System and method for post occlusion surge mitigation

Abstract

According to certain embodiments, a surgical cassette for an ophthalmic surgical system includes a perfusion conduit in fluid communication with a handpiece and delivering fluid to a surgical site. An aspiration conduit is in fluid communication with the handpiece and carries fluid away from the surgical site. An aspiration pump generates a vacuum pressure in the aspiration conduit to direct fluid through the aspiration conduit toward a drain. A reservoir is coupled to a pressure-vacuum source to manage the reservoir pressure. A valve is in fluid communication with the aspiration conduit and the reservoir and provides one or more passageways between the aspiration conduit and the reservoir. Each sensor detects a pressure associated with the surgical site. A computer controls the valve in response to the pressure detected by one or more of the pressure sensors to reduce pressure variations or volume variations.

Description

TECHNICAL FIELD

[0001] The present disclosure relates to ophthalmic surgical systems and methods, and more particularly to systems and methods that mitigate post-occlusion surges during ophthalmic surgery. BACKGROUND

[0002] Cataract surgery involves removing a cataract lens and replacing the lens with an intraocular lens (IOL). The cataract lens is typically removed by breaking up the lens and aspirating the lens fragments out of the eye. The lens can be broken up using, for example, a phacoemulsification handpiece, a laser handpiece, or other suitable handpiece. During the procedure, the handpiece breaks up the lens (using, for example, ultrasonic vibrations or laser energy) and the fragments are aspirated from the eye through, for example, a needle. Throughout the procedure, irrigation fluid is pumped into the eye to maintain intraocular pressure (IOP) to prevent the eye from collapsing.

[0003] A common complication during the breaking up process comes from occlusion of the needle. When irrigation fluid and emulsified tissue are aspirated through a hollow cutting needle, pieces of tissue larger than the needle bore can occlude the tip. When the tip is occluded, vacuum pressure builds up within the tip. When the occlusion is removed (e.g., the tissue breaks free and moves through the needle), a post-occlusion surge occurs. When the occlusion is removed, the vacuum pressure in the anterior chamber suddenly decreases, creating a post-occlusion surge. In some cases, the post-occlusion surge causes a relatively large amount of fluid and tissue to be rapidly aspirated from the eye, potentially collapsing the globe and / or tearing the lens capsule.

[0004] Various techniques have been designed to mitigate this surge. However, there remains a need for improved ophthalmic systems that mitigate post-occlusion surges and maintain a stable IOP under different flow conditions. The present disclosure overcomes one or more deficiencies in the prior art. SUMMARY

[0005] In certain embodiments, a surgical cassette for an ophthalmic surgical system includes an irrigation conduit, an aspiration conduit, an aspiration pump, a reservoir, a valve, one or more pressure sensors, and a computer. The irrigation conduit is in fluid communication with a handpiece and delivers fluid to a surgical site. The aspiration conduit is in fluid communication with the handpiece and carries fluid away from the surgical site. The aspiration pump generates a vacuum pressure in the aspiration conduit to direct fluid through the aspiration conduit toward a drain. The reservoir contains fluid and is coupled to a pressure-vacuum source to manage a reservoir pressure of the reservoir. The valve is in fluid communication with the aspiration conduit and the reservoir and provides one or more passageways between the aspiration conduit and the reservoir. Each sensor detects a pressure associated with the surgical site. The computer controls the valve in response to the pressures detected by the one or more pressure sensors to reduce pressure variations and / or volume variations.

[0006] Embodiments can not include or can include one, some or all of the following features:

[0007] In certain embodiments, the computer controls the valve to reduce the vacuum pressure in the suction conduit when the pressure associated with the surgical site is less than a first pressure threshold.

[0008] In certain embodiments, the computer controls the valve to reduce the vacuum pressure by controlling the valve to provide one or more passageways to allow fluid from the reservoir to the suction conduit. In certain cases, the computer controls the valve to provide one or more passageways by controlling the valve to provide a first passageway from the reservoir to the suction pump or a second passageway from the reservoir to a suction connector configured to be coupled to the handpiece. In other cases, the computer controls the valve to provide one or more passageways by controlling the valve to provide a first passageway from the reservoir to the suction pump and a second passageway from the reservoir to a suction connector configured to be coupled to the handpiece.

[0009] In certain embodiments, the first pressure threshold can have a value in a range of 0 to 207 mmHg.

