WO2014058973A1 - Systèmes & procédés de chirurgie femto-phaco de la cataracte combinée - Google Patents

Systèmes & procédés de chirurgie femto-phaco de la cataracte combinée Download PDF

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Publication number
WO2014058973A1
WO2014058973A1 PCT/US2013/064051 US2013064051W WO2014058973A1 WO 2014058973 A1 WO2014058973 A1 WO 2014058973A1 US 2013064051 W US2013064051 W US 2013064051W WO 2014058973 A1 WO2014058973 A1 WO 2014058973A1
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WO
WIPO (PCT)
Prior art keywords
phacoemulsification
subsystem
procedures
menu
select
Prior art date
Application number
PCT/US2013/064051
Other languages
English (en)
Inventor
Douglas Patton
Original Assignee
Douglas Patton
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
Priority claimed from US13/648,196 external-priority patent/US8986290B2/en
Application filed by Douglas Patton filed Critical Douglas Patton
Publication of WO2014058973A1 publication Critical patent/WO2014058973A1/fr

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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
    • A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
    • 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
    • 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
    • A61F2009/0087—Lens
    • 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
    • A61F2009/00885—Methods or devices for eye surgery using laser for treating a particular disease
    • A61F2009/00887—Cataract

Definitions

  • the field of the invention is cataract surgery.
  • phacoemulsification which is colloquially known as "phaco”.
  • the internal lens of an eye is emulsified with an ultrasonic handpiece, and the detritus is aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution.
  • an intraocular lens implant IOL
  • IOL intraocular lens implant
  • the phaco probe is an ultrasonic handpiece with a titanium or steel needle.
  • the tip of the needle vibrates at ultrasonic frequency to sculpt and emulsify the cataract, while the pump aspirates particles through the tip.
  • a second fine steel instrument called a "chopper" is used from a side port to help with chopping the nucleus into smaller pieces.
  • the cataract is usually broken into two or four pieces and each piece is emulsified and aspirated out with suction.
  • the nucleus emulsification makes it easier to aspirate the particles. After removing all hard central lens nucleus with phacoemulsification, the softer outer lens cortex is removed with suction only.
  • Phacoemulsification surgery involves the use of a machine with microprocessor- controlled fluid dynamics. Emulsification power applied through the probe, vacuum strength of the aspirator, and other operating parameters of the phaco device are controlled through software. Examples of graphic user interfaces of popular phacoemulsification software are depicted in prior art Figures 1 and 2.
  • phacoemulsification is performed by two entirely separate machines, requiring translocation and re-setup of the patient. This increases the time required for the procedure, and can cause undue stress on the patient.
  • the inventive subject matter provides apparatus, systems and methods in which devices to perform femtolaser ablation and phacoemulsification are physically and/or operationally combined.
  • At least one subsystem of the femtolaser ablation functionality is housed in a common housing with at least one subsystem of the phacoemulsification functionality.
  • a display screen displays both a first graphical user interface for the femtolaser ablation functionality and a second graphical user interface for the
  • software includes instructions disposed on a non-transitory computer-readable medium that are common to operation of both the femtolaser ablation functionality and the phacoemulsification functionality.
  • a non-transitory computer-readable memory provides data that can be used to operate each of the femtolaser ablation functionality and the phacoemulsification functionality.
  • Fig. 1 is a screen shot of a prior art graphical user interface for a phacoemulsification device.
  • Fig. 2 is a screen shot of an alternative prior art graphical user interface for a phacoemulsification device.
  • FIG. 3 is a prior art representation of the phacoemulsification device of Figures 1 and 2.
  • FIG. 4 is a prior art representation of a display of the phacoemulsification device of Figures 1 and 2, showing an eye during phacoemulsification.
  • FIG. 5 is a prior art representation of a display of the phacoemulsification device of Figures 1 and 2, showing an eye during aspiration.
  • Fig. 6 is a prior art screen shot of a prior art graphical user interface for a femtolaser ablation device.
  • Fig. 7 is a screen shot of another prior art graphical user interface of the femtolaser ablation device of Figure 3.
  • FIG. 8 is a prior art representation medical personnel using the femtolaser ablation device of Figures 6 and 7.
  • FIG. 9 is a prior art representation medical personnel using the femtolaser ablation device of Figures 6 and 7.
  • Fig. 10 is another prior art representation of a femtolaser ablation device.
  • Fig. 11 is a schematic of a graphical user interface of software configured to control both a femtolaser ablation device and a phacoemulsification device.
  • Fig. 12 is a schematic of the graphical user interface of Figure 11, showing a menu of procedures that can be selected for the femtolaser ablation device.
  • Fig. 13 is a schematic of the graphical user interface of Figure 11, showing a menu of procedures that can be selected for the phacoemulsification device.
