Surgical instrument integrated with pressure sensor for ophthalmic surgery

Abstract

Embodiments of the present disclosure provide a surgical instrument having a pressure sensor coupled to or adjacent to a distal end of the surgical instrument to achieve a direct intraocular pressure (IOP) reading of an eye. The surgical instrument may include a handheld device that is inserted into the eye to perform a surgical task.

Description

BACKGROUND

[0001] During ophthalmic surgery, such as vitreoretinal surgery or phacoemulsification surgery, irrigation fluid is injected into the eye to maintain a relatively consistent intraocular pressure (IOP) while removing certain material from the eye (e.g., a portion of the vitreous or cataract lens). During these surgeries, measuring IOP is critical to prevent the eye from collapsing or a sudden surge in pressure in the eye (e.g., post-blockage surge).

[0002] Currently, during various types of ophthalmic surgery, IOP is estimated based on measurements from a pressure sensor disposed outside of the patient’s eye. For example, in certain examples, a pressure sensor of a surgical console can be utilized to estimate IOP based on pressure within one or more fluid lines operably coupled to the pressure sensor. In certain other examples, a pressure sensor in a handpiece of a surgical tool can be utilized to estimate IOP based on pressure within one or more fluid lines disposed through the handpiece. Because these pressure sensors are located upstream of the eye, IOP control suffers from, among other inaccuracies, a time delay between pressure events occurring inside the eye and the sensed pressure changes at the surgical console or handpiece end. Furthermore, IOP measurements can be susceptible to inaccuracy due to unknown resistances in the fluid lines. For example, if the resistance of the irrigation line to the eye changes, it can affect the accuracy of IOP sensing, thereby affecting IOP maintenance effectiveness. These inaccuracies resulting from measuring IOP away from the eye make external IOP measurements less than desirable. SUMMARY

[0003] The present disclosure relates generally to surgical instruments integrated with pressure sensors for ophthalmic surgery.

[0004] Certain aspects provide an intraocular illuminator comprising: a handpiece; and a probe coupled to a distal end of the handpiece, the probe comprising an optical fiber and a pressure sensor, wherein: the pressure sensor is positioned proximate a distal end of the probe, the pressure sensor is configured to be inserted into an intraocular space of an eye, and the pressure sensor is configured to directly sense an intraocular pressure (IOP) associated with the intraocular space of the eye.

[0005] Certain aspects provide an instrument for ophthalmic surgery, the instrument comprising: a pressure sensor positioned proximate a distal end of the instrument, wherein the pressure sensor is configured to: be inserted into an intraocular space of an eye, and directly sense an intraocular pressure (IOP) associated with the intraocular space of the eye.

[0006] The following description and associated drawings set forth certain illustrative features of one or more embodiments. BRIEF DESCRIPTION OF DRAWINGS

[0007] Certain aspects of one or more embodiments are depicted in the drawings, and thus should not be thought of as limiting the scope of the disclosure.

[0008] Figure 1 A schematic cross-sectional view of an eye with an intraocular illuminator inserted therein is shown, the intraocular illuminator having one or more pressure sensors for providing direct intraocular pressure (IOP) measurements, in accordance with some embodiments of the present disclosure.

[0009] Figure 2 A schematic cross-sectional side view of an intraocular illuminator having one or more pressure sensors integrated at its distal end is shown, in accordance with some embodiments of the present disclosure.

[0010] Figure 3A A side perspective view of an intraocular illuminator having one or more pressure sensors integrated at its distal end is shown, in accordance with some embodiments of the present disclosure.

[0011] Figure 3B A schematic cross-sectional view of an eye with a surgical instrument inserted therein is shown, the surgical instrument having a pressure sensor for providing direct IOP measurements, in accordance with some embodiments of the present disclosure. Figure 3A A partial detailed side perspective view of a distal end portion of a tube of the intraocular illuminator shown.

[0012] Figure 3C A schematic cross-sectional view of an eye with a surgical instrument inserted therein is shown, the surgical instrument having a pressure sensor for providing direct IOP measurements, in accordance with some embodiments of the present disclosure. Figure 3B A front view cross-sectional view of a distal face at the distal end portion shown.

[0013] Figure 4A A side perspective view of an intraocular illuminator having a pressure sensor integrated at its distal end is shown, in accordance with some embodiments of the present disclosure.

[0014] Figure 4B A schematic cross-sectional view of an eye with a surgical instrument inserted therein is shown, the surgical instrument having a pressure sensor for providing direct IOP measurements, in accordance with some embodiments of the present disclosure. Figure 4A A partial detailed side perspective view of a distal end portion of a tube of the intraocular illuminator shown.

[0015] Figure 4C A schematic cross-sectional view of an eye with a surgical instrument inserted therein is shown, the surgical instrument having a pressure sensor for providing direct IOP measurements, in accordance with some embodiments of the present disclosure. Figure 4B A cross-sectional view of the vicinity of a distal end portion of a tube of the intraocular illuminator shown.

[0016] Figure 5 A schematic cross-sectional view of an eye with a surgical instrument inserted therein is shown, the surgical instrument having a pressure sensor for providing direct IOP measurements, in accordance with some embodiments of the present disclosure.

[0017] Figure 6A A distal end portion of a surgical instrument having a pressure sensor, in accordance with some embodiments of the present disclosure, is shown.

[0018] Figure 6BAnother distal portion of a surgical instrument having a pressure sensor according to some embodiments of the present disclosure is shown.

[0019] Figure 7 A schematic view of a surgical console and components thereof according to some embodiments of the present disclosure is shown.

[0020] For ease of understanding, the same reference numbers are used in the drawings and the specification to refer to the same elements. It is contemplated that elements and features of one embodiment can be beneficially incorporated into other embodiments without further recitation. DETAILED DESCRIPTION

[0021] While features of the present application can be discussed with respect to certain embodiments and drawings described below, all embodiments of the present application can include one or more of the advantageous features discussed herein. In other words, while one or more embodiments can be discussed as having certain advantageous features, one or more of such features can also be used in accordance with the various embodiments discussed herein. In a similar manner, while example embodiments can be discussed herein as devices, instrument, or method embodiments, it is contemplated that such exemplary embodiments can be implemented in various devices, instruments, and methods. As described below, the figures herein each illustrate devices and methods for reducing glare and improving surgical visualization of a patient’s eye when examined by a microscope.

[0022] As used herein, the term “proximal” refers to a position relative to a device or portion of a device that, during normal use, is closest to a clinician using the device and farthest from a patient using the device. Conversely, the term “distal” refers to a position relative to a device or portion of a device that, during normal use, is farthest from a clinician using the device and closest to a patient using the device. For example, as used herein, the terms “distal” and “proximal” can refer to relative positions with respect to an endoilluminator, a microscope, or a portion thereof.

[0023] As used herein, the term “about” can refer to + / - 10% variation from a nominal value. It is understood that any value provided herein can include such variation.

[0024] According to embodiments of the present application, a pressure sensor is incorporated at or proximate to a distal end of a surgical instrument to provide a direct intraocular pressure (IOP) reading from the anterior or posterior chamber of an eye. The surgical instrument can be a handheld device that can be inserted into an eye to perform a surgical task.

[0025] In some embodiments, a pressure sensor is incorporated at or proximate to a distal end of an illumination device (e.g., an endoilluminator) to provide an IOP reading from the anterior or posterior chamber of an eye.

