Ophthalmic system and cassette

Abstract

An ophthalmic system comprising a console (1) and a cassette (2) that can be arranged in or on the console (1), wherein the cassette (2) has at least one fluid inlet (3) for at least indirect connection with an irrigation source (4) and at least one fluid outlet (6) for at least indirect connection with a surgical hand device, and wherein the fluid inlet (3) and the fluid outlet (6) are connected to each other via at least two fluid channels (7, 8), wherein a pressure chamber (9, 9') is formed in at least one of the fluid channels (7, 8). wherein a pressure chamber inlet (10, 10') and / or a pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is closable and wherein at least one of the fluid channels (7, 8) and / or a fluid channel in which the fluid channels (7, 8) are formed together is assigned a pressure sensor (14) so ​​that an irrigation pressure can be determined, where, in addition to the hydrostatic infusion, a pressure infusion is also to be performed, so that the pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is opened.

Description

[0001] The invention relates to an ophthalmological system comprising a console and a cassette that can be arranged in or on the console, wherein the cassette has at least one fluid inlet for at least indirect connection to an irrigation source and at least one fluid outlet for at least indirect connection to a surgical handheld device, and wherein the fluid inlet and the fluid outlet are connected to one another via at least two fluid channels. The invention further relates to an ophthalmological cassette, in particular according to one of claims 1 to 11, with at least one fluid inlet for at least indirect connection to an irrigation source and at least one fluid outlet for at least indirect connection to a surgical handheld device, wherein the fluid inlet and the fluid outlet are connected to one another via at least two fluid channels.

[0002] Ophthalmic systems of the type in question have been known in practice for years and are used, for example, in phacoemulsification procedures. During phacoemulsification, the lens clouded by a cataract is destroyed using an ultrasonic needle carried by a handpiece, and the lens debris is suctioned out through this needle. During the procedure, an irrigation fluid is supplied to the eye, which serves primarily to maintain intraocular pressure. To ensure a sterile environment and a supply of irrigation fluid, it is known to provide interchangeable cassettes that can be connected to the console and enable a fluid connection between an irrigation source and the handpiece.

[0003] The irrigation fluid is typically provided as a hydrostatic infusion, meaning the irrigation source is arranged as an irrigation bottle on a height-adjustable stand, allowing the infusion pressure to be adjusted by changing the height of the irrigation source. It is also known to apply pressure to the internal volume of the irrigation bottle to generate the desired infusion pressure.

[0004] The documents US 2016 / 0220751 A1, WO 2018 / 083182 A1 and US 2014 / 0074011 A1 each show an ophthalmological system comprising an irrigation source.

[0005] The disadvantages of existing systems are their complicated design and application, and they also offer limited control of the irrigation pressure. To protect the eye from injury, the intraocular pressure must be maintained as precisely as possible, requiring precise adjustment of the irrigation pressure. Changes in intraocular pressure must therefore be responded to as quickly and accurately as possible, meaning that the irrigation pressure must be adjustable as quickly and accurately as possible.

[0006] The present invention is therefore based on the object of designing and developing an ophthalmic system of the type mentioned above in such a way that the irrigation pressure can be maintained as precisely as possible using simple structural means. Furthermore, a cassette for such an ophthalmic system is to be specified.

[0007] According to the invention, the above object is achieved by the features of claim 1.According to this, an ophthalmological system comprising a console and a cassette which can be arranged in or on the console is described, wherein the cassette has at least one fluid inlet for at least indirect connection to an irrigation source and at least one fluid outlet for at least indirect connection to a surgical hand-held device, and wherein the fluid inlet and the fluid outlet are connected to one another via at least two fluid channels, wherein a pressure chamber is formed in at least one of the fluid channels, wherein a pressure chamber inlet and / or a pressure chamber outlet of the pressure chamber can be closed, and wherein a pressure sensor is assigned to at least one of the fluid channels and / or a fluid channel in which the fluid channels are jointly formed, so that an irrigation pressure can be determined, wherein in addition to the hydrostatic infusion, a pressure infusion is also to take place so that the pressure chamber outlet of the pressure chamber is opened.

