WO2005086693A2

WO2005086693A2 - Microsurgical tubing with infusion cannula

Info

Publication number: WO2005086693A2
Application number: PCT/US2005/007094
Authority: WO
Inventors: Gregg D. Scheller; Michael D. Auld
Original assignee: Synergetics, Inc.
Priority date: 2004-03-05
Filing date: 2005-03-04
Publication date: 2005-09-22
Also published as: EP1737370A2; JP2007535341A; WO2005086693A3

Abstract

A length of malleable tubing (24) has proximal (56) and distal (58) ends, with the proximal end (56) being adapted for connection to a surgical light source, the distal (58) end being adapted for attachment to an ophthalmosurgery instrument. The tubing (24) has an interior bore that extends along the length of the tubing. A length of wire (72) or of hollow piping is secured to the tubing (24) along the tubing length. The wire (72) or piping is malleable and holds the tube in a bent configuration.

Description

MICROSURGICAL TUBING WITH INFUSION CANNULA AND CHANDELIER ILLUMINATOR

This patent application is a continuation-in-part of Application Serial No. 10/940,401, filed on September 14, 2004, and currently pending, and claims the benefit of Provisional Applications No. 60/550,671 filed March 5, 2004, and No. 60/550,794 filed March 5, 2004.

Background of the Invention

(1) Field of the Invention The present invention pertains to a malleable length of tubing that is primarily intended for use with ophthalmic surgery instruments. More specifically, the present invention pertains to a length of tubing having opposite proximal and distal ends, where the proximal end is adapted for connection to a surgical light source or a surgical fluid source, and the distal end is adapted for attachment to an ophthalmic surgery instrument. The tubing has an interior bore that extends along the length of the tubing. A length of wire or thin piping is secured to the tubing along the tubing length. The wire or piping is malleable, and bending the wire or piping into a bent configuration holds the tubing in the bent configuration. In alternate embodiments of the tubing, the length of wire or piping is secured to an interior surface of the tubing interior bore, or is contained in the side wall of the tubing between the bore interior surface and the tubing exterior surface. Both embodiments of the invention may also include manually operable clips and/or moveable supports on the tubing. (2) Description of the Prior Art In many ophthalmic surgery procedures, it is necessary that a light source be provided to illuminate the interior of the eye, and that an additional surgical instrument be provided that can provide either aspiration, liquid infusion, or both to the interior of the eye. In addition to the above, it is also often necessary that a separate incision be provided in the eye that receives the ophthalmic surgery instrument being manipulated by the surgeon. Each of these instruments secured to the eye typically have a length of tubing that extends from the instrument. For example, the light provided to the interior of the eye is typically transmitted by a length of tubing containing one or more optic fibers. The tubing distal end is secured to the eye with the optic fiber distal end extending into the eye. The tubing proximal end is communicated with a light source. Aspiration and/or infusion of the eye interior is typically provided by a length of tubing secured to the eye at its distal end and communicating with a source of aspiration and/or infusion at its opposite proximal end. Often the surgical instrument being used by the surgeon also has a length of tubing extending from the instrument. For example, a microsurgical laser probe has a length of tubing containing the optic fiber length that conducts the laser light to the instrument. It can be appreciated that the multiple lengths of tubing extending from the small area of the eye surgical site make it difficult for the surgeon to easily access the surgical site, and can add to the difficulty and mental strain of the surgeon in performing the surgery. Any modification to a microsurgical instrument that can organize the multiple lengths of tubing extending to the surgical site and simplify accessing the surgical site by the surgeon would provide a significant contribution to the field of ophthalmic surgery.

