Tapered optical fiber for surgical instrument

Abstract

Embodiments disclosed herein relate to devices and systems for ophthalmic surgery. In some embodiments, a handpiece device for use with a surgical system is provided. The handpiece device includes a housing, a cable assembly, and a tapered optical fiber. A cable assembly is disposed through the distal end of the housing and optically coupled to the tapered fiber. A diameter of the tapered fiber decreases between a proximal end and a distal end of the tapered fiber. In some embodiments, the tapered fiber includes a single crystal fiber. In further embodiments, the tapered fiber includes a tapered sapphire core fiber.

Description

Cross-reference to related applications

[0001] This application claims priority to U.S. Provisional Application No. 63 / 581,700, filed September 11, 2023, which is incorporated herein by reference in its entirety. Background Technology

[0002] Lasers are used in various ophthalmic surgeries to perform procedures and / or treat a patient's anatomy. For example, in laser emulsification, a probe of a microsurgical instrument projects a laser beam to emulsify and ablate the lens of the eye for cataract removal. In vitrectomy, the surgeon inserts a microsurgical instrument, such as a vitrectomy probe, through one or more incisions made in the eye to remove and excise the vitreous humor within the eye. The microsurgical instruments used in this procedure can perform one or more functions of the surgery using a laser emitted by a laser system and transmitted through one or more optical fibers terminated distally within the probe. In some cases, such as in vitrectomy, the vitrectomy probe uses a laser delivered from a laser system to remove the vitreous humor, followed by aspiration of the removed biological material for removal. Summary of the Invention

[0003] This disclosure generally relates to optical fibers, and more specifically to components for energy delivery in surgical laser systems. In some embodiments, a handheld device for ophthalmic surgery is provided. The handheld device includes a housing and a cable assembly disposed within the housing, wherein the cable assembly extends from a supply port at a proximal end of the housing. The cable assembly includes an optical fiber optically connected to a tapered optical fiber disposed within the housing and having a diameter decreasing between the proximal and distal ends of the tapered optical fiber. The proximal end of the tapered optical fiber is optically coupled to the distal end of the optical fiber in the cable assembly.

[0004] In some embodiments, a cable assembly for a surgical system is provided. The cable assembly includes an optical fiber having a proximal end and a distal end, a first tapered optical fiber having a proximal end and a distal end, and a second tapered optical fiber. The distal end of the first tapered optical fiber is optically coupled to the proximal end of the optical fiber, wherein the first tapered optical fiber includes a first diameter decreasing from the proximal end to the distal end of the first tapered optical fiber, and the diameter of the distal end of the first tapered optical fiber is smaller than the diameter of the proximal end of the optical fiber. The proximal end of the second tapered optical fiber is optically coupled to the distal end of the optical fiber.

[0005] In other embodiments, a surgical system is provided. The surgical system includes a surgical console with a laser system and a handheld device communicating with the laser system. The handheld device includes a housing and a cable assembly disposed within the housing and extending from a supply port at a proximal end of the housing, wherein the cable assembly includes an optical fiber having a proximal end and a distal end. The handheld device also includes a tapered optical fiber disposed within the housing and having a diameter decreasing between the proximal and distal ends of the tapered optical fiber, wherein the proximal end of the optical fiber is optically coupled to the laser system, and the distal end of the optical fiber is optically coupled to the proximal end of the tapered optical fiber. Attached Figure Description

[0006] To gain a detailed understanding of the features described above, reference can be made to the embodiments for a more specific description of the briefly summarized disclosure, some of which are illustrated in the accompanying drawings. However, it should be noted that the drawings only illustrate exemplary embodiments and should not be construed as limiting their scope, and other equally effective embodiments are permissible.

[0007] Figure 1A A side view of an exemplary surgical system for use during ophthalmic surgical procedures, according to certain embodiments of this disclosure, is shown.

[0008] Figure 1B This disclosure illustrates certain embodiments of the functionality that can be implemented according to this disclosure. Figure 1A A perspective view of an exemplary handheld device implemented in a surgical system.

[0009] Figure 1C This disclosure illustrates certain embodiments of the functionality that can be implemented according to this disclosure. Figure 1A A longitudinal cross-sectional view of an exemplary handheld device implemented in a surgical system.

[0010] Figure 2A Certain embodiments according to this disclosure are shown. Figure 1B and Figure 1C A plan view of the far end of the handheld device.

[0011] Figures 2B to 2D Certain embodiments according to this disclosure are shown. Figure 1B and Figure 1C Longitudinal cross-sectional view of the distal end of the handheld device.

[0012] Figure 3 This disclosure illustrates certain embodiments of the functionality that can be implemented according to this disclosure. Figure 1A A longitudinal schematic diagram of an exemplary cable assembly implemented in a surgical system.

[0013] Figure 4 This disclosure illustrates certain embodiments of the functionality that can be implemented according to this disclosure. Figure 1AA longitudinal schematic diagram of another exemplary cable assembly implemented in the surgical system.

[0014] For ease of understanding, the same reference numerals have been used where possible to refer to common elements in the figures. It is contemplated that elements and features of one embodiment may be advantageously combined in other embodiments without further description. Detailed Implementation

[0015] In the following description, details are illustrated by way of example to aid understanding of the disclosed subject matter. However, it will be clear to those skilled in the art that the disclosed embodiments are exemplary and not an exhaustive list of all possible implementations. Therefore, it should be understood that references to the described examples are not intended to limit the scope of this disclosure. Those skilled in the art to which this disclosure pertains will generally be fully capable of conceiving any changes and further modifications to the described apparatus, instruments, and methods, as well as any further applications of the principles of this disclosure. In particular, it will be fully contemplated that features, components, and / or steps described for one embodiment can be combined with features, components, and / or steps described for other implementations of this disclosure.

