CN101502460B - 根据手持设备的割尖上的负载控制手术系统的方法 - Google Patents

根据手持设备的割尖上的负载控制手术系统的方法 Download PDF

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CN101502460B
CN101502460B CN2009101182311A CN200910118231A CN101502460B CN 101502460 B CN101502460 B CN 101502460B CN 2009101182311 A CN2009101182311 A CN 2009101182311A CN 200910118231 A CN200910118231 A CN 200910118231A CN 101502460 B CN101502460 B CN 101502460B
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米哈伊尔·伯克尼
拉斐尔·乔丹
迈克尔·莫甘
安·亚德洛斯基
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Abstract

手术系统能够感应堵塞的起始或其他手术事件以及堵塞中止的瞬间。为帮助避免尖端的过热,利用冲洗流速系统确定眼睛的大致温度并且如果预测到过热情况,自动地降低给予手持设备的功率。可选地或例外地,系统监视由手持设备汲取的功率,该功率表明尖端上的切割负载,并且自动地调整尖端的功率或行程以补偿尖端上增加的负载。

Description

根据手持设备的割尖上的负载控制手术系统的方法
本申请是爱尔康公司提交的、国际申请日为2005年3月21日、国际申请号为PCT/US2005/009274、中国国家申请号为200580009298.1、发明名称为“根据手持设备的割尖上的负载控制手术系统的方法”的发明专利申请的分案申请。
技术领域
本发明一般涉及眼科手术领域,并且尤其涉及控制白内障超声乳化吸除术系统的手术参数的方法。
背景技术
通过经由称作角膜的透明外层部分传导光线并且经由晶状体将图像聚焦到视网膜上,人眼起着提供视力的作用。聚焦图像的质量取决于包括眼睛的尺寸和形状、以及角膜和晶状体的透明度的许多因素。当年龄或疾病导致晶状体变得不太透明时,由于可被传送到视网膜的减弱的光线,视力降低。这种缺陷在医学上被称为白内障。白内障的可接受治疗是通过手术去除白内障,并且用人工晶体(IOL)替换晶状体。在美国,大多数内障性的晶状体利用被称作白内障超声乳化吸除术的手术技术被去除。在该过程期间,细小的割尖被插入患病的晶状体中并且用超声波震动。震动的割尖液化或乳化了晶状体,以使晶状体可被从眼睛中吸出。一旦被移去,患病的晶状体被IOL替代。
适用于眼科手术进程的典型的超声波手术设备包括用超声波驱动的手持设备(handpiece)、附装的割尖(cutting tip)、冲洗套管以及电子控制台。手持设备组件通过电缆或连接器以及软管被连接到控制台。外科医生控制传递给手持设备的割尖的超声波功率,并且通过踩踏脚蹬来请求功率直到控制台上设置的最高功率,在任何给定时间将功率应用于组织。软管经由手持设备组件提供冲洗液给眼睛并且从眼睛抽出吸入液体。
手持设备的操作部分是连接到一组压电晶体的、固定在中心的中空谐振棒或角状物。晶体由控制台控制并且在白内障超声乳化吸除术期间提供驱动角状物和连接的割尖的超声波振动。晶体/角状物组件通过挠性安装被悬挂在中空体或手持设备的外壳内。手持设备体终止于减小的直径部分或机身的远端处的头锥。头锥被从外部穿线以接受冲洗套管。同样,角状物钻在其末端被从内部穿线以接收割尖的外部穿线。冲洗套管还具有被旋到头锥的外部穿线上的内部穿线的钻。调整割尖以使尖端仅射出预先确定的量通过冲洗套管的开口端。
使用中,割尖的尖端和冲洗套管被插入角膜、巩膜或其他位置中预先确定宽度的小切口中。通过晶体驱动的超声波喇叭,一个已知的割尖在冲洗套管内沿着其纵轴用超声波震动,从而乳化该处所选择的组织。割尖的中空钻与角状物中的钻通信,该角状物随后与从手持设备到控制台的吸管通信。其他合适的割尖包括产生既有纵向又有扭转振动的压电元件。这种割尖的一个例子在美国专利号6,402,769(Boukhny)中被描述,其内容在这里被通过参考引入。
控制台中的减压或真空源经由割尖的开口端、割尖和角状物钻以及吸管从眼睛中抽出或吸出乳化的组织,然后到收集设备中。乳化的组织的吸出借助于通过冲洗套管的内表面与割尖之间的小环形间隙被注入到手术位置中的盐溶液或其他冲洗液。
一种已知的手术技术是将到眼睛的前房中的切口做得尽可能小以便减小诱发散光的风险。这些小的切口引起紧紧地挤压冲洗套管而阻止震动尖端的非常紧的创口。冲洗套管与震动尖端之间的摩擦产生热。尖端过热与灼伤组织的危险通过尖端内流动的吸出液体的冷却作用来减小。
当尖端变得阻塞或为乳化的组织所阻塞时,吸出流可被减小或消除,让尖端变热,从而减小冷却而导致温度升高,其可灼伤切口处的组织。此外,在堵塞期间,较大的真空可在吸出管中形成以致当堵塞最终中止时,较大的液体量可快速地从眼睛抽吸,可能导致眼球萎陷或对眼睛的其他伤害发生。
已知的设备已使用检测抽吸真空中大量增长、以及基于具体预先确定的抽吸真空度来检测堵塞的传感器。根据该检测的堵塞,可减小手持设备的功率以及/或可增加冲洗和吸出流率。见美国专利号5,591,127,5,700,240和5,766,146(Barwick,Jr.等),此处通过参考引入其全部内容。然而,这些设备使用固定的抽吸真空度来触发来自系统的响应。该固定度是基于所选择的真空上限的固定百分比的阈值。然而,这种系统的使用和有效性是有限的,因为其直到达到预置的抽吸真空度才做出响应。Boukhny等的美国专利6,179,808(其全部内容此处作为参考被引入)描述了这样一种系统,即当温度超过预先确定的限度时,按照根据测量或估算的冲洗流来计算,从而减小信号幅度以及/或占空比。
已知的堵塞感应系统可因此被改进,因为实际上,抽吸真空度在堵塞的不同阶段期间在很短时间内可能改变。将该预置真空限度设置太低导致系统过早地改变其工作参数,并且在堵塞已清除后保持那些参数。将限度设置太高可导致系统太接近于堵塞的实际出现时而不能改变其设置,以及在堵塞的清除之前将其设置改变回正常。此外,当割尖被阻塞时,切割效率是最大化的,因此当检测到阻塞情况时,增加功率使切割效率最大化,但增加了使环绕尖端的组织过热的危险。
进一步地,整个手术期间,存在当尖端按压晶状体以便乳化晶状体组织的时候,并且存在当尖端没有与晶状体接触的时候。然而,超声波能量一直保持到外科医生释放脚蹬,甚至在当晶状体物质被吸出,外科医生将尖端从晶状体移开或晶状体离开尖端时。手术的效果降低,并且浪费的能量可导致尖端的不必要加热,其可增加对切口处组织不希望的灼伤的可能性。
因此,对更准确地检测到手术吸出系统中堵塞的出现并且清除的堵塞检测系统存在着持续的需要。该信息可被控制系统使用来据此调整功率,例如堵塞期间增加功率以便提高超声波尖端的切割效率,以及/或当相对温度达到预先确定的阈值时减小功率以便防止过热。通过增加检测尖端何时不再与晶状体物质接触并且自动地调整功率的负载检测系统,可进一步提高切割效率。
发明内容
