Abstract:
An irrigating component provides a flow of irrigation liquid into a lens capsule or chamber during eye surgery while a separate aspiration component withdraws fluid from the capsule or chamber. The irrigating component is designed to permit a flow rate that at least balances the flow rate of the aspiration component.

Description:
CROSS-REFERENCE TO RELATED APPLICATION  
       [0001]     This application claims the benefit of U.S. Provisional Application No. 60/490,164, filed on Jul. 25, 2003. 
     
    
     FIELD OF THE INVENTION  
       [0002]     The present invention relates to an ophthalmic surgical instrument system having one component that provides a flow of irrigating liquid into a lens capsule during use and a separate component for aspiration. The two components have tips that are inserted through separate incisions or tunnels, preferably a substantial distance apart.  
       BACKGROUND OF THE INVENTION  
       [0003]     Cataract surgery uses phaco emulsifiers, choppers, irrigators, and aspirators to emulsify and/or chop a clouded natural lens and clean the lens capsule or chamber in preparation for insertion of an artificial lens.  
       SUMMARY OF THE INVENTION  
       [0004]     The present invention provides an ophthalmic irrigation instrument, which in combination with an ophthalmic aspiration instrument, generates irrigation and aspiration flow rates sufficient to prevent collapse of a lens capsule or chamber during a “bimanual” procedure. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0005]     The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same become better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein:  
         [0006]      FIG. 1  is a top perspective of an ophthalmic irrigation handpiece;  
         [0007]      FIG. 2  is a top plan thereof;  
         [0008]      FIG. 3  is a side elevation thereof; and  
         [0009]      FIG. 4  is a longitudinal section thereof.  
         [0010]      FIG. 5  is an enlarged, somewhat diagrammatic, top perspective of an irrigating chopper tip, in a preliminary stage of manufacture, usable with the handpiece of  FIGS. 1-4 ;  
         [0011]      FIG. 6  is a side elevation thereof;  
         [0012]      FIG. 7  is a longitudinal section thereof;  
         [0013]      FIG. 8  is a front end elevation thereof; and  
         [0014]      FIG. 9  is a rear end elevation thereof.  
         [0015]      FIG. 10  is an enlarged, somewhat diagrammatic, top perspective of another irrigating chopper tip usable with the handpiece of  FIGS. 1-4 ;  
         [0016]      FIG. 11  is a side elevation thereof;  
         [0017]      FIG. 12  is a further enlarged, fragmentary detail of the distal tip portion thereof; and  
         [0018]      FIG. 13  is an enlarged, fragmentary section of the distal tip portion thereof.  
         [0019]      FIG. 14  is an enlarged, somewhat diagrammatic, top perspective of another irrigating chopper tip usable with the handpiece of  FIGS. 1-4 ;  
         [0020]      FIG. 15  is a side elevation thereof;  
         [0021]      FIG. 16  is a further enlarged, fragmentary detail of the distal tip portion thereof; and  
         [0022]      FIG. 17  is a detail view taken from B-B of  FIG. 15 .  
         [0023]      FIG. 18  is an enlarged, somewhat diagrammatic, top perspective of another irrigating chopper tip usable with the handpiece of  FIGS. 1-4 ;  
         [0024]      FIG. 19  is a side elevation thereof;  
         [0025]      FIG. 20  is a further enlarged, fragmentary detail of the distal tip portion thereof; and  
         [0026]      FIG. 21  is a detail view taken from B-B of  FIG. 19 .  
         [0027]      FIG. 22  is an enlarged, somewhat diagrammatic, top perspective of another irrigating chopper tip usable with the handpiece of  FIGS. 1-4 ;  
         [0028]      FIG. 23  is a side elevation thereof;  
         [0029]      FIG. 24  is an enlarged, fragmentary detail of the distal tip portion thereof;  
         [0030]      FIG. 25  is a detail view taken from B-B of  FIG. 23 ;  
         [0031]      FIG. 26  is a detail view taken from C-C of  FIG. 25 ; and  
         [0032]      FIG. 27  is a detail view taken from D-D of  FIG. 26 .  
         [0033]      FIG. 28  is an enlarged, somewhat diagrammatic, top perspective of another irrigating chopper tip usable with the handpiece of  FIGS. 1-4 ;  
         [0034]      FIG. 29  is a side elevation thereof;  
         [0035]      FIG. 30  is an enlarged, fragmentary detail of the distal tip portion thereof;  
         [0036]      FIG. 31  is a detail view taken from B-B of  FIG. 29 ; and  
         [0037]      FIG. 32  is a detail view taken from C-C of  FIG. 29 .  
