Instrument for opening the capsular bag of an eye and treatment device with the instrument

Abstract

Instrument (1) for opening a capsular bag (31) of an eye (34), comprising a cannula (2) configured to be inserted into the eye (34) in an insertion direction (20) of the cannula (2), a cannula longitudinal end (6) arranged in the insertion direction (20), a cannula opening (15) arranged in a cannula section extending from the cannula longitudinal end (6), a rotor (3) rotatably arranged about an axis of rotation (9) within the cannula (2), a rotor longitudinal end (7) arranged in the direction of the axis of rotation (9), an extended state in which the rotor (3) extends through the cannula opening (15) and thus protrudes from the cannula (2), and a gripping device (10) arranged in the The extension state is arranged outside the cannula (2) and is designed to grasp part of the capsule bag (31),wherein the rotor (3) is configured to wind up the portion of the capsule bag (31) by rotating the rotor (3).

Description

[0001] The invention relates to an instrument for opening a capsular bag of an eye and a treatment device comprising the instrument.

[0002] During cataract treatment, the natural lens of an eye is replaced with an artificial intraocular lens. This requires a capsulorhexis to be performed to create an opening in the capsular bag of the eye, through which the natural lens is removed and the intraocular lens is then inserted into the capsular bag. During capsulorhexis, an initial opening is pierced or cut in the capsular bag of the eye. By repeatedly tearing the capsular bag open using a tool such as a curved needle (cystotome) or forceps, the initial opening is enlarged until the opening is approximately 5 mm in diameter. The capsular bag must be grasped several times with the tool, and a tear in the capsular bag must be created by moving the tool away from the natural lens.Due to the short available depth in the anterior chamber, grasping is challenging because the tool must be lifted and thereby approached closer to sensitive structures such as endothelial cells. In addition, depth perception is challenging for a surgeon, making it difficult to safely lift and replace the tool on the capsular bag. Safe replacement must also be achieved in such a way that the tool penetrates deep enough into the capsular bag to enable a reliable tear. In addition, the trajectory of the tool deviates from the trajectory of the point at which the tear occurs, requiring a physician performing cataract treatment to perform a complex movement with the tool. Overall, performing capsulorhexis with a curved needle or forceps is laborious. WO 2023 / 177 761 A2 discloses devices and methods for intraocular tissue manipulation.US 2002 / 0 111 608 A1 discloses an instrument and a method for minimally invasive glaucoma surgery. US 2009 / 0 137 992 A1 discloses an apparatus and a method for treating glaucoma.

[0003] The object of the invention is therefore to provide an instrument and a treatment device with which a capsulorhexis can be easily performed.

[0004] The instrument according to the invention for opening a capsular bag of an eye comprises a cannula and a rotor. The cannula is configured to be inserted into the eye in an insertion direction of the cannula. The cannula has a cannula longitudinal end arranged in the insertion direction and a cannula opening arranged in a cannula subregion extending from the cannula longitudinal end. The rotor is arranged rotatably about a rotation axis within the cannula and has a rotor longitudinal end arranged in the direction of the rotation axis. Furthermore, the rotor has an extended state in which the rotor extends through the cannula opening and thus protrudes from the cannula, and the rotor longitudinal end is arranged outside the cannula.The rotor has a gripping device which, in the extended state, is arranged outside the cannula and is configured to grip a part of the capsular bag, wherein the rotor is configured to wind up the part of the capsular bag by rotating the rotor.

[0005] By providing the rotor, which rotates during capsulorhexis, it is conceivable, for example, that the instrument can be guided during capsulorhexis such that the instrument is kept at a constant distance from a point at which the capsular bag tears. Such an instrument path is less complex than with a conventional tool, which requires the tool to be moved away from the capsular bag. In addition, a longer distance of the capsular bag can be torn per grasping of the part of the capsular bag than with a conventional tool. This makes it less necessary to grasp the capsular bag. Thus, capsulorhexis can be performed more easily with the instrument according to the invention than with the conventional tool.

