Transscleral illumination for vitreous visualization

Abstract

An ophthalmic assembly includes a frame, a flange, and a light emitter. The frame supports the optical lens. A first end of the flange is connected to the frame. The second end of the flange rests on a ciliary body flat region of the sclera of the patient's eye. A light emitter is connected to the flange proximate the second end to direct light into a vitreous cavity of the patient's eye. Light passes through the sclera at the flat region of the ciliary body, uniformly illuminating the vitreous body. A transscleral illumination system includes the ophthalmic assembly and a processor in communication with the light emitter. The setting of the light emitter may be controlled via a processor, for example in response to a user input signal.

Description

Cross-references to related applications

[0001] This application claims the benefit of priority to U.S. Provisional Application No. 63 / 520,121, filed August 17, 2023, which is hereby incorporated in its entirety by reference for all purposes. Background Technology

[0002] This disclosure relates to hardware and related technologies used to visualize the vitreous humor of a patient's eye during ophthalmic surgery.

[0003] The human eye is filled with a gel containing collagen called the vitreous body, or simply the vitreous. In a healthy eye, the vitreous body is transparent, a feature that allows light entering the eye through the pupil and lens to travel unimpeded to the retina. Aging, injury, and other changes in the eye can cause the vitreous body to liquefy and thin. Within the vitreous cavity, clumps of collagen fibers (“floaters”) can cast shadows on the retina. Therefore, depending on the size, number, and location of the floaters within the vitreous cavity, they can adversely affect vision.

[0004] To accurately identify and ultimately treat floaters, clinicians can illuminate the vitreous cavity and observe the vitreous in real time using a set of optics. However, because floaters are mostly phase objects, typically absorbing only 1% to 2% of incident light, they are extremely difficult to distinguish under corneal and pupillary illumination. For example, incident light is scattered and reflected by the cornea, natural or artificial lens (IOL), or vitreous, producing problematic glare. Furthermore, internal and external illumination use relatively narrow beams and are unevenly distributed. Both of these characteristics are unsuitable for visualizing the vitreous. Summary of the Invention

[0005] This article discloses a transscleral illumination system for visualizing the vitreous cavity of a patient's eye, for example, during or in the preparation phase of ophthalmic surgery (such as laser vitreolysis or vitrectomy), along with associated controls and implementation methods. The solution described herein can be used during interactive, real-time visualization by clinicians, potentially in conjunction with a slit lamp, to provide clinicians with a true dark-field view of the patient's vitreous cavity. Unlike the transcorneal and transpupil methods outlined above, this approach provides uniform illumination of the vitreous cavity by directing light through the sclera and choroid of the eye at the ciliary body or pars plana region, rather than, for example, through the cornea, pupil, and lens / IOL.

[0006] Illumination is provided by a set of light-emitting diodes (LEDs) or other suitable light emitters. As described above, this specifically occurs in or along the pars plana region of the ciliary body, where precise placement of the light emitters is achieved by an ophthalmic assembly. As part of the disclosed assembly, a conical / skirt-shaped portion or flange is attached to or integrally formed with the annular body. The flange surrounds the cornea and rests directly on the conjunctiva above the sclera.

[0007] In particular, this document discloses an ophthalmic visualization tool for visualizing the vitreous body within a patient's eye. A non-limiting exemplary embodiment of the visualization tool includes a frame and a light emitter. The frame may include: an annular body configured to support an optical lens for observing the vitreous body; and a flange connected to the annular body. The flange has a first end and a second end. The first end is connected to the frame. The second end is configured to rest on the scleral surface of the eye near the pars plana region of the ciliary body. In this embodiment, the light emitter is connected to the flange near the second end and is configured to guide light through the scleral surface and into the vitreous cavity of the eye. This occurs at the pars plana region and is beneficial for uniform illumination of the vitreous body and for eliminating scattered light and reflections that would occur if illumination were to pass through the cornea, lens, or IOL as described above.

[0008] The annular body may include a set of tabs configured to engage the peripheral edge of an optical lens, which may be part of the tool.

[0009] The first end of the flange, which can be truncated conical in shape, is connected to the annular body. The second end is configured to rest on the surface of the sclera.

[0010] In one or more embodiments of the tool, the light emitter may include a plurality of LEDs, which may further include one or more blue LEDs. According to certain aspects of this disclosure, at least one of these LEDs is connected to an optical fiber. These LEDs may also be arranged in a bundle of optical fibers and connected to multiple optical fibers.

