Patent Publication Number: US-2021177655-A1

Title: Apparatus, system and method of ultrasonic power delivery in a surgical system

Description:
CROSS REFERENCES TO RELATED APPLICATIONS 
     This application is a divisional of and claims priority to U.S. patent application Ser. No. 16/152,179, filed Oct. 4, 2018, which claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 62/568,232, filed Oct. 4, 2017, all of which are incorporated herein by reference in their entirety. 
    
    
     BACKGROUND 
     Field of the Disclosure 
     The present disclosure relates to medical devices and systems, and, more specifically, to an apparatus, system and method of ultrasonic power delivery in a surgical system. 
     Description of the Background 
     Phacoemulsification is a medically recognized technique utilized for crystalline lens removal. Phacoemulsification includes making a corneal and/or scleral incision, and the insertion of a phacoemulsification handpiece, which is typically comprised of a needle that is ultrasonically driven, in order to emulsify, i.e., to liquefy, the natural crystalline lens and/or or to break a cataract into small pieces, by way of example. The emulsified pieces may subsequently be removed using the same handpiece or another handpiece. The surgeon may then insert implants in the eye through the incision. 
     The phacoemulsification handpiece is generally coupled to an irrigation source and an aspiration pump. The handpiece includes a distal tip for insertion within the anterior chamber of the patient&#39;s eye that emits the ultrasonic energy to emulsify the crystalline lens. The handpiece further includes an irrigation port proximal to the distal tip, which is coupled to an irrigation source via an irrigation line, and an aspiration port at the distal tip, which is coupled to an aspiration pump via an aspiration line. Fluid from the irrigation source, which is typically an elevated bottle of saline solution, is irrigated into the eye via the irrigation line and the irrigation port, and the irrigation fluid and emulsified crystalline lens material are aspirated from the eye by the aspiration pump via the aspiration port and the aspiration line. 
     Other medical techniques for the eye also typically include emulsifying, irrigating the eye and aspirating. Such procedures may or may not include the destruction, alteration or removal of features of the natural eye using the emulsification, irrigation and aspiration. Thus, the ultrasonic power delivered by the surgical console, and the flow of fluid to and from a patient through the irrigation or aspiration console, and the consequent need to control the phacoemulsification handpiece to deliver the foregoing, is critical to the procedure performed. 
     Phacoemulsification systems typically include a programmable microprocessor-based console with operator-selected presets for controlling, for example, aspiration rate, vacuum and ultrasonic power levels. The phacoemulsification handpiece may be interconnected with the control console by an electric cable for powering and controlling the piezoelectric transducer that provides the emulsification. Tubing provides the irrigation fluid to the eye, and enables withdrawal of aspiration fluid from an eye, through the handpiece under the control of the console. 
     Phase angles and other aspects associated with handpiece operation are determined and measured at all times during operation of the handpiece, such as to adjust the driving circuitry, achieve an optimum phase angle, and otherwise effect energy transfer into the tissue from the phacoemulsification handpiece. Automatic tuning of the handpiece may be provided by monitoring the handpiece electrical signals and adjusting the frequency and other aspects to maintain consistency with selected parameters. 
     Control of the ultrasonic power by the phacoemulsification handpiece is therefore highly critical to successful phacoemulsification surgery. Certain known systems address the requirements of power control for the phacoemulsification handpiece based on the phase angle between voltage applied to a handpiece piezoelectric transducer and the current drawn by the piezoelectric transducer and/or the amplitude of power pulses provided to the handpiece. The typical arrangement may be tuned for the particular handpiece, and, for example, power may be applied in a continuous fashion or in a series of solid bursts subject to the control of the surgeon. For example, the system may apply power for 150 ms, then cease power for 350 ms, and may repeat this on/off sequence for the necessary duration of power application. 
     Application of power during the aforementioned 150 ms period may be defined as a constant application of a 25 kHz to 50 kHz sinusoid. In certain circumstances, the surgeon/operator may wish to apply the power bursts for a duration of time, then cease application of power, then reapply at the initial or another power setting. The frequency and duration of the burst is typically controllable, as is the length of the stream of bursts applied to the affected area. The time period where power is not applied may enable periods in which broken sections may be removed using aspiration, such as may be provided by the handpiece or a secondary aspiration apparatus. 
     Current control methods for ultrasonic power delivery are generally limited to two modes, referred to herein as “panel” and “linear.” As to these referenced modes, the “panel” mode typically provides strict, fixed values upon user selection, and the “linear” mode allows only the simplest form of linear adjustment from 0% to 100%. Intermediate adjustments for delivery are not made freely available, in part in order to minimize the need for and risk inherent in manual adjustment. 
     The application of power in the aforementioned manners may, in certain circumstances, cause overheating, time lag, turbulence and/or chatter, as well as causing significant flow issues, such as requiring considerable use of fluid to relieve the area and remove particles. Also, the application of constant energy may cause fragments to be pushed away from the tip of the handpiece because of the resultant cavitation from the energy applied. 
     Thus, the existing methods of ultrasonic power delivery, as discussed above, are very simplistic, suffer from numerous disadvantages, and are thus not ideal in application for every eye surgery. Accordingly, new techniques other than the two existing simple methods (linear and panel) of power delivery are needed to provide advanced control methods and algorithms, such as may be used to regulate the delivery of ultrasonic power with varying rates of increase and decrease, from gradual to acute, and/or to define a sweet spot in controlling the ultrasonic power delivered. 
     SUMMARY 
     The disclosed apparatus, system and method may include at least a phacoemulsification surgical console having a customizable non-linear custom phacoemulsification mode. The apparatus, system and method may include an ultrasonic delivery tip; a footpedal; and non-transitory computing code resident on a computing memory associated with a computing processor which, when executed by the processor, causes to be executed the steps of: receiving a percentage actuation of the footpedal; calculating, including from a non-linear algorithm, a percentage actuation for the ultrasonic delivery tip corresponded to the received percentage footpedal actuation; and dictating the calculated percentage actuation for the ultrasonic delivery tip actuation to the ultrasonic delivery tip. 
     More particularly, a method of providing a customizable, non-linear custom mode for ultrasonic power in ophthalmic surgery may include receiving a footpedal actuation percentage from an ophthalmic surgery console; relationally comparing the footpedal actuation percentage to a non-linear custom zone algorithm which is calculated from at least one user-indicated set point for ultrasonic power corresponded to a particular one of the footpedal actuation percentage; and calculating a next one of the ultrasonic power from the custom zone algorithm. 
     Thus, the disclosed embodiments provide an apparatus, system, and method for providing a custom mode for vacuum and/or aspiration in a surgical system. 
    