[0026] In some embodiments, the pressure sensor is incorporated at or proximate to a distal end of another surgical instrument (e.g., a phacoemulsification probe, a vitrectomy probe, a tissue manipulation device, or other surgical instrument in place of an illumination device) that can be inserted into or proximate to an anterior chamber or a posterior chamber of an eye.

[0027] In some embodiments, examples of other surgical instruments that can incorporate one or more pressure sensors can include, but are not limited to, trocar cannula, infusion cannula, and other similar devices.

[0028] Other examples of surgical instruments that can incorporate one or more pressure sensors can include, but are not limited to, cutting probes, vitrectomy probes, phacoemulsification probes, laser probes, ablation probes, vacuum probes, irrigation probes, scissors, forceps, spatulas, hooks, Sinskey hooks, depressors, side-port blades, side-port knives, micro- incision coaxial surgery (MICS) knives, endoscope visualization probes, other ophthalmic devices, and / or combinations thereof. The surgical instruments can have configurable operational settings. An operational setting is a parameter whose value can be selected by a user (e.g., a surgeon, a medical technician, or other medical professional).

[0029] In some embodiments, the pressure sensor is incorporated at or proximate to a distal end of a surgical instrument and coupled to controller circuitry for identifying pressure-related events in an eye, such as a pressure increase or decrease, high pressure, low pressure, or globe rupture or collapse.

[0030] In some embodiments, the pressure sensor is configured to be inserted into an eye and interface (e.g., directly or in close contact) with an intraocular space, such as a substance (e.g., fluid) in the eye, to directly sense IOP associated with the intraocular space in the eye. Thus, directly sensing IOP refers to performing the sensing by the pressure sensor while interfacing with the intraocular space.

[0031] In some embodiments, direct IOP readings / measurement values generated by the pressure sensor (and / or information derived from the pressure sensor readings) can be visually displayed (e.g., on a standalone display, a heads-up display, an in-microscope display, or a display integrated into a surgical tray or console) and / or audibly announced. In some embodiments, alarms and / or safety measures can be activated based on the direct IOP readings / measurement values. Furthermore, in some embodiments, the direct IOP readings / measurement values can be used in a feedback control loop in order to control infusion rates and / or aspiration rates in anterior segment or posterior segment procedures. In some embodiments, the direct IOP readings / measurement values can be used to control and / or maintain IOP in an eye, e.g., by adjusting infusion rates and / or aspiration rates in ophthalmic procedures (e.g., anterior segment or posterior segment procedures) to control and / or maintain IOP in an eye.

[0032] In some embodiments, examples of the pressure sensor can include, but are not limited to, a microelectromechanical system (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gauge pressure sensor, a capacitive pressure sensor, a fiber-optic based pressure sensor, other micro pressure sensors, and / or any combination thereof.

[0033] Turning now to Figure 1 , a schematic cross-sectional view of an eye 130 with an intraocular illuminator 100 inserted therein is shown in accordance with some embodiments of the present disclosure. The intraocular illuminator 100 includes one or more micro pressure sensors 120 for providing direct measurements of IOP within the eye 130. In addition to providing direct IOP measurements, the intraocular illuminator 100 is configured to provide illumination to intraocular spaces of the eye 130 to facilitate procedures performed therein.

[0034] As shown in Figure 1 , the intraocular illuminator 100 includes a handpiece 102 and a shaft or tube 104. The handpiece 102 is coupled to a proximal end of the tube 104. In some embodiments, the handpiece 102 provides a graspable portion of the intraocular illuminator 100 for a user (e.g., an ophthalmologist) to enable the user to manipulate the depth and position of the tube 104 within the eye 130, direct light 112 propagating from a distal end 145 of the tube 104, and position the pressure sensor 120 within the eye 130.

[0035] In some embodiments, the tube 104 is a substantially hollow metal shaft or hypodermic tubing configured to be inserted into the eye 130 via an access cannula 106 disposed in the eye 130 through a sclerotomy 116. In some embodiments, the tube 104 is composed of stainless steel, aluminum, nitinol, other alloys, and / or other suitable surgical grade metal materials. In some examples, the tube 104 is fixedly coupled to the handpiece 102. In other examples, the tube 104 is rotatable relative to the handpiece 102. That is, the handpiece 102 includes a portion having a circular cross-section configured to be rotatably coupled to the tube 104 such that a user can rotate the tube 104 to adjust the incidence of the light 112 on the eye 130 and / or adjust the position of the pressure sensor 120 in the eye 130. In another example, the handpiece 102 is fixedly coupled to the tube 104 such that a user can rotate the tube 104 by rotating the handpiece 102. Although Figure 1 The tube 104 is illustrated as a straight shaft, but other embodiments can include tubes having other shapes. For example, a portion of the tube 104 can be curved or bent to provide the light 112 to areas of the eye 130 that are difficult to illuminate with a straight tube 104. In some embodiments, the intraocular illuminator 100 and its components can be an instrument set for ophthalmic surgery.

[0036] In some embodiments, the intraocular illuminator 100 is configured to house a single optical fiber 110a or a plurality (e.g., a bundle) of optical fibers 110a that are optically coupled to the light source 108 at a distal end of the optical fiber(s). In some embodiments, the optical fiber(s) 110a can be attached to an internal chamber of the intraocular illuminator 100 directly or indirectly through the handpiece 102 and the tube 104. The optical fiber(s) 110a (see, e.g., FIGS. 1A and 1B) are configured to direct the light 112 out of the distal end 145 of the tube 104. For example, the distal end 145 of the tube 104 includes one or more openings through which the distal end of the optical fiber 110a can propagate the light 112 into the eye 130. In some embodiments, the optical fiber 110a can include an array of optical fibers (e.g., a plurality of optical fibers in a regular linear arrangement or a 2-dimensional pattern arrangement) and / or one or more multi-core optical fibers (e.g., a single-mode (SM) or a multi-mode (MM) optical fiber having a plurality of cores). In particular, the hollow portion of the tube 104 includes an internal compartment configured to house the optical fiber 110a. The optical fiber 110a can include one or more of the following: polarization-maintaining optical fibers, polarization optical fibers, and / or any other optical fiber suitable for light transmission. Figure 2 、 Figures 3A to 3C and Figures 4A to 4C The optical fiber(s) 110a are configured to direct the light 112 out of the distal end 145 of the tube 104. For example, the distal end 145 of the tube 104 includes one or more openings through which the distal end of the optical fiber 110a can propagate the light 112 into the eye 130. In some embodiments, the optical fiber 110a can include an array of optical fibers (e.g., a plurality of optical fibers in a regular linear arrangement or a 2-dimensional pattern arrangement) and / or one or more multi-core optical fibers (e.g., a single-mode (SM) or a multi-mode (MM) optical fiber having a plurality of cores). In particular, the hollow portion of the tube 104 includes an internal compartment configured to house the optical fiber 110a. The optical fiber 110a can include one or more of the following: polarization-maintaining optical fibers, polarization optical fibers, and / or any other optical fiber suitable for light transmission.

