Abstract:
A surgical tool whose shaft terminates into a tip having a smooth, rounded edge and that has pores on its top or side, but none one the underside of its base. There may be a flattened base indicative of the shape of a bubble, basket, funnel, circular disc, oblong shape, Maltese cross or mulberry. The pores may be directed backward. A spring spiral may be provided within the shaft to exert a spring bias. The globe may be in the form of a sleeve fitted over a conventional phacoemulsification tip and needs to be positioned to keep the phacoemulsification tip from contacting the sleeve during operation. Alternatively, the globe may be part of a tip itself.

Description:
CROSS-REFERENCE TO COPENDING PATENT APPLICATIONS 
     The present application claims the benefit of priority from provisional patent application Ser. No. 61/184,399 filed Jun. 5, 2009. 
    
    
     BACKGROUND OF THE INVENTION 
     One aspect of the invention relates to surgical tools in the form of an elongated shaft and tip suited for use in phacoemulsification surgical instruments and irrigation-aspiration instruments. 
     Conventional phacoemulsification tips are sharp and have an overly large port that admits the eye capsule in a blink-of-an-eye. The eye capsule, when sucked into the overly large port, puckers and rips to produce rapidly widening tear lines through which vitreous prolapses, which often leads to vitreous loss. Therefore, the use such conventional phacoemulsification tips that are sharp with the overly large port run the risk of causing capsule ruptures, which is a very serious intraoperaive, i.e., surgical, complication. 
     There is therefore a need to reduce such a risk of causing capsule ruptures, i.e., by avoiding the use of conventional phacoemulsification tips that are sharp and that have an overly large port. That is, there is a need for phacoemulsification tips that are safe in the sense that they are not as likely to cause capsule ruptures. That is, the surgical tool should be “capsule friendly” to lessen the likelihood of creating capsule ruptures during their use in phacoemulsification surgical procedures or in irrigation-aspiration applications of the eye. 
     SUMMARY OF THE INVENTION 
     One aspect of the invention resides in “capsule friendly” tips suited for use with Alcon, Inc.&#39;s INFINI and LEGACY units, as well as for all other phacoemulsification type machines, that achieve safe removal of cataract fractions without sucking in iris tissue or pulling in and thus rupturing the capsule. The “capsule friendly” tips are constructed so only the aspiration of soft cortex occurs. That is, the capsule cannot enter the smooth rounded “bubble” tips with pores too small to admit the capsule under suction. Further, the smooth, rounded surfaces of the tips form no regions of sharpness that might otherwise cut into the capsule during aspiration. For instance, there are intersecting planar surfaces in such smooth, rounded surfaces of the tips. 
     In accordance with the invention, the tips are configured as (a) rounded, smoothly polished globe-like tips (“bubble” or “basket” tips), with multiple small pores (such as 0.3 mm or lower) on the surface and (b) as shaft tips with the aspiration prevented by wire guards from sucking in the capsule and iris. The pores admit only emulsified proteinaceous material, which leaves the capsule and the iris alone. In use, the tips are located at a distal end of a phacoemulfication ultrasonic surgical hand piece and/or an irrigation/aspiration surgical hand piece. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWING 
       For a better understanding of the present invention, reference is made to the following description and accompanying drawings, while the scope of the invention is set forth in the appended claims. 
         FIG. 1  is an isometric view of a basket sleeve tip embodiment in accordance with the invention in which a basket sleeve with pores is placed onto a conventional distal tip of an ultrasonic phacoemuslfication surgical hand piece. 
         FIG. 2  is an exploded, isometric view of the basket sleeve tip embodiment in accordance with  FIG. 1  prior to inserting a conventional distal tip of an ultrasonic phacoemuslfication surgical hand piece into a basket sleeve with pores and prior to mating internal grooves of the basket sleeve with external grooves on the outside of the hand piece. 
         FIG. 3  is an isometric view of the basket sleeve tip secured to the ultrasonic phacoemuslfication surgical hand piece in accordance with the embodiment of  FIGS. 1 and 2 . 
         FIG. 4  is isometric end view of the basket sleeve tip of  FIGS. 1-3 . 
         FIG. 5  is isometric view of a one-piece basket tip embodiment in accordance with the invention in which a basket tip with pores is integrally formed in a one-piece construction with a shaft or needle of an ultrasonic phacoemuslfication surgical hand piece to constitute a distal tip of the hand piece. 
         FIG. 6  is an enlarged isometric view of the one-piece basket tip embodiment of  FIGS. 4-5 , but showing more of the base than in  FIG. 5 . 