[0008] According to the invention, it was first recognized that the underlying problem can be solved in an astonishingly simple manner by forming a pressure chamber in or on at least one of the fluid channels. This makes it possible to provide the irrigation fluid in the usual way as a hydrostatic infusion, for example via a first fluid channel. Irrigation fluid can be fed from the same irrigation source to the pressure chamber via the second fluid channel. The pressure chamber can be pressurized in a simple manner so that, if necessary, irrigation fluid can be supplied to the fluid outlet and thus to the handpiece via the pressure chamber arranged in or on the second fluid channel, namely as a pressure infusion.This makes it possible to change the infusion pressure reliably and extremely quickly using simple structural means in order to maintain the patient's intraocular pressure as constant as possible.

[0009] The term “fluid channel” is to be understood in the broadest sense, namely a flow connection for transporting irrigation fluid. The fluid channel can be designed at least partially as a hose connection. It is important that the pressure chamber forms part of a fluid channel. Furthermore, the fluid channels can initially be designed as a common fluid channel, at least in the immediate vicinity of the fluid inlet and / or the fluid outlet, and can divide downwards in the direction of flow, for example, into a first fluid channel and a second fluid channel. Likewise, the fluid channels can be brought together in the direction of flow upstream of the fluid outlet, so that a single fluid channel is present in this area. It is also important that at least one fluid inlet can be formed. It is therefore conceivable, for example, to provide two fluid inlets, each of which merges into a fluid channel.are fluidly connected to it. It is also possible, for example, to have two fluid outlets. Furthermore, the fluid channels in the area upstream of the fluid outlet could be merged into a common channel.

[0010] According to an advantageous embodiment, the fluid inlet(s) of the cassette could be connected to an infusion mandrel, in particular formed integrally with it. By separating the lines from the fluid inlets to the infusion mandrel, a consistent infusion volume can be ensured in both lines and thus in both fluid channels. The infusion mandrel could furthermore have a preferably filtered opening for ventilation.

[0011] Advantageously, a pressure build-up means can be arranged in or on the pressure chamber. The pressure build-up means serves to generate a defined overpressure in the pressure chamber, so that an irrigation fluid contained in the pressure chamber can be provided at the fluid outlet at a defined irrigation pressure, i.e., a pressure infusion of the irrigation fluid can occur.

[0012] In a further advantageous manner, a check valve could be arranged in one of the fluid channels so that irrigation fluid is prevented from being pushed back into this fluid channel.

[0013] To enable the irrigation pressure to be adjusted as quickly as possible, pressure relief devices can be arranged in or on the pressure chamber. This allows any excess pressure in the pressure chamber to be at least partially relieved, provided that irrigation fluid with a lower irrigation pressure is to be provided at the fluid outlet.

[0014] To implement the pressure build-up means and / or the pressure relief means, at least one opening can be formed in the pressure chamber. Contamination can be avoided by a filter that may be provided if required. A plunger, which is formed, for example, on the console, can be assigned to the opening, so that an overpressure can be generated in the pressure chamber via the plunger. Alternatively or additionally, a plunger, which is formed, for example, on the console, can be assigned to the opening. In this case, when the plunger is lifted from the opening, any pressure prevailing in the pressure chamber could be reduced and / or a negative pressure could be “drawn” by the contacted plunger, so that an even faster pressure reduction occurs.

[0015] According to the invention, a pressure chamber inlet and / or a pressure chamber outlet can be closed. The terms “pressure chamber inlet” and “pressure chamber outlet” are to be understood in the broadest sense, namely they can also include an area of ​​the fluid channel located in the immediate vicinity of the pressure chamber. For example, the fluid channel could be formed by a hose upstream and / or downstream of the pressure chamber in the direction of flow, whereby the hose can be closed by a plunger. For this purpose, the plunger could be formed on the console and press the hose down to interrupt the flow connection. Alternatively or additionally, the pressure chamber inlet and / or the pressure chamber outlet could be closed by a valve operatively connected to the fluid channel.

