Patent Description:
Although the ophthalmic surgery may be performed, there are possible negative outcomes that increase with the number of ports used. Using four ports requires the surgeon to make four incisions in the sclera and to monitor surgical instruments at four different locations. This makes the procedure more difficult for the surgeon. A higher number of ports also carries a higher risk of complications and other negative outcomes for the patient than fewer ports. Additional ports, which are sometimes used for other purposes, may also make surgery more difficult for the physician and increase the risks for the patient.

Accordingly, what is needed is a mechanism for assisting a physician in ophthalmic surgery which decreases the number of required surgical incisions and access ports, which may thereby provide the possibility of improved ease of surgery, reduced surgical complications, and improved patient outcomes.

<CIT> provides an illumination system for a surgical device. The illumination system includes a tubular body made of a light permeable material and having at least one lumen extending between a distal end and a proximal end. The illumination system further includes a light source. At least one light diffusing optical fiber is disposed in the at least one lumen, the at least one light diffusing optical fiber having a core, primary cladding, and a plurality of nano-sized structures, the optical fiber further including an outer surface, and an end optically coupled to the light source.

<CIT> discloses an endoilluminator that includes a cannula, an intermediate material, and an optical fiber. The cannula has a substantially cylindrical shape that defines an interior region and has a cylindrical axis. The intermediate material is disposed within the interior region. The optical fiber is disposed within the intermediate material and has a fiber optical axis and a distal end configured to emit light. The emitted light has an illumination pattern with an illumination axis that is not parallel to the cylindrical axis.

<CIT> provides tools, materials and related methods to surgically access the suprachoroidal space of an eye for the purpose of performing minimally invasive surgery or to deliver drugs to the eye. The invention provides a flexible microcannula device that may be placed into the suprachoroidal space through a small incision of the overlying tissues, maneuvered into the appropriate region of the space, and then activated to treat tissues adjacent to the distal tip of the device.

<CIT> discloses an illuminated surgical instrument that has a working area located near an end of the instrument. An array of optical fibers terminates near the end of the instrument. The array of optical fibers is located adjacent to the instrument such that the array of optical fibers provides targeted illumination to the working area only on one side of the instrument.

A system provides a surgical infusion device including a cannula and an optical fiber. The cannula has a channel therethrough and an outside diameter. The channel has an inside diameter that is smaller than the outside diameter. The optical fiber is coupled with the cannula. The optical fiber coupled with the cannula has an optical fiber diameter of at least thirty micrometers and less than one hundred micrometers. In some embodiments, this diameter may be not more than one half the inside diameter. At least a portion of the optical fiber coupled with the cannula is within the channel. At least the portion of the optical fiber within the channel is in contact with infusion fluid flowing through the cannula. The surgical infusion device further comprises: a hub, where the optical fiber is positioned in the channel by the hub, the hub further including a plurality of members extending substantially radially from the hub and contacting an inside surface of the cannula. Consequently, the surgical infusion device may be used both for infusion and for illumination, thereby forming an illuminated infusion cannula. In some embodiments, the optical fiber may be centrally mounted in the cannula (e.g., extending close to the center of the cannula). In some embodiments, the optical fiber may be mounted off-center or even along a side of the cannula.

According to the system disclosed herein a single instrument may provide both illumination and infusion, allowing for fewer ports and the possibility of improved patient outcomes. The scope of the invention is defined by the claims which follow.

The exemplary embodiments relate to surgical instruments, such as those used in ophthalmic surgery. The following description is presented to enable one of ordinary skill in the art to make and use the various embodiments that are provided in the context of a patent application and its requirements. Various modifications to the exemplary embodiments and the generic principles and features described herein will be readily apparent. The exemplary embodiments are mainly described in terms of particular methods and systems provided in particular implementations. However, the methods and systems will operate effectively in other implementations. The methods described are not part of the claimed subject-matter and are described for illustrative purpose only. Phrases such as "exemplary embodiment", "one embodiment" and "another embodiment" may refer to the same or different embodiments as well as to multiple embodiments. The embodiments will be described with respect to systems and/or devices having certain components. However, the systems and/or devices may include more or less components than those shown, and variations in the arrangement and type of the components may be made without departing from the scope of the disclosure. The exemplary embodiments will also be described in the context of particular methods having certain elements. However, the method and system operate effectively for other methods having different and/or additional elements and elements in different orders that are not inconsistent with the exemplary embodiments. Thus, the present disclosure is not intended to be limited to the embodiments shown, but is to be accorded the widest scope consistent with the principles and features described herein.

The method and system are also described in terms of singular items rather than plural items. For example, an optical fiber is used and/or shown in some embodiments. One of ordinary skill in the art will recognize that these singular terms encompass plural. For example, multiple optical fibers might be used.

A method and system provide a surgical infusion device including a cannula and an optical fiber coupled with the cannula. The cannula has a channel therethrough and an outside diameter. The channel has an inside diameter that is smaller than the outside diameter. The optical fiber is coupled with the cannula. At least a portion of the optical fiber coupled with the cannula has a diameter of not more than one half the inside diameter. In some embodiments, this diameter of the optical fiber may not be more than one hundred micrometers. Consequently, the surgical infusion device may be used both for infusion and for illumination. The surgical infusion device may thus be an illuminated infusion cannula.