         FIG. 7  is a bottom view to show the base of the one-piece basket tip embodiment of  FIGS. 5-6 . 
         FIG. 8  is a top view to show the top of the one-piece basket tip embodiment of  FIGS. 5-6 . 
         FIG. 9  is a pin shape in accordance with a further embodiment of the invention. 
         FIG. 10  is a conventional sharp edge phacoemulsification tip. 
         FIG. 11  is an isometric view of a bubble tip embodiment in accordance with the invention shown protruding from a sleeve. 
         FIG. 12  is an isometric view of the bubble tip embodiment of  FIG. 11  inserted into an eye capsule. 
         FIG. 13  is an isometric view of a curved bubble tip embodiment in accordance with the invention in which an irrigation/aspiration shaft or needle curves to terminate into a globular shape with pores to constitute a distal tip of an irrigation/aspiration surgical hand piece. 
         FIG. 14  is an isometric view of a straight bubble tip embodiment in accordance with the invention in which a straight irrigation/aspiration shaft or needle terminates into a globular shape with pores to constitute a distal tip of an irrigation/aspiration surgical hand piece. 
         FIG. 15  is an isometric view of a funnel style kugeln tip embodiment in accordance with the invention in which an irrigation/aspiration shaft or needle curves to terminate into a funnel shape with pores directed backward to constitute a distal tip of an irrigation/aspiration surgical hand piece. 
         FIG. 16  is an isometric view of a horseshoe style kugeln tip embodiment in accordance with the invention in which an irrigation/aspiration shaft or needle curves to terminate into a horseshoe shape with pores directed backward to constitute a distal tip of an irrigation/aspiration surgical hand piece. 
         FIG. 17  is an isometric view of an oblong “Retro” style kugeln tip embodiment in accordance with the invention with longer backward reach in which an irrigation/aspiration shaft or needle curves to terminate into a oblong shape with pores directed backward to constitute a distal tip of an irrigation/aspiration surgical hand piece. 
         FIG. 18  is an isometric view of a spring assisted tip embodiment in accordance with the invention that includes a spring spiral within a shaft of a surgical hand piece. 
         FIG. 19  is an isometric end view of a cross-bun or Maltese cross tip embodiment in accordance with the invention. 
         FIG. 20  is an isometric side view of a cross-bun or Maltese cross tip embodiment in accordance with  FIG. 19 . 
         FIG. 21  is an isometric view of a mulberry tip in accordance with a straight shaft embodiment of the present invention. 
         FIG. 22  is an isometric view of a mulberry tip in accordance with an indented shaft embodiment of the present invention. 
         FIG. 23  is an isometric view of a conventional phacoemulsification tip. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     All tips in accordance with the  FIGS. 1-8 ,  11 - 22  of the invention have a rounded, almost spherical, upper two-thirds (⅔) of their shape and are dotted with pores, whose number depends upon what is practical with conventional pore making techniques (i.e., 3 holes, 5 holes, n holes). The tips of  FIGS. 1-8 ,  11 - 14  have a somewhat flatter solid base so there is no aspiration from below, but rather only from around the sides and from the top. The tip design aims to provide a smooth, rounded outer surface without sharp edges and with openings (pores) small enough so as to not suck in the eye capsule. 
       FIGS. 1-9 ,  11 - 14  show tips are configured as rounded, smoothly polished globe-like tips (“bubble” tips  30  or “basket” tips  10 ), with multiple small pores  12  (such as 0.3 mm or less) on the surface. Indeed, a pore size smaller than 0.3 mm will suffice. The pores  12  admit only emulsified proteinaceous material, which leaves the capsule and the iris alone. In use, the tips  10 ,  30  are located at a distal end of a phacoemulfication ultrasonic surgical hand piece  22  (which may have an infusion sleeve  16 ) and/or an irrigation/aspiration surgical hand piece. 
     The tips of  FIGS. 1-20  include surgical hand piece tips that are suited for ultrasonic phacoemulsification (U-Phaco) type applications, irrigation/aspiration (I/A) type applications or both types of applications. The U-phaco type tips include a) a basket sleeve  10  added onto a conventional phacoemulsification surgical hand piece tip  14  and b) a basket tip one-piece construction  30  that is integrally formed with the conventional phacoemulsification surgical hand piece. The I/A type tips include c) a straight bubble tip  40 , d) a curved bubble tip  50 , e) a kuglen type tip  60  and f) a spring assisted tip  70 . The tips for both applications (U-Phaco and I/A) include g) cross-bun or Maltese cross guard tips  80 . All embodiments of tips in accordance with the invention may be designed with a spring-loaded feature that employs a spring spiral in the tip shaft as discussed in connection with the discussion that follows regarding the f) spring assisted tip. 