[0006] The gripping device preferably comprises a tip, a pair of forceps, and / or a hook. These gripping devices also make it possible to create an initial opening in the capsular bag. Several of these hooks can also be provided, arranged on the rotor like a Velcro fastener.

[0007] It is particularly preferred that the rotor has a rotor interior that is arranged inside the rotor. It is particularly preferred that the gripping device is formed by the rotor interior, a rotor gripping opening that is arranged outside the cannula in the extended state and via which the rotor interior is accessible from outside the rotor, and a suction device that is configured to suck in part of the capsular bag. By blocking the rotor gripping opening from the part of the capsular bag, a negative pressure can be generated in the rotor interior by means of the suction device, so that the part of the capsular bag adheres to the rotor and can thus be gripped by the rotor. The suction device can, for example, be arranged in a handpiece of the instrument, wherein the handpiece can be grasped by the hand of a doctor performing cataract treatment.

[0008] The instrument preferably has an intermediate space arranged between the cannula and the rotor, which is accessible via the cannula opening. It is conceivable that the instrument is configured to irrigate or aspirate the eye via the intermediate space and the cannula opening. It is preferred that the rotor has a rotor opening arranged in a rotor subregion extending from the rotor longitudinal end, and via which the rotor interior is accessible, wherein the instrument is configured to irrigate or aspirate the eye via the rotor interior and the rotor opening.Particularly preferably, the instrument has the intermediate space, the rotor has the rotor opening, and the instrument is configured to irrigate the eye via the intermediate space and the cannula opening and to aspirate via the rotor interior and the rotor opening, or to aspirate the eye via the intermediate space and the cannula opening and to irrigate via the rotor interior and the rotor opening. This latter alternative is useful if a surgeon wishes to detach the suctioned portion of the capsular bag from the instrument. Irrigation is understood to mean the introduction of a fluid, in particular a liquid, into the eye, and aspiration is understood to mean the suctioning of the fluid, in particular the liquid, from the eye.Aspiration can be used to suction the part of the capsular bag, whereas irrigation can be used to add back fluid that was involuntarily sucked out during aspiration in order to minimize pressure fluctuations inside the eye.

[0009] In a first variant of the invention, it is preferred that the rotor is arranged so as to be longitudinally displaceable in the cannula and has a retracted state in which the rotor's longitudinal end is arranged completely within the cannula and at a distance from the cannula opening. In a second variant of the invention, it is preferred that the instrument has a contact ring which is arranged at a distance from the cannula's longitudinal end in the insertion direction, wherein the rotor and the contact ring are arranged so as to be longitudinally displaceable relative to one another, wherein in the extended state the rotor extends through the contact ring and the rotor's longitudinal end protrudes from the contact ring in the insertion direction, wherein the rotor has a retracted state in which the rotor's longitudinal end is arranged in a position proximal to the distal end of the contact ring. In both variants, it is conceivable to grip the capsular bag with the gripping device when the rotor is in the extended state.The rotor can then be moved longitudinally into the retracted state, and the capsular bag can be contacted with the longitudinal end of the cannula according to the first variant, and with the distal end of the contact ring according to the second variant. The rotor can then be rotated. This allows a nearly constant distance to be maintained between the rotor and the point at which the capsular bag ruptures. This allows the path at which the capsular bag ruptures to be controlled particularly precisely. It is particularly preferred that the contact ring is mounted so that it can be moved longitudinally in the insertion direction relative to the cannula, whereby the rotor and the contact ring are arranged so that they can be moved longitudinally relative to one another. This allows the rotor to be switched particularly easily between the extended state and the retracted state.

[0010] The instrument preferably has a joint that is arranged in a further rotor sub-region that extends from the rotor longitudinal end and divides the instrument into a first sub-arm and a second sub-arm that are arranged next to one another in the insertion direction, wherein the first sub-arm and the second sub-arm can be pivoted relative to one another by means of the joint. This makes it possible to rotate the rotor and pivot the first sub-arm relative to the second sub-arm simultaneously. This makes it easier to wind up part of the capsular bag, and less mechanical stress is created in the capsular bag. It is particularly preferred that the diameter of the rotor becomes longer or larger with increasing distance from the joint. This takes into account that a longer section of the capsular bag is wound up the further away from the joint, whereby particularly little mechanical stress is created in the capsular bag.

