CA2659613A1 - Vacuum sense control for phaco pulse shaping - Google Patents

Vacuum sense control for phaco pulse shaping Download PDF

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Publication number
CA2659613A1
CA2659613A1 CA002659613A CA2659613A CA2659613A1 CA 2659613 A1 CA2659613 A1 CA 2659613A1 CA 002659613 A CA002659613 A CA 002659613A CA 2659613 A CA2659613 A CA 2659613A CA 2659613 A1 CA2659613 A1 CA 2659613A1
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CA
Canada
Prior art keywords
vacuum pressure
pulse
aspiration vacuum
sensed
applying
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002659613A
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French (fr)
Other versions
CA2659613C (en
Inventor
James W. Staggs
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Johnson and Johnson Surgical Vision Inc
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Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2659613A1 publication Critical patent/CA2659613A1/en
Application granted granted Critical
Publication of CA2659613C publication Critical patent/CA2659613C/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems
    • A61M1/774—Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16831—Monitoring, detecting, signalling or eliminating infusion flow anomalies
    • A61M5/16854—Monitoring, detecting, signalling or eliminating infusion flow anomalies by monitoring line pressure
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16831—Monitoring, detecting, signalling or eliminating infusion flow anomalies
    • A61M2005/16863—Occlusion detection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3331—Pressure; Flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/06—Head
    • A61M2210/0612—Eyes
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
    • G16H20/17—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered via infusion or injection
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture

Abstract

A method and apparatus for precisely controlling particle movement relati ve to a phacoemulsification needle tip is provided. The design monitors actu al vacuum present and calculates a pulse shape amplitude waveform proportion al to the amount of measured vacuum. An increase in vacuum indicates that th e handpiece/needle is becoming occluded by a large particle. The present des ign determines whether additional power is required to bump or move a large particle away from the needle tip. The present design may employ a control l oop that senses and continuously monitors vacuum. The design may dynamically vary the amount of ultrasonic energy delivered to the surgical area in resp onse to the observed actual vacuum, and can actively vary the amount of powe r delivered to the surgical area based on the size of the particle and the r esultant vacuum realized.

Claims (26)

1. A method for delivering ultrasonic energy during a phacoemulsification procedure, comprising:

applying at least one pulse each comprising a pulse shape, wherein at least one pulse shape comprises:

a predetermined pulse shape portion; and at least one from a group comprising:

an increased energy portion comprising an increase in energy proportional to an increase in sensed aspiration vacuum pressure; and a decreased energy portion comprising a decrease in energy proportional to a decrease in sensed aspiration vacuum pressure.
2. The method of claim 1, further comprising monitoring sensed aspiration vacuum pressure, the sensed aspiration vacuum pressure encountered at a handpiece.
3. The method of claim 1, wherein the increased energy portion and the decreased energy portion are computed based on actual sensed aspiration vacuum pressure multiplied by maximum pulse amplitude minus minimum pulse amplitude and divided by maximum sensed aspiration vacuum pressure, added to minimum pulse amplitude.
4. The method of claim 1, wherein the applying tends to induce transient cavitation within an ocular region.
5. The method of claim 1, wherein aspiration vacuum is sensed via a first device and applying comprises applying the at least one pulse to a second device.
6. The method of claim 1, wherein applying comprises applying multiple pulses each comprising an individual pulse shape formed based on actual sensed aspiration vacuum pressure.
7. A method for applying ultrasonic energy to a device used in a surgical region, comprising:

monitoring actual vacuum pressure level at the surgical region;

dynamically calculating a pulse shape amplitude (PSA) level based on monitored actual vacuum pressure level;
generating a PSA waveform based on said dynamically calculating;

summing a predetermined wave shape with the PSA waveform to produce a PSA wave shape; and delivering said PSA wave shape to a handpiece.
8. The method of claim 7, wherein said monitoring actual vacuum pressure level occurs using a device separate from the handpiece.
9. The method of claim 7, wherein said handpiece comprises a needle that vibrates based on the PSA wave shape received from said delivering.
10. The method of claim 7, wherein dynamically calculating comprises assessing based on actual sensed aspiration vacuum pressure multiplied by maximum pulse amplitude minus minimum pulse amplitude and divided by maximum sensed aspiration vacuum pressure, added to minimum pulse amplitude.
11. The method of claim 7, wherein the delivering tends to induce transient cavitation within the surgical region.
12. The method of claim 7, wherein monitoring actual pressure level occurs using a first aspiration device.
13. The method of claim 7, wherein said dynamically calculating, generating, summing, and delivering is repeated, thereby delivering multiple pulses each comprising an individual pulse shape formed based on actual sensed aspiration vacuum pressure.
14. An apparatus for controlling ultrasonic power delivery to a surgical area, comprising:

a device configured to encounter vacuum pressure at the surgical area;

a vacuum sensor configured to monitor vacuum pressure encountered by said device; and a computer configured to compute an ultrasonic pulse profile for delivery to a needle configured to vibrate based on the ultrasonic pulse profile received, the ultrasonic pulse profile based on monitored vacuum pressure received from the vacuum sensor;

wherein the ultrasonic pulse profile comprises a baseline ultrasonic pulse region and an altered ultrasonic pulse region, the altered ultrasonic pulse region comprising a pulse portion altered based on monitored vacuum pressure.
15. The apparatus of claim 14, wherein the device comprises the needle.
16. The apparatus of claim 14, wherein the needle is within a second device.
17. The apparatus of claim 14, wherein the computer computes the ultrasonic pulse profile based on actual sensed aspiration vacuum pressure multiplied by maximum pulse amplitude minus minimum pulse amplitude and divided by maximum sensed aspiration vacuum pressure, added to minimum pulse amplitude.
18. The apparatus of claim 14, wherein the computer delivers the ultrasonic pulse profile to the needle and movement of the needle induces transient cavitation within fluid within the surgical area.
19. The apparatus of claim 14, wherein the computer computes and applies multiple pulses to the needle, the multiple pulses each comprising an individual pulse shape formed based on actual sensed aspiration vacuum pressure.
20. A method for delivering ultrasonic energy during an
21 emulsification procedure, comprising:

applying at least one pulse each comprising a pulse shape, wherein at least one pulse shape comprises:

a predetermined pulse shape portion; and at least one from a group comprising:

an increased energy portion comprising an increase in energy proportional to an increase in sensed aspiration vacuum pressure; and a decreased energy portion comprising a decrease in energy proportional to a decrease in sensed aspiration vacuum pressure.

21. The method of claim 20, wherein the emulsification procedure is a phacoemulsification procedure.
22. The method of claim 20, further comprising monitoring sensed aspiration vacuum pressure, the sensed aspiration vacuum pressure encountered at a handpiece.
23. The method of claim 20, wherein the increased energy portion and the decreased energy portion are computed based on actual sensed aspiration vacuum pressure multiplied by maximum pulse amplitude minus minimum pulse amplitude and divided by maximum sensed aspiration vacuum pressure, added to minimum pulse amplitude.
24. The method of claim 20, wherein the applying tends to induce transient cavitation within an ocular region.
25. The method of claim 20, wherein aspiration vacuum is sensed via a first device and applying comprises applying the at least one pulse to a second device.
26. The method of claim 20, wherein applying comprises applying multiple pulses each comprising an individual pulse shape formed based on actual sensed aspiration vacuum pressure.
CA2659613A 2006-08-01 2007-07-30 Vacuum sense control for phaco pulse shaping Active CA2659613C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11/461,741 2006-08-01
US11/461,741 US7785336B2 (en) 2006-08-01 2006-08-01 Vacuum sense control for phaco pulse shaping
PCT/US2007/074704 WO2008016870A2 (en) 2006-08-01 2007-07-30 Vacuum sense control for phaco pulse shaping

Publications (2)

Publication Number Publication Date
CA2659613A1 true CA2659613A1 (en) 2008-02-07
CA2659613C CA2659613C (en) 2015-06-30

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA2659613A Active CA2659613C (en) 2006-08-01 2007-07-30 Vacuum sense control for phaco pulse shaping

Country Status (5)

Country Link
US (6) US7785336B2 (en)
EP (1) EP2046250B1 (en)
AU (1) AU2007281300B2 (en)
CA (1) CA2659613C (en)
WO (1) WO2008016870A2 (en)

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US8202287B2 (en) 2012-06-19
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US8366728B2 (en) 2013-02-05
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