<FIG> are diagrams depicting an exemplary embodiment of a surgical infusion device <NUM> usable in ophthalmic surgery and the surgical infusion device <NUM> when used in conjunction with a console <NUM>. As discussed below, the surgical infusion device provides both illumination and infusion. Consequently, such a surgical infusion device may also be termed an illuminated infusion cannula. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown.

The illuminated infusion cannula <NUM> includes an optical fiber <NUM> and a cannula <NUM>. Also shown in <FIG> is an infusion line <NUM> that may be coupled with the cannula <NUM>. Although described as an infusion line <NUM>, the infusion line <NUM> may also be known as an irrigation line. The infusion line <NUM> may be formed of plastic tubing and carries fluid to the channel <NUM>. Other materials for the infusion line <NUM> are also possible.

The cannula <NUM> is hollow, having a channel <NUM> therein. In the embodiment shown, the channel <NUM> is along the axis of the cannula <NUM>. Therefore, although not explicitly indicated in <FIG>, the cannula has an inside diameter that is the diameter of the channel <NUM> and an outside diameter. The inside diameter is less than the outside diameter by at least the thickness of the walls of the cannula <NUM>. The cannula <NUM> may be a <NUM>, <NUM> or <NUM> gauge cannula in some embodiments. A fluid such as a BSS® (Balanced Salt Solution) irrigating solution may flow from the infusion line <NUM>, through the channel <NUM> and into the eye. This flow of fluid is indicated in <FIG> by arrows passing through the channel <NUM>. Consequently, the fluid flow through the cannula <NUM> may be used to maintain the eye pressure during a procedure.

The optical fiber <NUM> is coupled with the cannula <NUM>. In the embodiment shown, at least part of the optical fiber is within the channel <NUM>. Also in the embodiment shown, the optical fiber <NUM> lies along the wall of channel <NUM>. In other embodiments, the optical fiber <NUM> may be at another location. For example, the optical fiber may be along the axis of the cannula <NUM> or in another position in the channel <NUM>. Alternatively, the optical fiber <NUM> may be along the outside of the cannula <NUM>. The optical fiber <NUM> is also shown as being parallel to the axis of the channel <NUM>. In other embodiment, the optical fiber <NUM> may be curved or retained within or around the cannula <NUM> in another manner.

The diameter of at least a portion of the optical fiber <NUM> is small in comparison to the diameter of the channel <NUM>. In some embodiments, the portion of the optical fiber <NUM> within the channel <NUM> has a diameter that may not be more than one-half the inside diameter of the channel <NUM>. In some embodiments, the diameter of the optical fiber <NUM> may not be more than one hundred micrometers. In some such embodiments, at least the portion of the optical fiber <NUM> within the channel <NUM> has a diameter of not more than sixty micrometers. This diameter of the optical fiber <NUM> may be not more than fifty micrometers in some cases. For example, at least the portion of the optical fiber <NUM> within the channel may have a diameter of less than fifty micrometers and at least thirty micrometers. Some or all of the optical fiber <NUM> may have such a small diameter even if the optical fiber <NUM> lies along the cannula <NUM>, outside of the channel <NUM>.

In some embodiments, the optical fiber <NUM> is a fused silica (e.g. glass) fiber or a borosilicate fiber. In other embodiments, only the portion of the optical fiber <NUM> having the reduced diameter discussed above is formed of fused silica and/or borosilicate. Plastic may not be used for the reduced diameter portion of the optical fiber <NUM>, such as portions <NUM> and <NUM>. This allows the optical fiber <NUM> to withstand the heat generated by light transmitted through the optical fiber <NUM>. However, in other embodiments, additional or different material(s) may be used.

The optical fiber <NUM> may be formed by heating and drawing a fiber that initially has a larger diameter. Such a fiber may also be tapered. One such embodiment is shown in <FIG>. The optical fiber <NUM> has portions <NUM> and <NUM> having the diameter described above. Another portion <NUM> may have a larger diameter and is connected to the console <NUM>. Thus, portions <NUM> and <NUM> may be formed by drawing an optical fiber having a diameter at least as large as that of the portion <NUM>. Such a fiber may be heated using a laser and pulled to provide an optical fiber at least part of which has the smaller diameter described above. In other embodiments, the optical fiber consists of small diameter portions <NUM> and <NUM>, but is coupled with another fiber <NUM> that may have a larger diameter at the proximal input end, and that may be tapered to a smaller diameter where it is coupled to optical fiber <NUM>. Portion <NUM> of the optical fiber <NUM> extends out of the channel <NUM> of the cannula <NUM>. Thus, the tip of the optical fiber <NUM> is outside of the channel <NUM>. However, in other embodiments, the optical fiber <NUM> terminates at the tip/end of or within the channel <NUM> of the cannula <NUM>.