[0011] This document also discloses a transscleral illumination system for visualizing the vitreous humor within a patient's eye. The system may include an ophthalmic visualization tool having: a frame configured to support an optical lens; and a flange having a first end and a second end. As described above, the first end is connected to the frame. The second end is configured to rest on the scleral surface of the eye near the pars plana region of the ciliary body. A light emitter is connected to the flange near the second end and is configured to guide light across the scleral surface and into the vitreous cavity of the eye. As with the previously summarized embodiments of the tool, this occurs at the pars plana region, thereby providing uniform illumination of the vitreous humor. A processor communicates with the light emitter. In this configuration, the settings of the light emitter can be controlled via a processor or analog electronics.

[0012] An ophthalmic visualization tool according to another embodiment includes an optical lens, a frame, a flange, and a plurality of red, green, and blue (RGB) LEDs. The lens is configured for viewing the anterior, middle, or posterior portion of the vitreous body. The frame has an annular body and a neck portion configured to support the peripheral edge of the lens. In this non-limiting / representative configuration of the tool, the flange has a truncated conical shape, including a first end and a second end, the first end being connected to the neck portion, and the second end being configured to rest on the scleral surface of the eye at the pars plana region of the ciliary body. The LEDs are arranged in an annular arrangement connected to the flange near the second end. The LEDs in the annular arrangement guide light through the scleral surface into the vitreous cavity of the eye at the pars plana region, thereby providing uniform illumination of the vitreous body.

[0013] The above-described features and advantages, as well as other possible features and advantages, of this disclosure will become apparent from the following detailed description of the best mode for implementing this disclosure, taken in conjunction with the accompanying drawings. Attached Figure Description

[0014] Figure 1 This is an illustration of a representative ophthalmic surgery in which a clinician uses a transscleral illumination system according to this disclosure to visualize the vitreous humor of the patient's eye.

[0015] Figure 2 yes Figure 1 A schematic diagram of a portion of a transscleral illumination system.

[0016] Figure 3 It is used with Figure 1 and Figure 2 A cross-sectional side view illustration of an exemplary configuration of a visualization tool used with a transscleral illumination system.

[0017] Figure 4 yes Figure 3A 3D illustration of an exemplary visualization tool.

[0018] Figure 5 The illustration shows a light emitter arranged according to one or more embodiments.

[0019] The solutions disclosed herein may be modified or presented in alternative forms. Representative embodiments are illustrated by way of example in the accompanying drawings and described in detail below. However, the inventive step of this disclosure is not limited to the disclosed embodiments. Rather, this disclosure is intended to cover alternatives that fall within the scope of this disclosure as defined by the appended claims. Detailed Implementation

[0020] Referring to the accompanying drawings, where the same reference numerals refer to the same parts, such as... Figure 1 The representative visualization procedure 10 illustrated is performed using the transscleral visualization system 12 according to this disclosure. The transscleral visualization system 12 includes an ophthalmic visualization tool 14, which... Figure 1 The illustration shows a hand 13 grasping the object (not fully shown) by a clinician. The visualization tool 14 includes one or more light emitters 16, a frame 18, and a processor 20, as detailed below. As envisioned herein, the clinician can use the system 12 during visualization procedure 10 to assist in observing the vitreous body (“vitreous”) 24 within the eye 26 of the patient 28 (see [link to documentation]). Figure 2 ).

[0021] The visualization procedure 10 can be performed in conjunction with a stereomicroscope (“slit lamp”) 30. As those skilled in the art will understand, the slit lamp 30 is typically configured to emit a beam of light with clinician-controllable characteristics when observing the interior of the eye 26. During the visualization procedure, for example, in the preparation phase of vitrectomy or vitrectomy surgery or when performed concurrently with surgery, and with or without the slit lamp 30, the clinician can place the visualization tool 14 directly on the eye 26. Thus, the clinician can observe using the uniform illumination provided by the visualization tool 14. Figure 2 24. Vitreous body.

[0022] In one or more embodiments, a clinician can interact with the light emitter 16 to selectively adjust its settings. This action can occur in response to a user input signal 32, such as by using a voice command, foot pedal activation, or by using a button, touchscreen, etc. The processor 20 can receive the user input signal 32 and respond by changing one or more settings of the light emitter 16 (e.g., by adjusting color and / or intensity settings). This can be achieved by transmitting electronic control signals (CC... E)132 is implemented by the relevant drive circuit system that transmits data from processor 20 to optical transmitter 16.