     Basket Sleeve  10  on an Existing Tip  14  ( FIGS. 1-4 ) 
     The conventional phacoemulsification tip  14  has outside grooves  20  to which could be fastened a basket sleeve  10  configured with mating internal grooves  18  in accordance with this embodiment of the invention. Thus, the basket sleeve  10  may be screw threaded via its internal grooves  18  onto the exterior grooves  20  of the tip  14 . 
     Preferably, the basket sleeve  10  is made of a transparent material such as methylmethacrylate and sufficiently rigid to maintain its shape without collapsing onto the conventional phacoemulsification tip  14  while exposed to fluid pressures from ultrasonic speed operation. Further, the basket sleeve  10  is sized to allow the conventional phacoemulsification tip  14  to oscillate to and fro freely, but clear of the walls of the basket sleeve  10  so that the conventional phacoemulsification tip  14  in its longest excursion to-and-fro would never touch the wall of the basket sleeve  10 . Such oscillating motion is of benefit in disrupting cataract tissue over tiny distances such as up to 1 mm away from the oscillating tip. This result is based on clinical observations that ultrasound energy breaks tissue from a distance. 
     Basket Tip  30  in One-Piece Construction ( FIGS. 5-9 ,  10 - 11 ) 
     The material of the basket tip  30  may be stainless steel or other materials used in forming conventional phacoemulsification tips. The basket tip  30  has a hollow, elongated shaft  26  that terminates at, and is in fluid communication with, a hollow globe having a base  32  and a top  34 . The base  32  rises to about ⅓ of the total height of the basket tip  30  and the top  34  rises to about ⅔ of the total height of the basket tip  30  in the horizontal orientation of  FIG. 6 . The top  34  is smooth, rounded with pores  12 . The base  32  has no pores and may be flat with a straight base. The pore diameter of the pores  12  may be ¼ mm or ½ mm and arranged along a pin shaft  36  of  FIG. 9 . 
     Turning to the conventional phacoemulsification tip  14  of  FIG. 10 , the sharp edges and open center of the conventional phacoemulsification tip  14  contrasts markedly to the smooth, round top  34  of the tip  30 . Such sharp edges create the risk of snagging into tissue during passage through an incision to damage the same, which risk of snagging to cause tissue damage is considerably lessened with the smooth rounded tips of the present invention. 
       FIG. 11  shows the globe of the basket tip  50  projecting beyond an end of an infusion sleeve  16 . The globe of the basket tip  50  includes a top  34  and the base  32  of the basket tip  50  at a distal end of the shaft  26 . Only the top  34  has pores  12 .  FIG. 12  illustrates the insertion of the globe of the basket tip  30  through an incision to enter confines of the eye capsule  38 , with the elongated, hollow shaft  26  extending to the outside of the capsule. 
     Straight Bubble Tip  40   
     Turning to  FIG. 13 , the straight bubble tip  40  is shown inserted through an incision into the eye capsule  38 . The bubble tip  40  includes an elongated, hollow shaft  42  that extends in a substantially straight manner to a hollow globe  44  that has multiple pores  12  on its surface. 
     Curved Bubble Tip  50   
     Turning to  FIG. 14 , the curved bubble tip  50  is shown inserted through an incision into the eye capsule  38 . The curved bubble tip  50  is elongated so that its hollow, elongated shaft  52  extends in a curved manner to terminate into a hollow globe  44  with multiple pores  12  on its surface. The curvature enables positioning of the globe  44  into regions that may not otherwise be as accessible if a straight bubble tip  40  were used instead. 
     Kugeln Tip  60 ,  62 ,  64   
     Turning to  FIGS. 15-17 , kugeln tips in accordance with different embodiments of the invention are shown each with a face with pores directed backward toward the surgeon to facilitate the removal of hard-to-get cortex under the port of entry, which is usually the 12 o&#39;clock cortex. 
     In the case of  FIG. 15 , a funnel type kugeln tip is shown having a circular disc shaped globe  60  and an irrigation/aspiration shaft or needle  66  that extends within an infusion sleeve  16 . The shaft or needle  66  terminates into a funnel shape that diverges at a transition into a face of the circular disc shaped globe  60 . The pores  68  are directed backward and arranged in the face of the circular disc shaped globe  60  on the same side of the circular disc shaped globe  60  where the shaft or needle  66  funnels into the circular disc shaped globe  60 . 
