WO2007008437A1

WO2007008437A1 - Surgical system

Info

Publication number: WO2007008437A1
Application number: PCT/US2006/025316
Authority: WO
Inventors: Glenn Sussman; Philippe Crozafon
Original assignee: Alcon, Inc.
Priority date: 2005-07-07
Filing date: 2006-06-29
Publication date: 2007-01-18

Abstract

A surgical system for a liquefaction handpiece having audible tones indicative of the amount of power being delivered to the liquefaction handpiece. The system may use existing, commercially available surgical consoles under appropriate software control to produce the audible tones.

Description

SURGICAL SYSTEM

Background of the Invention

This invention relates generally to the field of cataract surgery and more particularly to a system and handpiece for practicing the liquefaction technique of cataract removal.

The human eye in its simplest terms functions to provide vision by transmitting light through a clear outer portion called the cornea, and focusing the image by way of the lens onto the retina. The quality of the focused image depends on many factors including the size and shape of the eye, and the transparency of the cornea and lens.

When age or disease causes the lens to become less transparent, vision deteriorates because of the diminished light which can be transmitted to the retina. This deficiency in the lens of the eye is medically known as a cataract. An accepted treatment for this condition is surgical removal of the lens and replacement of the lens function by an artificial intraocular lens (IOL).

In the United States, the majority of cataractous lenses are removed by a surgical technique called phacoemulsification. During this procedure, a thin phacoemulsification cutting tip is inserted into the diseased lens and vibrated ultrasonically. The vibrating cutting tip liquefies or emulsifies the lens so that the lens may be aspirated out of the eye. The diseased lens, once removed, is replaced by an artificial lens.

A typical ultrasonic surgical device suitable for ophthalmic procedures consists of an ultrasonically driven handpiece, an attached cutting tip, and irrigating sleeve and an electronic control console. The handpiece assembly is attached to the control console by an electric cable and flexible tubings. Through the electric cable, the console varies the power level transmitted by the handpiece to the attached cutting tip and the flexible tubings supply irrigation fluid to and draw aspiration fluid from the eye through the handpiece assembly.

The operative part of the handpiece is a centrally located, hollow resonating bar or horn directly attached to a set of piezoelectric crystals. The crystals supply the required ultrasonic vibration needed to drive both the horn and the attached cutting tip during phacoemulsification and are controlled by the console. The crystal/horn assembly is suspended within the hollow body or shell of the handpiece by flexible mountings. The handpiece body terminates in a reduced diameter portion or nosecone at the body's distal end. The nosecone is externally threaded to accept the irrigation sleeve. Likewise, the horn bore is internally threaded at its distal end to receive the external threads of the cutting tip. The irrigation sleeve also has an internally threaded bore that is screwed onto the external threads of the nosecone. The cutting tip is adjusted so that the tip projects only a predetermined amount past the open end of the irrigating sleeve. In use, the ends of the cutting tip and irrigating sleeve are inserted into a small incision of predetermined width in the cornea, sclera, or other location. The cutting tip is ultrasonically vibrated along its longitudinal axis within the irrigating sleeve by the crystal-driven ultrasonic horn, thereby emulsifying the selected tissue in situ. The hollow bore of the cutting tip communicates with the bore in the horn that in turn communicates with the aspiration line from the handpiece to the console. A reduced pressure or vacuum source in the console draws or aspirates the emulsified tissue from the eye through the open end of the cutting tip, the cutting tip and horn bores and the aspiration line and into a collection device. The aspiration of emulsified tissue is aided by a saline flushing solution or irrigant that is injected into the surgical site through the small annular gap between the inside surface of the irrigating sleeve and the cutting tip. Prior art phacoemulsification systems produce an audible tone of varying pitch indicative of aspiration pressure and flow rate. In addition, the ultrasonic vibrations of the piezoelectric crystals in the handpiece produce an audible tone indicative of the amount of power being sent to the handpiece Recently, a new cataract removal technique has been developed that involves the injection of hot (approximately 45⁰C to 105⁰C) water or saline to liquefy or gellate the hard lens nucleus, thereby making it possible to aspirate the liquefied lens from the eye. Aspiration is conducted with the injection of the heated solution and the injection of a relatively cool solution, thereby quickly cooling and removing the heated solution. This technique is more fully described in U.S. Patent No. 5,616,120 (Andrew, et al.), the entire contents of which is incorporated herein by reference. The apparatus disclosed in the publication, however, heats the solution separately from the surgical handpiece. Temperature control of the heated solution can be difficult because the fluid tubings feeding the handpiece typically are up to two meters long, and the heated solution can cool considerably as it travels down the length of the tubing.

