Surgical illumination system

Abstract

A surgical illumination system comprising a light source having at least two laser diodes configured to emit at least respective first and second laser light beams; a light source optical fiber having a proximal portion configured to receive the first and the second laser light beam from the at least two laser diodes, and a distal portion configured to emit a combined laser light beam from the light source; and an illumination microsurgical device removably coupled to the light source, the illumination microsurgical device including a device optical fiber with a proximal portion configured to receive the combined laser light beam from the light source and a distal portion configured to emit the combined laser light beam from the light source, the proximal portion of the device optical fiber having an aperture opening.

Description

SURGICAL ILLUMINATION SYSTEM CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to US Application No.18 / 181,891 and to PCT application No. PCT / US23 / 64111 both filed 10-March-2023, the subject matter of which is herein incorporated by reference in its entirety. BACKGROUND OF THE INVENTION

[0002] The subject matter herein relates generally to a surgical illumination system, and in particular to an ophthalmic illumination system with a light beam having a spot size modulated to an opening aperture of a device optical fiber to provide illumination to a surgical site during a surgical procedure.

[0003] Various ophthalmic surgical procedures, sometimes referred to as vitreo-retinal procedures, are commonly performed in the posterior segment of the eye. Ophthalmic surgical procedures are appropriate to treat many serious conditions of the posterior segment, such as age-related macular degeneration (AMD), diabetic retinopathy and diabetic vitreous hemorrhage, macular hole, retinal detachment, epiretinal membrane, CMV retinitis, and many other ophthalmic conditions.

[0004] During the surgical procedures, proper illumination of the inside of the eye is important. Typically, ophthalmic illumination systems, such as endoilluminator systems include a light source and a fiberoptically illuminated microsurgical device to provide light to the surgical site. A user, such as a surgeon or other medical professional, can insert the microsurgical device into the eye to illuminate the inside of the eye. The light source and other illumination optics direct a light beam into an optical fiber of the illuminated microsurgical device.

[0005] It is desirable to minimize the number and size of incisions required to perform ophthalmic surgical procedures. Typically, incisions are only madelarge enough to accommodate the size of the microsurgical instrument being inserted into the interior of the eye. Therefore, minimizing the size of the microsurgical instrument can minimize the incision size and eliminate the need to surgical sutures. Reducing the number of incisions may be accomplished by integrating various microsurgical instruments. For example, the optical fiber may be incorporated into the working end of a microsurgical instrument to eliminate the need for a separate illumination incision.

[0006] However, prior attempts at integrating multiple microsurgical instruments resulted in larger instruments requiring larger incisions or were accompanied by a corresponding decrease in the performance of one or all of the integrated surgical instruments. For example, the size of the optical fiber used in microsurgical instruments has been limited by the size and volume of the light beam emitted by conventional light sources that use conventional light elements, such as Tungsten, Halogen, incandescent, Metal Halide arc, Xenon arc, Mercury Vapor arc, and LED.

[0007] All of the LED, incandescent, and arc sources within these lamps are large relative to the size of the fibers that they are coupled with. Generally, conventional light sources are limited to use with optical fibers with a diameter of 200 microns or greater. These conventional light sources are not capable of emitting a light beam with a focal point that is smaller than an opening aperture of the optical fiber. As a result, reducing the size of the optical fiber would reduce the amount of light transmitted by the optical fiber to an unacceptable level of performance.

[0008] Accordingly, there is a need for an surgical illumination system having a light source that can emit a light beam with a focal point modulated to an opening aperture of an optical fiber for illuminating a surgical site during a surgical procedure.

[0009] Additionally, there is a longtime need in using low-power laser instead of high-power lasers as high-power lasers are high-maintenance. They require higher power, thus drawing more power and increasing the cost of the electroniccomponents in the device. High-power lasers are more expensive than low-power lasers and besides that due to high output power they increase the risk to service technicians who come in direct contact with the lasers. This calls for stricter laser safety than low-power lasers. For using low-power lasers, it is essential to reduce light losses within the optical alignment system to reduce the sufficiency of high-power lasers by keeping the light output of the optical fiber for illuminating a surgical site during a surgical procedure on the same level.

[0010] Moreover, it is essential to have a stable setup with a high level of versatility. Typically, optics such as lenses, mirrors, gratings, optical diffusors, beam combiners, beam splitters or other optical setup devices need to be aligned and a slightly misalignment of the involved optics can cause a severely lower light output. Small movements or bumpings of the setup can make a realignment necessary which can be tedious as well as time and cost consuming. Hence, there is a need for reducing the alignment effort and ensuring a stable setup.

[0011] Additionally, surgical used light sources aiming at emitting light having a high degree of natural appearance. A color rendering index (CRI) is a quantitative measure of the ability of a light source to reveal the colors of various objects faithfully in comparison with a natural or standard light source. Light sources with a high CRI are desirable in color-critical applications such as but not limited to ophthalmic surgical procedures. Moreover, light from this kind of light sources causes less stress on the observers eyes when exposed to it for a longer duration. It also avoids the phenomenon where the white light may appear bluish to some individuals whereas it may appear redish to some individuals which may cause discomfort to the observer. Therefore it is indispensable that the emitted light beam of the light source of the surgical illumination system shows a natural appearance with high homogeneity and having a high color rendering index.

[0012] During posterior ophthalmic surgery, a trocar cannula is inserted into the eye, acting as the port for the surgeon to insert microsurgical instruments into the eye. A cannula is a port that allows different surgical instruments to enter the eye while maintaining the pressure in the eye. Additionally, illumination of the eye is required to allow the surgeon to visualize the surgical field. Illumination of the eye is often accomplished using hands-free Chandelier illumination. Hence, multiple numbers of incisions made in the eye are necessary for the surgeon to have a reasonable visualization of the surgical field resulting in a longer healing process. Therefore, it is essential to eliminate the need for an additional endoillumination device to aim at reducing the number of incisions made in the eye. BRIEF DESCRIPTION OF THE INVENTION

[0013] The subject-matter of the independent claims solves the above mentioned problems. Advantages embodiments of the invention are subject-matter of the dependent claims.

[0014] In one aspect of the invention, the inventive surgical illumination system comprises a light source having at least one laser diodes configured to emit an at least first laser light beam.

[0015] In other words, the first laser diode is configured to emit the first laser light beam. There can also be for example a second laser diode which then would be configured to emit a second laser light beam. There can also be for example a third laser diode which then would be configured to emit a third laser light beam. There can also be more than three laser diodes. In this case, i.e., if there would be a fourth laser diode, then this fourth laser diode would be configured to emit a fourth laser light beam.

[0016] Laser diode (LD) in this application is used in the common way and means a semiconductor device similar to a light-emitting diode in which a diodepumped directly with electrical current can create lasing conditions at the diode's junction. Laser diodes are often referred to as injection laser diode (ILD) or diode laser.

[0017] Additionally, the light source comprises a backlight element configured to emit a backlight beam. The backlight beam backlights the at least first laser light beam.

[0018] The light source is configured to combine the at least first laser light beam with the backlight beam to a combined beam. A combined light beam means in this context that the at least first laser light beam emitted by the at least first laser diode and the backlight beam are forming the combined light beam. The combined light beam can be a unitary light beam.

[0019] The at least first laser light beam and the backlight beam can be for example coherently or incoherently combined, polarization combined or specrally combined by the use of optical elements, i.e., beam splitters, lenses, gratings, mirrors or beam combiners or by the use of optical fibers.

[0020] In addition, the inventive surgical illumination system comprises an illumination microsurgical device removably coupled to the light source. In other words, the illumination microsurgical device can be detachable coupled to the light source.

[0021] The illumination microsurgical device includes a device optical fiber with a proximal portion configured to receive the combined light beam from the light source and a distal portion configured to emit the combined light beam from the light source.

[0022] In other words, the device optical fiber comprises a proximal portion and a distal portion. The proximal portion of the device optical fiber is configured to receive the combined light beam from the light source and the distal portion is configuredto emit the combined light beam from the light source. The distal portion can be configured to emit the combined light beam for instance to a surgical site.

[0023] Additionally, the proximal portion of the device optical fiber comprises an aperture opening.

[0024] In a preferred embodiment, the combined light beam has a spot size at the proximal portion of the device optical fiber. The light beam has to a first approximation a Gaussian beam shape with an intensity distribution of I(r,z)=I_0 (ω_0 / (ω(z)))^2 exp((-2r^2) / ^ω(z)^^2 )waist, ω_0=ω(0) is the waist radius, ω(z) is the radius at which the field amplitudes fall to 1 / e of their axial values (i.e., , where the intensity values fall to 1 / e2 of their axial values), at the plane z along the beam, r is the radial distance from the center axis of the beam and z is the axial distance from the beam’s focus (or “waist”). In the context of this application, the spot size is defined as the full width at half maximum, in which case the diameter obtained is the full width of the beam at half its maximum intensity, i.e., the beam width at which the irradiance is a 1 / 2 fraction of the beam's peak irradiance.

[0025] The spot size of the combined light beam can be smaller than or equal to two times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.9 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.8 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.7 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.6 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.5 times the size of the aperture opening of the device optical fiber. The spot size of thecombined light beam can be smaller than or equal to 1.4 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.3 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.2 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 1.1 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.9 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.8 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.7 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.6 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.5 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.4 times the size of the aperture opening of the device optical fiber. The spot size of the combined light beam can be smaller than or equal to 0.3 times the size of the aperture opening of the device optical fiber.

[0026] With this kind of relationships between the spot size of the combined light beam and the size of the aperture opening of the device optical fiber, an efficient light transfer and coupling into the device optical fiber can be ensured resulting in an efficient output power of the fiber.

[0027] In a preferred embodiment, the combined light beam has a numerical aperture and the device optical fiber has a numerical aperture.

[0028] The numerical aperture is defined asNA=n ^*sin^^θof refraction of the medium through which the light beam is propagating and the medium in which the optical fiber is working, respectively, and θ is the beam divergence angle of the light beam and the half-angle of the maximum cone of light that can enter or exit the optical fiber, respectively.

[0029] The beam divergence angle of the light beam θ can be calculated by θ=λ / (π*n*ω_0 ) where λ is the free-space wavelength and ω_0=ω(0) is the beam waist radius.

[0030] The Numerical Aperture (NA) of a fiber is defined as the sine of the largest angle an incident ray can have for total internal reflectance in the core of the fiber.

[0031] The numerical aperture of the combined light beam can be smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 1.4 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 1.3 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 1.2 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 1.1 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 0.9 times the size of the numerical aperture of thedevice optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 0.8 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 0.7 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 0.6 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined light beam can be smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber.

[0032] With this kind of relationships between the numerical aperture of the combined light beam and the numerical aperture of the device optical fiber, an efficient light transfer and coupling into the device optical fiber can be ensured resulting in an efficient output power of the fiber.

[0033] In this context, it is immediately and unambiguously clear that any combination of the above disclosed relationship between the spot size of the combined light beam and the size of the aperture opening and the relationship between the numerical aperture of the combined light beam and the numerical aperture of the device optical fiber is possible and herein disclosed in this application.

[0034] Different beams with different numerical apertures can be coupled into the device optical fiber.

[0035] Since the beam divergence angle θ depends on the wavelength λ of the light beam, in a preferred embodiment it is ensured that the beam shapes of the first laser light beam and the backlight beam, having both different wavelength ranges, overlap for all angles to prevent different color gradients for different beam shapes.

[0036] Preferably, the beam shapes of the first laser light beam and the backlight beam overlap for all angles in such a way that in about more than 80% of theilluminated radius, the color gradient is smaller than 10 macadam, Preferably smaller than 4 macadam, more Preferably smaller than 2 macadam.

[0037] This can be ensured by keeping the beam divergence angle constant for each wavelengths resulting to different beam waist radiuses ω(0) for the different light beams. The overlapping procedure can be optimized by flyens or by diffusion plates.

[0038] In a preferred embodiment, the backlight element comprises at least one LED, Preferably at least two LEDs. The backlight element can also comprise more than two laser LEDs. LED in this application is used in the common way as a light- emitting diode.

[0039] Using a LED for backlighting the emitted laser light beam from the at least three laser diodes, helps in increasing the color rendering index of the combined light beam. Using more than one LED for backlighting the emitted laser light beam from the at least three laser diodes helps in controlling the color temperature of the combined light beam in a finer manner.

[0040] In a preferred embodiment, the at least one LED is configured to emit light with a color temperature between 4000K and 7000K.

[0041] In this color temperature range, the appearance of the LED is closest compared to natural white light and thus backlighting with this specific color temperature helps blend in the white light emitting from the laser diodes thus a more natural appearance white light.

[0042] In a preferred embodiment, the intensity of the at least one LED is adjustable. Additionally or instead, the color temperature of the at least two LEDs is adjustable.

[0043] By using an intensity-adjustable LED it is possible to choose the desired output intensity of the emitted combined light beam depending on the surgical conditions. By using a color temperature-adjustable LED it is possible to choose the desired color temperature of the emitted combined light beam depending on the surgical conditions. The surgeon is able to adjust what is most favorable to him.

[0044] In a preferred embodiment, the backlight element comprises at least one additional laser diode, Preferably at least two additional laser diodes. The backlight element can also comprise more than two additional laser diodes.

[0045] Adding an additional laser diode besides the already present red, green and blue laser diode helps to cover a lager wavelengths spectrum. By combining the emitted laser light beams to a combined light beam, white light with a more natural appearance is produced.

[0046] In a preferred embodiment, the at least one additional laser diode is configured to emit light in a spectral range between about 380 nm to about 730 nm, excluding a wavelength range of about 450 nm to about 460 nm, Preferably excluding a wavelength range of about 440 nm to about 500 nm, excluding a wavelength range of about 510 nm to about 530 nm, Preferably excluding a wavelength range of about 510 nm to about 570 nm, or excluding a wavelength range of about 650 nm to about 670 nm, Preferably excluding a wavelength range of about 620 nm to about 670 nm.

[0047] In other words, the emitted light of the at least one additional laser diode can be in the visible wavelength range but is not in the wavelength range of a blue laser diode (about 450 nm to about 460 nm), Preferably not in a wavelength range about 440 nm to about 500 nm, and not in the wavelength range of a green laser diode (about 510 nm to about 530 nm), Preferably not in a wavelength range of about 510 nm to about 570 nm, and not in the wavelength range of a red laser diode (about 650 nm to about 670 nm), Preferably not in a wavelength range about 620 nm to about 670 nm.

[0048] The spectral range of the at least additional laser laser diode of the backlight element can therefore be in the wavelength range of about 380 nm to about 450 nm, Preferably in the wavelength range of about 380 nm to about 440 nm. The spectral range of the at least additional laser laser diode of the backlight element can also be in the wavelength range of about 460 nm to about 510 nm, Preferably in the wavelength range about 500 nm to about 510 nm. The spectral range of the at least additional laser laser diode of the backlight element can also be in the wavelength range of about 530 nm to about 650 nm, Preferably in the wavelength range about 530 nm to about 620 nm or Preferably in the wavelength range about 570 nm to about 650 nm, more Preferably in the wavelength range between about 530 nm to about 570 nm or more Preferably in the wavelength range between about 620 nm to about 650 nm, most Preferably in the wavelength range between about 570 nm to about 620 nm. The spectral range of the at least additional laser laser diode of the backlight element can also be in the wavelength range of about 670 nm to about 730 nm.

[0049] Using an additional laser diode in these wavelengths regimes, provides additional wavelengths besides the already present red, green and blue wavelengths to cover a broader wavelengths spectrum or to provide more than three discrete spectral ranges within the overall wavelength spectrum.

[0050] Additionally or instead, the emitted light of one of the at least additional laser diodes can be in the ultraviolet spectral range, i.e., in the wavelength regime of about 280 nm to about 380 nm. Additionally or instead, the emitted light of one of the at least additional laser diodes can also be in the infrared spectral regime, i.e., in the wavelength range of about 730 nm to about 1000 nm.

[0051] A laser diode in the ultraviolet or in the infrared spectral regime can be used for surgical procedures.

[0052] If there is more than one additional laser diode, one of the additional laser diodes can be configured to emit light in one of the above mentioned wavelengths ranges, but the other additional laser diodes can be configured to emit light in one of the other above mentioned wavelengths ranges. It can also be that the more than one additional laser diodes are configured to emit light in the same of the above mentioned wavelengths range.

[0053] In a preferred embodiment, the light source has at least three laser diodes configured to emit at least respective first, second and third laser light beams. One of the at least three laser diodes is configured to emit light in a spectral range between about 440 nm to about 500 nm, Preferably in a spectral range between about 450 nm to about 460 nm. Additionally or instead, another one of the at least three laser diodes is configured to emit light in a spectral range between about 510 nm to about 570 nm, Preferably in a spectral range between about 510 nm to about 530 nm. Additionally or instead, another one of the at least three laser diodes is configured to emit light in a spectral range between about 620 nm to about 670 nm, Preferably in a spectral range between about 650 nm to about 670 nm.

[0054] Using a blue, green and red laser diode helps to create a wide spectrum white light showing a high CRI and a natural color appearance.

[0055] In a preferred embodiment, the color rendering index of the combined light beam is larger than 50, Preferably larger than 80, most Preferably larger than 85. A color rendering index of the combined light beam in this ranges can be achieved by combining the laser beams of an appropriate number of laser diodes. The number of combined laser beams may depend on the spectral emission characteristics of each of the laser diodes. Accordingly, the laser diodes as well as the number of different laser diodes to be combined are selected according to their individual spectral emission characteristics and the spectral characteristics of the resulting combined beam.

[0056] Emitting a combined light beam with a large color rendering index shows a more natural appearance which causes less stress on the observers eyes when exposed to it for a longer duration. It also avoids the phenomenon where the white light may appear bluish to some individuals whereas it may appear redish to some individuals which may cause discomfort to the observer.

[0057] In another aspect of the invention, the inventive surgical illumination system comprises a light source having at least two laser diodes configured to emit an at least respective first and a second laser light beam.

[0058] In other words, the first laser diode is configured to emit the first laser light beam and the at least second laser diode is configured to emit the second laser light beam. There can also be more than two laser diodes. In this case, i.e., if there would be a third laser diode, then this third laser diode would be configured to emit a third laser light beam.

[0059] Additionally, the light source comprises a light source optical fiber having a proximal portion configured to receive the first and the second laser light beam from the at least two laser diodes, and a distal portion configured to emit a combined laser light beam from the light source.