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
       Referring now to the figures incorporated herein, shown are non-limiting embodiments of the present disclosure, wherein like numerals represent like elements, and wherein: 
         FIG. 1  is a block diagram illustrating a computing system according to the embodiments; 
         FIG. 2  is a diagram of an ophthalmic surgical console according to the embodiments; and 
         FIG. 3  is a flow diagram of a method according to the embodiments. 
     
    
    
     DETAILED DESCRIPTION 
     The figures and descriptions provided herein may have been simplified to illustrate aspects that are relevant for a clear understanding of the herein described apparatuses, systems, and methods, while eliminating, for the purpose of clarity, other aspects that may be found in typical similar devices, systems, and methods. Those of ordinary skill may thus recognize that other elements and/or operations may be desirable and/or necessary to implement the devices, systems, and methods described herein. But because such elements and operations are known in the art, and because they do not facilitate a better understanding of the present disclosure, for the sake of brevity a discussion of such elements and operations may not be provided herein. However, the present disclosure is deemed to nevertheless include all such elements, variations, and modifications to the described aspects that would be known to those of ordinary skill in the art. 
     Exemplary embodiments are provided throughout so that this disclosure is sufficiently thorough and fully conveys the scope of the disclosed embodiments to those who are skilled in the art. Numerous specific details are set forth, such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. Nevertheless, it will be apparent to those skilled in the art that certain specific disclosed details need not be employed, and that exemplary embodiments may be embodied indifferent forms. As such, the exemplary embodiments should not be construed to limit the scope of the disclosure. As referenced above, in some exemplary embodiments, well-known processes, well-known device structures, and well-known technologies may not be described in detail. 
     The terminology used herein is for the purpose of describing particular exemplary embodiments only and is not intended to be limiting. For example, as used herein, the singular forms “a”, “an” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The terms “comprises,” “comprising,” “including,” and “having,” are inclusive and therefore specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. The steps, processes, and operations described herein are not to be construed as necessarily requiring their respective performance in the particular order discussed or illustrated, unless specifically identified as a preferred or required order of performance. It is also to be understood that additional or alternative steps may be employed, in place of or in conjunction with the disclosed aspects. 
     When an element or layer is referred to as being “on”, “engaged to”, “connected to” or “coupled to” another element or layer, it may be directly on, engaged, connected or coupled to the other element or layer, or intervening elements or layers may be present, unless clearly indicated otherwise. In contrast, when an element is referred to as being “directly on,” “directly engaged to”, “directly connected to” or “directly coupled to” another element or layer, there may be no intervening elements or layers present. Other words used to describe the relationship between elements should be interpreted in a like fashion (e.g., “between” versus “directly between,” “adjacent” versus “directly adjacent,” etc.). Further, as used herein the term “and/or” includes any and all combinations of one or more of the associated listed items. 
     Yet further, although the terms first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer or section from another element, component, region, layer or section. Terms such as “first,” “second,” and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the exemplary embodiments. 
     Certain types of ocular dysfunction, such as cataracts, are commonly treated with surgical procedures, such as to remove the natural lens from the eye and replace it with a clear artificial lens. More particularly and byway of example, phacoemulsification refers to a surgery, often employed when a patient suffers from cataracts, in which the eye&#39;s natural lens is emulsified by applying ultrasonic energy to the lens with a handpiece. Once the lens is emulsified, it is aspirated from the eye by applying a vacuum tube to the emulsified lens material. 
     To perform the afore-discussed and similar procedures, a surgeon often utilizes a computer-controlled system of specialized equipment called a phacoemulsification system to control and execute the ultrasonic emulsification and aspiration of the natural lens of the eye prior to inserting the IOL. Phacoemulsification systems use various computer programs for performing these various tasks, which are controlled in part by adjusting settings of these programs, for example, to emulsify and aspirate the subject lens material and to do other tasks necessary to complete the surgery. Different phacoemulsification systems may provide different programs for use in different situations, whereby are provided different operational modes. For example, program modes may take into account the particular subject eye on which surgery is performed such as based, for example, on measurements of the eye and various other aspects of the patient&#39;s physiology. 
     New alternative modes provided according to the embodiments may open up different desirable options to provide a range of different power deliveries in different modes for different cataract and/or other surgical needs In addition, customized power delivery modes may allow for enhanced comfort in the use of peripherals to the phacoemulsification console, such as footpedals, by, for example, allowing a surgeon ease in operating in a zone of footpedal use that is most comfortable and efficient for that surgeon, and by tying that zone algorithmically to certain custom operations of the emulsifier. 
     Further, these new operational modes, beyond the known linear and panel modes, may overcome the inefficiencies of limited power delivery methods, slow transition between power deliveries, and difficulties in controlling and maintaining power at necessary power levels. These new modes provide advanced control methods and algorithms to regulate the delivery of power with varying rates of increase and decrease, from gradual to acute, and to define optimal power control forgiven circumstances. 