[0010] In certain embodiments, the first pressure sensor detects when the pressure associated with the surgical site is less than the first pressure threshold. In certain cases, the first pressure sensor includes a perfusion pressure sensor configured to detect a perfusion pressure within a perfusion conduit. In other cases, the first pressure sensor includes a perfusion pressure sensor configured to detect a perfusion pressure of the surgical site. In other cases, the first pressure sensor includes a handpiece pressure sensor positioned on the handpiece.

[0011] In certain embodiments, the computer controls the valve to reduce the vacuum pressure in the suction conduit when the pressure associated with the surgical site is less than a first pressure threshold. In certain cases, the computer controls the valve to stop the reduction of the vacuum pressure in the suction conduit by controlling the valve to stop allowing fluid after a predetermined period of time. In other cases, the computer controls the valve to stop the reduction of the vacuum pressure in the suction conduit by controlling the valve to stop allowing fluid when a diverter of the valve reaches a closed angle.

[0012] The computer controls the valve to stop the reduction of the vacuum pressure in the suction conduit by controlling the valve to stop allowing fluid when the pressure associated with the surgical site reaches a second pressure threshold. In certain cases, the second pressure threshold has a value between 0 and 760 mmHg. In certain cases, a second pressure sensor detects when the pressure associated with the surgical site reaches the second pressure threshold. The second pressure sensor can include a suction pressure sensor that detects a suction pressure within the suction conduit.

[0013] In certain embodiments, the surgical cassette further includes a perfusion pump in fluid communication with the perfusion conduit and the reservoir. The perfusion pump provides a perfusion fluid pressure to the reservoir.

[0014] In certain embodiments, the pressure-vacuum source maintains a reservoir pressure of the reservoir at a specific pressure in a range of 0 to 500 mmHg.

[0015] In certain embodiments, the valve is positioned at the reservoir.

[0016] In certain embodiments, the valve is positioned along the suction conduit and between the suction connector and the reservoir. The suction connector can be coupled to the handpiece.

[0017] In certain embodiments, a surgical cassette for an ophthalmic surgical system includes a perfusion conduit, a suction conduit, a suction pump, a reservoir, a valve, one or more pressure sensors, and a computer. The perfusion conduit is in fluid communication with the handpiece and delivers fluid to the surgical site. The suction conduit is in fluid communication with the handpiece and carries fluid away from the surgical site. The suction pump generates a vacuum pressure in the suction conduit to direct fluid through the suction conduit toward a drain. The reservoir contains fluid and is coupled with a pressure-vacuum source to manage a reservoir pressure of the reservoir. The valve is in fluid communication with the suction conduit, the reservoir, and the suction pump and provides one or more passageways between the suction conduit, the reservoir, and the suction pump. Each sensor detects a pressure associated with the surgical site. The computer controls the valve in response to the pressure detected by the one or more pressure sensors to reduce pressure variations and / or volume variations.

[0018] In certain embodiments, a method for surge mitigation in an ophthalmic surgical system includes carrying fluid toward a surgical site through a perfusion conduit that is in fluid communication with a handpiece, carrying fluid away from the surgical site through a suction conduit that is in fluid communication with the handpiece, generating a vacuum pressure in the suction conduit through a suction pump to direct fluid through the suction conduit toward a drain, providing one or more passageways between the suction conduit and a reservoir through a valve, the reservoir configured to be coupled with a pressure-vacuum source to manage a reservoir pressure of the reservoir, the valve in fluid communication with the suction conduit and the reservoir, detecting a pressure associated with the surgical site through one or more pressure sensors, and controlling the valve through a computer in response to the pressure detected by the one or more pressure sensors to reduce pressure variations and / or volume variations. BRIEF DESCRIPTION OF DRAWINGS

[0019] Figure 1 FIG. illustrates an example of an ophthalmic surgical system that can be used to perform ophthalmic surgery on an eye;

[0020] Figure 2 is Figure 1a block diagram of a surgical console of an ophthalmic surgical system of

[0021] Figure 3 a schematic diagram illustrating a fluidics subsystem that can be used with Figure 1 and Figure 2 a surgical console of

[0022] Figures 4A to 4F a schematic diagram illustrating a fluidics subsystem of Figure 3 examples of operations that can be performed by valves of

[0023] Figures 5A to 5F examples of valve operations that can be controlled to perform valve operations of Figures 4A to 4F

[0024] Figure 6 examples of methods that can be used by a fluidics subsystem of Figure 3 to mitigate post-occlusion surge; and

[0025] Figure 7 another example of a method that can be used by a fluidics subsystem of Figure 3 to mitigate post-occlusion surge. DETAILED DESCRIPTION

[0026] For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to embodiments illustrated in the drawings and specific language will be used to describe these embodiments. It will nevertheless be understood that no limitation of the scope of the disclosure is intended. Alterations and further modifications of the described devices, instruments, methods, and any further applications of the principles of the disclosure are contemplated by those skilled in the art to which the present disclosure pertains. In particular, it is fully intended to use the features, components, and / or steps described with respect to one embodiment in combination with the features, components, and / or steps described with respect to other embodiments of the present disclosure. However, for the sake of brevity, the numerous iterations of these combinations will not be individually described. For the sake of simplicity, in certain instances, identical reference numbers are used throughout the drawings and textual description to indicate like elements or parts.