  • Fig. 14 is a schematic of the graphical user interface of Figure 11, concurrently showing menus of procedures that can be selected for the femtolaser ablation device and the phacoemulsification device
  • Fig. 15 is a schematic of a graphical user interface concurrently showing menus of procedures that can be selected for a device that combines femtolaser ablation functionality and phacoemulsification functionality.
  • Fig. 16 is a schematic of a device that combines femtolaser ablation functionality and phacoemulsification functionality, using a common GUI control platform.
  • Fig. 17 is a schematic of a device that utilizes a common GUI control platform to control physically separate femtolaser ablation and phacoemulsification devices.
  • inventive subject matter provides example embodiments of the inventive subject matter. Although each embodiment represents a single combination of inventive elements, the inventive subject matter is considered to include all possible combinations of the disclosed elements. Thus if one embodiment comprises elements A, B, and C, and a second embodiment comprises elements B and D, then the inventive subject matter is also considered to include other remaining combinations of A, B, C, or D, even if not explicitly disclosed.
  • a single GUI and/or software can combine control of ophthalmic phacoemulsification and femtolaser functionalities for cataract removal. These can be combined in many diverse ways for surgical use on at least one of a computer touch screen, a set of dedicated buttons, a foot pedal, and a voice interface.
  • Fig. 11 is a schematic of a graphical user interface of software configured to control both a femtolaser ablation device and a phacoemulsification device.
  • the platform can be local to one or more of the devices, and can alternatively or additionally be at least partially disposed on one or more distal servers (e.g., cloud, PaaS, IaaS, SaaS, etc.).
  • distal servers e.g., cloud, PaaS, IaaS, SaaS, etc.
  • Coupled to is intended to include both direct coupling (in which two elements that are coupled to each other contact each other) and indirect coupling (in which at least one additional element is located between the two elements). Therefore, the terms “coupled to” and “coupled with” are used synonymously.
  • the terms “coupled to” and “coupled with” are also use euphemistically to mean
  • any language directed to a computer or software platform should be read to include any suitable combination of computing devices, including servers, interfaces, systems, databases, agents, peers, engines, controllers, or other types of computing devices operating individually or collectively.
  • the computing devices comprise a processor configured to execute software instructions stored on a tangible, non- transitory computer readable storage medium (e.g., hard drive, solid state drive, RAM, flash, ROM, etc.).
  • the software instructions preferably configure the computing device to provide the roles, responsibilities, or other functionality as discussed below with respect to the disclosed apparatus.
  • the various servers, systems, databases, or interfaces exchange data using standardized protocols or algorithms, possibly based on HTTP, HTTPS, AES, public-private key exchanges, web service APIs, known financial transaction protocols, or other electronic information exchanging methods.
  • Data exchanges preferably are conducted over a packet-switched network, the Internet, LAN, WAN, VPN, or other type of packet switched network.
  • FIG. 12 is a schematic of the graphical user interface of Figure 1 1 , showing a menu of procedures that can be selected for the femtolaser ablation device. These are exemplary procedures only, and contemplated femtolaser GUI interfaces may list other or additional procedures.
  • Figures 12 - 15 are merely schematics, and commercial embodiments of the interfaces would be much more detailed and user friendly, such as along the lines of that shown in Figures 1 or 2.
  • Fig. 13 is a schematic of the graphical user interface of Figure 1 1 , showing a menu of procedures that can be selected for the phacoemulsification device.
  • Fig. 14 is a schematic of the graphical user interface of Figure 1 1 , concurrently showing menus of procedures that can be selected for separate femtolaser ablation and phacoemulsification devices.
  • Fig. 15 is a schematic of a graphical user interface concurrently showing menus of procedures that can be selected for a device that combines femtolaser ablation functionality and phacoemulsification functionality.
  • This interface differs from that shown in Figure 14 because the listing of functionalities is customized in some manner, for example by including custom functionalities not programmed into off-the-shelf devices, and/or by hiding functionalities that might otherwise be available.
  • Such customization of main menu and/or submenu procedures for phaco and femto could be arranged by the manufacturer and/or or surgeon in an order that is thought to best fit the process of cataract removal and soft lens insertion for a particular practitioner or office.
  • FIG. 16 is a schematic of a device that combines femtolaser ablation functionality and phacoemulsification functionality, using a common GUI control platform.
  • Fig. 17 is a schematic of a device that utilizes a common GUI control platform to control physically separate femtolaser ablation and phacoemulsification devices.
  • Each of the interfaces of Figures 12-15 could be used with each of the embodiments shown in Figures 16 and 17.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • User Interface Of Digital Computer (AREA)