[0060] In other words, the light source optical fiber comprises a proximal portion and a distal portion. The proximal portion of the light source optical fiber is configured to receive the first laser light beam emitted by the first laser diode and the at least second laser light beam emitted by the second laser diode. The distal portion of the light source optical fiber is configured to emit a combined laser light beam from the light source.

[0061] A combined laser light beam means in this context that the first laser light beam emitted by the first laser diode and the at least second laser light beam emitted by the at least second laser diode are forming the combined laser light beam. Thecombined laser light beam can be a unitary laser light beam. The first laser light beam and the at least second laser light beam can be for example coherently or incoherently combined, polarization combined or specrally combined.

[0062] An optical fiber typically comprises a core, a cladding surrounding the core, and a coating.

[0063] In addition, the inventive surgical illumination system comprises an illumination microsurgical device removably coupled to the light source. In other words, the illumination microsurgical device can be detachable coupled to the light source.

[0064] The illumination microsurgical device includes a device optical fiber with a proximal portion configured to receive the combined laser light beam from the light source and a distal portion configured to emit the combined laser light beam from the light source.

[0065] In other words, the device optical fiber comprises a proximal portion and a distal portion. The proximal portion of the device optical fiber is configured to receive the combined laser light beam from the light source and the distal portion is configured to emit the combined laser light beam from the light source. The distal portion can be configured to emit the combined laser light beam for instance to a surgical site.

[0066] Additionally, the proximal portion of the device optical fiber comprises an aperture opening defined a frontal surface of the core of the device optical fiber at its proximal portion.

[0067] In a preferred embodiment, the combined laser light beam has a spot size at the distal portion of the light source optical fiber. The light beam has to a first approximation a Gaussian beam shape with an intensity distribution of I(r,z)=I_0 (ω_0 / (ω(z)))^2 exp((-2r^2) / ^ω(z)^^2 )where I_0 is the intensity at the center of the beam waist, ω_0=ω(0) is the waist radius, ω(z) is the radius at which the field amplitudes fall to 1 / e of their axial values (i.e., , where the intensity values fall to 1 / e2 of their axial values), at the plane z along the beam, r is the radial distance from the center axis of the beam and z is the axial distance from the beam’s focus (or “waist”). In the context of this application, the spot size is defined as the full width at half maximum, in which case the diameter obtained is the full width of the beam at half its maximum intensity, i.e., the beam width at which the irradiance is a 1 / 2 fraction of the beam's peak irradiance.

[0068] The spot size of the combined laser light beam can be smaller than or equal to two times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.9 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.8 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.7 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.6 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.5 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.4 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.3 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.2 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 1.1 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.9 times the size of the aperture opening of the device optical fiber. Thespot size of the combined laser light beam can be smaller than or equal to 0.8 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.7 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.6 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.5 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.4 times the size of the aperture opening of the device optical fiber. The spot size of the combined laser light beam can be smaller than or equal to 0.3 times the size of the aperture opening of the device optical fiber.

[0069] With this kind of relationships between the spot size of the combined laser light beam and the size of the aperture opening of the device optical fiber, an efficient light transfer and coupling into the device optical fiber can be ensured resulting in an efficient output power of the fiber.

[0070] In a preferred embodiment, the combined laser light beam has a numerical aperture and the device optical fiber has a numerical aperture.

[0071] The numerical aperture is defined as NA=n ^*sin^^θ where n is the index of refraction of the medium through which the laser light beam is propagating and the medium in which the optical fiber is working, respectively, and θ is the beam divergence angle of the laser light beam and the half-angle of the maximum cone of light that can enter or exit the optical fiber, respectively.

[0072] The beam divergence angle of the laser light beam θ can be calculated byθ=λ / (π*n*ω_0 ) where λ is the free-space wavelength and ω_0=ω(0) is the laser beam waist radius.

[0073] The numerical aperture of the combined laser light beam can be smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 1.4 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 1.3 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 1.2 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 1.1 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 0.9 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 0.8 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 0.7 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 0.6 times the size of the numerical aperture of the device optical fiber. The numerical aperture of the combined laser light beam can be smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber.

[0074] The numerical aperture of the device optical fiber again is defined as described above as the sine of the largest angle an incident ray can have for total internal reflectance in the core of the device optical fiber

[0075] With this kind of relationships between the numerical aperture of the combined laser light beam and the numerical aperture of the device optical fiber, an efficient light transfer and coupling into the device optical fiber can be ensured resulting in an efficient output power of the fiber.

[0076] In this context, it is immediately and unambiguously clear that any combination of the above disclosed relationship between the spot size of the combined laser light beam and the size of the aperture opening and the relationship between the numerical aperture of the combined laser light beam and the numerical aperture of the device optical fiber is possible and herein disclosed in this application.

[0077] Different beams with different numerical apertures can be coupled into the device optical fiber.

[0078] Since the beam divergence angle θ depends on the wavelength λ of the light beam, in a preferred embodiment it is ensured that the beam shapes of the first laser light beam and the backlight beam, having both different wavelength ranges, overlap for all angles to prevent different color gradients for different beam shapes.

[0079] Preferably, the beam shapes of the first laser light beam and the backlight beam overlap for all angles in such a way that in about more than 80% of the illuminated radius, the color gradient is smaller than 10 macadam, Preferably smaller than 4 macadam, more Preferably smaller than 2 macadam.

[0080] This can be ensured by keeping the beam divergence angle constant for each wavelengths resulting to different beam waist radiuses ω(0) for the different light beams. The overlapping procedure can be optimized by flyens or by diffusion plates.

[0081] In a preferred embodiment, each of the at least two laser diodes is coupled to a respective diode optical fiber, i.e., the first laser diode is coupled to a firstdiode optical fiber and the at least second laser diode is coupled to a second diode optical fiber.

[0082] Each of the diode optical fibers has a proximal portion configured to receive the laser light beam from the respective laser diode, and a distal portion configured to emit the respective laser light beam to a fused optical fiber.

[0083] The fused optical fiber has a proximal portion configured to receive the first and the second laser light beam and a distal portion configured to emit the combined laser light beam.

[0084] The light source optical fiber comprises the at least two diode optical fibers and the fused optical fiber. In other words, the at least two diode optical fibers and the fused optical fiber compose the light source optical fiber.

[0085] The coupling of the laser diodes to the diode optical fibers helps reducing the light losses and hence assuring the use of low-power lasers. Additionally, thereby the need for alignment can be eliminated.

[0086] It is preferred that the distal portions of the at least two diode optical fibers are coupled to the proximal portion of the fused optical fiber. It is especially preferred that the distal portions of the at least two diode optical fibers are heat-fused or spliced to the proximal portion of the fused optical fiber. The distal portions of the at least two diode optical fibers can also coupled to the proximal portion of the fused optical fiber by tapering or glueing or by using a microoptic combiner.

[0087] The coupling of the fused optical fibers to the diode optical fibers helps reducing the light losses and hence assuring the use of low-power lasers. Additionally, thereby the need for alignment can be eliminated.

[0088] Preferably, the fused optical fiber has an etendue which is equal to or larger than the etendue of the diode optical fibers.

[0089] In another preferred embodiment, the core diameter of each of the at least two diode optical fibers is smaller than the core diameter of the proximal portion of the fused optical fiber. Additionally or instead, the core diameter of the distal portion of the fused optical fiber is preferred smaller than or equal to the core diameter of the device optical fiber.

[0090] By ensuring the core diameter of the diode optical fibers to be smaller than the core diameter of the fused optical fiber, an effective transfer of the light inside of the light source can be guaranteed. All of the light from the smaller diode optical fibers can be captured und directed into the larger fused optical fiber. By ensuring the core diameter of the diode optical fibers to be smaller than the core diameter of the fused optical fiber, an effective transfer of the light from the light source to the illumination microsurgical device can be guaranteed.

[0091] Preferably, the at least two diode optical fibers are tapered down from with their larger core diameter at their proximal portion to their smaller core diameter at their distal portion. In other words, the core diameter at the proximal portion of the at least two diode optical fibers is larger than the core diameter at the distal portion of the at least two diode optical fibers.

[0092] This enables a higher versatility in the fusion process. By tapering the diode optical fibers, the spot size of the combined laser light beam at the distal portion of the light source optical fiber (or in other words at the distal portion of the fused optical fiber) can be reduced, e.g., the desired spot size of the combined laser light beam at the distal portion of the light source optical fiber (or in other words at the distal portion of the fused optical fiber) can be adjusted by adjusting the tapering of the diode optical fibers. In other words, the numerical aperture from the proximal portion to the distal portion of the diode optical fibers can be adjusted. By having a larger core diameter at the proximal portion of the diode optical fibers, the majority of the light can be captured.

[0093] It can also be that the at least two diode optical fibers are tapered up from with their smaller core diameter at their proximal portion to their larger core diameter at their distal portion.

[0094] In a preferred embodiment, the fused optical fiber is tapered down from with its larger core diameter at its proximal portion to its smaller core diameter at its distal portion. In other words, the core diameter at the proximal portion of the fused optical fiber is larger than the core diameter at the distal portion of the fused optical fiber.

[0095] By tapering the fused optical fiber, the spot size of the combined laser light beam at the distal portion of the light source optical fiber can be reduced, e.g., the desired spot size of the combined laser light beam at the distal portion of the light source optical fiber can be adjusted by adjusting the tapering of the fused optical fiber. In other words, the numerical aperture from the proximal portion to the distal portion of the fused optical fiber can be adjusted. By having a larger core diameter at the proximal portion of the fused optical fiber, the majority of the light can be captured.

[0096] It can also be that the fused optical fiber is tapered up from with its smaller core diameter at their proximal portion to their larger core diameter at its distal portion.

[0097] In a preferred embodiment, the core diameter of the at least two diode optical fibers at the distal and / or proximal portion is between 10 and 150 microns, especially preferred between 10 and 50 microns. Additionally or instead, the core diameter of the fused optical fiber at the distal and / or proximal portion is preferred between 50 and 500 microns, especially preferred between 50 and 200 microns. Additionally or instead, the core diameter of the device optical fiber at the distal and / or proximal portion is between 50 and 250 microns.

[0098] By using diode optical fibers and / or a fused optical fiber and / or a device optical fiber in this core diameter range, the efficiency of the system can beincreased and losses are reduced, which enables using low powered lasers, and hence reducing the costs for the inventive surgical illumination system by lowering the laser safety requirements at the same time.

[0099] Preferably, the at least two diode optical fibers comprise, but are not limited to, silica and / or borosilicate and / or and / or acryl (PMMA) and / or a polyermer based material, especially preferred plastic and / or transparent ceramic, especially preferred polycrystalline ceramic. Additionally or instead, the fused optical fiber Preferably comprise, but are not limited to, silica and / or borosilicate and / or acryl (PMMA) and / or a polyermer based material, especially preferred plastic and / or transparent ceramic, especially preferred polycrystalline ceramic. Additionally or instead, the device optical fiber Preferably comprise, but are not limited to, silica and / or acryl (PMMA) and / or a polyermer based material, especially preferred plastic and / or transparent ceramic, especially preferred polycrystalline ceramic.

[0100] In a preferred embodiment, the at least two diode optical fibers have a numerical aperture between 0.2 and 0.7. Additionally or instead, the fused optical fiber has a numerical aperture between 0.2 and 0.7. Additionally or instead, the device optical fiber has a numerical aperture between 0.2 and 0.7.

[0101] This is advantageous, as by increasing the numerical aperture, gathering more light is ensured which enables using low-power lasers.

[0102] In a preferred embodiment, the first and the at least second laser light beam are configured to be spectrally combined, polarization combined or coherently combined to form the combined laser light beam.

[0103] In a preferred embodiment, the light source has at least three laser diodes configured to emit an at least respective first, second and third laser light beam. Additionally, the light source has a backlight element configured to emit a backlight beam. In this embodiment, the proximal portion of the light source optical fiber is configured toreceive the at least first, second and third laser light beam and the backlight beam. The distal portion of the light source optical fiber is configured to emit the combined light beam from the light source.

[0104] By backlighting the emitted laser light beam of the at least three laser diodes, the combined light beam shows a more natural appearance with high degree of homogeneity and having a high color rendering index.

[0105] In a preferred embodiment, the backlight element comprises at least one LED, Preferably at least two LEDs. The backlight element can also comprise more than two laser LEDs. LED in this application is used in the common way as a light- emitting diode.

[0106] Using a LED for backlighting the emitted laser light beam from the at least three laser diodes, helps in increasing the color rendering index of the combined light beam. Using more than one LED for backlighting the emitted laser light beam from the at least three laser diodes helps in controlling the color temperature of the combined light beam in a finer manner.

[0107] In a preferred embodiment, the at least one LED is configured to emit light with a color temperature between 4000K and 7000K.

[0108] In this color temperature range, the appearance of the LED is closest compared to natural white light and thus backlighting with this specific color temperature helps blend in the white light emitting from the laser diodes thus a more natural appearance white light.

[0109] In a preferred embodiment, the intensity of the at least one LED is adjustable. Additionally or instead, the color temperature of the at least one LED is adjustable.

[0110] By using an intensity-adjustable LED it is possible to choose the desired output intensity of the emitted combined light beam depending on the surgical conditions. By using a color temperature-adjustable LED it is possible to choose the desired color temperature of the emitted combined light beam depending on the surgical conditions. The surgeon is able to adjust what is most favorable to him.

[0111] In a preferred embodiment, the backlight element comprises at least one additional laser diode, Preferably at least two additional laser diodes. The backlight element can also comprise more than two additional laser diodes.

[0112] Adding an additional laser diode besides the already present red, green and blue laser diode helps to cover a lager wavelengths spectrum. By combining the emitted laser light beams to a combined light beam, white light with a more natural appearance is produced.

[0113] In a preferred embodiment, the at least one additional laser diode is configured to emit light in a spectral range between about 380 nm to about 730 nm, excluding a wavelength range of about 450 nm to about 460 nm, Preferably excluding a wavelength range of about 440 nm to about 500 nm, further excluding the wavelength range of about 510 nm to about 530 nm, Preferably excluding a wavelength range of about 510 nm to about 570 nm, and further excluding the wavelength range of about 650 nm to about 670 nm, Preferably excluding a wavelength range of about 620 nm to about 670 nm.

[0114] In other words, the emitted light of the at least one additional laser diode can be in the visible wavelength range but is not in the wavelength range of a blue laser diode (a wavelength range of about 450 nm to about 460 nm), Preferably not in a wavelength range of about 440 nm to about 500 nm, and not in the wavelength range of a green laser diode (a wavelength range of about 510 nm to about 530 nm), Preferably not in a wavelength range of about 510 nm to about 570 nm, and not in the wavelength range ofa red laser diode (a wavelength range of about 650 nm to about 670 nm), Preferably not in a wavelength range of about 620 nm to about 670 nm.

[0115] The spectral range of the at least one additional laser diode of the backlight element can therefore be in the wavelength range of about 380 nm to about 450 nm, Preferably in the wavelength range of about 380 nm to about 440 nm. The spectral range of the at least one additional laser diode of the backlight element can also be in the wavelength range of about 460 nm to about 510 nm, Preferably in the wavelength range of about 500 nm to about 510 nm. The spectral range of the at least one additional laser diode of the backlight element can also be in the wavelength range of about 530 nm to about 650 nm, Preferably in the wavelength range of about 530 nm to about 620 nm or Preferably in the wavelength range of about 570 nm to about 650 nm, more Preferably in the wavelength range between about 530 nm to about 570 nm or more Preferably in the wavelength range between about 620 nm to about 650 nm, most Preferably in the wavelength range between about 570 nm to about 620 nm. The spectral range of the at least additional laser laser diode of the backlight element can also be in the wavelength range of about 670 nm to about 730 nm.

[0116] Using an additional laser diode in these wavelengths regimes, provides additional wavelengths besides the already present red, green and blue wavelengths to cover a broader wavelengths spectrum.

[0117] Additionally or instead, the emitted light of the at least one additional laser diode can be in the ultraviolet spectral regime, i.e., in the wavelength range of about 280 nm to about 380 nm. Additionally or instead, the emitted light of the at least one additional laser diode can also be in the infrared spectral regime, i.e., in the wavelength range of about 730 nm to about 1000 nm.

[0118] A laserdiode in the ultraviolet or in the infrared spectral regime can be used for surgical procedures.

[0119] If there is more than one additional laser diode, one of the additional laser diodes can be configured to emit light in one of the above mentioned wavelengths ranges, but the other additional laser diodes can be configured to emit light in one of the other above mentioned wavelengths ranges. It can also be that the more than one additional laser diodes are configured to emit light in the same of the above mentioned wavelengths range.

[0120] In a preferred embodiment, one of the at least three laser diodes is configured to emit light in a spectral range between about 440 nm to about 500 nm, Preferably in a spectral range between about 450 nm to about 460 nm. Additionally or instead, another one of the at least three laser diodes is configured to emit light in a spectral range between about 510 nm to about 570 nm, Preferably in a spectral range between about 510 nm to about 530 nm. Additionally or instead, another one of the at least three laser diodes is configured to emit light in a spectral range between about 620 nm to about 670 nm, Preferably in a spectral range between about 650 nm to about 670 nm.

[0121] Using a blue, green and red laser diode helps to create a wide spectrum white light showing a high CRI and a natural color appearance.

[0122] In a preferred embodiment, the color rendering index of the combined light beam is larger than 50, Preferably larger than 80, most Preferably larger than 85. As described above, a color rendering index of the combined light beam in this ranges can be achieved by combining the laser beams of an appropriate number of laser diodes. The number of combined laser beams may depend on the spectral emission characteristics of each of the laser diodes. Accordingly, the laser diodes as well as the number of different laser diodes to be combined are selected according to their individual spectral emission characteristics and the spectral characteristics of the resulting combined beam.

[0123] Emitting a combined light beam with a large color rendering index shows a more natural appearance which causes less stress on the observers eyes when exposed to it for a longer duration. It also avoids the phenomenon where the white light may appear bluish to some individuals whereas it may appear redish to some individuals which may cause discomfort to the observer.

[0124] Preferably, the device optical fiber is disposable.

[0125] Preferably, the illumination microsurgical device includes a device connector at the proximal portion of the device optical fiber, the device connector being removably coupled to the light source.