根据一个实施例,控制手术系统的方法包括建立阈值功率电平,基于切割功率间歇之间的非零感应功率间隔期间由手持设备汲取的电压和电流,监视超声波手持设备的割尖上的负载。由手持设备汲取的功率与阈值功率电平相比,并且根据需要调整,例如,如果通过调整超声波手持设备的输出的幅度或行程,由手持设备汲取的功率超过阈值功率电平。
在可选实施例中,控制手术系统的方法包括建立阈值功率电平,以及基于切割功率间歇之间的非零感应功率间隔期间由手持设备汲取的电压和电流,监视超声波手持设备的割尖上的负载。由手持设备汲取的功率与阈值功率电平相比,并根据需要调整。进一步地,建立阈值温度,并且监视通向手持设备的管中的冲洗压力。计算冲洗液的流率以及确定冲洗液流率的吸热量。比较或分析吸热量与提供给手持设备的功率以确定眼睛的温度,将其与阈值温度相比。根据需要调整提供给手持设备的割尖的功率。
根据另一个实施例,控制手术系统的方法包括建立阈值功率电平,以及基于切割功率间歇之间的非零感应功率间隔期间由手持设备汲取的电压和电流,监视超声波手持设备的割尖上的负载。由手持设备汲取的功率与阈值功率电平相比,并且如果由手持设备汲取的功率超过阈值功率电平的话,调整该功率。功率可通过改变超声波手持设备的幅度或行程(stroke)来调整。此外,确定手术系统的操作参数的变化率,并且基于该变化率确定堵塞的阶段。基于所确定的堵塞的阶段,根据需要调整提供给手持设备的割尖的功率。
在各种实施例中,在感应间隔或者脉冲处于小于切割脉冲的功率电平的功率电平期间,通过监视电压和电流执行负载监视。在脉冲或间隔的基本恒定的部分期间或在感应间隔或脉冲的衰减期间,可监视电压和电流。感应脉冲或间隔可具有固定的或可变的期间。感应脉冲或间隔可刚好在切割脉冲之前或紧随其后,或可以是从切割脉冲中分离出的脉冲或间隔。负载监视也可以在非零感应功率间隔的衰减期间执行。因为感应间隔处于较低的功率电平,所以一些切割程度可发生。
通过调整切割脉冲的行程或继非零感应间隔之后的间隔,可调整功率。在各种实施例中,通过调整超声波手持设备的输出的占空比,可做出功率调节。灵敏度调整可被用于调整提供给割尖的功率。
也可以使功率调节与计算冲洗液的流率与确定吸热容量相关以确定眼睛的温度,其与阈值温度相比以判断功率是否应该被调整。
附图说明
现在参考附图,其中类似的附图标记自始至终代表相应的部件,并且在其中:
图1是可被用于各种实施例的示例性手术系统的透视图;
图2是示出了手术系统的部件的方框图;
图3A-3B图解了可被用于各种实施例的示例性超声波手持设备;
图4是图解了根据模式以及一个或多个工作参数的变化率,调整传递到手持设备的功率的方法的一个实施例的流程图;
图5图解了可被用于本发明的实施例的堵塞的阶段;
图6图解了处于图5中所示的堵塞的不同的阶段,抽吸真空以及冲洗压力的模式;
图7是图解了调整功率以阻止换能器尖端过热的方法的一个实施例的流程图;
图8A-8B是图7中所示实施例的一个实施例的更详细的流程图;
图9图解了具有等幅和不同非导通时间、以及由脚蹬的按下控制的不同非导通时间的示例性突发模式脉冲;
图10图解了具有不同占空比、以及由脚蹬的按下控制的占空比的示例性脉冲方式脉冲;
图11图解了根据一个实施例,切割脉冲之间的非零感应功率等级;
图12是图解根据功率、阈值以及灵敏度计算调整功率的方法的流程图;
图13是可被用于一个实施例的手持设备供电系统的示意图;
图14图解了根据另外的实施例,具有持续期间比图11中所示的感应功率电平持续期间短的非零感应功率电平;
图15图解了根据另外的实施例,切割等级之间以及具有超时改变的持续期间的非零感应功率电平;
图16图解了根据另一个实施例,切割脉冲之间分立的非零感应功率脉冲以及切割与感应功率脉冲之间为零的功率;
图17图解了根据另外的实施例,切割脉冲之间期间的分立的感应功率脉冲,以及比图16中所示的感应功率脉冲的持续期间短的感应功率脉冲的期间;
图18图解了根据另一个实施例,具有超时改变的持续期间的分立的非零感应功率脉冲;
图19图解了根据另一个实施例,刚好在切割脉冲之前的非零感应功率脉冲;
图20图解了根据另一个实施例,刚好在切割脉冲之后的非零感应功率脉冲;
图21图解了根据另一个实施例,切割脉冲之间期间的非零感应功率脉冲以及基于衰减的感应功率脉冲所做的感应功率测量;
图22图解了根据较慢衰减的感应功率脉冲所做的测量;
图23图解了根据较快衰减的感应功率脉冲所做的测量;以及
图24图解了根据另一个实施例,在从高电平到低电平切换切割脉冲后,根据切割脉冲的衰减速率所做的感应测量。
具体实施方式
本说明书描述了例如在白内障超声乳化吸除术中使用的控制手术系统的方法的实施例。这些实施例提供了手术系统,通过检测吸出系统、冲洗系统或其组合的压力级的变化,其能够检测诸如堵塞的手术事件的阶段,例如堵塞的起始、预堵塞情况、完全堵塞以及堵塞何时中止。通过监视抽吸真空或冲洗压力级如何变化,堵塞的起始以及中止可被准确地检测到。一旦检测到堵塞,或者通过增加尖端的行程或者通过增加脉冲式的超声波功率的占空比,可给手术系统编程以增加手持设备的可用功率。
为帮助避免尖端的过热,手术系统监视冲洗流速并且如果预测到过热情况,自动地减小手持设备的功率。可选地,或者此外,由手持设备汲取的功率量可被监视,其表明尖端上的切割负载。该信息可被用于自动地调整尖端的功率或者行程(位移)以补偿尖端上的负载变动。在下面的描述中,参考了附图,但是不是限制的目的,而是图解说明了可被利用的特定的实施例。
实施例可在市场上可买到的手术系统或控制台上通过适当的硬件和软件控制来实现。一个适当的系统100在图1中被一般地图解并且代表从Alcon Laboratories公司,6201 South Freeway,Q-148,FortWorth,Texas 76134买到的
Figure G2009101182311D00071
视觉系统。
图2更详细地图解了一个示例性控制系统100。控制系统100被用来操作超声波手持设备112并且包括控制台114,其具有控制模块或中央处理器116,吸出、真空或螺形压缩泵118,手持设备电源供给120,冲洗压力传感器(“IPS)122以及阀门124。控制台114可以是任何市场上可买到的诸如
Figure G2009101182311D00072
手术系统的手术控制台,也可从AlconLaboratories公司买到。虽然示出了冲洗压力传感器,但是本领域技术人员将认识到也可使用流率传感器,而不是压力传感器,。
各种超声波手持设备112以及割尖可被利用,包括但不限于美国专利号3,589,363;4,223,676;4,246,902;4,493,694;4,515,583;4,589,415;4,609,368;4,869,715;4,922,902;4,989,583;5,154,694以及5,359,996中所描述的手持设备以及尖端,此处其全部内容作为参考被引入。为说明的目的,而不是限制,示例性手持设备在图3A-B中示出。
再参考图2,中央处理器116可以是任何合适的微处理器、微控制器、计算机或数字逻辑控制器。泵118可以是螺状的、膜片式的、Venturi或其他合适的泵。电源供给120可以是任何合适的超声波驱动器,诸如装在ACCURUS手术系统,也可以从Alcon Laboratories公司买到。阀门124可以是诸如螺线管制动收缩阀的任何适合的阀门。诸如盐水的冲洗液的浸剂可由盐水源126提供,其可以是任何市场上可买到的用瓶或袋提供的冲洗溶液。
