JPH05300921A - Cataract operating device - Google Patents

Abstract

PURPOSE:To control crushing force according to the hardness of the nucleus of the lens and to efficiently suck the crushed matter. CONSTITUTION:This operating device has an ultrasonic probe 1 which generates ultrasonic waves, a suction section 4 which sucks the crushed matter M crushed by this ultrasonic probe 1, a foot switch 10 which generates an operation signal by an operator's operation and a control section 2 which forms the control signals CS1, CS2 to the ultrasonic probe 1 and the suction section 4 based on the operating signal OS of the foot switch 10. The control of the control section 2 of the cataract operating device includes the range where both of the intensity of the ultrasonic waves of the ultrasonic probe 1 and the suction quantity of the suction section 4 increase and decrease according to the treading down quantity of the foot switch 10.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cataract surgery device using ultrasonic waves.

[0002]

2. Description of the Related Art Cataract surgery using ultrasonic waves is also called lens emulsification. Conventional cataract surgery devices include the devices of the following two types (1) and (2). Alternatively, in another cataract surgery device, these two types of devices (1) and (2) can be combined and switched for operation.

(1) The pressure (suction pressure) for sucking a nucleus that has already been crushed in the lens changes in accordance with the amount of depression of a foot switch or the like, but the strength of ultrasonic waves for crushing the nucleus is The set value remains the same regardless of how much the foot switch is depressed.

(2) Contrary to the device of the system of (1), the intensity of ultrasonic waves changes according to the depression amount of a foot switch or the like, but the intensity of suction pressure remains the set value. It is constant regardless of how much the foot switch is depressed.

In the device of the type (1), the hardness of the nucleus of the crystalline lens is almost constant, and the suction force is adjusted to shorten the operation time.

The device of the type (2) adjusts the crushing force when the hardness of the nucleus of the lens is uneven.

[0007]

In the method (1), the efficiency of crushing the nucleus is poor.

In the method (2), even if the operator further depresses the foot switch to intensify the ultrasonic wave for crushing the nucleus, the force for sucking the crushed nucleus remains at the value initially set. .. Therefore, the crushed nuclei cannot be sucked efficiently.

It is an object of the present invention to provide a cataract surgery device capable of efficiently sucking crushed nuclei and shortening the operation time.

[0010]

The present invention provides an ultrasonic probe (1) for generating ultrasonic waves, and an ultrasonic probe (1).
The suction unit (4) for sucking the crushed material (M) crushed by the step, the foot switch (10) for generating an operation signal by the operation of the operator, and the operation signal (O) of the foot switch (10).
S) and a control unit (2) that forms control signals (CS1, CS2) to the ultrasonic probe (1) and the suction unit (4), and the control of the control unit (2) is performed by a foot switch. Based on the operation signal of (10), the foot switch (1
Ultrasonic probe (1) according to the depression amount (D) of 0)
The cataract surgery device is characterized by including a range in which both the intensity of the ultrasonic wave and the suction amount of the suction unit (4) increase and decrease.

Preferably, in the present invention, the control section (2) is
The ultrasonic intensity of the ultrasonic probe (1) is controlled so as to increase or decrease according to the depression amount (D) of the foot switch (10), and the suction amount of the suction unit (4) is controlled by the ultrasonic wave. When the intensity of the ultrasonic wave of the probe (1) becomes equal to or lower than a predetermined intensity, control is performed so that the suction force is substantially constant regardless of the depression amount (D) of the foot switch (10). It is a cataract surgery device characterized in that it is configured.

Preferably, in the present invention, the suction force that becomes substantially constant regardless of the amount of depression (D) of the foot switch (10) is set to a value sufficient to suck the cortex (50) of the lens (22). It is a cataract surgery device characterized in that

[0013]

[Operation] The strength of the ultrasonic wave and the suction amount (also called suction force) according to the depression amount (D) of the foot switch (10)
But increase and decrease at the same time. As a result, the core is crushed according to the hardness of the core, and the fragments of the crushed core are sucked efficiently.
When the intensity of ultrasonic waves is equal to or lower than a predetermined intensity, the suction force is substantially constant regardless of the depression amount (D) of the foot switch. With this constant suction force, the residual cortex is suctioned.

[0014]

FIG. 1 shows a preferred embodiment of the cataract surgery device of the present invention.

The cataract surgery device comprises an ultrasonic probe 1, an output control unit 2, a suction unit 4, a perfusion control unit 6, a perfusion bottle 8,
A foot switch 10 is provided. The output control unit 2, the suction unit 4, and the perfusion control unit 6 form a main body 12.

The ultrasonic probe 1 is also called a handpiece and has a casing 14, an insertion portion 16 and a vibrating portion 18. The casing 14 is a portion that the operator holds with his / her hand.
The insertion section 16 and the vibration section 18 are adapted to be inserted into the crystalline lens 22 through the incision 21 of the cornea 20 of the eye E as shown in FIG.