[0126] Preferably, the light source includes a source connector configured to receive the illumination microsurgical device and optically couple the device optical fiber to the fused optical fiber.

[0127] Preferably, the light source includes a light source housing holding the at least two laser diodes, the light source including a control panel having at least one user input for controlling the at least two laser diodes.

[0128] Preferably, the at least two laser diodes includes a red laser diode, a blue laser diode, and a green laser diode; the red laser diode configured to emit a red laser light beam in the red spectral range, the blue laser diode configured to emit a blue laser light beam in the blue spectral range and the green laser diode configured to emit a green laser light beam in the green spectral range.

[0129] Preferably, the light source includes a beam combiner configured to combine the red laser light beam, the blue laser light beam and the green laser light beam into the combined laser light beam and direct the combined laser light beam.

[0130] Preferably, the red laser diode, the blue laser diode, and the green laser diode are independently controlled to change a color of the combined laser light beam.

[0131] Preferably, the illumination microsurgical device of the inventive surgical illumination system includes a surgical tool, the distal end of the device optical fiber integrated into the surgical tool.

[0132] Preferably, the illumination microsurgical device of the inventive surgical illumination system includes a cannula.

[0133] During posterior ophthalmic surgery, a trocar cannula is inserted into the eye, acting as the port for the surgeon to insert microsurgical instruments into the eye. A cannula is a port that allows different surgical instruments to enter the eye while maintaining the pressure in the eye. Additionally, illumination of the eye is required to allow the surgeon to visualize the surgical field. Including a cannula in the illumination microsurgical device of the inventive surgical illumination system eliminates the need for an additional endoillumination device since the cannula itself can be illuminated, thus reducing the number of incisions made in the eye.

[0134] Preferably, the device optical fiber is attached to the cannula.

[0135] Attaching in the context of this application can for instance mean but is not limited to fusing, e.g., heat-fusing, heat-sealing, welding, splicing, as well as tapering, using a microoptic combiner, gluing, screwing, tightening etc.

[0136] This ensures that the combined light beam from the light source can be transferred to the cannula.

[0137] Preferably, the device optical fiber is attached to the outer surface of the cannula.

[0138] Attaching the device optical fiber to the outer surface of the cannula, out of the way of the surgeons work field, ensures that the cannula is illuminated by the device optical fiber which does not interfere with the surgeon’s work area.

[0139] Preferably, the device optical fiber is fixed in a groove of the outer surface of the cannula.

[0140] This ensures a more stable implementation of the device optical fiber onto the outer surface of the cannula. The device optical fiber runs along the outer wall of the cannula such that it does not change the gauge specification of the cannula itself. Having it on the outer wall of the canula prevents it from interfering with instrument inserted in the canula.

[0141] Preferably, the cannula has a hollow interior and the device optical fiber is routed through the hollow interior.

[0142] By this, illumination inside the eye is ensured. The device optical fiber inside the eye can be modified into a cone like shape to produce a chandelier effect inside the eye, thus eliminating the need for an additional endoillumination device.

[0143] Preferably, the cannula comprises a cannula head and a cannula tube. The device optical fiber is attached, Preferably fused, to the cannula head. The device optical fiber can be for instance spliced, heat-fused or glued to the cannula head.

[0144] Attaching the device optical fiber to the cannula ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the cannula. Fusing the device optical fiber makes the attachment more secure.

[0145] Preferably, the cannula head is frosted. In addition or instead, the cannula head is sandblasted. In addition or instead, the cannula head is painted.

[0146] Frosting, sandblasting or painting the cannula’s head reduces the light which is directed to the surgeon directly.

[0147] Preferably, the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber. Instead, the device optical fiber can be a circular hollow optical fiber.

[0148] A circular hollow optical fiber ensures a 360° illumination and thus helps for a better vizualisation of the surgical site for the surgeon. Having only one optical fiber in terms of a circular hollow optical fiber reduces the number of fusion points and thus makes a more stable and light-efficient setup.

[0149] Preferably, the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

[0150] Attaching the device optical fiber to the circular hollow optical fiber ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the circular hollow optical fiber. Fusing the device optical fiber makes the attachment more secure.

[0151] Preferably, the circular hollow optical fiber is tapered. The circular hollow optical fiber can be tapered up or tapered down. By tapering of the circular hollow optical fiber it can be ensured that the circular hollow optical fiber can be integrated into the cannula head and the cannula tube which both are limited in size. Nevertheless, the circular hollow optical fiber may not be tapered as well.

[0152] Preferably, the cannula is made of a light transmitting material. In particular, the cannula can be made of glass, e.g., silica. In addition, the cannula can be made of plastic, e.g., acryl. In a more preferred embodiment, the cannula is made of a transparent ceramic, Preferably a polycrystalline ceramic.

[0153] The transparent ceramic is Preferably a polycrystalline ceramic. The polycrystalline ceramic can be used in particular as a transparent ceramic, for example aluminum oxynitride, which is also known under the trade name Alon, or aluminum oxide,which is also known as corundum and sapphire crystal. By virtue of its hardness, the transparent ceramic is suitable in particular for the production of stable rod-shaped or sleeve-shaped portions with small and very small dimensions, in particular with small and very small diameters. A surgical instrument according to the preferred embodiment is therefore highly suitable as a microsurgical instrument, for example for vascular surgery, neurosurgery or, in particular, for ophthalmic surgery.

[0154] A light transmitting material can not only transmit the light to illuminate the inside of the eye but can also illuminate the cannula itself which helps the surgeons during repositioning or adding a new cannula. Hence, the surgeons do not have to turn the operating room light back on before adding the new cannula and switch off all lights again once everything is in place to continue with the surgery.

[0155] Additionally or instead, the cannula can be made out of a metal. This can only be the case, if the light from the lightsource is transferred by the device optical fiber and / or the circular hollow optical fiber to the surgical site without emitting by the transparent cannula.

[0156] Preferably, the device optical fiber comprises, but is not limited to, a light transmitting material, Preferably comprises glass, e.g., silica. Additionally or instead, the device optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the device optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0157] Additionally or instead the circular hollow optical fiber comprise, but is not limited to, a light transmitting material, Preferably comprise, but is not limited to, glass, e.g., silica. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0158] Having a device optical fiber or a circular hollow optical fiber comprising a light transmitting material helps in a broader illumination of the whole surgical site. The light can be emitted in all directions and thus ensuring a better visualization of the surgical site for the surgeon.

[0159] Preferably, the illumination microsurgical device includes a probe configured to be inserted into the patient to position the distal portion of the device optical fiber relative to the patient.

[0160] Preferably, the probe includes a cannula at a distal end of the probe, the cannula having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter, the device optical fiber passing through the cannula.

[0161] Preferably, the distal portion of the device optical fiber is movable relative to a distal end of the probe to change an output angle of the laser light beam emitted from the illumination microsurgical device.

[0162] Preferably, the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the laser light beam and wherein the distal portion of the device optical fiber is located beyond the distal end of the probe to provide a wide output angle of the combined laser light beam.

[0163] Preferably, the distal end of the probe is beveled to form a shield to block the combined laser light beam in one direction more than another direction.

[0164] Preferably, the surgical illumination system further comprises an optical spacing between the distal portion of the light source optical fiber and the aperture opening at the proximal portion of the device optical fiber.

[0165] Preferably, the diode optical fiber, the fused optical fiber and / or the device optical fiber has at its proximal and / or distal portion a core diameter of 250 microns or less.

[0166] Preferably, each of the at least two laser diodes has a discrete spectral range.

[0167] Preferably, one of the at least two laser diodes has a generally blue spectral range that is within a safe region of the aphakic hazard level.

[0168] Preferably, the light source includes a despeckling mechanism, especially Preferably a mechanical, electronic or optical despeckling mechanism.

[0169] In another embodiment, an illumination microsurgical device is provided and includes a device optical fiber having a proximal portion configured to receive a combined laser light beam from two laser diodes of a light source and a distal portion configured to emit the combined laser light beam. The proximal portion includes an aperture opening which has a core diameter of less than 200 microns. The illumination microsurgical device includes a device connector at the proximal portion. The device connector is configured to be removably coupled to the light source. The illumination microsurgical device includes a surgical tool configured to be inserted into the patient. The distal end of the device optical fiber is integrated into the surgical tool for insertion of the distal end of the optical fiber into the patient. The device optical fiber, the device connector, and the surgical tool are disposable after use.

[0170] Preferably, the device connector is configured to be threadably coupled to a source connector of the light source to position the proximal portion of the device optical fiber to receive the laser light beam from the light source.

[0171] Preferably, the surgical tool of the inventive illumination microsurgical device includes a cannula.

[0172] During posterior ophthalmic surgery, a trocar cannula is inserted into the eye, acting as the port for the surgeon to insert microsurgical instruments into the eye. A cannula is a port that allows different surgical instruments to enter the eye whilemaintaining the pressure in the eye. Additionally, illumination of the eye is required to allow the surgeon to visualize the surgical field. Including a cannula in the illumination microsurgical device of the inventive surgical illumination system eliminates the need for an additional endoillumination device since the cannula itself can be illuminated, thus reducing the number of incisions made in the eye.

[0173] Preferably, the device optical fiber is attached to the cannula.

[0174] This ensures that the combined light beam from the light source can be transferred to the cannula.

[0175] Attaching in the context of this application can for instance mean but is not limited to fusing, e.g., heat-fusing, heat-sealing, welding, splicing, as well as tapering, using a microoptic combiner, gluing, screwing, tightening etc.

[0176] Preferably, the device optical fiber is attached to the outer surface of the cannula.

[0177] Attaching the device optical fiber to the outer surface of the cannula, out of the way of the surgeons work field, ensures that the cannula is illuminated by the device optical fiber which does not interfere with the surgeon’s work area.

[0178] Preferably, the device optical fiber is fixed in a groove of the outer surface of the cannula.

[0179] This ensures a more stable implementation of the device optical fiber onto the outer surface of the cannula. The device optical fiber runs along the outer wall of the cannula such that it does not change the gauge specification of the cannula itself. Having it on the outer wall of the canula prevents it from interfering with instrument inserted in the canula.

[0180] Preferably, the cannula has a hollow interior and the device optical fiber is routed through the hollow interior.

[0181] By this, illumination inside the eye is ensured. The device optical fiber inside the eye can be modified into a cone like shape to produce a chandelier effect inside the eye, thus eliminating the need for an additional endoillumination device.

[0182] Preferably, the cannula comprises a cannula head and a cannula tube. The device optical fiber is attached, Preferably fused, to the cannula head. The device optical fiber can be for instance spliced, heat-fused or glued to the cannula head.

[0183] Attaching the device optical fiber to the cannula ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the cannula. Fusing the device optical fiber makes the attachment more secure.

[0184] Preferably, the cannula head is frosted. In addition or instead, the cannula head is sandblasted. In addition or instead, the cannula head is painted.

[0185] Frosting, sandblasting or painting the cannula’s head reduces the light which is directed to the surgeon directly.

[0186] Preferably, the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber. Instead, the device optical fiber can be a circular hollow optical fiber.

[0187] A circular hollow optical fiber ensures a 360° illumination and thus helps for a better visualization of the surgical site for the surgeon. Having only one optical fiber in terms of a circular hollow optical fiber reduces the number of fusion points and thus makes a more stable and light-efficient setup.

[0188] Preferably, the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

[0189] Attaching the device optical fiber to the circular hollow optical fiber ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the circular hollow optical fiber. Fusing the device optical fiber makes the attachment more secure.

[0190] Preferably, the circular hollow optical fiber is tapered. The circular hollow optical fiber can be tapered up or tapered down. By tapering of the circular hollow optical fiber it can be ensured that the circular hollow optical fiber can be integrated into the cannula head and the cannula tube which both are limited in size. Nevertheless, the circular hollow optical fiber may not be tapered as well.

[0191] Preferably, the cannula is made of a light transmitting material. In particular, the cannula can be made of glass, e.g., silica. In addition, the cannula can be made of plastic, e.g., acryl. In a more preferred embodiment, the cannula is made of a transparent ceramic, Preferably a polycrystalline ceramic.

[0192] The transparent ceramic is Preferably a polycrystalline ceramic. The polycrystalline ceramic can be used in particular as a transparent ceramic, for example aluminum oxynitride, which is also known under the trade name Alon, or aluminum oxide, which is also known as corundum and sapphire crystal. By virtue of its hardness, the transparent ceramic is suitable in particular for the production of stable rod-shaped or sleeve-shaped portions with small and very small dimensions, in particular with small and very small diameters. A surgical instrument according to the preferred embodiment is therefore highly suitable as a microsurgical instrument, for example for vascular surgery, neurosurgery or, in particular, for ophthalmic surgery.

[0193] A light transmitting material can not only transmit the light to illuminate the inside of the eye but can also illuminate the cannula itself which helps the surgeons during repositioning or adding a new cannula. Hence, the surgeons do not haveto turn the operating room light back on before adding the new cannula and switch off all lights again once everything is in place to continue with the surgery.

[0194] Additionally or instead, the cannula can be made out of a metal. This can only be the case, if the light from the lightsource is transferred by the device optical fiber and / or the circular hollow optical fiber to the surgical site without emitting by the transparent cannula.

[0195] Preferably, the device optical fiber comprise, but is not limited to, a light transmitting material, Preferably comprise glass, e.g., silica. Additionally or instead, the device optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the device optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0196] Additionally or instead the circular hollow optical fiber comprise, but is not limited to, a light transmitting material, Preferably comprise glass, e.g., silica. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0197] Having a device optical fiber or a circular hollow optical fiber comprising a light transmitting material helps in a broader illumination of the whole surgical site. The light can be emitted in all directions and thus ensuring a better visualization of the surgical site for the surgeon. Preferably, the surgical tool includes a probe configured to be inserted into the patient to position the distal portion of the device optical fiber relative to the patient.

[0198] Preferably, the probe includes a cannula at a distal end of the probe, the cannula having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter, the device optical fiber passing through the cannula.

[0199] Preferably, the distal portion of the device optical fiber is movable relative to a distal end of the probe to change an output angle of the combined laser light beam emitted from the illumination microsurgical device.

[0200] Preferably, the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the combined laser light beam and wherein the distal portion of the device optical fiber is located beyond the distal end of the probe to provide a wide output angle of the combined laser light beam.

[0201] Preferably, a distal end of the probe is beveled to form a shield to block the combined laser light beam in one direction more than another direction.

[0202] In a further embodiment, a method of manufacturing a surgical illumination system is provided. The method provides a light source having at least two laser diodes configured to emit an at least respective first and a second laser light beam to a light source optical fiber as a combined laser light beam. The method couples an illumination microsurgical device to the light source to receive the combined laser light beam. The illumination microsurgical device includes a device optical fiber transmitting the laser light beam from a proximal portion to a distal portion. The proximal portion of the device optical fiber has an aperture opening. The method emits the combined laser light beam at a distal portion of the light source optical fiber with a spot size. The spot size of the combined laser light beam at the distal portion of the light source optical fiber is less than the size of the aperture opening at the proximal portion of the device optical fiber.

[0203] Preferably, the illumination microsurgical device is removable coupled to the light source and disposable after use.

[0204] Preferably, the at least two laser diodes includes a red laser diode configured to emit a red laser light beam in the red spectral range, a blue laser diode configured to emit a blue laser light beam in the blue spectral range, and a green laser diode configured to emit a green laser light beam in the green spectral range, said emitting thecombined laser light beam at the distal portion of the light source optical fiber comprises emitting the red laser light beam at the distal portion of the light source optical fiber, emitting the blue laser light beam at the distal portion of the light source optical fiber, and emitting the green laser light beam at the distal portion of the light source optical fiber.

[0205] In another embodiment, a surgical illumination system is provided and includes a light source having at least one laser diode configured to emit a laser light beam. The laser light beam has a focal point at a focal point plane. The surgical illumination system includes an illumination microsurgical device removably coupled to the light source. The illumination microsurgical device includes a device optical fiber with a proximal portion configured to receive the laser light beam from the light source and a distal portion configured to emit the laser light beam from the light source. The proximal portion has an aperture opening. The size of the focal point is less than the size of the aperture opening.

[0206] In a further embodiment, a method of manufacturing a surgical illumination system is provided. The method provides a light source having at least one laser diode configured to emit a laser light beam. The method couples an illumination microsurgical device to the light source to receive the laser light beam. The illumination microsurgical device includes an optical fiber transmitting the laser light beam from a proximal portion to a distal portion. The proximal portion has an aperture opening. The method focuses the laser light beam at a focal point at a focal point plane. The size of the focal point is less than the size of the aperture opening.

[0207] In another aspect of the invention, a cannula for use in an inventive surgical illumination system or for use in an inventive illumination microsurgical device is provided. The cannula comprises a cannula head, a cannula tube and a device optical fiber attached to the cannula.

[0208] The cannula head can be the proximal end of the cannula. The cannula tube can be the distal end of the cannula. The cannula tube can also be described as a cannula needle. The cannula can be a trocar cannula. The cannula can also be described as a trocar. The trocar cannula can be inserted into a patient, Preferably into the eye of the patient, acting as a port for a surgeon to insert microsurgical instruments into the eye. The device optical fiber is configured to illuminate the surgical site, particularly the eye. The device optical fiber can have the same properties as the described optical fiber for the inventive surgical illumination system and for the inventive illumination mircrosurgical device. The device optical fiber can be attached to the cannula head or to the cannula tube. Attaching in the context of this application can for instance mean but is not limited to fusing, e.g., heat-fusing, heat-sealing, welding, splicing, as well as tapering, using a microoptic combiner, gluing, screwing, tightening etc.

[0209] During posterior ophthalmic surgery, a trocar cannula is inserted into the eye, acting as the port for the surgeon to insert microsurgical instruments into the eye. A cannula is a port that allows different surgical instruments to enter the eye while maintaining the pressure in the eye. Additionally, illumination of the eye is required to allow the surgeon to visualize the surgical filed. Including a cannula in the illumination microsurgical device of the inventive surgical illumination system eliminates the need for an additional endoillumination device since the cannula itself can be illuminated, thus reducing the number of incisions made in the eye.

[0210] Preferably, the device optical fiber is attached to the outer surface of the cannula.

[0211] Attaching the device optical fiber to the outer surface of the cannula, out of the way of the surgeons work field, ensures that the cannula is illuminated by the device optical fiber which does not interfere with the surgeon’s work area.