[0027] ​The present disclosure relates generally to devices, systems, and methods for performing phacoemulsification. During phacoemulsification, mitigating post-occlusion surges can be critical to the success of the procedure. The devices, systems, and methods disclosed herein include a valve and a reservoir for mitigating post-occlusion surges. When an occlusion disruption is detected, the valve allows flow from the reservoir to increase the volume of fluid to reduce the vacuum pressure within the aspiration path connected to the handpiece and pump, thereby reducing or preventing post-occlusion surges. In this way, the valve can reduce pressure changes and / or volume changes, which can be expressed as changes in pressure or volume, where “or” is included. The reservoir can be pressurized to allow for more reactive mitigation. Further, the valve can allow flow from the reservoir through one or more channels. When the pressure is sufficiently restored, the valve can stop reducing the vacuum pressure.

[0028] Figure 1 An example of an ophthalmic surgical system 10 that can be used to perform ophthalmic surgery on an eye is illustrated. In the illustrated example, the system 10 includes a console 100 coupled as shown and described with reference to Figure 2 The console 100, housing 102, display screen 104, foot pedal 108, fluid subsystem 110, and handpiece 112 are described in more detail.

[0029] Figure 2 is Figure 1 a block diagram of the subsystems of the console 100. The console 100 includes a housing 102 that houses a computer 103 and subsystems 106, 110, 116, and 120 that support components 108, 112, 109, and 122. The foot pedal subsystem 106 receives input from the foot pedal 108. The fluidics subsystem 110 provides fluid control to the handpiece 112, the irrigation sleeve 109, and the vitrectomy handpiece 122. The handpiece subsystem 116 supports the handpiece 112. For example, the subsystem 116 can manage ultrasonic oscillations for a phaco handpiece or can provide laser energy to a laser handpiece. The pneumatic vitrectomy cutter subsystem 120 controls the vitrectomy handpiece 122. The display screen 104 displays data provided by the computer 103.

[0030] Figure 3 is a block diagram illustrating a system 10 that can be used to perform ophthalmic surgery on an eye. In the illustrated example, the system 10 includes a console 100 coupled as shown and described with reference to Figure 1 and Figure 2FIG. 1 is a schematic diagram of a surgical console 100 in use with a fluidics subsystem 110. Generally, a computer 103 controls portions of the fluidics subsystem 110 to maintain a target intraocular pressure (IOP) of an eye (which can have a value in a range of 0 to 110 millimeters of mercury (mmHg)) during a surgical procedure. The computer 103 can determine the IOP by measuring a pressure associated with a surgical site of the eye, or a “surgical site pressure.” The surgical site pressure is a pressure that is representative of the intraocular pressure (IOP) of the eye (not necessarily measured at the surgical site). For example, the fluidics subsystem 110 can include a sensor located at or within the eye that can directly measure the IOP of the eye. The fluidics subsystem 110 can then receive a measurement of the surgical site pressure from the sensor. As another example, an irrigation pressure measured at an irrigation conduit and / or an aspiration pressure measured at an aspiration conduit can be representative of the IOP. The surgical site pressure can not be identical to the IOP, but can correspond to the IOP in that a higher surgical site pressure is representative of a higher IOP and a lower surgical site pressure is representative of a lower IOP. The fluidics subsystem 110 has various sensors 330, 365 (described below) that can measure the surgical site pressure.