Summary of the Invention The present invention seeks to control the positioning of one or more lengths of tubing extending to a ophthalmic surgery site, and thereby facilitate the surgeon's access to the surgical site. Basically, the present invention provides a length of malleable ophthalmic surgery tubing that may be used with a variety of different microsurgical instruments. For example, the malleable tubing of the invention may be used with a microsurgical laser probe, an illuminator, and an aspiration/infusion cannula, to name only a few examples of surgical instruments with which the tubing of the invention may be used. The malleable ophthalmic surgery tubing is provided in any desired length that extends between opposite proximal and distal ends of the tubing. The distal end of the tubing is adapted for attachment to a surgical instrument such as the types described earlier. The proximal end of the tubing is adapted for attachment to a connector that connects the tubing proximal end to a source of illumination, aspiration and/or liquid infusion. The tubing has a hollow interior bore that extends along the length of the tubing. The interior bore is dimensioned to receive a length of optic fiber where the tubing is used with a source of illumination and a surgical instrument that provides light to the surgical site. In addition to the length of optic fiber, or in place of the length of optic fiber, the tubing interior bore also conducts aspiration and/or infused liquids between a source and the surgical site. The tubing is flexible along a majority of its length, and in particular the portion of the tubing length adjacent the surgical instrument. This enables the surgeon to easily manipulate the majority of the length of tubing. The surgical tubing of the present invention differs from prior art tubing in that a length of wire or slender piping is secured to the tubing along the tubing length. The wire or piping is bendable into a bent configuration or shape, where the wire or piping holds the tubing in the bent configuration or shape of the wire. This enables the portion of the tubing length adjacent the surgical site to be bent and moved to a position relative to the site where the length of the tubing does not interfere with easy access to the surgical site. The piping hollow interior bore may also be used to contain a length of optic fiber, or conduct a fluid to or from the surgical site. In this manner, the malleable ophthalmic surgery tubing of the present invention facilitates the surgeon's access to the surgery site. Brief Description of the Drawings Further features of the malleable ophthalmic surgery tubing of the invention are set forth in the following detailed description of the invention and in the following drawing figures wherein: Figure 1 is a plan view of one example of an ophthalmic surgery instrument employing the malleable tubing of the invention; Figure 2 is a cross-section view through the malleable ophthalmic surgery tubing of Figure 1 ; Figure 3 is an enlarged partial view of the distal end of the tubing of

Figure 1 ; Figure 4 is a plan view of a further embodiment of a surgical instrument employing the malleable ophthalmic surgery tubing of the invention; Figure 5 is an enlarged partial view of the distal end of the tubing of Figure 4; Figure 6 is cross-section of the malleable ophthalmic surgery tubing of Figure 4; Figure 7 is an enlarged partial view of the distal end of a variant embodiment of the instrument of Figure 5; and, Figure 8 is an enlarged partial view of the distal end of a variant embodiment of the instrument of Figure 6.