[0212] Preferably, the device optical fiber is fixed in a groove of the outer surface of the cannula.

[0213] This ensures a more stable implementation of the device optical fiber onto the outer surface of the cannula. The device optical fiber runs along the outer wall of the cannula such that it does not change the gauge specification of the cannula itself. Having it on the outer wall of the canula prevents it from interfering with instrument inserted in the canula.

[0214] Preferably, the cannula has a hollow interior and the device optical fiber is routed through the hollow interior.

[0215] By this, illumination inside the eye is ensured. The device optical fiber inside the eye can be modified into a cone like shape to produce a chandelier effect inside the eye, thus eliminating the need for an additional endoillumination device.

[0216] Preferably, the device optical fiber is attached, Preferably fused, to the cannula head. The device optical fiber can be for instance spliced, heat-fused or glued to the cannula head.

[0217] Attaching the device optical fiber to the cannula ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the cannula. Fusing the device optical fiber makes the attachment more secure.

[0218] Preferably, the cannula head is frosted. In addition or instead, the cannula head is sandblasted. In addition or instead, the cannula head is painted.

[0219] Frosting, sandblasting or painting the cannula’s head reduces the light which is directed to the surgeon directly.

[0220] Preferably, the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber. Instead, the device optical fiber can be a circular hollow optical fiber.

[0221] A circular hollow optical fiber ensures a 360° illumination and thus helps for a better visualization of the surgical site for the surgeon. Having only one optical fiber in terms of a circular hollow optical fiber reduces the number of fusion points and thus makes a more stable and light-efficient setup.

[0222] Preferably, the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

[0223] Attaching the device optical fiber to the circular hollow optical fiber ensures a secure attachment while maximizing the light transmitted from the device optical fiber into the circular hollow optical fiber. Fusing the device optical fiber makes the attachment more secure.

[0224] Preferably, the circular hollow optical fiber is tapered. The circular hollow optical fiber can be tapered up or tapered down. By tapering of the circular hollow optical fiber it can be ensured that the circular hollow optical fiber can be integrated into the cannula head and the cannula tube which both are limited in size. Nevertheless, the circular hollow optical fiber may not be tapered as well.

[0225] Preferably, the cannula is made of a light transmitting material. In particular, the cannula can be made of glass, e.g., silica. In addition, the cannula can be made of plastic, e.g., acryl. In a more preferred embodiment, the cannula is made of a transparent ceramic, Preferably a polycrystalline ceramic.

[0226] The transparent ceramic is Preferably a polycrystalline ceramic. The polycrystalline ceramic can be used in particular as a transparent ceramic, for example aluminum oxynitride, which is also known under the trade name Alon, or aluminum oxide,which is also known as corundum and sapphire crystal. By virtue of its hardness, the transparent ceramic is suitable in particular for the production of stable rod-shaped or sleeve-shaped portions with small and very small dimensions, in particular with small and very small diameters. A surgical instrument according to the preferred embodiment is therefore highly suitable as a microsurgical instrument, for example for vascular surgery, neurosurgery or, in particular, for ophthalmic surgery.

[0227] A light transmitting material can not only transmit the light to illuminate the inside of the eye but can also illuminate the cannula itself which helps the surgeons during repositioning or adding a new cannula. Hence, the surgeons do not have to turn the operating room light back on before adding the new cannula and switch off all lights again once everything is in place to continue with the surgery.

[0228] Additionally or instead, the cannula can be made out of a metal. This can only be the case, if the light from the lightsource is transferred by the device optical fiber and / or the circular hollow optical fiber to the surgical site without emitting by the transparent cannula.

[0229] Preferably, the device optical fiber comprise, but is not limited to, a light transmitting material, Preferably comprise, but is not limited to, glass, e.g., silica. Additionally or instead, the device optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the device optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0230] Additionally or instead the circular hollow optical fiber comprises, but is not limited to, a light transmitting material, Preferably comprises, but is not limited to, glass, e.g., silica. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, plastic, e.g., acryl. Additionally or instead, the circular hollow optical fiber can comprise, but is not limited to, transparent ceramic, e.g., polycrystalline ceramic.

[0231] Having a device optical fiber or a circular hollow optical fiber comprising a light transmitting material helps in a broader illumination of the whole surgical site. The light can be emitted in all directions and thus ensuring a better visualization of the surgical site for the surgeon. BRIEF DESCRIPTION OF THE DRAWINGS

[0232] Figure 1 illustrates a surgical illumination system in accordance with an exemplary embodiment.

[0233] Figure 2 is a cross-section view of the surgical illumination system illuminating an interior region of an eye in accordance with an embodiment.

[0234] Figure 3 is a schematic diagram of the surgical illumination system in accordance with an exemplary embodiment.

[0235] Figure 4 is another schematic diagram of the surgical illumination system in accordance with another exemplary embodiment.

[0236] Figures 5a-5d are schematic diagrams of the surgical illumination system in accordance with other exemplary embodiments.

[0237] Figure 6 is a diagram illustrating the surgical illumination system in accordance with an exemplary embodiment.

[0238] Figure 7 is a front view of the light source in accordance with an exemplary embodiment.

[0239] Figure 8 is a top view of the light source with the cover removed to illustrate components of the light source in accordance with an exemplary embodiment.

[0240] Figure 9 is an enlarged view of a portion of the light source showing the despeckling mechanism in accordance with an exemplary embodiment.

[0241] Figure 10 is a graph showing output of the surgical illumination system in accordance with an exemplary embodiment.

[0242] Figure 11A is an overhead view of a first alternate embodiment of the illuminated microsurgical instrument.

[0243] Figure 11B is an enlarged cross-section view of the first alternate embodiment of the illuminated microsurgical instrument in an open position.

[0244] Figure 11C is an enlarged cross-section view of the first alternate embodiment of the illuminated microsurgical instrument in a closed position.

[0245] Figure 12A is an overhead view of a second alternate embodiment of the illuminated microsurgical instrument.

[0246] Figure 12B is cross-section view of a second alternate embodiment of the illuminated microsurgical instrument in a closed position.

[0247] Figure 12C is an enlarged view of a second alternate embodiment of the illuminated microsurgical instrument with a non-beveled tip in a closed position.

[0248] Figure 12D is an enlarged view of a second alternate embodiment of the illuminated microsurgical instrument with a non-beveled tip in an open position.

[0249] Figure 12E is an enlarged view of a second alternate embodiment of the illuminated microsurgical instrument with a beveled tip in a closed position.

[0250] Figure 12F is an enlarged view of a second alternate embodiment of the illuminated microsurgical instrument with a beveled tip in an open position.

[0251] Figure 13A is an overhead view of a third alternate embodiment of the illuminated microsurgical instrument.

[0252] Figure 13B is an enlarged view of a third alternate embodiment of the illuminated microsurgical instrument with a focal tip.

[0253] Figure 13C is an enlarged view of a third alternate embodiment of the illuminated microsurgical instrument with a standard widefield tip.

[0254] Figure 13D is an enlarged view of a third alternate embodiment of the illuminated microsurgical instrument with a shielded widefield tip.

[0255] Figure 14A is an overhead view of a fourth alternate embodiment of the illuminated microsurgical instrument.

[0256] Figure 14B is an enlarged view of a fourth alternate embodiment of the illuminated microsurgical instrument with a focal tip.

[0257] Figure 14C is an enlarged view of a fourth alternate embodiment of the illuminated microsurgical instrument with a standard widefield tip.

[0258] Figure 14D is an enlarged view of a fourth alternate embodiment of the illuminated microsurgical instrument with a shielded widefield tip.

[0259] Figure 15A is an overhead view of a fifth alternate embodiment of the illuminated microsurgical instrument.

[0260] Figure 15B is an enlarged cross-section view of a fifth alternate embodiment of the illuminated microsurgical instrument.

[0261] Figure 15C is another enlarged cross-section view of a fifth alternate embodiment of the illuminated microsurgical instrument with a standard widefield tip.

[0262] Figure 15D is an enlarged view of a fifth alternate embodiment of the illuminated microsurgical instrument illustrating an area of light output.

[0263] Figure 16 is an overhead view of a sixth alternate embodiment of the illuminated microsurgical instrument.

[0264] Figure 17A is a cross-section view of a seventh alternate embodiment of the illuminated microsurgical instrument.

[0265] Figure 17B is an enlarged view of a seventh alternate embodiment of the illuminated microsurgical instrument illustrating a standard area of light output.

[0266] Figure 17C is an enlarged view of view of a seventh alternate embodiment of the illuminated microsurgical instrument with a wide area of light output.

[0267] Figure 18A is an overhead view of an eighth alternate embodiment of the illuminated microsurgical instrument.

[0268] Figure 18B is an overhead view of a patch cable for the eighth embodiment of the illuminated microsurgical instrument.

[0269] Figure 18C is an enlarged cross-section view of the patch cable for the eighth embodiment of the illuminated microsurgical instrument.

[0270] Figure 18D is an enlarged cross-section view of the eighth embodiment of the illuminated microsurgical instrument.

[0271] Figure 19A is a cross-section view of a ninth alternate embodiment of the illuminated microsurgical instrument.

[0272] Figure 19B is an enlarged cross-section view of a ninth alternate embodiment of the illuminated microsurgical instrument.

[0273] Figure 19C is an enlarged cross-section view of a ninth alternate embodiment of the illuminated microsurgical instrument with a forceps in the closed position.

[0274] Figure 19D is an cross-section view of a ninth alternate embodiment of the illuminated microsurgical instrument with a forceps in an open position.

[0275] Figure 20 illustrates a cannula in accordance with an exemplary embodiment.

[0276] Figure 21 illustrates the cannula in accordance with another exemplary embodiment.

[0277] Figure 22 illustrates the cannula in accordance with another exemplary embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0278] Figure 1 illustrates a surgical illumination system 100 in accordance with an exemplary embodiment. The surgical illumination system 100 is used to provide illumination to a surgical site during a surgical procedure. In various embodiments, the surgical illumination system 100 is an ophthalmic illumination system used for imaging an eye during an ophthalmic surgical procedure, such as vitreo-retinal procedures. The surgical illumination system 100 may be used to treat ophthalmic conditions of the posterior segment of the eye, such as age-related macular degeneration (AMD), diabetic retinopathy and diabetic vitreous hemorrhage, macular hole, retinal detachment, epiretinal membrane, CMV retinitis, and many other ophthalmic conditions. The surgical illumination system 100 may be used for other surgical procedures in alternative embodiments performed on other parts of the patients body.

[0279] The surgical illumination system 100 includes a light source 110 and an illumination microsurgical device 200 for performing a surgical procedure. Thelight source 110 is used to illuminate the illumination microsurgical device 200 and / or the patient through the illumination microsurgical device 200. The light source 110 generates a light beam. The illumination microsurgical device 200 receives the light beam and transmits the light beam through an device optical fiber 210 to illuminate a surgical field. The illumination microsurgical device 200 includes a surgical tool 250 for performing use in the surgical procedure and a device connector 220 for connecting the illumination microsurgical device 200 to the light source 110. The device connector 220 may be removably coupled to the light source 110, such as to dispose of the illumination microsurgical device 200 after use and replace with a new illumination microsurgical device 200. The device optical fiber 210 may be integrated with the surgical tool 250. The surgical tool 250 may be a lighting tool, a cutting tool, an aspiration tool, an irrigation tool, a forceps tool, or another type of tool for aiding the physician in performing the surgical procedure.

[0280] The device optical fiber 210 has a proximal portion 212, a distal portion 214, and a central portion 216 extending between the proximal portion 212 and the distal portion 214. The device optical fiber 210 is configured to receive the light beam at the proximal portion 212. The device optical fiber 210 is configured to output the light beam from the distal portion 214. The distal portion 214 is provided at the surgical tool 250. For example, the distal portion 214 may pass through the surgical tool 250. The distal portion 214 may be embedded in the surgical tool 250. The distal portion 214 may extend from the end of the surgical tool 250. The distal portion 214 may be movable relative to the surgical tool 250, such as to change the lighting pattern. In an exemplary embodiment, the device optical fiber 210 is configured to emit the light beam from the light source 110 to the surgical field in an expanded light pattern relative to the originally emitted light pattern from the light source 110. The light beam output may be at a high intensity, such as greater than 10 Lumen. In various embodiments, the light output beam may be greater than 20 Lumen, such as 30 Lumen or more. The color temperature of the light output may be adjustable. In various embodiments, the color temperature may be between 5500-6000K, however the color temperature may be adjustable up to 8300K in various embodiments. In an exemplary embodiment, the device optical fiber 210 has a very small diameter, allowing use of smaller surgical tools 250 and / or allowing smaller incisions or openings in the patient to perform the invasive surgical procedure. In various embodiments, the device optical fiber 210 may be sized with a core diameter of less than 200 microns. The device optical fiber 210 may be sized with a core diameter in the range of about 50 microns to 100 microns. In an exemplary embodiment, the light source 110 utilizes one or more laser diodes to generate the light beam having sufficient lighting for the very small diameter device optical fiber 210.

[0281] Figure 2 is a cross-section view of the surgical illumination system 100 illuminating an interior region of an eye 20 in accordance with an embodiment. The surgical tool 250 may be inserted through a sclera 22 (generally at the pars plana) into a vitreous region 24 in connection with performing a vitreo-retinal procedure. The eye 20 may be illuminated by the device optical fiber 210 through the surgical tool 250. Various other microsurgical instruments 50 may additionally be inserted into the eye 20 during various intra-operative procedures, such as vitreo-retinal surgery. For example, the microsurgical instruments may include, but are not limited to, a vitrectomy probe, an infusion cannula, cutting probe, an aspiration probe, scissors, forceps, or other types of microsurgical probes.

[0282] Figure 3 is a schematic diagram of the surgical illumination system 100 in accordance with an exemplary embodiment. The surgical illumination system 100 includes the light source 110 and the illumination microsurgical device 200 connected to the light source 110. The illumination microsurgical device 200 receives the light beam 102 from the light source 110.

[0283] The illumination microsurgical device 200 includes the device optical fiber 210, the surgical tool 250 for performing use in the surgical procedure and the device connector 220 for connecting the illumination microsurgical device 200 to the lightsource 110. For example, the surgical tool 250 is provided at the distal portion 214 for insertion into the patient and the device connector 220 is provided at the proximal portion 212 for removable connection to the light source 110. The device optical fiber 210 is configured to emit the light beam 102 from the light source 110 to the surgical field in an expanded light pattern relative to the originally emitted light pattern from the light source 110. In an exemplary embodiment, the device optical fiber 210 has a very small diameter, allowing use of smaller surgical tools 250 and / or allowing smaller incisions or openings in the patient to perform the invasive surgical procedure.

[0284] The light source 110 includes a light source housing 120 having walls 122 forming an internal cavity 124. The light source 110 includes a light assembly 130 received in the cavity 124. The light assembly 130 generates a light beam 102. In an exemplary embodiment, the light source 110 includes a bridge assembly 150 between the light assembly 130 and the illumination microsurgical device 200. The bridge assembly 150 receives the light beam 102 and transmits the light beam 102 from the light assembly 130 to the illumination microsurgical device 200. The light source 110 includes a controller 160 for controlling the light assembly 130. The light source 110 includes one or more user inputs 170, operably coupled to the controller 160, for the physician to control the light assembly 130. Optionally, the light source 110 may include a display 180 for displaying information to the physician, such as one or more operating parameters (for example, brightness, color, or other characteristics of the light beam 102). In various embodiments, the light source 110 includes a despeckling mechanism 190. The despeckling mechanism 190 can be e.g., mechanical, electronic or optical.

[0285] The light assembly 130 includes one or more light elements 132 for generating the light beam 102. The light assembly 130 can output a diagnostic light beam, a treatment light beam, and / or an illumination light beam. The light beam 102 can include any suitable wavelength(s) of light, such as visible light, infrared light, ultraviolet (UV) light, etc. For example, the light beam 102 can transmit bright, broadband, and / or white light to illuminate a surgical field when employed during the surgical procedure.

[0286] In an exemplary embodiment, the light elements 132 are or comprise laser diodes 134a, 134b, 134c. The laser diodes 134a, 134b, 134c generate different color laser light beams, such as laser light beams at different wavelengths. The outputs from the laser diodes 134a, 134b, 134c are combined to form the laser light beam 102. The laser diodes 134a, 134b, 134c may be operated independently to control the characteristics of the laser light beam 102. When employing laser diodes, the emitted laser light beam 102 generally possesses a high degree of spatial coherence. High spatial coherence typically enables the beam to be focused to small spot sizes for delivery to fiber optic cabling. The ability to focus light emitted from the laser diodes 134a, 134b, 134c to small spot sizes may enable the use of small-scale optical fibers for transmitting the light to the interior of eye. Small-scale optical fibers generally have a diameter (or other largest cross-sectional dimension) of less than 200 microns. In various embodiments, the optical fibers may have core diameters of 100 microns or less, such as 50 microns. The size of the focused beam may have a spot size diameter of less than the core diameter of the optical fiber for efficient transmission to the optical fiber, and thus enhanced brightness from the optical fiber. When integrated with microsurgical instruments, the small core diameter of the small scale optical fiber may enable a reduction in the cross-sectional area of the instrument, which in turn may reduce the size of the surgical incision in the sclera of the eye through which the instrument is inserted.

[0287] In an exemplary embodiment, the light source 110 includes an array of three laser diodes 134a, 134b, 134c that are arranged to combine and emit a single laser light beam that can be modulated to produce a predetermined spectral range. The laser diodes 134a, 134b, 134c generate highly collimated output beams with a divergence angle smaller than 0.5°, more Preferably smaller than 0.3°, most Preferably 0.15°. The color temperature of the output beams are adjustable, such as by controlling the power to the laser diodes 134a, 134b, 134c. Each of the laser diodes 134a, 134b, 134c may include a discrete spectral range, such as a generally blue spectral range, a generally green spectral range, and a generally red spectral range. In one embodiment, the generally blue spectralrange may include a wavelength range of about 440 nm to about 460 nm, the generally green spectral range may include a wavelength range of about 510 nm to about 530 nm, and the generally red spectral range may include a wavelength range of about 650 nm to about 670 nm. The generally blue spectral range should have a wavelength that is within a safe region of the aphakic hazard level. Although the embodiment includes three laser diodes 134a, 134b, 134c, greater or fewer laser diodes 134a, 134b, 134c may be used. In the illustrated embodiment, the three laser diodes 134a, 134b, 134c include a red laser diode 134a, a green laser diode 134b, and a blue laser diode 134c. The red laser diode 134a is configured to emit a red laser light beam in the red spectral range. The green laser diode 134b is configured to emit a green laser light beam in the green spectral range. The blue laser diode 134c is configured to emit a blue laser light beam in the blue spectral range. The laser diodes 134a, 134b, 134c are mounted to a circuit board 136 and operably coupled to the controller 160. Operation of the laser diodes 134a, 134b, 134c is controlled by the controller 160. For example, the controller 160 may independently control ON / OFF of the various laser diodes 134a, 134b, 134c and / or intensity / brightness of the laser diodes 134a, 134b, 134c. The color may be adjusted during the surgery, such as to enhance parts, features, or issues of the patient’s eye.