[0031] The surgical site pressure can have a target range that corresponds to the target IOP of the eye. For example, the irrigation pressure can have a target range of 0 to 110 mmHg (e.g., a value in a range of 0 to 30 mmHg, 30 mmHg to 70 mmHg, or 70 mmHg to 110 mmHg), or the aspiration pressure can have a target range of -760 mmHg to 110 mmHg (e.g., a value in a range of -760 mmHg to -300 mmHg, -300 mmHg to -100 mmHg, or -100 mmHg to 110 mmHg). If the computer 103 determines that the surgical site pressure is outside of the target range, which indicates that the IOP is also outside of the target range, the computer 103 controls the fluidics subsystem 110 to bring the pressure back into the target range. For example, to relieve post-occlusion surges, a first pressure threshold can indicate when the surgical site pressure is below the first threshold in response to a disruption in occlusion, and a second pressure threshold can indicate when the surgical site pressure is acceptable, indicating that the surgical site pressure has recovered. In certain embodiments, when the surgical site pressure is less than the first pressure threshold, the computer 103 controls a valve to reduce a vacuum pressure in the aspiration conduit, and when the surgical site pressure reaches the second pressure threshold, the computer controls the valve to stop reducing the vacuum pressure after a certain time has elapsed or after a swash plate of the valve reaches a closed angle.

[0032] In the illustrated example, the fluidics subsystem 110 has a cassette body 301 that can be housed by the surgical console 100 as a surgical cassette. The fluidics subsystem 110 includes an irrigation system 300 and an aspiration system 305 that are controlled by the computer 103 (e.g., controller 360). The irrigation system 300 and the aspiration system 305 are in fluid communication with the handpiece 112. Being in fluid communication with each other refers to portions that allow fluid to pass between (to and / or from) the portions.

[0033] The console 100 can include one or more handpieces 112 that include an ultrasonic driven phacoemulsification handpiece, a laser handpiece, and / or other suitable handpieces. In certain embodiments, the handpiece 112 can be an ultrasonic driven phacoemulsification handpiece. In the illustrated example, the phacoemulsification handpiece 112 includes an irrigation portion 320, a cutting needle 355, and a handpiece pressure sensor (HPS) 365. The irrigation portion 320 provides fluid to the surgical site and can be an irrigation tip or an irrigation sleeve that surrounds the needle 355. The cutting needle 355 is a hollow needle that vibrates at a fixed frequency to break up tissue. Fluid and tissue can be aspirated through the needle 355.

[0034] In certain embodiments, the handpiece 112 can be a laser handpiece. The laser handpiece uses laser energy to break up the lens to facilitate the phacoemulsification process. In embodiments, the fluidics subsystem 110 supports the laser handpiece in a similar manner to the phacoemulsification handpiece (e.g., providing irrigation and aspiration functions). In certain embodiments, the laser handpiece can include a sensor that measures the surgical site pressure to provide a measure of post-occlusion relief.

[0035] The HPS 365 is an irrigation pressure sensor that detects the irrigation pressure within the irrigation conduit 302. In the illustrated example, the HPS 365 is located on the handpiece 112 proximate to the surgical site, e.g., less than 12 inches from the surgical site. Being proximate to the surgical site can quickly detect changes in pressure (as can occur during occlusion breaks) and allow for real-time surge suppression. In some examples, the HPS 365 detects pressure changes within 50 milliseconds of an occlusion break, which can allow the controller 360 to react to pressure deviations before the IOP is negatively impacted by excessive amounts. In general, the irrigation pressure sensor can be located at any suitable location, e.g., any suitable location of the handpiece 112 (e.g., proximal, distal, or proximate to the irrigation portion 320), along the irrigation conduit, or in any suitable component that is in fluid communication with the surgical site (e.g., within a separate tube or probe).

[0036] The suction system 305 transports fluid from the surgical site to the drain reservoir 340 by creating and maintaining a vacuum pressure (or negative pressure) in the suction conduit 303. The vacuum pressure can be described as a negative pressure. Thus, increasing the vacuum pressure can be described as increasing the negative pressure or decreasing the pressure, and decreasing the vacuum pressure can be described as decreasing the negative pressure or increasing the pressure.

[0037] The suction system 305 includes the suction conduit 303, the valve 337, the reservoir 333, the pressure-vacuum source 336, the aspiration pressure sensor (APS) 330, the suction pump 335, and the drain reservoir 340 in fluid communication along a suction path as shown. The suction conduit 303 provides fluid communication between the suction system 305 and the handpiece 112. In the illustrated example, the suction conduit 303 aspirates from the needle 355 of the handpiece 112. The reservoir 333 stores fluid that can be used for surge mitigation. The pressure-vacuum source 336 maintains and regulates the reservoir pressure of the reservoir 333. For surge mitigation, the reservoir pressure can be in the range of 0 to 500 mmHg (e.g., a value in the range of 0 to 100 mmHg, 100 mmHg to 400 mmHg, or 400 mmHg to 500 mmHg). Examples of the reservoir 333 include a venturi, a drain, a vent, a perfusion tube, and other suitable reservoirs, and the reservoir 333 can be implemented as one or more reservoirs.

