WO2003030792A1 - Multi-functional second instrument for cataract removal - Google Patents
Multi-functional second instrument for cataract removal Download PDFInfo
- Publication number
- WO2003030792A1 WO2003030792A1 PCT/US2002/028426 US0228426W WO03030792A1 WO 2003030792 A1 WO2003030792 A1 WO 2003030792A1 US 0228426 W US0228426 W US 0228426W WO 03030792 A1 WO03030792 A1 WO 03030792A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- instrument
- irrigation
- cataract
- lens capsule
- needle
- Prior art date
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
- the present invention generally relates to surgical instruments, and more particularly, relates to apparatus which provides for improved irrigation and reduced risk of corneal or sclera tissue damage during cataract removal .
- Cataracts cause the lens of an eye to become clouded, and a common practice to alleviate this condition is by surgically removing the cataractic lens and replacing it with an artificial intraocular lens.
- Phacoemulsification enables the removal of a cataractic lens through a much smaller incision, for example, between about 2.5 to about 4mm.
- a needle is inserted through the incision into a lens capsule and the needle is vibrated to mechanically emulsify the lens.
- the lens material is aspirated through a lumen through the phacoemulsification needle.
- a simultaneous flow of irrigation fluid into the lens capsule has been provided around the needle through an annulus established by a sleeve concentrically disposed over the needle.
- This flow of liquid into the eye is necessary to prevent collapse of the interior chamber of the eye during aspiration.
- the irrigation fluid cools the needle in order to prevent any thermal damage of the corneal or sclera tissue.
- the sleeve surrounding a phacoemulsification needle provides the important function of establishing an annulus for introducing irrigation fluid into the lens capsule it also enlarges the overall diameter of the sleeve needle for which an incision must be made.
- the present invention overcomes the drawbacks of a sleeved phacoemulsification needle.
- Apparatus in accordance with the present invention includes a first instrument for inserting into a lens capsule and removing a cataract therein, the needle including a lumen therethrough for aspiration of lens tissue and irrigation fluid from said lens capsule through a primary aspiration port defined by an end of said lumen and a second instrument for inserting into the lens capsule and manipulating the cataract as the cataract is being removed, said second instrument having an irrigation port for introducing the irrigation fluid into said lens capsule.
- the second instrument may include a tip, such as a hook or blade, attached to a shaft for manipulating the cataract and the shaft includes a shaft lumen for delivery the irrigation fluid to the irrigation port.
- the second instrument may include a conduit attached to the shaft, for delivering the irrigation fluid to the irrigation port.
- a plurality of irrigation ports may be provided, each in fluid communication with the shaft lumen or conduit .
- the first instrument may include a sonic or ultrasonic device needle for emulsifying the lens tissue.
- the needle includes a lumen for aspiration of emulsifying lens tissue and aspiration flow from the lens capsule.
- Figure 1 is a diagram of apparatus in accordance with the present invention generally showing a first needle for introducing an irrigation fluid into a lens capsule through a handpiece from an operating console along with a second vibrated needle for inserting into the lens capsule and operated by a phacoemulsification handpiece connected to an aspiration line and controlled by the console through an ultrasonic power line;
- Figure 2 is a view of the vibrated needle shown in Figure 1 showing a primary aspiration port along with two secondary aspiration ports formed in the needle in a spaced apart distance from the primary aspiration port;
- Figure 3 is a view of the needle tip shown in Figure 2 illustrating non-turbulent aspiration of lens tissue and irrigation fluid;
- Figure 4 is a similar view of a prior art sleeved needle top illustrating turbulence or roiling of fluid in front of the needle tip caused by countercurrent fluid flow with results in a cloud of emulsified lens tissue and repulsion of the same;
- FIG. 5 is a diagram of alternative apparatus in accordance with the present invention generally showing a first instrument including a vibrated needle for inserting into a lens capsule and operation by a handpiece connected to an aspiration line and controlled by a console through a power line along with a second instrument for inserting into the lens capsule for manipulating a cataract during removal thereof and for providing irrigation fluid to the lens capsule;
- a first instrument including a vibrated needle for inserting into a lens capsule and operation by a handpiece connected to an aspiration line and controlled by a console through a power line along with a second instrument for inserting into the lens capsule for manipulating a cataract during removal thereof and for providing irrigation fluid to the lens capsule;
- Figure 6 is an enlarged representation of a second instrument tip illustrating introduction of irrigation fluid through irrigation ports from a lumen in a shaft supporting a tool tip
- Figure 7 is similar to Figure 6 illustrating the introduction of irrigation fluid through irrigation ports from a conduit adhered to a shaft supporting a tool tip
- Figure 8 is similar to Figure 6 illustrating a different tool tip which may be fixed to a separate shaft or used as a replaceable tip.