[0288] In an exemplary embodiment, the light assembly 130 includes a beam combiner 140 configured to combine the individual beams from the laser diodes 134a, 134b, 134c into the laser light beam 102. The beam combiner 140 includes lenses or mirrors 142 to focus the laser beams along a common path. For example, the mirrors may be hot or cold dichroic mirrors or fold mirrors. The light assembly 130 may include other components, such as a condenser having a plurality of lenses to focus the laser light beam 102 output by the laser diodes 134a, 134b, 134c. The light assembly 130 may include beam splitters, lenses, gratings, filters, and / or combinations thereof, which facilitate the transmission of light to the optical fiber 210. The beam combiner 140 directs the laser beams to a focal point 144 at a focal point plane 146. The individual laser beams from the laser diodes 134a, 134b, 134c are focused and / or combined at the focal point 144. Forexample, the individual laser beams are directed along a common path passing through the focal point 144. In an exemplary embodiment, a lens assembly 148 is provided to focus the beam to the focal point 144 at the focal point plane 146. The bridge assembly 150 is provided at the focal point plane 146 to receive the laser light beam 102. The lens assembly 148 may include one or more lenses, filters or other focusing optics for transmitting the laser light beam 102 into a diffraction limited focused spot having an area having a diameter that is less than the diameter of the component receiving the laser light beam (for example, the fiber optic), such as at the bridge assembly 150 and / or the device optical fiber 210.

[0289] In an exemplary embodiment, the bridge assembly 150 includes a bridge optical fiber 152 and a light source connector 154. The bridge optical fiber 152 includes a first end 156 and a second end 158. The first end 156 is located at the focal point plane 146 to receive the light beam 102 from the light assembly 130. The light source connector 154 is provided at the second end 158. The illumination microsurgical device 200 is coupled to the light source connector 154. The bridge assembly 150 transmits the light from the light assembly 130 to the illumination microsurgical device 200. The light source connector 154 may include a ferrule or other type of fiber optic connector to connect the bridge optical fiber 152 with the device optical fiber 210 of the illumination microsurgical device 200. In an exemplary embodiment, the light source connector 154 defines a separable interface with the illumination microsurgical device 200 to allow removal of the illumination microsurgical device 200 from the light source 110, such as for disposal and replacement of the illumination microsurgical device 200. In an alternative embodiment, rather than using the bridge optical fiber 152, the light beam 102 may be transmitted from the light assembly 130, through air / free space, directly into the device optical fiber 210 of the illumination microsurgical device 200. For example, the light source connector 154 may precisely position the device optical fiber 210 to receive the light beam 102 from the light assembly 130. In another alternative embodiment, rather than using the bridge optical fiber 152, the light beam 102 may be transmitted by a light sourceoptical fiber 192 to the device optical fiber 210 of the illumination microsurgical device 200 which is described in more detail in figure 4.

[0290] The controller 160 includes a control circuit board 162 and one or more electrical components mounted to the control circuit board 162. The electrical components may include one or more processors, memories, drivers, and the like. The control circuit board 162 is connected to the user inputs 170 to receive inputs from the user inputs 170. The user inputs 170 may be buttons, dials, sliders, keypads, touchpads, or other types of user inputs. In various embodiments, a user input 170 may be provided for independent control of each of the laser diodes 134a, 134b, 134c, such as to control the intensity / frequency of the laser diodes 134a, 134b, 134c independently. The user input 170 may include a brightness input to control brightness of the laser light beam 102. In various embodiments, the user inputs 170 can be independently adjusted by the user to modulate the spectral ranges of each laser diode 134a, 134b, 134c. The user inputs 170 may include presets that allow the user to select a predetermined color or spectral range. The control circuit board 162 is connected to the display 180 to provide output to the display 180. The display 180 may include a visual indicator that displays the color and / or brightness of the selected spectral range of the final laser light beam emitted from the system 100, which may allow the user to preview the color or spectral range prior to use in a patients eye. The control circuit board 162 is connected to the light assembly 130, such as to the circuit board 136 of the light assembly 130 to control the laser diodes 134a, 134b, 134c. For example, the control circuit board 162 may supply control signals or power to the laser diodes 134a, 134b, 134c to control operation of the laser diodes 134a, 134b, 134c.

[0291] The despeckling mechanism 190 is operably coupled to the light assembly 130. For example, the despeckling mechanism 190 may be coupled to the circuit board 136 and / or the laser diodes 134a, 134b, 134c to vibrate the laser diodes 134a, 134b, 134c to reduce speckling in the laser light beam 102. In other various embodiments, the despeckling mechanism 190 may vibrate the bridge optical fiber 152 to reduce the speckling of the combined laser light beam and produce more uniform illumination. Forexample, the despeckling mechanism 190 may include a vibration element attached to a stripped optical fiber within the system. A light beam produced by combining multiple individual light beams to produce a single light beam having the spectral ranges of the individual light beams, such as implemented with light source 110, may be subject to a phenomenon referred to as speckling. Speckling occurs when multiple light waves having different phases interfere with one another. When added together, the interferences produce a light wave having an intensity that varies randomly. In alternate embodiments, options for reducing speckling include, for example, using rotating diffusers or lenses arranged in the optical path of the light beam to disrupt the spatial coherence of the emitted light beam.

[0292] The device connector 220 is configured to be removably coupled to the light source 110, such as to the housing 120 and / or the light source connector 154. The device connector 220 includes a connector housing 222. In an exemplary embodiment, the connector housing 222 includes a ferrule holding the end of the device optical fiber 210. In various embodiments, the connector housing 222 may be threadably coupled to the housing 120 / light source connector 154. The connector housing 222 may include a threaded nut configured to be threadably coupled to the housing 120 / light source connector 154.

[0293] The surgical tool 250 is provided at the distal end of the illumination microsurgical device 200. The surgical tool 250 includes a tool body 252 extending between an inner end 254 and an outer end 256. The inner end 254 is a working end configured to be inserted into the patient. The outer end 256 is a holding end configured to be held and manipulated by the physician to position the surgical tool 250 during the surgical procedure. In an exemplary embodiment, the surgical tool 250 includes a handle 258 at the outer end 256 configured to be held by the physician.

[0294] In an exemplary embodiment, the surgical tool 250 includes an operating portion 260 at the inner end 254. The operating portion 260 is configured to interact with the patient, such as to perform the surgical procedure. The operating portion260 is configured to be inserted into the patient. In an exemplary embodiment, the operating portion 260 includes a probe 262 at the inner end 254 configured to be inserted into the patient. In various embodiments, the operating portion 260 includes a light pipe for illuminating the patient (for example, the eye) during the procedure. The light pipe may be a wide angle light pipe. The light pipe may be a narrow light pipe, such as a spot light. In various embodiments, the lighting may be variable, such as variable between narrow angle lighting and wide angle lighting to change the lighting during the procedure using the same surgical tool. In various embodiments, the operating portion 260 includes a surgical tip configured to perform a surgical procedure. For example, the surgical tip may include a scalpel, scissors, forceps, a needle, a cannula, an irrigation device, an aspiration device, a multi-flex tool, and the like.

[0295] In an exemplary embodiment, the surgical tool 250 includes a cavity 270 through the interior of the surgical tool 250. The cavity 270 may be open at the inner end 254 and the outer end 256. The cavity 270 may be a cylindrical bore along a central axis of the surgical tool 250. The cavity 270 may have other shapes, such as being stepped or cone shaped. The cavity 270 receives the device optical fiber 210. For example, the device optical fiber 210 passes through the cavity 270 to the inner end 254 to emit the light forward of the surgical tool 250. The cavity 270 may receive another component, such as a cannula or needle that supports or holds the device optical fiber 210.

[0296] In various embodiments, the surgical tool 250 is a disposable light pipe. The small optical fiber allows the wall thicknesses of the surrounding stainless steel tube of the light pipe to be thicker, such as making 25 and 27 gauge light pipes stiffer.

[0297] In various embodiments, the surgical tool 250 is a tangential illuminator configured for use during ILM procedures. The surgical procedure is enhanced because the ILM has a corrugated appearance under tangential illumination.

[0298] In various embodiments, the surgical tool 250 is an adjustable field output illuminator configured to be used to perform macular work under focal illumination and to perform peripheral retina membrane peeling under wide-field illumination using the same surgical tool and simply adjusting the lighting pattern without changing instruments. The small format fiber, having sufficient illumination from the high- power laser light beam generated by the laser diodes, allows for effective wide to narrow field illumination, such as to see vitreous across the eye.

[0299] In various embodiments, the surgical tool 250 is an aspirating endoilluminator. The small fiber occupies smaller area in the instrument compared to conventional fiber optics thus allowing aspiration of the shredded pieces of membranes and removed from the eye by vacuum. The gap created between the small fiber and the inside diameter of the tubing allows membrane evacuation.

[0300] In various embodiments, the surgical tool 250 is a slit output illuminator. The light pipe may be manufactured to have a slit pattern light output to see a better cross-section of the eye during vitreous surgery due to the near-point light source provided by the optical fiber.

[0301] In various embodiments, the surgical tool 250 is a chandelier illuminator. The small diameter of the optical fiber reduces the size of the probe for mounting the chandelier illuminator to the eye. For example, the probe may be manufactured to be less than 25 gauge, thus reducing the possibility of wound leakage and eliminating the need for suture at the insertion site. The micro incision needed to insert the small diameter probe will allow the chandelier illuminator to be removed and replaced in a different location at the surgeons will without risk of leakage.

[0302] In various embodiments, the surgical tool 250 is an irrigating chandelier. The small optical fiber size allows more area for irrigating flow. The small- fiber format provides minimal in-flow interruption.

[0303] In various embodiments, the surgical tool 250 is an illuminated cannula. The optical fiber is fed to a cannula head with the illumination coming out of the bottom of a transparent cannula tube. Instruments inserted through the cannula would "follow" the instrument tip with light. In addition, the cannula head would glow, which would eliminate the need to turn on the room lights in order for the surgeon to find the cannula hole again.

[0304] In various embodiments, the surgical tool 250 is an illuminated laser probe including both the optical fiber for illumination as well as another laser fiber to perform surgery, such as to perform vitrectomy. Illumination is more than adequate, and the surgeon can use the laser to achieve hemostasis during surgery. In various embodiments, the surgical tool 250 is a single-fiber illuminated laser probe having the laser and illumination down the same fiber.

[0305] Figure 4 is a schematic diagram of the surgical illumination system 100 in accordance with another exemplary embodiment. The surgical illumination system 100 includes the light source 110 and the illumination microsurgical device 200 connected to the light source 110. The illumination microsurgical device 200 receives the light beam 102 from the light source 110.

[0306] The illumination microsurgical device 200 includes the device optical fiber 210, the surgical tool 250 for performing use in the surgical procedure and the device connector 220 for connecting the illumination microsurgical device 200 to the light source 110. For example, the surgical tool 250 is provided at the distal portion 214 of the device optical fiber 210 for insertion into the patient and the device connector 220 is provided at the proximal portion 212 of the device optical fiber 210 for removable connection to the light source 110. The device optical fiber 210 is configured to emit the light beam 102 from the light source 110 to the surgical field in an expanded light pattern relative to the originally emitted light pattern from the light source 110. In an exemplary embodiment, the device optical fiber 210 has a very small core diameter, allowing use ofsmaller surgical tools 250 and / or allowing smaller incisions or openings in the patient to perform the invasive surgical procedure.

[0307] The light source 110 includes a light source housing 120 having walls 122 forming an internal cavity 124. The light source 110 includes a light assembly 130 received in the cavity 124. The light assembly 130 generates a light beam 102. Alternative to the embodiment depicted in figure 3, the light source 110 does not include a bridge assembly between the light assembly 130 and the illumination microsurgical device 200 but is using a light source optical fiber 192. The light source optical fiber 192 receives the light beam 102 and transmits the light beam 102 from the light assembly 130 to the illumination microsurgical device 200. The light source 110 includes a controller 160 for controlling the light assembly 130. The light source 110 includes one or more user inputs 170, operably coupled to the controller 160, for the physician to control the light assembly 130. Optionally, the light source 110 may include a display 180 for displaying information to the physician, such as one or more operating parameters (for example, brightness, color, or other characteristics of the light beam 102). In various embodiments, the light source 110 includes a despeckling mechanism 190. The despeckling mechanism 190 can be e.g., mechanical, electronic or optical.

[0308] The light assembly 130 includes one or more light elements 132 for generating the light beam 102. The light assembly 130 can output a diagnostic light beam, a treatment light beam, and / or an illumination light beam. The light beam 102 can include any suitable wavelength(s) of light, such as visible light, infrared light, ultraviolet (UV) light, etc. For example, the light beam 102 can transmit bright, broadband, and / or white light to illuminate a surgical field when employed during the surgical procedure.

[0309] The light elements 132 are configured to emit respective light beams and are coupled to respective diode optical fibers having a proximal portion 194a1; 194b1; 194c1 and a distal portion 194a2; 194b2; 194c2. The proximal portion of the diode optical fiber 194a1; 194b1; 194c1 is configured to receive the light beam from thecorresponding light element 132 and the distal portion of the diode optical fiber 194a2; 194b2; 194c2 is configured to emit a combined light beam to a proximal portion of a fused optical fiber 196a. The fused optical fiber additionally comprises a distal portion 196b configured to emit the combined light beam to the proximal portion of the device optical fiber 212. The diode optical fibers and the fused optical fiber are forming the light source optical fiber 192. The distal portions of the diode optical fibers 194a2;194b2;194c2 are coupled to the proximal portion of the fused optical fiber 196a. The distal portions of the diode optical fibers 194a2;194b2;194c2 can be e.g., heat-fused or spliced to the proximal portion of the fused optical fiber 196a.

[0310] In an exemplary embodiment the core diameters of the distal portion of the diode optical fibers 194a2;194b2;194c2 are smaller than the core diameter of the proximal portion 196a of the fused optical fiber 196. Additionally, the core diameter of the distal portion 196b of the fused optical fiber 196 is smaller than the core diameter of the proximal portion of the device optical fiber 212.

[0311] In an exemplary embodiment, the diode optical fibers are tapered down from with their larger core diameter at their proximal portion 194a1;194b1;194c1 to their smaller core diameter at their distal portion 194a2;194b2;194c2. Additionally, the fused optical fiber is tapered down from with its larger core diameter at its proximal portion 196a to its smaller core diameter at its distal portion 196b.

[0312] In an exemplary embodiment, each core diameter diode optical fibers 194a;194b;194c is 50 microns and the core diameter of the fused optical fiber is tapered down from 200 microns at its proximal portion 196a to 75 microns at its distal portion 196b.The core diameter of the device optical fiber 210 is 150 microns.

[0313] In an exemplary embodiment, the diode optical fibers 194a;194b;194c, the fused optical fiber 196 and the device optical fiber 210 comprise a polymer based material or glass, i.e., silica or as plastic.

[0314] In an exemplary embodiment, the proximal portion of the diode optical fibers 194a1;194b1;194c1 has a numerical aperture of 0.25, the proximal portion of the fused optical fiber 196a has a numerical aperture of 0.5 and the proximal portion of the device optical fiber 212 has a numerical aperture of 0.5.

[0315] In an exemplary embodiment, the light elements 132 are laser diodes 134a, 134b, 134c. The laser diodes 134a, 134b, 134c generate different color laser light beams, such as laser light beams at different wavelengths. The outputs from the laser diodes 134a, 134b, 134c are combined to form the combined laser light beam 102. Each of the laser diodes 134a, 134b, 134c may be operated independently to control the characteristics of the laser light beam 102. When employing laser diodes, the emitted laser light beam 102 generally possesses a high degree of spatial coherence. High spatial coherence typically enables the beam to be focused to small spot sizes for delivery to fiber optic cabling. The ability to focus light emitted from the laser diodes 134a, 134b, 134c to small spot sizes may enable the use of small-scale optical fibers for transmitting the light to the interior of eye. Small-scale optical fibers generally have a diameter (or other largest cross-sectional dimension) of less than 200 microns. In various embodiments, the optical fibers may have core diameters of 100 microns or less, such as 50 microns. Each of the optical fibers emit at its distal end a Gaussian beam. The combined laser light beam emitted by the distal portion of the light source optical fiber 192, i.e., by the distal portion of the fused optical fiber 196b has a certain spot size. For efficient transmission to the device optical fiber, the spot size of the combined laser light beam at the distal portion of the light source optical fiber 192 is chosen such that it is smaller than the core diameter of the proximal potion of the device optical fiber 212; and thus enhanced brightness from the device optical fiber is achieved. When integrated with microsurgical instruments, the small core diameter of the small scale distal portion of the device optical fiber 214 may enable a reduction in the cross-sectional area of the instrument, which in turn may reduce the size of the surgical incision in the sclera of the eye through which the instrument is inserted.

