WO2021053382A1

WO2021053382A1 - A pre-chopper for cataract surgery

Info

Publication number: WO2021053382A1
Application number: PCT/IB2019/059688
Authority: WO
Inventors: Dr. Sohel Irfan Mohammed KHAN
Original assignee: Khan Dr Sohel Irfan Mohammed
Priority date: 2019-09-16
Filing date: 2019-11-12
Publication date: 2021-03-25

Abstract

Phacoemulsification is the procedure of choice to fragment the nucleus of cataractous lens through a very small incision into the eye. Looking at nature of surgery and fragile organ to be operated, risk of damaging other parts of eye is5inherently associated with the complex instruments.The pre-chopper disclosed has three main components, first being a curved blade (1) having an inner cutting edge (1A), an outer blunt edge (1B) and a pointed tip (1C); second being a flat planer object named a shaft (2); and third being a holding mean (3). The curved blade is connected at its another end to a shaft at an angle ranging between 100° to 120°. Another end of said shaft is connected to the holding mean at an angle ranging between 130° to 140°. This is very crucial connection arrangement as the blade is operated safely inside the delicate eye at this arrangement.

Description

TITLE : A PRE-CHOPPER FOR CATARACT SURGERY

FIELD OF INVENTION

The invention relates to an instrument for use in a cataract surgery. More particularly it relates to a pre-chopper for cataract surgery.

BACKGROUND OF INVENTION

Natural lens in eye is a transparent convex lens which is enclosed in a thin bag called as capsular bag. When this clear lens starts to get cloudy or opaque, it’s called cataract. Once cataract develops and causes significant blurring of vision, surgical removal of this opaque lens (cataract) is the only way to improve vision. Cataract surgery includes removal of opaque lens and placing an Artificial Intra- Ocular Lens (herein after referred to as AIOL) in the capsular bag from where the cataract has been removed.

For correcting vision of cataract patient, removing cataract lens from the eye for placement of artificial intra ocular lens is primary task of the surgery.

Phacoemulsification is today the procedure of choice to fragment the nucleus of cataractous lens through a very small incision (2.2 to 2.8 mm) into the eye.

The use of ultrasound energy used in this procedure of phacoemulsification efficiently breaks the nucleus of lens. But at the same time this energy collaterally can damage the vital structures of eye like corneal endothelium, iris and posterior capsule. It can also produce the disastrous wound burn complication in very hard nuclei of cataractous lens.

Hence today the quest of every phaco surgeon is to minimize the use of phaco energy to reduce the extent of the collateral damage. FLACS - Femtolaser assisted cataract surgery is another giant leap in this quest to minimize the use of phacoenergy, But FLACS is extremely expensive for the eye surgeon and the patients.

Evolution of various mechanical devices to break the nucleus during phaco surgery are called Phaco Choppers.

Similarly mechanical devices to disassemble the nucleus prior to phaco called as PRECHOPPERS are also available.

Various mechanical devices to fragment the nucleus prior to phaco are called ‘Pre-chop’ devices.

The current available devices are much complicated and requires phenomenal skill for handling such instruments. Looking at the nature of surgery and the fragile organ to be operated, the risk of damaging other parts of eye is inherently associated with the complex instruments.

One such currently available device is Akahoshi pre-chopper forcep. After inserting the sharp tip jaws into the core of the nucleus of cataract, the forceps handle is gently squeezed to spread the jaws and divide the nucleus. Many times this is very inconvenient for the surgeons looking at the delicacy of the eye components.

Though these pre-chop instruments continued to evolve, none of them have been phenomenally successful and have steep learning curve and difficult to master.

The Pre chopper device disclosed in this specification is an elegant device to produce nuclear disassembly prior to phaco. It is very simple, sleek, user friendly and ergonomically designed device to use through the main phaco wound of either 2.2 or 2.8 mm. Unlike other devices it does not have a cross action so anterior chamber shallowing is minimal. It is compatible for use in a soft and a very hard cataract hence it is a Universal pre-chopper. It is very easy to manoeuver and master and doesn’t invite complications like Descement’s membrane detachment, or a posterior capsular tears. It can be made both as steel or titanium instrument. This pre-chopper device is a giant leap towards simplifying pre-chop technique thorough precision and elegance.

SUMMARY OF INVENTION

An invention in first aspect provide a pre-chopper for cataract surgery which comprises a) a curved blade (1) having an inner cutting edge (1 A), an outer blunt edge (IB), a pointed tip (1C) at its one end, and - being connected at its another end to a shaft (2) at an angle ranging between 100° to 120°; b) a shaft (2) being a flat planer object connected at its one end to the blade and at its another end to the holding mean (3) at an angle ranging between 130° to 140°; and c) a holding mean (3) for holding the pre-chopper.