         [0038]      FIG. 33  is an enlarged, somewhat diagrammatic, top perspective of another irrigating tip usable with the handpiece of  FIGS. 1-4 ; and  
         [0039]      FIG. 34  is a side elevation thereof.  
         [0040]      FIG. 35  is an enlarged, somewhat diagrammatic, top perspective of another irrigating tip usable with the handpiece of  FIGS. 1-4 ; and  
         [0041]      FIG. 36  is a side elevation thereof.  
         [0042]      FIG. 37  is a top perspective of an ophthalmic aspiration handpiece;  
         [0043]      FIG. 38  is a top plan thereof;  
         [0044]      FIG. 39  is a side elevation thereof; and  
         [0045]      FIG. 40  is a longitudinal section thereof.  
         [0046]      FIG. 41  is an enlarged, somewhat diagrammatic, top perspective of an aspiration tip usable with the handpiece of  FIGS. 37-40 ; and  
         [0047]      FIG. 42  is a side elevation thereof.  
         [0048]      FIG. 43  is an enlarged, somewhat diagrammatic, top perspective of another aspiration tip usable with the handpiece of  FIGS. 37-40 ; and  
         [0049]      FIG. 44  is a side elevation thereof.  
         [0050]      FIG. 45  is a diagrammatic perspective view of a fragment of an eye and instruments used in the system of the present invention during cataract removal. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0051]      FIGS. 1-4  illustrate a representative irrigator handpiece  10  used in the system of the present invention. The proximate end of the handpiece has a coupling  12  for connection to a source S of irrigating liquid under pressure. Coupling  12  opens through the proximate end portion of the handpiece to an inner conduit  14 . Conduit  14  leads to the distal end portion  16  of the handpiece, which may be contoured for convenient grasping. The distal end  18  forms an internally threaded socket  20 . The components of the handpiece can be press-fitted or otherwise secured together. The long central portion of the bandpiece can be formed by a tubular shell and the conduit  14  may be formed of several sections joined end to end. Preferably, the long central channel or bore is open and unobstructed for free flow of irrigating liquid therethrough.  
         [0052]      FIGS. 5-9  show an irrigating chopper tip  24  usable in the system of the present invention, at an intermediate stage of manufacture. Preferably, the tip  24  is formed of a rigid, machineable metal, such as titanium or a suitable alloy. Tip  24  has a proximate stem  26  that is externally threaded to mate with the internal threads of the distal end of the handpiece. Stem  26  leads to a hub  28 , which may be configured for grasping by a user or suitable wrench or other tool for attaching the tip to the handpiece. Hub  28  also may form a proximate shoulder that limits insertion of the stem into the threaded bore of the handpiece. A long, narrow tube  30  extends distally from the hub  28 , with a distal end opening  32 . The long bore or channel of the tip  24  is open and unobstructed throughout its entire length, permitting a free flow of irrigating liquid therethrough. At the distal end of the tip, a chopper component  34  projects substantially radially outward from the end of the tube. In  FIGS. 5-9 , the chopper is illustrated as being of rectangular cross-section. The chopper  34  can be sharpened by machining to any one of several different chopping configurations. For example, the radially outer end of the chopper  34  can be sharpened for a “tomahawk” chopping action and/or the side, trailing, or leading edges can be sharpened to achieve a desired chopping configuration. Since the entire tip  24  is formed in one piece, with all aspects integral, there are no crimps, bends, adhesive, welding beads, etc., to interfere with free flow of irrigation liquid through the tip, or with chopping effectiveness of a desired distal end configuration. The threaded stem also is configured to achieve a smooth flow of liquid when mated to the associated handpiece, preferably with the proximate end abutting or nearly abutting the base of the handpiece socket.  
         [0053]     In the embodiment of  FIGS. 10-13 , the configuration of the stem  26  and hub  28  are identical to the embodiment previously described, but the long distal tube  30  (formed integral) is bent at a moderate angle. The chopper projection  34  is machined with a blunt, almost hemispherical, radially outer end  36 , whereas the proximate edge  38  and transverse edges  40  of the chopper are sharpened. The distal end of the irrigator tube  30  is beveled as illustrated in these views.  
         [0054]     The embodiment of  FIGS. 14-17  is essentially the same as the embodiment of  FIGS. 10-13  except for the more moderate bend of the tube  30  and the sharpening of the chopper  34 . The side edges  40  are sharpened to a somewhat greater degree than the radially outer tip  36 , with some sharpening of the leading or distal edge as well as the trailing or proximate edge.  
