WO2023170498A1 - Système de phacoémulsification à détection automatique de tube d'extension - Google Patents

Système de phacoémulsification à détection automatique de tube d'extension Download PDF

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Publication number
WO2023170498A1
WO2023170498A1 PCT/IB2023/051578 IB2023051578W WO2023170498A1 WO 2023170498 A1 WO2023170498 A1 WO 2023170498A1 IB 2023051578 W IB2023051578 W IB 2023051578W WO 2023170498 A1 WO2023170498 A1 WO 2023170498A1
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WO
WIPO (PCT)
Prior art keywords
aspiration
phacoemulsification
flow profile
extension tubing
irrigation
Prior art date
Application number
PCT/IB2023/051578
Other languages
English (en)
Inventor
Vadim Gliner
Assaf Govari
Original Assignee
Johnson & Johnson Surgical Vision, Inc.
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 US18/106,608 external-priority patent/US20230285190A1/en
Application filed by Johnson & Johnson Surgical Vision, Inc. filed Critical Johnson & Johnson Surgical Vision, Inc.
Publication of WO2023170498A1 publication Critical patent/WO2023170498A1/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
    • A61F9/00736—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 disclosure relates generally to phacoemulsification systems , and particularly to detection and mitigation of vacuum surges in phacoemulsification systems .
  • a cataract is a clouding and hardening of the eye' s natural lens , a structure which is positioned behind the cornea, iris and pupil .
  • the lens is mostly made up of water and protein and as people age these proteins change and may begin to clump together obscuring portions of the lens .
  • a physician may recommend phacoemulsification cataract surgery .
  • the surgeon makes a small incision in the sclera or cornea of the eye .
  • a portion of the anterior surface of the lens capsule is removed to gain access to the cataract .
  • the surgeon uses a phacoemulsification probe , which has an ultrasonic handpiece with a needle .
  • the tip of the needle vibrates at ultrasonic frequency to sculpt and emulsify the cataract while a pump aspirates particles and fluid from the eye through the tip .
  • Aspirated fluids are replaced with irrigation of a balanced salt solution to maintain the anterior chamber of the eye .
  • the softer outer lens cortex is removed with suction .
  • An intraocular lens ( IOL ) is then introduced into the empty lens capsule restoring the patient ' s vision .
  • Fig . 1 is a schematic, pictorial view of a phacoemulsification system, in accordance with an example of the present disclosure ;
  • Fig . 2 schematically illustrates alternative configurations of a phacoemulsification system, with and without an extension tubing , and respective vacuum surge profiles , in accordance with an example of the present disclosure ;
  • Fig . 3 is a flow chart that schematically illustrates a method for configuring vacuum-surge detection parameters , in accordance with an example of the present disclosure .
  • emulsified lens particles are aspirated via an aspiration line that runs through the phacoemulsification handpiece and further proximally to an aspiration pump .
  • an aspiration line that runs through the phacoemulsification handpiece and further proximally to an aspiration pump .
  • the vacuum in the aspiration line increases .
  • the aspiration line later becomes unblocked e . g . , when the particle is subsequently sucked into the aspiration line
  • the high vacuum in the aspiration line resulting from the blockage may cause a vacuum surge with potentially traumatic consequences to the eye.
  • an Anti-Vacuum Surge (AVS) module may be inserted in the aspiration and irrigation lines, or only in the aspiration line.
  • the AVS module comprises a valve that is configured to cut-off the flow in the aspiration line.
  • a processor in the AVS module or in the phacoemulsification system console, may detect a vacuum surge, e.g., by reading a pressure or flow sensor coupled with the aspiration line, and close the valve. Techniques of this sort are described, for example, in U.S. Patent Application 17/130,409, filed December 22, 2020, entitled "A module for Aspiration and Irrigation Control," which is hereby incorporated by reference .
  • AVS module refers to any device that is inserted at least in the aspiration line for the purpose of detecting and mitigating vacuum surges.