The shape of curved blade in itself is unique and specifically devised for the cataract surgery of the eye. The cutting edge (1A) is basically the shorter length edge forming inner side of the curved blade (1). The outer edge (IB) of the curved blade (1) is kept blunt. During operation, the pointed tip (1C) is fixed into the nucleus of cataract i.e. cloudy lens. Then it divides the nucleus of cataract in to two halves followed by in to four pie shaped quadrants. The cutting is assisted by the cutting edge (1 A) of curved blade with the help of unique shape of entire pre chopper. The curved blade (1) is connected at its another end to a shaft (2) which is a flat planer object at an angle ranging between 100° to 120°. In turn another end of said shaft (2) is connected to the holding mean (3) at an angle ranging between 130° to 140°. This is very crucial connection arrangement as the blade is operated safely inside the delicate eye at this arrangement.

BRIEF DESCRIPTION OF DRAWINGS The embodiments herein will be better understood from the following detailed description with reference to the drawings, in which:

FIGURE 1 illustrates a pre-chopper device in three different embodiments according to current invention in which

A) denotes the pre-chopper device with 1.4 mm curved blade length and angle of 120° between the shaft and the holding mean which is beneficial for use in soft cataract surgery,

B) denotes the pre-chopper device with 1.6 mm curved blade length and angle of 120° between the shaft and the holding mean which is beneficial for use in medium density cataract surgery, and C) denotes the pre-chopper device with 1.8 mm curved blade length and angle of 100° between the shaft and the holding mean which is beneficial for use in hard cataract surgery;

FIGURE 2 illustrates a curved blade and a shaft forming part of the pre-chopper device according to current invention;

FIGURE 3 and 4 illustrates the perspective views of patient eyes in sequential stages of routine surgery when the pre-chopper device of current invention is inserted in the eye and the nucleus of cataract is divided in to two halves followed by in to four pie shaped quadrants; and FIGURE 5 illustrate a pre-chopper device made in accordance with the example 1.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

For correcting vision of cataract patient, removing cataract lens from the eye for placement of artificial intra ocular lens is primary task of the surgery. The current available devices are much complicated and requires a very high level of skill for handling such instruments. Looking at the nature of surgery and the fragile organ to be operated, the risk of damaging other parts of eye is inherently associated with the complex instruments. As mentioned, there remains a long felt need to provide a solution in such situations, which is unequivocally efficient and effective for alleviating surgeon's stress and completing the surgery with successful removal of cataract lens. The present embodiment tries to address this long felt need.

Referring to Fig. 1, the pre-chopper for cataract surgery is illustrated. It has three main components, the first being a curved blade (1) having an inner cutting edge (1A), an outer blunt edge (IB) and a pointed tip (1C) at its one end; second being a flat planer object named a shaft (2) which is connected at its one end to the blade (1) and at its another end to the holding mean (3); and third being a holding mean (3) for holding the pre-chopper.

The curved blade (1) is connected at it’s another end to said shaft (2) at an angle ranging between 100° to 120° and said shaft (2) is connected to the holding mean (3) at an angle ranging between 130° to 140°.

More preferably the angle of connection between the curved blade (1) and the shaft (2) is 100° for hard cataract and is 120° for medium density and soft cataract. Thus, in one embodiment the curved blade (1) is connected at it’s another end to a shaft (2) at an angle of 120° and in another embodiment the curved blade (1) is connected at its another end to a shaft (2) at an angle of 101°. Fig. 2 illustrate the curved blade part of the pre-chopper device according to current invention. The structure of the curved blade in which the inner cutting edge (1A), the outer blunt edge (IB) and the pointed tip (1C) is been illustrated in this figure. The pointed tip (1C) preferably has thickness ranging between 0.01mm to 0.02mm. The shaft (2) is also shown in said figure. Preferably the shaft has breadth ranging between 0.75 to 1.0 mm.

The shaft (2) is connected at its another end to the holding mean (3) preferably at an angle of 135° for providing comfort and ease to the surgeon while operating the cataract eye. The holding mean (3) is preferably a longitudinal handle having length ranging between 8 to 80 mm.

Referring to Fig. 3 and 4, the perspective views of patient eyes under routine surgery is illustrated in these figures; when the pre-chopper device of current invention is inserted in the eye through an incision of around 2.2 to 2.8mm (main incision) and the nucleus of cataract is first divided in to two halves and then in to four pie shaped quadrants. Referring now to these figures, where similar reference characters denote corresponding features consistently throughout the figures, preferred embodiments are shown. A patient herein include humans and animals who undergoes cataract surgery.