       FIG. 1  depicts an exemplary computing system  100  for use in association with an ophthalmic surgical console in accordance with herein described system and methods. Computing system  100  is capable of executing software, such as an operating system (OS) and one or more computing applications  190 , such as may run the handpiece discussed herein via the I/O port. The operation of exemplary computing system  100  is controlled primarily by computer readable instructions, such as instructions stored in a computer readable storage medium, such as hard disk drive (HDD)  115 , optical disk (not shown) such as a CD or DVD, solid state drive (not shown) such as a USB “thumb drive,” or the like. Such instructions may be executed within central processing unit (CPU)  110  to cause computing system  100  to perform operations. In many known computer servers, workstations, personal computers, and the like, CPU  110  is implemented in an integrated circuit called a processor. 
     It is appreciated that, although exemplary computing system  100  is shown to comprise a single CPU  110 , such description is merely illustrative, as computing system  100  may comprise a plurality of CPUs  110 . Additionally, computing system  100  may exploit the resources of remote CPUs (not shown), for example, through communications network  170  or some other data communications means. 
     In operation, CPU  110  fetches, decodes, and executes instructions from a computer readable storage medium such as HDD  115 . Such instructions may be included in software such as an operating system (OS), executable programs, and the like. Information, such as computer instructions and other computer readable data, is transferred between components of computing system  100  via the system&#39;s main data-transfer path. The main data-transfer path may use a system bus architecture  105 , although other computer architectures (not shown) can be used, such as architectures using serializers and deserializers and crossbar switches to communicate data between devices over serial communication paths. System bus  105  may include data lines for sending data, address lines for sending addresses, and control lines for sending interrupts and for operating the system bus. Some busses provide bus arbitration that regulates access to the bus by extension cards, controllers, and CPU  110 . Devices that attach to the busses and arbitrate access to the bus are called bus masters. Bus master support also allows multiprocessor configurations of the busses to be created by the addition of bus master adapters containing processors and support chips. 
     Memory devices coupled to system bus  105  may include random access memory (RAM)  125  and/or read only memory (ROM)  130 . Such memories include circuitry that allows information to be stored and retrieved. ROMs  130  generally contain stored data that cannot be modified. Data stored in RAM  125  can be read or changed by CPU  110  or other hardware devices. Access to RAM  125  and/or ROM  130  may be controlled by memory controller  120 . Memory controller  120  may provide an address translation function that translates virtual addresses into physical addresses as instructions are executed. Memory controller  120  may also provide a memory protection function that isolates processes within the system and isolates system processes from user processes. Thus, a program running in user mode may normally access only memory mapped by its own process virtual address space; in such instances, the program cannot access memory within another process&#39; virtual address space unless memory sharing between the processes has been set up. 
     In addition, computing system  100  may contain peripheral communications bus  135 , which is responsible for communicating instructions from CPU  110  to, and/or receiving data from, peripherals, such as peripherals  140 ,  145 , and  150 , which may include printers, keyboards, and/or the surgical elements, such as footpedals, discussed herein throughout. An example of a peripheral bus is the Peripheral Component Interconnect (PCI) bus. 
     Display  160 , which is controlled by display controller  155 , may be used to display visual output and/or presentation generated by or at the request of computing system  100 , responsive to operation of the aforementioned computing program. Such visual output may include text, graphics, animated graphics, and/or video, for example. Display  160  may be implemented with a CRT-based video display, an LCD or LED-based display, a gas plasma-based flat-panel display, a touch-panel display, or the like. Display controller  155  includes electronic components required to generate a video signal that is sent to display  160 . 
     Further, computing system  100  may contain network adapter  165  which may be used to couple computing system  100  to external communication network  170 , which may include or provide access to the Internet, an intranet, an extranet, or the like. Communications network  170  may provide user access for computing system  100  with means of communicating and transferring software and information electronically. Additionally, communications network  170  may provide for distributed processing, which involves several computers and the sharing of workloads or cooperative efforts in performing a task. It is appreciated that the network connections shown are exemplary an d other means of establishing communications links between computing system  100  and remote users may be used. 
     Network adaptor  165  may communicate to and from network  170  using any available wired or wireless technologies. Such technologies may include, by way of non-limiting example, cellular, Wi-Fi, Bluetooth, infrared, or the like. 
     It is appreciated that exemplary computing system  100  is merely illustrative of a computing environment in which the herein described systems and methods may operate, and does not limit the implementation of the herein described systems and methods in computing environments having differing components and configurations. That is to say, the inventive concepts described herein may be implemented in various computing environments using various components and configurations. 
     As illustrated in  FIG. 2 , one peripheral that may communicate using peripheral communications bus  135  is a footpedal. The actuation of the foot pedal  200  by, for example, a user&#39;s foot, may have corresponded thereto by the actuation a travel distance, which may be visually indicated on at least one graphical user interface (GUI)  604  of the phacoemulsification system  600  communicatively associated with the foot pedal  200 . The system may employ the computer system  100  discussed above, by way of example. 
