WO2000074615A2 - Trocart de phaco-emulsification - Google Patents

Trocart de phaco-emulsification Download PDF

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Publication number
WO2000074615A2
WO2000074615A2 PCT/US2000/015012 US0015012W WO0074615A2 WO 2000074615 A2 WO2000074615 A2 WO 2000074615A2 US 0015012 W US0015012 W US 0015012W WO 0074615 A2 WO0074615 A2 WO 0074615A2
Authority
WO
WIPO (PCT)
Prior art keywords
tip
needle
phaco
handpiece
orifices
Prior art date
Application number
PCT/US2000/015012
Other languages
English (en)
Other versions
WO2000074615A3 (fr
Inventor
Armand Maaskamp
Original Assignee
Alcon Universal Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alcon Universal Ltd. filed Critical Alcon Universal Ltd.
Priority to AU54529/00A priority Critical patent/AU5452900A/en
Publication of WO2000074615A2 publication Critical patent/WO2000074615A2/fr
Publication of WO2000074615A3 publication Critical patent/WO2000074615A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic

Definitions

  • This invention relates to irrigation/aspiration needle devices for the ophthalmic surgery field, and more particularly to ultrasonically energized needles used in phaco- emulsification procedures.
  • the wrench flats are necessarily substantially bigger than the needle, so that a tapered merger region is disposed between the distal end of the needle and the wrench flats.
  • the tapered region introduces another problem, for when the needle is ultrasonically vibrated, the tapered region presents a surface area nonparallel to the direction of the ultrasonic vibration which generates ultrasonic waves within the irrigation fluid. These waves are then reflected and re-reflected within the area between the needle and the infusion sleeve. At one or more points along the reflection path of these ultrasonic waves the fluid will begin to resonate and points of maximum and minimum pressure will be created, introducing cavitation and bubbles in the fluid which are deleterious to body tissue and must be avoided.
  • a phaco-emulsification needle in which a substantial proportion of a proximal end of the needle is threaded to engage into a handpiece and incorporates longitudinal wrench flats which extend for a substantial length inside an inner sleeve which forms a part of the distal end of the handpiece.
  • One or more shunt flow orifices are formed in the needle walls in the distal end of the needle and/or the wrench flat area.
  • the proximal end of the needle and the distal end of the handpiece are substantially encompassed by a flexible outer infusion sleeve which detachably engages the inner sleeve of the handpiece but stops short of covering the needle tip.
  • the transition between the wrench flats and the distal end of the needle is curved but of short length and placed beyond the inner sleeve so that complex reflections and re-reflections are not transmitted via the irrigation fluid between the needle and the inner sleeve, and consequently cavitation is not introduced.
  • the extended length of wrench flat enables a much wider distribution of the torque that is generated when a wrench is turned, and therefore lower force loading on the wrench flat when it is time to disengage the needle from the handpiece. consequently reducing damage rates to a minimum.
  • the shunt flow orifices in the distal end of the needle and/or the wrench flats divert increased fractions of irrigation fluid into the aspiration flow path during momentary clogging of the needle tip to prevent increased suction forces from the peristaltic pump and the resulting suction surge from affecting flow balance when the clogged matter breaks free.
  • the reduced suction surge when occluded material breaks free minimizes momentary flow imbalances and improves fluid stability within the eye chamber.
  • Fig. 1 is a side sectional view of an example of a needle coupled to a handpiece (shown partially) and having shunt flow orifices and substantially encompassed by a flexible outer infusion sleeve in a device in accordance with the invention;
  • Fig. 2 is a more detailed side sectional view of the Fig. 1 example of the wrench flat area of a needled coupled to a handpiece (shown partially);
  • Fig. 3 is an enlarged side sectional view of an example of a distal end of a needle with shunt flow orifices substantially encompassed by a flexible outer infusion sleeve in accordance with the invention
  • Fig. 4 is a perspective view of an example of a needle with shunt flow orifices in the wrench flat area, providing an alternative example in accordance with the invention
  • Fig. 5 is a perspective view of the distal end of a curved needle with shunt flow orifices in accordance with the invention
  • Fig. 6 is a side sectional view of an example of a shunt flow orifice in the wall of a needle in accordance with the invention.
  • Fig. 7 is a side sectional view of another example of a shunt flow orifice in the wall of a needle in accordance with the invention
  • Fig. 8 is a side sectional view of another example of a shunt flow orifice in the wall of a needle in accordance with the invention.
  • Fig. 9 is a side sectional view of another example of a shunt flow orifice in the wall of a needle in accordance with the invention.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Figs. 1 and 2 are side sectional views of an advantageous version of a phaco- emulsification needle coupled to a handpiece (shown partially) and substantially encompassed by a flexible outer infusion sleeve.
  • the needle is specifically designed for phaco-emulsification procedures for ophthalmic surgery.
  • the invention comprises a hollow needle 10 of small outer diameter (e.g. about 0.0365 inches or less) at its tip, to be inserted into an eye chamber through a small incision.
  • the distal end of the needle is a thin, hollow, elongated cylinder for emulsifying and withdrawing body material through an open end 12 and into a hollow central bore 18.
  • the needle exterior curves in a transition region 13 to a second, elongated, thicker area that is no longer cylindrical, but faceted with flat surfaces or "wrench flats" 14 for engagement by a special wrench.