[0038] The valve 337 controls the flow to and / or from the reservoir 333 for the handpiece 112. The valve 337 controls the vacuum pressure within the suction conduit 303 by opening and / or closing a passage to mitigate the effects of post-occlusion surges. Examples of the valve 337 include a vent valve, a drain valve, a rotary valve, a variable vacuum relief valve, and other suitable valves, and the valve 337 can be implemented as one or more valves. The valve 337 can be positioned at any suitable location of the fluidics subsystem 110. For example, the valve 337 can be positioned closer to the eye, e.g., near the suction connector, which can improve the mitigation performance. As another example, the valve 337 can be positioned at the reservoir 333 or along the suction conduit 303 between the suction connector and the reservoir 333. See Figures 4A to 4F The valve operation is described in more detail.

[0039] The APS 330 detects the aspiration pressure within the suction conduit 303. The suction pump 335 creates a vacuum pressure within the suction conduit 303 between the pump 335 and the eye to draw fluid from the surgical site and into the drain reservoir 340. The pump 335 can be, for example, a dual-segment elastomeric pump. The drain reservoir 340 receives fluid from the surgical site. The drain reservoir 340 can be a bag or a junction of conduits that receives fluid within the cassette body 301.

[0040] Controller 360 is a computer that controls portions of fluidics subsystem 110, e.g., valves (e.g., 337) and pumps (e.g., 335), in response to pressure sensors (e.g., 330, 365, sensors at or within the eye) to control pressure within conduits 302, 303 to maintain a target pressure at the surgical site. In certain embodiments, controller 360 controls valve 337 to mitigate post-occlusion surges. In embodiments, when the surgical site pressure is less than a first pressure threshold, computer 103 controls valve 337 to reduce vacuum pressure in the suction conduit, and when the surgical site pressure reaches a second pressure threshold, after a certain time has elapsed, or after a swash plate of the valve reaches a closed angle, the computer controls the valve to stop reducing the vacuum pressure.

[0041] Controller 360 can open and / or close a passageway of valve 337 to regulate vacuum pressure in suction conduit 303. A passageway is opened by making it larger. A passageway that is opened to allow maximum fluid flow will be fully open; otherwise, the passageway will be partially open. A passageway is closed by making it smaller. A passageway that is closed so that no fluid passes through will be fully closed; otherwise, the passageway will be partially closed.

[0042] In some embodiments, controller 360 regulates the amount by which a passageway is opened or closed (i.e., the size of the passageway) in accordance with a deviation between the detected pressure and the target pressure. For example, for a larger deviation, the passageway can be larger to allow more fluid. For a smaller deviation, the passageway can be smaller to allow less fluid. In these examples, as the detected pressure reaches the target pressure, the deviation decreases, and thus the passageway can become smaller.

[0043] In certain embodiments, controller 360 can access memory that stores one or more pressure thresholds, and can perform an action in response to a detected pressure reaching a pressure threshold. For example, when the detected pressure reaches a pressure threshold, controller 360 controls the valve to regulate the pressure. In certain embodiments, a first pressure threshold can indicate that the pressure associated with the surgical site has rapidly decreased to an unacceptable level, e.g., in response to an occlusion disruption. In response, controller 360 reduces vacuum pressure in suction conduit 303 to reduce the rapid decrease in the surgical site pressure. A second pressure threshold can indicate that the surgical site pressure has recovered. In response, controller 360 stops reducing the vacuum pressure in suction conduit 303.

[0044] The controller can determine the surgical site pressure from one or more suitable sensors. In certain embodiments, a decrease in perfusion pressure can indicate a decrease in surgical site pressure in response to a surge after an occlusion is relieved. In the illustrated example, one or more perfusion pressure sensors (e.g., HPS 365) detect the perfusion pressure within perfusion conduit 302. The first pressure threshold can define the perfusion pressure at which the controller 360 should decrease the vacuum pressure, and can have any suitable value, such as a value in the range of 0 to 207 mmHg (e.g., a value in the range of 0 to 35 mmHg, 35 mmHg to 100 mmHg, or 100 mmHg to 207 mmHg).

[0045] In certain embodiments, the aspiration pressure can indicate when an acceptable surgical site pressure has been reached in response to a surge after an occlusion is relieved. In the illustrated example, aspiration pressure sensor 330 detects the aspiration pressure. The second pressure threshold can define the aspiration pressure at which the controller 360 should stop decreasing the vacuum pressure, and can have any suitable value, such as a value in the range of 0 to 760 mmHg (e.g., a value in the range of 0 to 30 mmHg, 30 mmHg to 300 mmHg, or 300 mmHg to 760 mmHg). In some embodiments, because the vacuum pressure typically continues to decrease for a small amount of time after the controller 360 takes action to stop decreasing, the second pressure threshold can be selected so that the controller 360 stops decreasing the vacuum pressure before the target IOP range is reached.