[0016] It should be noted that, as described herein, the distal end, distal segment, or distal portion of a component refers to the end, segment, or portion of the component that is closer to the patient's body during use. On the other hand, the proximal end, proximal segment, or proximal portion of a component refers to the end, segment, or portion that is farther from the patient's body and closer to, for example, a surgical console.

[0017] As used herein, the term "about" can refer to a variation of + / - 10% from the nominal value. It should be understood that any value provided herein may include such variation.

[0018] The embodiments disclosed herein generally relate to optical fibers used with surgical systems, and more specifically to tapered optical fibers used with surgical laser systems and microsurgical instruments connected thereto. The methods, systems, and devices described herein can be used in combination with any suitable surgical instruments for ophthalmic surgery that have light-emitting capabilities (e.g., lasers, illumination lights, etc.), such as the surgical instruments described below.

[0019] In surgical systems using lasers in ophthalmic surgery, such systems typically rely on delivering laser energy from a laser source to the patient via one or more optical fiber assemblies. In such systems, the optical fiber assembly may include one or more optical fibers extending between the laser source and the microsurgical instruments. In use, the laser delivered by the one or more optical fibers can be projected from the probe of the microsurgical instrument for surgical procedures. Various characteristics of the one or more optical fibers can affect laser delivery and how these fibers are implemented within the microsurgical instruments. For example, both the diameter and material of the one or more optical fibers can affect the efficiency of laser transmission, as well as the flexibility and durability of the corresponding optical fiber assembly.

[0020] Microsurgical instruments commonly used in such procedures also provide suction via probes during the surgical process. Therefore, the diameter of the optical fiber can affect how the fiber and / or cable assembly is integrated with the microsurgical instrument, such as extending the fiber through the probe of the instrument and maintaining sufficient space within the probe for suction. However, with the increasing use of surgical instruments with smaller probes (e.g., due to their potential for improved safety and shorter healing times) in ophthalmic surgery, correspondingly smaller diameter optical fibers are needed to deliver laser light to the probe and provide continuous suction through the probe of the microsurgical instrument. Therefore, to enable microsurgical instruments to simultaneously provide laser and suction functions, a balance between efficient laser transmission via the optical fiber and maintaining sufficient space within the probe (e.g., around the fiber) for suction is crucial.

[0021] In some existing surgical systems, the fiber optic cable assembly used to deliver lasers includes optical fibers with a core of 200 µm (micrometers). In such systems, reducing the diameter of some fibers (e.g., reducing the fiber core to below 200 µm) to accommodate smaller probes in microsurgical instruments connected to these fibers can lead to unacceptable optical transmission losses. For example, some fibers exhibit optical loss when used to deliver lasers over long distances (e.g., distances greater than approximately 50 mm, such as approximately 2 meters). Furthermore, as the fiber diameter decreases, the fiber's durability also decreases, thus shortening the lifespan of this component. On the other hand, fibers with a core of 200 µm (or larger), suitable for transmitting lasers over longer distances from the laser source, may be relatively stiff and easily impede the movement of microsurgical instruments connected to them. In this case, one or more fibers with a core of 200 µm (or larger) may further present ergonomic problems for the end user or surgeon manipulating the microsurgical instruments.

[0022] Embodiments of this disclosure provide a system for laser transmission via one or more optical fibers that reduce optical loss and the likelihood of cable assembly failure when delivering laser light from a laser source to a probe of a microsurgical instrument. As discussed in further detail below, the various techniques described herein achieve a tapered optical fiber that allows laser light to be projected from the probe through the distal end of the fiber with a reduced diameter. For example, a tapered optical fiber can be used to transmit laser light through a smaller diameter fiber or a portion of a fiber disposed within the probe of a microsurgical instrument to enable aspiration and / or improve flow through the probe. A tapered optical fiber can also be used to reduce the diameter of a portion of the fiber disposed near a microsurgical handpiece device to increase the flexibility of the fiber at that specific portion.

[0023] In some aspects, one or more optical fibers extending between a laser source and a probe of a microsurgical instrument in an optical cable assembly may include two or more fibers coupled together to provide specific characteristics to different parts of the optical cable assembly (e.g., a fiber with greater flexibility coupled to a fiber with better transmission performance). When laser is transmitted through the cores of two or more fibers, the cores of adjacent fibers are aligned when the fibers are coupled together to facilitate laser transmission between the corresponding cores of the coupled fibers. However, due to tolerances in the diameter and centrality of the cores of each such coupled fiber, a portion of the laser transmitted between the coupling ends of adjacent fibers (e.g., at the coupling interface, the distal end of one fiber and the proximal end of an adjacent fiber) may be partially delivered to the adhesive surrounding the cores of the fibers. In this case, stray energy from the laser can heat the adhesive of the fiber receiving the laser, ultimately damaging the optical cable assembly and / or causing it to fail.

[0024] Embodiments of this disclosure include techniques for implementing tapered optical fibers at coupling interfaces between adjacent optical fibers in an optical cable assembly. The tapered optical fiber positioned at the coupling interface between adjacent coupled optical fibers can help focus laser delivery onto a smaller area aligned with the core of the laser-receiving fiber. By utilizing tapered optical fibers to couple adjacent optical fibers, the techniques described herein reduce the likelihood of alignment with the adhesive portion of the coupled optical fibers and / or the optical cable assembly and correspondingly delivering stray laser energy to the adhesive.

