the hollow aspiration needle 106. During a
phacoemulsification procedure, the aspiration needle 106 is
inserted through an incision in the anterior chamber of the eye 202
up to and including the irrigation port 102. The aspiration needle
106 is vibrated ultrasonically to break up (emulsify) lens material
in the eye 202. The small pieces of the emulsified lens material
are sucked through the hollow aspiration needle 106 away from the
eye 202 along the aspiration pathway 156 by way of the aspiration
pump 154. The aspiration pump 154 is adapted to pull (vacuum) a
volume of emulsified lens material at a particular rate from the
eye 202 by way of the aspiration port 108. Generally, the
aspiration rate is approximately 5 cc of fluid/minute. Irrigation
fluid replaces the removed lens material (at the same particular
rate of aspirated lens material) by way of gravity from the
infusion bottle 150 that is raised at an appropriate distance above
the eye 202 to maintain IOP. The irrigation fluid flows (is
discharged) into the inside of the eye 202 through the irrigation
port 102 that is inside of the eye 202. In other words, the
irrigation fluid replaces the lens material at the rate at which
the lens material is removed from the eye 202 to maintain
appropriate IOP, thus avoiding collapse of the anterior chamber of
the eye 202. Hence, the irrigation flow rate into the eye
essentially equals the aspiration flow rate from the eye. The word
essentially is used here to indicate that at some level there flow
rate is not exactly equal, but for all intents and purposes is more
or less equal. The irrigation port 102 is a pathway into the
irrigation sleeve 104, whereby irrigation fluid passes from the
irrigation sleeve 104 out the irrigation port 102 into the eye 202.
The irrigation sleeve is spaced apart from the aspiration needle
106 to form an irrigation pathway 158. The irrigation pathway 158
extends from the irrigation port 102, through the handpiece 114 to
the infusion bottle 150.
[0020] FIG. 3 shows a cross section of the phacoemulsification
device 100 of FIG. 1. The phacoemulsification needle 106 and
irrigation ports 102 are located completely inside the eye 202. The
aspiration pathway 156 extends from the aspiration port 108 through
the hollow phacoemulsification needle 106 and handpiece 102. In the
depicted embodiment, the irrigation sleeve 104 is spaced apart from
the aspiration needle 106 to provide the irrigation pathway 158
where through irrigation fluid is adapted to flow. In this
embodiment, the irrigation sleeve 104 is hollow. The irrigation
pathway 158 extends through the handpiece 114 and to the infusion
bottle 150. The irrigation port 102 is an opening into the
irrigation sleeve 104, which provides an exit for the irrigation
fluid to pass from the irrigation pathway 158 outside of the
phacoemulsification device 100 and into the eye 202. As previously
discussed, the irrigation fluid is adapted to flow through the
irrigation port 102 to replace the volume of lens material/fluid
aspirated from the eye 202 to maintain IOP. The irrigation flow
rate into the eye 202 is essentially the same as the aspiration
flow rate from the eye 202 (to balance the volume of fluid in the
eye 202). As is also depicted, the irrigation sleeve hub 112
possesses at least one irrigation aperture 110 forming an outlet
from the irrigation pathway 158 through which a portion of the
irrigation fluid can flow. Certain embodiments contemplate the
irrigation aperture 110 simply extending through the irrigation
sleeve 104. The irrigation aperture 110 when in use is not intended
to be inserted inside of the eye 202. Certain embodiments herein
contemplate that no part of the irrigation aperture 110 comes into
contact with the surface of the eye 202 (in contact with the eye
202 is intended to include touching, overlapping, near contact, or
simply being at the eye surface. The intention in this embodiment
is that the irrigation aperture 110 is spaced at least slightly
away from the surface of the eye 202). For example, no part of the
irrigation aperture 110 overlaps the eye 202 or touches the eye 202
in anyway. The irrigation aperture 110 stays away from the surface
of the eye to direct irrigation fluid to the eye 202 when needed.
Preferably, the irrigation aperture 110 is at least one-eighth
(1/8) of an inch from the surface of the eye 202. One embodiment
contemplates a phacoemulsification needle having dimensions wherein
the irrigation port 102 is less than one-half of an inch from the
aspiration port 108 (so that the irrigation port 102 remains within
the eye 202) and the irrigation aperture 110 is at least
three-quarters of an inch from the aspiration port 108. Other
embodiments contemplate the irrigation port 102 less than the
diameter of a dilated pupil (so the irrigation port 102 is always
in the eye during the phacoemulsification procedure) and the
irrigation aperture 110 is greater than the diameter of the dilated
pupil (so the irrigation aperture 110 always remains outside of and
not in contact with the eye 202). The irrigation aperture 110 is
arranged to direct aspiration fluid towards the eye 202 at an
accelerated rate if the aspiration needle 106 fails to pull lens
material at the normal aspiration rate, which can occur when the
aspiration needle 106 becomes occluded, or partially occluded, with
a large, obstructing, piece of lens material 350. Normal aspiration
rate (normal flow rate, or the rate at which ocular material is
withdrawn from inside of an eye freely) is considered the
aspiration rate of lens material at an unobstructed flow rate
determined by the suction rate from the aspiration pump 154, which
can be at a rate of 5 cc/minute in some eye surgery procedures. As
should be appreciated, if there is a vacuum surge during
aspiration, there will be essentially an equal influx of irrigation
fluid into the eye 202 via the irrigation port/s 102.
