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
  • A61F9/008—Methods or devices for eye surgery using laser
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
  • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
  • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00064—Constructional details of the endoscope body
  • A61B1/0011—Manufacturing of endoscope parts
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• • 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
  • A61F9/008—Methods or devices for eye surgery using laser
  • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
• • 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
  • A61F9/008—Methods or devices for eye surgery using laser
  • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
  • A61F9/00823—Laser features or special beam parameters therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B2017/00526—Methods of manufacturing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00636—Sensing and controlling the application of energy
  • A61B2018/00696—Controlled or regulated parameters
  • A61B2018/00714—Temperature
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
  • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
  • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
  • A61B2018/2255—Optical elements at the distal end of probe tips
  • A61B2018/2261—Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
  • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
  • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
  • A61B2018/2255—Optical elements at the distal end of probe tips
  • A61B2018/2272—Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam
  • A61B2018/2277—Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam with refractive surfaces
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
  • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
• • 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
  • A61F9/008—Methods or devices for eye surgery using laser
  • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
  • A61F2009/00863—Retina
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
  • Y10T29/00—Metal working
  • Y10T29/49—Method of mechanical manufacture
  • Y10T29/49826—Assembling or joining
  • Y10T29/49885—Assembling or joining with coating before or during assembling

Definitions

• This invention relates to optical surgical probes and, more particularly, to a multi-spot laser surgical probe using faceted optical elements.
• Optical surgical probes deliver light to a surgical field for a variety of applications. In some applications, it may be useful to deliver light to multiple spots in the surgical field. For example, in pan-retinal photocoagulation of retinal tissue, it may be desirable to deliver laser light to multiple spots so as to reduce the time of the pan-retinal photocoagulation procedure.
• Various techniques have been employed to produce multiple beams for a multi-spot pattern. For example, one approach uses diffractive elements to divide an incoming beam into multiple spots.
• multi-spot generator that can be placed at a distal end of the optical surgical probe to more easily produce multiple spots from a single input beam, so that the multi-spot generator can more easily be used with existing laser sources without the need for additional components to align the laser surgical probe with the sources.
• Difficulties can arise in the use of diffractive elements at a distal end of the optical surgical probe.
• diffractive elements produce a multitude of higher diffraction orders, and while these orders are relatively lower in light intensity as compared to the primary spot pattern, they may not always be negligible in terms of their effects.
• a diffractive element may not perform identically in different refractive media. For example, if the diffractive element is placed into a medium other than air, such as saline solution or oil, spaces between the diffractive elements can be filled with material having a different refractive index than air, which can ruin the spot pattern.
• the spacing between the spots can vary for different wavelengths, which can be problematic when an aiming beam is of a certain color while a treatment beam is of a different color.
• diffractive elements are frequently expensive and difficult to produce, and this is particularly the case when the diffractive element must be constructed to fit into a small area, such as a distal tip of a surgical probe for surgical instruments that are 23-gauge or smaller.
• an optical surgical probe that can produce multiple spots at a target area using optical elements at a distal end of the surgical probe.
• an optical surgical probe includes a handpiece, a light guide within the handpiece, and a multi-spot generator at a distal end of the handpiece.
• the handpiece is configured to optically couple to a light source.
• the light guide is configured to carry a light beam from the light source to a distal end of the handpiece.
• the multi-spot generator includes a faceted optical element with a faceted end surface spaced from a distal end of the light guide.
• the faceted end surface includes at least one facet oblique to a path of the light beam.
• the faceted end surface may be convex or concave.
• the multi-spot generator further includes a focusing element, such as a gradient index (GRIN) lens or a sapphire ball lens.
• a focusing element such as a gradient index (GRIN) lens or a sapphire ball lens.
• the faceted end surface is formed in optical adhesive, and the multi-spot generator may include multiple optical adhesive materials.
• a method of manufacturing a multi-spot optical surgical probe includes depositing an optical adhesive in a cannula for a handpiece.
• the handpiece for which the cannula is formed includes at least one light guide configured to carry a light beam from a light source through the handpiece.
• the method further includes forming the optical adhesive to produce a faceted face.
• the method also includes curing the optical adhesive.
• the method additionally includes assembling the cannula with the handpiece to form a multi-spot generator that includes the optical adhesive at a distal end of the handpiece.
• the optical adhesive may be formed on or around a focusing element, such as a GRIN lens or a sapphire ball lens. In certain embodiments, multiple optical adhesive materials may also be used.
• FIGURE 1 illustrates a distal end of a handpiece for an optical surgical probe including a multi-spot generator according to a particular embodiment of the present invention
• FIGURE 2 illustrates another multi-spot generator according to a particular embodiment of the present invention
• FIGURE 3 illustrates yet another multi-spot generator according to a particular embodiment of the present invention
• FIGURE 4 is a flow chart illustrating an example method of manufacturing a multi-spot optical surgical probe according to a particular embodiment of the present invention.