[0046] While the above examples use a first pressure threshold defined in terms of perfusion pressure and a second pressure threshold defined in terms of aspiration pressure, the first and second thresholds can be defined by any suitable sensor indicative of pressure at the surgical site in terms of a suitable pressure type used (e.g., aspiration pressure, perfusion pressure, or intraocular pressure). Furthermore, the first and / or second thresholds can be defined in terms of the same or different types of pressure, e.g., both thresholds can be defined in terms of aspiration pressure.

[0047] Figures 4A to 4F An example of the operation of a valve (such as valve 337) that can be controlled to perform is illustrated. In certain embodiments, the controller can move the diverter to an open angle to open a passageway of a rotary valve. As fluid flows through the passageway and the pressure is decreased, the diverter can move in the opposite direction. When the diverter reaches a closed angle, indicating a decrease to a desired pressure, the controller can close the passageway. The open and closed angles can be selected according to the operation of a particular valve in a particular fluidics subsystem 110, particularly according to the pressure reached when the diverter is at a particular angle in the particular fluidics subsystem 110. These angles can be determined by operating the diverter at different angles in the fluidics subsystem 110 and noting the pressure produced.

[0048] (1) Venting of the reservoir. During venting (e.g., for surge mitigation), a channel from reservoir 333 to suction pump 335 and / or a channel from reservoir 333 to suction connector can be opened. Figure 4A A channel from reservoir 333 via reservoir pathway 390 to suction pump 335 via pump pathway 392 and a channel from reservoir 333 via reservoir pathway 390 to suction connector via suction connector pathway 394 are shown for dual venting. Figure 4B A channel from reservoir 333 via reservoir pathway 390 to suction pump 335 via pump pathway 392 is shown for reservoir drainage or for reservoir-driven backflow to a suction path. Figure 4C A channel from reservoir 333 via reservoir pathway 390 to suction connector via suction connector pathway 394 is shown for suction or for reservoir-driven backflow.

[0049] The channels to be opened can be selected according to any suitable factor. For example, if there is a large deviation between the detected pressure and a pressure threshold, both channels can be opened to increase the flow and drain the stored vacuum more quickly. The value of the large deviation can be between, for example, 0 to 35 mmHg (e.g., a value in the range of 0 to 10 mmHg, 10 mmHg to 20 mmHg, or 20 mmHg to 35 mmHg).

[0050] (2) Maintenance of the reservoir. In one example of maintaining a fluid level in reservoir 333, a channel from suction connector to reservoir 333 and a channel from reservoir 333 to suction pump 335 can be opened, such that valve 337 supports different flows for different channels. Pressure-vacuum source 336 can cause a vacuum to arise in reservoir 333 to increase the flow from the suction connector. Figure 4D A channel from suction connector via suction connector pathway 394 to reservoir 333 via reservoir pathway 390 and a channel from reservoir 333 via reservoir pathway 390 to suction pump 335 via pump pathway 392 are shown for reservoir-driven suction using drainage pumping.

[0051] (3) Suction pump-connector passage. A channel between suction connector and suction pump 335 (e.g., from suction connector to suction pump 335 and / or from suction pump 335 to suction connector) can be opened. Figure 4E A channel from suction connector via suction connector pathway 394 to suction pump 335 via pump pathway 392 is shown for suction driven directly by pumping. Figure 4FThis illustrates the passage from the suction pump 335 via pump passage 392 to the suction connector via suction connector passage 394, for pump-driven return flow. In some embodiments, any passage to the reservoir 333 can be closed and / or the pressure-vacuum source 336 can be disabled to prevent fluid from entering or leaving the reservoir 333.

[0052] Figures 5A to 5F The diagrams illustrate what can be controlled to execute. Figures 4A to 4F An example of the operation of valve 337a is provided. Valve 337a can be any suitable valve, for example, a single-channel valve with two paths can be provided.

