The present invention relates generally to surgical instruments, and more particularly to ophthalmic surgical instruments having a pair of cooperating blade elements, which together define a cutting tip when placed in an abutting relationship, with the instruments being particularly configured to facilitate incision and splitting of the nucleus of a lens such as during a cataract removal procedure.
Phacoemulsification has come to be a technique of choice for the removal of damaged or diseased natural lenses from the eye. Commonly, such surgery is called for when a patient develops cataracts, a condition in which a portion of the eye lens becomes hard and opaque. Unless the damaged lens is removed and replaced with a properly selected artificial lens, blindness or severely impaired vision will result.
Phacoemulsification is the use of ultrasonic energy to emulsify the damaged lens and aspirate the resulting lens particles from the eye. One of the most significant advantages of the use of phacoemulsification is that the apparatus itself is small and can fit through a relatively small incision, resulting in less fluid leakage from the eye capsule and shorter patient recovery times.
It is desirable to limit the amount of ultrasonic energy used as much as possible in order to minimize the risk of damage to eye tissue. Often, the lens nucleus (the hardest portion of the lens) is chopped or split into smaller pieces prior to or during phacoemulsification. Smaller pieces require less energy to emulsify, and this shortens the time during which ultrasonic energy is actually being supplied to the phacoemulsification apparatus.
Known fractionating techniques include making incisions into the lens and, thereafter, prying the incisions open to split the lens into halves or quarters. U.S. Pat. No. 6,262,682, hereby incorporated by reference in its entirety, discloses a surgical instrument which facilitates the chopping and splitting of the lens nucleus.
The present invention is directed to an improved construction for an ophthalmic surgical instrument which facilitates chopping and splitting of the lens nucleus, and separation of the nucleus fragments.
In accordance with the present invention, an ophthalmic surgical instrument for nucleus splitting separation is disclosed which is particularly configured to facilitate chopping and splitting of a lens nucleus, and separation of the broken pieces of the nucleus. The instrument includes a handle having proximal and distal ends, wherein the distal end includes a pair of cooperating blade mounts which can be selectively moved relative to each other by manipulation of the handle.
The instrument includes a pair of blade elements respectively joined to the blade mounts at the distal end of the instrument handle. Each of the blade elements has a lower cutting surface positioned generally beneath an axis that is defined by the respective blade mount of each blade element. Each of the blade elements has a non-cutting, blunt surface positioned generally above the axis of the respective blade mount. The lower cutting surfaces, when brought into a contacting relationship, define a cutting edge for penetration of the nucleus of the eye.
In another aspect of the present invention, the blunt surface has a first thickness and the lower cutting surface has a second thickness, both thicknesses in the direction normal to the central axis of the blade mount, and the second thickness is substantially less than the first thickness of the blunt surface.
In another aspect of the present invention, the blade elements have a distal end and a tapering configuration from their blunt surface to their lower cutting surface, when viewed looking toward the blade mount in a plane that is normal to the axis and taken through the blade element distal end.
In yet another aspect of the present invention, each of the blade elements has a distal end and each of the blade elements has a generally elliptical shape having a major axis and a minor axis. The major axis extends between the blade mount and the distal end. The minor axis extends between the blunt surface and the lower cutting surface and is perpendicular to the major axis.
In one aspect of the present invention, each of the blade elements has a distal end and each of the blade elements has a plurality of cutouts on its lower cutting surface to define at least one tooth or a plurality of teeth. The teeth preferably have a generally triangular shape.
In still another form of the present invention, the lower cutting surface of each of the blade elements is substantially straight. Preferably, the substantially straight lower cutting surface of each of said blade elements is substantially parallel to the axis defined by the respective blade mount of each blade element.
In another aspect of the present invention, the blunt surface of each of the blade elements is rounded.
In another aspect of the present invention, at least one of the blade elements has an indicium or indicia for indicating the location of one of either the blunt surface or the lower cutting surface.
In another broad form of the present invention, an ophthalmic surgical instrument for nucleus splitting separation is disclosed which is particularly configured to facilitate chopping and splitting of a lens nucleus, and separation of the broken pieces of the nucleus. The instrument includes a handle having proximal and distal ends, wherein the distal end includes a pair of cooperating blade mounts which can be selectively moved relative to each other by manipulation of the handle.
The instrument includes a pair of blade elements respectively joined to the blade mounts at the distal end of the instrument handle. Each of the blade elements has a lower cutting surface positioned generally beneath an axis that is defined by the respective blade mount of each blade element. Each of the blade elements has a non-cutting, blunt surface positioned generally above the axis of the respective blade mount. The lower cutting surfaces terminate at a pointed cutting tip for penetration of the nucleus.
The handle of the present surgical instrument can be configured generally as forceps to activate and manipulate the cooperating blade elements of the instrument by either a regular action, or a reverse action. That is, a hand grip portion of the instrument handle can be configured such that it can be squeezed to move the blade elements toward each other (regular action) or can be configured such that the hand grip portion of can be squeezed to move said blade elements away from each other (reverse action.)