[0023] By way of non-restrictive examples, Figure 1 The light emitter 16, schematically shown, may include light-emitting diodes (LEDs), such as red, green, and blue (RGB) diodes or an array of RGB diodes, to generate and output white light. The settings for the light emitter 16 may include adjustable color settings. (Due to the observation...) Figure 2 Using blue light during the vitreous phase 24 may be advantageous. In one or more embodiments, the aforementioned RGB LED can be configured to selectively emit blue light in response to a user input signal 32. Therefore, the setting of the light emitter 16 can include the color of the light emitter 16, where the user input signal 32 includes a requested color for the light emitter 16, such as a surgeon's preferred color.

[0024] Now for reference Figure 2 The illustration depicts a representative laser vitrectomy procedure 100, during which discrete fragments of the vitreous 24 move as floaters 124 within the vitreous cavity 43 of the patient's eye 26. As this occurs, the floaters 124 are individually targeted by a laser beam 33 emitted from an external laser device 34. As understood in the art, vitrectomy typically involves emitting nanosecond-length light pulses, depending on the size and position of the floaters 124, to disperse or vaporize them. In a typical setup, the laser device 34 is implemented as a yttrium aluminum garnet (YAG) laser; laser devices 34 with shorter pulse lengths (e.g., emerging femtosecond lasers) may be used as part of the vitrectomy procedure 100.

[0025] In an exemplary embodiment of the laser vitreolysis procedure 100, as shown, a laser beam 33 is guided through the cornea 36 and lens 38 of the eye 26 into the vitreous body 24. A vitreous cavity 43 exists between the lens 38 located anterior to the eye 26 and the optic nerve 45 located posterior to the eye 26, wherein the vitreous body 24 fills the vitreous cavity 43 and contacts the retina 50. The laser beam 33 thus passes through the vitreous body 24 to be incident on the floater 124, and as understood in the art, the energy applied by the laser beam 33 ultimately reduces or vaporizes the floater 124.

[0026] Because the float 124 is a dynamic phase object, it may be difficult to properly visualize it and distinguish it from the surrounding vitreous body 24. For this purpose, a light emitter 16 is positioned as shown, allowing emitted light 16L to pass through the sclera 40 and choroid 42 into the vitreous cavity 43. See below for details. Figure 3 and Figure 4As described herein, the light emitter 16 is positioned near or within the ciliary body plana region 46, specifically, approximately 4 mm (4 mm) from the ciliary muscle portion near the junction of the sclera 40 and iris 49. Positioning the light emitter 16 in this manner offers various accompanying benefits, including, but not limited to, reducing or eliminating scattered light, such as scattered light from the lens 38 when the lens 38 is constructed as an artificial intraocular lens. Therefore, the specific location of the light emitter 16 near the ciliary body plana region 46 is intended to facilitate visualization of the vitreous body 24.

[0027] Further regarding the positioning of the light emitter 16, when... Figure 2 When viewed from the side, the eye 26 has a shape primarily formed by the surrounding sclera 40. The sclera 40 thus forms the outer wall of the eye 26. The conjunctiva 52 lies on the sclera 40 and on the underside of the eyelid (not shown), serving as a transparent mucous membrane that protects and lubricates the eye 26. Figure 3 As shown, the light emitter 16 is connected to the frame 60, a portion of which rests on the sclera 40, with the conjunctiva 52 positioned between them. In some embodiments, the sclera-conjunctiva interface may be treated with a viscous thixotropic material to increase friction, with the aim of maintaining the desired optimal position of the light emitter 16 and reducing saccade speed.

[0028] refer to Figure 3 An ophthalmic visualization tool 14 is shown positioned on a patient's eye 26. In this exemplary configuration, the visualization tool 14 includes a frame 60 and a light emitter 16, wherein the light emitter is depicted as communicating wirelessly with a processor (P) 20, either wired or wirelessly. In this embodiment, the frame 60 includes an annular body 62 configured to support an optical lens 63 therein, such as a high-power or wide-angle lens that can be used by a clinician to observe the vitreous 24, for example, a replaceable lens for observing the anterior, middle, or posterior portion of the vitreous as needed during a specific visualization task. For example, the annular body 62 may include a set of tabs 66 configured to engage the peripheral edge 63E of the optical lens 63.