  • the phacoemulsification system comprises an optional extension tubing, which the physician may choose to insert between the phacoemulsification handpiece and the AVS module.
  • the phacoemulsification system supports one configuration in which the AVS module is attached directly to the handpiece, and another configuration in which an extension tubing is inserted between the handpiece and the AVS module .
  • a typical length of the extension tubing is in the range of twenty-three to twenty-eight centimeters , e . g . , twenty-five centimeters .
  • Some physicians may prefer to use the extension tubing , as it reduces the torque applied to the handpiece by the weight of the AVS module .
  • Other physicians may prefer direct attachment of the AVS module to the handpiece .
  • the extension tubing has a damping effect that modifies the characteristics of the vacuum surge as it is sensed at the AVS module .
  • the vacuum surge will reach the AVS module with a smaller amplitude , longer duration and longer propagation delay, relative to a comparable vacuum surge in absence of an extension tubing .
  • the differing characteristics make it difficult for the processor to detect vacuum surges reliably, e . g . , to maximize the detection probability and minimize the probability of false detections .
  • a processor of the phacoemulsification system overcomes the above-described challenge by automatically detecting whether an extension tubing is present .
  • the processor then configures the system with a suitable parameter setting for detection of vacuum surges .
  • the parameter setting may comprise , for example , one or more thresholds that are defined for the amplitude , slope and/or duration of the vacuum surge .
  • the processor detects the presence or absence of an extension tubing during a priming process applied by the physician to the handpiece .
  • a priming process the tip of the handpiece is covered with a "priming chamber” or “test chamber” - a sealed cap that causes irrigation fluid to be fed-back into the aspiration line .
  • the processor applies a predefined irrigation-flow profile to the irrigation line .
  • the irrigation-flow profile is a "step function" profile .
  • the processor measures the aspiration-flow profile that occurs in the aspiration line , at the AVS module , in response to the predefined irrigation-flow profile .
  • the processor decides whether an extension tubing is present or absent .
  • the processor checks whether the characteristics of the aspiration-flow profile are closer to those expected in a directly-attached AVS module or in an AVS module connected via an extension tubing .
  • the processor may check, for example , amplitude of the aspiration-flow profile , a slope of the aspiration-flow profile , a duration of the aspiration-flow profile , and/or a delay of the aspiration-flow profile relative to the predefined irrigation-flow profile .
  • the disclosed techniques enable physicians to deploy an AVS module with or without an extension tubing, without compromising reliability in detection and management of vacuum surges .
  • Fig. 1 is a schematic, pictorial view of a phacoemulsification system 10 comprising a phacoemulsification probe ("handpiece") 12, in accordance with an example of the present disclosure.
  • Phacoemulsification probe 12 comprises a hollow needle, which is configured for insertion into a lens capsule of an eye of a patient 19 by a physician 15, for treating a cataract.
  • a pumping subsystem 24 in a console 28 pumps irrigation fluid from an irrigation reservoir (not shown) , via an irrigation tubing line 43, to an irrigation sleeve coupled with and substantially surrounding the needle, for irrigating the eye.
  • Eye fluid and waste matter e.g. , emulsified parts of the cataract
  • a pumping subsystem 26 also comprised in console 28, using an aspiration tubing line 46 running from probe 12 to console 28.
  • pumping subsystem 24 may be coupled or replaced with a gravity-fed irrigation source such as a balanced salt solution bottle/bag.
  • system 10 comprises an Anti-Vacuum Surge (AVS) module 50, coupled via suitable fluid connectors to the irrigation and aspiration lines.
  • the AVS module is configured to control aspiration and irrigation flow rates, e.g., in order to reduce risks to the eye from irregular performance of aspiration and/or irrigation in probe 12, such as from vacuum surges caused by occlusion breaks at the tip of the needle.
  • the AVS module is coupled with the aspiration and irrigation lines externally to handpiece 12.