[0011] The treatment device according to the invention comprises the instrument according to the invention or a preferred embodiment thereof.

[0012] The instrument can be configured to be guided by a physician's hand. Alternatively, it is conceivable that the treatment device comprises a surgical robot configured to guide the instrument.

[0013] The treatment device is preferably configured to control the rotation of the rotor based on the distance traveled by the instrument in the eye and / or the distance torn by the portion of the capsular bag. The distance traveled can be determined, for example, based on the movement performed by the surgical robot. Alternatively or additionally, it is conceivable for the treatment device to comprise a surgical microscope having an image processing unit configured to determine the distance traveled by the instrument. In another example, the distance traveled can be determined using an acceleration sensor by double integration of the measured values. Another possibility is to provide a potentiometer between the rotor and the cannula.It is conceivable for the treatment device to comprise a surgical microscope having an image processing unit configured to determine the torn section of the capsular bag. In another example, the torn section can also be determined using coherence tomography. In particular, the rotation of the rotor can be controlled such that the wound-up section of the capsular bag corresponds to the distance traveled by the instrument in the eye or the torn section of the capsular bag. This ensures that the distance between the instrument and the point at which the capsular bag ruptures is kept constant. This is advantageous because it allows the direction of the further tear to be easily controlled. This facilitates the performance of the capsulorhexis.

[0014] Alternatively, the treatment device is configured to regulate the rotation of the rotor so that the distance of the instrument from the position at which the capsular bag ruptures is kept constant. For this purpose, the treatment device may comprise a surgical microscope having an image processing unit configured to determine the point at which the capsular bag ruptures, the position of the instrument, and the distance between the point and the position.

[0015] It is preferred that the treatment device be configured to take into account, when regulating the rotation of the rotor, that due to wound layers of the capsular bag, a longer section of the capsular bag is wound up per revolution of the rotor as the rotation duration of the rotor increases. For this purpose, the treatment device can, for example, have a computing unit in which an average thickness of a capsular bag is stored and which is used for this purpose.

[0016] The invention is explained in more detail below with reference to the attached schematic drawings. Fig. 1 a perspective view of a first embodiment of the instrument according to the invention at a first time, Fig. 2 a perspective view of the first embodiment at a second time, Fig. 3 a perspective view of the first embodiment at a third time, Fig. 4 a side view of a second embodiment of the instrument according to the invention, Fig. 5 a perspective view of a third embodiment of the instrument according to the invention at a first time, Fig. 6 a perspective view of the third embodiment at a second time, Fig. 7 a side view of a fourth embodiment of the instrument according to the invention, Fig. 8 is a plan view of a fifth embodiment of the instrument according to the invention, Fig. 9 a plan view of a sixth embodiment of the instrument according to the invention, Fig. 10 is a perspective view of a seventh embodiment of the instrument according to the invention, Fig. 11 is a perspective view of an eighth embodiment of the instrument according to the invention at three different times, with time progressing from left to right, and Fig. 12 a section through a treatment device.

[0017] How it turns out Fig. 1 to 12, an instrument 1 for opening a capsular bag 31 of an eye 34 comprises a cannula 2 and a rotor 3. The cannula 2 is designed to be inserted into the eye 34 in an insertion direction 20 of the cannula 2. In addition, the cannula 2 has a cannula longitudinal end 6 arranged in the insertion direction 20 and a cannula opening 15 ( Fig. 1 to 3, 5, 6, 10 and 11), which is arranged in a cannula section extending from the cannula longitudinal end 6. The rotor 3 is rotatable about a rotation axis 9 (see Fig. 1 to 12) is arranged inside the cannula 2. The rotor 3 has a rotor longitudinal end 7 arranged in the direction of the rotation axis 9, has an extended state in which the rotor 3 extends through the cannula opening 15 and thus protrudes from the cannula 2 and the rotor longitudinal end 7 is arranged outside the cannula 2. The extended state is in Fig. 1 to 10 and the first time of Fig. 11. In addition, the rotor 3 has a gripping device 10 (see Fig. 1 to 11), which in the extended state is arranged outside the cannula 2 and is configured to grip a part of the capsular bag 31, wherein the rotor 3 is configured to wind up the part of the capsular bag 31 by rotating the rotor 3.