     Moreover, the programmable travel positions of the foot pedal  200  may control different functions provided by the console  606 , and/or may be additive in functionality. For example, a first travel position for foot pedal  200  may be programmed to have the console  606  provide a specific ultrasonic power function, a second position may add an irrigation function, and a third position may add another function. In addition, other switches  216  may allow for control of the functions activated via the foot pedal  200 . For example, if an aspiration function is activated, at least one other switch  216  may be programmed to control the strength of the vacuum applied. 
     Although the present foot pedal control may be used in various surgical environments and applications, a particularly useful application is in an ocular surgical system, such as a phacoemulsification/vitrectomy system. In an exemplary phacoemulsification system  600 , a serial communication cable  602  may connect a GUI  604  and console  606  for the purposes of controlling the console  606  by the GUI host  604 . The console  606  may be considered a computational device in the arrangement shown, but other arrangements are possible. A switch module associated with an exemplary foot pedal  200 , such as described herein, transmits control signals relating internal physical and virtual switch position information as input to the console  606  over a serial communications cable  610 , or wirelessly if desired. 
     The system  600  has a handpiece  612  that typically includes a needle and electrical means, such as a piezoelectric crystal, for ultrasonically vibrating the needle. The console  606  supplies power on line  614  to the operative tip  612 . An irrigation fluid source  616  can be fluidly coupled to operative tip  612  through line  618 . The irrigation fluid and ultrasonic power are applied by the operative tip  612  to an eye  620 , or other affected area or region. Alternatively, the irrigation source may be routed to the eye  620  through a separate pathway independent of the handpiece. Aspiration is provided from the eye  620  by one or more pumps (not shown), such as a peristaltic pump and/or venturi pump, via the console  606 , through lines  622  and  624 . A surgeon/operator may select modes of operation of the foregoing, and variables within each mode, via the GUI, using the foot pedal, and/or by voice command, by way of non-limiting example. 
     An interface communications cable  626  connects to the console  606  for distributing instrument data  628 , and may include distribution of instrument settings and parameter information to other systems, subsystems and modules within and external to console  606 . Although shown connected to the console  606 , interface communications cable  626  may be connected or realized on any other subsystem (not shown) that could accommodate such an interface device able to distribute the respective data. 
     The disclosed embodiments may provide at least customizable, non-linear “custom modes” for emulsification in ophthalmic surgery, such as for phacoemulsification surgery performed using the foregoing console and footpedal, for example. More particularly, footpedal  200  may be used to indicate various custom operations for the handpiece  612 . These custom operations may be corresponded to particular positions for footpedal  200  in or by the operative program operating on console  606 , such as using one or more databases  704  associated with the programming on console  606 . 
     The timing and power variance between the aforementioned custom (and any non-custom) zones may be defined by the user. For example, the user may select a set of values, such as the foot pedal treadle percentage in a particular zone, such as in “use-zone 2” (variable “X”) of the footpedal  200 , which may then be algorithmically corresponded to a power level  614  percentage of ultrasonic tip  612  (hereinafter, variable “Y”) for timing within a certain zone prior to changeover to another zone. That is, the algorithms discussed throughout may interrelate the values X to the values Y based on a set point (X1, Y1), and the function provided by the algorithms may vary in different use zones. Accordingly, the value set may be applied to algorithmically calculate the slopes and trajectories, i.e., the mathematical function, of the Y values dependent on the X values, which slopes and trajectories may differ upon crossover between the zones discussed throughout. 
     More particularly and in order to provide optimal control for ultrasonic power delivery, various new power delivery modes are included in the embodiments, such as may be provided to the tip  612  via the console  606  responsive to actuation of the footpedal  200 . By way of non-limiting example, the power modes may be divided into two categories, a user-definable “custom mode” and pre-defined modes, such as a pre-defined “progressive mode”. Each “custom mode” may comprise interpolation algorithms, wherein the power delivery is broken into multiple segments defined by the user, such as to tailor to a particular region of footpedal  200  operation, such as in “zone 3,” within which the surgeon may comfortably stay while effectively managing the range of power to optimally break up a cataract, by way of example. 
     The “progressive mode” may provide pre-defined algorithms to deliver ultrasonic power in a non-linear manner, such as may be selected by a surgeon. By way of non-limiting example, the pre-defined algorithms in this mode may gradually reach maximum power, or may acutely rise to 80 to 85% of the maximum power, and then gradually taper towards 100%. The surgeon may thus be able to choose from the aforementioned power delivery modes that best suit her surgical needs and techniques. 
     In an exemplary embodiment, custom mode may be a user-defined power delivery mode wherein the user selects, for example, two sets of values consisting of the desired foot pedal treadle percentage and the desired correspondent power percentage. Thereby, the power delivery may have corresponded thereto three distinct segments of power deliveries having different trajectories between 0 and 100% within the foot pedal treadle zone 3 (FP3), e.g. the zone of the foot pedal where power delivery occurs. Table 1 illustrates exemplary custom ultrasonic modes based on two user set points. 
     