     In the case of  FIG. 16 , a horseshoe style kugeln tip is shown with a horseshoe shaped globe  62  and an irrigation/aspiration shaft or needle  66  that extends within an infusion sleeve  16 . The shaft or needle  66  terminates into the horseshoe shaped globe  62 . The pores  68  are directed backward in the horseshoe shaped globe  62  on the same side of the globe  62  from which approaches the shaft or needle  66  to reach the horseshoe shaped globe  62 . 
     In the case of  FIG. 17 , an oblong “Retro” style kugeln is shown having an oblong globe  64  with a longer backward reach that in the case of the embodiments of  FIGS. 15 and 16 . The irrigation/aspiration shaft or needle  66  of  FIG. 17  extends within an infusion sleeve  16  and terminates into the oblong globe  64 . The oblong globe  64  has pores  68  that are directed backward on the same side of the oblong globe  64  that the shaft or needle  66  reaches the oblong globe  64 . 
     Spring Assisted Tip  70   
     Turning to  FIG. 18 , the spring assisted tip  70  or spring loaded tip has a delicate spring spiral  72  within its shaft  74  that allows the surgeon (user) to press the tip gently against the cortex against the spring bias. The spring spiral  72  then recoils under bias (since it has as tendency to do so) and effectuates minimal movement against the cortex and allows onion like layers to loosen their compactness and be aspirated into the pores faster than without the spring action. The distal end of the spring-assisted tip  70  may be adopted for any of the tip embodiments of the present invention. 
     Cross-Bun or Maltese Cross Guard Tips  80  for Both U-Phaco and I/A Hand Pieces 
     Turning to  FIGS. 19-20 , the cross-bun or Maltese cross guard tips  80  resemble conventional U-Phaco and I/A tips the most out of all the embodiments and thus are likely the easiest to retool an existing tip manufacturing facility and thus the easiest for a conventional tip manufacturer to produce. Both U-Phaco and I/A type cross-bun or Maltese cross guard tips  80  look somewhat alike in that the aspiration port of each is located dead front and each has a built-in guard that is all one-piece with the tip. 
     The globe of the tip of the cross-bun or Maltese cross type is constituted by two wire arms  82  made of fine smooth micro wires that straddle crosswise the port  84  of an elongated, hollow shaft  86 . They minimally bulge to appear slightly rounded and not sharp and connect to the edges of the port widened a bit, as if in shape of a Maltese cross. The two wire arms  82  cross at 90 degrees across the port  84 , thereby dividing the port  84  into four smaller entrances that are each too small for the capsule to enter. The emulsified matter, however, flow faster through the wires, but then quickly join together to flow the full sized channel downstream of the wire part of he port to continue to be aspirated in accordance with the flow dynamics of conventional tips. 
     Turning to  FIGS. 21 and 22 , two types of mulberry tips  90 ,  92  are shown, i.e.,  FIG. 21  is for a straight phaceoemuslfication shaft and  FIG. 22  is for an indented phacoemulsification shaft. The size of the shaft for each type of mulberry tip  90 ,  92  is the same as that of a shaft of a conventional phacoemulsification tip  100  of  FIG. 23 . The conventional phacoemulsification tip  100  in this example has an end that is to smooth and thus just compresses the cortex material to shrivel it up so it could be aspirated better. 
     Each mulberry tip  90 ,  92  has a respective irregularity shape  94 ,  96  that is configured to engage epinucleus cortical material to work as a “battering ram” to divide cortical fibers so they can become dislodged and be aspirated with more ease than for conventional phacoemulsification tips  100  of  FIG. 23 . For instance, the irregularity shape  94 ,  96  may take the form of a plurality of rounded protrusions that extend in a direction of elongation of the shaft (from which the mulberry tip extends). The rounded protrusions may be arranged concentric with a center axis of the tip and may be arranged in a symmetrical manner. 
     Further, the hole, port or opening  98  for aspiration has a wire  99  across it if the hole, port or opening  98  for aspiration is otherwise the same dimension as is found in conventional phacoemulsification tips  100  of  FIG. 23  to compensate for the overly large dimension of the hole, port or opening  98 . That is, “overly” in the sense of being capable of admitting the capsule during aspiration due to the overly large dimension of the hole, port or opening  98 . 
     In the case of the “capsule friendly” tips as depicted in all the embodiments of the present invention, such may be used as the irrigation-aspiration tips for all models and makes of conventional irrigation-aspiration handpieces utilizing in phacoemulsification consoles by conventional manufacturers. The choice of material for the “capsule friendly” tips of any of the embodiments of the present invention may include that of metal or hardened silicone. 
     While the foregoing description and drawings represent the preferred embodiments of the present invention, it will be understood that various changes and modifications may be made without departing from the scope of the present invention.