[0018] The rotor 3 can be configured to rotate less than one revolution, to rotate more than one revolution, or to rotate several revolutions.

[0019] The cannula section can, for example, have an extension of 7 to 8 mm in the insertion direction 20 in order to achieve a capsulorhexis with a diameter of 5 mm.

[0020] The rotor 3 can, for example, have a modulus of elasticity in a range of 40*10 9 Pa up to 200*10 9 Pa. This makes it possible for the rotor 3 to extend through a curved region of the cannula 2 and also to rotate within the curved region. This modulus of elasticity also makes it possible for the rotor 3 to be displaced longitudinally within the cannula 2 despite the curved region.

[0021] It is conceivable that the cannula 2 is beveled in the region of the cannula's longitudinal end 6, in that the cannula 2 has a cannula end face 36 that directly adjoins the cannula opening 15 and whose normal forms an angle with the rotation axis 9 that is different from 0°. This allows the cannula 2 to be inserted particularly easily into the eye 34. In particular, the angle lies in a range of 10° to 80°.

[0022] Fig. 1, Fig. 2 and Fig. 4 show that the gripping device 10 may have a tip 11. The tip 11 may become narrower with increasing distance from the rotation axis 9. Fig. 5, Fig. 6 and Fig. 11 show that the gripping device 10 may comprise a pair of tongs 14. The tongs 14 may comprise two arms which have a spacing state in which the two arms are spaced apart from each other (see Fig. 5), and have an approach state in which the two arms are brought closer together and in which the part of the capsular bag 31 can be clamped by the two arms (see Fig. 6 and Fig. 11). Clamping can be achieved by pulling the arms into the cannula.

[0023] The rotor 3 may have a rotor interior 5 which is arranged inside the rotor 3, compare Fig. 1 to 3 and 10. Fig. Figure 10 shows that the gripping device 10 can be formed by the rotor interior 5, a rotor gripping opening 16, which in the extended state is arranged outside the cannula 2 and via which the rotor interior 5 is accessible from outside the rotor 3, and a suction device configured to suck in the part of the capsular bag 31. The rotor interior 5 can be incorporated into a peripheral surface of the rotor 3, see Fig. 10, so that the rotor interior 5 is accessible from outside the rotor 3 in a direction perpendicular to the rotation axis 9.

[0024] The gripping device 10 can have one hook or a plurality of hooks. With a plurality of hooks, it is conceivable that the hooks are arranged on the rotor 3 like a hook-and-loop fastener, thus forming a structured surface 12 of the rotor 3, see Fig. 7 to 9.

[0025] Fig. 1 to 3, 5, 6, 10 and 11 show that the instrument 1 can have an intermediate space 4 which is arranged between the cannula 2 and the rotor 3 and which is accessible via the cannula opening 15. It is conceivable that the instrument 1 is configured to irrigate or aspirate the eye 34 via the intermediate space 4 and the cannula opening 15. The rotor 3 can have a rotor opening 17 which is arranged in a rotor sub-region which extends from the rotor longitudinal end 7 and via which the rotor interior 5 is accessible. It is conceivable that the instrument 1 is configured to irrigate or aspirate the eye 34 via the rotor interior 5 and the rotor opening 17. The rotor sub-region can, for example, have an extension of 5 mm or 3 mm in the insertion direction 20. In particular, the rotor opening 17 can be introduced into a rotor end face 8 of the rotor 3, wherein the rotor end face 8 forms the rotor longitudinal end 7, see Fig. 1 to 3. In particular, the instrument 1 can be configured to irrigate the eye 34 via the intermediate space 4 and the cannula opening 15 and to aspirate via the rotor interior 5 and the rotor opening 17 or to aspirate the eye 34 via the intermediate space 4 and the cannula opening 15 and to irrigate via the rotor interior 5 and the rotor opening 17.