  • the wrench flats merge into a threaded length 16 which engages a mating thread on the handpiece 20.
  • the handpiece may include an inner sleeve 22 which surrounds a part of the wrench flats 14 but stops short of covering the entire wrench flat area.
  • the extending wrench flat areas may be more readily engaged by a special wrench 34 (shown in dotted line form in Fig. 2 only) used to couple and decouple the needle to the handpiece.
  • a special wrench 34 shown in dotted line form in Fig. 2 only
  • the proximal end of the needle and the distal end of the handpiece are substantially encompassed by a flexible outer infusion sleeve 24. which detachably engages the inner sleeve of the handpiece but stops short of covering the needle tip.
  • the outer infusion sleeve extends far enough distally to cover one or more lateral shunt flow orifices 26 formed in the walls of the needle near (less than about 0.5 inches from) the tip, as shown in Fig. 3.
  • the outer infusion sleeve leaves approximately 1.0 to 2.0 mm of exposed tip.
  • Fig. 5 illustrates another variant of the present invention wherein the needle tip is bent to improve emulsification and the reach of the needle within the eye cavity. If a plurality of shunt flow orifices are employed as illustrated in Fig. 5, the orifices may be provided at different longitudinal positions to minimize the chance of needle breakage during ultrasonic vibration.
  • the shunt flow orifices can be placed in other regions of the needle, including the wrench flat segments as shown in Fig. 4. Such a placement enables the use of more or larger shunt flow orifices, as required, because of the increased structural integrity of the needle in the wrench flat areas. In addition, because of the lower flow rate of irrigation fluid in the wrench flat area, as compared to the flow rate near the distal end of the needle, shunt flow orifices in the wrench flats may able to shunt the irrigation fluid more efficiently than orifices near the needle tip.
  • the distal end of the needle is inserted into the surgical site and ultrasonically vibrated as irrigation fluid flows around it and aspirated material is withdrawn through it, being drawn by a peristaltic pump.
  • the ultrasonically vibrated needle tip contacts tissue such as a formed cataract in some stage of solidification, the material is emulsified and is then aspirated (suctioned) into the hollow bore of the needle and transported to a collection area.
  • the irrigation fluid 28 is fed into the eye chamber from along a gap 30 between the infusion sleeve and the wrench flats leading into the smaller gap 32 between the infusion sleeve and the needle at the distal end.
  • the shunt flow orifices of the present invention allow irrigation fluid to flow directly into the hollow bore during moments of clogging at the tip.
  • the flow of irrigation fluid through the shunt flow orifice reduces the pressure differential between the outside and the inside of the needle, and a vacuum effect builds more slowly than without a shunt flow orifice.
  • the reduced pressure differential counteracts aspiration flow surges by reducing the likelihood of total occlusion at the hollow bore.
  • the flow within the hollow bore between the tip of the needle and the shunt flow orifice usually remains dynamic as some amount of aspiration occurs through the only partially occluded tip. This aspiration flow allows material within the hollow bore near the tip to be evacuated even during moments of partial tip occlusion, which reduces the time it takes to return the hollow bore to its unclogged state once the occlusion breaks free.
  • the dimensions of the needle, bore and shunt flow orifices are selected with respect to the operating parameters of the handpiece, and infusion sleeve, as well as the pressure of the irrigation fluid and the suction within the hollow needle, to ensure the proper balance of flows into and out of the eye chamber, as well as modified response to surge conditions.
  • Many combinations of the above parameters may be combined with varying effect.
  • a shunt flow orifice may be designed to produce a shunt flow rate of 4 cc/min at full occlusion.
  • the same needle operating with a vacuum of 400 mm Hg may employ a shunt flow orifice designed to produce a shunt flow rate of 11 cc/min at full occlusion.
  • shunt flow orifice may be designed to produce a shunt flow rate 6 cc/min at full occlusion.
  • the same needle operating with a vacuum of 400 mm Hg may employ a shunt flow orifice designed to produce a shunt flow rate of 15 cc/min.
  • the shunt flow rate at full occlusion has a direct correlation to the response of the needle to surge conditions.
  • the shunt flow orifice is designed such that 11 cc/min of irrigation fluid is drawn through the orifice during total tip occlusion, the flow into the hollow bore will be reduced by approximately 11 cc/min at occlusion break.
  • Figs. 6-9 illustrate possible variants of the shunt flow orifice in the wall of the distal end of the needle or the wrench flats.
  • Fig. 6 illustrates the basic approach where the orifice side walls are perpendicular to the direction of irrigation and aspiration flows. This approach is also easiest from a manufacturing standpoint, using precision lasers to drill the orifices.
  • Figs. 7-9 illustrate variants which increase the shunt flow of irrigation fluid through an orifice of given cross-sectional area.
  • Fig. 7 illustrates an orifice angled in the direction of irrigation flow.
  • Fig. 8 illustrates an orifice with a larger opening on the irrigation flow side.
  • FIG. 9 illustrates a perpendicularly formed orifice with protrusions 38 located in the distal side of the orifices. These protrusions create an area of increased fluid pressure 40 in the irrigation flow stream, and an area of decreased fluid pressure 42 in the aspiration flow stream. The resulting pressure differential increases the shunt flow of irrigation fluid through the orifice.

