Abstract:
An ophthalmic surgical device is disclosed that combines laser energy for treatment of vision or ocular defect and illumination energy for visualization of a treatment site during surgery in a single common waveguide fiber, thereby enabling reduction of a diameter of a probe or canula of the device, whereby a smaller incision may be utilized to reduce trauma to the eye. The device may further include additional features, such as a conduit for supply of material or removal of material from the treatment site.

Description:
TECHNICAL FIELD 
     The present invention relates generally to ocular surgery devices, and, more particularly, to a waveguide ophthalmic surgery probe. 
     BACKGROUND OF THE INVENTION 
     Laser energy has been implemented for use with surgical devices in treatment of various kinds of vision or ocular defects. In many such implementations, an incision or other opening into eye of the patient is required to accurately deliver the laser energy to the treatment site, such as a retina. Furthermore, one or more additional surgical tool(s), such as a surgical-site visualization tool, may be needed. Such additional surgical tools may require additional incisions, whereby recovery time for the patient may be increased, and wherein the risk of complications may likewise be increased. 
     In an attempt to reduce the need for such additional tools, particularly those requiring a separate incision, laser energy surgical probes have been designed to deliver both laser energy for treatment and illumination energy, such as for visualization, using a single probe. Thus, only a single incision may be required for visualization of the treatment area, as well as for delivery of laser energy to the treatment area to accomplish the surgery. 
     Such devices fail, however, to reduce the need for additional incisions for other additional surgical instruments, and further disadvantageously require a relatively large incision, and associated sutures, due to the necessity for separate conduits for laser and visualization energy. As such, it is clear that there is an unmet need for an ophthalmic surgical device capable of delivering illumination energy and laser energy for treatment of a patient&#39;s eye via a single incision, while maintaining a small diameter probe for reducing unwanted injury to the eye. 
     BRIEF SUMMARY OF THE INVENTION 
     Briefly described, in a preferred embodiment, the present invention overcomes the above-mentioned disadvantages and meets the recognized need for such a device by providing an ophthalmic surgical device that combines laser energy and illumination energy within a single-fiber waveguide housed within a surgical probe, whereby laser and illumination energy may selectively be delivered, via a single small incision, to a surgical site for use in treatment of vision and/or ocular defects or problems via a single small incision. 
     According to its major aspects, and broadly stated, the surgical device includes a hollow probe having a single-fiber waveguide disposed therein and suitable for conducting laser energy and illumination energy therealong. The single-fiber waveguide may be coupled to a laser energy source and to an illumination energy source, wherein the single fiber waveguide combines the energy from each source for common delivery thereof to the surgical site. 
     More specifically, the surgical device comprises a hand-piece adapted for manipulation by a user, such as a surgeon, and a probe attached thereto. During surgery, the user may control the position, attitude, location, or the like, of the probe via manipulation of the hand-piece, whereby a tip at a first end of the probe may be controlled. A source of laser energy is provided and is operable with the probe and the hand-piece to supply laser energy to a second end of the probe, such as via one or more fiber waveguide(s). An optical coupling is preferably provided to ensure adequate transmission of the laser energy from the laser energy source into a first end of a single-fiber waveguide disposed within the probe. 
     Likewise, an illumination energy source is provided and is operable with the probe and the hand-piece to supply illumination energy (and received reflected visualization energy, such as when in use with a microscope) to the second end of the probe, such as via one or more different fiber waveguide(s). The optical coupling preferably further ensures adequate transmission of the illumination energy from the illumination energy source into the first end of the single-fiber waveguide of the probe. The single-fiber waveguide preferably conducts the laser and/or illumination energies to a second end of the single-fiber waveguide, proximate the tip of the probe, where the energies may exit the probe for treatment and/or visualization of the treatment site. 
     In its simplest form, the optical coupling comprises at least a portion of a cross-sectional surface of the single-fiber waveguide disposed in abutting contact with at least a portion of a cross-sectional surface of a laser energy source waveguide, and at least another portion of the cross-sectional surface of the single-fiber waveguide disposed in abutting contact with at least a portion of a cross-sectional surface of an illumination energy source waveguide. The optical coupling is preferably adequately efficient to allow a relatively low-power laser energy source and a relatively low-power illumination energy source to be utilized, while still allowing transmission of sufficient amounts of each energy into and through the single-fiber waveguide. Alternatively, however, the optical coupling may comprise one or more reflective device(s), refractive device(s), anti-reflective coating(s), anti-scattering coating(s), optical gel(s), tapered fiber(s), fusion, bond(s), weld(s), combinations thereof, or the like, to reduce losses during transmission of one or both of the laser energy and the illumination energy from the respective source to the first end of the single-fiber waveguide. 