[0021] FIGS. 4A and 4B illustratively show the cross sections of
the phacoemulsification device 100 in operation. As depicted in
FIG. 4A, under normal operation, emulsified lens material is
aspirated through the hollow phacoemulsification needle 106 as
indicated by arrow 306. As also previously mentioned, in order to
maintain IOP equilibrium, irrigation fluid replaces the aspirated
lens material at the same rate the lens material is remove from the
eye 202 by flowing through the irrigation port/s 102 as shown by
the arrow 302. This can be accomplished by positioning the
irrigation bottle 150 at a level above the eye 202 that can
essentially maintain a IOP ("essentially maintained" because as the
level of the irrigation fluid in the irrigation bottle 150 drops
and pressure may change up and down a little between effects of
aspiration and irrigation). In the present embodiment as
illustratively depicted, while irrigation fluid flows 302 freely
("freely" is intended herein to mean without any flow reduction due
to an occlusion or other flow interruption in the
phacoemulsification needle 106) through the irrigation ports 102,
the aperture 110 leaks irrigation fluid towards the eye 202 as
indicated by the arrow 304. Certain embodiments contemplate the
aperture 110 possessing a smaller opening than the irrigation port
102 to insure sufficient irrigation fluid to flow into the eye 202
via the irrigation port 102 based on irrigation port 102 being the
path of least resistance for the irrigation fluid to exit the
phacoemulsification device 100. Some benefits of the irrigation
fluid directed towards the eye 202 via the aperture 110 during
normal operation is to keep the outer portion of the eye 202 moist,
which otherwise is typically done manually with eye droppers.
[0022] As illustratively shown in FIG. 4B, when a piece of lens
material 350 occludes aspiration flow, shown here as lens material
350 lodged outside of the phacoemulsification needle 106 blocking
the aspiration port 108 (but may be elsewhere along the aspiration
pathway 156, such as in the aspiration needle 106), flow through
the irrigation port/s 102 is halted due to the balanced hydrostatic
pressure between the irrigation fluid pressurized at the infusion
bottle level and the IOP in the eye 202. As the flow through the
irrigation port/s 102 is halted, flow through the aperture 110 is
accelerated towards the eye 202. This acceleration of irrigation
fluid towards the eye 202 helps transfer heat created by the
ultrasonically vibrating aspiration needle 106 Likely, the lens
material 350 will break apart via the continued ultrasonic
vibrations in the aspiration needle 106 and be aspirated away, thus
resuming the normal flow of FIG. 4A. Because of the constant
pressure created by the raised infusion bottle 150 (due to
gravitational forces on the liquid in the infusion bottle 150
because it is raised above the eye 202), if there is a decrease in
aspiration flow 306, there will be a decrease in the irrigation
flow 302 through the irrigation port 102 and an increase in
aperture flow 304 through the aperture 110.
[0023] Embodiments further contemplate that when the aspiration
flow rate from the eye 202 decreases, the irrigation flow rate onto
the eye 202 from the irrigation apertures 110 increases
proportionally. Hence, for example, if there is an irrigation
aperture flow rate of 0.2 cc/minute when ocular material is being
aspirated freely at 5 cc/minute, if the aspiration flow rate slows
to 2 cc/minute then the irrigation aperture flow rate will direct
irrigation fluid to the outside of the eye 202 at 3.2 cc/minute. Or
if the aspiration flow rate comes to a stop, the irrigation
aperture flow rate will direct irrigation fluid to the outside of
the eye 202 at 5.2 cc/minute. Other embodiments contemplate that
when the aspiration flow rate is flowing freely (say at 5
cc/minute), there is no flow onto the outside of the eye 202 from
the irrigation apertures 110, but if the aspiration flow rate slows
to zero, the irrigation aperture flow rate increases proportionally
(to say 5 cc/minute).
