CAPSULORHEXIS APPARATUS AND METHOD
20230355437 · 2023-11-09
Inventors
Cpc classification
A61F9/00763
HUMAN NECESSITIES
International classification
Abstract
Apparatus (100) for use with a motion source that generates reciprocating linear motion. The apparatus includes a cutting ring (120) comprising a sharp cutting edge shaped and sized to engage an anterior lens capsule of the eye (20) and a longitudinal-motion member (150) coupled to the cutting ring, and that is configured to be coupled to the motion source, such that the motion source imparts reciprocating linear motion to the longitudinal motion member. The apparatus additionally includes a motion-conversion mechanism coupled to the longitudinal-motion member and to the cutting ring and configured to convert the reciprocating linear motion of the longitudinal-motion member into back-and-forth rotational motion of the cutting ring to create a circular aperture in the anterior capsule of the eye by the cutting ring. Other applications are also described.
Claims
1. Apparatus for use with a motion source that generates reciprocating linear motion, the apparatus comprising: a cutting ring comprising a sharp cutting edge shaped and sized to engage an anterior lens capsule of the eye; a longitudinal-motion member coupled to the cutting ring, and that is configured to be coupled to the motion source, such that the motion source imparts reciprocating linear motion to the longitudinal motion member; and a motion-conversion mechanism coupled to the longitudinal-motion member and to the cutting ring and configured to convert the reciprocating linear motion of the longitudinal-motion member into back-and-forth rotational motion of the cutting ring to create a circular aperture in the anterior capsule of the eye by the cutting ring.
2. The apparatus according to claim 1, wherein the cutting ring comprises a first cutting ring and wherein the apparatus further comprises at least a second cutting ring, and wherein the motion-conversion mechanism is coupled to the longitudinal-motion member and to the first and second cutting rings and configured to convert the reciprocating linear motion of the longitudinal-motion member into back-and-forth rotational motion of the first and second cutting rings, the back-and-forth rotational motion of the first cutting ring being in an opposite direction of the back-and-forth rotational motion of the second cutting ring.
3. The apparatus according to claim 1, wherein the apparatus is configured for use with motion source that generates reciprocating axial linear motion, and the motion-conversion mechanism is configured to convert the reciprocating axial linear motion of the longitudinal-motion member into back-and-forth rotational motion of the cutting ring.
4. The apparatus according to claim 1, wherein the apparatus is configured for use with motion source that generates reciprocating transverse linear motion, and the motion-conversion mechanism is configured to convert the reciprocating transverse linear motion of the longitudinal-motion member into back-and-forth rotational motion of the cutting ring.
5-7. (canceled)
8. The apparatus according to claim 1, wherein the sharp cutting edge is shaped to define a serrated cutting edge.
9. The apparatus according to claim 1, wherein the motion source includes an ultrasonic motion source.
10. The apparatus according to claim 9, wherein the ultrasonic motion source includes a phacoemulsification probe and wherein the longitudinal-motion member comprises a shaft that is configured to be coupled to the phacoemulsification probe.
11. The apparatus according to claim 1, wherein the motion-conversion mechanism comprises a shaft engaging the longitudinal-motion member and the cutting ring such that the reciprocating linear motion imparted to the longitudinal-motion member produces (a) relative motion of the shaft with respect to the ring, and (b) rotation of the ring with respect to a longitudinal axis of the longitudinal motion member.
12. The apparatus according to claim 11, wherein the cutting ring comprises a first cutting ring and wherein the apparatus further comprises at least a second cutting ring, and wherein the apparatus further comprises a first cantilever engaging the longitudinal-motion member and the first cutting ring, and a second cantilever engaging the longitudinal-motion member and the second cutting ring.
13. The apparatus according to claim 1, wherein the apparatus is configured to restrain linear motion of the cutting ring.
14. The apparatus according to claim 13, wherein the longitudinal-motion member comprises an outer shaft that is fixedly coupled to the cutting ring at a first location on the cutting ring, and an inner shaft that is able to undergo reciprocating linear motion with respect to the cutting ring and that is coupled to the cutting ring at a second location on the cutting ring, such that the reciprocating linear motion that is imparted to the longitudinal-motion member produces back-and-forth rotational motion of the ring with respect to the longitudinal motion member.