使用中,冲洗压力传感器122通过冲洗管130,132和134被连接到手持设备112以及浸剂液体源126上。冲洗压力传感器122测量从源126到手持设备112的冲洗液的压力,并且通过电缆136将该信息提供给中央处理器116。冲洗液压力数据可被中央处理器116使用以利用软件指令控制控制台114的工作参数。例如,中央处理器116可以通过电缆140改变电源供给120的输出,其中所述电源供给120的输出通过电力电缆142发送到手持设备112和尖端113。中央处理器116也可使用由冲洗压力传感器122提供的数据以通过电缆144改变泵118的操作。泵118通过管146从手持设备112吸出液体并且通过管148送到收集容器128中。中央处理器116也可使用由冲洗压力传感器122提供的数据并且使用电源供给120的输出来给用户提供可听音。有关这种手术系统的补充细节可在美国专利号6,179,808(Boukhny等)以及6,261,283(Morgan等)中被找到,此处其全部内容作为参考被引入。
在一个实施例中,控制台114基于堵塞事件的阶段可控制提供给手持设备112的功率量。更具体地,基于抽吸真空度、冲洗压力级、或者抽吸真空和冲洗压力级二者做出功率调节。改变例如可以是抽吸真空以及/或冲洗压力的增减的变化率。
提供给手持设备的功率量的调整可以如图4中所示做出。开始,在步骤400中,经过一段时间周期,检测堵塞或者其他手术事件期间手术操作参数的模式。操作参数可以是抽吸真空以及/或冲洗压力。也可以检测到两个压力,然而,为说明而不是限制的目的,主要参考单个操作参数。在步骤410中,操作参数的值以及/或变化率可以被确定或者计算。基于该计算,确定堵塞的阶段。在步骤430中,根据需要,基于堵塞的阶段,提供给手持设备112的割尖的功率量可以被调整。
更具体地,在堵塞之前、期间以及之后,跟随可检测的模式之后的抽吸真空以及冲洗压力级已被确定。该模式可被用于识别堵塞的阶段并且据此调整提供给手持设备112的功率。
如图5所示,典型的堵塞事件具有下面的阶段:堵塞起始500;预堵塞510;完全堵塞520;堵塞中止530;以及恢复540。术语“起始”一般被用于指堵塞的最开始或者初始阶段,而“预堵塞”一般被用来指在堵塞起始之后以及在完全堵塞之前的时刻。换言之,“起始”一般被用于指堵塞的发展的开始,而“预堵塞”一般被用于指堵塞成长成完全堵塞的阶段。
图6更详细地图解了检测到的抽吸真空和冲洗压力的模式。对于每个阶段,抽吸真空被表示为时间(t)上(mmHg)而冲洗液或者盐水的压力被表示为相同时间(t)上(cmH20)。下面更详细地讨论这些阶段。
如图6所示,堵塞起始事件或者情况500的特点在于自真空以及冲洗压力为相对稳定或恒定期间(600以及605)的非堵塞的状态下,抽吸真空中的快速增长610以及冲洗压力中的快速增长615。换言之,真空以及冲洗压力以其增加的速率>0。如所示,起始500通过增加的抽吸真空以及冲洗压力被识别。然后冲洗压力可略减小(617)并且稳定(618)。然而,抽吸真空的级开始增加,并且在冲洗压力保持稳定的时候持续增加。
在堵塞起始事件500之后,堵塞发展或成长为预堵塞事件或情况510。如图6所示,预堵塞事件510的特点在于抽吸真空中的增长率的减缓620,以及相对稳定的冲洗压力625。因此,抽吸真空的增长率以及冲洗压力两者都逐渐地减小到零的速率。换言之,真空以及冲洗压力两者都变得相对稳定。
预堵塞情况510成长为完全堵塞520。完全堵塞的特点在于最大限度630。进一步地,冲洗压力是稳定的635。
在完全堵塞520之后,堵塞中止530。堵塞中止事件530的特点在于抽吸真空640以及冲洗压力645两者的快速减小。如图6中所示,在堵塞的中止之后,抽吸真空和冲洗压力级两者都快速地减小(相应的速率<0)。在快速减小之后,抽吸真空的衰减的速率减小642,而冲洗压力级可反向略向上然后稳定648。
在堵塞中止520之后是堵塞恢复阶段530。恢复阶段530的特点在于抽吸真空650和冲洗压力655的减少率的持续减缓,最终达到基本恒定水平。换言之,真空和冲洗压力的衰减速率从负数逐渐地增加到近似0。
基于测试的手术系统,图6中所示的真空和冲洗压力的模式对于各个手术系统是一致的并且利用各种已知的数字信号处理方法可以被检测到。在一个实施例中,真空和冲洗压力利用相关法被检测到。例如,通过计算预先定义的模式与从手术系统的实际抽吸真空或冲洗压力传感器读数之间的线性相关,可以检测堵塞的阶段。定义堵塞起始的抽吸真空的预先定义模式例如可以是由线性增加的真空读数的12点紧随的相同真空读数的4点。
例如,两个序列xi与yi之间的线性相关是一个序列通过线性变换可被如何接近地变换成另一个的衡量:
yi=axi+b
其中:a=线性相关系数,b=偏移量。
假定两个序列,线性相关R计算如下:
R = Σ i = 0 N x i y i - Σ i = 0 N x i Σ i = 0 N y i N Σ i = 0 N x i 2 - ( Σ i = 0 N x i ) 2 N Σ i = 0 N y i 2 - ( Σ i = 0 N y i ) 2 N
其中:N-相关长度(即,序列中的点的数量)
线性相关系数计算如下:
a = Σ i = 0 N x i y i - Σ i = 0 N x i Σ i = 0 N y i N Σ i = 0 N x i 2 - ( Σ i = 0 N x i ) 2 N
根据一个实施例的方法包括计算手术系统的使用期间,所收集的抽吸真空以及/或冲洗压力传感器读数的采样序列与代表所讨论的堵塞事件的预定义模式之间的线性相关。所计算的相关值反映了采样序列与预定义模式之间的相似性,用最高可能值1.0代表绝对符合。表明足够相关的值的范围最好为0.80与0.99之间。
一旦建立匹配或可接受的相关性,诸如预堵塞和堵塞恢复的一些手术事件的必然性为高,并且系统的手术参数可以根据需要被调整。
对于诸如堵塞起始和堵塞中止的事件,基于测试值的改变的速率,模式匹配应该被核准。利用线性相关系数可估算真空和冲洗压力的变化率,线性相关系数反映了测试序列以及预定义模式的斜率比,并且因此可以被用来估算采样序列是否具有具体的事件的足够变化率。
在一个实施例中,变化率是导数(ΔValue/ΔTime),或值中的变量对某一时刻的直接计算。对于不同设置(例如,不同的抽吸泵速率)的给定系统,足够速率的标准可以凭经验建立。
对于要求既在模式匹配又在变化率上核准的情况,当两个情况都满足时,认为堵塞事件将被检测到。一旦检测到堵塞事件,可以调整系统的手术参数。所描述的方法可被应用于检测堵塞序列(堵塞起始、预堵塞、堵塞、堵塞中止以及恢复)中的所有事件。通过检测抽吸真空以及/或冲洗压力级的模式,功率应该当时调整的定时可被准确地确定。因此,实施例比依赖于阈值或预先确定的抽吸真空度来识别完全堵塞的已知系统更准确。
在进一步的实施例中,利用卷积而不是相关性可实现模式的匹配。因此,本领域普通技术人员将理解此处所讨论的相关性、导数以及卷积技术仅仅是说明性例子而没有意指限制。
在进一步的实施例中,提供给手持设备的功率量可被调节以防止尖端113的过热,其可导致破坏眼睛组织。该实施例被称为ThermalWatchTM并且在图7中被一般地图解。