  • the AVS module may be connected directly to a handle 21 of the handpiece, or via an extension tubing, as will be discussed below. Further aspects AVS modules are described in U.S. Patent Application 17/130,409, filed December 22, 2020, entitled "A module for Aspiration and Irrigation Control," cited above.
  • the AVS module establishes variable fluid communication between aspiration line 46 and irrigation line 43, to control the flow of fluid between the two lines, so as to maintain pressures in the two lines within predefined limits. Moreover, the AVS module can discontinue aspiration, in order to provide a fast response (e.g. , within several milliseconds) to a detected occlusion or vacuum surge.
  • the AVS module may comprise its own processor and can be used with existing phacoemulsification systems as a disposable element to improve control over intraocular pressure (TOP) during the surgical cataract removal procedure.
  • TOP intraocular pressure
  • a different type of AVS module can be used that is coupled only with the aspiration part of the system (i.e., without involving irrigation) .
  • Phacoemulsification probe 12 includes other elements (not shown) , such as a piezoelectric crystal coupled to a horn to drive vibration of the needle.
  • the piezoelectric crystal may be configured to vibrate the needle in a resonant vibration mode. The vibration of the needle is used to break the cataract into small pieces during the phacoemulsification procedure.
  • Console 28 comprises a piezoelectric drive module 30, coupled with the piezoelectric crystal, using electrical wiring running in a cable 33.
  • Drive module 30 is controlled by a processor 38 and conveys processor-controlled driving signals via cable 33 to, for example, maintain the needle at maximal vibration amplitude.
  • the drive module may be realized in hardware or software, for example, in a proportional- integral-derivative (PID) control architecture.
  • PID proportional- integral-derivative
  • Processor 38 may receive user-based commands via a user interface 40, which may include setting a vibration mode, duty cycle, and/or frequency of the piezoelectric crystal, and setting or adjusting an irrigation and/or aspiration rate of the pumping subsystems 24/26.
  • user interface 40 and display 36 may be combined as a single touch screen graphical user interface.
  • the physician uses a foot pedal (not shown) as a means of control.
  • processor 38 may receive the user commands from controls located in handle 21 of probe 12.
  • processor 38 may be combined in a single physical component or, alternatively, implemented using multiple physical components. These physical components may comprise hardwired or programmable devices, or a combination of the two. In some examples, at least some of the functions of processor 38 may be carried out by suitable software stored in a memory 35 (as shown in Fig. 1) . This software may be downloaded to a device in electronic form, over a network, for example. Alternatively or additionally, the software may be stored in tangible, non-transitory computer-readable storage media, such as optical, magnetic, or electronic memory.
  • the system shown in Fig. 1 may include further elements which are omitted for clarity of presentation.
  • physician 15 typically performs the procedure using a stereomicroscope or magnifying glasses, neither of which are shown .
  • Physician 15 may use other surgical tools in addition to probe 12 , which are also not shown in order to maintain clarity and simplicity of presentation .
  • Fig . 2 schematically illustrates two alternative configurations of phacoemulsification system 10 , in accordance with an example of the present disclosure .
  • the figure also shows the structure of handpiece 12 in greater detail .
  • handpiece 12 comprises a coaxial irrigation sleeve 56 that at least partially surrounds needle 16 and creates a fluid pathway between the external wall of the needle and the internal wall of the irrigation sleeve .
  • Needle 16 is hollow, so as to provide an aspiration pathway .
  • the irrigation sleeve may have one or more side ports at or near its distal end, to allow irrigation fluid to flow toward the distal end of the handpiece through the fluid pathway and out of the port ( s ) .
  • the top of Fig . 2 shows a system configuration in which AVS module 50 is attached directly or very close to handpiece 12 .
  • the bottom of Fig . 2 shows an alternative system configuration, in which an extension tubing 60 is inserted between AVS module 50 and handpiece 12 .
  • a typical length of the extension tubing is in the range of twenty-three to twenty-eight centimeters , e . g . , twenty- five centimeters . This length range was found to strike a balance between ergonomic convenience to the physician and reliability in detecting and managing vacuum surges .
