CN102470045B - 超声乳化白内障摘钩状刀片 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
- A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
Abstract
在各种的实施例中,具有直的轴和该直的轴的偏离角度部分的超声乳化白内障吸除刀片可以在角度部分上包括用于使刀片的旋转轴线移动得更加与轴的中心线对准的钩。所述刀片可以构造为垂直于轴的中心线作往复扭转旋转(例如,绕y轴线旋转)。在一些实施例中,可以通过使用钩来平衡原本偏心配重的钩而减小绕不带钩的刀片中的y轴扭转旋转导致的横向振动(例如,沿垂直于y轴的x轴或z轴从一侧至另一侧的振动)。
Description
发明人:Alex Artsyukhovich、Ramon Dimalanta、Mikhail Boukhny和James Y.Chon
技术领域
本发明总体涉及超声乳化白内障吸除(phacoemulsification)。更具体地,本发明是关于但不限于超声乳化白内障吸除刀片。
背景技术
简而言之,人眼的功能是通过使光线传递穿过被称为眼角膜的透明外层部分并通过晶状体将图像聚焦至视网膜上而提供视觉。聚焦图像的质量取决于很多因素,包括眼睛的大小和形状,眼角膜和晶状体的透明度。
当年龄或者疾病导致晶状体透明度降低时,视力会因为能传递到视网膜的光线的减少而下降。这种眼睛的晶状体的缺陷在医学上已知为白内障。针对这种情况的被接受的治疗方案是通过手术移除晶状体,并由人工晶状体(IOL)替换晶状体的功能。
白内障患者的晶状体可以通过一种叫做超声乳化白内障吸除的手术技术移除。在此过程中,超声乳化白内障吸除薄刀片可插入到白内障晶状体中,并超声振动。振动的刀片可使晶状体液化或乳化,使得晶状体可以从眼部抽吸出。白内障晶状体一旦被移除就可以被替换成人工晶状体。
发明内容
在各种的实施例中,具有直的轴和该直的轴的偏离角度部分的超声乳化白内障吸除刀片可以在角度部分上包括用于使刀片的旋转轴线移动得更加与轴的中心线对准的钩。所述刀片可以构造为垂直于轴的中心线作往复扭转旋转(例如,绕y轴线旋转)。在一些实施例中,可以通过使用钩来平衡原本偏心配重的钩而减小绕不带钩的刀片中的y轴扭转旋转导致的横向振动(例如,沿垂直于y轴的x轴或z轴从一侧至另一侧的振动)。
附图说明
为更全面理解本发明,结合附图参照下述说明,在附图中:
图1a-b示出超声乳化白内障吸除刀片,该刀片的末端相对于刀片的轴的中心线具有角度;
图2a示出根据一种实施例通过冲洗线和抽吸线连接至机头的超声乳化白内障吸除手术操作台;
图2b示出根据一种实施例的附装至钩状刀片的超声变幅器;
图3a-b示出钩状刀片的一种实施例;
图4示出根据一种实施例的钩状刀片的运动;
图5示出根据一种实施例的插入在眼部中的切口中的钩状刀片;
图6a-c示出钩状刀片的其它实施例。
应理解,上述总的说明和下述详细说明仅为示例性的和阐释性的,旨在提供对所要求保护的本发明的进一步解释。
具体实施方式
图1a-b示出超声乳化白内障吸除刀片100,该刀片的末端相对于刀片轴108具有角度。刀片100可以包括大部分是直的轴108,该轴的末端部分以角度102弯曲(例如大约20度的弯曲)。其它的角度也是可预期的(例如5度的弯曲、35度的弯曲等)。末端部分可以具有喇叭形端部和/或倾斜端部。刀片100可与超声乳化白内障吸除机头(handpiece)204一起使用(例如图2所示)。当与机头204一起使用时,刀片100可做纵向运动或者横向运动。刀片100可以偏心配重,使得尖端材料仅在延伸轴中心线104的一侧(因为角度102)。这里使用的“延伸轴中心线”是指包括轴中心线且与轴中心线共线的直线(如图1a和3a示出)。因此,偏心配重刀片可以具有一个旋转中心106,该旋转中心在刀片100的一部分上(例如至少沿刀片100在底部的10%长度)从轴108的延伸轴中心线104位移。其它的部分的长度也是可预期的(例如,旋转中心106可以在刀片100的长度的50%或者逐渐在刀片的整个长度上从延伸轴中心线104位移)。例如,如图3a示出,旋转中心106可以从延伸轴中心线104的平行方向偏离约0至10度的角度。旋转中心106的其它角度和构造也是可预期的(例如旋转中心106可以从所述延伸轴中心线104位移并与该延伸轴的中心线平行)。当刀片100通过轴108振动(例如旋转振动或者纵向振动)时,使偏心配重刀片旋转和/或流体对刀片100的运动产生的阻力可以使偏心配重刀片100横向振动。