在步骤700中,阈值温度被建立。在步骤710中,诸如盐水的冲洗液126的源的压力被监视。在步骤720中,计算或确定由来自被监视的冲洗液源126的冲洗液的流速组成。在步骤730中,确定吸收热量的冲洗液的流率的容量,或冲洗液的吸热量。在步骤740中,比较或分析所确定的吸热量与提供给手持设备112的功率。基于该比较或分析,眼睛或其他组织的温度在步骤750中被确定。
例如,以离散时间步骤通过执行温度计算可确定眼睛的大约温度,其中通过将先前温度估算乘以冷却系数(其<1)得到当前时刻处的估算温度,然后加上在时间间隔期间供给的功率乘以功率系数,减去时间间隔期间的流率乘以流率系数。
在步骤760中,比较估算的眼睛温度与阈值温度。在步骤770中,基于估算的温度是否超过阈值或超过阈值预先确定的量,根据需要,调整提供给超声波手持设备112的割尖113的功率量。例如,如果估算的温度超过阈值,通过减小超声波信号的幅度以及/或减少超声波信号的占空比,可以减小提供给手持设备的功率,而如果估算的温度低于阈值可以保持或增加功率。
图8图解了实现图7中所示的过程的实现。参考图8,在步骤800中,做出判断Thermal WatchTM特性是否启用。如果没有启用ThermalWatchTM,那么在步骤805中,利用线性超声波控制功能系统操作。换言之,所供给的超声波功率通过控制台设置以及外科医生踏下脚蹬来控制。
如果Thermal WatchTM被启用,那么在步骤810中,由外科医生设置的阈值被注意到或由系统读取。阈值可以是无单位的并且从“断开”到“最高”可以用许多步骤。
在步骤815中,系统监视冲洗液的压力(“IPS读数”)以及/或在步骤820中,监视冲洗液源瓶子126的高度。这些冲洗液压力参数,表明冲洗液的流率,即,在步骤825中,某一时刻上冲洗液的数量。已知冲洗液流动的速率,该冲洗液流动的速率的热量冷却容量可以是近似的(步骤830)。用时间函数表示的流动函数F(t)可约等于穿过射流管的压力衰减的线性函数:F(t)=R(Po-P(t)),其中Po是冲洗源压力(例如,冲洗瓶子高度),P(t)是冲洗压力传感器读数,以及R是压力源与冲洗压力传感器之间的射流管电阻。对于给定射流(即可消耗的)配置凭经验建立电阻R。以上近似值产生稳态流情况的准确结果。为提高瞬时响应的估算精度,指数衰减校正可被如下加到上面的方程式中:
F ( t ) = R [ ( 1 + δ ) ( P 0 - P ( t ) ) - δ 1 τ 0 ∫ - ∞ t e - τ τ 0 ( P 0 - P ( τ ) ) dτ ]
其中δ是瞬时系数,以及τo是近似的射流管的时间常数。对于给定的射流(即可消耗的)配置可凭经验建立两个值。为可消耗的Alcon
Figure G2009101182311D00132
系统建立的采样值为:δ=0.3,τo=1.3秒。上面的方程式可容易地转换成容许方法的实际实现的离散形式。
在步骤835中还监视由手持设备112(即,Ultrasonic或“US PowerLevel”)的超声波割尖113产生的热量。然后在步骤840中,比较冲洗液流动的热量冷却容量的近似值与由超声波割尖113产生的热量,以确定眼睛的近似温度。在步骤845中做出判断,眼睛的温度是否比预置阈值高或者是否在阈值的某个容限范围之内。例如,容限可以是阈值以内(例如低于)3华氏度,如图8中所示。本领域技术人员将理解取决于所期望的系统的灵敏度,也可以使用其他预先确定的量或者容限。
如果眼睛的温度不在容限(例如,3华氏度)内或者不超过阈值,则可使用线性超声波控制函数(步骤850)。然而,如果眼睛的温度在容限范围之内或者超过阈值,那么在步骤855中系统利用算法来计算适当的占空比。控制算法例如可以是诸如PI(比例-积分)或PID(比例-积分-导数)控制算法的标准线性控制算法。控制算法也可以是非线性的控制算法,诸如有或者没有滞后的继电式控制器。本领域技术人员将理解各种算法可被用于不同的应用中。
例如,在步骤860中,开始做判断系统当前是否以连续模式运行。在连续模式中,连续的电源供应不中止地被应用于手持设备。如果系统处于连续模式,则在步骤865中,系统将运行方式从连续的切换到脉冲的超声波功率。如果系统不在连续模式中,则在步骤870中做出判断系统是否以突发或脉冲方式运行。
参考图9a-9b,突发模式提供了超声波功率的一系列周期性的、固定宽度的、等幅的脉冲900,每个后面有“断开”时刻910。本领域技术人员将理解,实际上,图9a-9b及其他图中所示的脉冲不是“理想的”脉冲。更确切些,不同状态之间的脉冲渐变段或斜坡例如应归于电容和电感。因此,图9a-9b及其他图中所示的理想的或模型矩形脉冲为说明和图解的目的而提供,实际上脉冲不具有理想的矩形形状。
固定宽度脉冲900之间的非导通时间910例如经由脚蹬的按下,由外科医生的输入控制。换言之,在突发模式中,每个脉冲900具有固定的“导通”时间以及可变的“断开”时间。“断开”时间通过调整脚踏板或脚踏开关的位置来改变。
例如,图9a-9b图解了脚踏开关的四个位置:当脚踏板最初处于位置1并且进一步按下到位置2时,非导通时间910降低,当被从位置2按下到位置3时,降低更进一步。因此,随着脚踏板被进一步按下,一段时间中的固定宽度的、等幅的脉冲的数量增加了。随着脚踏板被进一步按下,非导通时间最终等于导通时间。这种情况下,脚踏板从位置3到位置4的进一步按下导致脉冲的幅度被增加,而保持相同的非导通时间910。换言之,在非导通时间与导通时间相同之后,可产生脉冲振幅,从而增加了提供给手持设备的功率。
再参考图8和9a-9b,如果系统处于突发模式,通过减少功率“导通”时间或增加功率“断开”时间,在步骤875中,可调整具有相同脉冲宽度的超声波功率的脉冲数,从而,在给定时间内给超声波尖端113提供较少的固定宽度脉冲以及较少功率,以便冷却尖端113。如果系统不在突发模式中,在步骤880中,系统处于脉冲方式。
参考图8以及10,如果系统处于脉冲方式,那么脉冲1000的幅度保持恒定,并且通过调整提供给手持设备112的功率脉冲的占空比,在步骤885中可调整提供给手持设备的功率。在理想的矩形脉冲1000的序列中,脉冲期间对脉冲周期的比或“高”脉冲级的期间对“高”和“低”级(一个周期)的期间总和的比为占空比,表示为分数或百分比。因此,可改变每个等幅脉冲1000的持续期间(例如,变得更窄或更宽)以改变占空比,并且因此改变提供给手持设备的功率量。
可选地,如果系统以连续模式运行(860),并且眼睛温度高于阈值,则电源可被关掉直到眼睛温度降低于阈值。进一步地,如果系统以突发或脉冲方式运行并且眼睛的温度高于阈值,由于脉冲的余量,可关掉电源,并且下一个功率脉冲可被推迟,如果必要的话,直到眼睛温度减少到低于阈值。
本领域技术人员将理解Thermal Watch特性可被用于脉冲的不同类型,例如,连续的、脉冲的、突发的以及具有不同模式的脉冲,诸如稍后在该详细说明中所描述的以及图14-24中所示的脉冲,如前所述,因为Thermal Watch起调节器的作用,其周期性地确定提供的功率量,而不考虑脉冲类型或脉冲模式,以及所确定的功率量如何与阈值比较以及功率量如何与阈值比较。
当检测到堵塞事件时,可做类似的功率调节。例如,在一个实施例中,通过在超声波占空比中增加“导通”时间或通过减少电源“断开”时间可增加提供给尖端113的功率,以便增加手持设备112的切割效率。利用Thermal Watch特性在尖端113变得过热之前,可监视眼睛的温度以减小电源“导通”时间,或增加电源“断开”时间。因此,实施例提供了必要时(例如,当堵塞事件发生时)有效地增加功率的方法,然而根据需要,有效地监视以及降低功率,以免尖端113的过热以及灼伤或伤害眼睛组织。