Detailed Description of the Preferred Embodiment of the Invention Figure 1 shows one embodiment of a microsurgical instrument, an illuminator, employing the malleable ophthalmic surgery tubing of the invention. Although the apparatus and method of the invention are described with reference to a microsurgical illuminator 12, it should be understood that the apparatus and method of the invention are equally well suited for use with other types of surgical instruments that include a length of tubing having an interior bore that contains and protects a length of optic fiber extending through the bore, and/or having an interior bore that communicates the surgical instrument with a source of aspiration and/or infusion fluids, as well as other types of surgical instruments. Thus, the description of the malleable ophthalmic surgery tubing of the invention being used with a particular type of surgical instrument is intended to be illustrative only, and should not be interpreted as limiting the use of the tubing of the invention with any one particular type of instrument. As shown in Figure 1, the microsurgical instrument 12 is basically comprised of the instrument tip 14 that projects illumination, a length of optic fiber 16 that extends through the instrument 12, a length of fiber tubing 18 that surrounds and protects a portion of the optic fiber 16, a length of fluid transmitting tubing 22, and the malleable ophthalmic surgery tubing 24 of the present invention. Because the malleable tubing 24 of the invention may be employed with a variety of different types of surgical instruments as explained earlier, the component parts of the microsurgical illuminator 12 shown in Figures 1 and 3 will not be described in detail. The illuminator tip 14 has a curved base plate or hilt 28 that is adapted to be secured to the surface of the eye at a desired surgical site. A portion 28' of the support plate projects asymmetrically outwardly from the optic fiber 16. This projecting portion 28' of the plate is accessible by the surgeon to be used in attaching the plate 28 at a surgical site. The base plate 28 projects radially outwardly from a center axis of the tip 14. The base plate 28 has a concave surface 30 that is positioned to engage the surface of the eye in orienting the tip 14 relative to the eye. The surface 30 is provided to conform to the eye wall radius. The plate 28 also stabilizes the tip 14 relative to the eye. A tubular cannula 32 projects a short distance from the concave surface 30 of the base plate 28. In the illustrated embodiment, the cannula 32 is formed as a 20 gauge needle having a beveled tip to facilitate insertion of the cannular through an eye incision. A hollow collar 34 projects from the opposite convex surface of the base plate 28. The collar 34 is secured to the tubing 24 with the tubing extending over the collar and abutting against the base plate 28. The tubing interior bore communicates with the aligned interior bores of the cannula 32 and the collar 34. The interior bores of the cannula 32 and collar 34 receive a distal end portion 36 of the optic fiber 16. The optic fiber 16 extends from its distal end portion 36 through the malleable ophthalmic tubing 24 of the invention, through a Y-connector 42, and through the optic tubing 18 to the proximal end portion of the optic fiber contained in a light source connector 44. The particular light source connector 44 shown in Figure 1 is only one example of a light source connector that could be employed with the surgical instrument of the invention. A conical tip 38 is formed at the optic fiber distal end. The conical configuration of the tip 38 disperses light across the surgical site. Other equivalent types of diffusing methods may be employed, for example providing a lens or providing spherical glass micro-beads at the fiber distal end. As best seen in Figure 3, the distal end portion 36 of the optic fiber is secured in the interior of the cannula 32 and collar 34 with the interior surfaces of the cannula 32 and collar 34 being spaced radially outwardly from the exterior surface of the fiber. This provides a fluid flow path through the cannula 32 and the collar 34 around the optic fiber distal end portion 36. This enables fluid to pass through the tubing 22 and the surgical instrument tip 14 with the fluid being discharged in the area of the optic fiber tip 38. In the illustrated embodiment, a single length of optic fiber 16 is shown. In variant embodiments of the invention, the singe length of optic fiber may be replaced with multiple lengths of optic fibers arranged in a bundle. A manually operable clip 46 is attached to the optic tubing 18. The clip 46 includes a sleeve 48 mounted around the optic tubing 18. The sleeve 48 is dimensioned to slide over the exterior surface of the optic tubing 18. The clip 46 is operable to removably secure the optic tubing 18 and the surgical instrument 12 to a separate object to support the instrument. As is conventional, with the light source connector 44 connected to a source of light, the optic fiber 16 transmits the light through the surgical instrument 12 to the distal end portion 36 of the optic fiber where the light is projected on the surgical site. The fluid tubing 22 extends from its distal end connected to the Y- connector 42 to its proximal end connected to a fluid source connector 52. The fluid source connecter 52 shown in Figure 1 is only one example of a fluid source connector that could be used with the instrument 12 of the invention. As is conventional, the fluid source connector 52 is adapted to be connected to a source of fluid, either air pressure, suction, or liquid, and transmits the fluid through the length of the fluid tubing 22, through the interior of the Y- connector 42, and through the malleable tubing 24 and the instrument tip 14. The malleable ophthalmic tubing 24 of the invention has a length with opposite proximal 56 and distal 58 ends. The overall length of the malleable tubing 24 can be chosen to best suit the instrument 12 for the particular surgical procedure for which it is to be used. The tubing 24 has an interior bore 62 that extends through the entire length of the tubing. The interior bore 62 is defined by a cylindrical interior surface 64 of the tubing. The tubing also has an opposite, generally cylindrical exterior surface 66. The tubing 24 is preferably constructed