[0016] In a further advantageous manner, it is conceivable for a pressure chamber to be formed in each fluid channel. For example, two fluid channels could be arranged, each with a pressure chamber. The pressure chambers could be filled hydrostatically with a portion of the irrigation fluid when the cassette is inserted into the console. When the operation starts, a first pressure chamber could remain connected to the hydrostatic infusion, i.e. the pressure chamber inlet and outlet of the first pressure chamber could be open. This allows the irrigation fluid to flow to the handset as a hydrostatic infusion, while the inlet and outlet of a second pressure chamber are closed. To activate the pressure infusion, the outlet of the second pressure chamber can be opened, whereby pressure is built up in the second pressure chamber via a piston and the irrigation fluid is pumped to the patient.

[0017] Furthermore, it is conceivable that at least one of the fluid channels in the area of ​​the fluid outlet can be closed, for example, via a plunger arranged in the console, which presses on the fluid channel, which is implemented as a hose connection at least in this area. Particularly advantageously, this can be an area in which the fluid channels are converged, i.e., they are routed into a common fluid channel. Alternatively or additionally, a valve could be used to close / open the fluid channel(s).

[0018] To ensure optimal adjustment of the irrigation pressure, a pressure sensor is arranged in or on at least one of the fluid channels so that the irrigation pressure or the associated irrigation volume can be determined. This can be, for example, a measuring membrane that could be in flow connection with the fluid channel and whose deflection can be used to determine the irrigation pressure or the irrigation volume. Taking the determined pressure value into account, the pressure in the irrigation chamber can be adjusted or a decision can be made as to whether a pressure infusion should be carried out in addition to the hydrostatic infusion, so that the outlet of the pressure chamber is opened. Furthermore, the height of the irrigation source and thus the hydrostatic infusion pressure can be adjusted taking the measured pressure into account.

[0019] In a further advantageous manner, a fill level sensor could be arranged to monitor the fill level of the pressure chamber. This allows activation and / or filling of the pressure chamber to be controlled based on the measured fill level. The fill level sensor could be located on or in the pressure chamber or cassette. It is also conceivable for the fill level sensor to be located on the console. If multiple pressure chambers are provided, each of them can be monitored by a fill level sensor.

[0020] The underlying problem is further solved by an ophthalmological cassette according to claim 11.

[0021] The ophthalmic cassette is designed for use in an ophthalmic system according to any one of claims 1 to 11 and can thus have the features and advantages of the ophthalmic cassettes mentioned with reference to these claims.

[0022] There are now various possibilities for advantageously embodying and developing the teaching of the present invention. For this purpose, reference is made, on the one hand, to the claims subordinate to claim 1 and, on the other hand, to the following explanation of preferred embodiments of the invention with reference to the drawing. In conjunction with the explanation of the preferred embodiments of the invention with reference to the drawing, generally preferred embodiments and developments of the teaching are also explained. The drawing shows: Fig. 1 in a schematic representation, an embodiment of a system according to the invention comprising a cassette according to the invention, Fig. 2 in a schematic representation, a further embodiment of a system according to the invention comprising a cassette according to the invention, Fig. 3 in a schematic representation, a further embodiment of a system according to the invention comprising a cassette according to the invention, Fig. 4 in a schematic representation, a further embodiment of a system according to the invention comprising a cassette according to the invention, and Fig. 5 in a schematic representation, a further embodiment of a system according to the invention comprising a cassette according to the invention.

[0023] Fig. Figure 1 shows an embodiment of a system according to the invention. The system comprises a console 1 and a cassette 2 that can be arranged in or on the console 1. The cassette 2 has a fluid inlet 3 that is connected to an irrigation source 4 via a check valve 5. Furthermore, a fluid outlet 6 is formed, which is fluidly connected to a surgical handheld device (not shown), so that irrigation fluid can be delivered to the handheld device.