15. The apparatus according to claim 13, wherein the longitudinal-motion member comprises an inner shaft that is fixedly coupled to the cutting ring at a first location on the cutting ring, and an outer shaft that is able to undergo reciprocating linear motion with respect to the cutting ring and that is coupled to the cutting ring at a second location on the cutting ring, such that the reciprocating linear motion that is imparted to the longitudinal-motion member produces back-and-forth rotational motion of the ring with respect to the longitudinal motion member.
16. A method for creating a circular aperture in the anterior capsule of an eye of a subject, comprising: creating a corneal incision in the eye of the subject; inserting a cutting ring through the incision; positioning a sharp cutting edge of the cutting ring over the anterior capsule of the eye; activating a motion source to produce reciprocating linear motion; using a motion-conversion mechanism, generating back-and-forth rotational motion in the cutting ring by converting the reciprocating linear motion into back-and-forth rotational motion; and creating a circular aperture in the anterior capsule of the eye using the back-and-forth rotational motion of the cutting ring.
17. The method according to claim 16, wherein inserting the cutting ring through the incision comprises radially compressing the cutting ring to facilitate insertion of the cutting ring through the incision.
18. The method according to claim 16, wherein the reciprocating linear motion includes reciprocating axial linear motion, and wherein converting comprises converting the reciprocating axial linear motion into back-and-forth rotational motion.
19. The method according to claim 16, wherein the reciprocating linear motion includes reciprocating transverse linear motion, and wherein converting comprises converting the reciprocating transverse linear motion into back-and-forth rotational motion.
20. Apparatus for use with a phacoemulsification probe that includes a source of ultrasonic motion that generates ultrasonic motion, the apparatus comprising: a cutting ring comprising a sharp cutting edge shaped and sized to engage an anterior capsule of the eye; a shaft coupled to the cutting ring and configured to be coupled to the phacoemulsification probe such as to impart the ultrasonic motion to the cutting ring, to thereby cause the ring to cut an aperture in the anterior capsule of the eye.
21. The apparatus according to claim 20, wherein the shaft has a proximal portion and a distal portion, and wherein the proximal portion of the shaft is configured to be removably couplable to the phacoemulsification probe and the cutting ring is disposed on the distal portion of the shaft.
22. The apparatus according to claim 20, wherein the ultrasonic motion includes a reciprocating linear motion and wherein the apparatus further comprises a motion-conversion mechanism coupled to the shaft and to the cutting ring and configured to convert the reciprocating linear motion into back-and-forth rotational motion of the cutting ring to create the aperture in the anterior capsule of the eye.
23. The apparatus according to claim 22, wherein the shaft comprises an outer shaft and wherein the motion-conversion mechanism comprises a an inner shaft disposed within the outer shaft and engaging the cutting ring such that reciprocating linear motion to the inner shaft produces (a) relative motion of the inner shaft with respect to the cutting ring, and (b) rotation of the cutting ring with respect to a longitudinal axis of the outer shaft.
24. A method comprising: creating a corneal incision in the eye of the subject; inserting a cutting ring through the incision, the cutting ring being disposed on a shaft, the shaft being coupled to a phacoemulsification probe that includes an ultrasonic motion source; positioning a sharp cutting edge of the cutting ring over the anterior capsule of the eye; using the ultrasonic motion source of the phacoemulsification probe, imparting motion through the shaft to the cutting ring; and thereby cutting an aperture in the anterior capsule of the eye using the cutting ring.
25. The method according to claim 24, further comprising removing the lens of the eye at least partially using the phacoemulsification probe.
26. The method according to claim 24, wherein inserting the cutting ring through the incision comprises radially compressing the cutting ring to facilitate insertion of the cutting ring through the incision.
27. The method according to claim 24, wherein the phacoemulsification probe is configured to undergo reciprocating linear motion and wherein the method further comprises converting the reciprocating linear motion of the phacoemulsification probe into back-and-forth rotational motion of the cutting ring, and wherein cutting the aperture comprises using the back-and-forth rotational motion of the cutting ring to cut the aperture.