[0025] Figure 1AExemplary surgical systems 100 for performing laser-assisted ophthalmic surgery according to certain embodiments of this disclosure are illustrated. In some embodiments, surgical system 100 may include a surgical console similar to known and used ophthalmic surgical consoles (such as the CONSTELLATION® vision system available from Alcon Laboratories, Inc. (Fort Worth, Texas, USA) or the CENTURION® vision system available from Alcon Laboratories, Inc. (Fort Worth, Texas, USA), or any other ophthalmic surgical console suitable for the principles described herein.

[0026] As shown, the surgical system 100 includes a laser system 102 having one or more laser sources connected to a handheld device 112 via a cable assembly 111. The surgical system 100 may also include a suction system 108 having a vacuum source in fluid communication with the handheld device 112 to provide suction via the handheld device 112. In some embodiments, the laser system 102 and / or the suction system 108 may be part of or incorporated into the aforementioned surgical console. The suction system 108 may also be connected to the handheld device 112 via the cable assembly 111. In some embodiments, the cable assembly 111 may include one or more cables connected together. In some embodiments, the cable assembly 111 includes one or more optical fibers for delivering laser light from the laser system 102 to the handheld device 112. In some embodiments, the cable assembly 111 may further include a vacuum line for providing suction to the handheld device 112.

[0027] In some embodiments, the handheld device 112 may include a vitrectomy probe for laser-assisted surgery, such as for cutting vitreous fibrous material in a patient's eye. Figure 1AA handheld device 112 is shown with a probe 110 inserted into the vitreous humor of a patient's eye 125 to perform ophthalmic surgery. As the probe 110 moves through the vitreous humor, a laser is emitted within the probe 110 by one or more optical fibers of a cable assembly 111. A user (e.g., a surgeon) can use a switch on the handheld device 112, a foot pedal connected to the surgical system 100, or other means to switch the laser between an open and closed position. The switch and / or foot pedal can also be configured to control suction performed by the handheld device 112, such as for removing severed vitreous humor from the intraocular space of the eye 125 during vitreoretinal surgery. In other embodiments, the handheld device 112 can be configured to perform other laser-assisted ophthalmic procedures using the laser delivered to the handheld device 112 by one or more optical fibers of the cable assembly 111, such as ablation (e.g., for treating the anterior segment of the eye 125) and phacoemulsification. In other words, Figure 1A The handheld device 112 shown is merely exemplary and for illustrative purposes only. In particular, although the handheld device 112 illustrates a vitrectomy handheld device with the probe 110 inserted into the vitreous body, the embodiments herein are similarly applicable to handheld devices used in other surgical procedures such as photocoagulation, photoemulsification, and / or phacoemulsification.

[0028] Figure 1B A perspective view is shown of an exemplary handheld device 112 that can be implemented in the surgical system 100 described above, according to certain embodiments of this disclosure. The handheld device 112 includes a probe 110 and a housing 120. The probe 110 is disposed partially and longitudinally through the distal end 121 of the housing 120 and can be directly or indirectly attached to the distal end in an internal cavity of the housing 120.

[0029] The housing 120 further includes one or more supply ports 123 at its proximal end 124 (e.g., Figure 1B A supply port 123 is depicted for routing one or more supply lines into the internal cavity of the housing 120. For example, the supply port 123 may provide a connection between the housing 120 and a cable assembly 111 disposed through the proximal end 124 of the housing 120. The supply port 123 may also provide a connection to a suction system 108 for suction by a handheld device 112. In some embodiments, the handheld device 112 may be sterilized and used in more than one surgical procedure, or the handheld device 112 may be a disposable device. In the case where the handheld device 112 is a disposable device, the cable assembly 111 is connected and disconnected from the housing 120 via the supply port 123 before and after each surgical procedure.

[0030] In some embodiments, the housing 120 may have an outer surface configured for gripping by a user (such as a surgeon). For example, the contours of the housing 120 may be ergonomically designed to substantially conform to the user's hand. Figure 1B As shown, the outer surface may be textured or have one or more gripping features formed thereon, such as one or more grooves and / or ridges. The housing 120 may be made of any material commonly used in such instruments and suitable for ophthalmic surgery. For example, the housing 120 may be formed of lightweight aluminum, polymers, or other suitable materials.

[0031] The distal end of the cable assembly 111 is coupled to the handheld device 112. In some embodiments, the proximal end of the cable assembly 111 may further be coupled to a laser system 102 having a light source (e.g., a laser source, an illumination source, etc.). One or more optical fibers of the cable assembly 111 are configured to deliver laser light provided by the laser source to the handheld device 112. In some embodiments, the proximal end of the cable assembly 111 may also be connected to a vacuum source, such as the vacuum source of the suction system 108, for providing suction to the handheld device 112.

[0032] In some embodiments, the cable assembly 111 has a length between about 1 meter and about 3 meters, such as about 2 meters, but in some embodiments, it may have a longer or shorter length. In some embodiments, the cable assembly 111 includes one or more optical fibers 113. In some embodiments, the optical fiber 113 includes a core and a cladding circumferentially surrounding the core. Typically, one or more optical fibers 113 of the cable assembly 111 may be disposed in a cable coating to further support and protect each of the one or more optical fibers 113.