[0037] In some embodiments, the intraocular illuminator 100 is further configured to house one or more pressure sensors 120 and electrical wires 110b required to power the pressure sensors 120 and / or exchange (e.g., send and receive) data / signals with, for example, the controller 114 (e.g., having control circuitry). In some embodiments, the electrical wires 110b for the pressure sensors 120 can be attached, directly or indirectly, to the interior chamber of the intraocular illuminator 100 through the handpiece 102 and the tube 104 along with the optical fibers 110a. In some embodiments, the electrical wires 110b for the pressure sensors 120 are disposed longitudinally in the handpiece 102 and the tube 104 along the direction of the optical fibers 110a.

[0038] In some embodiments, the pressure sensors 120 can be exposed (e.g., to the external environment outside of the intraocular illuminator 100) via one or more openings at the distal end 145 of the tube 104 and configured to make direct pressure (e.g., IOP) measurements within the eye 130 when the intraocular illuminator 100 is inserted into the eye 130. For example, the distal end 145 of the tube 104 includes one or more openings through which the micro-pressure sensors 120 can be in direct contact with the fluid within the eye 130. In some embodiments, the one or more openings for the pressure sensors 120 (as shown) are positioned adjacent to the openings through which the light 112 is able to propagate into the eye 130 from the distal ends of the one or more optical fibers 110a. In some embodiments, the one or more openings for the pressure sensors 120 (as shown) are formed in the sidewall of the tube 104 proximate to the distal end 145. Figures 3A to 3C Figures 4A to 4C

[0039] In some embodiments, the intraocular illuminator 100 is operably coupled to and / or in communication with the surgical console 140 via an electrical cable 110 configured to house the one or more optical fibers 110a and the one or more electrical wires 110b. As Figure 1 shown, the handpiece 102 of the intraocular illuminator 100 is coupled to the distal end of the electrical cable 110, while the proximal end of the electrical cable 110 interfaces with the surgical console 140. The one or more optical fibers 110a and the one or more electrical wires 110b for the micro-pressure sensors 120 are routed from the intraocular illuminator 100 to the light source 108 and the controller 114 in the surgical console 140, respectively, through the optical electrical cable 110.

[0040] ​​In the illustrated example, the surgical console 140 includes the light source 108 and the controller 114. However, it should be noted that in some embodiments, the light source 108 and the controller 114 can be located external to the surgical console 140. In some embodiments, in addition to housing the light source 108 and the controller 114, the surgical console 140 can be configured to interface with and drive other surgical instruments and systems, which can include, but are not limited to, various probe types of ophthalmic probes, including laser probes (e.g., picosecond infrared laser probes, femtosecond laser probes), vitrectomy probes, phacoemulsification probes, flap cutters, and other ophthalmic surgical tools. In operation, the surgical console 140 can function to assist a user in performing various ophthalmic surgeries, such as vitrectomy, phacoemulsification, cataract surgery, LASIK (laser-assisted in-situ keratomileusis), and similar surgeries.

[0041] In some embodiments, the light source 108 can be configured to generate and direct the light 112 into a proximal entry point of the optical fiber 110a, which in turn can propagate the light 112 to the distal end 145 of the tube 104. In some embodiments, the light source 108 can include a high-brightness phosphor-based white LED and / or an RGB LED. In some embodiments, more than one light source 108 can be provided to simultaneously provide the light 112 to the intraocular illuminator 100 via optical coupling. In some embodiments, a single light source 108 can be shared between two or more illumination components, e.g., via a free-space or fiber splitter. In some embodiments, the light source 108 can include a xenon, mercury vapor, halogen, and / or other light source suitable for ophthalmic surgery. It should be noted that in some embodiments, the light source 108 can not be external to the handpiece 102. For example, in certain embodiments, the handpiece 102 can contain the light source 108 within its housing or structure.

[0042] In some embodiments, the controller 114 can be configured to receive data / signals from the pressure sensor 120 via the electrical wiring cable 110b. These data / signals may, for example, correspond to fluid pressure readings (e.g., direct IOP measurements) in the eye 130. The controller 114 is further configured to send output signals to other components coupled to the surgical console 140 (e.g., infusion and aspiration lines, valves and pumps, etc.) to control and / or maintain a desired IOP of the eye 130 during surgery based on the direct IOP measurements. Details of the controller 114 are described below with reference to FIG. 2. Figure 7 It should be noted that in some embodiments, the controller 114 can not be external to the handpiece 102. For example, in certain embodiments, the handpiece 102 can contain the controller 114 within its housing or structure. In certain embodiments, the controller 114 or a separate power source can be configured to power the pressure sensor 120 via the electrical wiring cable 110b.

[0043] According to embodiments of the present disclosure, the pressure sensor 120 integrated at the distal end 145 of the tube 104 can be inserted into the eye 130 to provide direct IOP measurements of the eye 130, for example, during vitreoretinal surgery and cataract surgery. Monitoring IOP within the eye 130 during ophthalmic surgery, such as vitreoretinal surgery or cataract surgery, is important and necessary. Lack of control of IOP can compromise the effectiveness or ease of the surgery and, in some cases, can cause tissue damage. For example, insufficient pressurization of intraocular regions can cause collapse of the globe of the eye 130 with concomitant tissue damage. Conversely, over-pressurization of intraocular spaces can also cause damage to sensitive retinal, optic nerve, or corneal tissue. At times, in certain situations, it can be desirable to apply controlled high pressure for a short period of time, for example, to stop bleeding in the intraocular space.

[0044] The integration of the pressure sensor 120 positioned at the distal end 145 of the tube 104 enables improved IOP control, thereby maintaining a stable anterior or posterior chamber. With the direct measurement capability, the integration eliminates sensitivity to external factors during IOP closed-loop control. Furthermore, the integration of the pressure sensor 120 at the distal end 145 of the tube 104 allows for a faster response to adverse pressure-related events that occur during surgery. For example, because the pressure sensor 120 provides direct IOP measurements in the eye 130, the intraocular illuminator 100 effectively eliminates inaccuracies and inefficiencies that would otherwise be caused by a time delay between a pressure-related event occurring inside the eye 130 and a sensed upstream pressure change, and / or any inaccuracies caused by resistance in the fluid line, as opposed to providing pressure estimates upstream of the eye (e.g., at the surgical console).

[0045] For vitreoretinal surgery and similar procedures, because intraocular illumination is utilized throughout the surgery, and because the pressure sensor 120 is integrated to the distal end of the tube 104 of the intraocular illuminator 100, according to embodiments of the present application, the intraocular illuminator 100 provides the user with a means for receiving direct IOP measurements of the eye 130 throughout the surgery. Additionally, because the electrical wires 110b for the pressure sensor 120 are disposed longitudinally with the optical fiber 110a, the integration of the pressure sensor 120 into the intraocular illuminator does not significantly increase the overall size of the intraocular illuminator 100. Thus, the intraocular illuminator 100 is able to maintain a relatively small incision in the eye 130 for insertion.

[0046] Additionally, for cataract and similar procedures, the direct sensing of IOP in the eye 130 by the pressure sensor 120 eliminates the need to account for wound constriction properties near the incision site and / or surgical instrument materials when measuring pressure. Such wound constriction properties and instrument materials can greatly affect pressure readings when pressure is determined indirectly, resulting in inaccurate IOP assessments. For example, different materials of irrigation and / or aspiration lines of a surgical instrument can have different fluid resistances, resulting in different readings of IOP.

[0047] Furthermore, unlike systems in which the pressure sensing element is operatively coupled with an operating irrigation or aspiration line, with embodiments according to the present disclosure, the intraocular illuminator 100 integrated with the pressure sensor 120 does not suffer from inaccurate pressure readings due to the proximity of the pressure sensing element to the operating irrigation or aspiration line or due to debris clogging the corresponding channel.