[0024] The fluid inlet 3 is fluidly connected to the fluid outlet 6 via a first fluid channel 7 and a second fluid channel 8. A pressure chamber 9 is formed in the first fluid channel 7. The pressure chamber inlet 10 and the pressure chamber outlet 11 can be closed via an inlet valve 12 and an outlet valve 13. It should be noted that the valves 12, 13 can also be designed as plungers arranged on the console 1 and pressing on a fluid channel implemented as a hose connection to close it.

[0025] Furthermore, a pressure sensor 14 is provided, via which the irrigation pressure or the irrigation volume can be determined in the region in which the first fluid channel 7 and the second fluid channel 8 are formed as one piece. Furthermore, a fluid outlet valve 15 is arranged to close the region in which the fluid channels 7, 8 are formed together. Here, too, a plunger can be provided instead of a fluid outlet valve 15, which presses off a hose line.

[0026] Furthermore, pressure build-up means 16 and pressure reduction means 17 are arranged in the pressure chamber 9. When the cassette 2 is inserted into the console 1, the pressure chamber 9 can initially be filled hydrostatically with a portion of the irrigation fluid from the irrigation source 4 by opening the inlet valve 12. At the start of the operation, the inlet valve 12 and the outlet valve 13 can be closed, so that irrigation fluid is conveyed to the fluid outlet 6 via the second fluid channel 8 by hydrostatic infusion. As soon as a higher irrigation pressure or a larger irrigation volume is required, the pressure chamber 9 can be activated in addition to the hydrostatic infusion. For this purpose, the pressure chamber outlet 11 is opened via the outlet valve 12 and an overpressure is generated in the pressure chamber 9 via the pressure build-up means 16. This increases the irrigation pressure orthe irrigation quantity, since in addition to the irrigation fluid provided via the second fluid channel 8, irrigation fluid is also conveyed to the fluid outlet 6 at increased pressure via the first fluid channel 7.

[0027] The check valve 5 prevents the irrigation fluid from flowing back. As soon as the additional irrigation pressure is no longer required, the pressure chamber outlet 11 can be closed again. To fill the pressure chamber 9, the pressure chamber inlet 10 can also be opened until the required amount of irrigation fluid has flowed from the irrigation source 4 into the pressure chamber 9.

[0028] In Fig. 1 also shows the aspiration side of the ophthalmic system. Fluid can be aspirated from a surgical handpiece via this side, for which purpose a roller pump 18 and a Venturi pump 19 can be arranged. The aspirated fluid can be collected in an aspiration bag 20 and / or in a Venturi chamber 21. Furthermore, aspiration valves 22 and a pressure sensor 23 are arranged. The aspiration side can be arranged at least partially in the console 1, in the cassette 2 and / or in another aspiration cassette (not shown). The control or regulation of the irrigation, in particular of the pressure chamber 9, can also take into account the aspiration pressure determined by the pressure sensor 23 and the associated aspiration volume.

[0029] Fig. 2 shows a further embodiment of a system according to the invention. The system comprises a console 1 and a cassette 2 that can be arranged in the console 1. A pressure chamber 9 is arranged in a first fluid channel 7, wherein the pressure chamber inlet 10 and the pressure chamber outlet 11 can be closed via valves 12, 13 or tappets 24. Furthermore, two openings 25 are arranged in the pressure chamber 9, which interact with plungers 26 of the console 1. The plungers 26 serve as pressure build-up means 14 and pressure reduction means 15, respectively. Furthermore, a second fluid channel 8 is arranged, via which an irrigation fluid is provided by means of hydrostatic infusion. A check valve 5 is provided in the second fluid channel 8. Furthermore, a pressure sensor 14 is arranged. In the region of the fluid outlet 6, a further plunger 24 is formed, with which the fluid line can be closed.Instead of the tappet 24, a fluid outlet valve 15 can also be provided.

[0030] The function of the device according to Fig. 2 essentially corresponds to the function of the device according to Fig. 1, so that reference can be made to the relevant comments.