     The probe is preferably formed as a generally hollow cylinder or tube, wherein the single-fiber waveguide may be carried. The probe may comprise a durable material, such as a metal, plastic, ceramic, or the like, whereby the single-fiber waveguide may be protected from damage, including cuts, scratches, abrasion, or the like, which damage may adversely impact performance of the single-fiber waveguide during use. A space between the single-fiber waveguide and the cylinder or tube may be used for removal of waste or fluid material, for supply of material, such as a medicine, a rinsing agent, or the like, or for detecting and/or measuring one or more parameter proximate the surgical site. Alternatively, an additional conduit may be included within the hollow center of the probe, for removal or supply of a selected material and/or measuring one or more parameter. 
     Accordingly, one feature and advantage of the present invention is its ability to deliver laser energy and illumination energy through a single-fiber waveguide, whereby a necessary dimension of an incision, or a required number of incisions, may be reduced through the elimination of duplicative fiber waveguides via effective and efficient combination of each of the laser energy and the illumination energy within the single-fiber waveguide. 
     Another feature and advantage of the present invention is its ability to combine and transmit light energy in a probe of a surgical instrument via a single-fiber waveguide, wherein the light energy is supplied from two or more separate conventional sources of light energy, thereby eliminating the need to replace, modify, or supplement pre-existing light energy source devices. 
     These and other features and advantages of the present invention will become more apparent to those ordinarily skilled in the art after reading the following Detailed Description of the Invention and Claims in light of the accompanying drawing Figures. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Accordingly, the present invention will be understood best through consideration of, and with reference to, the following drawing Figures, viewed in conjunction with the Detailed Description of the Invention referring thereto, in which like reference numbers throughout the various Figures designate like structure, and in which: 
         FIG. 1  is a partial cut-away perspective view of an ophthalmic surgical device according to the present invention; 
         FIG. 2  is an axial-section view of the ophthalmic surgical device of  FIG. 1 ; 
         FIG. 3  is an axial-section view of an ophthalmic surgical device according to an alternate configuration; and 
         FIG. 4  is an axial-section view of an ophthalmic surgical device according to another alternative configuration. 
     
    
    
     It is to be noted that the drawings presented are intended solely for the purpose of illustration and that they are, therefore, neither desired nor intended to limit the invention to any or all of the exact details of construction shown, except insofar as they may be deemed essential to the claimed invention. 
     DETAILED DESCRIPTION OF THE INVENTION 
     In describing preferred embodiments of the present invention illustrated in the figures, specific terminology is employed for the sake of clarity. The invention, however, is not intended to be limited to the specific terminology so selected, and it is to be understood that each specific element includes all technical equivalents that operate in a similar manner to accomplish a similar purpose. 
     In that form of the preferred embodiment of the present invention chosen for purposes of illustration,  FIGS. 1-4  show instrument  100  comprising hand-piece  110  and probe or canula  120 , in combination with laser energy source  130 , illumination energy source  140 , and accessory  150 . Each of laser energy source  130  and illumination energy source  140  is preferably formed as a currently-available energy source device adapted to supply appropriate respective laser and illumination energies via respective source fiber waveguides  131  and  141 , such as a single-fiber waveguide or a multi-fiber waveguide. Accordingly, each of laser energy source  130  and illumination energy source  140  is preferably controllable to selectively adjust an intensity, a wavelength/frequency, a polarity, or other characteristic of the energy, including selectively preventing any output thereof. It is contemplated, however, that other light sources may be used, as desired, to provide a light having a desired wavelength/frequency, including those within the visible spectrum, as well as those outside the visible spectrum. 
     Specifically, laser energy source waveguide  131  is preferably formed as single-fiber waveguide  131   a , whereas illumination energy source waveguide  141  is preferably formed as a multi-fiber waveguide, such as six fiber waveguides  141   b - g . As is known in the art, each of waveguides  131  and  141  may include durable covers  132  and  142  to prevent damage to the waveguide. Each of source waveguides  131  and  141  may additionally include an appropriate connector at a proximal end for enabling removable connection of the waveguide to a respective energy source device. 
     Hand-piece  110  preferably includes grip  111 , whereby a user, such as a surgeon, may grasp and manipulate instrument  100  to control a position, attitude, and/or orientation of probe  120  as desired, and probe  120  mounted proximate a distal end thereof. Probe  120  is preferably formed as generally hollow tube  125 , such as a round cylinder, having a generally small exterior diameter, such as approximately 25 gauge, approximately 23 gauge, or the like, suitable for use with a trocar, and formed from a substantially durable material, such as a surgical-grade metal, plastic, ceramic, or the like, e.g. stainless steel. 