         [0055]     Similarly, the embodiment of  FIGS. 18-21  is essentially the same as the embodiment of  FIGS. 14-17 , except for a modified sharpening of the chopper  34 , which is similar but not identical.  
         [0056]     In the embodiment of  FIG. 22-27 , the chopper  34  has a blunt, rounded distal face, whereas the side and radially outer edges are sharpened for an effective chopping action.  
         [0057]     In the embodiment of  FIGS. 28-32 , the chopper  34  is machined to a thin blade-like configuration with essentially flat proximate and distal surfaces.  
         [0058]     In the embodiment of  FIGS. 33 and 34 , the irrigation tip  24  has the same stem  26  and hub  28  as the previously described embodiments, with a curved, long, narrow tube  30  extending distally from the hub. Tube  30  has a distal end opening  32  for expelling irrigation liquid, but no integral, radially projecting chopper.  
         [0059]     In the embodiment of  FIGS. 35 and 36 , the irrigator  24  again has the same threaded stem  26 , hub  28 , and narrow tube  30 . However, the distal end of the tube is closed, and a port  32 ′ is provided at each side for expelling irrigation liquid.  
         [0060]     In the preferred embodiment the tube  30  is formed integrally with the hub  28  and stem  26 , but in alternative embodiments the parts could be formed separately and, for example, press fitted together, so long as there is no interference with flow through the bore of the irrigation tip. Known designs have crimps or welds or other features or designs at one or more locations, for which may limit the flow rate of irrigation fluid from the tip.  
         [0061]      FIGS. 37-40  illustrate a representative aspirator handpiece  50  used in the system of the present invention. The proximate end of the handpiece has a coupling  52  for connection to a source V of reduced pressure or vacuum. Coupling  52  opens through the proximate end portion of the handpiece to an inner conduit  54 . Conduit  54  leads to the distal end portion  56  of the handpiece, which may be contoured for convenient grasping. The distal end  58  forms an internally threaded socket  20 , identical to the socket of the irrigator handpiece discussed above. The long central portion of the handpiece  50  can be formed by a tubular shell, and the conduit  54  may be formed of several sections adjoined end to end. Preferably the long central channel or bore is open and essentially unobstructed for free flow of aspirated liquid therethrough.  
         [0062]      FIGS. 41 and 42  show an aspiration tip  64  usable in the system of the present invention. Preferably the tip  64  is formed of a rigid, machineable metal, such as titanium or a suitable alloy. Tip  64  has a proximate stem  66  that is externally threaded to mate with the internal threads of the distal end of the aspiration handpiece. Stem  66  leads to a hub  68 , which may be configured for grasping by a user or suitable wrench or other tool for attaching the tip to the handpiece. Hub  68  also may form a proximate shoulder that limits insertion of the stem into the threaded bore of the handpiece. A long, narrow tube  70  extends distally from the hub  68  and aspiration port  72  formed in the underside of the distal end portion of the tube.  
         [0063]     In the embodiment of  FIGS. 43 and 44 , the configuration of the stem  66  and hub  68  are identical to the aspiration tip embodiment previously described, but with the long distal tube  30  bent more abruptly and at a slightly different angle, as may be preferred by a user. Otherwise, the aspiration tip of  FIG. 43  is identical to the aspiration tip of  FIGS. 41 and 42 .  
         [0064]      FIG. 45  shows irrigation and aspiration instruments used in the present invention and during cataract surgery, i.e., during removal of pieces of a clouded lens. One of the irrigation tips  24  is positioned with its distal tube  30  extending closely through a tunnel or slit in or adjacent to the cornea C. One of the aspiration tips  64  extends through a corresponding slit or tunnel spaced a substantial distance from the slit or tunnel for the irrigation tip. The end configuration of the aspiration tip can be as shown in  FIGS. 41, 42 ,  43 , and  44 , or another configuration, such as that illustrated in  FIG. 45  in which the aspiration tip has an open end which can assist in holding a piece of the clouded lens while it is chopped. In accordance with the present invention, the flow rate of irrigation liquid from the irrigating tip is balanced with the aspiration rate from the aspirator tip, to maintain adequate pressure and prevent collapse of the cornea.  
         [0065]     While the preferred embodiment of the invention has been illustrated and described, it will be appreciated that various changes can be made therein without departing from the spirit and scope of the invention.