In the embodiment shown in <FIG>, the tip of the optical fiber <NUM> may be flat cleaved. In other embodiments, the tip of the optical fiber <NUM> may be configured in another manner. For example, the tip of the optical fiber <NUM> may be tapered, have a scattering tip or otherwise shaped to provide the desired illumination. Because it has a small diameter and may not be unduly lossy, the optical fiber <NUM> may concentrate the light input to the end <NUM>. This may not only increase the temperature of the optical fiber <NUM>, but also the intensity of the light output by the optical fiber <NUM>. However, the more intense light illuminates a smaller area. Consequently, a tapered or scattering tip which directly light in multiple directions may be desired to increase the field that is illuminated. If the flat cleaved tip shown is used, then the input launch angle of the beam into the optical fiber <NUM> may be increased in order to augment scattering. For example, the input launch half-angle may be at least thirty degrees from the axis of the fiber <NUM>. Thus, a high numerical aperture may also be desired for the optical fiber <NUM>. Alternatively, the tip of the optical fiber <NUM> may be shaped or have another component used to increase the size of the area illuminated.

The illuminated infusion cannula <NUM> is shown in use in <FIG>. The illuminated infusion cannula <NUM> is coupled with the console <NUM>. The console <NUM> includes a fluid source <NUM>, control block <NUM> and light source <NUM>. In other embodiments, the fluid source <NUM> and/or light source <NUM> may be physically separated from the console. The control block <NUM> may include a processor executing instructions stored in a memory and capable of communicating an input/output device such as a graphical user interface (GUI) or other mechanism that the user employs to control the fluid flow and light. The fluid source <NUM> is coupled with the cannula <NUM> via the infusion line <NUM>, which may be formed of tubing. The fluid source <NUM> may be a source of BSS®. The BSS® in the fluid source <NUM> can be placed under a positive pressure and driven through the infusion line <NUM>. The light source <NUM> is coupled with the small-diameter portions <NUM> and <NUM> of the optical fiber via portion <NUM>. As discussed above, some or all of the portion <NUM> may be formed of a different optical fiber coupled to the optical fiber <NUM>. A user, such as a surgeon, may control the illumination, fluid, and/or other electronics for the illuminated infusion cannula <NUM> using the console <NUM>.

In operation, the cannula <NUM> may be inserted into an incision in the eye to perform ophthalmic surgery. In some embodiments, the cannula <NUM> may be inserted into another cannula, such as a trocar cannula already being used in the procedure. The surgeon may make additional incision(s) for other purposes. Fluid may flow from the fluid source <NUM> through infusion line <NUM> and through the channel <NUM> of the cannula <NUM>. The arrows within the infusion line <NUM> and cannula <NUM> depict the direction of fluid flow. Because the diameter of the optical fiber <NUM> is significantly smaller than the diameter of the channel <NUM>, the optical fiber occupies a very small portion of the cross section of the channel <NUM>. This allows the fluid to flow relatively freely through the cannula <NUM>. Consequently, eye pressure may be maintained.

In addition, light from the light source <NUM> is coupled into the optical fiber <NUM>. As discussed above, the light may be scattered from the tip of the optical fiber <NUM> in order to illuminate a larger region. As a result, the illuminated infusion cannula may not only illuminate the operating field, but also provide fluid to the eye.

The illuminated infusion cannula <NUM> may result in improved outcomes. Because both illumination and fluid are provided via a single device <NUM>, only one incision may be made in the eye to provide light and maintain eye pressure. For example, a surgery previously requiring four ports may use not more than three ports. As another example, bimanual procedures may be performed using three incisions. Fewer incisions carry reduced risk of complications to the patient. Furthermore, the surgeon must monitor fewer incisions. Consequently, surgery may be made simpler, faster and less error prone. Because the optical fiber <NUM> is sufficiently thin for fluid to flow more freely in the channel <NUM>, a high pressure for the infusion line may not be necessary. The optical fiber <NUM> is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of a portion of another exemplary embodiment of an illuminated infusion cannula <NUM>' usable in ophthalmic surgery. <FIG> is not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula <NUM>' are shown.

The illuminated infusion cannula <NUM>' is analogous to the illuminated infusion cannula <NUM>. Consequently, the illuminated infusion cannula <NUM>' includes an optical fiber <NUM> and a cannula <NUM> that are analogous to the optical fiber <NUM> and cannula <NUM> of the illuminated infusion cannula <NUM>. For example, the sizes and material(s) used for the cannula <NUM> and optical fiber <NUM> are analogous to those described above. Also shown in <FIG> is the infusion line <NUM>' to which the illuminated infusion cannula <NUM>' is connected.

The infusion line <NUM>' is desired to be oriented at a nonzero angle, θ, from the axis of channel <NUM>. Thus, the fluid flow from the infusion line <NUM>' is at the angle, θ, from fluid flow through the cannula <NUM>. This is in contrast to the situation shown in <FIG>, in which the direction of fluid flow through the infusion line <NUM> is substantially the same as that in the channel <NUM>. In order to facilitate the change in direction of the fluid flow, an adapter <NUM> is added to the illuminated infusion cannula <NUM>'. The adapter <NUM> may be connected with the cannula <NUM>. In other embodiments, the cannula <NUM> and adapter <NUM> may be formed as a single piece. In either case, the direction of fluid flow may be altered.