[0048] By directly monitoring IOP in real-time, the user (e.g., surgeon) and / or the surgical console can better control one or more pressure management tools and / or surgical tools (e.g., a valve on one or more of the irrigation and / or aspiration lines) to maintain IOP within a predetermined value range. For example, the surgeon and / or the surgical console can control IOP by adjusting the irrigation source pressure to a level appropriate for the combination of other settings (aspiration rate, vacuum limit, tip, sleeve, etc.) used for the procedure being performed. The surgeon and / or the surgical console can assess and establish certain IOP levels based on his / her experience with a particular instrument and / or stored values, processes, procedures, and applications, respectively.

[0049] According to particular embodiments of the present disclosure, the pressure sensor 120 can detect pressure changes in the eye 130 in a time of 3 milliseconds (msec) or less. Detecting pressure changes in the first 3 msec or less allows the surgical console 140 to provide a fast response to compensate for pressure changes, greatly reducing the risk of injury or even rupture or collapse of the eye 130. In some embodiments, algorithms used in existing phacoemulsification devices, including all varieties of Active Surge Mitigation and / or Active Sentry System developed by Alcon, Inc. of Fort Worth, Texas, can be readily adapted for pressure management (e.g., pressure compensation and control) with the systems and methods described herein.

[0050] Figure 2A schematic cross-sectional side view of an exemplary intraocular illuminator 200 having one or more miniature pressure sensors 220 integrated at a distal end of the intraocular illuminator 200 is shown in accordance with some embodiments of the present disclosure. In some embodiments, the intraocular illuminator 200 can substantially correspond to the intraocular illuminator 100 in Figure 1 . For example, the intraocular illuminator 200 can include a handpiece 202, a tube 204, a cable 210, and a pressure sensor 220 that can substantially correspond to the handpiece 102, the tube 104, the cable 110, and the pressure sensor 120, respectively, of the intraocular illuminator 100 in Figure 1 . Accordingly, details of the handpiece 202, the tube 204, the cable 210, and the pressure sensor 220 are omitted for the sake of brevity.

[0051] As shown in Figure 2 , one or more optical fibers 232 (large dashed lines) are disposed through the tube 204, the handpiece 202, and the cable 210 of the intraocular illuminator 200 for propagating illumination light generated by an illumination light source to a distal end 245 of the tube 204 where the optical fibers 232 terminate. As further shown, the pressure sensor 220 is positioned at the distal end 245 to facilitate direct measurement of IOP within a patient’s eye. Accordingly, in some embodiments, the pressure sensor 220 can be operably coupled to one or more electrical wires 222 (small dashed lines) at the distal end 245 of the tube 204. Such electrical wires 222 can extend through the tube 204, the handpiece 202, and the cable 210 along with the optical fibers 232 for coupling to a controller, such as a controller integrated with a surgical console, to facilitate operation of the miniature pressure sensor 220. As shown in Figure 2 , an adapter 298, such as a plug, can be used to couple the cable 210 from the intraocular illuminator 200 to the surgical console.

[0052] In contrast to conventional intraocular illuminators, the increase in diameter of the tube 204, the handpiece 202, and / or the cable 210 to accommodate the electrical wires 222 can be minimized as these components are already configured to have one or more optical fibers and / or electrical wires integrated therein to achieve a probe function. In one particular example, in a handheld illumination device (e.g., an intraocular illuminator), the total diameter increase for accommodating such electrical wires 222, optical fibers 232, and other electrical wires of the cable of the intraocular illuminator 200 for the pressure sensor 220 can be less than or equal to 0.5 millimeters (mm). In some embodiments, the integration minimizes additional electrical wiring, with the diameter increase being substantially zero.

[0053] Figure 3A , Figure 3B and Figure 3CVarious views of an intraocular illuminator 300 according to some embodiments of the present disclosure are shown, having one or more miniature pressure sensors 320 integrated at a distal end thereof.

[0054] Figure 3A A side perspective view of an intraocular illuminator 300 according to some embodiments of the present disclosure is shown. As shown, the intraocular illuminator 300 includes a handpiece 302 and a shaft or tube 304. The handpiece 302 is coupled to a proximal end of the tube 304. In some embodiments, the handpiece 302 and the tube 304 can substantially correspond to the handpiece 102 and the tube 104, respectively, of the intraocular illuminator 100 of Figure 3A Figure 1 In some embodiments, the handpiece 302 and the tube 304 can be composed of one or more surgical grade metal materials (e.g., stainless steel, titanium, nitinol, aluminum, or platinum).

[0055] In the example shown, the intraocular illuminator 300 includes a bundle 324 extending through the intraocular illuminator 300. The bundle 324 includes one or more optical fibers 332 and electrical wires for the pressure sensors 320 (e.g., electrical wires 322 as shown in Figure 3B

[0056] The optical fibers 332 are configured to receive light 312 from one or more light sources (e.g., the light sources 108 of the intraocular illuminator 100) and propagate the received light 312 to a distal end 345 of the tube 304 where the light 312 is emitted. Each of the optical fibers 332 can include a cladding or can be uncladded. In some embodiments, one or more of the optical fibers 332 are sapphire optical fibers or other optically transmissive materials. In some embodiments, one or more of the optical fibers 332 can have a uniform material composition along a length of the optical fiber 332. In other embodiments, one or more of the optical fibers 332 can have a first region having a first material composition and a second region having a second material composition, where the first material composition and the second material composition differ from one another in one or more respects. In some embodiments, one or more of the optical fibers 332 can be single core optical fibers. In other embodiments, one or more of the optical fibers 332 can be multi-core optical fibers. Figure 1 In some embodiments, the light sources can produce unpolarized light 312 that is received and propagated by the optical fibers 332 of the intraocular illuminator 300. In such embodiments, the optical fibers 332 can polarize the received light 312 and maintain the polarization while propagating the light 312 to the distal end 345 of the tube 304 where the light 312 is emitted.

[0057]

[0058] ​​​In some embodiments, the light source can provide polarized light 312 that is received and propagated by the optical fibers 332 of the intraocular illuminator 300. In such embodiments, the optical fibers 332 can maintain and / or change the polarization of the received light 312. In certain examples, the optical fibers 332 can receive linearly polarized light 312 from the light source. In certain examples, the optical fibers 332 can be configured to circularly or elliptically polarize the received light 312 and maintain the circular polarization of the light as the light 312 propagates through the intraocular illuminator 300. Alternatively, the optical fibers 332 can be configured to maintain the linear polarization of the light 312 as it propagates through the intraocular illuminator 300 from the light source to the distal end 345 of the light 312 of the tube 304.

[0059] In some embodiments, each of the optical fibers 332 can have a diameter between about 0.1 mm and about 1.0 mm, such as between about 0.2 mm and about 0.8 mm, such as between about 0.3 mm and about 0.7 mm, such as between about 0.4 mm and about 0.6 mm, such as about 0.5 mm, although other suitable dimensions are also contemplated. In the illustrated example, for example, the intraocular illuminator 300 includes three optical fibers 332, although the intraocular illuminator 300 can include any suitable number (fewer than or greater than three) of optical fibers 332 to provide the desired illumination characteristics.