[0026] It is conceivable that in the extended state the rotor 3 protrudes in the insertion direction 20 from the cannula 2, compare Fig. 1 to 3 and 5 to 11. The rotation axis 9 can be arranged parallel to the insertion direction 20. Alternatively, it is conceivable that in the extended state the rotor 3 protrudes from the cannula 2 transversely to the insertion direction 20, compare Fig. 4. Fig. 4 shows that the cannula 2 can be curved, in particular to effect a deflection of the rotor 3 such that there is a first region in which the rotation axis 9 is oriented parallel to the insertion direction 20, and a second region in which the rotation axis 9 is arranged transversely, in particular perpendicularly, to the insertion direction 20.

[0027] How it turns out Fig. 11, the instrument 1 can have a contact ring 18 which is arranged at a distance from the cannula longitudinal end 6 in the insertion direction 20. The rotor 3 and the contact ring 18 can be arranged so as to be longitudinally displaceable relative to one another, wherein in the extended state the rotor 3 extends through the contact ring 18 and the rotor longitudinal end 7 protrudes from the contact ring 18 in the insertion direction 20, wherein the rotor 3 has a retracted state in which the rotor longitudinal end 7 is arranged in a position proximal to the distal end of the contact ring 18. The contact ring 18 can be mounted so as to be longitudinally displaceable in the insertion direction 20 relative to the cannula 2. The instrument 1 can have a rod 19 which is fastened to the cannula 2, in particular is fastened so as to be longitudinally displaceable, and to which the contact ring 18 is fastened. It is also conceivable that the instrument 1 has two rods or more than two of the rods 19.It is also conceivable for the instrument 1 to have a guide ring 23 through which the rotor 3 extends in the extended state and which is spaced apart and arranged proximally from the contact ring 18 and distally from the cannula's longitudinal end 6. It is also conceivable for the instrument 1 to have a plurality of guide rings 23, each of which is spaced apart from one another. It is conceivable for the contact ring 18 to be beveled at an angle in the region of the distal end 27 of the contact ring 18, in that the contact ring 18 has an end face that directly borders the contact ring opening and whose normal encloses an angle with the rotation axis 9 that is different from 0°. This allows the contact ring 18 to be inserted into the eye 34 particularly easily. In particular, the angle is in a range of 10° to 80°.

[0028] As an alternative to providing the contact ring 18, the rotor 3 can be arranged so as to be longitudinally displaceable within the cannula 2 and have a retracted state in which the rotor's longitudinal end 7 is arranged completely within the cannula 2 and spaced from the cannula opening 15. However, the embodiment with the contact ring 18 has the advantage that the part of the capsular bag 31 can reach a free area between the contact ring 18 and the cannula's longitudinal end 6 when wound onto the rotor 3, thus preventing the cannula 2 from becoming clogged with the part of the capsular bag 31.

[0029] Fig. 8 and Fig. 9 show that the instrument 1 can have a joint 13, which is arranged in a further rotor sub-region extending from the rotor longitudinal end 7, and divides the instrument 1 into a first sub-arm 21 and a second sub-arm 22, which are arranged next to one another in the insertion direction 20, wherein the first sub-arm 21 and the second sub-arm 22 can be pivoted relative to one another by means of the joint 13. For example, the instrument 1 can have a cable or two rods arranged in the cannula 2 to drive the joint 13. By pulling the cable or pushing one of the rods, the first sub-arm 21 and the second sub-arm 22 can be pivoted relative to one another. Alternatively, it is conceivable for the joint 13 to have two separate pressure chambers, which can be independently subjected to pressure or negative pressure, thus changing their volume and thereby driving the joint 13.The first arm 21 may comprise the gripping device 10. The joint 13 may, for example, be formed by the cannula 2 (see . Fig. 8) and / or be formed by the rotor 3 (see Fig. 9). In the extended state, the further rotor section can, for example, have an extension in the insertion direction 20 that is longer than the extension of the rotor section in the insertion direction 20. Fig. Figure 9 shows that the diameter of the rotor 3 in a region that is arranged outside the cannula 2 in the extended state can increase with increasing distance from the joint 13. For example, the rotor 3 can have the shape of a truncated cone 24, with the base surface 25 of the truncated cone 24 forming the rotor's longitudinal end 7. The cover surface 26 of the truncated cone 24 is arranged proximal to the base surface 25 and can, in particular, border the joint 13.