     Single-fiber waveguide  121  is preferably disposed within tube  125  and preferably has a cross-sectional area less than that of a hollow interior of tube  125 , wherein a space between single-fiber waveguide  121  and tube  125  defines conduit  123 , which may be used to provide access to distal end  120   a , i.e. to the tip, of probe  120  for supply and/or removal of one or more selected material(s), or for detection or measurement of one or more selected parameter(s). When such a space is utilized, tube  125  may preferably include an opening through a sidewall thereof for allowing passage of material, whereby material may be diverted from tube  125  and not interfere with an interface To between single-fiber waveguide  121  and source fiber waveguides  131  and  141 . Conduit  151  may be operable with such an opening to operably connect accessory  150  to the space between single-fiber waveguide  121  and tube  125 . 
     By way of example, and not limitation, accessory  150  may be formed as a supply of wash or rinse fluid, a source of gas, a vacuum device for removal of waste or other substance from the surgical site, an energy source, such as an infrared energy source or the like, or one or more sensor(s) for detecting one or more parameters). As such, conduits  151  and  123  are preferably selected to provide adequate means of transmission, supply, removal, or the like, of one or more selected material(s), chemicals), energy(ies), parameter(s), or the like, without contamination, loss, degradation, or the like, of the selected materials), chemical(s), energy(ies), parameters, or the like. 
     Accordingly, selected material may be removed from, or supplied to, distal end  120   a  of probe  120  by accessory  150  via conduit  151  and conduit  123 . Alternatively, one or more selected parameter(s) may be measured proximate distal end  120   a  of probe  120  via one or more sensor(s) disposed proximate distal end  120   a  of probe  120 , or elsewhere within instrument  100 , and one or more signal(s) corresponding to the parameter communicated to accessory  150  via conduits  123  and  151 , or via a conductor or other signal carrier disposed therein. As another alternative, one or more sensor(s) may be included in accessory  150 , and may measure one or more parameters) proximate hand-piece  110 , probe  120 , or proximate distal end  120   a  of probe  120 , via conduits  151  and  123 . 
     Single-fiber waveguide  121 , disposed within tube  125 , preferably extends from distal end  120   a  of probe  120  to optical coupling  115 , proximate proximal end  120   b  thereof. Optical coupling  115  preferably defines an operable connection of single-fiber waveguide  121  and each of source waveguides  131  and  141 . Such operable connection may be accomplished via an abutting relationship of at least a portion of proximal end  121   a  of single-fiber waveguide  121  with at least a portion of one or more fiber waveguide(s) of each of source waveguides  131  and  141 . Each fiber waveguide of source waveguides  131  and  141  is preferably optically coupled to single-fiber waveguide  121  at proximal end  121   a  thereof, whereby laser energy and illumination energy may be transmitted into single-fiber waveguide  121 . 
     According to the preferred embodiment, single-fiber waveguide  131   a  of source waveguide  131  is optically connected to single-fiber waveguide  121  of probe  120 , such as proximate a cross-sectional center of single-fiber waveguide  121 , via optical coupling  115 . Further according to the preferred embodiment, each of the preferred plurality of six fiber waveguides  141   b - g  of source waveguide  141  is connected to single-fiber waveguide  121  of probe  120  via optical coupling  115 . Each of fiber waveguides  141   b - g  is preferably disposed about single-fiber waveguide  131 , as shown in  FIG. 2 . As will be understood by those ordinarily skilled in the art, a cross-sectional area of single-fiber waveguide  131  is preferably smaller than a cross-sectional area of single-fiber waveguide  121 , and the total cross-sectional area of source waveguides  131  and  141 , arranged as described above, may be greater than the cross-sectional area of single-fiber waveguide  121 . Nonetheless, a sufficient amount of laser energy and of illumination energy is transmitted into single-fiber waveguide  121  via optical coupling  115 . 
     Fiber waveguides  121 ,  131   a , and  141   b - g  are preferably retained in such operable connection via coupler  170 . Coupler  170  may be free to move within hand-piece  110 , or may be connected to hand-piece  110 , such as via a potting, an adhesive, a structural member, or the like. Fiber waveguides  131   a  and  141   b - g , and probe  120  and/or single-fiber waveguide  121  are preferably retained within coupler  170  via friction fit, adhesive, potting, threading, or the like, and may or may not be removable therefrom. Coupler  170  preferably prevents optical coupling  115  from being adversely affected during manipulation of instrument  100 , including when a tension force is applied to one or more of source waveguides  131  and  141 , and conduit  151 . Thus, coupler  170  preferably ensures that an adequate amount of light energy is transmitted between each of source waveguides  131 ,  141  and single-fiber waveguide  121 . 