28. The method according to claim 27, wherein the phacoemulsification probe is configured undergo reciprocating axial linear motion, and wherein converting comprises converting the reciprocating axial linear motion of the phacoemulsification probe into back-and-forth rotational motion of the cutting ring.
29. The method according to claim 27, wherein the phacoemulsification probe is configured to move in a reciprocating transverse linear motion pattern, and wherein converting comprises converting the reciprocating transverse linear motion of the phacoemulsification probe into back-and-forth rotational motion of the cutting ring.
30-38. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF EMBODIMENTS
[0089] Reference is made to
[0090] For some applications, cutting ring 120 has a sharp cutting edge 122 shaped and sized to engage the anterior lens capsule of the eye to create a circular aperture of a predetermined diameter in the anterior lens capsule of the eye. Cutting ring 120 typically comprises a resilient yet flexible metal alloy, e.g. nitinol. Cutting ring 120 is typically shaped to define sharp cutting edge 122, a blunt edge 124 and a circumferential surface having an inner surface 128 and an outer surface 126. For some applications, cutting ring 120 has a nominal diameter of 4-9 mm, e.g., 4.2-8.2 mm, and a wall thickness of 0.05-0.25 mm.
[0091] For some applications, longitudinal-motion member 150 has a proximal end 154 and a distal end 156. It is noted that in this context, in the specification and in the claims, “proximal” means closer to the user of the apparatus, and “distal” means farther from the user. The proximal and distal ends of the apparatus are indicated in
[0092] Apparatus 100 is for use with a motion source that generates reciprocating linear motion (the motion source is not shown in
[0093] For some applications, the reciprocating linear motion generated by the motion source is a reciprocating axial linear motion (i.e., a back-and-forth motion along longitudinal axis A1 of the longitudinal-motion member) as indicated by arrow A4 in
[0094] For some applications, longitudinal-motion member 150 has an outer shaft 158 and an inner shaft 152 that facilitate motion conversion from the linear motion of longitudinal-motion member 150 to the rotational motion of cutting ring 120. For some applications, outer shaft 158 of longitudinal-motion member 150 is configured to be coupled to the motion source. Inner shaft 152 typically engages outer shaft 158 and cutting ring 120 such that the reciprocating linear motion imparted to longitudinal-motion member 150 produces (a) relative motion of inner shaft 152 with respect to outer shaft 158 and with respect to cutting ring 120, and (b) rotation of cutting ring 120 with respect to a longitudinal axis A1 of longitudinal-motion member 150. Alternatively (not shown), inner shaft 152 of longitudinal-motion member 150 is configured to be coupled to the motion source. For such application, outer shaft 158 typically engages inner shaft 152 and cutting ring 120 such that the reciprocating linear motion imparted to longitudinal-motion member 150 produces (a) relative motion of outer shaft 158 with respect to inner shaft 152 and with respect to cutting ring 120, and (b) rotation of cutting ring 120 with respect to a longitudinal axis A1 of longitudinal-motion member 150.
[0095] Referring to the application shown in
[0096] Typically, relative motion of inner shaft 152 with respect to slit 136 (inner shaft moving sideways in the slit) causes back-and-forth rotational motion of cutting ring 120 in the directions indicated by double-headed arrow A6. Thereby, when placed on the anterior lens capsule of the eye, cutting ring 120 cuts a circular aperture in the lens capsule through high-speed back-and-forth rotational motion of the ring as indicated by arrow A6. Typically, the motion source (e.g., the ultrasonic motion source) generates high-speed vibrational motion such that the reciprocating linear motion imparted to longitudinal-motion member 150 is converted into high-speed rotational back-and-forth motion of cutting ring 120 (arrow A6). This high-speed rotational back-and-forth motion of cutting ring 120 typically prevents the lens capsule from adhering to the cutting ring during motion of the cutting ring, thereby resulting in a clean and clear cut of the anterior lens capsule.
[0097] It is noted that slit 136 is shown by way of illustration and not limitation. For some applications, the circumferential surface of cutting ring 120 is shaped to define a curved groove instead of slit 136. For some such applications, inner shaft 152 passes out of outer shaft 158 through lateral opening 138 and into the curved groove. A distal end of inner shaft 152 is typically disposed within the curved groove, and is configured such that reciprocating linear motion of longitudinal-motion member 150 produces relative motion of inner shaft 152 with respect to the curved groove causing rotation of the cutting ring with respect to longitudinal axis A1 of longitudinal-motion member 150.