[0060] In some embodiments, the pressure sensor 320 is located at the distal end 345 of the tube 304 and is connected to the electrical wire 322 that is positioned in the longitudinal direction (e.g., z-direction) with the optical fibers 332 in the bundle 324. In some embodiments, the pressure sensor 320 can substantially correspond to the pressure sensor 120 of Figure 1

[0061] Figure 3B is Figure 3A a partial detailed side perspective view of a distal end portion 344 of the tube 304, as shown. It should be noted that the distal end portion 344 of the tube 304 can also be a distal end portion of the intraocular illuminator 300, and the distal end 345 of the tube 304 can also be a distal end of the intraocular illuminator 300. As Figure 3B illustrated, the bundle 324 includes the optical fibers 332 and the electrical wire 322 for the pressure sensor 320.

[0062] As Figure 3B ​As shown, a lens (or window) 360 is disposed in an opening 352 within the distal end 345 of the tube 304. Optical fibers 332 each terminate at or substantially near the interface 346 between the bundle 324 and the lens 360. The interface 346 and / or the lens 360 may be configured to facilitate the propagation of a desired illumination pattern from the optical fiber 332 toward a target site (such as a target site within a patient's eye). In some embodiments, a pressure sensor 320 extends beyond the interface 346 and through the opening 352 to sense IOP associated with the intraocular space within the eye.

[0063] In some embodiments, the distal end 348 of the bundle 324 may abut against the proximal end face 354 of the lens 360 at the interface 346 with positive pressure. In other embodiments, one or more optical transmission elements or materials may be located at the interface 346 between the distal end 348 and the lens 360. In some embodiments, the lens 360 may be a GRIN (gradient refractive index) lens, a spherical lens, or an aspherical lens. In other embodiments, the lens 360 may be a set of lenses made of an optically transparent material.

[0064] Lens 360 may include one or more lenses made of visible transparent glass or ceramic. For example, the materials used to construct one or more lenses of these lenses 360 may include fused silica, borosilicate, or sapphire. In some embodiments, lens 360 may include a single-element cylindrical GRIN rod lens operable to receive one or more illumination lights 312 from optical fiber 332 and to direct the received illumination light 312 toward the distal end 345 of tube 304. In some cases, the distal end 345 of tube 304 may also correspond to the distal end of lens 360. In other cases, a protective window may be provided between the distal end of lens 360 and the distal end 345 of tube 304. In other embodiments, the window may extend beyond the distal end 345 of tube 304.

[0065] As referenced above Figure 3A As described, the pressure sensor 320 is located at the distal end 345 of the tube 304. More specifically, in Figure 3B In the example, the pressure sensor 320 is positioned through the distal surface 356 of the lens 360, thereby exposing the pressure sensor 320 to the external environment (e.g., the exterior of the intraocular illuminator 300). Therefore, in Figure 3B In this configuration, wire 322 extends beyond distal end 348 and interface 346, and passes through lens 360 to connect with pressure sensor 320. In such an example, wire 322 and pressure sensor 320 may pass through one or more features formed in lens 360 (e.g., referenced below). Figure 3CThe described opening 326) is configured such that, by exposing the pressure sensor 320 to the external environment, the pressure sensor 320 can come into contact with substances (e.g., fluids) in the patient's eye to perform direct IOP measurement during ophthalmic surgery. In some examples, the pressure sensor 320 can be in contact (e.g., in direct or close contact) with the intraocular space (such as with substances in the eye) to directly sense the IOP associated with the intraocular space in the eye.

[0066] Figure 3C Showing Figure 3B The diagram shows a frontal cross-sectional view of the distal end 345 of the tube 304 of the intraocular illuminator 300. As shown, pressure sensors 320 are each disposed within an opening 326 in the lens 360 (e.g., embedded in an opening) and exposed on the distal end face 356 of the lens 360. The opening 326 may extend through the entire thickness of the lens 360 (e.g., in the z-direction) to facilitate external exposure of the pressure sensors 320. In such an embodiment, a wire 322 may extend through the opening 326 in the lens 360 to connect to the pressure sensor 320. Thus, unlike the optical fiber 332, the pressure sensor 320 is not covered or obstructed by the lens 360 and is configured to be in direct contact with the fluid in the eye to provide direct IOP measurements.

[0067] In some embodiments, the pressure sensor 320 is not disposed in or through the lens 360, and the lens 360 only covers the portion of the bundle 324 containing the optical fiber 332. In such embodiments, the pressure sensor 320 may be disposed in the space between the lens 360 and the tube 304. In such embodiments, the pressure sensor 320 is exposed at the distal end 345 of the tube 304, and the wire 322 extends beyond the interface 346 in the space between the lens 360 and the tube 304 to connect to the pressure sensor 320. In such embodiments, a filler material (such as an adhesive) may be used to fill the space between the lens 360 and the tube 304 and to hold the pressure sensor 320 and the wire 322 in place.

[0068] like Figure 3CAs further shown, the optical fiber 332 is disposed in an optional sleeve 334. In some embodiments, the sleeve 334 can include a filler material to fill the space not occupied by the optical fiber 332. In some embodiments, the pressure sensor 320 and the electrical wires 322 are disposed in a second optional sleeve 336 disposed around or adjacent to the sleeve 334. In some embodiments, the sleeve 336 can also include a filler material to fill the space not occupied by the pressure sensor 320 and the electrical wires 322. In some embodiments, the optical fiber 332 and the pressure sensor 320, along with the electrical wires 322, can be disposed in a single sleeve, which can include a filler material to fill the space not occupied by the optical fiber 332, the pressure sensor 320, and the electrical wires 322. In some embodiments, the optical fiber 332 and / or the pressure sensor 320 are coupled to the sidewall of the tube 304, or are freely disposed within the tube 404 without a sleeve.

[0069] Although Figure 3B and Figure 3C three optical fibers 332 are shown in the example shown, the scope of the present disclosure is not so limited. Rather, in other implementations, the intraocular illuminator 300 can include fewer optical fibers 332, while other implementations can include more than three optical fibers 332. In some implementations, the intraocular illuminator 300 can include two, four, or more optical fibers 332, and in some examples, the optical fibers 332 can form a 2x2 array.

[0070] Further, although Figure 3B and Figure 3C three pressure sensors 320 are shown in the example shown, the scope of the present disclosure is not so limited. Rather, in other implementations, the intraocular illuminator 300 can include fewer pressure sensors 320, while other implementations can include more than three pressure sensors 320. In some implementations, for example, the intraocular illuminator 300 can include one, two, four, or more pressure sensors 320 to provide direct IOP measurements.

[0071] In certain embodiments, the tube 304 can have a diameter of about 1.5 mm or less, such as about 0.8 mm or less, although other suitable dimensions are also contemplated. In certain embodiments, the tube 304 can have a diameter of about 0.5 mm or less. In general, the tube 304 can be sized to easily pass through a corresponding access cannula (such as a trocar cannula) and into the intraocular space of a patient’s eye. In certain embodiments, the tube 304 has a diameter corresponding to a gauge size of about 21-Ga, 22-Ga, 23-Ga, 24-Ga, 25-Ga, 26-Ga, 27-Ga, 28-Ga, 29-Ga, 30-Ga, etc. In certain embodiments, each micro pressure sensor 320 can have a diameter between about 0.25 mm and 1.55 mm, although other suitable dimensions are also contemplated.