[0316] In an exemplary embodiment, the light source 110 includes an array of three laser diodes 134a, 134b, 134c that are by means of the light source optical fiber 192 arranged to combine and emit a combined laser light beam that can be modulated to produce a predetermined spectral range. Each of the laser diodes 134a, 134b, 134c generate highly collimated output beams. The color temperature of the output beams are adjustable, such as by controlling the power to the laser diodes 134a, 134b, 134c. Each of the laser diodes 134a, 134b, 134c may include a discrete spectral range, such as a generally blue spectral range, a generally green spectral range, and a generally red spectral range. In one embodiment, the generally blue spectral range may include a wavelength in the range of about 440 nm to about 460 nm, the generally green spectral range may include a wavelength in the range of about 510 nm to about 530 nm, and the generally red spectral range may include a wavelength in the range of about 650 nm to about 670 nm. The generally blue spectral range should have a wavelength that is within a safe region of the aphakic hazard level. Although the embodiment includes three laser diodes 134a, 134b, 134c, greater or fewer number of laser diodes 134a, 134b, 134c may be used. In the illustrated embodiment, the three laser diodes 134a, 134b, 134c include a red laser diode 134a, a green laser diode 134b, and a blue laser diode 134c. The red laser diode 134a is configured to emit a red laser light beam in the red spectral range. The green laser diode 134b is configured to emit a green laser light beam in the green spectral range. The blue laser diode 134c is configured to emit a blue laser light beam in the blue spectral range. The laser diodes 134a, 134b, 134c are mounted or connected to a circuit board 136 and operably coupled to the controller 160. Operation of the laser diodes 134a, 134b, 134c is controlled by the controller 160. For example, the controller 160 may independently control ON / OFF of the various laser diodes 134a, 134b, 134c and / or intensity / brightness of each of the laser diodes 134a, 134b, 134c. The color may be adjusted during the surgery, such as to enhance parts, features, or issues of the patient’s eye.

[0317] The light assembly 130 includes the diode optical fibers 194a;194b;194c configured to receive the individual beams from the laser diodes 134a,134b, 134c to emit to the fused optical fiber 196. Between the laser diodes 134a, 134b, 134c and the diode optical fibers 194a;194b;194c; optical devices such as lenses or mirrors are provided to guide the laser beams into the diode optical fibers 194a; 194b;194c. For example, the mirrors may be hot or cold dichroic mirrors or fold mirrors. It could also be that between the laser diodes 134a, 134b, 134c and the diode optical fibers 194a;194b;194c no optical devices such as lenses or mirrors are provided to guide the laser beams into the diode optical fibers 194a; 194b;194c but each the laser diodes 134a, 134b, 134c is directly coupled to respective one of the diode optical fibers 194a;194b;194c. The light assembly 130 may include other components, such as a condenser having a plurality of lenses to guiding the laser light beam 102 output by the laser diodes 134a, 134b, 134c. The light assembly 130 may include beam splitters, lenses, gratings, filters, and / or combinations thereof, which facilitate the transmission of light to the diode optical fibers 194a;194b;194c. The diode optical fibers 194a;194b;194c directs the laser beams to the fused optical fiber 196 which spectrally combines the laser beams to a combined laser light beam and then directs this combined laser light beam to the device optical fiber 210. For example, the individual laser beams are directed along a common path passing through the light source optical fiber 192. The combined laser light beam has a spot size at the distal portion of the light source optical fiber 192, i.e., at the distal portion of the fused optical fiber 196b which is less than the size of the aperture opening at the proximal portion of the device optical fiber 212.

[0318] In an exemplary embodiment, the distal portion of the light source optical fiber 192 is connected to the proximal portion of the device optical fiber 212 via a light source connector 154. The light source optical fiber 192 includes a proximal portion, i.e., the proximal portion of the diode optical fibers 194a1;194b1;194c1 and a distal portion, i.e., the distal portion of the fused optical fiber 196. The proximal portion is coupled to the laser diodes 134a, 134b, 134c to receive the laser light beams 102. The light source connector 154 is provided at the distal portion. The illumination microsurgical device 200 is coupled to the light source connector 154. The light source optical fiber 192transmits the light from the light assembly 130 to the illumination microsurgical device 200. The light source connector 154 may include a ferrule or other type of fiber optic connector to connect the light source optical fiber 192 with the device optical fiber 210 of the illumination microsurgical device 200. In an exemplary embodiment, the light source connector 154 defines a separable interface with the illumination microsurgical device 200 to allow removal of the illumination microsurgical device 200 from the light source 110, such as for disposal and replacement of the illumination microsurgical device 200.

[0319] The controller 160 includes a control circuit board 162 and one or more electrical components mounted to the control circuit board 162. The electrical components may include one or more processors, memories, drivers, and the like. The control circuit board 162 is connected to the user inputs 170 to receive inputs from the user inputs 170. The user inputs 170 may be buttons, dials, sliders, keypads, touchpads, or other types of user inputs. In various embodiments, a user input 170 may be provided for independent control of each of the laser diodes 134a, 134b, 134c, such as to control the intensity / frequency of each of the laser diodes 134a, 134b, 134c independently. The user input 170 may include a brightness input to control brightness of the laser light beam 102. In various embodiments, the user inputs 170 can be independently adjusted by the user to modulate the spectral ranges of each laser diode 134a, 134b, 134c. The user inputs 170 may include presets that allow the user to select a predetermined color or spectral range. The control circuit board 162 is connected to the display 180 to provide output to the display 180. The display 180 may include a visual indicator that displays the color and / or brightness of the selected spectral range of the final combined laser light beam emitted from the system 100, which may allows the user to preview the color or spectral range prior to use in a patients eye. The control circuit board 162 is connected to the light assembly 130, such as to the circuit board 136 of the light assembly 130 to control the laser diodes 134a, 134b, 134c. For example, the control circuit board 162 may supply control signals or power to the laser diodes 134a, 134b, 134c to control operation of the laser diodes 134a, 134b, 134c.

[0320] The despeckling mechanism 190 is operably coupled to the light assembly 130. For example, the despeckling mechanism 190 may be coupled to the circuit board 136 and / or the laser diodes 134a, 134b, 134c to vibrate the laser diodes 134a, 134b, 134c to reduce speckling in the laser light beam 102. In other various embodiments, the despeckling mechanism 190 may vibrate the light source optical fiber 192 to reduce the speckling of the combined laser light beam and produce more uniform illumination. For example, the despeckling mechanism 190 may include a vibration element attached to a stripped optical fiber within the system. A light beam produced by combining multiple individual light beams to produce a single light beam having the spectral ranges of the individual light beams, such as implemented with light source 110, may be subject to a phenomenon referred to as speckling. Speckling occurs when multiple light waves having different phases interfere with one another. When added together, the interferences produce a light wave having an intensity that varies randomly. In alternate embodiments, options for reducing speckling include, for example, using rotating diffusers or lenses arranged in the optical path of the light beam to disrupt the spatial coherence of the emitted light beam.

[0321] The device connector 220 is configured to be removably coupled to the light source 110, such as to the housing 120 and / or the light source connector 154. The device connector 220 includes a connector housing 222. In an exemplary embodiment, the connector housing 222 includes a ferrule holding the end of the device optical fiber 210. In various embodiments, the connector housing 222 may be threadably coupled to the hosing 120 / light source connector 154. The connector housing 222 may include a threaded nut configured to be threadably coupled to the housing 120 / light source connector 154.

[0322] The surgical tool 250 may be the same and / or have the same properties as the surgical tool 250 as described in the embodiment depicted in figure 3.

[0323] Figure 5a is another schematic diagram of the surgical illumination system 100 in accordance with another exemplary embodiment. In addition to the exemplary embodiment depicted in figure 4, the light source 110 of this exemplarysurgical illumination system 100 comprises a backlight element in terms of an additional laser diode 135a. The additional laser diode 135a is configured to emit a backlight beam. The backlight beam backlights the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c. The additional laser diode 135a is coupled to a diode optical fiber having a proximal portion 195a1 and a distal portion 195a2. The proximal portion of the diode optical fiber 195a1 is configured to receive the backlight beam from the additional laser diode 135a and the distal portion of the diode optical fiber 195a2 is configured to emit the backlight beam to a proximal portion of a fused optical fiber 196a. The fused optical fiber additionally comprises a distal portion 196b configured to emit a combined light beam (comprising the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c as well as the backlight beam emitted by the additional laser diode 135a) to the proximal portion of the device optical fiber 212. The diode optical fibers and the fused optical fiber are forming the light source optical fiber 192. The distal portions of the diode optical fibers 194a2;194b2;194c2;195a2 are coupled to the proximal portion of the fused optical fiber 196a. The distal portions of the diode optical fibers 194a2;194b2;194c2;195a2 can be e.g., heat-fused or spliced to the proximal portion of the fused optical fiber 196a.

[0324] Instead of guiding the emitted light of the first laser diode 134a, the second laser diode 134b and the third laser diode 134c as well as of the additional laser diode 135a by means of the light source optical fiber 192 comprising the diode optical fibers and the fused optical fiber, optics such as beam splitters, lenses, gratings, mirrors or beam combiners can be used.

[0325] In this exemplary embodiment, the first laser diode 134a is configured to emit laser light having a wavelength of about 455 nm, the second laser diode 134b is configured to emit laser light having a wavelength of about 520 nm and the third laser diode 134c is configured to emit laser light having a wavelength of about 635 nm.The additional laser diode 135a is configured to emit laser light having a wavelength of about 420 nm to backlight the emitted laser light beams.

[0326] The diode optical fibers 194a;194b;194c; 195a directs the laser beams to the fused optical fiber 196 which spectrally combines the laser beams to a combined laser light beam and then directs this combined laser light beam to the device optical fiber 210. For example, the individual laser beams are directed along a common path passing through the light source optical fiber 192. The combined laser light beam has a spot size at the proximal portion of the device optical fiber 212 which is less than the size of the aperture opening at the proximal portion of the device optical fiber 212. The combined light beam has in this configuration a color rendering index larger than 50.

[0327] Figure 5b is another schematic diagram of the surgical illumination system 100 in accordance with another exemplary embodiment. In addition to the exemplary embodiment depicted in figure 5a, the light source 110 of this exemplary surgical illumination system 100 comprises a backlight element in terms of two additional laser diode 135a; 135b. The first additional laser diode 135a is configured to emit a first backlight beam and the second additional laser diode 135b is configured to emit a second backlight beam. These backlight beams backlight the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c.

[0328] The first additional laser diode 135a is coupled to a fourth diode optical fiber having a proximal portion 195a1 and a distal portion 195a2. The second additional laser diode 135b is coupled to a fifth diode optical fiber having a proximal portion 195b1 and a distal portion 195b2. The proximal portion of the fourth and fifth diode optical fiber 195a1; 195b1 are configured to receive the backlight beam from the respective additional laser diode 135a; 135b and the distal portion of the fourth and fifth diode optical fiber 195a2; 195b2 are configured to emit the respective backlight beam to a proximal portion of a fused optical fiber 196a. The fused optical fiber additionally comprises a distalportion 196b configured to emit a combined light beam (comprising the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c as well as the backlight beams emitted by the first additional laser diode 135a and second additional laser diode 135b) to the proximal portion of the device optical fiber 212.

[0329] The diode optical fibers 194a;194b;194c; 195a; 195b directs the laser beams to the fused optical fiber 196 which spectrally combines the laser beams to a combined laser light beam and then directs this combined laser light beam to the device optical fiber 210. The combined laser light beam has a spot size at the proximal portion of the device optical fiber 212 which is less than the size of the aperture opening at the proximal portion of the device optical fiber 212.

[0330] In this exemplary embodiment, the first laser diode 134a is configured to emit laser light having a wavelength of about 455 nm, the second laser diode 134b is configured to emit laser light having a wavelength of about 520 nm and the third laser diode 134c is configured to emit laser light having a wavelength of about 635 nm. The first additional laser diode 135a is configured to emit laser light having a wavelength of about 420 nm and the second additional laser diode 135b is configured to emit laser light having a wavelength of about 570 nm to backlight the emitted laser light beams.

[0331] By adding the second additional laser diode 135b to the already present first additional laser diode 135a helps to provide more spectral components within the wavelength spectrum or to cover a larger wavelengths spectrum and thus generating a combined light beam having a higher a color rendering index.

[0332] Figure 5c is another schematic diagram of the surgical illumination system 100 in accordance with another exemplary embodiment. In addition to the exemplary embodiment depicted in figure 5a, the light source 110 of this exemplary surgical illumination system 100 comprises a backlight element in terms of a LED 137.The LED 137 is configured to emit a backlight beam. The backlight beam backlights the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c.

[0333] The LED 137 is coupled to a fourth diode optical fiber having a proximal portion 197a1 and a distal portion 197a2. The proximal portion of the fourth diode optical fiber 197a1 is configured to receive the backlight beam from the LED 137 and the distal portion of the fourth diode optical fiber 197a2 is configured to emit the backlight beam to a proximal portion of a fused optical fiber 196a. The fused optical fiber additionally comprises a distal portion 196b configured to emit a combined light beam (comprising the first, second and third laser light beam emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c as well as the backlight beam emitted by the LED 137) to the proximal portion of the device optical fiber 212. Instead of one LED, there could also be two LEDs configured to emit a respective backlight beam.

[0334] The LED 137 is configured to emit light in an adjustable color temperature range between of 5000K and 6000K. In addition, the intensity of the LED is adjustable.

[0335] Figure 5d is another schematic diagram of the surgical illumination system 100 in accordance with another exemplary embodiment. In addition to the exemplary embodiment depicted in figure 5c, the light source 110 of this exemplary surgical illumination system 100 comprises a backlight element comprising in addition to the LED 137 an additional laser diode 135a. The additional laser diode 135a is configured to emit a laser backlight beam and the LED 137 is configured to emit a LED backlight beam. These backlight beams backlight the first, second and third laser light beams emitted respectively by the first laser diode 134a, the second laser diode 134b and the third laser diode 134c.

[0336] The backlight element of the light source 110 of the inventive surgical illumination system 100 can comprise multiple combinations of LEDs and / or additional laser diodes. The backlight element can for instance comprise two LEDs, three LEDs or four LEDs. The backlight element can for instance also comprise two LEDs and one additional laser diode, two LEDs and two additional laser diodes or two LEDs and three additional laser diodes. The backlight element can for instance also comprise three LEDs and one additional laser diode, three LEDs and two additional laser diodes or three LEDs and three additional laser diodes. The backlight element can for instance also comprise two additional laser diodes, three additional laser diodes or four additional laser diodes.

[0337] Figure 6 is a diagram illustrating the surgical illumination system 100 in accordance with an exemplary embodiment. The surgical illumination system 100 includes the light source 110 and the illumination microsurgical device 200 connected to the light source 110. The illumination microsurgical device 200 includes the device optical fiber 210, the surgical tool 250 for performing use in the surgical procedure and the device connector 220 for connecting the illumination microsurgical device 200 to the light source 110. The illumination microsurgical device 200 receives the light beam 102 from the light source 110 and emits the light beam 102 to the surgical field. The device optical fiber 210 can have any suitable length. For example, the length can be between approximately 0.1 m and approximately 10 m. In an exemplary embodiment, the device optical fiber 210 has a very small diameter, allowing use of smaller surgical tools 250 and / or allowing smaller incisions or openings in the patient to perform the invasive surgical procedure. The light source 110 of the surgical illumination system 100 includes at least one laser diode 134a, 134b, 134c configured to emit the laser light beam 102. The laser light beam 102 has the focal point 144 at the focal point plane 146. The device optical fiber 210 receives the laser light beam 102 from the light source 110 and emits the laser light beam 102 from an end of the device optical fiber 210. In an exemplary embodiment, the size of the focal point is less than the size of the aperture opening of the device optical fiber 210.

[0338] The device optical fiber 210 has the central portion 216 between the proximal portion 212 and the distal portion 214. The device optical fiber 210 includes a core 202, a cladding 204 surrounding the core 202, and a coating 206 surrounding the cladding 204. The core 202 can be a cylinder of glass, plastic, silica, borosilicate, and / or other suitable material through which light propagates. The cladding 204 surrounds the core 202 and confines the light within the core 202. The cladding 204 includes a dielectric material with an index of refraction less than the index of refraction of the core 202. The coating 206 surrounds the cladding 204 and protects the device optical fiber 210 from physical damage.

[0339] In an exemplary embodiment, the core 202 of the device optical fiber 210 has a diameter 208. Optionally, the core diameter 208 may be uniform / constant along the length of the device optical fiber 210 (for example, along the proximal portion 212, the central portion 216, and the distal portion 214). In various embodiments, the proximal portion 212 may be cone shaped, such as widening from the central portion 216 to the proximal end of the proximal portion. In various embodiments, the distal portion 214 may be cone shaped, such as widening or narrowing from the central portion 216 to the distal end of the distal portion. In an exemplary embodiment, the core 202 of the device optical fiber 210 has an inlet aperture opening 213 at the face of the proximal end 212. The inlet aperture opening 213 receives the laser light beam 102. The inlet aperture opening 213 has a diameter 209, which may be the same as the core diameter 208 of the central portion 216 along the length of the device optical fiber 210. The device optical fiber 210 is configured to receive the laser light beam 102 through the inlet aperture opening 213 at the proximal portion 212. In an exemplary embodiment, the device optical fiber 210 has a very small core diameter, allowing use of smaller surgical tools 250 and / or allowing smaller incisions or openings in the patient to perform the invasive surgical procedure. In various embodiments, the diameters 208 and / or 209 of the device optical fiber 210 may be sized with a diameter of less than 200 microns. The diameters 208 and / or 209 of the device optical fiber 210 may be sized with a diameter in the range of about 50 micros to 100microns. In an exemplary embodiment, spot size of the focal point of the laser diodes 134a, 134b, 134c of the light source 110 is less than the size of the inlet aperture opening 213. For example, the light source 110 and the device optical fiber 210 have high optical efficiency. The laser light beam 102 is focused at the inlet aperture opening 213, such as by the lens assembly 148, to minimize or eliminate wasted or uncollected light. The laser diodes 134a, 134b, 134c are operated to generate the laser light beam having sufficient lighting for the very small diameter device optical fiber 210.

[0340] In use, the light beam 102 traverses an optical path extending between the light source 110 and the surgical field, including through the device optical fiber 210. The device optical fiber 210 facilitates transmission of the light beam 102 between the light source 110 and the surgical tool 250. In various embodiments, the bridge assembly 150 is provided between the light assembly 130 and the device optical fiber 210. For example, the bridge optical fiber 152 receives the light beam 102 from the light assembly 130 and emits the light beam 102 into the device optical fiber 210. The first end 156 of the bridge optical fiber 152 is provided at the focal point plane 146 with the focal point 144 aligned with the first end 156 to direct the light beam 102 directly into the bridge optical fiber 152. In an exemplary embodiment, the bridge optical fiber 152 is an extension of the device optical fiber 210. The bridge optical fiber 152 may be equivalent to the device optical fiber 210, such as being manufactured form the same material and having the same core diameter. The proximal portion 212 of the device optical fiber 210 is optically coupled to the second end 158 of the bridge optical fiber 152. The proximal portion 212 of the device optical fiber may abut against the second end 158 of the bridge optical fiber. The inlet aperture opening 213 of the device optical fiber receives the light beam 102 from the second end 158 of the bridge optical fiber 152. In alternative embodiments, the system may be provided without the bridge assembly 150. Rather, the light beam 102 may be emitted directly into the inlet aperture opening 213 of the device optical fiber. For example, the inlet aperture opening 213 of the device optical fiber may be provided at the focal point144 at the focal point plane 146 rather than positioning the first end 156 of the bridge optical fiber 152 at the focal point 144 of the focal point plane 146.