[0030] Fig. 12 shows a treatment device 40 with the instrument 1. The eye 34 is depicted with a cornea 35, the capsular bag 31, and a lens 32, with the cannula longitudinal end 6 and the rotor longitudinal end 7 of the instrument 1 being arranged in the eye 34. The instrument 1 can have a motor 45 configured to rotate the rotor 3. Furthermore, the instrument 1 can have a handpiece 44 that can be grasped by a physician performing cataract treatment. The motor 45 can, for example, be arranged in the handpiece 44.

[0031] The treatment device 40 may comprise a surgical microscope 41 with a field of view 33 (see also Fig. 9). In addition, the treatment device 40 may have an image processing unit 42 that is coupled to the surgical microscope 41 and configured to analyze images captured by the surgical microscope 41.

[0032] The treatment device 40 can be configured to control the rotation of the rotor 3 based on the distance traveled by the instrument 1 in the eye 34 and / or the distance torn in the capsular bag 31. For this purpose, the treatment device 40 can have a control unit 43 coupled to the motor 45 and configured to control the angular velocity of the motor 45. The distance traveled by the instrument 1 and / or the distance torn in the capsular bag 31 can be determined using the surgical microscope 41 and the image processing unit 42, wherein the control unit 43 is coupled to the image processing unit 42. However, it is also conceivable for the treatment device to have a surgical robot configured to guide the instrument 1, and for the distance traveled by the instrument 1 to be determined based on the coordinates traversed by the surgical robot.In particular, the rotation of the rotor can be controlled so that the wound-up distance of the part of the capsular bag 31 corresponds to the distance traveled by the instrument in the eye or the torn distance of the capsular bag 31.

[0033] Alternatively, the treatment device 40 can be configured to control the rotation of the rotor 3 such that the distance of the instrument 1 from the position at which the capsular bag 31 ruptures is kept constant. For this purpose, the treatment device 40 can also comprise a control unit 43 coupled to the motor 45 and configured to control the angular velocity of the motor 45. The image processing unit 42 can be coupled to the control unit 43 and configured to determine the position of the instrument 1, the position at which the capsular bag 31 ruptures, and the distance between these two positions.

[0034] In addition, it is conceivable that the treatment device 40 is configured to take into account, when regulating the rotation of the rotor 3, that due to wound-up layers of the capsular bag 31, a longer section of the capsular bag 31 is wound up per revolution with increasing duration of the rotation of the rotor 3, compare for example Fig. 3, in which one layer of the part of the capsular bag 31 is arranged on another layer of the part of the capsular bag 31. List of reference symbols 1 instrument 2 cannulas 3 Rotor 4 gap 5 Rotor interior 6 cannula longitudinal end 7 Rotor longitudinal end 8 Rotor face 9 Rotation axis 10 Gripping device 11 top 12 Surface structuring 13 Joint 14 pliers 15 Cannula opening 16 Rotor gripping opening 17 Rotor opening 18 Contact ring 19 staff 20 Insertion direction 21 first arm 22 second arm 23 Guide ring 24 truncated cone 25 floor space 26 deck area 27 distal end of the contact ring 31 Capsular bag 32 lens 33 field of view surgical microscope 34 Eye 35 Cornea 36 Cannula face 40 Treatment device 41 Surgical microscope 42 Image processing unit 43 Control unit 44 Handpiece 45 engine