     In order to ensure that an adequate amount of laser and illumination energies are transmitted into single-fiber waveguide  121 , one or more refractive device, reflective device, anti-reflective coating, anti-scattering coating, optical gel, tapered fiber, fusion bond, weld, combinations thereof, or the like, may be included in optical coupling  115 , and may be retained in position via coupler  170 . For example, referring more particularly to  FIG. 3 , lens  161  may be disposed in optical communication with each of the fiber waveguides of source waveguides  131  and  141  and single-fiber waveguide  121 , whereby laser and illumination energy may be transferred therebetween, while reducing energy loss during such transfer. Selective arrangement and sizing of source waveguides  131  and  141  and single-fiber waveguide  121  may allow adequate transfer of laser and illumination energy for surgical use even though a portion of such energies may be lost at optical coupling  115  due to a difference in diameters of single-fiber waveguide  121  within probe  120  and the group of fiber waveguides of source waveguides  131  and  141 . Optionally, lens  161 , or other refractive device, reflective device, tapered fiber, optical gel, or the like, may be retained within coupler  170 , or may be otherwise coupled to source waveguides  131 ,  141 , and single-fiber waveguide  121  (and/or probe  120 ), such as via adhesive, fusion bond, weld, potting, or the like. 
     With continued reference to  FIG. 3 , single-fiber waveguide  121  may optionally be securely housed within tube  125  of probe  120  via potting, adhesive, friction fit, or the like, wherein a space between single-fiber waveguide  121  and tube  125  is substantially reduced or eliminated, in order to reduce a dimension of probe  120 . Preferably, an interior dimension of tube  125  of probe  120  may be reduced to a size substantially equal to a corresponding exterior dimension of single-fiber waveguide  121 . In such a case, conduit  123  is effectively eliminated, and instrument  100  may not be operable with accessory  150 . If, however, access for accessory  150  is desired, and potting, adhesive, or other filler is desired between tube  125  and single-fiber waveguide  121 , then conduit  151 , formed as a tube, may be included within probe  120  and may be connected to accessory  150  to provide access to distal end  120   a  of probe  120 . In such an arrangement, conduit  151  is preferably arranged such that it does not interfere with transmission of light energy at optical coupling  115 , but may, nonetheless, pass through optical coupling  115 . 
     Now referring more particularly to  FIG. 4 , each of source waveguides  131  and  141  may optionally include connectors  133  and  143 , respectively, at a distal end for removable connection of source waveguides  131 ,  141  to hand-piece  110  in addition to, or instead of the connectors at the proximal ends. Hand-piece  110  may likewise optionally include connectors  113   a ,  113   b , adapted to securely and removably engage connectors  133  and  143 , respectively. Connectors  113   a ,  113   b  are preferably spaced from probe  120  such that connectors  133  and  143  are not likely to interfere with physical manipulation or control of probe  120 , such as proximate an end of hand-piece  110 , as shown in  FIG. 4 . When source waveguides  131  and  141  are removable from hand-piece  110  via connectors  113   a ,  113   b ,  133 , and  143 , a corresponding number of connector fibers, such as connector fibers  115   a - g , are preferably included in optical coupling  115 . Connector fibers  115   a - g  are preferably in operable connection with fiber waveguides  131   a  and  141   b - g  at connectors  113   a  and  113   b , and are in operable connection with single-fiber waveguide  121 , as described above, at optical coupling  115 , i.e. proximal end  121   a  of single-fiber waveguide  121 . 
     Specifically, each of connector fibers  115   a - g  is preferably selected to have a cross-sectional area and shape approximately equal to the corresponding one of fiber waveguides of waveguides  131   a  and  141   b - g , and each is preferably connected generally coaxially therewith at connectors  113   a ,  113   b . Thus, the fiber waveguides of optical coupling  115  preferably act as extensions of the fiber waveguides of source waveguides  131  and  141 . As a result of such mating of appropriately-sized waveguides, losses of light at connectors  113   a ,  113   b  may preferably be reduced or eliminated, such that an amount of light in optical coupling  115  proximate connectors  113   a ,  113   b  is preferably substantially equal to an amount of light in source waveguides  131  and  141  proximate connectors  133  and  143 . 