[0341] The light source connector 154 positions and / or connects the bridge assembly 150 to the illumination microsurgical device 200. Optionally, the light source connector 154 may be directly coupled to the device connector 220 of the illumination microsurgical device 200. Alternatively, both the light source connector 154 and the device connector 220 of the illumination microsurgical device 200 may be connected to the housing 120. The light source connector 154 and / or the device connector 220 may include a ferrule or other type of fiber optic connector to connect the bridge optical fiber 152 with the device optical fiber 210. In an exemplary embodiment, the illumination microsurgical device 200 includes a separable interface to allow removal of the illumination microsurgical device 200 from the light source 110, such as for disposal and replacement of the illumination microsurgical device 200.

[0342] Figure 7 is a front view of the housing of the light source 110 in accordance with an exemplary embodiment. The light source 110 includes the light source housing 120. The light source 110 includes one or more user inputs 170, operably coupled to the controller 160, for the physician to control the light assembly 130. In the illustrated embodiment, the user inputs 170 are dials. However, other types of user inputs 170 may be used in alternative embodiments. In an exemplary embodiment, the user inputs 170 are configured to control the red laser diode, the green laser diode, and the blue laser diode to control the color of the combined laser light beam. The user inputs 170 may control the intensity or brightness of the laser light beams emitted by each of the laser diodes independently from one another and thereby controlling the color or color temperature of the combined the laser light beam. The user inputs 170 may, in addition, control the intensity or brightness of the laser light beams emitted by the backlight element, i.e., by the additional laser diodes or of the backlight LEDs independently of each other and independently of the first, second and third laser diodes 134a, 134b, 134c and therebycontrolling the color or color temperature of the combined beam consisting of the combined laser beam and the backlight beam.

[0343] Figure 8 is a top view of the light source 110 with the cover removed to illustrate components of the light source 110 in accordance with an exemplary embodiment. The light source 110 includes the light source housing 120 having the walls 122 forming the internal cavity 124. The light source 110 includes the light assembly 130, the lens assembly 148, the bridge assembly 150, the controller 160, and the despeckling mechanism 190 for generating the light beam. Wires may be used to electrically connect the various components. The light assembly 130 directs the light beam at the focal point on the focal point plane, such as at the lens assembly 148. The bridge assembly 150 receives the light beam at the focal point plane and then directs the light beam to the device optical fiber 210. However, in alternative embodiments, the lens assembly 148 may direct the light beam, through free space or air directly to the optical fiber.

[0344] Figure 9 is an enlarged view of a portion of the light source 110 showing the despeckling mechanism 190 in accordance with an exemplary embodiment. An optical fiber, such as the bridge optical fiber 152, is connected to and vibrated by the despeckling mechanism 190 to reduce speckling of the combined light beam and produce more uniform illumination.

[0345] Figure 10 is a graph showing output of the surgical illumination system 100 in accordance with an exemplary embodiment. The laser light beam output from the light assembly to the optical fiber is combined from the multiple laser diodes (for example, red / green / blue) and can be modulated to produce a predetermined spectral range. Each of the laser diodes may emit in a discrete spectral range, such as a generally blue spectral range, a generally green spectral range, and a generally red spectral range. In one embodiment, the generally blue spectral range may include a wavelength in the range of about 440 nm to about 460 nm, the generally green spectral range may include a wavelength in the range of about 510 nm to about 530 nm, and the generally red spectralrange may include a wavelength in the range of about 650 nm to about 670 nm. The generally blue spectral range should have a wavelength that is within a safe region of the aphakic hazard level.

[0346] Generally, Figures 11-19 illustrate various embodiments of illuminated microsurgical instruments that may be used in conjunction with the surgical illumination system 100.

[0347] Figure 11A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 11B is an enlarged cross- section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment in an open position. Figure 11C is an enlarged cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment in a closed position.

[0348] In the illustrated embodiment shown in Figures 11A-11C, the surgical tool 250 is a micro-chandelier. The micro-chandelier provides wide angle illumination of the interior of the eye during surgery. The small core diameter of the device optical fiber 210 and the high intensity and brightness of the light beam emitted from the device optical fiber 210 make the surgical tool efficient for surgical procedures. The micro- chandelier is small enough to not need any suturing when removing from the eye. This allows the surgeon to easily move the chandelier to any location needed during surgery.

[0349] The surgical tool 250 includes the tool body 252 extending between the inner end 254 and the outer end 256. The surgical tool 250 includes the handle 258 at the outer end 256 configured to be held by the physician to load the operating portion 260 at the inner end 254 into the eye. For example, the probe 262 is provided at the inner end 254 for insertion into the eye.

[0350] In an exemplary embodiment, the surgical tool 250 includes the cannula or needle 264 received in the cavity 270. The device optical fiber 210 passes through the needle 264. The needle 264 extends from the front end of a hub 253 of the tool body 252. The hub 253 is sized to be held with the finger or with a pair of needle holders / blunt forceps to position the surgical tool 250. The needle 264 has a tip 266. The needle 264 of the surgical tool 250 is beveled and sharp at the tip 266 to pierce the sclera as well as act as a shield to block glare. The device optical fiber 210 is fixed inside of the hub 253 via a fiber stop 280 and a plug 282 on the back-side of the hub 254. The fiber stop 280 facilitates adjustability of the tip of the device optical fiber 210 with respect to the tip 266 of the needle 264. The fiber stop 280 provides a limit to the adjustability by contact with the backside of the needle 264 and the plug 282 in the hub 253. The surgical tool 250 is inserted into the eye first by recessing the device optical fiber 210 into the needle 264 until the fiber stop 280 is contacting the plug 282. The needle 264 is then inserted into the eye into the position the surgeon desires via his fingers or a pair of needle holders. The device optical fiber 210 is then adjusted to the position desired by the surgeon. If the surgeon wishes to move the surgical tool 250 during the case, the device optical fiber 210 may be recessed into the needle 264 and then the needle 264 may be removed from the eye. The surgeon is then able to re-insert the surgical tool 250 wherever they chose to.

[0351] Figure 12A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 12B is cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment in a closed position. Figure 12C is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a non-beveled tip in a closed position. Figure 12D is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a non-beveled tip in an open position. Figure 12E is an enlarged view of a portion of the illuminationmicrosurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a beveled tip in a closed position. Figure 12F is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a beveled tip in an open position.

[0352] In the illustrated embodiment shown in Figures 11A-11F, the surgical tool 250 is an adjustable light pipe. The adjustable light pipe combines the advantages of a widefield as well as a focal light pipe. The small core diameter of the device optical fiber 210 and the high intensity and brightness of the light beam emitted from the device optical fiber 210 make the surgical tool efficient for surgical procedures. The adjustable light pipe is small enough to not need any suturing when removing from the eye.

[0353] The surgical tool 250 includes the tool body 252 extending between the inner end 254 and the outer end 256. The surgical tool 250 includes the handle 258 at the outer end 256 configured to be held by the physician to load the operating portion 260 at the inner end 254 into the eye. For example, the probe 262 is provided at the inner end 254 for insertion into the eye. In an exemplary embodiment, the device optical fiber 210 is fixed in place relative to the handle 258 via a fiber couple 284 and a set screw 285 in the handle 258.

[0354] In the illustrated embodiment, the surgical tool 250 includes a light pipe tube 265 at the inner end 254. The device optical fiber 210 passes through the cavity in the light pipe tube 265. The light pipe tube 265 extends from the front end of the hub 253 of the tool body 252. In an exemplary embodiment, the surgical tool 250 includes a button 257 attached to the light pipe tube 265. The button 257 is able to be actuated (for example, slide relative to the handle 258), which in turn actuates the light pipe tube 265 in position with respect to the tip of the device optical fiber 210. The button 257 is actuated forward to the “closed position”. In the closed position, the device optical fiber 210 is covered or recessed in the light pipe tube 265. The button 257 is actuated rearward to the“open position”. In the open position, the tip of the device optical fiber 210 protrudes from the front of the light pipe tube 265. In the open position, the light pipe is comparable to a widefield light pipe. The output of the device optical fiber 210 can be compared to a room light or a “chandelier.” In the closed position, the light pipe is comparable to a focal light pipe. The output of the device optical fiber 210 can be compared to a flashlight with a focused / narrow beam of light. The focal beam is more “narrow” compared to a regular focal light pipe. That is, the beam of light is more focused and facilitates use across the eye whereas a normal focal light pipe is unable to do this.

[0355] In an exemplary embodiment, the button 257 is able to be actuated continuously from the “open” position to the “closed” position to allow the surgeon to decide how wide the output of light needs to be during use rather than being restricted to a single angle of output. The device optical fiber 210 is fixed to the back of the fiber couple 284, the fiber couple 284 is vented to facilitate venting of air when being inserted into the eye. This combats air bubbles being released into the eye during surgery which obstructs the view of the surgeon. The end of the light pipe tube 265 can be provided with a beveled tip to form a shield 286. The shield 286 is positioned between the surgeon and the inside of the eye, which cuts down on glare when being used.

[0356] Figure 13A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 13B is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a focal tip. Figure 13C is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a widefield tip. Figure 13D is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a shielded widefield tip.

[0357] In the illustrated embodiment shown in Figures 13A-13D, the surgical tool 250 is a light pipe. The small gauge device optical fiber 210 forms a small gauge light pipe. The device optical fiber 210 is held in the light pipe tube 265. In various embodiments, the optical fibers 210 may have gauge sizes less than 23ga, such as 29ga, 30ga, 31ga, 32ga, 33ga. The tips of the device optical fiber 210 can be shaped to produce focal or widefield outputs. Focal outputs are produced by polishing the face of the output side of the fiber flat. Widefield outputs are produced by shaping the tip of the output surface of the fiber into the shape of a cone. Widefield light pipes can be provided with a beveled tip to act as a shield and block glare from obstructing the surgeon’s view. Optionally, stiffening sleeves can be provided with the probes to increase probe stiffness.

[0358] Figure 14A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 14B is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a focal tip. Figure 14C is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a standard widefield tip. Figure 14D is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a shielded widefield tip.

[0359] In the illustrated embodiment shown in Figures 13A-13D, the surgical tool 250 is an aspirating light pipe. The surgical tool 250 allows the combination of a light pipe with the ability to aspirate ILM and ERM from the tips of forceps during bimanual surgery. The surgical tool 250 has a Y connector 290 on the back side that acts the same way as the luer on an MVP. The Y connector 290 allows for the ability to combine the device optical fiber 210 with a silicone aspiration line 292. The device optical fiber 210 is small enough (50-75 micron) to not obstruct the lumen 288 of the surgical tool 250, therefore keeping the lumen of the surgical tool 250 clear for better aspiration of ILM andERM. The device optical fiber 210 can be provided in a widefield or focal output. The tip of the surgical tool 250 can be beveled to act as a shield to block glare.

[0360] Figure 15A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 15B is an enlarged cross- section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment. Figure 15C is another enlarged cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a standard widefield tip. Figure 15D is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment illustrating an area of light output.

[0361] In the illustrated embodiment shown in Figures 15A-15D, the surgical tool 250 is an irrigating chandelier. The surgical tool 250 combines a light pipe, such as a chandelier, with an infusion cannula 294. The light pipe provides efficient illumination due to the brightness provided by the laser diodes and focused laser light beam. The small gauge of the optical fiber allows adequate infusion rates. For example, the small device optical fiber 210 is small enough to provide adequate infusion rates as well as adequate illumination output to be useful during surgery. The small fiber format allows for a smaller overall gauge size while still providing adequate flow rate into the eye. The surgical tool 250 consists of an entry site cannula for the device optical fiber 210 as well as the irrigation cannula 294. The irrigation cannula 294 has a luer barb 296 on the backside to connect to the silicone infusion line 298 as well as a tapered needle 264 on the front to provide a secure connection to the entry site cannula. The silicone infusion line 298 is connected to the “Y” connector 290, which combines the device optical fiber 210 and the separate infusion line 298. The device optical fiber 210 is fed through the Y connector 290 and then into the infusion cannula. The device optical fiber 210 is positioned in the Y connector 290 such that it protrudes from the tip of the entry site cannula 294. Theentry site cannula 294 can be beveled on the end to provide a “shield” and block glare during the surgery.

[0362] Figure 16 is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. In the illustrated embodiment shown in Figure 16, the surgical tool 250 is a stiff illuminated multi-flex. The Stiff Illuminated Multi-Flex has a small gauge size (such as 27ga or 29ga). The small device optical fibers 210 used for illumination (50 or 75 micron) facilitates the ability to make the probe in a smaller gauge. A stiffening sleeve may be provided to increase probe stiffness.

[0363] Figure 17A is an cross-section view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 17B is an enlarged view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment illustrating a standard area of light output. Figure 17C is an enlarged view of view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a wide area of light output.

[0364] In the illustrated embodiment shown in Figures 17A-17C, the surgical tool 250 is an illuminated cannula. The illuminated cannula combines an entry site cannula 300 with a chandelier or focal light pipe. The cannula 300 consists of a cannula head 304 and a cannula tube 302. The cannula head 304 and the cannula tube 302 are made of material that is able to accept and transmit light, such as acrylic, borosilicate glass, transparent ceramic, and the like. The device optical fiber 210 has a small core diameter (for example, 50-75 micron). The device optical fiber 210 is attached to the cannula head 304 and a jacket 306 secures the device optical fiber 210 to the cannula head 304. The tip of the cannula tube 302 can be manufactured to produce a “widefield” output or a narrow “focal” output. The cannula 300 is desired to be sized in 23 and 25ga sizes. When used, the interface between the device optical fiber 210 and the cannula head 304 leaks light in away that illuminates the cannula tube 302, removing the need to turn on a room light in order to reinsert an instrument into the eye through the cannula tube 302. When used, the light output will follow the surgical tool 250.

[0365] Figure 18A is an overhead view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 18B is an overhead view of a portion of the illumination microsurgical device 200 showing a patch cable 310 of the surgical tool 250 in accordance with an exemplary embodiment. Figure 18C is an enlarged cross-section view of the patch cable. Figure 18D is an enlarged cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment. In the illustrated embodiment shown in Figures 18A-18F, the surgical tool 250 is a single fiber stiff illuminated multi-flex. The surgical tool 250 includes the disposable probe 312 and the patch cable 310.

[0366] The disposable probe 312 includes a non-illuminated stiff multi- flex laser probe with the device optical fiber 210 sized to facilitate the acceptance of two separate spots. The core diameter of the device optical fiber 210 matches the diameter of the illumination fiber in the patch cable 310. The gauge size of the probe 312 may be a small gauge, such as 27ga or 29ga. A stiffening sleeve may be provided to increase probe stiffness. A connector 314 of the probe 312 mates to a receptacle 316 of the patch cable 310.

[0367] The patch cable 310 includes a reusable device that consists of a laser fiber 320 and an illumination fiber 322. The two fibers 320, 322 connect to their respective sources and then are run into the receptacle 316. The fibers 320, 322 are polished flat in the receptacle 316. The receptacle 316 accepts the connector 314 that is on the disposable probe 312. The combination of the core diameters of the fibers 320, 322 are such that the sum is smaller than the core diameter of the single fiber in the disposable probe 312. The illumination fiber core diameter is equal to the core diameter of the singlefiber in the disposable probe 312. The core diameter of the laser fiber is smaller than the core diameter of the single fiber in the disposable probe 312. The output of each fiber 320, 322 is accepted into the single fiber in the disposable probe 312 and then transmitted into the eye via the single fiber.

[0368] Figure 19A is a cross-section view of an illumination microsurgical device 200 in accordance with an exemplary embodiment. Figure 19B is an enlarged cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment. Figure 19C is an enlarged cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a forceps in the closed position. Figure 19D is an cross-section view of a portion of the illumination microsurgical device 200 showing the surgical tool 250 and device optical fiber 210 in accordance with an exemplary embodiment with a forceps in an open position.

[0369] In the illustrated embodiment shown in Figures 19A-19F, the surgical tool 250 is an illuminated forceps. A forceps assembly 330 with the addition of the device optical fiber 210 at a tip 332 of the instrument improves the visibility of the surgical field during membrane peeling. The tips 332 may be metal tips. The small fiber format allows for the instrument gauge size to be relatively small, such as 23ga, 25ga, 27ga. The device optical fiber 210 is positioned to run through a lumen of the tube next to the welded forceps. However, the device optical fiber 210 may be located at other locations, such as in a side by side tubing where one tube houses the forceps, and one tube houses the fiber running the fiber within a partial thickness channel along the length of the tube that houses the forceps. Changing the welded forceps assembly to use a tube instead of a wire, and then putting a hole through the center of the forceps, to allow the fiber to go directly through the welded tubing / forceps assembly and come out in between the forceps tines. The tip of the fiber can be shaped to provide focal or widefield outputs. The forceps / scissors tip style can be many embodiments.

[0370] Figure 20 illustrates a cannula 300 in accordance with an exemplary embodiment. The cannula 300 comprises a cannula head 304, a cannula tube 302 and a device optical fiber 210 attached to the cannula head 304.

[0371] The cannula head 304 is the proximal end of the cannula 300. The cannula tube 302 is the distal end of the cannula 300. The cannula 300 can be inserted into the eye of the patient, acting as a port for a surgeon to insert microsurgical instruments into the eye. The microsurgical instruments can be inserted through the inner trocar lumen 308.

[0372] The device optical fiber 210 is fused to the cannula head 304. The combined light beam is transferred by the device optical fiber 210 to the cannula head 304. Since the canula head 304 as well as the cannula tube 302 is made of a transparent ceramic, e.g., polycrystalline ceramic, the light can be emitted out of the cannula 300 to a surgical site.