[0098] Typically, not only is apparatus 100 configured to convert linear motion into rotational motion, but apparatus 100 is additionally configured to inhibit axial linear motion of cutting ring 120. For some applications, a portion of longitudinal-motion member 150 is fixedly coupled to cutting ring 120 such that axial linear motion of cutting ring 120 is restrained. For example, as shown in
[0099] As described hereinabove, for some applications, the functions of inner shaft 152 and outer shaft 158 of longitudinal-motion member 150 are reversed, Mutatis mutandis.
[0100] Reference is now made to
[0101] In accordance with some applications of the present invention, apparatus 200 is for use with a motion source that generates reciprocating transverse linear motion as indicated by arrow A9 in
[0102] Typically, a portion of longitudinal-motion member 250 is fixedly coupled to cutting ring 220 such that only motion of cutting ring 220 in the direction indicated by arrow A6, is possible. For example, as shown in
[0103] For some applications, the motion source that generates the transverse linear motion is an ultrasonic motion source, e.g., a phacoemulsification probe, and proximal end 254 of longitudinal-motion member 250 is coupled to the phacoemulsification probe.
[0104] Reference is now made to
[0105] Reference is now made to
[0106] First and second concentric rings 322 and 324 typically rotate back and forth in opposite directions thereby facilitating smooth and well-defined cutting of the circular aperture in the anterior lens capsule typically while preventing adherence of the lens capsule to the cutting rings.
[0107] For example, as shown in
[0108] As shown in
[0109] Typically, cutting edges of first and second cutting rings 322 and 324 are sharpened on opposite edges from each other such that when assembled together, the cutting edges of concentric rings 322 and 324 are closely positioned with respect to each other (as shown in
[0110] Reference is now made to
[0111] Typically, subsequently to creating a corneal incision in eye 20, apparatus 100 is advanced towards the anterior lens capsule 70, as shown
[0112] Subsequently to performing the capsulorhexis by cutting the aperture in anterior lens capsule 70, apparatus 100 is removed from eye 20. As mentioned in the Background section, typically following capsulorhexis, the lens of the eye is removed by phacoemulsification. In accordance with some applications of the present invention, the same phacoemulsification probe 300 that is used for capsulorhexis is also used to subsequently emulsify and remove the lens.
[0113] It is noted that although
[0114] Reference is now made to
[0115] Reference is now made to
[0116] At the distal end of the elongate shaft, the shaft is curved such as to define an offset axial portion 404 that is offset relative to the proximal end of the shaft. (That is to say that the offset axial portion is radially offset with respect to proximal end of the shaft. However, the offset axial portion is typically parallel to the proximal end of the shaft, as shown.) The offset axial portion of the elongate shaft is coupled to a cutting ring 420 of the apparatus, e.g., by being inserted into an opening 422 of the cutting ring, and/or in some other manner (e.g., by being welded to the ring). (Cutting ring 420 is typically generally similar to cutting rings 120 and 220 described hereinabove. For example the dimensions and configuration of the edges of cutting ring 420 are typically generally similar to those of cutting rings 120 and 220 described hereinabove.) Due to the offset of offset axial portion 404, as the elongate shaft rotates it causes offset axial portion 404 to move from side-to-side in an alternating manner. In turn, this causes the portion of the cutting ring to which offset axial portion 404 is coupled (e.g., opening 422) to move from side-to-side in an alternating manner. For example, referring to
[0117] For some applications, the cutting ring is stabilized such that it remains centered about a central axis 424. For example, a plurality of struts 426 may extend radially from the central axis to the cutting ring to stabilize the cutting ring such that it remains centered about central axis 424. Typically, as a result of the cutting ring being maintained such as to be centered about central axis 424, the side-to-side motion of portion 404 is converted to back and forth rotational motion of cutting ring 420, as indicated by arrow A13. Typically, cutting ring 420 is configured to be radially compressed (e.g., as shown in
[0118] It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description.