       
         
           
               
               
               
               
               
             
               
                 TABLE 1 
               
               
                   
               
               
                   
                 Custom 
                   
                 Custom 
                 Custom 
               
               
                 FP Zone 
                 Mode 
                   
                 Mode 
                 Mode 
               
               
                 Percentage 
                 Example 1 
                 Linear 
                 Example 2 
                 Example 3 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 0 
                 0 
                 0 
                 0 
                 0 
               
               
                 5 
                 16 
                 5 
                 3.125 
                 30 
               
               
                 10 
                 32 
                 10 
                 6.25 
                 60 
               
               
                 15 
                 48 
                 15 
                 9.375 
                 90 
               
               
                 20 
                 64 
                 20 
                 12.5 
                 90 
               
               
                 25 
                 80 
                 25 
                 15.625 
                 90 
               
               
                 30 
                 80 
                 30 
                 18.75 
                 90 
               
               
                 35 
                 80 
                 35 
                 21.875 
                 90 
               
               
                 40 
                 80 
                 40 
                 25 
                 90 
               
               
                 45 
                 80 
                 45 
                 25.625 
                 90 
               
               
                 50 
                 80 
                 50 
                 26.25 
                 90 
               
               
                 55 
                 80 
                 55 
                 26.875 
                 91 
               
               
                 60 
                 80 
                 60 
                 27.5 
                 92 
               
               
                 65 
                 80 
                 65 
                 28.125 
                 93 
               
               
                 70 
                 82.85714286 
                 70 
                 28.75 
                 94 
               
               
                 75 
                 85.71428571 
                 75 
                 29.375 
                 95 
               
               
                 80 
                 88.57142857 
                 80 
                 30 
                 96 
               
               
                 85 
                 91.42857143 
                 85 
                 47.5 
                 97 
               
               
                 90 
                 94.28571429 
                 90 
                 65 
                 98 
               
               
                 95 
                 97.14285714 
                 95 
                 82.5 
                 99 
               
               
                 100 
                 100 
                 100 
                 100 
                 100 
               
               
                   
               
            
           
         
       
     
     The three segments may be formed using interpolation algorithms, such as based on user selection of start and endpoints, such as for the start and end of the middle segment. Algorithmically, (X1, Y1) and (X2, Y2) may be the start and end points provided for the two variables (i.e., power may be represented by variable Y, and foot pedal FP3 travel may be represented by variable X). Therefrom, three segments may be created, i.e., Start Segment prior to (X1, Y1), Performance Segment between (X1, Y1) and (X2, Y2), and Final Segment after (X2, Y2 Accordingly, the three segments may be interpolated from the two points provided by the user to create a segmented, customized power delivery trajectory, such as may be tailored to a surgeon&#39;s needs and comfort. By way of non-limiting example, the three segments may be defined and calculated as shown below, (wherein X is the desired FP3 percentage, Y is the desired power percentage, and FP3% is actual foot pedal treadle zone 3 percentage). Settings on the GUI may allow customization of MAX Power, X and Y. 
     If Actual FP3%&lt;=defined X1, New FP3% may be calculated as: 
       Start Segment: 
       New Factor=( Y 1/ X 1)* FP 3% 
     If Actual FP3%&gt;=X1 but &lt;=X2, New FP3% may be calculated as: 
       Performance Segment: 
       New Factor=[1/( X 2− X 1)]*[( Y 2− Y 1)* FP 3%+ X 1* Y 2+ X 2* Y 1]
 
     If Actual FP3%&gt;X2, New FP3% may be calculated as: 
       Final Segment: 
       New Factor=[1/(100− X 2)]*[(100− Y 2)* FP 3%+100*( Y 2− X 2)]
 
     The foregoing result may be used to calculate a firmware power value for the console as: 
       Firmware Power=New Factor*Max Power(from GUI) 
     To better illustrate the above algorithms, the following examples are provided. For example, the actual FP3% is at 10% and the user customized values in GUI may be: 
     Max Power=60% 
     Start SegmentFP3% Limit X1=20% 
     Start Segment Power % Limit Y1=60% 
     Performance Segment FP3% Limit X2=80% 
     Performance Segment Power % Limit Y2=70% 
     Since actual FP3% is 10%, (10%&lt;X1=20%), the Start Segment Algorithm may be: 
       New Factor=( Y 1/ X 1)* FP 3% 
       New Factor=(60%/20%)*10%=30% 
     Then calculate Power Value for Firmware: 
       Firmware Power=New Factor*Max Power 
       Firmware Power=(30%*60%)=18% 
     In another example, actual FP3% is at 50% and the user customized values in GUI are: 
     Max Power=60% 
     Start SegmentFP3% Limit X1=20% 
     Start Segment Power % Limit Y1=60% 
     Performance Segment FP3% Limit X2=80% 
     Performance Segment Power % Limit Y2=70% 
     Since actual FP3% is at 50% (X1=20%=&lt;50%=&lt;X2=80%), the Performance Segment Algorithm may indicate: 
       New Factor=[(1/( X 2 −X 1))]*[( Y 2 −Y 1 XFP 3%)+ Y 1* X 2 −Y 2* X 1] 
       New Factor=[(1/80−20))]*[(70−60×50)+(60*80)−(70*20)]=65%
 