- apparatus 10 for the removal of lens tissue 12 which includes a first needle 14 for introducing an irrigation fluid indicated by the arrow 18 into a lens capsule 20.
- Manipulation of the needle 14 within the lens capsule 20 is effected through a handpiece 24 which communicates to a control console 26 through an irrigation line 28.
- the control console 26 may be of any suitable type as for example, one manufactured by Allergan, Inc., under the trade name Sovereign.
- a second needle 32 which is ultrasonically vibrated by a handpiece 34.
- Any suitable handpiece may be utilized such as for example, one sold by Allergan, Inc., under the trade name Sovereign.
- the handpiece 34 is interconnected to the console 26 and control thereby through an aspiration line 38 and a power line 40 for controlling ultrasonic power delivered to the needle 32 by the handpiece 34.
- the second needle 32 fragments or emulsifies the cataractic lens 12 which is then aspirated along with irrigation fluid through a lumen 42 in the needle 32 as indicated by the arrow 44.
- Manipulation of the irrigating needle 14 is effective in enabling more efficient removal of the cataractic lens 12 as the fluid is now a manipulation tool, moving fragments of lens 12 to the needle 32.
- the needle 32 does not include a conventional sleeve (not shown in Figures 1 and 2) a smaller incision or wound 50 is required.
- the wound size may be as small as 0.8mm which is to be compared with conventional sleeved needles (not shown) which would require a slit or wound opening, of about 2.5 to 3mm (or larger) .
- the needle 32 includes a primary aspiration port 52 defined by the lumen 42 and one or more secondary aspiration ports 54, 56 disposed along a length 60 of the needle 32 between the primary aspiration port 52 and a hub 62 for attachment of the needle 32 to the handpiece 34.
- the secondary aspiration ports 54, 56 may be spaced apart axially from the primary aspiration port and one another as shown in Figure 2 or, alternatively, as shown in Figure 1, aspiration ports 64, 66 may be disposed along the needle 32 in a spaced apart radial relationship with one another resulting in aspiration of fluid from the lens capsule 20 in opposing direction as indicated by the arrows 70, 72.
- the secondary aspiration ports 54, 56, 64, 66 also provide an important function in maintaining the fluid flow through the needle should the primary aspiration port 52 become occluded. This insures cooling of the needle 32 to prevent overheating thereof.
- the secondary aspiration ports 54, 56, 64, 66 are disposed within 6mm of the primary aspiration port to insure that their aspirating functionality is performed within the lens capsule 20.
- the total cross-sectional area of the secondary aspiration ports 54, 56, 64, 66 be no more than 10% of the cross-sectional area of the primary aspiration port 52.
- Figure 3 illustrates smooth laminar flow of aspiration fluid as shown by the arrows 78 into the primary aspiration port 52 and secondary aspiration ports 64, 66.
- a conventional phacoemulsification needle tip 80 which is surrounded by a sleeve 82 for the introduction of irrigation fluid proximate to an aspiration port 84 as indicated by the arrows 86.
- the sleeve 82 also has side holes 88 for irrigation outflow.
- aspiration of fluid as indicated by the arrows 90, 92 may be partially diverted from the port 84 before entering which causes a roiling of the fluid indicated by the arrows 96, 98.
- This roiling of fluid causes a "milky cloud" to appear proximate the needle tip 80 and pushes lens fragments away which interferes with the physician acuity of the needle tip 80 which interferes with efficient phacoemulsification of lens tissue, not shown in Figure 4.
- Embodiment 100 includes a first instrument 102 which includes a vibrated needle 104 for inserting into a lens capsule 106 for removing a cataract 108 therein.
- the needle 104 includes a lumen 112 therethrough for aspiration of cataract tissue from the lens through a primary aspiration port 114 defined by an end 116 of the needle 104, this aspiration is indicated by the arrow 118.
- second aspiration ports 120, 122 are provided in the needle 112 for aspirating cataractic tissue, as well as irrigation fluid, from the lens capsule 106 as indicated by the arrows 126, 128.
- a second instrument 130 which includes a shaft 132 and tool tip 134, is inserted into the lens capsule 106 for manipulating the cataract to 108 as the cataract 108 as being emulsified by the needle 104.