Recently, a device was commercially introduced that practices the liquefaction method. The AQUALASE^® handpiece, part of the INFINITI^® Vision System available from Alcon Laboratories, Inc., Fort Worth, Texas, produces pulses of heated irrigation fluid for lens removal and cortical cleanup. This device, however, does not produce any audible tone indicative of the amount of power being delivered to the handpiece. This is because the process of generating the pressurized pulse of fluid is relative silent, as opposed to a phacoemulsification handpiece where excitation of the piezoelectric crystals produces an audible tone.

Therefore, a need continues to exist for a control system for a liquefaction handpiece that produces an audible tone indicative of the power or energy being delivered to the handpiece.

Brief Summary of the Invention

The present invention improves upon the prior art by providing a control system for a liquefaction handpiece having audible tones indicative of the amount of power being delivered to the liquefaction handpiece. The system may use existing, commercially available surgical consoles under appropriate software control to produce the audible tones.

Accordingly, one objective of the present invention is to provide a surgical console control system. Another objective of the present invention is to provide a surgical console control system that generates audible tones indicative of the amount of power being delivered to the liquefaction handpiece.

These and other advantages and objectives of the present invention will become apparent from the detailed description and claims that follow.

Brief Description of the Drawings

FIG. 1 is a perspective view of a surgical system that can be used with the control system of the present invention. FIG. 2 is a graft plotting volume or pitch versus power level for a tone to be used with a liquefaction handpiece with the power to the handpiece being delivered continuously.

FIG. 3 is a graft plotting volume or pitch versus power level for a tone to be used with a liquefaction handpiece with the power to the handpiece being delivered in pulses or bursts.

Detailed Description of the Invention

As best seen in FIG. 1, system 10 of the present invention generally includes control console 12 and handpiece 14. System 10 may be any suitable system, such as the INFINITI^® Vision System available from Alcon Laboratories, Inc., Fort Worth, Texas. Handpiece 14 may be any suitable handpiece, such as the AQUALASE^® handpiece available from Alcon Laboratories, Inc., Fort Worth, Texas. Handpiece 14 is fluidly connected to console 12 by fluid tubings 16 and 18, and electrically connected to console 12 by electrical cable 20, such tubings and cabling being well- known in the art. Control console 12 contains appropriate hardware and software (not shown, but well-known in the art) for providing control signals to handpiece 14, including power level control signals, and for producing audible tones indicative of the power level control signal being sent to handpiece 14.

As shown in FIGS. 2 and 3, system 10 may be programmed to produce an audible tone or tones indicative of the power being delivered to handpiece 14. The tone may continuously rise in pitch or volume as the power increases. When continuous power is being applied, the tone will be audible continuous, as shown in FIG. 2. When power is being applied in bursts or pulses, the tone till turn on and off with each pulse or burst, as shown in FIG. 3 or at a lower frequency (example - 50% burst will be 100ms on/ 100ms off, although another preferred tone is 1 second on/ 1 off). Such a system allows users of a liquefaction system to have the same or a similar auditory feedback as users of phacoemulsification systems.

This description is given for purposes of illustration and explanation. It will be apparent to those skilled in the relevant art that changes and modifications may be made to the invention described above without departing from its scope or spirit. For example, it will be recognized by those skilled in the art that the present invention may be combined with ultrasonic and/or rotating cutting tips to enhance performance.

Claims

We claim:

1. A liquefaction system, comprising: a) a liquefaction handpiece; and b) a liquefaction control console, the control console providing control signals to the handpiece, including power level control signals, and for producing audible tones indicative of the power level control signal being sent to the handpiece.