[0033] In some embodiments, the core of optical fiber 113 may comprise any transparent material, such as fused silica or glass. In some embodiments, optical fiber 113 may comprise germanate glass (e.g., GeO2), fluoride glass (e.g., ZBLAN, aluminum fluoride, etc.) or other materials. In some embodiments, the core of optical fiber 113 may be doped. For example, the core of optical fiber 113 may be germanium-doped silicon dioxide. Doping the core of optical fiber 113 with germanium or a similar dopant can increase the refractive index of the core of optical fiber 113 relative to the refractive index of the cladding, thereby achieving laser-guided properties within the core of optical fiber 113. The cladding may also comprise a transparent material, such as fused silica or glass. In some embodiments, the cladding is doped in addition to or instead of doping the core. For example, the cladding, which may comprise fused silica, is doped with a dopant that lowers the refractive index of the cladding relative to the refractive index of the core. Exemplary dopant includes fluorine (F), chlorine (Cl), boron (B), etc. When doped, the cladding has a lower refractive index than the core, thus enabling light-guiding properties within the core.

[0034] In some embodiments, optical fiber 113 includes a hollow-core optical fiber capable of guiding light through a hollow region / air core within the fiber. In some embodiments, optical fiber 113 may be a hollow-core optical fiber with a silver reflective coating, a hollow-core photonic crystal fiber, or an anti-resonant hollow-core optical fiber.

[0035] Figure 1C A longitudinal cross-sectional view of the handheld device 112 is shown, in which an optical fiber 113 of the cable assembly 111 is coupled to a tapered optical fiber 128 disposed within a housing 120. As discussed above, the distal end 127 of the optical fiber 113 extends from the proximal end 124 of the housing 120 into the housing 120. In some embodiments, the core of the optical fiber 113 may have a diameter between about 170 µm and about 280 µm, for example, between about 200 µm and about 250 µm, but in some embodiments, it may have a larger or smaller diameter. In some embodiments, the core and cladding of the optical fiber 113 have a combined diameter between about 180 µm and about 400 µm, for example, between about 180 µm and about 250 µm, or between about 250 µm and about 400 µm, or between about 200 µm and about 300 µm, for example, about 230 µm, but in some embodiments, it may have a larger or smaller combined diameter.

[0036] In some embodiments, optical fiber 113 is coupled to tapered optical fiber 128 to enable laser transmission from housing 120 through probe 110 of handheld device 112. For example... Figure 1C (and further discussed and shown below) Figure 1C A magnified detailed view of the selected portion Figure 2D As shown, the proximal end 129 of the tapered optical fiber 128 is connected to the distal end 127 of the optical fiber 113 at the coupling interface 132 within the housing 120. See below (for example, refer to...). Figure 2C and Figure 2D In more detail, the distal portion of the tapered optical fiber 128 includes a diameter smaller than that of the core and / or cladding of the optical fiber 113, thereby allowing the tapered optical fiber 128 to extend partially into the probe 110. As discussed above, in some embodiments, the tapered optical fiber 128, partially disposed within the probe 110, is configured to project a laser beam from the distal end of the tapered optical fiber into the interior of the probe 110 (e.g., for laser-assisted ophthalmic functions, such as cutting vitreous material).

[0037] In the housing 120, the handheld device 112 further includes a collar 126 disposed at and surrounding the distal end 127 of the optical fiber 113, adjacent to a collar 130 disposed at the proximal end 129 of the tapered optical fiber 128. In some embodiments, the distal end 127 of the optical fiber 113 and the collar 126 disposed thereon are in optical contact (e.g., mating coupling) with the proximal end 129 of the tapered optical fiber 128 and its collar 130, so that laser light can be transmitted from the optical fiber 113 of the cable assembly 111 to the tapered optical fiber 128.

[0038] In some embodiments, a small air gap may be formed at the coupling interface 132 between the mating coupling ends of the optical fiber 113 and the tapered optical fiber 128. In some embodiments, portions of the optical fiber 113, the tapered optical fiber 128, and the collars 126 and 130 at the coupling interface 132 are further disposed within a sleeve 131 to maintain the optical connection between the optical fiber 113 and the tapered optical fiber 128. In some embodiments, the sleeve 131 comprises a cylindrical tube configured to clamp the coupling ends of the collars 126 and 130 and the ends of the optical fiber 113 and the tapered optical fiber 128 at the coupling interface 132. The collars 126 and 130 and the sleeve 131 help protect and align the coupling ends of the optical fiber 113 and the tapered optical fiber 128 to reduce transmission loss at the coupling interface 132. In some embodiments, the collars 126 and 130 may be or comprise metal tubes, ceramic tubes, sapphire tubes, or other materials.

[0039] As described above, in some embodiments, the handheld device 112 is intended for single-use application, and thus a user can connect a new handheld device 112 to the cable assembly 111 before each surgical procedure. In some embodiments, the distal end 127 of the optical fiber 113 and the ferrule 126 disposed thereon are configured to be removably connected to the proximal end 129 and ferrule 130 of the tapered optical fiber 128, such that the distal end 127 and ferrule 126 can be detached from and removed from the housing 120. To disconnect the cable assembly 111 from the handheld device 112, the user retracts the distal end 127 and ferrule 126 of the optical fiber 113 from the sleeve 131 and the proximal end 124 of the housing 120. To connect the cable assembly 111 to a new handheld device 112, the user then inserts the distal end of the optical fiber 113 and the ferrule 126 disposed thereon into the sleeve 131 of the new handheld device 112 to couple the optical fiber 113 and the tapered optical fiber 128 in the new handheld device 112 together.

[0040] Figure 2AA plan view of probe 110 and the distal end 121 of housing 120 is shown. As illustrated, probe 110 may be an elongated laser-cutting member that can be inserted into the eye (e.g., by inserting the probe for performing laser-assisted ophthalmic surgery, which may be aspiration-based or non-aspiration-based). Therefore, probe 110 may be formed of a material suitable for minimally invasive ophthalmic surgery. In some embodiments, probe 110 includes one or more segments formed of a material configured to transmit laser, visible light, ultraviolet light, infrared light, or any other type of light. For example, probe 110 may include one or more segments formed of a translucent or transparent material (such as plastic and / or polymer materials). Probe 110 may further include one or more segments formed of more conventional surgical-grade materials (such as stainless steel and / or aluminum).