  • physician 15 has the freedom to choose whether to use the top configuration ( direct attachment without extension tubing ) or the bottom configuration (with extension tubing ) .
  • extension tubing 60 comprises an extension for the irrigation line and an extension for the aspiration line .
  • the AVS module and the extension tubing may be inserted only in aspiration line 46 .
  • AVS module 50 typically comprises a valve for cutting-off the flow in aspiration line 46 .
  • AVS module typically also comprises one or more flow, vacuum, or pressure sensors , for measuring the fluid pressure , vacuum, or flow in aspiration line 46 and/or in irrigation line 43 .
  • sensor , “flow sensor” , “pressure sensor” and “vacuum sensor” are used interchangeably herein .
  • a graph in the middle of Fig . 2 illustrates profiles of vacuum surges that are typical of the two system configurations , as measured in aspiration line 46 at AVS module 50 .
  • the horizontal axis of the graph denotes time
  • the vertical axis denotes pressure , vacuum or flow level in the aspiration line .
  • a plot 64 illustrates a vacuum surge characteristic of the direct attachment configuration .
  • a plot 68 illustrates a vacuum surge characteristic of the extension tubing configuration .
  • the vacuum surge (plot 64 ) is typically strong in amplitude , has a steep slope and a short duration, and arrives at AVS module 50 after a small propagation delay .
  • the vacuum surge (plot 68 ) is typically weaker in amplitude , has a more moderate slope , is longer in duration, and arrives at the AVS module after a longer propagation delay .
  • processor 38 in console 28 detects such vacuum surges with high reliability, notwithstanding the differences in the surge characteristics between the two system configurations .
  • processor 38 automatically detects the system configuration being used, i . e . , detects whether extension tubing 60 is present between AVS module 50 and handpiece 12 .
  • Processor 38 sets one or more parameters for vacuum-surge detection depending on the detected system configuration .
  • these tasks may be performed by a processor in AVS module 50 , or j ointly by processor 38 and a processor in the AVS module .
  • the description that follows refers generally to "a processor" that carries out the disclosed technique .
  • Fig . 3 is a flow chart that schematically illustrates a method for configuring vacuum-surge detection parameters in system 10 , in accordance with an example of the present disclosure .
  • the method is carried out during a priming process that precedes the phacoemulsification procedure .
  • the priming process aims to flush air from the system ( e . g . , from the irrigation and aspiration pumps , irrigation and aspiration lines , and needle 16 ) .
  • the priming process thus ensures that these system components are filled with fluid before the phacoemulsification procedure begins .
  • Fig . 3 begins at a priming preparation stage 80 .
  • physician 15 covers the tip of handpiece 12 with a "priming chamber” or “test chamber” , which allows any irrigation fluid that flows out of the tip via the sleeve to flow back into aspiration line 46 via the needle .
  • the processor instructs pumping subsystem 24 to pump a predefined irrigation-flow profile in irrigation line 43 .
  • the irrigation-flow profile typically comprises a "step function" profile , i . e . , a substantially instantaneous transition from zero irrigation to a certain constant irrigation flow .
  • any other suitable irrigationflow profile can be used, e . g . , an irrigation pulse having a predefined duration .
  • the processor measures the aspiration-flow profile , at AVS module 50 , resulting from the predefined irrigation-flow profile .
  • the processor typically measures the aspiration-flow profile by reading a sensor that is coupled with aspiration line 46 at AVS module 50 .
  • the measured aspiration-flow profile is expected to have a strong amplitude , a steep slope , a short duration, and to arrive at the AVS module with a small propagation delay relative to the irrigation-flow profile .
  • the measured aspiration-flow profile is expected to be weaker in amplitude , to have a more moderate slope , to be longer in duration, and to arrives at the AVS module after a longer propagation delay relative to the irrigation-flow profile .
  • the aspiration-flow profiles (with and without extension tubing 60 ) measured during priming may differ from the aspiration-flow profiles (with and without extension tubing 60 ) observed following occlusion break during an actual procedure .