图2a示出通过冲洗线206和抽吸线208连接到机头204的超声乳化白内障吸除手术操作台214。在一些实施例中,动力可通过电缆210供应给机头204,通过线206和208的流量可以由用户控制(例如通过脚踏开关212)以进行超声乳化白内障吸除步骤。用于超声乳化白内障吸除手术步骤的机头的一个示例在题为“超声机头”的美国专利申请公开中描述过,该专利申请的公开号是No.2006/0041220,序列号是11/183,591,发明人是Mikhail Boukhny、James Y.Chon和Ahmad Salehi,提交于2005年7月18日,在此通过引用将其全部内容结合与此,如同在此作了充分的和完整的阐释。
在一些实施例中,机头204可以包括至少一套压电元件227,该压电元件被极化以便在被以相关共振频率激活时产生纵向运动。如图2b里示出的,压电晶状体227可与超声变幅器(ultrasonic horn)216相连接,刀片202附装至超声变幅器216。超声变幅器216和/或刀片202可以包括多个对角的狭缝或凹槽224。当压电晶体被以共振频率激活时,狭缝或凹槽224可在刀片202中产生扭转运动。由与机头204中的固定元件接合的凹槽224引起的刀片202的运动可以包括相对于与超声变幅器216共线的旋转轴线的扭转旋转成分。
在一些实施例中,机头204可以联接至超声乳化白内障吸除手术刀片202。如图3a所示,超声乳化白内障吸除刀片202可以包括钩310,该钩位于超声乳化白内障吸除刀片202的轴304中的角312附近。在一些实施例中,钩310可以包括一个曲线、突起或者肘形的几何形状,该几何形状可以通过以下来用作配重体:与在角312下方偏离延伸轴中心线316成一定角度的尖端材料相比,在延伸轴中心线的相对侧布置更多的尖端材料。在一些实施例中,刀片可具有约0.5mm至2mm(例如1.5mm)的直径。在一些实施例中,刀片可以具有喇叭形尖端,该尖端的顶部的直径约为1.5mm,尖端的末端附近的直径约为0.5mm(其它的直径和构造也是可预期的)。在一个实施例中,刀片202可以具有约1+3/8英寸的长度,钩部长度约为5/32英寸。其它尺寸也是可预期的。钩310可以用于使旋转中心306靠近延伸轴中心线316(例如在0.25*轴直径的距离314内)或者在延伸轴中心线316上。旋转中心306和延伸轴中心线316之间的其它距离也是可预期的(例如,在0.5*轴直径的距离内、在等于轴直径的距离内等等)。在一些实施例中,刀片100的顶部的运动可以因为其与夹住刀片100的超声变幅器相邻近而受到限制,使得刀片100的顶部的旋转轴线可能沿着延伸轴中心线316而刀片100的末端(例如,沿着刀片100在底部的约10%长度)可能远离延伸轴中心线316。在一些实施例中,从刀片100的顶部到刀片100的底部,旋转中心306可以相对于延伸轴中心线316具有渐变的位移。如上所述,钩310可有效地使旋转中心306移动以使旋转中心在刀片100的底部部分处靠近(例如,在0.25*轴直径的距离314内)延伸轴中心线316或在延伸轴中心线上。
钩310可以包括具有不同的弯曲角度、长度和深度等的各种几何形状(例如,见图3a和6a-6c)。钩310的几何形状也可以被构造成:使得穿过刀片的质量中心并平行于刀片202的延伸轴中心线的直线移动得更靠延伸轴中心线,以便在旋转运动或纵向运动期间减小偏心运动(包括横向振动)。