The illuminated infusion cannula <NUM>' may share the benefits of the illuminated infusion cannula <NUM>. Because both illumination and fluid are provided via a single device <NUM>', a single incision may be used to maintain eye pressure and provide light. For example, bimanual procedures previously requiring four ports may use not more than two ports. Fewer incisions carry reduced risk of complications to the patient and may make surgery simpler, faster and less error prone. Because the optical fiber <NUM> is sufficiently thin for fluid to flow more freely in the channel <NUM>, a high pressure for the infusion line may not be necessary. The optical fiber <NUM> is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depict side views of another exemplary embodiment of an illuminated infusion cannula <NUM>" usable in ophthalmic surgery. The illuminated infusion cannula <NUM>" is analogous to the illuminated infusion cannulas <NUM> and/or <NUM>'. Consequently, the illuminated infusion cannula <NUM>" includes an optical fiber <NUM> and a cannula <NUM>' that are analogous to the optical fiber <NUM> and cannula <NUM> of the illuminated infusion cannula <NUM> and/or <NUM>'. For example, the sizes and material(s) used for the cannula <NUM>' and optical fiber <NUM> are analogous to those described above. Also shown in <FIG> is the infusion line <NUM>" to which the illuminated infusion cannula <NUM>' is connected.

<FIG> depicts the illuminated infusion cannula <NUM>" in the region where the fluid, such as BSS®, is added to a channel including the optical fiber. <FIG> depicts the distal region of the illuminated infusion cannula <NUM>" where the optical fiber <NUM> exits the channel. <FIG> is a cross-sectional view of the distal end of the illuminated infusion cannula <NUM>". <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula <NUM>" are shown.

The illuminated infusion cannula <NUM>" also includes an optical fiber tube <NUM>, a Y-adapter <NUM>' and a spider-shaped hub <NUM>. The optical fiber tube <NUM> contains and protects the optical fiber <NUM>. The Y-adapter <NUM>' allows the fluid to be provided to the channel <NUM>. The direction of travel of the fluid is shown in <FIG> by arrows within the channel <NUM>' and within the infusion line <NUM>'. Also shown is nozzle 120A and spider <NUM>. The nozzle 120A may be a <NUM> gauge, <NUM> gauge or <NUM> gauge cannula. The nozzle 120A contains the fiber outside of the remaining portion of the illuminated infusion cannula <NUM>' and within the eye. The spider-shaped hub <NUM> has multiple opposed flexible members (e.g., arranged in a plurality of longitudinally disposed groups) to provide stable attachment of the fiber within a proximal portion of the cannula <NUM>'. The spider aids in positioning the fiber tip at the proper location with respect to nozzle 120A to distribute the desired light pattern, and in allowing for coaxial flow without significantly restricting flow.

In some embodiments, as seen in <FIG>, the spider shaped hub <NUM> may position the optical fiber <NUM> in the center of the cannula <NUM> (and, for example, in the center of the nozzle 120A). In some embodiments, the optical fiber <NUM> may start in a central portion at the proximal end of the cannula <NUM> (the end extending outside of the eye). The optical fiber <NUM> may then emerge from the spider shaped hub <NUM> into the central portion of the nozzle 120A. The optical fiber <NUM> may be rigid such that the optical fiber <NUM> tends to stay toward the center of the cannula <NUM> (and nozzle 120A) even as the optical fiber <NUM> extends toward the distal end of the nozzle 120A. Further, the optical fiber <NUM> may extend down cannula <NUM> (and down the nozzle 120A) off of an interior channel wall such that infusion fluid flowing down the nozzle 120A circumscribes the optical fiber <NUM>. In some embodiments, fluid flow around the optical fiber <NUM> may further reinforce the optical fiber's position in the center (i.e., fluid flow may bias the optical fiber <NUM> toward the center of the nozzle 120A as the fluid flows down the nozzle 120A on all sides of the optical fiber <NUM>).

The illuminated infusion cannula <NUM>" may share the benefits of the illuminated infusion cannula <NUM> and/or <NUM>'. Because both illumination and fluid are provided via a single device <NUM>", a single incision may be used to maintain eye pressure and provide light. For example, bimanual procedures previously requiring four ports may use not more than two ports. Fewer incisions carry reduced risk of complications to the patient and may make surgery simpler, faster and less error prone. Because the optical fiber <NUM> is sufficiently thin for fluid to flow more freely in the channel <NUM>, a high pressure for the infusion line may not be necessary. The optical fiber <NUM> is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an illuminated infusion cannula <NUM> usable in ophthalmic surgery. <FIG> is a cross-sectional view of a portion of the illuminated infusion cannula. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula <NUM> are shown.

The illuminated infusion cannula <NUM> includes an optical fiber <NUM> and a cannula <NUM> that are analogous to the optical fiber <NUM> and cannula <NUM>, respectively. The cannula <NUM> is hollow and has a channel <NUM> that is parallel to the axis and analogous to the channel <NUM>. The inside diameter of the cannula <NUM>, d1, is the diameter of the channel <NUM>. The outside diameter of the cannula <NUM> is d2. In some embodiments, the inside diameter d1 is on the order of three hundred through five hundred micrometers. For example, the cannula <NUM> may be a <NUM>, <NUM> or <NUM> gauge cannula. However, other sizes are possible.