可选实施例涉及负载检测系统和方法,通常被称为“按需要通电”,如果确定将请求太多的功率,限制或驳回由外科医生请求的功率量,以免破坏眼睛组织。系统可检测到割尖113何时不再与晶状体组织接触或与具有不同硬度的晶状体组织的不同的部分接触,并且自动地调整提供给手持设备的功率量。
如先前所讨论的,手持设备112中的一个或多个压电晶体由电源供给提供的电源驱动。晶体震动,其随后导致手持设备中的针震动并且发出超声波能量。外科医生定位针以使超声波能量被提供给诸如晶状体的眼睛组织,例如来破碎白内障。单独的吸出系统被用来移去组织碎片。通过,例如按下脚踏开关或其他开关激励器,外科医生可要求一定的功率量被提供给尖端113。在手术期间,系统将电压的低电平应用到晶体,导致它们发出少量超声波能量。然后,在这个条件下测量晶体两端的电压和通过晶体的电流。电压和电流值被用来计算由手持设备汲取的功率值。当尖端113与更硬的组织或物质(诸如白内障的晶状体)接触时,超声波手持设备112力图汲取更多功率以便保持给定的行程(幅度)。基于典型的白内障手术中接触通过尖端遇到的材料,该功率的增加已被发现是可以较低的功率设置测量的。在改进的脉冲方式中,在用于切割组织的较高功率脉冲之间,少量的功率被应用于尖端112。换言之,在低功率期间应用少量的功率。
例如如图11中所示,脉冲方式类型驱动信号包括切割间隔1100之间的高的交变间隔或切割功率1100a-e(通常1100)以及低的交变间隔或感应功率1110a-e(通常1110)。然而,感应间隔1110的幅度大于零。换言之,感应功率在切割间隔之后没有减小到零。
在图解的实施例中,切割间隔1100和感应间隔1110的持续期间是近乎相同的。在感应间隔期间执行电压和电流测量,以便使由手持设备112在感应间隔期间汲取的功率量与尖端113处的负载1130相关。因为少量功率仍应用于尖端,某一程度的切割也可发生,然而,切割主要发生在较高功率的切割间隔期间。因此,虽然该详细说明涉及″感应″间隔,感应和切割都可发生在该间隔期间。
由手持设备112汲取的功率量在感应间隔1110期间确定,然后用于调整下一个或随后的切割间隔1100的功率。基于检测到的功率和外科医生的要求,成比例地调整功率。换言之,如果在尖端处检测到较高负载,在下一个切割间隔上,由外科医生要求的功率的较高部分(可能全部)将被传递。同样,如果检测到较低的负载,在下一个切割间隔1110期间,由外科医生要求的功率的较小部分(可能没有)将被传递。
例如,在感应间隔1110a期间所检测到的功率被用来成比例地调整下一个切割间隔1100b的功率电平。类似地,在感应间隔1110b期间所检测到的功率被用来成比例地调整下一个切割间隔1100c。因此,切割功率1100被连续地调节,以补偿手持设备112的超声波尖端113上的不同负载1130。
如图11中所示,感应间隔1110的功率电平对时间是相对恒定的。然而,感应间隔1110可改变,但是不应为零,或者如此低以至于尖端处的负载不能被检测到。感应间隔1110的功率电平可改变,例如取决于系统参数和测量设备的灵敏度。因此,利用非零感应期间的实施例与已知的“脉冲方式”驱动系统相反,已知的“脉冲方式”驱动系统通常使用交变的高功率和零功率脉冲,即,“导通”和“断开”之间的切换,而不是高功率的和低功率或“导通”和“低功率.”之间的切换。
由于超声波手持设备和割尖中的变化,负载1130感应特性应该在每个手术开始时校准。例如,在“调准循环”(tune cycle)期间可执行校准,在此期间手持设备尖端113处于装满冲洗液的测试箱中。此时,超声波功率以感应功率设置被应用于尖端113。在此基准情况之下,由手持设备汲取的功率量112作为阈值或“空载”情况被保存在控制系统存储器中。如果必要的话,随着手术进行,控制系统114可使用自动阈值调整,基于手术期间所测量的负载1130调整该阈值。
负载感应特性还容许外科医生控制由控制系统114所做的调整的灵敏度。更具体地说,灵敏度调整是线性或系数调整,其设置当感应到小于满负载时所做的功率减小的增益。一旦设置了阈值和灵敏度,手持设备112的功率基于算法而可被调整。
图12和13图解了算法和系统的实施例,该系统根据用于基于所感应的电压和电流负载1130执行这些功率行程或振幅变化的算法操作。最初,在步骤1200中确定阈值1355。如先前所讨论的,阈值功率1355是固定值,在冲洗溶液或盐水或其他参考环境中操作超声波机头112之后,阈值功率1355被确定。换言之,当没有组织将被切割时,阈值功率1355代表基准功率。
由割尖113汲取的功率在步骤1210中被监视。电源供给120被连接到手持设备112并且经由电源线1302提供功率给尖端113。功率控制系统1300经由连接器1303-1305被连接到电源供给120的输入和输出。连接器1304和1305被连接到电源供给120的输出,并且连接器1303被连接到电源供给120的输入。
所示的功率控制系统1300包括电压和电流的反馈1310和1311。反馈单元1310和1311被耦合到连接器1304和1305。在感应间隔1110期间获得的电压和电流测量结果基于手持设备112中的压电晶体上所置的应力。如果针或尖端113遇到更多对切割的抵抗(高负载),电压以及/或电流的幅值可增加,而如果针或尖端113遇到更多容易切割的组织(较低的负载),则电压以及/或电流的数值可减小。由反馈1310和1311在每个感应间隔1110期间获得的电压和电流值被提供给相应的均方根(“RMS”)转换器1320和1321。
RMS转换器1320和1321确定所定义的时间周期上平均电压幅值和平均电流幅值。这些均方根值被提供给模拟到数字的(“A/D”)转换器1330和1331,这些转换器将代表相应的测量到的模拟电压和电流的数字信号提供给微处理器1340。
微处理器1340可以是如以上所讨论的相同的微处理器116或单独的微处理器或控制器。数字电压和电流值通过A/D转换器1330和1331提供给微处理器1340。微处理器1340中的软件根据由A/D转换器1330和1331提供的值,按照功率(“P”)=电压(“V”)x电流(“I”),计算1350在感应间隔1110期间检测到的“感应”功率1352。因此,不必对诸如相位和谐振的非线性属性作出说明,计算包括线性计算。然后,将感应功率1352与阈值或基准功率1355比较。
当手持设备112切割组织需要功率时,即,当手持设备112被应用于某物而不是基础材料或诸如盐水的液体时,所计算的感应功率1352超过阈值或基准功率1355。感应功率1352与阈值功率1355的比较被用来确定将被提供给手持设备112的功率应该被如何调整,如果有的话,在步骤1240中的下一个切割间隔期间,根据通过手持设备112的尖端113遇到的组织的特性。该比较乘以定标因子1356,其中所述定标因子1356存储在手持设备中,或者存储在将感应功率1352超过阈值功率1355的量与检测到的满负载的分数1357相关联的软件中。定标因子1356例如可以根据系统先前的操作凭经验确定。