Claims

[1] Instrument (1) for opening a capsular bag (31) of an eye (34), comprising a cannula (2) which is designed to be inserted into the eye (34) in an insertion direction (20) of the cannula (2), and a cannula longitudinal end (6) arranged in the insertion direction (20) and a cannula opening (15) which is arranged in a cannula sub-region extending from the cannula longitudinal end (6), and a rotor (3) which is arranged rotatably about a rotation axis (9) within the cannula (2), has a rotor longitudinal end (7) arranged in the direction of the rotation axis (9), has an extended state in which the rotor (3) extends through the cannula opening (15) and thus protrudes from the cannula (2), and the rotor longitudinal end (7) is arranged outside the cannula (2), and a gripping device (10) which, in the extended state, is arranged outside the cannula (2) and is designed to grip a part of the capsular bag (31),wherein the rotor (3) is arranged to wind up the part of the capsular bag (31) by rotating the rotor (3). [2] Instrument (1) according to claim 1, wherein the rotor (3) has a rotor interior (5) arranged within the rotor (3). [3] Instrument (1) according to claim 2, wherein the gripping device (10) is formed by the rotor interior (5), a rotor gripping opening (16) which, in the extended state, is arranged outside the cannula (2) and via which the rotor interior (5) is accessible from outside the rotor (3), and a suction device which is configured to suck a fluid out of the rotor interior (5). [4] Instrument (1) according to claim 2 or 3, wherein the instrument (1) has an intermediate space (4) which is arranged between the cannula (2) and the rotor (3) and which is accessible via the cannula opening (15), and the rotor (3) has a rotor opening (17) which is arranged in a rotor partial region which extends from the rotor longitudinal end (7), wherein the instrument (1) is designed to irrigate the eye (34) via the intermediate space (4) and the cannula opening (15) and to aspirate via the rotor interior (5) and the rotor opening (17) or to aspirate the eye (34) via the intermediate space (4) and the cannula opening (15) and to irrigate via the rotor interior (5) and the rotor opening (17). [5] Instrument (1) according to one of claims 1 to 4, wherein the rotor (3) is arranged longitudinally displaceably in the cannula (2) and has a retracted state in which the rotor longitudinal end (7) is arranged completely within the cannula (2) and spaced from the cannula opening (15), or wherein the instrument (1) has a contact ring (18) which is arranged spaced from the cannula longitudinal end (6) in the insertion direction (20), wherein the rotor (3) and the contact ring (18) are arranged longitudinally displaceably relative to one another, wherein in the extended state the rotor (3) extends through the contact ring (18) and the rotor longitudinal end (7) protrudes from the contact ring (18) in the insertion direction (20), wherein the rotor (3) has a retracted state in which the rotor longitudinal end (7) is in a position proximal to the distal end of the contact ring (18) is arranged. [6] Instrument (1) according to one of claims 1 to 5, wherein the instrument (1) has a joint (13) which is arranged in a further rotor sub-region which extends from the rotor longitudinal end (7) and divides the instrument (1) into a first sub-arm (21) and a second sub-arm (22) which are arranged next to one another in the insertion direction (20), wherein the first sub-arm (21) and the second sub-arm (22) are pivotable relative to one another by means of the joint (13). [7] Instrument (1) according to claim 6, wherein the diameter of the rotor (3) becomes longer with increasing distance from the joint (13). [8] Treatment device (40) with an instrument (1) according to one of claims 1 to 7. [9] Treatment device (40) according to claim 8, wherein the treatment device (40) is arranged to regulate the rotation of the rotor (3) by taking into account the distance traveled by the instrument (1) in the eye (34) and / or by taking into account the torn distance of the part of the capsular bag (31), or wherein the treatment device (40) is arranged to regulate the rotation of the rotor (3) such that the distance of the instrument (1) to the position at which the capsular bag (31) tears is kept constant. [10] Treatment device according to claim 9, wherein the treatment device (40) is arranged to take into account, when regulating the rotation of the rotor (3), that due to wound-up layers of the capsular bag (31) a longer distance of the part of the capsular bag (31) is wound up per revolution with increasing duration of the rotation of the rotor (3).

Images