The optical fiber <NUM> is analogous to the optical fiber <NUM> and may have similar diameters. Thus, the diameter, t, of the optical fiber <NUM> may not be more than one half of the diameter of the channel <NUM>. In some embodiments, t may not be more than one third of d1. In some such embodiments, the optical fiber diameter may not be more than one hundred micrometers. In other embodiments, the diameter of the optical fiber <NUM> may not be more than sixty micrometers. The diameter of the optical fiber <NUM>, t, may be not more than fifty micrometers. In some cases, t may be at least thirty micrometers. The diameter of the optical fiber <NUM> is such that the optical fiber <NUM> can transmit the desired amount of light without heat induced damage while being sufficiently small to allow fluid to flow through the channel <NUM>. As can be seen in <FIG>, the optical fiber <NUM> may be along the axis (center) of the channel <NUM>. However, other locations may be possible. In some embodiments, the optical fiber <NUM> may be secured to a central portion at the proximal end of the cannula <NUM> (the end extending out of the eye). For example, the optical fiber <NUM> may emerge from spider shaped hub <NUM> (e.g., secured to a proximal end of the cannula <NUM>) in a central portion of the needle <NUM>. The optical fiber <NUM> may be rigid such that the optical fiber <NUM> tends to stay in central position of the channel <NUM> even as the optical fiber <NUM> extends toward the distal end of the nozzle 120A. Further, the optical fiber <NUM> may extend down the channel <NUM> off of an interior channel wall such that infusion fluid flowing down the channel <NUM> circumscribes the optical fiber <NUM>. A portion <NUM> of the optical fiber <NUM> protrudes from the cannula <NUM>. In other embodiments, the optical fiber <NUM> may terminate at the tip of or within the channel <NUM>. Although a flat cleaved tip is shown for the optical fiber <NUM>, other tips may be used.

The illuminated infusion cannula <NUM> shares the benefits of the illuminated infusion cannula <NUM>. Both illumination and fluid are provided via a single device <NUM>. Thus, light may be provided and eye pressure maintained using only a single incision in the eye. Fewer incisions carry reduced risk of complications to the patient. Furthermore, surgery may be made simpler, faster and less error prone. Because the optical fiber <NUM> is sufficiently thin, the optical fiber <NUM> occupies a small fraction of the cross-sectional area of the channel <NUM>. Thus, fluid may flow more freely in the channel <NUM> and a high pressure for the infusion line may not be necessary. The optical fiber <NUM> is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an illuminated infusion cannula 150A usable in ophthalmic surgery. <FIG> is a cross-sectional view of a portion of the illuminated infusion cannula 150A. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula 150A are shown.

The illuminated infusion cannula 150A includes an optical fiber <NUM>' and a cannula <NUM> that are analogous to the optical fiber <NUM> and cannula <NUM>, respectively. The cannula <NUM> is hollow and has a channel <NUM>. The inside diameter of the cannula <NUM>, d1, is the diameter of the channel <NUM>. The outside diameter of the cannula <NUM> is d2.

The optical fiber <NUM>' is analogous to the optical fiber <NUM> and may have similar diameters. Thus, t, d1 and d2 may be analogous to those described above. However, the optical fiber <NUM>' terminates at the end of the channel <NUM>. In addition, the optical fiber <NUM>' is shown as residing off of the axis for the channel <NUM>. Thus, there is no requirement that an optical fiber lie along the axis, against a wall of the channel <NUM> or at a particular location. In some embodiments, as seen in <FIG>, the optical fiber <NUM>' may be secured to an off-axis portion at the proximal end of the cannula <NUM> (the end extending out of the eye). For example, the optical fiber <NUM>' may emerge from an eccentrically shaped spider shaped hub <NUM>' (which functions similar to spider shaped hub <NUM>, but with legs configured to place the optical fiber <NUM>' in an off-axis portion of the channel <NUM>). The optical fiber <NUM>' may be rigid such that the optical fiber <NUM>' tends to stay in the off-axis position of the channel <NUM> even as the optical fiber <NUM>' extends toward the distal end of the nozzle 120A. Further, the optical fiber <NUM>' may extend down the channel <NUM> off of an interior channel wall such that infusion fluid flowing down the channel <NUM> circumscribes the optical fiber <NUM>'. Although a flat cleaved tip is shown for the optical fiber <NUM>', other tips may be used.

The illuminated infusion cannula 150A shares the benefits of the illuminated infusion cannula <NUM>. Both illumination and fluid are provided via a single device 150A. Thus, only one incision may be made in the eye to provide light and maintain eye pressure. Fewer incisions carry reduced risk of complications to the patient and may make surgery simpler, faster and less error prone. Because the optical fiber <NUM> is sufficiently thin for fluid to flow more freely in the channel <NUM>, a high pressure for the infusion line may not be necessary. The optical fiber <NUM>' is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>'. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an illuminated infusion cannula 150B usable in ophthalmic surgery. <FIG> is a cross-sectional view of a portion of the illuminated infusion cannula 150B. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the infusing illuminated infusion cannula 150B are shown.

The illuminated infusion cannula 150B includes an optical fiber <NUM>" and a cannula <NUM>' that are analogous to the optical fiber <NUM> and/or <NUM>' and cannula <NUM>, respectively. The cannula <NUM>' is hollow and has a channel <NUM>'. The inside diameter of the cannula <NUM>', d1, is the diameter of the channel <NUM>'. The outside diameter of the cannula <NUM>' is d2. In addition, the channel <NUM>' includes a depression <NUM>, or groove, in which the optical fiber <NUM>" resides. The groove <NUM> may be used to guide and retain the optical fiber <NUM>" in the channel <NUM>'. In some embodiments, epoxy, resin or another substance may be used to hold the optical fiber <NUM>" in the groove <NUM>. The epoxy may also serve to provide mechanical protection, optical isolation, heat sinking, or serve another purpose for the optical fiber <NUM>".