of a flexible material such as silicone. In the preferred embodiment the material is constant along the length of the tubing 24 and between the tubing interior surface 64 and exterior surface 66. In variant embodiments, other layers of materials may be added to reinforce the ophthalmic tubing or otherwise change the properties of the tubing. However, these variations of the tubing would not detract from the ability of the tubing to be bent and hold its bent configuration to be described. The malleable ophthalmic tubing 24 of the present invention differs from tubing of the prior art in that it is provided with a length of wire 72 that is secured to the tubing. The length of wire 72 extends along the tubing between a proximal end 74 of the wire at the tubing proximal end 56 and a distal end 76 of the wire at the tubing distal end 58. In the preferred embodiment, the wire 72 is a single stand of copper wire, although other types of materials may be employed. The single strand of wire 72 is preferred as it facilitates the ability of the surgeon to bend the wire in any desired configuration. In equivalent embodiments, multiple wires and braided wires could be used in lieu of the single wire 72. In each embodiment of the wire 72, the wire can be bent by the surgeon and will remain in its bent configuration. As seen in Figures 1, 2, and 3, the wire 72 is entirely contained in the side wall of the tubing 24 on one side of the tubing interior bore 62. As shown in Figure 2, the wire 72 is encapsulated in the material of the tubing side wall between the tubing interior surface 64 and the tubing exterior surface 66. The dimensioning of the wire 72 and the material of the wire is chosen to enable the wire to be bent in any desired configuration and to remain in its bent configuration. In addition, the wire 72, when bent into its bent configuration must also hold the malleable ophthalmic tubing 24 and the length of the optic fiber 16 in the bent configuration of the wire. With the construction of the microsurgical instrument 12 described above, it can be seen that the malleable ophthalmic tubing 24 can be bent into any desired configuration by the surgeon and remain in that configuration. This enables the surgeon to configure and position the length of tubing 24 in any of a plurality of desired configurations and/or positions to provide unobstructed access to the surgical site. Figures 4, 5, and 6 show a variant embodiment of the microsurgical instrument 82. The surgical instrument 82 shown is another type of microsurgical illuminator. However, as explained earlier, the malleable ophthalmic tubing of the invention may be employed with other types of surgical instruments. Because the basic construction of the surgical instrument is known, it will not be described in detail. The surgical instrument 82 is basically comprised of an instrument tip 84, a length of optic fiber 86, and a length of surgical tubing 88, a portion of which is the malleable ophthalmic surgery tubing 92 of the invention. The instrument tip 84, similar to the previously described embodiment, has a curved base plate 94 adapted for attachment to the surface of the eye at the desired surgical site. A cylindrical collar 96 projects from one side of the base plate 94. A hollow interior bore extends through both the collar 96 and the base plate 94 and receives a distal end portion 98 of the optic fiber 86. In a variant embodiment of the optic fiber distal end portion 98, a portion of the optic fiber adjacent the distal end is provided with a small bulge 100. The bulge 100 can extend outwardly from the entire circumference of the optic fiber, or could extend outwardly from only a portion or portions of the optic fiber circumference. The bulge 100 is provided on the optic fiber distal end 98 to provide an obstruction that resists the removal of the optic fiber end from an incision in the eye, and functions to secure the optic fiber distal end in the incision. The length of tubing 88 extends from the instrument tip collar 96 to a light source connector 102 at the opposite end of the tubing. As explained earlier, the light source connector 102 is only one type of connecter with which the surgical instrument 82 may be provided. As in the previously described embodiment, the surgical instrument 82 is also provided with a manually operated clip 104 mounted by a sleeve 106 for movement along a portion of the length of the tubing 88. Additionally, a V-shaped stabilizer or bipod support 108 is mounted on the exterior of the tubing 88 for sliding movement. The support includes a cylindrical sleeve 109 that is mounted to the exterior of the tubing 88. The sleeve 109 is dimensioned to slide over the tubing to adjustably position the sleeve on the instrument. The/sleeve 109 engages in a friction engagement with the exterior surface of the tubing 88 so that it will remain in its adjusted position along the length of the instrument. The support has a pair of bendable legs 110 that project outwardly from the sleeve 109. The pair of legs 110 are one piece that is bent in a V-shape and is mounted on the sleeve 109. The legs 110 project forwardly from the instrument tube 88, and can be bent in any desired configuration to conform the legs 110 to the surface of the patient's face around the eye to be attached to the patient's face by surgical tape or other equivalent means. Securing the support 108 to the patient's face stabilizes the optic fiber distal end 98 relative to the patient's eye. As in the previously described embodiment, the length of tubing 88 has an interior bore 112 that is defined by a cylindrical interior surface 114 of the tubing. The bore 112 extends through the entire length of the tubing and provides a protective surrounding for the optic fiber 86. The side wall of the tubing is defined between the tubing cylindrical interior surface 114 and a cylindrical exterior surface 116 of the tubing. The malleable portion of the tubing 96 is defined by a length of wire 122 contained in the portion of the tubing. The length of wire 122 is a single strand of wire that extends from a proximal end 124 of the wire to an opposite distal end 126 of the wire. The wire proximal end 74 defines the proximal end 128 of the malleable portion of the tubing and the wire distal end 76 defines the distal end 132 of the malleable portion of the tubing. This embodiment