• FIGURE 5 is a flow chart illustrating another example method of manufacturing a multi-spot optical surgical probe according to a particular embodiment of the present invention.
• FIGURE 1 illustrates a distal end of a handpiece 100 for an optical surgical probe that includes a multi-spot generator 102 in a cannula 101 in accordance with a particular embodiment of the present invention, the term “distal” referring to a direction along the probe 100 toward a target area and its antonym “proximal” referring to the opposite direction.
• the multi-spot generator 102 includes a proximal faceted optical element 104 and a distal faceted optical element 106.
• faceted refers to any optical element having an end surface formed of multiple subsurfaces (facets) so that the intersections between the facets are not smooth.
• the facets may be, but need not be, planar.
• a facet may be a curved subsurface intersecting another subsurface so that the curvature is not smooth across the intersection of the subsurfaces; such embodiments may provide optical focusing power.
• a light guide 108 delivers a light beam to a proximal planar face of the proximal faceted optical element 104.
• the light guide 108 could in principle be any suitable structure for transmitting light to the distal end of the handpiece 100, optical fibers are most commonly used in surgical applications.
• the central axis of the emitted beam from the light guide 108 is referred to as the "beam path.”
• the light beam diverges as it travels away from the light guide 108 to a degree that depends on the numerical aperture for the light beam coupled into the light guide 108. For this reason, the faceted optical surface of faceted optical elements is spaced from a distal end of the light guide 108 so that portions of the diverging beam are refracted to different locations.
• At least one facet is oriented such that a direction normal to a facet at a center of the facet is not parallel to the beam path of the emitted light beam.
• Such facets are described herein as being "oblique to the beam path.”
• the faceted optical elements 104 and 106 each have different refractive indices, so that as the beam exiting the light guide 108 diverges, the faceted interface between the concave faceted face of the proximal optical element 104 and the convex faceted face of the distal optical element 106 produces multiple spots emerging from a distal planar face of the distal faceted optical element 106.
• Concave and “convex” in this context refer to whether the faceted surface is formed inwardly or outwardly of the optical element along the beam path.
• the spots could further diverge as they pass from the distal face of the optical element 106 into the medium.
• the proximal faceted optical element 104 could have an index of refraction of 1 .36 and the distal faceted optical element could have an index of refraction of 1 .58, which can produce a spot spacing on the order of a millimeter for a target around 4 mm away, assuming an angle between the facets and the beam path is in the range of 35 to 55 degrees.
• the optical elements 104 and 106 each have four triangular facets oblique to the beam path that meet at a point aligned with a center of the light beam from the light guide, so that the multi-spot generator 102 produces four output spots.
• the number and shape of the facets could be adjusted to produce a desired pattern of output spots. For example, the number of facets could be increased.
• the faceted optical elements 104 and 106 may advantageously be formed of optical adhesives.
• Using optical adhesives to form faceted optical elements has several technical advantages.
• One advantage is that the refractive index of the faceted optical elements 104 and 106 can be selected from a number of available materials.
• Another advantage is relative ease of forming the faceted surface as compared to harder refractive materials that may be difficult to mold, etch, cut, or machine into a suitable shape.
• a third advantage is that the optical adhesive material can be relatively durable in use as compared to other optical elements, like diffraction gratings, that can be relatively fragile.
• a fourth advantage is that the optical adhesive may be formed around other optical components, allowing the optical adhesive and the other optical components to work together in generating a multi-spot pattern.
• FIGURE 2 illustrates a multi-spot generator 202 according to particular embodiments of the particular invention that includes a faceted optical element 204 formed around a ball lens 206.
• the primary function of the ball lens 206 is to focus the incident beam so it is either collimated or converging on the distal side of the ball lens 206.
• the ball lens 206 may be any spherical or nearly spherical lens formed from any refractive material for transmitting light from the light source through the lens.
• the refractive index of the ball lens should be greater than that of the surrounding adhesive medium.
• a convex faceted end surface 208 of the faceted optical element 204 is arranged to point toward the light guide 108 with the faceted end surface 208 spaced from a distal end of the light guide 108. Portions of the emitted light beam are then refracted into multiple spots by the faceted optical element 204, and the spots are transmitted through the ball lens 206 out of a planar distal surface of the faceted optical element 204.
• the faceted end surface 208 could be concave.
• the ball lens 206 can converge the beams directed into the various spots to some degree to produce a multi-spot pattern that does not spread as rapidly when the distance from the end of the handpiece 100 increases, which in turn allows the multi-spot pattern to have a more consistent spot spacing despite slight variations in the spacing between the distal end of the handpiece 100 and the target area.
• FIGURE 3 illustrates an example of with a multi-spot generator 302 incorporating a proximal faceted optical element 304, a distal faceted optical element 306, and a cylindrical gradient index (GRIN) lens 308.
• the light beam emitted from the light guide 108 is expanded and then collimated or converged by the GRIN lens 308.