[0024] Other embodiments contemplate that the irrigation flow rate
from the irrigation apertures 110 is zero until the aspiration
needle 106 becomes occluded and the aspiration flow stops. Some
embodiments contemplate that the irrigation flow rate from the
irrigation apertures 110 flows at a rate of 1 cc/minute when
spraying irrigation fluid onto the outside of the eye 202 assuming
the aspiration flow rate is 5 cc/minute. As will be appreciated,
the different flow rates described herein are by way of example and
are merely embodiments of other flow rate ranges that can be
reasonably used to withdraw ocular material from an eye 202 and
replenish irrigation fluid into the eye 202, and if there is an
occlusion causing rapid localized heating of the eye 202 where the
aspiration needle 106 is ultrasonically vibrating without
irrigation fluid flowing through the irrigation port/s 102 to cool
the aspiration needle 106, irrigation fluid from the irrigation
aperture/s 110 spray on the eye 202 to cool the incision site 449
of the eye 202 to help prevent burning of the ultrasonically
vibrating aspiration needle 106.
[0025] FIG. 5 shows steps of a method embodiment for using the
phacoemulsification device 100 for eye surgery consistent with
embodiments of the present invention. Step 502 provides a
phacoemulsification device 100 consistent with FIGS. 1A-4B, which
generally comprises a handpiece 114 through which extends an
irrigation sleeve 104 and an aspiration needle 106. The aspiration
needle 106 extends distally from the irrigation sleeve 104 which
surrounds a portion of the aspiration needle 106, whereby the
distal end of the aspiration needle 106 is not covered by the
irrigation sleeve 104 as depicted in FIG. 1. The irrigation sleeve
104 extends from the handpiece 114 towards the distal end of the
aspiration needle 106 wherein an inner surface of the irrigation
sleeve 104 and an outer surface of the aspiration needle 106 are
spaced apart to create an irrigation flow channel/pathway 158
adapted to accommodate irrigation fluid. The irrigation sleeve 104
provides an irrigation port 102 which extends through the
irrigation sleeve 104 into the irrigation flow space 158, at least
one aperture 110 that extends into the irrigation flow space 158
(the aperture 110 is intended to remain outside of the eye 202),
and a liquid source, such as the infusion bottle 150, that
transfers irrigation liquid at essentially a constant supply
pressure though the irrigation sleeve 104 and out through the
irrigation port 102. Step 504 is a step for inserting the
aspiration needle 106 to at least include the irrigation port 102
into an eye 202. Step 506 is a step for ultrasonically vibrating
the aspiration needle 106 to emulsify lens material in the eye 202,
such as to break up a cataract lens. Step 508 is a step for
aspirating lens material from the eye 202 through the aspiration
needle 106 at an aspiration flow rate after the inserting step 504
and while the aspiration needle 106 is ultrasonically vibrating.
Step 510 is a step for replacing the lens material with a
sufficient amount of the irrigation liquid to maintain essentially
constant lens pressure in the eye 202. The sufficient amount of the
irrigation liquid flows through the irrigation flow space and
through the irrigation port 102 at the same rate as the aspiration
flow rate (wherein the lens material is being aspirated). Step 512
is a decision step questioning if the aspiration flow rate has
diminished or stopped. If the aspiration flow rate has not
diminished or stopped then the process will continue smoothly to
decision step 520. However, if the aspiration flow rate has
diminished or stopped, such as due to an occlusion of lens material
350, then step 514 shows the response is to immediately accelerate
irrigation fluid to the eye 202 by way of the aperture 102. As
shown in step 516, if the aspiration flow rate has returned to
normal, such as if the lens material 350 is no longer blocking the
aspiration pathway 156 (the continued ultrasonic vibrations are
likely to break up the lens material 350) then the irrigation fluid
directed to the outer eye 202 through the aperture 102 is
decelerated back to before the occlusion occurred, step 518, and
the phacoemulsification procedure returns to normal, step 520. If
the aspiration flow rate has not returned to normal (i.e., the lens
material 350 is still blocking the aspiration pathway 156) then the
high rate of irrigation fluid directed to the eye 202 through the
aperture 110 of step 514 is continued). As shown in step 520, if
all the lens material intended to be removed from the eye 202 is
indeed removed, then withdraw the phacoemulsification device 100
from the eye 202, step 522. If there is still lens material to
remove, proceed to step 506 and continue through the flow
diagram.
[0026] Some embodiments contemplate the irrigation fluid to be
continuously flowing at a low rate towards the eye 202 through the
aperture 110, where in step 514 the low flow rate is increased to a
high flow rate. Likewise, if in step 516 the aspiration flow has
returned to normal, the flow rate of irrigation fluid towards the
eye 202 is decelerated back to the low flow rate through the
aperture 110. Other embodiments contemplate that the irrigation
fluid is essentially not flowing through the aperture 110 if the
aspiration flow rate is normal.