- the second instrument 130 includes one or more irrigation ports 136, 138, 140 for introducing irrigation fluid into the eye capsule 106 as indicated by the arrows 142.
- FIG. 6 An enlarged view of the tool tip 34 and shaft 132 are shown in Figure 6. Irrigation fluid is provided to the ports 138, 140 shown in Figure 6 through a lumen 146 within the shaft 132. Alternatively, as shown in Figures 7, the tool tip 34 may be supported by a solid shaft 148 and a separate conduit 150 may be utilized to provide irrigation fluid to irrigation ports 152, 154.
- the tool tip 134 may be of any suitable type, such as for example, a hook or a blade, for manipulation of the cataractic tissue 108 and may be fixed to a shaft 148 as shown in Figure 7 or removably coupled to a shaft 132 by a conventional coupling mechanism 160.
- a coupler 160 When a coupler 160 is utilized, alternative tool tips 162, as shown in Figure 8, may be attached to the shaft 132 by the user.
- the irrigation ports 138, 140, 152, 154 are preferably spaced apart axially on the shaft 132, 148 respectively or, as illustrated in Figure 5, there may be also space radially about the shaft.
- the size of the ports 138, 140, 152, 154 may be 0.6 to 1.5mm in order to introduce irrigation fluid 164 at the rate of 20 - 60cc/min.
- the irrigation port 138, 140, 152, 154 size and location is dependant upon surgeon technique and incision location.
Landscapes
- Health & Medical Sciences (AREA)
- Ophthalmology & Optometry (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP02800829A EP1463472B1 (en) | 2001-10-09 | 2002-09-06 | Multi-functional second instrument for cataract removal |
DE60221286T DE60221286T2 (en) | 2001-10-09 | 2002-09-06 | MULTIFUNCTIONAL SECONDARY INSTRUMENT FOR CATARACT REMOVAL |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/973,139 US6830555B2 (en) | 2001-10-09 | 2001-10-09 | Multi-functional second instrument for cataract removal |
US09/973,139 | 2001-10-09 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2003030792A1 true WO2003030792A1 (en) | 2003-04-17 |
Family
ID=25520543
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2002/028426 WO2003030792A1 (en) | 2001-10-09 | 2002-09-06 | Multi-functional second instrument for cataract removal |
Country Status (5)
Country | Link |
---|---|
US (3) | US6830555B2 (en) |
EP (2) | EP1797849B1 (en) |
AT (1) | ATE367138T1 (en) |
DE (1) | DE60221286T2 (en) |
WO (1) | WO2003030792A1 (en) |
Cited By (1)
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EP3694452A4 (en) * | 2017-10-13 | 2021-07-14 | Surgical Design Corporation | Dual lumen surgical hand-piece with ultrasonic knife |
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US7182759B2 (en) * | 2001-09-07 | 2007-02-27 | Advanced Medical Optics, Inc. | Cataract extraction apparatus and method with rapid pulse phaco power |
US6830555B2 (en) * | 2001-10-09 | 2004-12-14 | Advanced Medical Optics | Multi-functional second instrument for cataract removal |
US20050159758A1 (en) * | 2003-07-25 | 2005-07-21 | Lawrence Laks | Ophthalmic irrigation-aspiration system |
US7351219B2 (en) * | 2004-01-08 | 2008-04-01 | Alcon, Inc. | Method and instrumentation for cooling a surgical incision |
US6852093B1 (en) | 2004-05-10 | 2005-02-08 | Alcon, Inc. | Surgical method and apparatus |
US7857794B2 (en) | 2004-06-14 | 2010-12-28 | Alcon, Inc. | Handpiece tip |
US7066923B2 (en) * | 2004-06-25 | 2006-06-27 | Alcon, Inc. | Surgical method and apparatus using dual irrigation paths |
US7094229B2 (en) * | 2004-06-25 | 2006-08-22 | Alcon, Inc. | Surgical method and apparatus |
US7601136B2 (en) * | 2004-07-20 | 2009-10-13 | Takayuki Akahoshi | Infusion sleeve |