The inventor has found that the surgical instruments according to the present invention are more suitable for improving safety and maneuverability during pre-chopping or chopping of the nucleus. Conventional, prior art pre-choppers have a narrow blade with a sharp edge that have been found to not provide sufficient separating force to the bisected nucleus. Furthermore, such prior art pre-choppers pose a danger to the delicate lens capsule with their sharp edge.
Other features and advantages will become readily apparent from the accompanying drawings and the appended claims.
In the accompanying drawings forming part of the specification, in which like numerals are employed to designate like parts throughout the same,
While the present invention is susceptible of embodiment in various forms, there is shown in the drawings and will hereinafter be described the presently preferred embodiments, with the understanding that the present disclosure should be considered as an exemplification of the invention and is not intended to limit the invention to the specific embodiments illustrated.
In accordance with the illustrated embodiments, the present ophthalmic surgical instrument 10 comprises an instrument handle 12 having proximal and distal ends, wherein the distal end includes a pair of cooperating blade mounts 14 which can be selectively moved relative to each other by manipulation of a hand grip portion of the handle 12 located intermediate of the proximal and distal ends.
As will be further described, the instrument further includes a pair of blade elements 16, which are a mirror image of one another, and are respectively joined to the blade mounts 14 at the distal end of the instrument handle 12. Each of the blade elements 16 includes a lower cutting surface 18, positioned generally beneath an axis 19 defined by the respective blade mount 14, and non-cutting, blunt surface 20 positioned generally above the axis 19 of the respective blade mount 14. Each of the blade elements 16, includes an exterior surface 22 and an interior surface 24 facing or opposing the adjacent blade element 16. The exterior surfaces 22 of each blade element 16 may be substantially straight between the cutting surfaces 18 and the blunt surface 20 or may be curved.
Notably, each of the cutting surfaces 18, when brought into a contacting, adjacent relationship, defines at least one, non-pointed or pointed, cutting surface or edge for penetration of the nucleus.
In the illustrated embodiments, it is contemplated that each blade element 16 has an outside dimension on the order of 2.2 mm.
The handle 12 of the present surgical instrument 10 can be configured generally as forceps to activate and manipulate the cooperating blade elements 16 of the instrument by either a regular action, or a reverse action. That is, the hand grip portion of the instrument handle 12 can be configured such that it can be squeezed to move the blade elements 16 toward each other (regular action) or can be configured such that the hand grip portion of can be squeezed to move said blade elements away from each other (reverse action.)
The blade elements of the illustrated shapes can also be designed on micro handles, for movement through a micro-incision (i.e., less than about 1.0 mm.)
The handle body of the instrument 10 can be made of lightweight titanium or medical grade stainless steel. The blade elements of the instrument can be made of stainless steel of various grades, including 420SS, 304SS, and 17-4 pH.
A first illustrated embodiment of a surgical instrument 10 according to the present invention is shown in
Referring to
Still referring to
With reference to
The inventor has found that the first illustrated embodiment of the instrument 10, having elliptical/paddle shaped blade elements 16, is particularly advantageous and is most suitable for a soft nucleus and for a nucleus fragmented by a femtosecond laser.
A second embodiment of a surgical instrument according to the present invention is shown in
A third embodiment of a surgical instrument according to the present invention is shown in
Referring to
Still referring to
A fourth embodiment of a surgical instrument according to the present invention is shown in
With reference to
In this embodiment of the instrument 10C, each blade element 16C includes a radiused, blunt surface 20C or edge located generally opposite the sharpened cutting surface 18C, with the blunt surface 20C positioned above the axis 19C of the respective blade mount 14C. The cutting tip 40C merges into the radiused blunt surface 20C of the blade element 16C in a radiused cutting surface 44C which extends across (above) the axis 19C.
The inventor has found that the fourth illustrated embodiment of the instrument 10C, having semi-circular shaped blade elements 16C which terminate in a cutting tip 40C at the distal ends, is especially suitable for a Grade 2+/3− nucleus, which may present a particularly difficult problem for prior art pre-chopping instruments. Such a nucleus is typically too hard to pre-chop using some prior art instruments, and yet such a nucleus is not hard enough for other prior art pre-chopping instruments.
A fifth embodiment of a surgical instrument according to the present invention is shown in
Referring now to
Still referring to
As illustrated
In effect, the embodiment of the instrument 10D illustrated in
From the foregoing, it will be observed that numerous modifications and variations can be effected without departing from the true spirit and scope of the novel concept of the present invention. It is to be understood that no limitation with respect to the specific embodiments illustrated herein is intended or should be inferred. The disclosure is intended to cover, by the appended claims, all such modifications as fall within the scope of the claims.
Filing Document | Filing Date | Country | Kind |
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PCT/US19/26330 | 4/8/2019 | WO | 00 |
Number | Date | Country | |
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62716095 | Aug 2018 | US | |
62733245 | Sep 2018 | US | |
62792614 | Jan 2019 | US |