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Devices For Medical Bathing And Washing (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne la pointe d'une pièce à main de phaco-émulsification. La géométrie de ladite pointe réduit de manière avantageuse la cavitation du fluide d'irrigation fourni par ladite pièce à main. La pointe peut se présenter avec des orifices d'écoulement de dérivation qui réduisent les risques de surpression de l'oeil et d'effondrement de la cavité oculaire lorsque la pointe du trocart s'obstrue. L'invention traite en outre de diverses géométries et emplacements avantageux des orifices d'écoulement de dérivation.
PCT/US2000/015012 1999-06-04 2000-06-01 Trocart de phaco-emulsification WO2000074615A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU54529/00A AU5452900A (en) 1999-06-04 2000-06-01 Phaco-emulsification needle

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13758899P 1999-06-04 1999-06-04
US60/137,588 1999-06-04

Publications (2)

Publication Number Publication Date
WO2000074615A2 true WO2000074615A2 (fr) 2000-12-14
WO2000074615A3 WO2000074615A3 (fr) 2001-07-05

Family

ID=22478140

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2000/015012 WO2000074615A2 (fr) 1999-06-04 2000-06-01 Trocart de phaco-emulsification

Country Status (2)

Country Link
AU (1) AU5452900A (fr)
WO (1) WO2000074615A2 (fr)

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001056520A1 (fr) * 2000-02-02 2001-08-09 Ooo Meditsinsky Nauchno-Issledovatelsky Oftalmologichesky Tsentr 'novy Vzglyad' Canule de kourenkov destinee a une methode d'operation de keratectomie photorefractive intrastromale par laser excimere
US7204820B2 (en) 2003-04-04 2007-04-17 Ravi Nallakrishnan Phacoemulsification needle
CN100448416C (zh) * 2003-09-17 2009-01-07 博士伦公司 超声乳化套管
WO2010045300A1 (fr) * 2008-10-14 2010-04-22 Bausch & Lomb Incorporated Systèmes et procédés d'ajustement d'aiguilles pour chirurgie ophtalmique
JP2012512713A (ja) * 2008-12-18 2012-06-07 アルコン リサーチ， リミテッド 鰓部付きの水晶体超音波乳化吸引術用灌流スリーブ
US8568422B2 (en) 2008-09-01 2013-10-29 Nigel Morlet Cutting needle tip for surgical instrument
CN105934224A (zh) * 2013-12-05 2016-09-07 诺华股份有限公司 用于抽吸期间的尖端真空控制的设备、系统和方法
US9566189B2 (en) 2011-08-03 2017-02-14 Nigel Morlet Grooved needle tip for surgical instrument
US9867736B2 (en) 2010-03-29 2018-01-16 Nigel Morlet Needle tip for surgical instrument
RU201235U1 (ru) * 2020-08-26 2020-12-04 федеральное государственное бюджетное образовательное учреждение высшего образования "Ростовский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО РостГМУ Минздрава России) Устройство для дренирования дакриостомы при эндоскопической эндоназальной дакриоцисториностомии