       Firmware Power=New Factor*Max Power 
       Firmware Power=(65%*60%)=39% 
     In another example, actual FP3% is at 90% and the user customized values in GUI are: 
     Max Power=60% 
     Start Segment FP3% Limit X1=20% 
     Start Segment Power % Limit Y1=60% 
     Performance Segment FP3% Limit X2=80% 
     Performance Segment Power % Limit Y2=70% 
     Since Actual FP3 is at 90% (90%&gt;X2=80%), the Final Segment Algorithm may indicate: 
       New Factor=[(1/(100− X 2))]*[((100− Y 2)( FP 3%))+100*( Y 2− X 2)]
 
       New Factor=[1/(100−80%)]*[((100−70%(90%))+100*(70−80)]=85%
 
       Firmware Power=New Factor*Max Power 
       Firmware Power=(85%*60%)=51% 
     Custom mode may allow for refined control of ultrasonic base power delivery, in a manner tailored to a surgeon&#39;s preferences and comfort, as mentioned above. Customized power delivery in custom mode may be combined with other available modes to produce additional unique power delivery modes. Interpolation of power data in custom mode may occur using two points, but may also be devised in general with any provided n points into (n+1) custom delivery segments. In short, the algorithm for any two consecutive points (Xrn, Ym) and (Xn, Yn) forms a segment of power delivery as follows: 
         Y =[( Yn−Ym )* X+Xn*Ym−Xm*Yn ] I ( Xn−Xm ) 
     Progressive mode, as mentioned above, may provide pre-defined power delivery algorithms in which the concentration of power delivery targets a preferred range, such as in the foot pedal “zone 3” region. By way of non-limiting example, if 40% to 80% of power is the most commonly used range for a particular surgeon, by selecting a new targeted power delivery for that range, the surgeon has substantially optimal control in the indicated range. 
     Additionally and in a non-limiting example, multiple categories of power delivery algorithms may be provided for selection of modes therewithin by the surgeon. For example, two categories, “slowmo” and “quickmo”, in which a surgeon may choose a categorical mode to either slowly or quickly, respectively, increase the power, such as in a non-linear fashion, when pressing the treadle of the foot pedal, such as in the “zone 3” region. Exemplary slowmo and quickmo categorical modes are provided immediately below in Table 2. For a custom non-linear implementation, the user may not specify the Start Segment Limits in the GUI. Rather and by way of example, a slider may be provided to select one of several, such as seven, predefined Power Delivery Methods as pre-calculated below in Table 2. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 2 
               
             
            
               
                   
                   
               
               
                   
                 Slow-Mo Modes 
                 Linear 
                 Quick-Mo Modes 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 FP Zone 
                 Slow-Mo 
                 Slow-Mo 
                 Slow-Mo 
                 (Current 
                 Quick-Mo 
                 Quick-Mo 
                 Quick-Mo 
               
               
                 Percentage 
                 Low 
                 Medium 
                 High 
                 Method) 
                 Low 
                 Medium 
                 High 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
               
               
                 5 
                 0.000313 
                 0.125078 
                 0.25 
                 5 
                 9.75 
                 31.22499 
                 43.068985 
               
               
                 10 
                 0.005 
                 0.501256 
                 1 
                 10 
                 19 
                 43.5889894 
                 58.642988 
               
               
                 15 
                 0.025316 
                 1.1314 
                 2.25 
                 15 
                 27.75 
                 52.6782688 
                 69.137092 
               
               
                 20 
                 0.080032 
                 2.02041 
                 4 
                 20 
                 36 
                 60 
                 76.837491 
               
               
                 25 
                 0.195504 
                 3.175416 
                 6.25 
                 25 
                 43.75 
                 66.1437828 
                 82.679728 
               
               
                 30 
                 0.405823 
                 4.60608 
                 9 
                 30 
                 51 
                 71.4142843 
                 87.172243 
               
               
                 35 
                 0.753149 
                 6.32503 
                 12.25 
                 35 
                 57.75 
                 75.9934208 
                 90.636292 
               
               
                 40 
                 1.288299 
                 8.348486 
                 16 
                 40 
                 64 
                 80 
                 93.29523 
               
               
                 45 
                 2.071774 
                 10.69714 
                 20.25 
                 45 
                 69.75 
                 83.5164654 
                 95.314938 
               
               
                 50 
                 3.175416 
                 13.39746 
                 25 
                 50 
                 75 
                 86.6025404 
                 96.824584 
               
               
                 55 
                 4.685062 
                 16.48353 
                 30.25 
                 55 
                 79.75 
                 89.3028555 
                 97.928226 
               
               
                 60 
                 6.70477 
                 20 
                 36 
                 60 
                 84 
                 91.6515139 
                 98.711701 
               
               
                 65 
                 9.363708 
                 24.00658 
                 42.25 
                 65 
                 87.75 
                 93.67497 
                 99.246851 
               
               
                 70 
                 12.82776 
                 28.58572 
                 49 
                 70 
                 91 
                 95.3939201 
                 99.594177 
               
               
                 75 
                 17.32027 
                 33.85622 
                 56.25 
                 75 
                 93.75 
                 96.8245837 
                 99.804496 
               
               
                 80 
                 23.16251 
                 40 
                 64 
                 80 
                 96 
                 97.9795897 
                 99.919968 
               
               
                 85 
                 30.86291 
                 47.32173 
                 72.25 
                 85 
                 97.75 
                 98.8685997 
                 99.974684 
               
               
                 90 
                 41.35701 
                 56.41101 
                 81 
                 90 
                 99 
                 99.4987437 
                 99.995 
               
               
                 95 
                 56.93101 
                 68.77501 
                 90.25 
                 95 
                 99.75 
                 99.8749218 
                 99.999687 
               