[0041] In some embodiments, the probe 110 has a length L1 between about 15 mm and about 30 mm, but in some embodiments, it may have a longer or shorter length. In some embodiments, the handheld device 112 further includes a reinforcing member 230 that is fixedly or slidably coupled to at least a portion of the probe 110 and substantially surrounds at least a portion of the probe. For example, the reinforcing member 230 may be slidably coupled to the outer surface 236 of the probe 110. Figures 2B to 2C (As shown), and can extend from and retract into the housing 120. The stiffener 230 can be adjustable relative to the probe 110, allowing the user to position the stiffener 230 at different points along the length L1 of the probe 110 outside the housing 120. Accordingly, the user can selectively adjust the stiffness level of the probe 110 by repositioning the stiffener 230 relative to the distal end 216, thereby manipulating the amount of support provided to the probe 110 and stabilizing the handheld device 112 during its use.

[0042] Figure 2B A longitudinal cross-sectional view is shown of a probe 110 and the distal end 121 of a housing 120 in which a tapered optical fiber 128 is disposed, according to certain embodiments of the present disclosure. Figure 2C A close-up partial longitudinal cross-sectional view of the extension of the tapered optical fiber 128 into the probe 110 according to certain embodiments of this disclosure is shown. Figure 2D A longitudinal cross-sectional view is shown illustrating the coupling of tapered optical fibers 128 and 113 at coupling interface 132 according to certain embodiments of this disclosure. For clarity, this document will... Figures 2B to 2D Combined descriptions.

[0043] like Figure 2BThe probe 110 depicted includes a lumen 260 and a port 222 located near a distal end 216. The lumen 260 may have an inner diameter D1 ranging from about 220 µm to about 500 µm. In some embodiments, the lumen 260 has a substantially circular cross-section. However, a lumen 260 with a non-circular cross-section (e.g., square or octagonal) is also contemplated. In some embodiments, the port 222 is sized and shaped to allow vitreous collagen fibers to enter the lumen 260 during vitrectomy. Vitreous collagen fibers can be aspirated into the lumen 260 through the port 222. In some embodiments, the distal end 242 of a tapered optical fiber 128 is configured such that the tapered optical fiber 128 projects a laser beam across the port 222 to cut the vitreous collagen fibers disposed within the lumen 260. In some other embodiments, the port 222 may be configured such that the distal end 242 of the tapered optical fiber 128 is configured to project a laser beam from the distal end 216 of the probe 110.

[0044] like Figure 2C As shown, the tapered optical fiber 128 can be rigidly suspended within the cavity 260, such that the tapered optical fiber 128 is separated from the inner sidewall of the probe 110 and circumferentially surrounded by the annular gap 228. In some embodiments, the positioning of the tapered optical fiber 128 is maintained by an adhesive disposed around the distal end of the adjacent ferrule 130, such as... Figure 2C As shown. The annular gap 228 formed between the tapered optical fiber 128 and the inner sidewall of the probe 110 provides a coaxial path for aspirating, cutting, and / or severing vitreous material through the probe 110. In some embodiments, the tapered optical fiber 128 may be centrally disposed within the lumen 260 such that the radial distance between the inner sidewall and the tapered optical fiber 128 is uniform along the circumference of the tapered optical fiber 128.

[0045] In some embodiments, the tapered optical fiber 128 has a length between about 30 mm and about 50 mm, for example, between about 35 mm and about 43 mm, for example, about 40 mm, but in some embodiments, it may have a longer or shorter length. Figure 2A and Figure 2B As shown, the distal end 242 of the tapered optical fiber 128 can terminate at any point along the length L1 of the probe 110 to achieve optimal cutting and suction of the glass fiber. In some embodiments, the distal end 242 of the tapered optical fiber 128 terminates within the lumen 260 at a point distal to the proximal end 224 of the port 222. In some other embodiments, the distal end 242 of the tapered optical fiber 128 terminates within the lumen 260 at a point substantially aligned with the proximal end 224 of the port 222. In yet another embodiment, the distal end 242 of the tapered optical fiber 128 terminates within the lumen 260 at a point proximal to the proximal end 224 of the port 222.

[0046] As described above, the tapered fiber 128 includes a tapered diameter such that the diameter D2 of the portion of the tapered fiber 128 disposed in the probe 110 is smaller than the diameter D3 of the portion of the tapered fiber 128 disposed in the housing 120, and therefore can also be smaller than the diameter of the distal end 127 of the fiber 113. Reducing the diameter of the portion of the tapered fiber 128 in the probe 110 correspondingly increases the annular gap 228 circumferentially surrounding the tapered fiber 128 in the probe 110, and / or maintains the annular gap 228 in a smaller-sized probe 110. Increasing the size of the annular gap 228 in the probe 110 achieves sufficient flow through the lumen 260, which in turn is beneficial for aspirating fluid or vitreous material cut off by the laser beam projected from the tapered fiber 128. Having a sufficient annular gap 228 in the probe 110 is also advantageous for preventing blockage in the probe 110 during such aspiration and / or reducing the chance of blockage occurring in the probe during such aspiration.