US7601135B2 (en) * | 2005-03-01 | 2009-10-13 | Takayuki Akahoshi | Multi-port infusion sleeve |
US20060036215A1 (en) * | 2004-08-12 | 2006-02-16 | Mikhail Boukhny | Surgical apparatus |
US20060047241A1 (en) * | 2004-09-02 | 2006-03-02 | Mikhail Boukhny | Surgical apparatus |
US7063680B2 (en) * | 2004-09-09 | 2006-06-20 | Alcon, Inc. | Surgical apparatus |
US7704244B2 (en) * | 2004-09-09 | 2010-04-27 | Alcon, Inc. | Surgical method |
US20070078470A1 (en) * | 2005-09-21 | 2007-04-05 | Alcon, Inc. | Surgical apparatus |
US8565839B2 (en) | 2005-10-13 | 2013-10-22 | Abbott Medical Optics Inc. | Power management for wireless devices |
US8380126B1 (en) | 2005-10-13 | 2013-02-19 | Abbott Medical Optics Inc. | Reliable communications for wireless devices |
US20070260173A1 (en) * | 2006-05-05 | 2007-11-08 | Alcon, Inc. | Irrigation/aspiration tip |
US8814870B2 (en) * | 2006-06-14 | 2014-08-26 | Misonix, Incorporated | Hook shaped ultrasonic cutting blade |
US8142388B2 (en) * | 2006-10-30 | 2012-03-27 | Gomez Mario P | Apparatus to facilitate removal of cataracts of from the eyes |
US20080103430A1 (en) * | 2006-10-30 | 2008-05-01 | Gomez Mario P | Apparatus to facilitate removal of cataracts from the eyes |
US10959881B2 (en) | 2006-11-09 | 2021-03-30 | Johnson & Johnson Surgical Vision, Inc. | Fluidics cassette for ocular surgical system |
US8414534B2 (en) | 2006-11-09 | 2013-04-09 | Abbott Medical Optics Inc. | Holding tank devices, systems, and methods for surgical fluidics cassette |
US8491528B2 (en) | 2006-11-09 | 2013-07-23 | Abbott Medical Optics Inc. | Critical alignment of fluidics cassettes |
US9295765B2 (en) | 2006-11-09 | 2016-03-29 | Abbott Medical Optics Inc. | Surgical fluidics cassette supporting multiple pumps |
US9522221B2 (en) | 2006-11-09 | 2016-12-20 | Abbott Medical Optics Inc. | Fluidics cassette for ocular surgical system |
US7967775B2 (en) * | 2007-01-09 | 2011-06-28 | Alcon, Inc. | Irrigation/aspiration tip |
US10596032B2 (en) | 2007-05-24 | 2020-03-24 | Johnson & Johnson Surgical Vision, Inc. | System and method for controlling a transverse phacoemulsification system with a footpedal |
US10485699B2 (en) | 2007-05-24 | 2019-11-26 | Johnson & Johnson Surgical Vision, Inc. | Systems and methods for transverse phacoemulsification |
US10363166B2 (en) | 2007-05-24 | 2019-07-30 | Johnson & Johnson Surgical Vision, Inc. | System and method for controlling a transverse phacoemulsification system using sensed data |
US20080300531A1 (en) * | 2007-05-30 | 2008-12-04 | Gills Jr James Pitzer | Single infusion port apparatus and method for phacoemulsification |
US10342701B2 (en) | 2007-08-13 | 2019-07-09 | Johnson & Johnson Surgical Vision, Inc. | Systems and methods for phacoemulsification with vacuum based pumps |
US10292861B2 (en) * | 2008-11-07 | 2019-05-21 | Johnson & Johnson Surgical Vision, Inc. | Rotational alignment of fluid delivery device |
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WO2010054145A1 (en) * | 2008-11-07 | 2010-05-14 | Abbott Medical Optics Inc. | Surgical cassette apparatus |
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US9795507B2 (en) | 2008-11-07 | 2017-10-24 | Abbott Medical Optics Inc. | Multifunction foot pedal |
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US10349925B2 (en) | 2008-11-07 | 2019-07-16 | Johnson & Johnson Surgical Vision, Inc. | Method for programming foot pedal settings and controlling performance through foot pedal variation |
US9351871B2 (en) * | 2008-11-12 | 2016-05-31 | Alcon Research, Ltd. | Distal plastic end infusion/aspiration tip |
US9492317B2 (en) | 2009-03-31 | 2016-11-15 | Abbott Medical Optics Inc. | Cassette capture mechanism |
US8623040B2 (en) | 2009-07-01 | 2014-01-07 | Alcon Research, Ltd. | Phacoemulsification hook tip |