除了该阈值比较与百分比负载计算之外,灵敏度调整或系数1360由外科医生设置,以表明在下一个切割间隔期间根据感应功率1352超过阈值功率1355的量,由外科医生请求的功率的多少部份应该提供给尖端。灵敏度系数1360从0到1,或者被通常表示为%值,例如,20%、50%或85%。这些值对于外科医生代表为断开、低、中、高或者其它的定标或示值。在步骤1250中,由(感应电压-阈值)x定标因子计算所得到的值乘以灵敏度系数1360。所请求功率1370(例如,如由脚踏开关1375的级指示)的更大量被提供给具有较高灵敏度系数而不是具有较低的灵敏度系数的手持设备112。例如,如果外科医生通过脚踏板1375请求“X”功率量1370,则取决于灵敏度系数1360,该“X”功率1370的一些、全部、或者没有一部分可被提供给手持设备112。
因此,实际上提供给手持设备112的功率1380可小于或者相同于由外科医生通过脚踏板1375的按下所请求的功率量1370。因此,实施例利用线性关系和计算、阈值确定和基于灵敏度系数的线性计算,以便调整提供给手持设备112的功率量1380。
图11图解了一个包括用于图12和13中所示的按要求提供功率的系统的切割和感应间隔的脉冲图形。图11中所示的脉冲图形包括相对恒定以及近乎相同持续期间的切割和感应间隔。在可选实施例中,如图14-24中所示,不同的脉冲图形可被用于不同的切割以及感应间隔。为了图解不同的切割和感应脉冲以及间隔,在没有相应的负载的情况下显示脉冲,然而,本领域技术人员将理解基于手持设备的尖端处的负载,根据需要来调整切割间隔的幅度。该详细说明涉及“间隔”和“脉冲”。脉冲是开始于以及结束于零功率的信号,而间隔可以被认为是脉冲的一部分,并且因此,或者开始或者结束于零功率。然而,为了该详细说明的目的,这些术语是可互换的,因为它们都提供了感应功率的持续期间和切割功率的持续期间。因此,“间隔”意欲包括“脉冲”,而“脉冲”意欲包括“间隔”。
参考图14,在一个可选实施例中,感应间隔1110的持续期间在时间上近乎相同而比切割间隔1100的持续期间短。在进一步的实施例中,如图15所示,感应间隔1110的持续期间经过一段时间可以改变,以使它们比切割间隔短、与切割间隔期间几乎相同、或者比切割间隔长。例如,感应间隔1110的持续期间可以被调节,以适应信号噪声比(S/N)和系统响应。较长的感应间隔1110可提供更好的S/N比和更多的延迟响应。因此,可以选择感应间隔1110的持续期间来与系统部件和能力相协调。
参考图16,在进一步的可选中,感应间隔1110可以刚好位于分立的切割间隔1100之前。例如,在感应间隔1110期间,功率从零电平增加到低功率电平。紧随感应间隔1100之后的是切割间隔1100。切割间隔1100处于比感应间隔1110高的功率电平。在切割间隔1100之后,功率归零,并且间隔序列可被重复。图17图解了类似的配置,除了高功率切割脉冲1100紧随一段零功率之后。感应间隔1110紧跟随较高功率切割间隔1100,然后继之以零功率,根据需要其可被重复。
图18图解了另一个实施例,其中分立的低功率、感应脉冲1110在分立的较高功率切割脉冲1100之间被触发。在该图解的实施例中,切割和感应脉冲1100和1110具有几乎相同的持续期间。图19图解了另一个可选实施例,其利用分立的感应脉冲1110和切割脉冲1100,并且在其中感应脉冲1110的持续期间比切割脉冲1100的持续期间短。图20图解了进一步的实施例,在其中分立的感应脉冲1110具有变化的持续期间并且在切割脉冲1100之间。
图21图解了进一步的可选实施例,其包括分立的感应脉冲1110和切割脉冲1100,并且其中电压和电流数据在感应脉冲1110的衰减2100期间获得。该实施例在图22和23中被更详细地图解。不同于如图11中所示确定负载,可以设置系统确定感应间隔脉冲1110衰减到某一水平所花费的时间。衰减速率可以受尖端上的负载的影响。例如,较大的负载将导致感应脉冲衰减更快,而较小的负载将导致感应脉冲衰减更慢。图22显示了由于较小负载花费较长时间衰减的感应脉冲,图23图解了由于较大负载衰减更快的感应脉冲。该衰减技术也可被应用于其他脉冲图形,包括紧随切割间隔之后的感应间隔,例如图17中所示的感应间隔。
感应脉冲或者间隔衰减到某一水平所要求的时间可以与尖端处的负载相关。这例如可以利用交叉参考衰减速率和尖端处的负载的查阅表来完成。该衰减和负载信息然后可以被用来调整下一个切割脉冲或者间隔的功率电平,如果必要的话。例如,参考图22和23中的参考点C,图23中所示的脉冲的衰减速率比图22中所示的脉冲的衰减速率快。因此,在跟随图22中所示的感应脉冲之后的下一个切割脉冲期间所供给的功率量可小于在跟随图23中所示的感应脉冲之后的下一个切割脉冲期间所供给的功率量,因为由于尖端处的较大负载,图23中所示的脉冲衰减的更快。衰减速率分析可以被重复以连续地调整下一个切割脉冲或者间隔期间提供给尖端的功率。
根据进一步的实施例,切割和感应脉冲可以在不同频率上。例如,切割脉冲可以特定频率被应用,而感应脉冲可以切割脉冲频率的谐波之一被应用。例如,切割脉冲可被以大约40kHz应用,而感应脉冲可被以诸如80kHz或者120kHz的谐波之一应用。
本领域技术人员将理解的是,与示例性感应和切割间隔模式一样提供图11和14-23,而不是意欲限制,因为对于不同的系统和应用,根据需要可以调整感应和切割间隔。进一步地,本领域技术人员将理解的是,在较低的功率感应间隔期间,感应和一些切割程度都可以发生,因为与在较高功率切割间隔期间发生的切割相比,虽然切割量小,但是感应以非零级发生并且发生一些切割。本领域技术人员还将理解,Thermal Watch特性可以被用于这些不同脉冲图形,因为ThermalWatch考虑供给的功率量而不依赖于具体的脉冲图形。
参考图24,在进一步的可选实施例中,切割脉冲1100的衰减速率2400可以与尖端处的负载相关。基于切割脉冲1100的幅度,可以期望采样衰变脉冲2400的末端2410,因为衰减切割脉冲的功率电平在衰减期开始时可能太高,从而导致干扰功率和电流测量。切割脉冲衰减到某一级所要求的时间可以利用查阅表而被交叉参考,以使衰减速率可以与尖端处的负载相关。该衰减和负载信息然后可以被用来调整下一个切割脉冲的功率电平,如果必要的话。
虽然在上述描述中已涉及各种实施例,本领域普通技术人员将认识到,在没有背离实施例的范围的情况下,可以对所描述的实施例做非实质的修改、变更和替换。例如,本领域普通技术人员将认识到各种可能性和实施例可以分别地或者组合地被运行。例如,在一个可选实施例中,涉及确定抽吸真空以及/或冲洗压力中的变化的实施例可以与图7和8中所示的“Thermal Watch”实施例以及/或与图9-11中所示的“Power On Demand”实施例结合。类似地,参考图7和8所描述和所示的“Thermal Watch”实施例可以与参考图9-11所描述的和所示的“Power On Demand”实施例结合。因此,实施例可以一起或者分别操作以提供所期望的系统功能。

Claims (78)

1.一种控制系统(100),包括:
超声波手持设备,所述超声波手持设备具有切割组织的割尖;以及
控制台(114),其用于
建立阈值功率电平;
通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔在切割功率间隔之间;
比较由所述超声波手持设备汲取的功率量与所述阈值功率电平;以及
如果由所述超声波手持设备汲取的功率超过所述阈值功率电平,通过调整所述超声波手持设备的输出的幅度或行程,调整提供给所述超声波手持设备的割尖的功率量。