The optical fiber <NUM>" is analogous to the optical fibers <NUM> and/or <NUM>' and may have similar diameters. Thus, t, d1 and d2 may be analogous to those described above. The optical fiber <NUM>" may terminate outside of the channel <NUM>' as shown or at another location. In addition, the optical fiber <NUM>" is shown as residing at a particular location along the wall of the chamber <NUM>. Other locations are possible. Although a flat cleaved tip is shown for the optical fiber <NUM>", other tips may be used.

The illuminated infusion cannula 150B shares the benefits of the illuminated infusion cannula <NUM> and/or 150A. Both illumination and fluid are provided via a single device 150B. Consequently, a single incision in the eye may be used both to provide light and maintain eye pressure. Fewer incisions carry reduced risk of complications to the patient. Surgery may also be simpler, faster and less error prone. Because the optical fiber <NUM>" occupies a small area of the cross section of the channel <NUM>', fluid may flow more freely in the channel <NUM>. A high pressure for the infusion line may not be necessary. The optical fiber <NUM>" is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>". Use of epoxy or an analogous substance may also improve the robustness of the optical fiber <NUM>". Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an illuminated infusion cannula 150C usable in ophthalmic surgery. <FIG> is a cross-sectional view of a portion of the illuminated infusion cannula 150C. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula 150C are shown.

The illuminated infusion cannula 150C includes an optical fiber <NUM>‴ and a cannula <NUM>" that are analogous to the optical fiber <NUM> and/or <NUM>' and cannula <NUM> and/or <NUM>', respectively. The cannula <NUM>" is hollow and has a channel <NUM>'. The inside diameter of the cannula <NUM>", d1, is the diameter of the channel <NUM>". The outside diameter of the cannula <NUM>" is d2. In addition, the channel <NUM>" includes a depression <NUM>', or groove, in which the optical fiber <NUM>‴ resides. In this case, the groove <NUM> may not be parallel to the axis of the channel <NUM>". In some embodiments, epoxy, resin or another substance may be used to hold the optical fiber <NUM>‴ in the groove <NUM>'. The epoxy may also serve to provide mechanical protection, optical isolation, heat sinking or serve another purpose for the optical fiber <NUM>'".

The optical fiber <NUM>‴ is analogous to the optical fibers <NUM>/<NUM>' and may have similar diameters. Thus, t, d1 and d2 may be analogous to those described above. The optical fiber <NUM>‴ may terminate inside of the channel <NUM>" as shown or at another location. In addition, the optical fiber <NUM>'" is shown as residing at a particular location along the wall of the chamber <NUM>. Other locations are possible. Although a flat cleaved tip is shown for the optical fiber <NUM>'", other tips may be used.

The illuminated infusion cannula 150C shares the benefits of the illuminated infusion cannula <NUM>, 150A and/or 150B. Because both illumination and fluid are provided via a single device 150C, only one incision may be made in the eye to provide light and maintain eye pressure. Fewer incisions carry reduced risk of complications to the patient and may make surgery simpler, faster and less error prone. Because the optical fiber <NUM>‴ is sufficiently thin for fluid to flow more freely in the channel <NUM>", a high pressure for the infusion line may not be necessary. The optical fiber <NUM>‴ is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>'''. Use of epoxy or an analogous substance may also improve the robustness of the optical fiber <NUM>'". Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an illuminated infusion cannula 150D usable in ophthalmic surgery. <FIG> is a cross-sectional view of a portion of the illuminated infusion cannula 150D. <FIG> are not to scale and for explanatory purposes only. Thus, a particular illuminated infusion cannula is not intended to be shown. In addition, only some portions of the illuminated infusion cannula 150D are shown.

The illuminated infusion cannula 150D includes an optical fiber 160ʺʺ and a cannula <NUM>‴ that are analogous to the optical fiber <NUM>, <NUM>', <NUM>", and/or <NUM>‴ and cannula <NUM>, <NUM>' and/or <NUM>", respectively. The cannula <NUM>‴ is hollow and has a channel <NUM>'". The inside diameter of the cannula <NUM>'", d1, is the diameter of the channel <NUM>'". The outside diameter of the cannula <NUM>‴ is d2. In addition, the outside of the cannula <NUM>‴ includes a depression <NUM>", or groove, in which the optical fiber 160ʺʺ resides. In this case, the groove <NUM>" is parallel to the axis of the channel <NUM>". However, another configuration is possible. In some embodiments, epoxy, resin or another substance may be used to hold the optical fiber 160ʺʺ in the groove <NUM>". The epoxy may also serve to provide mechanical protection, optical isolation, heat sinking or serve another purpose for the optical fiber <NUM>"". Because the optical fiber <NUM>' is outside of the channel <NUM>'", more space in the channel is available for fluid flow.