[0047] In some embodiments, the diameter D3 of the proximal end 129 of the tapered fiber 128 at the coupling interface 132 can substantially match the diameter of the distal end 127 of the fiber 113, for example, between about 180 µm and about 300 µm, or between about 200 µm and about 250 µm, or about 200 µm; however, in some embodiments, it can have a larger or smaller diameter. Starting from the proximal end 129, the diameter of the tapered fiber 128 tapers or decreases as it approaches the probe 110. In some embodiments, the diameter D2 of the portion of the tapered fiber 128 disposed in the lumen 260 of the probe 110 can be between about 50 µm and about 150 µm, for example, between about 80 µm and 120 µm, or about 100 µm; however, in some embodiments, depending on the size of the lumen 260, it can have a larger or smaller diameter.

[0048] In some embodiments, the tapered optical fiber 128 comprises a single-crystal optical fiber, which is at least partially disposed within the cable coating to protect the tapered optical fiber 128 from surface contamination. In some embodiments, the single-crystal optical fiber of the tapered optical fiber 128 is a single-crystal sapphire optical fiber made of α-Al₂O₃. In other embodiments, the single-crystal optical fiber of the tapered optical fiber 128 may be made of Ti:sapphire, Y₃Al₅O₃, etc. 12It can be made of (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF4-BaF2-LaF3-AlF3-NaF (ZBLAN). However, any material capable of propagating laser 241 and its wavelength can be used and is also contemplated, as discussed further below. In this embodiment, the single-crystal fiber lacks a cladding compared to an optical fiber having both a core and a cladding, and therefore can generally have a smaller diameter and / or be thinner compared to a clad fiber, while still being able to propagate laser with similar or better efficiency.

[0049] Compared to amorphous silica or germanium oxide fibers, single-crystal fibers offer higher thermal conductivity, which in turn provides the advantage of propagating laser 241 with greater efficiency. In addition to allowing for a larger annular gap 228 within the cavity 260, the smaller diameter fiber at the distal end 242 of the tapered fiber 128 focuses the projection of the laser beam from the distal end 216 onto a smaller surface area, thereby enabling the handheld device 112 to perform cuts with a smaller spot size for greater precision. In some cases, the smaller diameter fiber at the distal end 242 of the tapered fiber 128 also allows for the projection of the laser beam with less energy, which can be beneficial for certain ophthalmic surgeries.

[0050] Tapered fiber 128 can be configured to operate as an optical waveguide to propagate laser 241. Tapered fiber 128 can be configured to project laser 241 from its distal end 242. In other embodiments, the characteristics of laser 241 propagating through tapered fiber 128 cause laser 241 to cause rupture of vitreous collagen fibers within its path. Rupture refers to the breakdown of tissue by rapid ionization of tissue molecules. In some embodiments, laser 241 propagated by tapered fiber 128 has a wavelength between about 2.0 µm and about 3.5 µm, for example, between about 2.5 µm and about 3.3 µm. However, the techniques disclosed herein can realize any suitable type of laser for ophthalmic surgery.

[0051] Figure 3A plan view of an exemplary tapered optical fiber for coupling optical fiber 113 of cable assembly 111 to adjacent optical fibers, according to certain embodiments of this disclosure, is shown. In some embodiments, the distal end 306 of the delivery optical fiber 308 from laser system 102 is configured to focus a delivery laser 241 onto the core of optical fiber 113 to transmit the laser 241 through optical fiber 113 to tapered optical fiber 128. As discussed above, in some cases, laser propagation between the coupling ends of adjacent optical fibers may be partially delivered to the adhesive surrounding the core of the optical fiber receiving the laser (e.g., optical fiber 113 receiving laser from delivery optical fiber 308 in the illustrated example). Such heating of the adhesive can damage optical fiber 113 or cause optical fiber failure.

[0052] like Figure 3 As shown, in some embodiments, a first tapered fiber segment 302 with a tapered shape, similar to that of tapered fiber 128, can be implemented at the coupling interface between the proximal end 304 of fiber 113 and the distal end 306 of delivery fiber 308. The first tapered fiber segment 302 helps to focus the energy delivery of laser 241 onto a smaller area aligned with the core of fiber 113. Using the first tapered fiber segment 302 to couple fiber 113 to the delivery fiber 308 of laser system 102 reduces the likelihood of misalignment (and therefore heat generation) between the adhesive at the proximal end 304 of delivery fiber 308 and fiber 113.

[0053] To limit the possibility of damage to the first tapered fiber segment 302 itself, the first tapered fiber segment 302 includes a proximal end 310 having a diameter larger than the diameter of the distal end 306 of the transport fiber 308. In some embodiments, when the proximal end 310 of the first tapered fiber segment 302 is coupled to the distal end 306 of the transport fiber 308 having a diameter of about 200 µm, the proximal end 310 of the first tapered fiber segment 302 may have a diameter between about 200 µm and 300 µm, for example, between about 230 µm and about 270 µm, for example, about 250 µm, but in some embodiments, it may have a larger or smaller diameter. The larger diameter of the proximal end 310 of the first tapered fiber segment 302 limits the chance of the first tapered fiber segment 302 itself being damaged by stray energy of the laser 241 delivered by the transport fiber 308.

[0054] Similar to the tapered fiber 128, the diameter of the first tapered fiber segment 302 can similarly decrease towards the distal end 312 of the first tapered fiber segment 302 to focus and deliver the laser 241 to a smaller area. In some embodiments, when the proximal end 304 of the fiber 113 having a diameter of about 200 µm at the core (e.g., about 230 µm including the cladding) is coupled to the distal end 312 of the first tapered fiber segment 302, the distal end 312 may further have a diameter between about 150 µm and 230 µm, such as between about 160 µm and about 200 µm, such as about 180 µm, but in some embodiments, it may have a larger or smaller diameter.