of the malleable tubing differs from the previously described embodiment in that an intermediate portion of the wire 72 is not secured to the tubing 92, but is free to move in the tubing interior bore 112. The entire length of the wire 122 extends through the tubing interior bore 112 and only the wire proximal end 124 and distal end 126 are secured to the tubing interior surface 114 by adhesives or other equivalent means. The length of wire 122 secured in the malleable portion of the tubing 92 enables the tubing portion to be bent in any desired configuration by the surgeon and positioned to provide the surgeon with unobstructed access to the surgical site. Figure 7 is a variant embodiment of the microsurgical instrument shown in Figures 1-3. Because many of the structural features of the instrument shown in Figure 7 are the same as those of the surgical instrument shown in Figures 1-3, the same reference numbers used to identify these structural features in Figures 1-3 are also used in Figure 7, with the reference numbers of Figure 7 being followed by a prime ('). The variant embodiment of the microsurgical instrument shown in Figure 7 makes use of the same instrument tip 14'. The optic fiber 16' extends through the instrument with the distal end portion 36' of the optic fiber in the instrument tip 14'. The cannula 32' projects from one side of the tip base plate 28' and the collar 34' projects from the opposite side. The optic fiber distal end 36' extends through the tip cannula 32'. The surgical instrument shown in Figure 7 basically differs from that shown in Figures 1-3 in that the malleable wire of the previously described embodiment is replaced with a length of malleable piping 142. The malleable piping 142 has a hollow interior bore 144 that extends through the length of the piping between a proximal end 146 and a distal end 148 of the piping. Unlike the malleable wire of the previously described embodiment, the piping 142 is contained in the interior bore 62' of the tubing and is not encased in the material of the tubing 24' itself. Furthermore, the length of the piping 142 extends for the entire length of the instrument with the piping proximal end 146 projecting adjacent either the light source connector 44 or the fluid source connector 52. This enables the piping proximal end 146 to be connected to a separate aspiration or vacuum source to provide aspiration or vacuum through the interior bore 144 of the piping. If an optic fiber is routed through the interior bore 144 of the piping 142, the piping proximal end 146 is adapted for connection to a light source. The piping distal end 148 is positioned adjacent the distal end of the tip cannula 32' where the aspiration or vacuum can be delivered proximate to the surgical site. As in the previously described embodiments of the invention, the malleable piping 142 enables the instrument length to be bent in any desired position or configuration and to hold the bent configuration. Like the embodiment of Figure 7, many of the structural features of the instrument shown in Figure 8 are the same as though of the surgical instrument shown in Figures 4-6. The same reference numbers used in identifying the structural features of the instrument of Figures 1-3 are also used in identifying the structural features of the instrument of Figure 8, with the reference numbers of Figure 8 being followed by a prime ('). The variant embodiment of the microsurgical instrument shown in Figure 8 makes use of the same instrument tip 84'. The optic fiber 86' extends through the instrument with the distal end portion 98' of the optic fiber in the instrument tip 84'. The fiber distal end portion 98' projects outwardly from the tip base plate 94'. The tip collar 96' projects from the opposite end of the base plate 94' and abuts against the distal end of the ophthalmic surgery tubing 92'. The surgical instrument of Figure 8 basically differs from that shown in Figures 4-6 in that the malleable wire of the previously described embodiment is replaced with a length of malleable piping 152, as in the embodiment of Figure 7. The malleable piping 152 has a hollow interior bore 154 that extends through the length of the piping between a proximal end 156 and a distal end 158 of the piping. The length of piping 152 is contained in the interior bore 112' of the length of tubing 92'. Like the Figure 7 embodiment, the length of the piping 152 extends for the entire length of the instrument tubing with the piping proximal end 156 projecting adjacent either the light source connector 44 or the fluid source connector 52. This enables the piping proximal end 156 to be connected to a separate aspiration or vacuum source to provide aspiration or vacuum through the interior bore 154 of the piping. If an optic fiber is routed through the interior bore 154 of the piping 152, the piping proximal end 156 is adapted for connection to a light source. The piping distal end 158 is positioned adjacent the distal end of the tip base plate 94' where the aspiration or vacuum delivered through the piping can be delivered proximate to the surgical site. As in the previously described embodiments of the invention, the malleable piping 152 enables the instrument length to be bent in any desired position or configuration and to hold the bent configuration. In a still further embodiment of the invention, the length of malleable wire would be held to the exterior surface of the length of optic fiber tubing by a tubular flexible outer jacket (not shown). The length of the wire will extend along the length of the optic fiber tubing as in the previously described embodiments, and the length of the outer jacket would also extend along the length of the optic fiber tubing. In the preferred embodiment, the outer jacket is constructed of a soft silicone that provides the jacket with its desired flexibility and securely holds the malleable wire to the exterior of the optic fiber tubing. When the optic fiber tubing and the malleable wire are bent, the outer jacket holds the tubing and the optic fiber adjacent the length of wire in the bent configuration. While the present invention has been described by reference to specific embodiments, it should be understood that modifications and variations of the invention may be constructed without departing from the scope of the invention defined by the following claims.