     In use, ophthalmic surgery may be accomplished via selective manipulation of hand-piece  110  to position probe  120  in a desired location, attitude, and orientation for delivery of a treatment, whereby distal end  120   a  thereof may be disposed proximate a desired surgical site. One or more of laser energy source  130 , illumination energy source  140 , and accessory  150  may be selectively activated, adjusted, or the like to provide one or more of laser energy, illumination energy, and/or a selected material, chemical, energy, or the like to distal end of probe  120   a  to effect the ophthalmic surgery or treatment. Preferably, laser energy, when provided by source  130 , is transmitted to distal end  121   b  of single-fiber waveguide  121  via single-fiber waveguide  131   a  and optical coupling  115 . Single-fiber waveguide  121  preferably receives substantially all of the laser energy from single-fiber waveguide  131   a , with little or no loss of energy, due to an abutting relationship between single-fiber waveguide  131   a  and single-fiber waveguide  121 , such that the end of single-fiber waveguide  131   a  is preferably completely covered by single-fiber waveguide  121 . 
     Furthermore, illumination energy, when provided by source  140 , is preferably transmitted to distal end  121   b  of single-fiber waveguide  121  via fiber waveguides  141   b - g  of source waveguide  141  and optical coupling  115 . Fiber waveguides  141   b - g  of source waveguide  141  are preferably disposed generally symmetrically about single-fiber waveguide  131   a , whereby at least a portion of the illumination energy therewithin may enter single-fiber waveguide  121  via abutting portions of each of fiber waveguides  141   b - g  of source waveguide  141  and single-fiber waveguide  121 . Additionally, any portion(s) of the end surfaces of fiber waveguides  141   b - g  of source waveguide  141  that are not in abutting relationship with an end of single-fiber waveguide  121  may be coupled with another waveguide or optical transmission device, or none at all, and may be directed to an exterior of hand-piece  110 , whereby a user may confirm that illumination energy is reaching an interface of single-fiber waveguide  121  and optical coupling  115 . Alternatively, however, the laser and/or illumination energies may be transmitted via one or more refractive device, reflective device, optical gel, anti-reflective coating, anti-scattering coating, tapered fiber, fusion bond, weld, combinations thereof, or the like, whereby light loss at the interface may be substantially reduced or eliminated. 
     A surgical microscope or other visualization tool may be operable with illumination energy source  140 , source waveguide  141 , optical coupling  115  and single-fiber waveguide  121  to allow illumination energy reflected from the surgical sight to be transmitted to the surgical microscope or other visualization tool, whereby a surgeon or other user of instrument  100  may be able to perceive a present status, characteristic, position, or the like of one or more structure or feature of interest at the surgical site. For example, a surgeon may preferably use a surgical microscope to identify a precise location where application of laser energy is needed to effect a surgery, position probe  121  at the precise location, verify such positioning via the surgical microscope, and deliver an appropriate amount of laser energy to the surgical site. 
     As will be understood by those ordinarily skilled in the art, a shape, dimension, material, or the like, of each of hand-piece  110 , grip  111 , and probe  120 , may be selected as desired to accommodate user preference, manufacturing considerations, or the like. All such components are, however, preferably formed from inert, hypo-allergenic, durable, and sterile or sterilizable materials, whereby use thereof in an operating or surgical environment is appropriate, and whereby the components may be cleaned, sterilized, or otherwise prepared for subsequent use, including repeated use, or whereby the components may be replaced for subsequent use. Likewise, the dimensions, configurations, materials, or the like, for connectors  113   a ,  113   b , source waveguides  131  and  141 , optical coupling  115 , single-fiber waveguide  121 , conduit  123 , and conduit  151  may be selected to enable proper, adequate, or desired functionality of instrument  100  in effecting a selected surgery. Such dimensions, configurations, materials, or the like, may be selected based on desired or required energy transmission characteristics, fluid flow rates, durability, chemical reactivity, price, workability, or the like, and the cross-sectional dimension of at least single-fiber waveguide  121  and tube  125  is each preferably selected to be as small as possible without substantially adversely affecting the performance characteristics thereof. 
     Having thus described exemplary embodiments of the present invention, it should be noted by those ordinarily skilled in the art that the within disclosures are exemplary only and that various other alternatives, adaptations, and modifications may be made within the scope and spirit of the present invention. For example, while probe  120  is shown as straight, probe  120  may be formed in other shapes, such as curved, angled, stepped, combinations thereof, or probe  120  may be flexible or adjustable. Similarly, while probe  120 , single-fiber waveguide  121 , conduit  123 , conduit  151 , source waveguides  131 ,  141 , and fiber waveguides  131   a ,  141   b - g  are shown as round, other shapes may be utilized to accomplish the functions described herein. Accordingly, the present invention is not limited to the specific embodiments as illustrated herein, but is only limited by the following claims.