[0029] Flange 64 is connected to or integrally formed with an annular body 62, for example, at a narrowed interface or neck portion 75. The neck portion 75 may be integral with this set of tabs 66 and is thus configured to support the peripheral edge 63E of the optical lens 63. Flange 64 has a first end E1 and a second end E2. The first end E1 is connected to the annular body 62. The second end E2 is configured to rest on the sclera 40 of the patient's eye 26. In this embodiment, a light emitter 16 is connected to flange 64 near the second end E2, such that the light emitter 16 is configured to guide light 16L into the vitreous cavity 43. The light passes through the sclera 40 and the choroid 42 interspersed tissue, and is therefore transscleral.

[0030] At a specific location near the pars plana region 46 of the ciliary body, the emitted light 16L uniformly illuminates the vitreous body 24 without undesirable scattering or reflection. Therefore, clinicians are able to better track floaters 124 as they move within the vitreous body 24. The second end E2 rests on the sclera 40. Therefore, the flange 64, or at least its distal surface 65, should be constructed of a material comfortable for temporary contact with the eye 26. Exemplary materials include synthetic polymers such as polymethyl methacrylate (PMMA), rubberized or coated plastics, silicone rubber, etc.

[0031] Now for reference Figure 4 In the illustrated configuration, the flange 64 can have a truncated conical shape as shown, such that the flange 64 forms a skirt or skirt plate angled outward along the optical axis AA toward the eye 26. The light emitter 16 is connected to the flange 64 near the second end E2, wherein the circumferential inner wall 640 extends between the second end E2 and the light emitter 16. Directly behind the annular arrangement 70, i.e., at the eye 26 (… Figures 1 to 3 Between the first end E1 and the frame 60, an optical lens 63 can be attached to and surrounded by the frame 60 (in this case, its flange 64). An annular body 62 is attached to the first end E1, extends away from the flange 64, and provides sufficient surface area for the clinician to grip. As shown, a collar 620 can be provided / attached to the annular body 62 to facilitate manipulation and positioning in this manner.

[0032] like Figure 5 As illustrated, in one or more embodiments, the light emitter 16 may include a plurality of light-emitting diodes (LEDs) 160, such as red (R) LED 160R, green (G) LED 160G, and blue (B) LED 160B, respectively. The LEDs 160 may be connected to or arranged within an annular arrangement 70, which may further include one or more optical fibers 72 arranged therein. For example, in different embodiments, multiple (two, three, or four) optical fibers 72 bundled together (“fiber bundles”) may be used to connect to the respective LEDs 160 and provide desired uniform illumination along corresponding lengths of the optical fibers 72. Light emission ports 69 may be connected to the optical fibers 72 of the annular arrangement 70 and are equidistantly spaced as shown to ensure uniform illumination around the circumference of the second end E2.

[0033] This document describes embodiments of the disclosure. However, the disclosed embodiments are merely examples, and various alternative forms may be taken for other embodiments. The drawings are not necessarily drawn to scale. Some features may be enlarged or minimized to show details of specific components. Therefore, the specific structural and functional details disclosed herein should not be construed as limiting, but only as a representative basis for teaching those skilled in the art to employ the disclosure in various ways.

[0034] In the following description, certain terms may be used for illustrative purposes only and are therefore not intended to be limiting. For example, terms such as “above” and “below” refer to directions referenced in the accompanying drawings. Terms such as “front,” “rear,” “before,” “after,” “left,” “right,” “rear,” and “side” describe the orientation and / or position of a part or element within a consistent but arbitrary frame of reference, which will become clear by referring to the text describing the part or element under discussion and the associated drawings. Furthermore, terms such as “first,” “second,” and “third” may be used to describe individual parts. Such terms may include the words specifically mentioned above, their derivatives, and words with similar meanings.

[0035] The detailed descriptions and accompanying drawings are supportive and descriptive of this disclosure, but the scope of this disclosure is defined only by the claims. While some best modes and other embodiments for implementing the claimed disclosure have been described in detail, various alternative designs and embodiments exist to practice the disclosure as defined in the appended claims.