[0027] Some embodiments contemplate the aperture 110 in a location
other than the sleeve hub 112, so long as the irrigation fluid can
flow to the eye 202 as described.
[0028] Some embodiments contemplate the one or more apertures 110
smaller in diameter than the irrigation port 102. Because the
irrigation fluid will flow through the point of least resistance,
the irrigation port 102 being of larger diameter (or otherwise
least resistance) will freely feed the eye 202 with irrigation
fluid as needed. Certain embodiments contemplate aperture 110
diameter opening of between 0.002 inches to 0.02 inches.
[0029] FIGS. 6A-6D illustratively depict alternative aperture
embodiments consistent with embodiments of the present invention.
FIG. 6A depicts an aperture insert tubing 602 extending from the
irrigation hub 112 that directs irrigation flow 304 towards the eye
202 parallel to the aspiration needle 106. One embodiment of FIG.
6A contemplates the tubing 602 being a "stent" that creates a rigid
opening to be maintained in a flexible irrigation sleeve 104, such
as if the irrigation sleeve were latex or some other elastic
material that would tend to close around a hole (an aspiration
hole). FIG. 6B depicts an aperture insert tubing 604 extending from
the irrigation hub 112 that directs irrigation flow 304 towards the
eye 202 at an angle tilted away from the aspiration needle 106.
FIG. 6C depicts an aperture insert tubing 606 extending from the
irrigation hub 112 that directs irrigation flow 304 towards the eye
202 at an angle tilted towards from the aspiration needle 106. FIG.
6D depicts an aperture insert tubing 608 (an irrigation aperture
embodiment) extending from the irrigation sleeve 104 that directs
irrigation flow 304 towards the eye 202 at a bend so not to be
obstructed by the aspiration needle 106. FIG. 6E depicts and
embodiment of the irrigation hub 112 extending from the handle 114.
In certain embodiments, the aperture insert tubing is conceived to
be composed, made of, metal or plastic with aperture port diameter
openings from between 0.002 inches to 0.02 inches with a length
between 0.005 inches to 0.5 inches.
[0030] Some embodiments contemplate the irrigation sleeve 104 being
comprised of a pliable material such as silicone, for example.
Other embodiments contemplate the irrigation sleeve 104 being rigid
with a pliable coating, such as silicone. Yet, other embodiments
contemplate the irrigation sleeve 104 being rigid with no pliable
coating whatsoever.
[0031] Some embodiments contemplate the aperture 110 possessing a
valve system that essentially immediately responds by opening the
aperture 110 to a reduction in irrigation fluid flow through the
irrigation port 102. Such a valve is contemplated to be mechanical
or electro-mechanical.
[0032] It is to be understood that even though numerous
characteristics and advantages of various embodiments of the
present invention have been set forth in the foregoing description,
together with the details of the structure and function of various
embodiments of the invention, this disclosure is illustrative only,
and changes may be made in detail, especially in matters of
structure and arrangement of parts within the principles of the
present invention to the full extent indicated by the broad general
meaning of the terms used herein. For example, the irrigation fluid
comprised of a salt solution that is osmotically balance with the
eye 202 is well known in the art and can be interchanged with other
fluids with similar viscosity while still maintaining substantially
the same functionality without departing from the scope and spirit
of the present invention. In another example, the aperture 110 can
be configured differently from one or more holes in the irrigation
sleeve hub 112 without departing from the scope and spirit of the
present invention, such as a tube configured differently than that
shown for example, so long as aperture 110 directs irrigation fluid
externally to the eye 202 at an accelerated rate when the
aspiration pathway 156 becomes blocked or partially blocked. Though
embodiments are described herein with an irrigation sleeve 104
concentrically surrounding the aspiration needle 106, other
embodiments contemplate the irrigation sleeve 104 configured
differently so long as irrigation fluid is delivered to an eye 202
within the scope and spirit of the present invention. The preferred
embodiments described herein are directed to a phacoemulsification
device 100, which accordingly is not intended for uses beyond the
scope and spirit of eye surgery.
[0033] It will be clear that the present invention is well adapted
to attain the ends and advantages mentioned as well as those
inherent therein. While presently preferred embodiments have been
described for purposes of this disclosure, numerous changes may be
made which readily suggest themselves to those skilled in the art
and which are encompassed in the spirit of the invention disclosed.
Accordingly, it is to be understood that even though numerous
characteristics and advantages of various aspects have been set
forth in the foregoing description, together with details of the
structure and function, this disclosure is illustrative only, and
changes may be made in detail, especially in matters of structure
and arrangement to the full extent indicated by the broad general
meaning of the terms in which the appended claims are
expressed.
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