2.根据权利要求1的控制系统,其中所述阈值功率电平基于在盐水中操作的割尖。
3.根据权利要求1的控制系统,其中所述控制台监视由所述超声波手持设备汲取的功率量,所述功率量通过所述超声波手持设备汲取的电流与电压相乘的线性计算而确定。
4.根据权利要求1的控制系统,其中所述超声波手持设备的输出的占空比保持恒定或由外科医生控制。
5.根据权利要求1的控制系统,其中所述控制台监视以比切割功率间隔或脉冲的功率电平低的功率电平所执行的负载。
6.根据权利要求1的控制系统,其中所述控制台调整提供给所述超声波手持设备的割尖的功率量包括:调整功率量直到由用户请求的功率的最大量。
7.根据权利要求1的控制系统,其中所述控制台调整功率量包括:调整继所述非零感应功率间隔之后的切割脉冲或间隔的行程。
8.根据权利要求1的控制系统,其中所述控制台利用灵敏度系数调整将被提供给所述割尖的功率量。
9.根据权利要求1的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔具有与所述切割功率间隔几乎相同的持续期间。
10.根据权利要求1的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔比所述切割功率间隔更长或更短。
11.根据权利要求1的控制系统,其中所述控制台通过监视具有固定持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
12.根据权利要求1的控制系统,其中所述控制台通过监视具有可变持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
13.根据权利要求1的控制系统,其中所述控制台通过监视作为切割脉冲之间的分立脉冲的多个非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
14.根据权利要求1的控制系统,其中所述控制台通过监视刚好在切割间隔之前的非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
15.根据权利要求1的控制系统,其中所述控制台通过监视紧随切割间隔之后的非零感应功率间隔期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
16.根据权利要求1的控制系统,其中所述控制台通过监视非零感应功率间隔的衰减期间由所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载。
17.根据权利要求16的控制系统,其中所述控制台使非零感应功率间隔的衰减速率与由所述超声波手持设备引起的负载相关联。
18.根据权利要求1的控制系统,其中所述超声波手持设备在切割间隔期间切割组织,也在监视负载期间切割组织。
19.一种控制系统(100),包括:
超声波手持设备,所述超声波手持设备具有切割组织的割尖;以及
控制台(114),其用于:
建立阈值功率电平;
通过监视非零感应功率间隔期间被所述超声波手持设备汲取的电压与电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔在切割功率间隔之间;
比较被所述超声波手持设备汲取的功率量与所述阈值功率电平;
如果由所述超声波手持设备汲取的功率超过所述阈值功率电平,通过调整所述超声波手持设备的输出的幅度或行程,调整提供给所述超声波手持设备的割尖的功率量;
建立阈值温度;
监视到所述超声波手持设备的冲洗管中的压力;
计算冲洗液的流率;
判断对于所计算的冲洗液的流率的吸热量;
基于所述确定的吸热量以及提供给所述超声波手持设备的功率量,确定眼睛的温度;
将所述确定的眼睛的温度与所述阈值温度相比较;以及
基于所述确定的眼睛的温度与所述阈值温度的比较,调整提供给所述超声波手持设备的割尖的功率量。
20.根据权利要求19的控制系统,其中所述控制台调整功率量包括:调整所述超声波手持设备的输出的占空比。
21.根据权利要求19的控制系统,其中所述控制台调整功率包括:调整所述超声波手持设备的输出的行程或幅度。
22.根据权利要求19的控制系统,其中所述控制台在所述确定的眼睛的温度超过所述阈值温度的情况下减小功率。
23.根据权利要求19的控制系统,其中所述控制台在所述确定的眼睛的温度低于所述阈值温度的情况下保持或增加功率。
24.根据权利要求19的控制系统,其中所述阈值功率电平基于在盐水中操作的割尖。
25.根据权利要求19的控制系统,其中所述控制台监视由所述超声波手持设备汲取的功率量,所述功率量通过由所述超声波手持设备汲取的电流和电压相乘的线性计算而确定。
26.根据权利要求19的控制系统,其中所述超声波手持设备的输出的占空比保持恒定。
27.根据权利要求19的控制系统,其中所述控制台监视以比切割功率间隔或脉冲的功率电平低的功率电平所执行的负载。
28.根据权利要求19的控制系统,其中所述控制台调整提供给所述超声波手持设备的割尖的功率量包括:调整功率量直至由用户请求的功率的最大量。
29.根据权利要求19的控制系统,其中所述控制台调整功率量包括:调整继非零感应间隔之后的切割脉冲或间隔的行程。
30.根据权利要求19的控制系统,其中所述控制台利用灵敏度系数,调整将被提供给割尖的功率量。
31.根据权利要求19的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔具有与所述切割功率间隔几乎相同的持续期间。
32.根据权利要求19的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔比所述切割功率间隔更长或更短。
33.根据权利要求19的控制系统,其中所述控制台通过监视具有固定持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
34.根据权利要求19的控制系统,其中所述控制台通过监视具有可变持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
35.根据权利要求19的控制系统,其中所述控制台通过监视作为切割脉冲之间的分立脉冲的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
36.根据权利要求19的控制系统,其中所述控制台通过监视刚好在切割间隔之前的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
37.根据权利要求19的控制系统,其中所述控制台通过监视紧随切割间隔之后的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
38.根据权利要求19的控制系统,其中所述控制台通过监视非零感应功率间隔的衰减期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
39.根据权利要求38的控制系统,其中所述控制台使非零感应功率间隔的衰减速率与由所述超声波手持设备引起的负载相关联。
40.根据权利要求19的控制系统,其中所述超声波手持设备在切割间隔期间切割组织,也在监视负载期间切割组织。
41.一种控制系统(100),包括:
超声波手持设备,所述超声波手持设备具有切割组织的割尖;以及