[0072] Thus, the surgeon and / or surgical console are provided with a means for directly measuring the IOP within the eye, such that necessary adjustments can be made (e.g., in response to sudden changes in IOP during surgery) to more efficiently and safely control and / or maintain the IOP in the eye.

[0073] Figure 4A 、 Figure 4B and Figure 4C Various views of an intraocular illuminator 400 having a micro pressure sensor 420 integrated at a distal end thereof are shown in accordance with some embodiments of the present disclosure.

[0074] Turning to Figure 4A , a side perspective view of an intraocular illuminator 400 in accordance with some embodiments of the present disclosure is shown. As shown, the intraocular illuminator 400 includes a handpiece 402 and a shaft or tube 404. The handpiece 402 is coupled to a proximal end of the tube 404. In some embodiments, the handpiece 402 and the tube 404 can substantially correspond to the handpiece 102 and the tube 104, respectively, in Figure 1 In some embodiments, the handpiece 402 and the tube 404 can be composed of one or more surgical grade metal materials (e.g., stainless steel, titanium, nitinol, aluminum, or platinum).

[0075] Similar to other intraocular illuminators described herein, the intraocular illuminator 400 includes a bundle 424 extending through the intraocular illuminator 400. The bundle 424 includes one or more optical fibers 432 and electrical wires 422 for the pressure sensor 420 (as shown in Figure 4B ), which are disposed longitudinally (e.g., in the z-direction) within the handpiece 402 and the tube 404.

[0076] The optical fibers 432 are configured to receive light from one or more light sources (e.g., Figure 1The light source 108) transmits light 412, and the received light 412 is propagated to the distal end 445 of the emitted light 412 of the tube 404. In some embodiments, the optical fiber 432 may substantially correspond to Figures 3A to 3C The details of the optical fibers 432 are omitted for brevity. In the example shown, for instance, the intraocular illuminator 400 includes three optical fibers 432, but the intraocular illuminator 400 may include any suitable number (less or more than three) of optical fibers 432 to provide the desired illumination.

[0077] exist Figure 4A In the example, pressure sensor 420 is positioned in an opening 426 on the sidewall of tube 404, near the distal end 445 of tube 404, and connected to a wire 422 positioned in the longitudinal direction (e.g., the z-direction) together with optical fiber 432 in bundle 424. In some embodiments, pressure sensor 420 may substantially correspond to Figure 1 Pressure sensor 120 in the middle.

[0078] Figure 4B yes Figure 4A A detailed side perspective view of the distal portion 444 of the tube 404 is shown. It should be noted that the distal portion 444 of the tube 404 can also be the distal portion of the intraocular illuminator 400, and the distal end 445 of the tube 404 can also be the distal end of the intraocular illuminator 400. (As shown...) Figure 4B As shown, bundle 424 includes optical fiber 432 and wire 422 for miniature pressure sensor 420.

[0079] like Figure 4B As shown, lens (or window) 460 is disposed in opening 452 within distal end 445 of tube 404. Optical fibers 432 each terminate at or substantially near interface 446 between bundle 424 and lens 460. Interface 446 and / or lens 460 can be configured to facilitate the propagation of a desired illumination pattern from optical fiber 432 to a target site (such as a target site within a patient's eye).

[0080] In some embodiments, the distal end 448 of the bundle 424 may abut against the proximal end face 454 of the lens 460 at interface 446 with positive pressure. In other embodiments, one or more optical transmission elements or materials may be located at interface 446 between the distal end 448 and the lens 460. The lens 460 may substantially correspond to Figures 3A to 3C The lens 360 in the image has its details omitted for simplicity.

[0081] Figure 4C The tube 404 of the intraocular illuminator 400 is shown along, as... Figure 4B The cross-sectional view of line 4C-4C is shown. (See attached image.) Figure 4CAs shown, the bundle 424 includes optical fibers 432 disposed in an optional sleeve 434. In some embodiments, the sleeve 434 can include a filler material to fill the space not occupied by the optical fibers 432. In some embodiments, the optical fibers 432 are coupled to the sidewall of the tube 404, or are freely disposed within the tube 404 without a sleeve.

[0082] In some embodiments, the optical fibers 432 can substantially correspond to the optical fibers 332 in Figure 3B and Figure 3C For brevity, details of the optical fibers 432 are omitted. While three optical fibers 432 are shown in the illustrated example, the scope of the present disclosure is not so limited. Rather, in other implementations, the intraocular illuminator 400 can include fewer optical fibers 432, while other implementations can include more than three optical fibers 432. In some implementations, the intraocular illuminator 400 can include two, four, or more optical fibers 432, and in some examples, the optical fibers 432 can form a 2x2 array.

[0083] As shown in Figure 4C , the pressure sensor 420 is disposed in an opening (or window) 426 on the sidewall of the tube 404, proximate to the distal end 445. The opening 426 can extend through the entire thickness of the sidewall of the tube 404 to facilitate external exposure of the pressure sensor 420, enabling direct IOP measurement during ophthalmic surgery in direct contact with the substance (e.g., fluid) in the eye. In certain examples, the pressure sensor 420 can interface (e.g., directly or in close contact) with the intraocular space, such as with the substance in the eye, to directly sense the IOP associated with the intraocular space in the eye. The electrical wire 422 is coupled to the pressure sensor 420 within the tube 404. In some embodiments, the electrical wire 422 can extend through at least a portion of the sleeve 434, and can be disposed along the longitudinal direction (e.g., z-direction) with the optical fibers 432. In some embodiments, as shown in Figure 4C , the electrical wire 422 can extend through the tube 404 outside of the sleeve 434. In such embodiments, the electrical wire 422 can extend through a second sleeve within the tube 404, and / or can be adhered to the sidewall of the tube 404.

[0084] Although Figure 4B and Figure 4CA single pressure sensor 420 is shown in the middle, although the scope of the present disclosure is not limited thereto. Rather, in other embodiments, the intraocular illuminator 400 can include more than one pressure sensor 420. In some implementations, the intraocular illuminator 400 can include one, two, four, or more pressure sensors 420. In embodiments that utilize multiple pressure sensors 420, each of the pressure sensors 420 can be disposed in a separate opening (window) on the sidewall of the tube 404.

[0085] In certain embodiments, the tube 404 can have a diameter of about 1.5 mm or less, such as about 0.8 mm or less, although other suitable dimensions are also contemplated. In certain embodiments, the tube 404 can have a diameter of about 0.5 mm or less. In general, the tube 404 can be sized to easily pass through a corresponding access cannula (such as a trocar cannula) and into the intraocular space of a patient’s eye. In certain embodiments, the tube 404 has a diameter that corresponds to a gauge size of about 21-Ga, 22-Ga, 23-Ga, 24-Ga, 25-Ga, 26-Ga, 27-Ga, 28-Ga, 29-Ga, 30-Ga, etc. In certain embodiments, each pressure sensor 420 can have a diameter of between about 0.25 mm and 1.55 mm, although other suitable dimensions are also contemplated.

[0086] Accordingly, the surgeon and / or surgical console are provided with a means for directly measuring the IOP within the eye, such that necessary adjustments can be made (e.g., in response to sudden changes in IOP during surgery) to more efficiently and safely control and / or maintain the IOP in the eye.