As shown in FIGS. 2 and 3, the insertion portion 16 has a cylindrical shape, and a perfusate line 24, a suction line 26, and a line 28 pass through the insertion portion 16. One end of the perfusate line 24 is connected to the inlet 30. The inlet 30 is provided on the tip side of the insertion portion 16. The other end of the perfusion solution line 24 is connected to the line 34 of the perfusion bottle 8 in the perfusion control unit 6.
It is connected to the. By the function of the perfusion control unit 6, the amount of the perfusion liquid L sent from the perfusion bottle 8 into the lens 22 through the line 34 and the perfusion liquid line 24 can be adjusted or the supply can be stopped.

The vibrating portion 18 has a cylindrical shape and is coaxially attached to the insertion portion 16. The vibrating unit 18 is the output control unit 2.
Is electrically connected to the high frequency oscillation source 40 of FIG. The high frequency oscillation source 40 is, for example, a high frequency pulse oscillation source, and vibrates the vibrating portion 18 by oscillating a frequency of 27 to 55 Hz / sec. The vibration of the vibrating section 18 crushes the nucleus 46 shown in FIG. The vibrating portion 18 is formed in a cylindrical shape, for example, with laminated piezoelectric elements as the core. The suction port 42 of the vibrating portion 18 is formed obliquely.

As shown in FIG. 2, a suction passage 48 is formed in the vibrating portion 18 in the axial direction. The suction passage 48 is connected to the suction unit 4 via the suction line 26. The crushed material M (see FIG. 2) of the nucleus 46 crushed by the vibrating section 18 and the residual cortex 50 shown in FIG. 3 are stored in the storage tank (not shown) of the suction section 4 via the suction passage 48 and the suction line 26. )
Can be transferred to.

A foot switch 10 is connected to the output control section 2 of FIG. The output control unit 2 forms a control signal CS1 to the high frequency oscillation source 40 and a control signal CS2 to the suction unit 4 based on the operation signal OS of the foot switch 10. The operation signal OS of the foot switch 10 changes according to the depression amount D of the depression portion 11 of the foot switch 10 shown in FIG. Based on the operation signal OS corresponding to the depression amount D, the output control unit 2 can increase or decrease both the strength of the ultrasonic wave oscillated by the ultrasonic probe 1 and the suction force of the suction unit 4. The intensity of the ultrasonic wave and the magnitude of the suction force may be detected by the foot switch or the main body 12.

In the embodiment, preferably, as shown in FIG. 5, the relationship between the magnitude of the depression amount D of the depression portion 11 of the foot switch 10 and the strength of the ultrasonic wave and the magnitude of the suction force is set. The depression amount D is large in the right direction along the horizontal axis. Both the strength of ultrasonic waves and the suction force are large in the upward direction along the vertical axis. The intensity of ultrasonic waves is indicated by the solid line P. The strength of the suction force is shown by the broken line W. The amount of depression D of the foot switch and the ultrasonic wave intensity (P) have a linear relationship. On the other hand, the relationship between the depression amount D of the foot switch and the magnitude (W) of the suction force is linear in a range larger than the predetermined depression amount D1. However, in the range of the depression amount D1 or less, the suction force is constant as indicated by the substantially constant value W1. In other words, the suction force is a substantially constant value W1 when the intensity of the ultrasonic waves is ST or less.

The substantially constant suction force W1 at the predetermined depression amount D1 or less is a value sufficient to suck the residual cortex 50 of the lens 22 shown in FIG. As an example, the suction force W1 is about 40 mmHg.

Next, the cataract surgery by the cataract surgery device of the present invention will be described.

The operator holds the casing 14 of FIG. 1 and inserts the insertion portion 16 of the ultrasonic probe 1 through the incision 21 of the cornea 20 of the eye E. Then, as shown in FIG. 3, the vibrating portion 18 and part of the inserting portion 16 are inserted into the crystalline lens 22.

First, the operation of crushing and removing the nucleus 46 of the lens 22 will be described. The operator starts to depress the stepping portion 11 of the foot switch 10 shown in FIG. 4 with his foot, and depresses more than the stepping amount D1 shown in FIG. As a result, as shown in FIG. 5, both the ultrasonic wave intensity and the suction force linearly increase according to the amount of depression. That is, by increasing the strength of the ultrasonic wave, the crushing force of the nucleus 46 can be increased in accordance with the hardness of the nucleus 46 to enable rapid crushing, and the suction force also increases in real time. Crushed M
Can be quickly sucked into the suction portion 4 through the suction passage 48 and the suction line 26 of FIG. The suction force at this time is, for example, 40 to 650 mmHg. As a result, the crushed substance M of the crushed nucleus can be efficiently removed from the lens 22. In order to prevent the lens 22 from being crushed due to low intraocular pressure during this removal, the perfusion solution L is supplied from the perfusion bottle 8 shown in FIG.
Supply to 0.