[0055] The optical fiber 113 further includes a second tapered fiber segment 314 disposed between the distal end 127 of the optical fiber 113 and the proximal end 129 of the tapered optical fiber 128 to assist in delivering the laser 241 through the optical fiber 113 to the tapered optical fiber 128. In some embodiments, when the distal end 127 of the optical fiber 113, having a diameter of about 200 µm at the core (including about 230 µm of the cladding), is coupled to the proximal end 316 of the second tapered fiber segment 314, the proximal end 316 of the second tapered fiber segment 314 may have a diameter between about 180 µm and 260 µm, for example, between about 200 µm and about 240 µm, for example, about 220 µm, but in some embodiments, it may have a larger or smaller diameter.

[0056] Similar to the first tapered fiber segment 302, the diameter of the second tapered fiber segment 314 similarly decreases towards its distal end 318 to focus the delivery of the laser 241. In some embodiments, when the proximal end 129 of the tapered fiber 128, with a diameter of approximately 200 µm, is coupled to the distal end 318 of the second tapered fiber segment 314, the distal end 312 of the second tapered fiber segment 314 may have a diameter between approximately 110 µm and 200 µm, for example, between approximately 130 µm and approximately 180 µm, for example, approximately 150 µm; however, in some embodiments, it may have a larger or smaller diameter.

[0057] In some embodiments, the first tapered fiber segment 302 and the second tapered fiber segment 314 may have a length L2 between 8 mm and 20 mm, for example, between about 10 mm and 15 mm, for example, about 12 mm, but in some embodiments, they may have a longer or shorter length. In some embodiments, the first tapered fiber segment 302 and the second tapered fiber segment 314 may be similar to the tapered fiber 128 discussed above, comprising single-crystal fiber (e.g., sapphire-core fiber), while fiber 113 may comprise fiber with a core and cladding, such as germanium oxide glass fiber. Using germanium oxide glass fiber for fiber 113 allows the cable assembly 111 (and the fiber 113 disposed therein) to be more flexible than a corresponding sapphire-core fiber of the same diameter.

[0058] Figure 4 This disclosure illustrates certain embodiments of the functionality that can be implemented according to this disclosure. Figure 1A The exemplary optical fiber implemented in the surgical system 100 described herein. Even with the use of a first tapered fiber segment 302 and a second tapered fiber segment 314 to assist in the alignment between the coupled fibers, a certain amount of optical loss may still occur at the coupling interface between the optical fiber 113 and each of the first tapered fiber segments 302 and 314. Optical loss may also occur at the coupling interface between the optical fiber 113 discussed above and the tapered optical fiber 128 in the handheld device 112. Figure 4 As shown, in another embodiment, optical fiber 113 and tapered optical fiber 128 can be formed as a single integral optical fiber 400 extending between the laser system 102 of the surgical system 100 and the probe 110 of the handheld device 112 for propagating laser 241, without the need for coupling any optical fibers.

[0059] In some embodiments, optical fiber 400 includes a proximal portion 406 and a distal portion 410, the proximal portion being coupled to laser system 102 at a proximal end 408, and the distal portion extending into handheld device 112 and terminating at a distal end 404 located near distal end 216 within probe 110. In some embodiments, optical fiber 400 has a length between about 1 meter and about 3 meters, such as about 2 meters, but in some embodiments, it may have a longer or shorter length. Similar to tapered optical fiber 128, optical fiber 400 may include single-crystal optical fiber, such as tapered sapphire core optical fiber disposed in a cable sheath. Optical fiber 400 may alternatively include optical fiber made of any other material described above with respect to tapered optical fiber 128.

[0060] As described above, sapphire core fibers with a diameter less than 200 µm may exhibit excessive transmission loss. However, sapphire core fibers with a diameter of 200 µm or larger are relatively rigid and may pose ergonomic problems for users / surgeons using a handheld device 112 connected to the distal end 404 of fiber 113. Similar to tapered fiber 128, the sapphire core fiber in fiber 400 gives fiber 400 a tapered shape. To improve transmission through fiber 400, fiber 400 may further include a tapered shape, such that the proximal portion 406 of fiber 400 initially has a larger diameter to facilitate laser transmission. Then, as fiber 400 approaches handheld device 112, fiber 400 may taper to a smaller diameter toward the distal portion 410 to provide improved flexibility for fiber 400 near handheld device 112.

[0061] In some embodiments, the proximal portion 406 of the optical fiber 400 may have a diameter between about 250 µm and about 500 µm, for example, between about 350 µm and about 450 µm, or for example, between about 400 µm; however, in some embodiments, it may have a larger or smaller diameter. In some embodiments, the distal portion 410 of the optical fiber 400 may have a diameter between about 50 µm and about 200 µm, for example, between about 80 µm and 120 µm, or for example, between about 100 µm; however, in some embodiments, it may have a larger or smaller diameter. Similar to the tapered optical fiber 128, the tapered shape allows the optical fiber 400 to have a sufficiently small diameter near the distal end 404 of the probe 110 in the handheld device 112, and can provide similar advantages as described above.