[0053] Figure 6 The diagram shows that it can be made by Figure 3 The fluid dynamics subsystem 110 is used as an example of method 410 to mitigate post-occlusion surge. The method begins at step 412, where controller 360 monitors pressure associated with the surgical site. In steps 412 and 418, controller 360 may use any suitable sensor (e.g., sensors of fluid dynamics subsystem 110 or sensors directly measuring the IOP of the eye at or inside the eye) to measure the surgical site pressure. In some examples, controller 360 may use a perfusion sensor (e.g., HPS 365) to measure the perfusion pressure as surgical site pressure. In step 414, controller 360 determines whether the surgical site pressure has decreased below a first pressure threshold, indicating, for example, that occlusion interruption has occurred. If no such decrease occurs, the method returns to step 412, where controller 360 continues to monitor the surgical site pressure. If such a decrease occurs, the method proceeds to step 416.

[0054] In step 416, controller 360 reduces the vacuum pressure to initiate the return of surgical site pressure to the target range. In some examples, controller 360 may reduce the vacuum pressure by opening one or more passages of valve 337 to allow fluid to flow from reservoir 333 to aspiration catheter 303. In step 418, controller 360 monitors the surgical site pressure. In some examples, controller 360 may use aspiration pressure sensor 330 to measure the aspiration pressure as surgical site pressure.

[0055] In step 420, the controller 360 determines whether the surgical site pressure has reached (e.g., is equal to or greater than) a second pressure threshold. If the surgical site pressure has not reached the second pressure threshold, the method returns to step 418 to continue monitoring the surgical site pressure. If the surgical site pressure has reached the second pressure threshold, the method continues to step 422, where the controller stops decreasing the vacuum pressure in step 410. In certain examples, the controller 360 closes one or more passages to stop decreasing the vacuum pressure. Then, the method for mitigating post-occlusion surge ends.

[0056] Figure 7 FIG. 13 illustrates another example of a method 1300 that can be used by the fluidics subsystem 110 to mitigate post-occlusion surge. Steps 1302 and 1304 are similar to steps 1202 and 1204 of FIG. 12. Figure 3

[0057] In certain embodiments, the fluidics subsystem 110 performs steps 516a and 518a, and in other embodiments, the fluidics subsystem 110 performs steps 516b and 518b. In certain embodiments, in step 516a, the controller 360 opens one or more passages of the valve 337 to allow fluid flow, thereby decreasing the vacuum pressure. In step 518a, the controller 360 closes the one or more passages after a predetermined time period. The predetermined time period can have any suitable value, for example, a value between 1 millisecond and 10 seconds.

[0058] In other embodiments, in step 516b, the controller 360 moves the diverter of the valve 337 to an open angle along a rotation direction to open one or more passages to allow fluid flow, thereby decreasing the vacuum pressure. As the pressure decreases, the diverter moves along an opposite direction. In step 518b, the controller 360 closes the one or more passages after the diverter reaches a close angle. The open angle and the close angle can be selected according to the operation of the particular valve 337 in the particular fluidics subsystem 110, in particular, according to the pressure achieved when the diverter is at a particular angle in the fluidics subsystem 110.

[0059] In step 520, the controller 360 waits for a wait period before continuing with normal operation. The wait period allows the fluidics subsystem 110 to normalize after the occlusion disruption. The wait period can have any suitable value, for example, a value less than 10 seconds. Then, the method for mitigating post-occlusion surge ends.

[0060] ​The components of the systems and apparatuses disclosed herein (e.g., computer 103 or controller 360) can include interfaces, logic, and / or memory, any of which can include hardware and / or software. An interface can receive input for the components, send output from the components, and / or process the input and / or output. The logic can perform operations of the components. The logic can include one or more electronic devices that process data (e.g., execute instructions to generate output from input). Examples of such electronic devices include computers, processors, or microprocessors (e.g., central processing units (CPUs)) and computer chips. The logic can include computer software encoded on a computer-readable medium that, when executed by an electronic device, performs operations of the components. Examples of computer software include computer programs, applications, and operating systems.

[0061] The memory can store information and can include tangible, computer-readable, and / or computer- executable storage media. Examples of memory include computer memory (e.g., Random Access Memory (RAM) or Read-Only Memory (ROM)), mass storage media (e.g., a hard disk), removable storage media (e.g., a "flash" drive, an optical storage media, etc.), database and / or network storage (e.g., a server), and / or other computer-readable media. Particular embodiments can be directed to a memory encoded with computer software.

[0062] Although the present disclosure has been described in terms of certain embodiments, modifications (e.g., alterations, permutations, additions, subtractions, and / or the like) can be made to the embodiments without departing from the scope of the disclosure. For example, the systems and apparatuses disclosed herein can be modified. The components of the systems and apparatuses can be integrated or separated, and the operations of the systems and apparatuses can be performed by more, fewer, or other components. As another example, the methods disclosed herein can be modified. The methods can include more, fewer, or other steps, and the steps can be performed in any suitable order.