[0031] Fig. 3 shows a further embodiment of an ophthalmological system comprising a console 1 and a cassette 2. The cassette 2 has two fluid channels 7, 8, wherein, in contrast to the embodiments according to the Fig. 1 and Fig. 3, a pressure chamber 9, 9' is arranged in each of the fluid channels 7, 8. The pressure chamber inlets 10, 10' and pressure chamber outlets 11, 11' can be closed via tappets 24 or inlet valves 12, 12' and outlet valves 13, 13'. Furthermore, the pressure chambers 9, 9' have openings 25, 25', which interact with plungers 26, 26' of the console 1 and serve as pressure build-up means 16 and pressure relief means 17, respectively. A pressure sensor 21 is arranged in the area of ​​the fluid outlet 6. Furthermore, a further tappet 24 or a fluid outlet valve 15 is provided in this area to close the fluid channel at this point.

[0032] The pressure chambers 9, 9' can be hydrostatically filled with a portion of the irrigation fluid when the cassette 2 is inserted into the console 1. At the start of the operation, a chamber 9' can be activated and remain connected to the hydrostatic infusion. The hydrostatic infusion occurs by opening the pressure chamber inlet 10' and the pressure chamber outlet 11', allowing the irrigation fluid to flow from the fluid inlet 3 via the second fluid channel 8 to the fluid outlet 6. The pressure chamber inlet 10 and the pressure chamber outlet 11 of the other pressure chamber 9 are closed.

[0033] To increase the irrigation pressure, the pressure chamber outlet 11 can be opened and overpressure can be built up via the plunger 26, so that irrigation fluid is pumped from the pressure chamber 9 via the first fluid channel 7 to the fluid outlet 6. If the pressure in the pressure chamber 9 is throttled or rapidly regulated, the plunger 26 can also build up or "pull" a negative pressure. If the pressure regulation in the pressure chamber 9 is too slow, a hydrostatic infusion can take place from the pressure chamber 9'. As soon as the infusion fluid in the pressure chamber 9 is used up, the system can switch to the second pressure chamber 9'. After the switch, the pressure chamber 9, which is then not used, can be refilled.

[0034] Fig. 4 shows another embodiment of an ophthalmological system. The embodiment according to Fig. 4 essentially corresponds to the embodiment according to Fig. 3. In contrast to Fig. 3, a pressure sensor 14 is provided in each of the first fluid channel 7 and the second fluid channel 8, specifically in the region in which the first fluid channel 7 and the second fluid channel 8 are each formed as separate fluid channels. Furthermore, a plunger 24 and a fluid outlet valve 15 are arranged in each of the first fluid channel 7 and the second fluid channel 8. To avoid repetition, reference is further made to the explanations for Fig. 3, which is analogous to the embodiment according to Fig. 4 apply.

[0035] Fig. Figure 5 shows a schematic representation of another embodiment of a system according to the invention. Here, the cassette 2 has two fluid inlets 3, 3'. The fluid inlet 3 merges into a first fluid channel 7, which has a pressure chamber 9, so that pressure infusion is possible via this fluid channel 7. A fill level sensor 27 is assigned to the pressure chamber 9, via which the fill level of the irrigation fluid in the pressure chamber 9 can be monitored. This allows the activation or filling of the pressure chamber 9 to be controlled or regulated.

[0036] The additional fluid inlet 3' merges into the second fluid channel 8 and serves to provide the irrigation fluid in the sense of a hydrostatic infusion. Due to the separate fluid inlet 3', the hydrostatic line is not influenced by the first fluid channel 7.

[0037] Furthermore, Fig. 5 shows that the fluid inlets 3, 3' are connected to an infusion mandrel 28, for example via lines, in particular hose lines. The infusion mandrel 28 could thus be part of the cassette 2. A ventilation opening 29 is provided on the infusion mandrel 28. The ventilation opening 29 can be equipped with a filter to prevent contamination. The two separate fluid connections to the infusion mandrel ensure a consistent infusion volume in both channels 7, 8.

[0038] The Fig. The embodiment shown in Figure 5 furthermore corresponds to the Fig. 1 to 4, so that reference is made to the relevant explanations.

[0039] With regard to further advantageous embodiments of the device according to the invention, reference is made to the general part of the description and to the appended claims in order to avoid repetition.