Abstract

L'invention concerne des dispositifs pour mettre en œuvre l'ablation par laser femto-seconde et la phacoémulsification qui sont combinés physiquement et/ou fonctionnellement. Dans certains modes de réalisation, l'ablation par laser femto-seconde et la phacoémulsification sont logées ensemble et dans d'autres modes de réalisation, elles sont logées séparément, mais mises en fonctionnement par l'intermédiaire d'un écran d'affichage commun. Au moins certains logiciels peuvent être partagés par les fonctionnalités d'ablation par laser femto-seconde et de phacoémulsification. Une mémoire pouvant être lue par ordinateur non transitoire peut fournir des données qui peuvent être utilisées pour faire fonctionner chacune d'au moins une fonctionnalité d'ablation par laser femto-seconde et d'au moins une fonctionnalité de phacoémulsification.
PCT/US2013/064051 2012-10-09 2013-10-09 Systèmes & procédés de chirurgie femto-phaco de la cataracte combinée WO2014058973A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/648,196 US8986290B2 (en) 2011-10-06 2012-10-09 Systems and methods for combined femto-phaco cataract surgery
US13/648,196 2012-10-09

Publications (1)

Publication Number Publication Date
WO2014058973A1 true WO2014058973A1 (fr) 2014-04-17

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4218695A1 (fr) * 2020-01-03 2023-08-02 Lensar, Inc. Systèmes intégrés pour thérapies combinées laser-phacémulsification prédéterminées

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006073400A1 (fr) * 2005-01-05 2006-07-13 Advanced Medical Optics, Inc. Systeme de phacoemulsification mettant en application des interfaces utilisateur graphiques afin de regler les parametres d'impulsion
US7137980B2 (en) * 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
US20080281303A1 (en) * 2007-03-13 2008-11-13 William Culbertson Method and apparatus for creating ocular surgical and relaxing incisions
WO2009023809A1 (fr) * 2007-08-15 2009-02-19 Advanced Medical Optics, Inc. Systèmes et procédés de gestion et de distribution de profils d'utilisateur pour des systèmes chirurgicaux
US20100156646A1 (en) * 2008-12-19 2010-06-24 Cull Laurence J System to identify viscosity of aspirated material during ophthalmic surgery
WO2011147570A1 (fr) * 2010-05-27 2011-12-01 Carl Zeiss Meditec Ag Dispositif et méthode de chirurgie de la cataracte

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7137980B2 (en) * 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
WO2006073400A1 (fr) * 2005-01-05 2006-07-13 Advanced Medical Optics, Inc. Systeme de phacoemulsification mettant en application des interfaces utilisateur graphiques afin de regler les parametres d'impulsion
US20080281303A1 (en) * 2007-03-13 2008-11-13 William Culbertson Method and apparatus for creating ocular surgical and relaxing incisions
WO2009023809A1 (fr) * 2007-08-15 2009-02-19 Advanced Medical Optics, Inc. Systèmes et procédés de gestion et de distribution de profils d'utilisateur pour des systèmes chirurgicaux
US20100156646A1 (en) * 2008-12-19 2010-06-24 Cull Laurence J System to identify viscosity of aspirated material during ophthalmic surgery
WO2011147570A1 (fr) * 2010-05-27 2011-12-01 Carl Zeiss Meditec Ag Dispositif et méthode de chirurgie de la cataracte

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4218695A1 (fr) * 2020-01-03 2023-08-02 Lensar, Inc. Systèmes intégrés pour thérapies combinées laser-phacémulsification prédéterminées
EP4218694A1 (fr) * 2020-01-03 2023-08-02 Lensar, Inc. Procédés et systèmes pour des applications soniques et laser combinées pour l' il
EP4084752A4 (fr) * 2020-01-03 2024-01-10 Lensar Inc Systèmes intégrés pour polythérapies prédéterminées de laser-phacoémulsification
EP4084753A4 (fr) * 2020-01-03 2024-06-05 Lensar Inc Systèmes laser-phaco intégrés reconfigurables et compacts et procédés d'utilisation

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