在一些实施例中,刀片202可沿小的弧(例如+/-5度)作超声扭转振动。刀片202的扭转振动可以导致轴304和刀片202横向运动。激发的运动可以包括刀片202的垂直于延伸轴中心线316的一侧到另一侧的扭转运动(例如,绕图3a中的y轴旋转)。在一些实施例中,通过使用钩310来平衡原本偏心配重的钩,可以减小由偏心配重的刀片和/或阻碍绕y轴(例如,图1a中的刀片100)的往复扭转旋的流体阻力所导致的横向振动(例如,图3a中沿x轴或z轴的一侧到另一侧的振动)。
如图4所示,在一些实施例中,刀片202可在大约10度弧(例如,偏离中心(见中间的图2)正负五度)范围内作往复扭转旋转。在一些实施例中,刀片202可以以大约31kHz的频率往复旋转。其它弧和频率也是可预期的。比如,也可以使用正负20度的弧和/或10-60kHz的频率。图4所示的弧被夸大以示出运动(例如,示出的整个弧是180度,而刀片可以具有在10度的弧上的受限的往复旋转)。
如图5所示,在被用于进行超声乳化白内障吸除时,刀片202的端部和冲洗套筒226可以被插到眼角膜501、巩膜507或者眼部组织的其它位置的切口中以接近例如眼部509的前房503。在各种实施例中,刀片202的一部分或全部可以在冲洗套筒226内。刀片202可以通过晶体驱动的超声变幅器216在冲洗套筒226内沿着其纵向轴线作超声扭转振动,从而在接触时原位乳化组织。刀片202的中空孔可与超声变幅器的孔连通,超声变幅器的孔继而与从机头204到操作台214的抽吸线连通(例如,见图2a)。操作台214中降低的压力或者真空的环境可以通过刀片202的开口端部、刀片202的孔、超声变幅器的孔和抽吸线208从眼部509中将乳化组织汲取或抽吸到收集装置中。乳化组织的抽吸可以由盐水冲洗溶液或冲洗液协助,该盐水冲洗溶液或冲洗液可以通过冲洗套筒226的内表面和刀片202的外表面之间的环形间隙注入至手术位置中。
刀片202可以由不锈钢或者钛(也可以使用其它材料)来制成。刀片202具有0.50英寸至1.50英寸之间(例如1.20英寸)的长度。其它长度也是可预期的。刀片202可以使用传统金属工艺技术形成,并可以被电镀。轴304可成是大体管状的,具有0.005英寸至0.100英寸之间的外直径,以及0.001到0.090英寸之间的内直径(其它直径也是可预期的)。
本领域普通技术人员可以对上述实施例作各种修改。由于本说明书以及实施本文公开的本发明,本发明的其它实施例对本领域技术人员而言也是明了的。本说明书和示例旨在被看作是示例性的,而本发明的真正范围和宗旨由下述权利及其等同指示。
Claims (9)
1.一种超声乳化白内障吸除手术机头,包括:
变幅器,构造成使刀片以10-60kHz的频率扭转振动;
偏心配重刀片,包括:
包括直的轴的第一部分,所述直的轴包括刀片的近侧部分,所述近侧部分附装至手术机头的变幅器,所述直的轴具有中心线;
与所述第一部分形成角的第二部分;以及
形成钩的第三远侧部分,所述钩限定刀片的远侧端;
其中,所述第一部分、第二部分和第三部分被包括在单个构件中;
刀片的近侧部分的运动由于其与夹住刀片的变幅器相邻近而受到限制,使得近侧部分的旋转轴线沿着延伸轴中心线,而远侧部分远离延伸轴中心线;
钩的至少一部分设置在中心线的一侧,以有效地使刀片的旋转中心移动以使旋转中心在刀片的远侧部分靠近延伸轴中心线或者在延伸轴中心线上,以平衡原本偏心配重的钩。
2.如权利要求1所述的超声乳化白内障吸除手术机头,其中所述旋转中心在刀片的远侧部分从所述延伸轴中心线偏离小于0.25*轴直径的距离。
3.如权利要求1所述的超声乳化白内障吸除手术机头,其中所述旋转中心在刀片的远侧部分从所述延伸轴中心线偏离小于0.5*轴直径的距离。
4.如权利要求1所述的超声乳化白内障吸除手术机头,其中所述刀片被构造为在离中心正5度至负5度之间往复扭转振动。
5.如权利要求1所述的超声乳化白内障吸除手术机头,
其中所述刀片被构造为沿与所述延伸轴中心线平行的轴线往复扭转旋转;并且
其中第三部分平衡原本偏心配重的钩以减小垂直于所述轴线的往复横向振动。