[0063] To help the Patent Office and readers understand the claims, the applicants wish to point out that they do not intend any claim or claim element to invoke 35 U.S.C. § 112(f) unless the word "means" appears expressly in a claim element and is followed by the phrase "for...". The applicants understand that any other use of the word "means" in a claim element is adopted as a patent law term under 35 U.S.C. § 112(b) or 112(f).

Claims

1. A surgical system comprising: An infusion catheter, which is in fluid communication with the handpiece and is configured to deliver fluid to the surgical site; A suction catheter, which is in fluid communication with the handpiece and is configured to carry fluid away from the surgical site; A suction pump configured to generate a vacuum pressure in the suction conduit to direct fluid through the suction conduit to a drain tank. A Venturi reservoir, the Venturi reservoir being configured to contain fluid at a controlled reservoir pressure; A rotary valve located at the Venturi reservoir, wherein the rotary valve comprises: One or more first channels, the one or more first channels being used to provide fluid communication between the aspiration catheter and the Venturi reservoir; One or more second channels, said one or more second channels being used to provide fluid communication between the suction pump and the Venturi reservoir; Wherein, at least one position of the rotary valve provides dual ventilation by providing fluid communication between the suction conduit and the Venturi reservoir and between the suction pump and the Venturi reservoir; A first pressure sensor, configured to detect pressure associated with the surgical site; and A computer configured to control the rotary valve in response to the pressure detected by the first pressure sensor.

2. The system as claimed in claim 1, wherein, The computer is further configured to: When the pressure associated with the surgical site is below a first pressure threshold, the rotary valve is controlled to reduce the vacuum pressure in the aspiration catheter.

3. The system as described in claim 2, wherein, The computer is further configured to: The rotary valve is controlled to reduce the vacuum pressure by controlling the rotary valve to allow fluid to flow from the Venturi reservoir to the suction conduit.

4. The system as described in claim 3, wherein, Controlling the rotary valve to allow fluid from the Venturi reservoir to the suction conduit includes providing a channel from the Venturi reservoir to one of the one or more first channels, the suction connector being configured to be coupled to the head unit.

5. The system as described in claim 3, wherein, The computer is further configured to: The rotary valve is controlled to simultaneously provide one or more first channels between the suction conduit and the Venturi reservoir, and one or more second channels between the suction pump and the Venturi reservoir, for dual ventilation.

6. The system as claimed in claim 2, wherein, The value of the first pressure threshold is in the range of 0 to 207 mmHg.

7. The system as claimed in claim 2, wherein, The first pressure sensor detects when the pressure associated with the surgical site falls below the first pressure threshold.

8. The system of claim 7, wherein, The first pressure sensor includes an infusion pressure sensor configured to detect the infusion pressure within the infusion conduit.

9. The system of claim 7, wherein, The first pressure sensor includes an infusion pressure sensor configured to detect the infusion pressure at the surgical site.

10. The system of claim 7, wherein, The first pressure sensor is located at the machine head.

11. The system of claim 2, wherein, The computer is further configured to: By controlling the rotary valve to stop allowing the fluid after a predetermined time period, the rotary valve is controlled to stop the decrease in vacuum pressure in the suction conduit.

12. The system of claim 2, wherein, The computer is further configured to: By controlling the rotary valve to stop allowing the fluid when the deflector of the rotary valve reaches the closing angle, the rotary valve is controlled to stop the decrease in vacuum pressure in the suction conduit.

13. The system of claim 2, wherein, The computer is further configured to: When the pressure associated with the surgical site reaches a second pressure threshold, the rotary valve is controlled to stop allowing the fluid to flow, thereby controlling the rotary valve to stop the decrease in the vacuum pressure in the aspiration catheter.

14. The system of claim 13, wherein, The value of the second pressure threshold is in the range of 0 to 760 mmHg.

15. The system of claim 13, further comprising: A second pressure sensor detects when the pressure associated with the surgical site reaches a second pressure threshold.

16. The system of claim 15, wherein, The second pressure sensor includes a suction pressure sensor configured to detect suction pressure within the suction conduit.

17. The system of claim 1, wherein, The reservoir pressure of the Venturi reservoir is maintained at a specific pressure within the range of 0 to 500 mmHg.

18. The system of claim 1, wherein, The rotary valve is positioned along the suction conduit and between the suction connector and the Venturi reservoir, the suction connector being configured to connect to the head.

19. The system of claim 1, wherein, The computer is further configured to disable the pressure-vacuum source connected to the Venturi reservoir.

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