After the above-mentioned nuclear emulsification, the soft residual cortex 5 of FIG.
Remove 0. In this case, for example, the suction port 42 of the vibrating section 18 is inserted into the residual cortex 50. Then, as shown in FIG. 5, the depression amount of the foot switch is set to D1 or less. As a result, the suction force becomes a substantially constant value W1, and the soft residual cortex 50 can be sucked into the suction portion 4 through the suction passage 48 and the line 26 in FIG. Also at this time, the perfusion solution L of FIG. 1 is supplied from the supply port 30 into the crystalline lens 22 through the lines 34 and 24 in order to prevent it from being crushed due to low intraocular pressure.

After removing the nucleus 46 and the residual cortex 50, an artificial lens is implanted.

As described above, in the cataract surgery device of the present invention, the strength of ultrasonic waves for crushing the nucleus is increased according to the hardness of the nucleus, and the crushed material of the nucleus is aspirated according to the strength of the ultrasonic wave. The suction pressure for doing this can be changed. Moreover, the residual cortex is softer than the nucleus and can be aspirated without necessarily sonicating and crushing. This residual cortex is the depression amount D
Suction can be performed with a constant suction force within a range of 1 or less.

The present invention is not limited to the above embodiment. For example, the hardness of the nucleus varies from person to person. For this reason, it is better if it is possible to manually switch the operation so that it operates according to the method (1) and the method (2) of the related art.

[0030]

According to the invention of claim 1, both the strength of ultrasonic waves and the suction force are increased or decreased. Therefore, for example, even if the strength of ultrasonic waves is increased according to the hardness of the nucleus of the crystalline lens to increase the crushing amount, the suction force also increases accordingly,
The increased crushed material can be sucked sufficiently efficiently. Therefore, the ultrasonic emulsion suction operation time can be significantly shortened.

According to the second aspect of the present invention, the operation of cataract can be completed by removing the residual cortex of the crystalline lens, for example, without switching to the suction mode in which the suction force is constant, and rapid surgery is possible. ..

According to the invention of claim 3, not only the nucleus of the lens but also the residual cortex can be safely sucked by controlling the amount of depression.

[Brief description of drawings]

FIG. 1 is a view showing a preferred embodiment of the cataract surgery device of the present invention.

FIG. 2 is a diagram showing a part of an ultrasonic probe in a preferred embodiment of the cataract surgery device of the present invention.

FIG. 3 is a view showing a state where the ultrasonic probe of FIG. 2 is inserted into a nucleus of a crystalline lens.

FIG. 4 is a view showing an example of a foot switch of the cataract surgery device of the present invention.

FIG. 5 is a diagram showing the relationship between the amount of depression of a foot switch, the strength of ultrasonic waves, and the magnitude of suction force (suction amount) in the present invention.

FIG. 6 is a view showing a state where the ultrasonic probe of FIG. 2 is inserted into the cortex of the lens.

[Explanation of symbols]

 1 Ultrasonic probe 2 Output control part (control part) 4 Suction part 6 Perfusion control part 8 Perfusion bottle 10 Foot switch 16 Insertion part 18 Vibrating part 22 Crystalline lens 24 Line 26 Suction line 30 Supply port 40 High frequency oscillation source 42 Suction port 46 Nuclear 50 Residual cortex ◆

Claims (3)

[Claims] 1. An ultrasonic probe (1) for generating ultrasonic waves.
A suction unit (4) for sucking the crushed material (M) crushed by the ultrasonic probe (1), a foot switch (10) for generating an operation signal by an operation of an operator, and an operation of the foot switch (10) Based on the signal (OS)
An ultrasonic probe (1) and a control unit (2) that forms control signals (CS1, CS2) to the suction unit (4). The control unit (2) is controlled by operating a foot switch (10). Based on the signal (OS), the ultrasonic intensity of the ultrasonic probe (1) and the suction amount of the suction unit (4) both increase and decrease in accordance with the depression amount (D) of the foot switch (10). Cataract surgery device. 2. The control unit (2) includes an ultrasonic probe (1).
The intensity of the ultrasonic wave is controlled to increase or decrease according to the depression amount (D) of the foot switch (10),
The suction amount of the suction unit (4) is almost the same regardless of the depression amount (D) of the foot switch (10) when the ultrasonic wave intensity of the ultrasonic probe (1) becomes equal to or lower than a predetermined intensity. The cataract surgery device according to claim 1, which is configured to perform control so that a constant suction force is obtained. 3. The suction force, which becomes substantially constant regardless of the depression amount (D) of the foot switch (10), has a crystalline lens (2).
The cataract surgery device according to claim 2, wherein the value is set to a value sufficient to suck the cortex (50) of 2).