  • One reason for the difference is that the irrigation step-function profile ( applied during priming ) may differ from the profile of an occlusion break ( experienced during a real-life procedure ) .
  • the aspiration-flow profiles measured during priming enable the processor to decide whether extension tubing 60 is present or absent .
  • the step-function response of aspiration line 46 has a propagation delay of approximately 40ms for every 1 . 5m length of tubing .
  • the step-function response is typically dispersive , i . e . , low-frequency pressure waves move faster than high- frequency pressure waves along the aspiration line .
  • the processor uses any or all of the above characteristics to identify whether or not extension tubing 60 is present between AVS module 50 and handpiece 12 .
  • the processor configures a parameter setting that is suitable for detecting vacuum surges in the presence of an extension tubing, at an extension configuration stage 96 . If an extension tubing is found to be absent , the processor configures a ( different ) parameter setting that is suitable for detecting vacuum surges in absence of an extension tubing, at a direct-attachment configuration stage 100 .
  • the parameter settings may differ from one another in various parameters .
  • the processor may declare a vacuum surge if the amplitude of the surge exceeds a threshold .
  • the processor may set the threshold to a certain value for the direct- attachment configuration, and to a different value ( e . g . , lower ) for the extension-tubing configuration .
  • the processor may declare a vacuum surge if the slope of the surge exceeds a threshold .
  • the processor may set the threshold to a certain value for the direct-attachment configuration, and to a different ( e . g . , lower ) value for the extension-tubing configuration .
  • the processor may declare a vacuum surge if the duration of the surge is below a threshold .
  • a threshold As noted above , the response of the aspiration line is dispersive , therefore , a surge will typically have a longer duration when extension tubing 60 is present , and a shorter duration in a direct-attachment configuration .
  • the processor may set the threshold to a certain value for the direct-attachment configuration, and to a larger value for the extensiontubing configuration .
  • the processor may use a combination of multiple such thresholds , or any other suitable threshold or other mechanism.
  • a phacoemulsification system includes a phacoemulsification handpiece , an irrigation line and an aspiration line connected to the phacoemulsification handpiece , an Anti-Vacuum Surge (AVS ) module inserted at least in the aspiration line , and a processor .
  • a phacoemulsification handpiece includes a phacoemulsification handpiece , an irrigation line and an aspiration line connected to the phacoemulsification handpiece , an Anti-Vacuum Surge (AVS ) module inserted at least in the aspiration line , and a processor .
  • AVS Anti-Vacuum Surge
  • the processor is configured to automatically detect whether an extension tubing is present in the aspiration line between the phacoemulsification handpiece and the AVS module , to set a first parameter setting, for detecting vacuum surges in the aspiration line , in response to detecting that the extension tubing is present , and, in response to detecting that the extension tubing is not present , to set a second parameter setting , different from the first parameter setting , for detecting the vacuum surges in the aspiration line .
  • Example 2 The phacoemulsification system according to example 1 , wherein the processor is configured to detect whether the extension tubing is present by reading at least one sensor in the AVS module .
  • Example 3 The phacoemulsification system according to example 1 , wherein the processor is configured to detect whether the extension tubing is present by applying a predefined irrigation-flow profile to the irrigation line , and measuring an aspiration-flow profile occurring in the aspiration line , at the AVS module , in response to the predefined irrigation-flow profile .
  • Example 4 The phacoemulsification system according to example 3 , wherein the predefined irrigation-flow profile includes a step function .
  • Example 5 The phacoemulsification system according to example 3 , wherein the processor is configured to measure the aspiration-flow profile during a priming process applied to the phacoemulsification handpiece .
  • Example 6 The phacoemulsification system according to example 3 , wherein the processor is configured to detect whether the extension tubing is present by measuring one or more of : an amplitude of the aspirationflow profile ; a slope of the aspiration-flow profile ; a duration of the aspiration-flow profile ; and a delay of the aspiration-flow profile relative to the predefined irrigation-flow profile .