A hooking instrument may be used in this surgery. The embodiments illustrated show use of such hooking instrument in the surgery. As shown in Fig. 3 (a), the hooking instrument is inserted into the eye by a small incision 90° away from the main incision After inserting the hooking instrument inside the eye, it is hooked on the nucleus of cataract near a peripheral point and a small incision in eye opposite to said hooking position is made for entrance of the pre-chopper device. The device is specifically advantageous as it enter inside the eye through a very small incision such as 2.2 mm without damaging the eye. A small twisting of device by holding it through the holding mean allow the surgeon to insert it inside an eye of patient. Then as shown in Fig. 3 (b) and (c), the curved blade (1) and the shaft (2) are inserted in the eye and then the tip (1C) of the curved blade (1) is pierced into the substance of nucleus of cataract. It breaks the nucleus into multiple pie shaped small fragments. Moving further, the surgery progresses as illustrated in figures 4 (a) to (c) by moving the pre-chopper device inside eye towards the peripheral point at hooking instrument thereby cutting the nucleus in almost two halves. It can be further cut to divide the nucleus in to four pie shaped quadrants. The specific design of the pre-chopper device as explained herein before make the pointed tip (1C) and the inner cutting edge (1A) to assist the surgeon in cutting down the nucleus of cataract without damaging other delicate parts of the eye.

For human eye, the length of the curved blade (1) is preferably ranging between 1.4 mm to 1.8 mm and the shaft (2) length ranging between 8 to 12 mm is preferred. More preferably, the shaft has length 12 mm. Preferably, the curved blade (1) has breadth ranging between 0.2 to 0.3 mm.

Due to specific design mentioned hereinbefore, after chopping the nucleus of cataract and breaking down it in small pieces, the pre-chopper is very smoothly removed out from the eye without causing any harm to the delicate components of eye.

Example:

In an example embodiment, as illustrated in Fig. 5 the pre-chopper device of following specification according to current invention was made and used in the cataract surgery:

In another example embodiment, the pre-chopper device may be made in different sizes but in compliance with the shape, dimensions given in this specification depending upon the size of the eye, the size of incision. The material can alternatively be titanium also.

In the present embodiment, the pre-chopper device may be easily shipped, stored, handled, sterilized and adapted according to the size of the eye. In another embodiment, the pre-chopper device may be available as a disposable (single use) device.

Advantages of current pre-chopper device are it is suited for all grades of cataracts, it is sleek and doesn’t resemble any cross action forcep designs like the Akahoshi pre-chopper and it being a sleek instrument the anterior chamber is well maintained. This pre-chopper is easy to handle in cataract surgery. Thus the present embodiments mentioned herein provide the pre-chopper device which may be inserted into the eye and can divide the nucleus of cataract in a quick, easy and safe manner.

The foregoing description of the specific embodiments will so fully reveal the general nature of the embodiments herein that others can, by applying current knowledge, readily modify and/or adapt for various applications such specific embodiments without departing from the generic concept, and, therefore, such adaptations and modifications should and are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. Therefore, while the embodiments herein have been described in terms of preferred embodiments, those skilled in the art will recognize that the embodiments herein can be practiced with modification within the spirit and scope.

Claims

I/We claim:

1. A pre-chopper for cataract surgery comprising: a) a curved blade (1) having an inner cutting edge (1 A), - an outer blunt edge (IB), a pointed tip (1C) at its one end, and - being connected at its another end to a shaft (2) at an angle ranging between 100° to 120°; b) a shaft (2) being a flat planer object connected at its one end to the blade and at its another end to the holding mean (3) at an angle ranging between 130° to 140°; and c) a holding mean (3) for holding the pre-chopper.

2. The pre-chopper as claimed in claim 1, wherein the pointed tip (1C) of curved blade (1) has thickness ranging between 0.01mm to 0.02mm.

3. The pre-chopper as claimed in claim 1, wherein the curved blade (1) is connected at its another end to a shaft (2) at an angle of 100°.

4. The pre-chopper as claimed in claim 1, wherein the curved blade (1) is connected at its another end to a shaft (2) at an angle of 120°.

5. The pre-chopper as claimed in claim 1, wherein the shaft (2) is connected at its another end to the holding mean (3) at an angle of 130°.

6. The pre-chopper as claimed in claim 1, wherein the shaft (2) is connected at its another end to the holding mean (3) at an angle of 140°.

7. The pre-chopper as claimed in claim 1, wherein the curved blade (1) has length ranging between 1.4 mm to 1.8 mm.

8. The pre-chopper as claimed in claim 1, wherein the curved blade (1) has breadth ranging between 0.2 to 0.3 mm.

9. The pre-chopper as claimed in claim 1, wherein the shaft (2) has length ranging between 8 to 12 mm.

10. The pre-chopper as claimed in claim 1, wherein the shaft (2) has breadth ranging between 0.75 to 1.0 mm.

11. The pre-chopper as claimed in claim 1, wherein the shaft (2) has length 12 mm.

12. The pre-chopper as claimed in claim 1, wherein the holding mean (3) is a longitudinal handle having length ranging between 8 to 80 mm.

13. The pre-chopper as claimed in claim 1, wherein the holding mean (3) is a longitudinal handle having breadth ranging between 0.3 mm to 8 mm.

14. The pre-chopper as claimed in claim 1, wherein the curved blade (1) has thickness 0.02mm at inner cutting edge (1A) and thickness 0.03mm at outer blunt edge (IB).