               
                 100 
                 100 
                 100 
                 100 
                 100 
                 100 
                 100 
                 100 
               
               
                   
               
            
           
         
       
     
     More particularly, in the “slowmo” categories, modes may generally apply power gradually upon entering the treadle region controlling power, and may gradually increase power for the majority of the treadle region, such as until the last 20%-25% of the treadle region. Various algorithms may control the power delivery within a category of modes, such as one or more algorithms in each mode. 
     For example, one algorithm may limit the increase of power in a gradual manner until the last 25% of the treadle, at which point a sharp increase may be applied to reach the maximum power. Refinement may be included in the algorithm to achieve, for example, three distinct levels (i.e., low, medium, and high) of increase or decrease of power. 
     By way of additional example, control of power delivery may be further refined by defining the “control region” of gradual power increase as the first 80% of the FP3 region, and the last 20% of the FP3 region as a linear increase from 80% to 100% of full power. In relation to the foregoing examples, availability of variations for power delivery are helpful for surgeons who prefer to gradually increase the power after initial application, such as to avoid power over-use. 
     On the other hand and by way of example, in “quickmo” categories, upon entering the power region of the foot pedal treadle, modes may be provided in which ultrasonic power sharply rises before tapering gradually to maximum power. In a first algorithmic mode in this category, the first 20% of treadle travel may yield about 80% of the maximum power, with a gradual increase to the maximum power over the remaining depth of the treadle. Further refinement may also be available to provide three distinct levels of quickness (low, medium, and high). 
     In a second algorithmic mode within the quickmo category, the power may increase acutely in the initial 40% to 80% of the FP3 region, and may then increase in a linear fashion from 80% to 100% of the maximum power over the last 20% of the FP3. Modes in this category may be helpful for surgeons who prefer more significant power at the beginning of the treadle actuation in FP3, and a smooth range of targeted power to break up particles without the need to waver the treadle or substantially depress the foot pedal to its maximum to get to higher power. 
     Table 3, below, illustrates exemplary modes in accordance with the disclosed embodiments. In short, illustrated in Table 3 are algorithms and data supporting customized and progressive mode phacoemulsification power deliveries. For the progressive mode, Table 3 illustrates four variations (low, medium, high, and mixed) for the “slowmo” and “quickmo” modes. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 3 
               
               
                   
                   
               
               
                   
                 FP Zone3 Percentage 
                 Percentage of Max Power 
                   
               
               
                   
                 Input 
                 Delivered Output 
                 Status 
               
               
                   
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 Name 
                   
                   
                   
               
               
                 Panel 
                 0 &lt; X &lt;= 100 
                 F(X) = 100 
                 Existing Mode 
               
               
                   
                 1% to 100% 
                 100% 
               
               
                 Linear 
                 0 &lt; X &lt;= 100 
                 F(X) = X 
                 Existing Mode 
               
               
                   
                 1% to 100% 
                 1% to 100% 
               
               
                 Custom Mode 
               
               
                 Custom Mode 
                 0 &lt; (X1 &lt; X2) &lt; 100 
                 0 &lt;= (Y1 &lt; Y2) = 100 
                 New Mode 
               
               
                 Initial Seg 
                 0 &lt; X &lt;= X1 
                 F(X) = (Y1/X1) * X 
               
               
                 Sweet Spot Seg 
                 X1 &lt; X &lt;= X2 
                 F(X) = [1/(X2 − X1)*[(Y2 − 
               
               
                   
                   
                 Y1)*X + Y1*Y2 − Y2*X1] 
               
               
                 Final Seg 
                 X2 &lt; X &lt;= 100 
                 F(X) = [1/(100 − X2)]*[(100 − 
               
               
                   
                   
                 Y2) * X + 100(Y2 − X2)] 
               
               
                 Progressive SlowMo 
               
               
                 Modes 
               
               
                 SlowMo Low 
                 0 &lt; X &lt;= 100 
                 F(X) = 100 − SQRT (10{circumflex over ( )}4 − 
                 New Mode 
               
               
                   
                 01% to 45% 
                 (X/10){circumflex over ( )}4) 
               
               
                   
                 45% to 100% 
                 01% to 20% 
               
               
                   
                   
                 20% to 100% 
               
               
                 SlowMo Med 
                 0 &lt; X &lt;= 100 
                 F(X) = 100 SQRT(10{circumflex over ( )}4 − 
                 New Mode 
               
               
                   
                 01% to 60% 
                 X{circumflex over ( )}2) 
               
               
                   
                 60% to 100% 
                 01% to 20% 
               
               
                   
                   
                 20% to 100% 
               
               
                 SlowMo High 
                 0 &lt; X &lt;= 100 
                 F(X) = (X/10){circumflex over ( )}2 
                 New Mode 
               
               
                   
                 01% to 80% 
                 01% to 20% 
               
               
                   
                 80% to 100% 
                 20% to 100% 
               
               
                 SlowMo Mix 
                 0 &lt; X &lt;= 80 
                 F(X) = 2 * (100 − 
                 New Mode 
               
               
                   
                 80 &lt; X &lt;= 100 
                 SQRT(10{circumflex over ( )}4 − X{circumflex over ( )}2)) 
               
               
                   
                   
                 F(X) = X 
               
               
                   
                 01% to 45% 
               
               
                   
                 45% to 80% 
                 01% to 20% 
               
               
                   
                 80% to 100% 
                 20% to 80% 
               
               
                   