• the collimated or converged light beam then enters a planar proximal face of the proximal faceted optical element 304, and portions of the collimated or converged light beam are refracted into multiple spots as they pass through the interface between the faceted surfaces of the faceted optical elements 304 and 306.
• FIGURE 4 is a flow chart 400 illustrating an example method for forming faceted optical elements from optical adhesives having different refractive indices.
• a first optical adhesive is deposited within a cannula for a surgical handpiece.
• an optical fiber may be placed within the cannula using a centering cylinder during this step, and the first optical adhesive may be deposited directly onto a distal end of the optica! fiber.
• a GRIN lens can be placed within the cannula at a distal end of the light guide, and the first optical adhesive can be deposited on a distal end of the GRIN lens.
• a faceted surface is formed in the optical adhesive.
• a pin having a convex faceted shape may be molded into the optical adhesive from a distal end of the cannula to produce a concave faceted surface in the optical adhesive.
• the first optical adhesive is cured, such as by exposure ultraviolet (UV) light, heat, or a chemical curing agent, thereby hardening the first optical adhesive in the desired shape and allowing the molding pin to be removed.
• UV ultraviolet
• a second optical adhesive is deposited on the distal face of the previously-cured optical adhesive.
• the second optical adhesive conforms to the concave faceted surface of the first optical adhesive to produce a convex faceted surface in the second optical adhesive.
• the distal surface of the second optical adhesive may then be flattened by pressing down a mold plate.
• the deposition of the optical adhesive can be otherwise controlled to produce a desired shape, such as by introduction into a closed mold volume. In the latter case, two faceted surfaces could be formed if desired.
• the second optical adhesive is cured to harden it in the desired shape. Different curing processes may be used for the first and second optical adhesives.
• a wavelength of light used to cure the second adhesive may be different than a wavelength used to cure the second adhesive, so that there are no negative effects from overexposure of the first adhesive to curing radiation.
• a mold plate or other closed mold used to form the second optical adhesive may also be made from a material transparent to curing radiation (e.g., quartz for UV curing radiation), so that the second adhesive may be cured with the mold plate still in place. The mold plate can then be removed after curing. The cannula with the first and second optical adhesives may then be assembled into a surgical handpiece at step 412 to complete the method.
• FIGURE 5 is a flow chart 500 illustrating an example method for forming a faceted optical element around another optical element in according with another embodiment of the present invention.
• optical adhesive is deposited on a mold plate around a ball lens.
• the optical adhesive formed around the ball lens is pressed into a distal end of a cannula.
• the mold plate can include a cannula guide to facilitate alignment with the cannula. As the optical adhesive is pressed into the cannula, excess optical adhesive is forced out of the cannula, so that with sufficiently careful control of the amount of deposited adhesive, a consistent and accurate amount of optical adhesive will end up within the cannula.
• a faceted surface is formed on a proximal end of the optical adhesive.
• the faceted surface may be convex or concave.
• the faceted surface may be formed, for example, by using a pin with a complementary faceted surface on the end that is inserted into a proximal end of the cannula.
• the optical adhesive is cured, hardening the optical adhesive in the desired shape and allowing the molding pin and the mold plate to be removed.
• the handpiece is assembled with the cannula at step 510, completing the method.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Surgery (AREA)
• Engineering & Computer Science (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Veterinary Medicine (AREA)
• Physics & Mathematics (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Animal Behavior & Ethology (AREA)
• Ophthalmology & Optometry (AREA)
• Optics & Photonics (AREA)
• Molecular Biology (AREA)
• Medical Informatics (AREA)
• Vascular Medicine (AREA)
• Pathology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Otolaryngology (AREA)
• Electromagnetism (AREA)
• Biophysics (AREA)
• Manufacturing & Machinery (AREA)
• Radiology & Medical Imaging (AREA)
• Laser Surgery Devices (AREA)
• Radiation-Therapy Devices (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
• Endoscopes (AREA)

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Citations (8)

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• 2010
  • 2010-12-03 EP EP10836457.1A patent/EP2509525B1/en active Active
  • 2010-12-03 BR BR112012013750A patent/BR112012013750A2/pt active Search and Examination
  • 2010-12-03 RU RU2012128828/14A patent/RU2540913C2/ru not_active IP Right Cessation
  • 2010-12-03 MX MX2012006536A patent/MX2012006536A/es active IP Right Grant
  • 2010-12-03 KR KR1020127017700A patent/KR101689250B1/ko not_active Expired - Fee Related
  • 2010-12-03 WO PCT/US2010/058942 patent/WO2011071776A1/en not_active Ceased
  • 2010-12-03 ES ES10836457.1T patent/ES2557883T3/es active Active
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  • 2010-12-03 US US12/959,533 patent/US8764261B2/en active Active
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  • 2010-12-03 JP JP2012543172A patent/JP5753186B2/ja active Active
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• 2014
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• 2017
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