Claims

What is Claimed: 1. A surgical apparatus comprising: flexible tubing having a length with opposite proximal and distal ends, an interior bore extending through the tubing length, the tubing having an interior surface that surrounds the bore and an opposite exterior surface; a wire secured to the tubing and extending along the tubing length, the wire being bendable into a bent configuration where the wire holds the tubing in the bent configuration of the wire; a light source connector communicating with the tubing proximal end and the tubing interior bore; and, an optic fiber attached to the light source connector and extending through the tubing, the optic fiber being bendable into a bent configuration where the wire holds the optic fiber in the bent configuration.

2. The apparatus of Claim 1 , further comprising: a surgical instrument attached to the tubing distal end.

3. The apparatus of Claim 2, further comprising: the surgical instrument having an interior bore that communicates with the tubing interior bore.

4. The apparatus of Claim 2, further comprising: a fluid source connector communicating with the tubing proximal end and the tubing interior bore.

5. The apparatus of Claim 1 , further comprising: the wire extending through the tubing interior bore inside the tubing interior surface.

6. The apparatus of Claim 1 , further comprising: the wire extending through the tubing length inside the tubing exterior surface.

7. The apparatus of Claim 1 , further comprising: the wire extending through the tubing length between the tubing exterior surface and the tubing interior surface.

8. The apparatus of Claim 1 , further comprising: the tubing having a sidewall that surrounds the interior bore with the tubing interior surface and exterior surface being on the sidewall; and, the wire extending along the tubing length inside the sidewall.

9. The apparatus of Claim 1 , further comprising: a clip attached to the tubing for adjusting movement of the clip along the tubing length, the clip being manually operable to removably secure the tubing to a separate object.

10. The apparatus of Claim 1 , further comprising: a stabilizer attached to the tubing for adjusting movement of the stabilizer along the tubing length, the stabilizer having a pair of bendable legs that project from the tubing and are securable to a separate object to support the tubing.

11. A surgical apparatus comprising: flexible tubing having a length with opposite proximal and distal ends and an interior bore extending through the tubing length; an optic fiber having a length with opposite proximal and distal ends extending through the tubing interior bore, the tubing interior bore forming a fluid flow path that extends along at least a portion of the optic fiber length in the tubing interior bore; and, a support plate attached to the tubing distal end, the support plate having a surface that is adapted for placement against an exterior surface of an eye to position the optic fiber distal end in an interior of the eye and communicate the tubing interior bore with the interior of the eye.

12. The apparatus of Claim 11 , further comprising: the support plate surface being a concave surface that is complementary to the exterior surface of the eye.

13. The apparatus of Claim 11 , further comprising: the optic fiber distal end projecting from the support plate surface.

14. The apparatus of Claim 13, further comprising: the optic fiber distal end having a light diffusing tip.

15. The apparatus of Claim 13, further comprising: the optic fiber distal end having a bulge projecting outwardly from the optic fiber.

16. The apparatus of Claim 11 , further comprising: a support mounted on the tubing for movement of the support along the tubing length, the support having a pair of bendable legs.

17. The apparatus of Claim 11 , further comprising: a tubular needle projecting from the support plate surface, the needle having an interior bore that communicates with the tubing interior bore and the optic fiber distal end extends through the needle bore.

18. The apparatus of Claim 11 , further comprising: the flexible tubing having three sections that are connected together by a Y-shaped connector.

19. The apparatus of Claim 18, further comprising: a first tubing section is adapted to be connected to a source of fluid, a second tubing section is adapted to be connected to a source of light, and a third tubing section connects with the first and second tubing sections through the Y-shaped connector and is adapted to be moved to a bent configuration and to hold the bent configuration.

20. The apparatus of Claim 11 , further comprising: the support plate having a portion that projects asymmetrically outwardly from the optic fiber distal end whereby the support plate portion is accessible for attachment of the support plate portion to the eye by separate attachment means.