6.如权利要求1所述的超声乳化白内障吸除手术机头,其中所述刀片的末端具有相对于所述轴的旋转轴线,其与所述延伸轴中心线平行至偏离所述延伸轴中心线的平行方向5度的范围。
7.如权利要求1所述的超声乳化白内障吸除手术机头,其中所述刀片的第二部分、第三部分是所述刀片的长度的10%。
8.如权利要求5所述的超声乳化白内障吸除手术机头,其中所述钩的构造相对于所述延伸轴中心线至少三次改变方向。
9.如权利要求1所述的超声乳化白内障吸除手术机头,其中钩包括曲线、突起或者肘形的几何形状,该几何形状可以通过以下来用作配重体:与在角下方偏离延伸轴中心线成一定角度的尖端材料相比,在延伸轴中心线的相对侧布置更多的尖端材料。
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PCT/US2010/037610 WO2011002576A1 (en) | 2009-07-01 | 2010-06-07 | Phacoemulsification hook tip |
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US20110112466A1 (en) * | 2009-11-11 | 2011-05-12 | Ramon Carsola Dimalanta | Extended Point Phacoemulsification Tip |
US10258505B2 (en) * | 2010-09-17 | 2019-04-16 | Alcon Research, Ltd. | Balanced phacoemulsification tip |
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- 2010-06-07 EP EP10727254.4A patent/EP2448535B1/en active Active
- 2010-06-07 CN CN201080029202.9A patent/CN102470045B/zh not_active Expired - Fee Related
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Also Published As
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JP5624134B2 (ja) | 2014-11-12 |
CN102470045A (zh) | 2012-05-23 |
US8623040B2 (en) | 2014-01-07 |
EP2448535B1 (en) | 2015-07-22 |
AU2010266685B2 (en) | 2015-03-26 |
US20110004149A1 (en) | 2011-01-06 |
WO2011002576A1 (en) | 2011-01-06 |
ES2546867T3 (es) | 2015-09-29 |
JP2012531965A (ja) | 2012-12-13 |
EP2448535A1 (en) | 2012-05-09 |
US9233021B2 (en) | 2016-01-12 |
TW201103489A (en) | 2011-02-01 |
CA2765909C (en) | 2017-11-21 |
TWI574663B (zh) | 2017-03-21 |
AU2010266685A1 (en) | 2012-01-12 |
US20140052141A1 (en) | 2014-02-20 |
AR077749A1 (es) | 2011-09-21 |
CA2765909A1 (en) | 2011-01-06 |
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