US8545462B2 (en) | 2009-11-11 | 2013-10-01 | Alcon Research, Ltd. | Patch for irrigation/aspiration tip |
US10258505B2 (en) | 2010-09-17 | 2019-04-16 | Alcon Research, Ltd. | Balanced phacoemulsification tip |
US9050171B2 (en) | 2010-10-04 | 2015-06-09 | William J. Foster | Small diameter fragmatome for minimally traumatic retained lens fragments removal |
US8784361B2 (en) | 2010-12-07 | 2014-07-22 | Alcon Research, Ltd. | Combined coaxial and bimanual irrigation/aspiration apparatus |
US9452084B2 (en) * | 2011-09-06 | 2016-09-27 | Art, Limited | Apparatus and method for phacoemulsification |
US9433725B2 (en) | 2011-12-23 | 2016-09-06 | Alcon Research, Ltd. | Combined coaxial and bimanual irrigation/aspiration apparatus |
EP2825219B1 (en) | 2012-03-17 | 2023-05-24 | Johnson & Johnson Surgical Vision, Inc. | Surgical cassette |
RU2667184C2 (en) | 2013-06-06 | 2018-09-17 | Новартис Аг | Transformer irrigation/aspiration device |
US10624785B2 (en) | 2016-01-30 | 2020-04-21 | Carl Zeiss Meditec Cataract Technology Inc. | Devices and methods for ocular surgery |
CA3060373A1 (en) | 2017-05-04 | 2018-11-08 | Carl Zeiss Meditec Cataract Technology Inc. | Devices and methods for ocular surgery |
WO2019236615A1 (en) | 2018-06-05 | 2019-12-12 | Carl Zeiss Meditec Cataract Technology Inc. | Ophthalmic microsurgical tools, systems, and methods of use |
EP3917468B1 (en) | 2019-02-01 | 2023-11-15 | Carl Zeiss Meditec Cataract Technology Inc. | Ophthalmic cutting instruments having integrated aspiration pump |
WO2020236593A1 (en) | 2019-05-17 | 2020-11-26 | Carl Zeiss Meditec Cataract Technology Inc. | Ophthalmic cutting instruments having integrated aspiration pump |
CN114206277B (en) | 2019-06-07 | 2024-06-25 | 卡尔蔡司白内障医疗技术公司 | Multi-stage trigger for ophthalmic cutting tools |
CN210784277U (en) * | 2019-06-10 | 2020-06-19 | 中山大学中山眼科中心 | Intraocular ruler |
US11642246B1 (en) | 2021-12-06 | 2023-05-09 | Jon Gordon Dishler | Vibrating surgical instrument |
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-
2001
- 2001-10-09 US US09/973,139 patent/US6830555B2/en not_active Expired - Lifetime
-
2002
- 2002-09-06 DE DE60221286T patent/DE60221286T2/en not_active Expired - Lifetime
- 2002-09-06 AT AT02800829T patent/ATE367138T1/en not_active IP Right Cessation
- 2002-09-06 WO PCT/US2002/028426 patent/WO2003030792A1/en active IP Right Grant
- 2002-09-06 EP EP07007176.6A patent/EP1797849B1/en not_active Expired - Lifetime
- 2002-09-06 EP EP02800829A patent/EP1463472B1/en not_active Expired - Lifetime
-
2004
- 2004-10-05 US US10/958,971 patent/US7883521B2/en active Active
-
2011
- 2011-01-31 US US13/018,034 patent/US8246644B2/en not_active Expired - Fee Related
Patent Citations (5)
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US3732858A (en) * | 1968-09-16 | 1973-05-15 | Surgical Design Corp | Apparatus for removing blood clots, cataracts and other objects from the eye |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP3694452A4 (en) * | 2017-10-13 | 2021-07-14 | Surgical Design Corporation | Dual lumen surgical hand-piece with ultrasonic knife |
Also Published As
Publication number | Publication date |
---|---|
US7883521B2 (en) | 2011-02-08 |
EP1797849A3 (en) | 2010-11-24 |
US6830555B2 (en) | 2004-12-14 |
EP1463472A1 (en) | 2004-10-06 |
EP1797849B1 (en) | 2017-12-20 |
DE60221286T2 (en) | 2008-03-20 |
US20110125082A1 (en) | 2011-05-26 |
ATE367138T1 (en) | 2007-08-15 |
US20030069594A1 (en) | 2003-04-10 |
US8246644B2 (en) | 2012-08-21 |
EP1463472B1 (en) | 2007-07-18 |
DE60221286D1 (en) | 2007-08-30 |
US20050043671A1 (en) | 2005-02-24 |
EP1797849A2 (en) | 2007-06-20 |
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