The optical fiber 160ʺʺ is analogous to the optical fibers <NUM>, <NUM>', <NUM>" and/or <NUM>‴ and may have similar diameters. Thus, t, d1 and d2 may be analogous to those described above. The optical fiber 160ʺʺ may terminate at the end of the channel <NUM>‴ as shown or at another location. In addition, the optical fiber 160ʺʺ is shown as residing at a particular location along the wall of the chamber <NUM>. Other locations are possible. Although a flat cleaved tip is shown for the optical fiber 160ʺʺ other tips may be used.

The illuminated infusion cannula 150D shares the benefits of the illuminated infusion cannula <NUM>, 150A, 150B and/or 150C. Both illumination and fluid are provided via a single device 150D. Thus, only one incision may be made in the eye to provide light and maintain eye pressure. Fewer incisions carry reduced risk of complications to the patient, may make surgery simpler and faster and less error prone. Because the optical fiber 160ʺʺ is outside of the channel <NUM>‴ fluid may flow more freely in the channel <NUM>". Thus, a high pressure for the infusion line may not be necessary. The optical fiber 160ʺʺ is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>"". Use of epoxy or an analogous substance may also improve the robustness of the optical fiber <NUM>"". Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an optical fiber <NUM> that may be used in an illuminated infusion cannula usable in ophthalmic surgery. <FIG> is not to scale and for explanatory purposes only. Thus, a particular optical fiber is not intended to be shown. In addition, only some portions of the optical fiber <NUM> are shown. The optical fiber <NUM> may be used in an illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C, 150D and/or another illuminated infusion cannula. Also shown are input beam <NUM> and output light <NUM>.

The optical fiber <NUM> is analogous to the optical fibers <NUM>, <NUM>, <NUM>', <NUM>", <NUM>'", and/or 160ʺʺ and may have similar diameters. The diameter of the optical fiber <NUM> is t. Thus, t may be analogous to that described above. In addition, the optical fiber <NUM> has a tip <NUM>. The tip <NUM> is tapered. As a result, the output light <NUM> may be more efficiently spread. Thus, light may illuminate a larger region.

The optical fiber <NUM> shares the benefits of the optical fiber <NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴ and/or 160ʺʺ when used in an illuminated infusion cannula. Both illumination and fluid may be provided via a single device. Fewer incisions may be made and surgery may be simpler and faster. The optical fiber <NUM> may also be formed of silica or like materials to ensure they remain robust despite rises in temperature due to light carried in the fiber <NUM>. The optical fiber <NUM> is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an optical fiber <NUM>' that may be used in an illuminated infusion cannula usable in ophthalmic surgery. <FIG> is not to scale and for explanatory purposes only. Thus, a particular optical fiber is not intended to be shown. In addition, only some portions of the optical fiber <NUM>' are shown. The optical fiber <NUM>' may be used in an illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C, 150D and/or another illuminated infusion cannula. Also shown are input beam <NUM> and output light <NUM>.

The optical fiber <NUM>' is analogous to the optical fibers <NUM>, <NUM>, <NUM>', <NUM>", <NUM>'", 160ʺʺ and/or <NUM> and may have similar diameters. The diameter of the optical fiber <NUM>' is d. Thus, t may be analogous to that described above. In addition, the optical fiber <NUM> has a tip <NUM>'. The tip <NUM>' may more efficiently scatter light. Although an ellipsoid is shown for the tip <NUM>', the scattering tip <NUM>' may have another shape that scatters light. Thus, the output light <NUM> may illuminate a larger region.

The optical fiber <NUM>' shares the benefits of the optical fiber <NUM>, <NUM>, <NUM>', <NUM>", <NUM>'", 160ʺʺ and/or <NUM> when used in an illuminated infusion cannula. Both illumination and fluid may be provided via a single device. Fewer incisions may be made and surgery may be simpler and faster. The optical fiber <NUM>' may also be formed of silica or like materials to ensure they remain robust despite rises in temperature due to light carried in the fiber <NUM>'. The optical fiber <NUM>' is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>'. Thus, the risk to the patient and ease of surgery are further improved.

<FIG> depicts a side view of another exemplary embodiment of an optical fiber <NUM>' that may be used in an illuminated infusion cannula usable in ophthalmic surgery. <FIG> is not to scale and for explanatory purposes only. Thus, a particular optical fiber is not intended to be shown. In addition, only some portions of the optical fiber <NUM>" are shown. The optical fiber <NUM>" may be used in an illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C, 150D and/or another illuminated infusion cannula. Also shown are input beam <NUM>' and output light <NUM>.

The optical fiber <NUM>" is analogous to the optical fibers <NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, 160ʺʺ, <NUM> and/or <NUM>' and may have similar diameters. The diameter of the optical fiber <NUM>" is d. Thus, t may be analogous to that described above. In addition, the optical fiber <NUM> has a flat cleaved tip <NUM>". In order for the tip <NUM>" to more efficiently spread light, the input light <NUM>' may be at a higher angle, θ. For example, θ may be at least thirty degrees and less than ninety degrees. The numerical aperture for the fiber <NUM>" may also be correspondingly large to accept the large angle of the input light <NUM>'. Thus, the output light <NUM> may illuminate a larger region. In an alternate embodiment, the optical fiber <NUM>" might be tapered in the middle to increase the angular content of light before reaching to the flat cleaved tip <NUM>". In such an embodiment, the input angle of the light may be less than thirty degrees.