  • Example 7 The phacoemulsification system according to example 1 , wherein the first and second parameter settings differ from one another in one or more thresholds defined for one or more characteristics of a pressure profile measured in the aspiration line .
  • Example 8 The phacoemulsification system according to example 7 , wherein the one or more characteristics include at least one of an amplitude , a slope and a duration of the pressure profile in the aspiration line .
  • Example 9 A phacoemulsification system includes a phacoemulsification handpiece , an irrigation line and an aspiration line connected to the phacoemulsification handpiece , an Anti-Vacuum Surge (AVS ) module inserted at least in the aspiration line , and an extension tubing, which is inserted at least in the aspiration line between the phacoemulsification handpiece and the AVS module .
  • AVS Anti-Vacuum Surge
  • Example 10 The phacoemulsification system according to example 9 , wherein a length of the extension tubing is between twenty-three and twenty-eight centimeters .
  • Example 11 A method in a phacoemulsification system that includes a phacoemulsification handpiece , an irrigation line and an aspiration line connected to the phacoemulsification handpiece , and an Anti-Vacuum Surge (AVS ) module inserted at least in the aspiration line .
  • the method includes automatically detecting whether an extension tubing is present in the aspiration line between the phacoemulsification handpiece and the AVS module .
  • a first parameter setting is set for detecting vacuum surges in the aspiration line .
  • a second parameter setting is set for detecting the vacuum surges in the aspiration line .
  • a vacuum surge in the aspiration line is detected in accordance with the set first or second parameter setting .

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  • 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)
  • External Artificial Organs (AREA)

Abstract

Un système de phacoémulsification comprend une pièce à main de phacoémulsification, une conduite d'irrigation et une conduite d'aspiration raccordées à la pièce à main de phacoémulsification, un module anti-augmentation subite de vide (AVS) inséré au moins dans la conduite d'aspiration, et un processeur. Le processeur est configuré pour détecter automatiquement si un tube d'extension est présent dans la conduite d'aspiration entre la pièce à main de phacoémulsification et le module AVS, pour définir un premier réglage de paramètre, permettant de détecter des augmentations subites de vide dans la conduite d'aspiration, en réponse à la détection que le tube d'extension est présent, et, en réponse à la détection que le tube d'extension est absent, pour définir un second réglage de paramètre, différent du premier réglage de paramètre, permettant de détecter les augmentations subites de vide dans la conduite d'aspiration.
PCT/IB2023/051578 2022-03-08 2023-02-21 Système de phacoémulsification à détection automatique de tube d'extension WO2023170498A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US202263317674P 2022-03-08 2022-03-08
US63/317,674 2022-03-08
US18/106,608 US20230285190A1 (en) 2022-03-08 2023-02-07 Phacoemulsification system with automatic detection of extension tubing
US18/106,608 2023-02-07

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WO2023170498A1 true WO2023170498A1 (fr) 2023-09-14

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160166742A1 (en) * 2014-12-16 2016-06-16 Novartis Ag Quick-opening vent valve for phaco fluidics aspiration system
US20190099546A1 (en) * 2017-10-04 2019-04-04 Johnson & Johnson Surgical Vision, Inc. System and Method to Augment Irrigation Pressure and to Maintain IOP During Post Occlusion Surge
WO2020157723A2 (fr) * 2019-01-31 2020-08-06 Jaime Zacharias Pompe d'aspiration à hauteur d'aspiration pouvant être commandée

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160166742A1 (en) * 2014-12-16 2016-06-16 Novartis Ag Quick-opening vent valve for phaco fluidics aspiration system
US20190099546A1 (en) * 2017-10-04 2019-04-04 Johnson & Johnson Surgical Vision, Inc. System and Method to Augment Irrigation Pressure and to Maintain IOP During Post Occlusion Surge
WO2020157723A2 (fr) * 2019-01-31 2020-08-06 Jaime Zacharias Pompe d'aspiration à hauteur d'aspiration pouvant être commandée

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