[0040] Finally, it should be expressly pointed out that the embodiments of the device according to the invention described above serve only to explain the claimed teaching, but do not limit it to the embodiments. List of reference symbols 1 console 2 cassettes 3 Fluid inlet 4 Irrigation source 5 Check valve 6 Fluid outlet 7 first fluid channel 8 second fluid channel 9.9' pressure chamber 10, 10' pressure chamber entrance 11, 11' pressure chamber outlet 12 Inlet valve 13 Outlet valve 14 Pressure sensor 15 Fluid outlet valve 16 pressure build-up agents 17 Pressure relief agents 18 roller pump 19 Venturi pump 20 aspiration bags 21 Venturi chamber 22 Aspiration valve 23 Pressure sensor 24 tappets 25, 25' opening 26, 26' stamp 27 Level sensor 28 Infusion spike 29 Ventilation opening

Claims

[1] An ophthalmological system comprising a console (1) and a cassette (2) which can be arranged in or on the console (1), wherein the cassette (2) has at least one fluid inlet (3) for at least indirect connection to an irrigation source (4) and at least one fluid outlet (6) for at least indirect connection to a surgical hand-held device, and wherein the fluid inlet (3) and the fluid outlet (6) are connected to one another via at least two fluid channels (7, 8), wherein a pressure chamber (9, 9') is formed in at least one of the fluid channels (7, 8), wherein a pressure chamber inlet (10, 10') and / or a pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is closable and wherein at least one of the fluid channels (7, 8) and / or a fluid channel in which the fluid channels (7, 8) are formed together is assigned a pressure sensor (14), so that an irrigation pressure can be determined, wherein, in addition to the hydrostatic infusion, a pressure infusion is also to be carried out so that the pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is opened. [2] Ophthalmological system according to claim 1, characterized by that pressure build-up means (16) are arranged in or on the pressure chamber (9, 9'). [3] Ophthalmological system according to claim 1 or 2, characterized by that pressure reduction means (17) are formed in or on the pressure chamber (9, 9'). [4] Ophthalmological system according to one of claims 1 to 3, characterized by that the pressure chamber (9, 9') has at least one opening (25, 25'). [5] Ophthalmological system according to claim 4, characterized by that a plunger (26, 26') is formed on the console (1) or on the cassette (2), which plunger cooperates with one of the openings (25, 25') and serves as a pressure build-up means (16). [6] Ophthalmological system according to claim 4 or 5, characterized bythat a plunger (26, 26') is formed on the console (1) or on the cassette (2), which plunger cooperates with one of the openings (25, 25') and serves as a pressure relief means (17). [7] Ophthalmological system according to one of claims 1 to 6, characterized by that a pressure chamber inlet (10, 10') and / or a pressure chamber outlet (11, 11') can be closed via a tappet (24). [8] Ophthalmological system according to one of claims 1 to 7, characterized by , a pressure chamber (9, 9') is formed in each fluid channel (7, 8). [9] Ophthalmological system according to one of claims 1 to 8, characterized by that at least one of the fluid channels (7, 8) can be closed in the region of the fluid outlet (6). [10] Ophthalmological system according to one of claims 1 to 9, characterized by that a filling level of the pressure chamber (9, 9') can be determined via a filling level sensor (27). [11] Ophthalmological cassette (2) with a fluid inlet (3) for at least indirect connection to an irrigation source (4) and a fluid outlet (6) for at least indirect connection to a surgical hand-held device, wherein the fluid inlet (3) and the fluid outlet (6) are connected to one another via at least two fluid channels (7, 8), wherein a pressure chamber (9, 9') is formed in at least one of the fluid channels (7, 8), wherein a pressure chamber inlet (10, 10') and / or a pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is closable and wherein at least one of the fluid channels (7, 8) and / or a fluid channel in which the fluid channels (7, 8) are formed together is assigned a pressure sensor (14) so that an irrigation pressure can be determined, and wherein, in addition to the hydrostatic infusion, a pressure infusion is also to be carried out so that the pressure chamber outlet (11, 11') of the pressure chamber (9, 9') is opened.

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