[0087] Although described above with reference to an intraocular illuminator, the pressure sensing features presented herein are not limited to such a device. For example, the pressure sensing features presented herein can be integrated with other ophthalmic surgical instruments and / or devices that are inserted into the eye to provide substantially the same advantages as conventional systems. Such ophthalmic surgical instruments and / or devices can include probes and other tools for performing surgery related to vitrectomy, keratoplasty, trabeculectomy, goniotomy, cataract surgery, etc. Accordingly, Figure 5 A surgical instrument 500 is illustratively shown having one or more pressure sensors 520 integrated at a distal end thereof, in accordance with some embodiments of the present application.

[0088] As Figure 5As shown, the pressure sensor 520 can be integrated at the distal end portion 545 of the surgical instrument 500. The pressure sensor 520 can be coupled to a power source and / or controller 560 (e.g., integrated in a surgical console) by one or more wires 522 that extend through an internal chamber 523 of the surgical instrument 500. In some embodiments, the pressure sensor 520 can be coupled to wires external to the surgical instrument 500. In some embodiments, the pressure sensor 520 can be powered wirelessly by a battery pack, which can be integrated on the surgical instrument 500 (e.g., integrated on the backend). In some embodiments, the pressure sensor 520 can transmit and / or receive data / signals through a wireless transceiver.

[0089] In some embodiments, the surgical instrument 500 is configured to perform a surgical function. For example, the surgical instrument 500 can include a tool for manipulating ocular tissue during an ophthalmic procedure. Examples of tools for manipulating ocular tissue can include, but are not limited to, forceps, spatulas, hooks, Sinskey hooks, depressors, and the like. In certain embodiments, the surgical instrument 500 can include a tool for cutting ocular tissue during an ophthalmic procedure. Examples of tools for cutting ocular tissue can include, but are not limited to, scissors, side-port blades, side-port knives, micro-incision coaxial surgical (MICS) knives, and the like. In certain embodiments, the surgical instrument 500 can include a probe for performing a particular type of ophthalmic procedure, such as a cutting probe, a vitrectomy probe, a phacoemulsification probe, a laser probe, an ablation probe, a vacuum probe, an irrigation probe, and the like. In certain embodiments, the surgical instrument 500 can include a visualization device, such as an endoscopic visualization probe. In certain embodiments, the surgical instrument 500 includes an access cannula, such as a trocar cannula. In certain embodiments, the surgical instrument 500 includes an infusion cannula. Other ophthalmic devices and / or combinations thereof are also contemplated.

[0090] When the distal end of the surgical instrument 500 is inserted into the eye during a procedure to perform its surgical function, the pressure sensor 520 can interface (e.g., directly or in close contact) with the intraocular space in the eye (such as with the matter in the eye) to directly sense the IOP associated with the intraocular space in the eye. Thus, the surgeon and / or the surgical console are provided with a means for directly measuring the IOP in the eye, such that necessary adjustments can be made (e.g., in response to sudden changes in IOP during a procedure) to more efficiently and safely control and / or maintain the IOP in the eye.

[0091] Figure 6A A distal end portion 645A of a surgical instrument 600 according to some embodiments of the present disclosure is shown. In some embodiments, the surgical instrument 600 can substantially correspond to the surgical instrument 500 in Figure 5 some embodiments, the distal end portion 645A can correspond to the distal end portion 545 of the surgical instrument 500.Figure 5 The distal portion of the middle part is 545. For example... Figure 6A As shown, the pressure sensor 620A is integrated at the distal end of the surgical instrument and connected to the wire 622A embedded in the internal cavity 623A of the surgical instrument.

[0092] Figure 6B The distal portion 645B of a surgical instrument 601 according to some embodiments of this disclosure is shown. In some embodiments, the surgical instrument 601 may substantially correspond to Figure 5 Surgical instrument 500. In some embodiments, the distal portion 645B may correspond to Figure 5 The distal portion of the middle part is 545. For example... Figure 6B As shown, the pressure sensor 620B is integrated in an opening on the side wall of the surgical instrument and connected to a wire 622B embedded in the internal cavity 623B of the surgical instrument.

[0093] Figure 7 A schematic diagram of a surgical console 740 according to an embodiment disclosed herein is shown. In some embodiments, the surgical console 740 may substantially correspond to Figure 1 Surgical console 140.

[0094] like Figure 7 As shown, the surgical console 740 includes, but is not limited to, a control module 762, a user interface 764, interconnects 766, and at least one I / O (input / output) device interface 768, which allows various I / O devices (e.g., keyboard, display, mouse, pen input, etc.) to be connected to the surgical console 740. The surgical console 740 may also include an illumination source 708 (e.g., a continuous illumination source and / or a strobe illumination source), which is connected via a cable 710a to an intraocular illuminator (e.g., [missing information]). Figure 1 The surgical console 740 includes an optical fiber 732 for the intraocular illuminator 100. In some embodiments, the surgical console 740 may be operatively coupled to an external illumination source (e.g., a continuous illumination source and / or a strobe illumination source). The surgical console 740 may further include one or more pressure management tools 786 for managing IOP in the eye, for example, by ventilation and / or controlling infusion and / or aspiration rates. In some embodiments, the pressure management tool 786 includes a pump, a vacuum device, and / or other means for controlling infusion and / or aspiration, for example, via a probe that can be inserted into the patient's eye. In some embodiments, the surgical console 740 may include a display in a user interface 764 for displaying information to the user, including surgical parameters and device settings (the display may also be combined with a touchscreen for receiving user input).

[0095] The control module 762 includes a processor 714 (e.g., controller), a memory 770, and a storage device 772. The processor 714 (e.g., control circuitry) is configured to retrieve and execute programmed instructions stored in the memory 770. Similarly, the processor 714 can retrieve and store application data resident in the memory 770. An interconnect 766 transfers programmed instructions and application data between the processor 714, the I / O device interface 768, the user interface 764, the memory 770, the storage device 772, the illumination source 708, the pressure management tool 786, etc. The processor 714 can include a single CPU, multiple CPUs, a single CPU with multiple processing cores, etc. The memory 770 can be random access memory, while the storage device 772 can be a disk drive. Moreover, the memory 770 and / or the storage device 772 can be any type of readily available memory such as random access memory (RAM), read only memory (ROM), a floppy disk, a hard disk, solid state, flash memory, magnetic memory, or any other form of local or remote digital storage. In certain embodiments, the memory 770 and / or the storage device 772 include instructions that, when executed by the processor 714, cause the pressure management tool 786 to manage (e.g., adjust, control, increase, decrease, etc.) IOP in the patient’s eye based on direct IOP measurements. For example, the memory 770 includes a pressure management module 784 that can include computer executable instructions that, when executed by the processor 714, cause the processor 714 to control the pressure management tool 786 in order to manage IOP in the patient’s eye based on IOP measurements reflected by signals received from the one or more pressure sensors 720.

[0096] In particular, the processor 714 can receive signals from the one or more pressure sensors 720 via the electrical wiring 710b. For example, the signals correspond to fluid pressure readings (e.g., IOP) in the eye. The processor 714 is also configured to send output signals to the pressure management tool 786 via the interconnect 766. For example, the output signals allow the processor 714 to control operation of the pressure management tool 786 (e.g., exhaust valves, output valves, infusion valves and pumps, and aspiration valves and pumps, vacuum sources, etc.) based on the signals from the one or more pressure sensors 720 in order to maintain or control intraocular pressure of the eye.