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3589363A (en) 1967-07-25 1971-06-29 Cavitron Corp Material removal apparatus and method employing high frequency vibrations
US3693613A (en) 1970-12-09 1972-09-26 Cavitron Corp Surgical handpiece and flow control system for use therewith
US4493694A (en) 1980-10-17 1985-01-15 Cooper Lasersonics, Inc. Surgical pre-aspirator

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4425115A (en) * 1977-12-19 1984-01-10 Wuchinich David G Ultrasonic resonant vibrator
US4530356A (en) * 1983-02-08 1985-07-23 Helfgott Maxwell A Ophthalmic surgical instrument with beveled tip
US4515583A (en) * 1983-10-17 1985-05-07 Coopervision, Inc. Operative elliptical probe for ultrasonic surgical instrument and method of its use
US4808154A (en) * 1983-10-26 1989-02-28 Freeman Jerre M Phacoemulsification/irrigation and aspiration sleeve apparatus
US5242385A (en) * 1991-10-08 1993-09-07 Surgical Design Corporation Ultrasonic handpiece
WO1996038091A1 (fr) * 1995-06-02 1996-12-05 Surgical Design Corporation Piece a main, manchon et embout de phacoemulsification
FR2740028B1 (fr) * 1995-10-20 1998-01-23 Garnier Bernard Dispositif de regulation d'aspiration, pour appareil de microchirurgie notamment de chirurgie oculaire
US5830192A (en) * 1996-12-09 1998-11-03 Staar Surgical Company, Inc. Irrigation sleeve for phacoemulsification apparatus

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3589363A (en) 1967-07-25 1971-06-29 Cavitron Corp Material removal apparatus and method employing high frequency vibrations
US3693613A (en) 1970-12-09 1972-09-26 Cavitron Corp Surgical handpiece and flow control system for use therewith
US4493694A (en) 1980-10-17 1985-01-15 Cooper Lasersonics, Inc. Surgical pre-aspirator

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001056520A1 (fr) * 2000-02-02 2001-08-09 Ooo Meditsinsky Nauchno-Issledovatelsky Oftalmologichesky Tsentr 'novy Vzglyad' Canule de kourenkov destinee a une methode d'operation de keratectomie photorefractive intrastromale par laser excimere
US7204820B2 (en) 2003-04-04 2007-04-17 Ravi Nallakrishnan Phacoemulsification needle
CN100448416C (zh) * 2003-09-17 2009-01-07 博士伦公司 超声乳化套管
US8568422B2 (en) 2008-09-01 2013-10-29 Nigel Morlet Cutting needle tip for surgical instrument
WO2010045300A1 (fr) * 2008-10-14 2010-04-22 Bausch & Lomb Incorporated Systèmes et procédés d'ajustement d'aiguilles pour chirurgie ophtalmique
JP2012512713A (ja) * 2008-12-18 2012-06-07 アルコン リサーチ， リミテッド 鰓部付きの水晶体超音波乳化吸引術用灌流スリーブ
US9867736B2 (en) 2010-03-29 2018-01-16 Nigel Morlet Needle tip for surgical instrument
US9566189B2 (en) 2011-08-03 2017-02-14 Nigel Morlet Grooved needle tip for surgical instrument
CN105934224A (zh) * 2013-12-05 2016-09-07 诺华股份有限公司 用于抽吸期间的尖端真空控制的设备、系统和方法
JP2016538950A (ja) * 2013-12-05 2016-12-15 ノバルティス アーゲー 吸引中にチップの真空制御を行うための装置、システム、及び方法
US9731065B2 (en) 2013-12-05 2017-08-15 Novartis Ag Devices, systems, and methods for tip vacuum control during aspiration
RU201235U1 (ru) * 2020-08-26 2020-12-04 федеральное государственное бюджетное образовательное учреждение высшего образования "Ростовский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО РостГМУ Минздрава России) Устройство для дренирования дакриостомы при эндоскопической эндоназальной дакриоцисториностомии

Also Published As

Publication number Publication date
WO2000074615A3 (fr) 2001-07-05
AU5452900A (en) 2000-12-28

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