控制台(114),其用于
建立阈值功率电平;
通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔在切割功率间隔之间;
比较由所述超声波手持设备汲取的功率量与所述阈值功率电平;以及
如果由所述超声波手持设备汲取的功率超过所述阈值功率电平,通过调整所述超声波手持设备的输出的幅度或行程,调整提供给所述超声波手持设备的割尖的功率量;
确定所述控制系统的第一操作参数的变化率;
基于所述第一操作参数的变化率确定堵塞的阶段;以及
基于所述确定的堵塞的阶段,调整提供给所述超声波手持设备的割尖的功率量。
42.根据权利要求41的控制系统,其中所述第一操作参数的变化率是抽吸真空的变化率。
43.根据权利要求41的控制系统,其中所述第一操作参数的变化率是冲洗压力的变化率。
44.根据权利要求41的控制系统,其中所述控制台确定所述控制系统的第二操作参数的变化率。
45.根据权利要求44的控制系统,其中所述控制台基于对所述第一操作参数以及所述第二操作参数的变化率的确定,来确定堵塞的阶段。
46.根据权利要求44的控制系统,其中所述第一操作参数为抽吸真空,而所述第二操作参数包括冲洗压力。
47.根据权利要求41的控制系统,其中所述控制台识别堵塞的起始或初步指示。
48.根据权利要求41的控制系统,其中所述控制台确定所述控制系统的第二操作参数的变化率,并且
所述控制台基于涉及第一以及第二操作参数的确定,确定堵塞的阶段,
所述第一操作参数包括冲洗压力,所述第二操作参数包括抽吸真空,堵塞的起始通过增加真空以及冲洗压力来识别。
49.根据权利要求41的控制系统,其中所述控制台识别预堵塞情况。
50.根据权利要求49的控制系统,其中所述第一操作参数包括抽吸真空,所述预堵塞情况通过增加的抽吸真空而被识别。
51.根据权利要求50的控制系统,其中所述控制台在预堵塞情况之后,以比堵塞的起始与预堵塞情况之间的时间段期间的速率慢的速率增加所述抽吸真空。
52.根据权利要求41的控制系统,其中所述控制台确定所述控制系统的第二操作参数的变化率,并且其中
所述控制台基于所述第一与第二操作参数确定堵塞的阶段,所述第一操作参数为冲洗压力,所述第二操作参数为抽吸真空。
53.根据权利要求52的控制系统,其中所述控制台通过增加抽吸真空以及基本恒定的冲洗压力识别预堵塞情况。
54.根据权利要求53的控制系统,其中所述控制台以比堵塞的起始与预堵塞情况之间的时间段期间的速率慢的速率增加在预堵塞情况期间的抽吸真空。
55.根据权利要求41的控制系统,其中所述控制台识别完全堵塞。
56.根据权利要求41的控制系统,其中所述控制台确定所述控制系统的第二操作参数的变化率,并且其中所述控制台基于对涉及第一与第二操作参数的确定而确定堵塞的阶段,所述第一操作参数包括冲洗压力,所述第二操作参数包括抽吸真空,中止通过减少的抽吸真空以及减少的冲洗压力来识别。
57.根据权利要求56的控制系统,其中所述第一操作参数包括抽吸真空,恢复是通过抽吸真空的减少率的减缓来识别的。
58.根据权利要求56的控制系统,其中所述第一操作参数包括冲洗压力,恢复是通过冲洗压力的减少率的减缓来识别的。
59.根据权利要求58的控制系统,其中所述控制台确定所述控制系统的第二操作参数的变化率,并且其中所述控制台基于对涉及所述第一与第二操作参数的确定而确定堵塞的阶段,所述第一操作参数包括冲洗压力,所述第二操作参数包括抽吸真空,恢复期具有基本恒定的抽吸真空以及基本恒定的冲洗压力。
60.根据权利要求41的控制系统,其中所述控制台确定识别以下各项中的一项:
堵塞的起始,
跟随起始之后的预堵塞情况,
跟随预堵塞情况之后的完全堵塞,
完全堵塞的中止,和
跟随中止之后的恢复。
61.根据权利要求41的控制系统,其中所述控制台调整功率包括:调整所述超声波手持设备的输出的占空比。
62.根据权利要求41的控制系统,其中所述控制台调整功率包括:调整所述超声波手持设备的输出的幅度或行程。
63.一种控制系统(100),包括:
超声波手持设备,所述超声波手持设备具有切割组织的割尖;以及
控制台(114),其用于
建立阈值功率电平;
通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔在切割功率间隔之间;
比较由所述超声波手持设备汲取的功率量与所述阈值功率电平;以及
如果由所述超声波手持设备汲取的功率超过所述阈值功率电平,通过调整切割功率间隔的持续期间,调整提供给所述超声波手持设备的割尖的功率量。
64.根据权利要求63的控制系统,其中所述阈值功率电平基于在盐水中操作的割尖。
65.根据权利要求63的控制系统,其中所述控制台监视由所述超声波手持设备汲取的功率量,所述功率量通过由所述超声波手持设备汲取的电流和电压相乘的线性计算而确定。
66.根据权利要求63的控制系统,其中所述控制台监视以比切割间隔或脉冲的功率电平低的功率电平所执行的负载。
67.根据权利要求63的控制系统,其中所述控制台调整提供给所述超声波手持设备的割尖的功率量包括:调整功率量直至由用户请求的功率的最大量。
68.根据权利要求63的控制系统,其中所述控制台利用灵敏度系数调整将被提供给割尖的功率量。
69.根据权利要求63的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔具有与切割功率间隔几乎相同的持续期间。
70.根据权利要求63的控制系统,其中所述控制台通过监视非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载,所述感应功率间隔比所述切割功率间隔更长或更短。
71.根据权利要求63的控制系统,其中所述控制台通过监视具有固定持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
72.根据权利要求63的控制系统,其中所述控制台通过监视具有可变持续期间的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
73.根据权利要求63的控制系统,其中所述控制台通过监视作为切割脉冲之间的分立脉冲的多个非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
74.根据权利要求63的控制系统,其中所述控制台通过监视刚好在切割间隔之前的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
75.根据权利要求63的控制系统,其中所述控制台通过监视紧随切割间隔之后的非零感应功率间隔期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
76.根据权利要求63的控制系统,其中所述控制台通过监视非零感应功率间隔的衰减期间由所述超声波手持设备汲取的电压和电流,监视所述超声波手持设备的割尖上的负载。
77.根据权利要求76的控制系统,其中所述控制台使非零感应功率间隔的衰减速率与由所述超声波手持设备汲取的负载相关联。
78.根据权利要求63的控制系统,其中所述超声波手持设备在切割间隔期间切割组织,也在监视负载期间切割组织。
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