[0097] In Figure 7In embodiments, the processor 714 can include an integrated circuit capable of performing logical functions. In this manner, the processor 714 is in the form of a standard integrated circuit package with power pins, input pins, and output pins. In various embodiments, the processor 714 can control one or more valve or pump controllers, or other target device controllers. In this case, the processor 714 can perform specific control functions for a particular device, such as one or more valves, infusion pumps, and / or aspiration pumps. In other embodiments, the processor 714 is a microprocessor. In this case, the processor 714 is programmable such that it can function to control valves and infusion pumps and / or aspiration pumps, as well as other components coupled to the surgical console. In other cases, the processor 714 is not a programmable microprocessor, but instead is a dedicated controller configured to control different valves and pumps that perform different functions.

[0098] The surgical console 740 can be configured to drive one or more surgical instruments 790, which can include various probe types of ophthalmic probes, including intraocular illuminators, laser probes (e.g., picosecond infrared laser probes, femtosecond laser probes), vitrectomy probes, phacoemulsification probes, flap cutters, and other ophthalmic surgical tools. In operation, the surgical console 740 can function to assist a surgeon in performing various ophthalmic surgeries, such as vitrectomy, phacoemulsification, cataract surgery, LASIK, and similar surgeries. In some embodiments, the surgical instruments 790 can also include one or more valves, as well as infusion pumps and tubing.

[0099] In embodiments in which the surgical instruments 790 include a vitrector, the surgical console 740 can include one or more modules or components for powering the vitrector for the purpose of pulverizing (e.g., cutting) the vitreous. For example, in certain embodiments, the surgical console 740 can include a pneumatic module that uses compressed gas, such as nitrogen gas, to power the vitrector. In certain other embodiments, the surgical console 740 can include a laser source for generating a laser that the vitrector uses to pulverize the vitreous (see, e.g., U.S. Patent Publication No. 2019 / 0201238).

[0100] In some embodiments, the surgical tool 790 can include a phacoemulsification probe. For example, the surgical instrument 790 can include an ultrasonic phacoemulsification probe that is capable of emulsifying or pulverizing a lens during a cataract surgery. As another example, the surgical instrument 790 can be configured to emit a laser for performing a phacoemulsification. In embodiments in which the surgical instrument 790 can be a phacoemulsification probe, the surgical console 740 includes one or more modules or components for powering the phacoemulsification probe to emulsify a lens during a cataract surgery. In some embodiments, the surgical instrument 790 can include a picosecond infrared laser (pIRL).

[0101] In some embodiments, the surgical instrument 790 can be configured to emit a laser, such as a femtosecond laser, for making incisions and / or cutting flaps during an ophthalmic surgery. A suitable example femtosecond laser is the FS200 laser. In some embodiments, the surgical instrument 790 can be a laser, such as an excimer laser, for use in photorefractive keratectomy and / or LASIK surgery (e.g., laser ablation of the cornea). A suitable example excimer laser is the EX500 laser.

[0102] In some embodiments, the surgical instrument 790 can include an endoilluminator. In such embodiments, the optical fiber 732 can be disposed through the endoilluminator to introduce light from the illumination source 708 into the patient’s eye.

[0103] In some embodiments, one or more of the pressure sensors 720 can be integrated into a distal portion of at least one of the surgical instruments 790. Thus, this facilitates positioning the pressure sensors 720 in the eye to directly sense IOP associated with an intraocular space in the eye. In some embodiments, one or more of the pressure sensors 720 can interface (e.g., directly or in close contact) with an intraocular space, such as a substance in the intraocular space, via an opening in a distal portion of the at least one surgical instrument 790.

[0104] The surgical instrument 790 can be operatively coupled to the surgical console 740 via one or more ports of the surgical console 740. It should be noted that the surgical instrument 790 can be operatively coupled to the surgical console 740 via a plurality of different tubes or cables configured to interface with the ports of the surgical console 740. For example, such tubes or cables can include pneumatic tubing, optical fiber cables, ultrasonic power lines for powering the surgical instrument 790 for cutting purposes, and aspiration or vacuum lines for transporting aspirated substances back to the surgical console 740.

[0105] The foregoing description is provided to enable any person skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein can be applied to other embodiments. Thus, the claims are not intended to be limited to the embodiments shown herein, but is to be accorded the full scope consistent with the language of the claims. As such, to the extent there are any extraneous principles applied to the embodiments described herein, those are to be considered as exemplary applications of the underlying principles that are only intended to be limited as specifically set forth in the claims. Those skilled in the art will appreciate that the surgical instruments (e.g., intraocular illuminator and auxiliary surgical instruments) illustrated herein can include more components than the simplified illustrations described herein. The surgical instruments described herein include only those components that are useful in describing the salient features of embodiments within the scope of the claims.

Claims

1. An intraocular illuminator, comprising: a handpiece; and a probe coupled to a distal end of the handpiece, the probe comprising an optical fiber and a pressure sensor, wherein: the pressure sensor is positioned proximate a distal end of the probe, the pressure sensor is configured to be inserted into an intraocular space of an eye, and the pressure sensor is configured to directly sense an intraocular pressure (IOP) associated with the intraocular space of the eye.

2. The intraocular illuminator of claim 1, wherein, the pressure sensor comprises at least one of a microelectromechanical system (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gage pressure sensor, and a capacitive pressure sensor.

3. The intraocular illuminator of claim 1, wherein: a distal end of the probe comprises an opening through which light from a distal end of the optical fiber is configured to propagate; and the pressure sensor is configured to sense the IOP through the opening.

4. The intraocular illuminator of claim 1, wherein: a distal end of the probe comprises a first opening through which light from a distal end of the optical fiber is configured to propagate; and the distal end of the probe comprises a second opening through which the pressure sensor is configured to sense the IOP.

5. The intraocular illuminator of claim 4, wherein, the second opening is disposed in a sidewall of the probe proximate the distal end.

6. The intraocular illuminator of claim 1, wherein, the pressure sensor is coupled to one or more electrical wires that extend in the probe substantially along a longitudinal direction of the optical fiber.

7. The intraocular illuminator of claim 1, wherein, the intraocular illuminator is coupled to a light source configured to cause light into the optical fiber.

8. The intraocular illuminator of claim 1, wherein, the intraocular illuminator is coupled to a surgical console that provides power to the pressure sensor.

9. An instrument for ophthalmic surgery, the instrument comprising: a pressure sensor positioned proximate a distal end of the instrument, wherein the pressure sensor is configured to: be inserted into an intraocular space of an eye, and directly sense an intraocular pressure (IOP) associated with the intraocular space of the eye.

10. The apparatus of claim 9, further comprising: a power source coupled to the instrument for providing power to the pressure sensor.

11. The apparatus of claim 9, wherein, the pressure sensor comprises at least one of a microelectromechanical system (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gage pressure sensor, and a capacitive pressure sensor.

12. The apparatus of claim 9, wherein, the pressure sensor is disposed at a tip or a sidewall of the distal end of the instrument.

13. The apparatus of claim 9, wherein, the instrument comprises at least one of a forceps, a spatula, a hook, or a depressor.

14. The apparatus of claim 9, wherein, the instrument comprises at least one of a scissors or a knife.

15. The apparatus of claim 9, wherein, the instrument comprises at least one of a vitrectomy probe, a phacoemulsification probe, a laser probe, a vacuum probe, an endoscope visualization probe, or an intraocular illuminator.

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