The optical fiber <NUM>" shares the benefits of the optical fiber <NUM>, <NUM>, <NUM>', <NUM>", <NUM>'", <NUM>"", <NUM> and/or <NUM>' when used in an illuminated infusion cannula. Both illumination and fluid may be provided via a single device. Fewer incisions may be made and surgery may be simpler and faster. The optical fiber <NUM>" may also be formed of silica or like materials to ensure they remain robust despite rises in temperature due to light carried in the fiber <NUM>". The optical fiber <NUM>" is sufficiently robust to preclude or reduce damage from heat generated by the light carried in the optical fiber <NUM>". Thus, the risk to the patient and ease of surgery are further improved.

Various characteristics of illuminated infusion cannulas and optical fibers have been shown. One of ordinary skill in the art will recognize that one or more of these features may be combined in manners not explicitly shown herein.

<FIG> is a flow chart of an exemplary method <NUM> for providing an illuminated infusion cannula such as the illuminated infusion cannula(s) <NUM>, <NUM>', <NUM>, 150A, 150B, 150C and/or 150D. For simplicity, some elements may be omitted, interleaved, and/or combined. The method <NUM> is also described in the context of the illuminated infusion cannula <NUM>. However, the method <NUM> may be used to form the illuminated infusion cannula <NUM>', <NUM>, 150A, 150B, 150C, 150D and/or an analogous illuminated infusion cannulas.

The cannula <NUM> is provided, via <NUM>. The optical fiber <NUM> is also provided, via <NUM>. Element <NUM> may include inserting the optical fiber <NUM> into the cannula (e.g., into the channel <NUM>), and element <NUM> may include affixing the optical fiber to the cannula (e. g, through an adhesive applied between the optical fiber <NUM> and the channel <NUM>). Using the method <NUM>, the illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C and/or 150D may be fabricated. Thus, the benefits of one or more of the illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C and/or 150D may be achieved.

<FIG> is a flow chart depicting an exemplary method <NUM> for assisting a physician during ophthalmic surgery using an illuminated infusion cannula such as the illuminated infusion cannula <NUM>, <NUM>', <NUM>, 150A, 150B, 150C and/or 150D. For simplicity, some elements may be omitted, interleaved, performed in another order and/or combined. The method <NUM> is described in the context of ophthalmic surgery and the illuminated infusion cannula <NUM>. However, the method <NUM> may be extended to other types of surgery.

The method may commence after surgery has started. Fluid such as BSS® and illumination are provided via the illuminated infusion cannula <NUM>, via <NUM>. Thus, element <NUM> may include the surgeon making an incision in the eye of the patient and performing other required tasks. The surgeon may also insert the cannula <NUM> into the incision in patient's eye at <NUM>. Alternatively, the surgeon may insert the cannula <NUM> into another cannula, such as a trocar cannula, that is inserted into the eye. The fluid and illumination may be provided through the illuminated infusion cannula <NUM> within the trocar cannula. Thus, the pressure of the eye may be maintained and the operating field illuminated.

The desired procedure is performed, via <NUM>. Thus, portions of the vitreous may be removed. Other procedures may also be performed. The cannula <NUM> may then be removed, via <NUM>.

Claim 1:
A surgical infusion device (<NUM>, <NUM>', <NUM>", <NUM>, 150A, 150B, 150C) for bimanual ophthalmic surgery for the back of an eye, the surgical infusion device comprising:
a cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>") having an infusion channel (<NUM>, <NUM>, <NUM>', <NUM>") therethrough, the infusion channel (<NUM>, <NUM>, <NUM>', <NUM>") having an inside diameter (d1), the cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>") having an outside diameter (d2) greater than the inside diameter (d1); and
an optical fiber (<NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, <NUM>, <NUM>', <NUM>") coupled with the cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>"), wherein the optical fiber (<NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, <NUM>, <NUM>', <NUM>") has an optical fiber diameter (t) of at least thirty micrometers and less than one hundred micrometers;
wherein at least a portion of the optical fiber (<NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, <NUM>, <NUM>', <NUM>") coupled with the cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>") is within the infusion channel (<NUM>, <NUM>, <NUM>', <NUM>"),
wherein at least the portion of the optical fiber (<NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, <NUM>, <NUM>', <NUM>") within the infusion channel (<NUM>, <NUM>, <NUM>', <NUM>") is in contact with infusion fluid flowing through the cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>"),
characterized in that the surgical infusion device (<NUM>, <NUM>', <NUM>", <NUM>, 150A, 150B, 150C) further comprises:
a hub (<NUM>, <NUM>'), the optical fiber (<NUM>, <NUM>, <NUM>', <NUM>", <NUM>‴, <NUM>, <NUM>', <NUM>") being positioned in the infusion channel (<NUM>, <NUM>, <NUM>', <NUM>") by the hub (<NUM>, <NUM>'), the hub (<NUM>, <NUM>') further including a plurality of members extending substantially radially from the hub (<NUM>, <NUM>') and contacting an inside surface of the cannula (<NUM>, <NUM>', <NUM>, <NUM>', <NUM>"), wherein the plurality of members are flexible.