                   
                 80% to 100% 
               
               
                 Progressive QuickMo 
               
               
                 Modes 
               
               
                 QuickMo Low 
                 0 &lt; X &lt;= 100 
                 F(X) − 2 * X − (X/10){circumflex over ( )}2 
                 New Mode 
               
               
                   
                 01% to 45% 
                 01% to 70% 
               
               
                   
                 45% to 100% 
                 70% to 100% 
               
               
                 QuickMo Medium 
                 0 &lt; X &lt;= 100 
                 F(X) = SQRT(X * (200 − X)) 
                 New Mode 
               
               
                   
                 01% to 40% 
                 01% to 80% 
               
               
                   
                 40% to 100% 
                 80% to 100% 
               
               
                 QuickMo High 
                 0 &lt; X &lt;= 100 
                 F(X) = SQRT(10{circumflex over ( )}4 − ((100 − 
                 New Mode 
               
               
                   
                 01% to 20% 
                 X)/10){circumflex over ( )}4) 
               
               
                   
                 20% to 100% 
                 01% to 80% 
               
               
                   
                   
                 80% to 100% 
               
               
                 QuickMo Mix 
                 0 &lt; X &lt;= 80 
                 F(X) = SQRT(X * (160 − X)) 
                 New Mode 
               
               
                   
                 80 &lt; X &lt;= 100 
                 F(X) = X 
               
               
                   
                 01% to 30% 
                 01% to 60% 
               
               
                   
                 30% to 80% 
                 60% to 80% 
               
               
                   
                 80% to 100% 
                 80% to 100% 
               
               
                   
               
            
           
         
       
     
     As an example, actual FP3% may be at 35% and custom values in the GUI may be: 
     Power Mode: Quick-Mo Low 
     Max Power: 100% 
     Using the algorithm for Quick-Mo-Low, 
       Firmware Max Power=2* FP 3%−( FP 3%/10){circumflex over ( )}2
 
       Firmware Max Power=(2*35)−(35/10){circumflex over ( )}2=57.75=58
 
       Firmware Max Power=58*% 
     Of course, the exemplary algorithms discussed herein and specifically illustrated in Table 3 may vary, and algorithms may additionally vary with equipment variations. For example, algorithms may vary with alternative combinations or arrangements of ramping or linear applications, with different components or component locations, with different spatial or temporal relationships, and soon. By way of example, additional algorithms may include more distinct arcs and curves for the application of ultrasonic power. More specifically and by way of non-limiting example, alternatives for progressive modes may include auto-adjustment among the levels of slowmo and quickmo, such as dependent upon an occluded tip and/or level of density of cataract as may be defined by a surgeon during diagnostics. 
     Using the power delivery modes discussed throughout, surgeons may achieve preferred power ranges faster without having to navigate linearly through undesired power ranges. In addition to avoiding such inefficiencies, the foregoing examples may reduce the time and heat/energy in the eye by getting to targeted power ranges more quickly in the FP3 region. Further, such custom modes, particularly if provided with a custom user-defined “sweet spot” within a specific range in the FP3 region, may provide more control in ultrasonic power delivery within a comfortable zone in the foot pedal treadle uniquely tailored for a particular surgeon. Moreover, the providing of various optional custom modes allows for the flexibility of different power trajectories in different cases. 
     The use of custom power delivery modes also enables a smooth transition from occlusion to post occlusion while applying more effective power to break up occluded particles. For example, if a surgeon uses a quickmo mode too quickly increase power to break up a cataract and the equipment tip becomes occluded, instead of switching to a linear power delivery mode a slowmo mode may be set as the occluded mode. A new higher power setting may accordingly be achieved at the same foot pedal position, without requiring the surgeon to ease off the foot pedal. And, if backing off to a lower power is desired, gently easing off the foot pedal may provide the lower power, rather than dramatically lifting the foot off the treadle. 
     Additionally, in phacoemulsification systems, custom modes may be used for purposes beyond strict in-surgery use-zones. By way of non-limiting example, custom modes may also be used to apply pump ramp, aspiration levels and vacuum levels, such as to allow modified aspiration and vacuum for broken up particles as compared to gradual aspiration and vacuum levels for bigger or harder to break pieces. 
       FIG. 3  is a flow diagram illustrating a method  800  of providing a customizable, non-linear “custom mode” for phacoemulsification in ophthalmic surgery. At step  802 , a foot pedal actuation percentage is received. At step  804 , the foot pedal actuation percentage is compared relationally to a custom zone algorithm, which is calculated from at least one user-indicated set point for ultrasonic power corresponded to particular foot pedal actuation percentages, and which is used to calculate a particular power level for a given foot pedal actuation percentage within the zone. At step  806 , afoot pedal actuation percentage assessed as being in the custom zone is used by the algorithm for the custom zone to dictate the power level for the surgery. At step  808 , the dictated ultrasonic power level is employed by the surgical console. 
     In the foregoing detailed description, it may be that various features are grouped together in individual embodiments for the purpose of brevity in the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that any subsequently claimed embodiments require more features than are expressly recited. 
     Further, the descriptions of the disclosure are provided to enable any person skilled in the art to make or use the disclosed embodiments. Various modifications to the disclosure will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other variations without departing from the spirit or scope of the disclosure. Thus, the disclosure is not intended to be limited to the examples and designs described herein, but rather is to be accorded the widest scope consistent with the principles and novel features disclosed herein.