Claims

1. An ophthalmic visualization tool for visualizing the vitreous body within a patient's eye, the eye having a pars plana region of the ciliary body, the ophthalmic visualization tool comprising: A framework, the framework having: An annular body, the annular body being configured to support an optical lens; as well as A flange is connected to the annular body and has a first end and a second end, wherein the first end is connected to the frame and the second end is configured to rest on the scleral surface of the eye near the ciliary body plana region. as well as A light emitter connected to the flange near the second end, the light emitter being configured to guide light through the scleral surface and into the vitreous cavity of the eye in the region of the ciliary body plana, thereby providing uniform illumination to the vitreous body.

2. The ophthalmic visualization tool as described in claim 1, wherein, The annular body includes a set of tabs configured to engage the peripheral edge of the optical lens.

3. The ophthalmic visualization tool as described in claim 2, further comprising: The optical lens.

4. The ophthalmic visualization tool as described in claim 1, wherein, The flange has a truncated conical shape and has a first end and a second end.

5. The ophthalmic visualization tool as described in claim 1, wherein, The first end of the flange is connected to the annular body, and the second end is configured to rest on the scleral surface.

6. The ophthalmic visualization tool as described in claim 1, wherein, The light emitter includes multiple light-emitting diodes (LEDs).

7. The ophthalmic visualization tool as described in claim 6, wherein, The LED includes one or more blue LEDs.

8. The ophthalmic visualization tool as described in claim 6, wherein, At least one of the LEDs is connected to an optical fiber.

9. The ophthalmic visualization tool as described in claim 8, wherein, The optical fiber comprises multiple optical fibers, wherein the LED is connected to the optical fibers arranged in a ring.

10. A transscleral illumination system for visualizing the vitreous humor within a patient's eye, the eye having a pars plana region of the ciliary body, the transscleral illumination system comprising: An ophthalmic visualization tool, wherein the ophthalmic visualization tool has: A frame configured to support an optical lens; as well as A flange having a first end and a second end, wherein the first end is connected to the frame, and the second end is configured to rest on the scleral surface of the eye near the plana region of the ciliary body; and A light emitter connected to the flange near the second end, the light emitter being configured to guide light through the scleral surface and into the vitreous cavity of the eye at the plana region of the ciliary body, thereby providing uniform illumination to the vitreous body; and A processor that communicates with the optical transmitter, wherein the processor is capable of controlling the settings of the optical transmitter.

11. The transscleral illumination system of claim 10, wherein, The frame includes an annular body having a neck portion, wherein the neck portion is configured to support the peripheral edge of the optical lens.

12. The transscleral illumination system of claim 11, wherein, The flange has a truncated conical shape, including a first end and a second end, wherein the first end is connected to the neck portion, and the second end is configured to rest on the sclera in the ciliary body plana region.

13. The transscleral illumination system of claim 10, wherein, The light emitter includes multiple light-emitting diodes (LEDs).

14. The transscleral illumination system of claim 13, wherein, The LEDs are arranged in a ring.

15. The transscleral illumination system of claim 14, wherein, The ring arrangement includes one or more optical fibers connected to the LED.

16. The transscleral illumination system of claim 10, wherein, The processor is configured to adjust the settings of the light emitter in response to user input signals.

17. The transscleral illumination system of claim 16, wherein, The settings for the light emitter include the color of the light emitter, and wherein the user input signal is a requested color for the light emitter.

18. The transscleral illumination system of claim 10, further comprising the optical lens, wherein, The optical lens is configured as a replaceable lens, which is configured to observe the front, middle or rear of the glass body.

19. An ophthalmic visualization tool for visualizing the vitreous body within a patient's eye, the eye having a pars plana region of the ciliary body, the ophthalmic visualization tool comprising: An optical lens, configured to observe the front, middle, or rear of the glass body; A frame having an annular body and a neck portion, wherein the neck portion is configured to support the peripheral edge of the optical lens; A flange having a truncated conical shape, including a first end and a second end, wherein the first end is connected to the neck portion, and the second end is configured to rest on the scleral surface of the eye at the plana region of the ciliary body; and Multiple red, green, and blue (RGB) light-emitting diodes (LEDs) are arranged in a ring arrangement connected to the flange near the second end. The ring arrangement is configured to guide light through the scleral surface into the vitreous cavity of the eye in the plana region of the ciliary body, thereby providing uniform illumination to the vitreous body.

20. The ophthalmic visualization tool as described in claim 19, wherein, The plurality of RGB LEDs have adjustable color settings, including blue light, and wherein the RGB LEDs are configured to selectively emit blue light in response to a user input signal.

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