[0062] In summary, embodiments of this disclosure include apparatus and systems for performing laser-assisted ophthalmic surgery. Specifically, the aforementioned handheld apparatus and systems may include projection of laser light from a tapered optical fiber (e.g., a sapphire-core fiber made of sapphire material) partially disposed within a probe of the handheld apparatus, thereby enabling improved laser transmission characteristics through probes with smaller dimensions. In some embodiments, the use of a tapered optical fiber in a laser vitrectomy probe for cutting collagen fibers of vitreous material also allows the probe to maintain sufficient suction capacity to simultaneously remove the cut vitreous material during surgery. Furthermore, the use of a tapered optical fiber at the optical interface between the fiber of the cable assembly and the laser system (or the laser source therein) and / or the handheld apparatus reduces the risk of damage to the cable assembly and can increase its lifespan. In some embodiments, the fiber of the cable assembly (e.g., a hollow-core fiber, or made of germanate or fluoride glass) is coupled to a tapered optical fiber to efficiently deliver laser light to the tapered optical fiber in the handheld apparatus. Furthermore, some of the embodiments described herein improve laser transmission to handheld devices using more robust and easier-to-use single-crystal optical fibers, while still maintaining sufficient ergonomics for users to manipulate the handheld device connected to the single-crystal fiber. Accordingly, the described embodiments enable more efficient, less invasive, and safer ophthalmic surgeries.

[0063] Although vitrectomy and phacoemulsification are discussed as examples of surgical procedures that can benefit from the described embodiments, the advantages of the surgical devices and systems described herein can be beneficial to other ophthalmic procedures with light-emitting capabilities (e.g., lasers, illumination lights, etc.).

[0064] Although the foregoing describes embodiments of this disclosure, other and additional embodiments of this disclosure may be contemplated without departing from the essential scope of this disclosure, and the scope of this disclosure is defined by the appended claims.

Claims

1. A handheld device, comprising: case; A cable assembly disposed within the housing and extending from a supply port near the proximal end of the housing, the cable assembly including an optical fiber; and A tapered optical fiber, disposed within the housing and having a decreasing diameter between its proximal and distal ends. The near end of the tapered optical fiber is optically coupled to the far end of the optical fiber.

2. The handheld device of claim 1, further comprising a probe disposed through an opening at the distal end of the housing, the probe having an extending through-hole, wherein, The distal end of the tapered optical fiber is disposed in the cavity.

3. The handheld device as claimed in claim 2, wherein, The lumen further includes an annular gap circumferentially surrounding the tapered optical fiber, and the annular gap is configured to provide a coaxial path for suction through the lumen of the probe.

4. The handheld device as claimed in claim 1, wherein, The diameter of the distal end of the tapered optical fiber is between approximately 50 µm and approximately 150 µm.

5. The handheld device as claimed in claim 1, wherein, The diameter of the near end of the tapered optical fiber is between approximately 180 µm and approximately 250 µm.

6. The handheld device as claimed in claim 1, wherein, The optical fibers of the cable assembly have a diameter between about 180 µm and about 400 µm.

7. The handheld device as claimed in claim 1, wherein, The tapered optical fiber includes a single-crystal optical fiber, which is composed of α-Al₂O₃ (sapphire), Ti:sapphire, and Y₃Al₅O₃. 12 Materials composed of (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG or ZrF4-BaF2-LaF3-AlF3-NaF (ZBLAN).

8. A cable assembly for a surgical system, comprising: An optical fiber having a near end and a far end; A first tapered optical fiber has a distal end and a proximal end, the distal end of the first tapered optical fiber being optically coupled to the proximal end of the optical fiber, wherein... The first tapered optical fiber includes a first diameter that decreases from the proximal end to the distal end of the first tapered optical fiber, and The diameter of the distal end of the first tapered optical fiber is smaller than the diameter of the proximal end of the optical fiber; and A second tapered optical fiber, wherein the near end of the second tapered optical fiber is optically coupled to the far end of the optical fiber.

9. The cable assembly as claimed in claim 8, wherein, The second tapered optical fiber includes a second diameter that decreases from the proximal end of the second tapered optical fiber to the distal end of the second tapered optical fiber, and the diameter of the proximal end of the second tapered optical fiber is larger than the diameter of the distal end of the optical fiber.

10. The cable assembly of claim 8, wherein, The distal end of the second tapered optical fiber is configured to be optically coupled to the proximal end of a third optical fiber disposed in the handheld device, wherein the diameter of the proximal end of the third optical fiber is greater than or equal to the diameter of the distal end of the second tapered optical fiber.

11. The cable assembly of claim 8, wherein, The near end of the first tapered fiber is configured to be optically coupled to the laser system.

12. The cable assembly of claim 11, wherein, At least one of the first tapered optical fiber and the second tapered optical fiber comprises a single-crystal optical fiber, said single-crystal optical fiber being composed of a material including α-Al2O3 (sapphire), Ti:sapphire, Y3Al5O12 (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF4-BaF2-LaF3-AlF3-NaF (ZBLAN).

13. A surgical system comprising: A surgical console, the surgical console including a laser system; as well as Handheld device, the handheld device comprising: case; A cable assembly disposed within the housing and extending from a supply port at a proximal end of the housing, the cable assembly including optical fibers having a proximal end and a distal end; and A tapered optical fiber, disposed within the housing and having a decreasing diameter between its proximal and distal ends. The near end of the optical fiber is optically coupled to the laser system, and the far end of the optical fiber is optically coupled to the near end of the tapered optical fiber.

14. The surgical system of claim 13, wherein, The surgical console further includes a suction system; The handheld device further includes a probe that passes through an opening at the distal end of the housing, the probe having an extending through-cavity, and the distal end of the tapered optical fiber disposed within the cavity; and The lumen is in fluid communication with the suction system and further includes an annular gap circumferentially surrounding the tapered optical fiber, the annular gap being configured to provide a coaxial path for suction through the lumen of the probe.

15. The surgical system of claim 13, wherein, The tapered optical fiber includes a single-crystal optical fiber, which is composed of materials including α-Al2O3 (sapphire), Ti:sapphire, Y3Al5O12 (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF4-BaF2-LaF3-AlF3-NaF (ZBLAN).

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