[0373] Transparent ceramic can not only transmit the light to illuminate the inside of the eye but can also illuminate the cannula 300 itself which helps the surgeons during repositioning or adding a new cannula. Hence, the surgeons do not have to turn the operating room light back on before adding the new cannula and switch off all lights again once everything is in place to continue with the surgery.

[0374] The transparent ceramic can be a polycrystalline ceramic. The polycrystalline ceramic can be used in particular as a transparent ceramic, for example aluminum oxynitride, which is also known under the trade name Alon, or aluminum oxide, which is also known as corundum and sapphire crystal. By virtue of its hardness, the transparent ceramic is suitable in particular for the production of stable rod-shaped portion with very small dimensions, in particular with very small diameters. A cannula 300 made of polycrystalline ceramic is therefore highly suitable as a microsurgical instrument, for ophthalmic surgery.

[0375] The proximal portion of the cannula head 304 is forsted to reduce the light directed at the surgeon directly.

[0376] A valve 310 is present to maintain pressure in the eye.

[0377] The width of the cannula head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 7 mm. The thickness of the trocar head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 5 mm.

[0378] The inner diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 300 microns to approximate 800 microns. The outer diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 27 gauges to approximate 1000 microns. The length of the cannula tube 302 can be for example but not limited to between approximate 4 mm to approximate 7 mm.

[0379] Figure 21 illustrates the cannula 300 in accordance with another exemplary embodiment. The cannula 300 comprises the cannula head 304, the cannula tube 302 and the device optical fiber 210 integrated into the cannula 300. The cannula 300 has a hollow interior and the device optical fiber 210 is routed through the hollow interior of the cannula 300.

[0380] The cannula head 304 is the proximal end of the cannula 300. The cannula tube 302 is the distal end of the cannula 300. The cannula 300 can be inserted into the eye of the patient, acting as a port for a surgeon to insert microsurgical instruments into the eye. The microsurgical instruments can be inserted through the inner trocar lumen 308.

[0381] The device optical fiber 210 is fused to a connecting fiber 326. The connecting fiber 326 is fused to a circular hollow optical fiber 324. The combined lightbeam is transferred by the device optical fiber 210 to the circular hollow optical fiber 324. The light can be emitted out of the distal portion of the cannula tube 302 to a surgical site.

[0382] The valve 310 is present to maintain pressure in the eye.

[0383] The width of the cannula head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 7 mm. The thickness of the trocar head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 5 mm.

[0384] The inner diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 300 microns to approximate 800 microns. The outer diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 27 gauges to approximate 1000 microns. The length of the cannula tube 302 can be for example but not limited to between approximate 4 mm to approximate 7 mm.

[0385] The device optical fiber 210 can have for example but not limited to a core diameter between approximate 50 microns to approximate 250 microns. The inner diameter of the circular hollow optical fiber 324 can have for example but not limited to a diameter between approximate 300 microns to approximate 800 microns. The outer diameter of the circular hollow optical fiber 324 can have for example but not limited to a diameter between approximate 400 microns to approximate 900 microns.

[0386] Figure 22 illustrates the cannula 300 in accordance with another exemplary embodiment. The cannula 300 comprises the cannula head 304, the cannula tube 302 and the device optical fiber 210 attached to the outer surface of the cannula tube 302 by fixing in a groove of the outer surface of the cannula tube 302.

[0387] The cannula head 304 is the proximal end of the cannula 300. The cannula tube 302 is the distal end of the cannula 300. The cannula 300 can be inserted intothe eye of the patient, acting as a port for a surgeon to insert microsurgical instruments into the eye. The microsurgical instruments can be inserted through the inner trocar lumen 308.

[0388] The device optical fiber 210 is fused to the circular hollow optical fiber 324. The combined light beam is transferred by the device optical fiber 210 to the circular hollow optical fiber 324. The light can be emitted out of the distal portion of the cannula tube 302 to a surgical site and also emitted in the direction belonging to the side of the cannula 300 where the circular hollow optical fiber 324 is attached to.

[0389] A valve 310 is present to maintain pressure in the eye.

[0390] The width of the cannula head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 7 mm. The thickness of the trocar head 304 can have for example but not limited to a diameter between approximate 1 mm to approximate 5 mm.

[0391] The inner diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 300 microns to approximate 800 microns. The outer diameter of the cannula tube 302 can have for example but not limited to a diameter between approximate 27 gauges to approximate 1000 microns. The length of the cannula tube 302 can be for example but not limited to between approximate 4 mm to approximate 7 mm.

[0392] The device optical fiber 210 can have for example but not limited to a core diameter between approximate 50 microns to approximate 250 microns. The circular hollow optical fiber 324 can have for example but not limited to a core diameter between approximate 10 microns to approximate 250 microns.

[0393] In some example embodiments, a surgical illumination system is provided including a light source having at least one laser diode configured to emit a laser light beam having a focal point at a focal point plane and an illumination microsurgicaldevice removably coupled to the light source. The illumination microsurgical device includes an device optical fiber with a proximal portion configured to receive the laser light beam from the light source and a distal portion configured to emit the laser light beam from the light source. The proximal portion has an aperture opening. The size of the focal point is less than the size of the aperture opening.

[0394] Optionally, the device optical fiber is disposable. Optionally, the illumination microsurgical device includes a device connector at the proximal portion that is removably coupled to the light source.

[0395] In some aspects, the light source includes a source connector configured to receive the illumination microsurgical device and optically couple the optical fiber to the at least one laser diode. Optionally, the light source includes a bridge optical fiber between the at least one laser diode and the illumination microsurgical device. The bridge optical fiber receives the laser light beam from the at least one laser diode and transmits the laser light beam to the device optical fiber of the illumination microsurgical device. The bridge optical fiber may have a diameter equal to a core diameter of the device optical fiber.

[0396] In some aspects, the light source may include a light source housing holding the at least laser diode and a control panel having at least one user input for controlling the at least one laser diode. Optionally, the at least one laser diode may include a red laser diode, a blue laser diode, and a green laser diode, wherein the red laser diode configured to emit a red laser light beam in the red spectral range to the focal point, the blue laser diode configured to emit a blue laser light beam in the blue spectral range to the focal point, the green laser diode configured to emit a green laser light beam in the green spectral range to the focal point. The light source may include a beam combiner configured to combine the red laser light beam, the blue laser light beam and the green laser light beam into the combined laser light beam and direct the combined laser lightbeam to the focal point. The red laser diode, the blue laser diode, and the green laser diode may be independently controlled to change a color of the combined laser light beam.

[0397] Optionally, the illumination microsurgical device may include a surgical tool and the distal end of the device optical fiber may be integrated into the surgical tool. The illumination microsurgical device may include a cannula having a hollow interior and the device optical fiber may be routed through the hollow interior. The illumination microsurgical device may include a probe configured to be inserted into the patient to position the distal portion of the device optical fiber relative to the patient. Optionally, the probe includes a cannula at a distal end of the probe having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter. The device optical fiber passes through the cannula. The distal portion of the device optical fiber may be movable relative to a distal end of the probe to change an output angle of the light beam emitted from the illumination microsurgical device. Optionally, the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the light beam and the distal portion of the device optical fiber may be located beyond the distal end of the probe to provide a wide output angle of the light beam. Optionally, a distal end of the probe may be beveled to form a shield to block the light beam in one direction more than in another direction.

[0398] Optionally, an optical spacing may be provided between the focal point plane and the aperture opening. A bridge assembly having a bridge optical fiber may be located in the optical space to connect the optical fiber to the light beam at the focal point plane. Optionally, the optical fiber has a core diameter of 200 microns or less.

[0399] In an aspect, at least two laser diodes are provided wherein each laser diode has a discrete spectral range. Optionally, the laser diode may have a generally blue spectral range that is within a safe region of the aphakic hazard level.

[0400] Optionally, the light source may include a despeckling mechanism. The despeckling mechanism can be for instance mechanical, electronic or optical.

[0401] In some example embodiments, an illumination microsurgical device is provided including a device optical fiber having a proximal portion configured to receive a laser light beam from a laser diode of a light source and a distal portion configured to emit the laser light beam. The proximal portion includes an aperture opening having a diameter of 200 microns or less. The illumination microsurgical device includes a device connector at the distal portion configured to be removably coupled to the light source. The illumination microsurgical device includes a surgical tool configured to be inserted into the patient. The distal end of the device optical fiber is integrated into the surgical tool for insertion of the distal end of the device optical fiber into the patient. The device optical fiber, the device connector, and the surgical tool are disposable after use.

[0402] Optionally, the device connector is configured to be threadably coupled to a source connector of the light source to position the proximal portion of the device optical fiber to receive the light beam from the light source.

[0403] In an aspect, the surgical tool includes a cannula having a hollow interior with the device optical fiber routed through the hollow interior. The surgical tool may include a probe configured to be inserted into the patient to position the distal portion of the device optical fiber relative to the patient. The probe may include a cannula at a distal end of the probe having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter. The device optical fiber may pass through the cannula. The distal portion of the device optical fiber may be movable relative to a distal end of the probe to change an output angle of the light beam emitted from the illumination microsurgical device. Optionally, the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the light beam and the distal portion of the device optical fiber may be located beyond the distal end of the probe toprovide a wide output angle of the light beam. A distal end of the probe may be beveled to form a shield to block the light beam in one direction more than another direction.

[0404] In some example embodiments, a method of manufacturing a surgical illumination system is provided including providing a light source having at least one laser diode configured to emit a laser light beam and coupling an illumination microsurgical device to the light source to receive the laser light beam. The illumination microsurgical device includes a device optical fiber transmitting the laser light beam from a proximal portion to a distal portion. The proximal portion of the device optical fiber has an aperture opening. The method includes focusing the laser light beam at a focal point at a focal point plane. The size of the focal point is less than the size of the aperture opening.

[0405] Optionally, the illumination microsurgical device is removable coupled to the light source and disposable after use. In an aspect, the at least one laser diode includes a red laser diode configured to emit a red laser light beam in the red spectral range, a blue laser diode configured to emit a blue laser light beam in the blue spectral range, and a green laser diode configured to emit a green laser light beam in the green spectral range. The focusing of the laser light beam at the focal point includes focusing the red light laser beam to the focal point, focusing the blue laser light beam to the focal point, and focusing the green laser light beam to the focal point.

[0406] It is to be understood that the above description is intended to be illustrative, and not restrictive. For example, the above-described embodiments (and / or aspects thereof) may be used in combination with each other. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from its scope. Dimensions, types of materials, orientations of the various components, and the number and positions of the various components described herein are intended to define parameters of certain embodiments, and are by no means limiting and are merely exemplary embodiments. Many other embodiments and modifications within the spirit and scope of the claims will be apparent to those of skill inthe art upon reviewing the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. In the appended claims, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects. Further, the limitations of the following claims are not written in means-plus-function format and are not intended to be interpreted based on 35 U.S.C. § 112(f), unless and until such claim limitations expressly use the phrase “means for” followed by a statement of function void of further structure.

[0407] It is to be understood that the above description is intended to be illustrative, and not restrictive. For example, the above-described embodiments (and / or aspects thereof) may be used in combination with each other. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from its scope. Dimensions, types of materials, orientations of the various components, and the number and positions of the various components described herein are intended to define parameters of certain embodiments, and are by no means limiting and are merely exemplary embodiments. Many other embodiments and modifications within the spirit and scope of the claims will be apparent to those of skill in the art upon reviewing the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. In the appended claims, the terms "including" and "in which" are used as the plain-English equivalents of the respective terms "comprising" and "wherein." Moreover, in the following claims, the terms "first," "second," and "third," etc. are used merely as labels, and are not intended to impose numerical requirements on their objects. Further, the limitations of the following claims are not written in means-plus-function format and are not intended to be interpreted basedon 35 U.S.C. § 112(f), unless and until such claim limitations expressly use the phrase “means for” followed by a statement of function void of further structure.

Claims

WHAT IS CLAIMED IS:

1. A surgical illumination system, comprising: a light source having at least one laser diode configured to emit an at least first laser light beam; and a backlight element configured to emit a backlight beam, wherein the light source is configured to combine the at least first laser light beam with the backlight beam to a combined beam; and an illumination microsurgical device removably coupled to the light source, the illumination microsurgical device including a device optical fiber with a proximal portion configured to receive the combined light beam from the light source and a distal portion configured to emit the combined light beam from the light source, the proximal portion of the device optical fiber having an aperture opening.

2. The surgical illumination system of claim 1, wherein the combined light beam has a spot size at the proximal portion of the device optical fiber; and wherein the spot size of the combined light beam is smaller than or equal to two times the size of the aperture opening, Preferably smaller than or equal to 1.5 times the size of the aperture opening, more Preferably smaller than or equal to the size of the aperture opening, most Preferably smaller than or equal to 0.8 times the size of the aperture opening.

3. The surgical illumination system of one of claims 1 or 2, wherein the combined light beam has a numerical aperture and the device optical fiber has a numerical aperture; and wherein the numerical aperture of the combined light beam is smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber, Preferably smaller than or equal to the size of the numerical aperture of the device optical fiber, most Preferably smaller than or equal to 0.5 times the size of the numerical aperture of the device optical fiber.

4. The surgical illumination system of claim one of claims 1 to 3, wherein the backlight element comprises at least one LED, Preferably at least two LEDs.

5. The surgical illumination system of claim 4, wherein the at least one LED is configured to emit light with a color temperature between 4000K and 7000K.

6. The surgical illumination system of one of claims 4 or 5, wherein the intensity and / or the color temperature of the at least one LED, Preferably of the at least two LEDs, is adjustable.

7. The surgical illumination system of one of claims 1 to 3, wherein the backlight element comprises at least one additional laser diode, Preferably at least two additional laser diodes.

8. The surgical illumination system of claim 7, wherein the at least one additional laser diode is configured to emit light in a spectral range between about 380 nm to about 730 nm, excluding a wavelength of about 450 nm to about 460 nm, Preferably excluding a wavelength of about 440 nm to about 500 nm, of about 510 nm to about 530 nm, Preferably excluding a wavelength of about 510 nm to about 570 nm, or of about 650 nm to about 670 nm, Preferably excluding a wavelength of about 620 nm to about 670 nm.

9. The surgical illumination system of claim 1 or one of claims 7 or 8, wherein the light source has at least three laser diodes configured to emit at least respective first, second and third laser light beams; one of the at least three laser diodes is configured to emit light in a spectral range between about 440 nm to about 500 nm, Preferably between about 450 nm to about 460 nm, and / or another one of the at least three laser diodes is configured to emit light in a spectral range between about 510 nm to about 570 nm, Preferably between about 510 nm to about 530 nm, and / or another one of the at least three laser diodes is configured to emit light in a spectral range between about 620 nm to about 670 nm, Preferably between about 650 nm to about 670 nm.

10. The surgical illumination system of one of claims 1 to 9, wherein the color rendering index of the combined light beam is larger than 50, Preferably larger than 80, most Preferably larger than 85.

11. A surgical illumination system, comprising: a light source having at least two laser diodes configured to emit at least respective first and second laser light beams; a light source optical fiber having a proximal portion configured to receive the first and the second laser light beam from the at least two laser diodes, and a distal portion configured to emit a combined laser light beam from the light source; and an illumination microsurgical device removably coupled to the light source, the illumination microsurgical device including a device optical fiber with a proximal portion configured to receive the combined laser light beam from the light source and a distal portion configured to emit the combined laser light beam from the light source, the proximal portion of the device optical fiber having an aperture opening.

12. The surgical illumination system of claim 11, wherein the combined laser light beam has a spot size at the distal portion of the light source optical fiber; and wherein the spot size of the combined laser light beam is smaller than or equal to two times the size of the aperture opening, Preferably smaller than or equal to 1.5 times the size of the aperture opening, more Preferably smaller than or equal to the size of the aperture opening, most Preferably smaller than or equal to 0.8 times the size of the aperture opening.

13. The surgical illumination system of one of claims 11 or 12, wherein the combined laser light beam has a numerical aperture and the device optical fiber has a numerical aperture; and wherein the numerical aperture of the combined laser light beam is smaller than or equal to 1.5 times the size of the numerical aperture of the device optical fiber, Preferably smaller than or equal to the size of the numerical aperture of the deviceoptical fiber, most Preferably smaller than or equal to 0.5 times the size of the numerical aperture of the device optical fiber.

14. The surgical illumination system of one of claims 11 to 13, wherein each of the at least two laser diodes is coupled to a respective diode optical fiber; wherein each of the diode optical fibers has a proximal portion configured to receive the laser light beam from the respective laser diode, and a distal portion configured to emit the respective laser light beam to a fused optical fiber with a proximal portion configured to receive the first and the second laser light beam and a distal portion configured to emit the combined laser light beam; and wherein the light source optical fiber comprises the at least two diode optical fibers and the fused optical fiber.

15. The surgical illumination system of claim 14, wherein the distal portions of the at least two diode optical fibers are coupled to the proximal portion of the fused optical fiber, especially wherein the distal portions of the at least two diode optical fibers are heat-fused or spliced to the proximal portion of the fused optical fiber.

16. The surgical illumination system of one of claims 14 or 15, wherein the core diameter of each of the at least two diode optical fibers is smaller than the core diameter of the proximal portion of the fused optical fiber and / or wherein the core diameter of the distal portion of the fused optical fiber is smaller than or equal to the core diameter of the device optical fiber.

17. The surgical illumination system of one of claims 14 to 16, wherein the at least two diode optical fibers are tapered down from with their larger core diameter at their proximal portion to their smaller core diameter at their distal portion.

18. The surgical illumination system of one of claims 14 to 17, wherein the fused optical fiber is tapered down from with its larger core diameter at its proximal portion to its smaller core diameter at its distal portion.

19. The surgical illumination system of one of claims 14 to 18, wherein the core diameter of the at least two diode optical fibers is between 10 and 150 microns, especially between 10 and 50 microns and / or wherein the core diameter of the fused optical fiber is between 50 and 500 microns, especially between 50 and 200 microns and / or the core diameter of the device optical fiber is between 50 and 250 microns.

20. The surgical illumination system of one of claims 14 to 19, wherein the at least two diode optical fibers and / or the fused optical fiber and / or the device optical fiber comprise a polymer based material, silica, acryl, and / or plastic.

21. The surgical illumination system of one of claims 14 to 20, wherein the at least two diode optical fibers and / or the fused optical fiber and / or the device optical fiber has a numerical aperture between 0.2 and 0.

7.

22. The surgical illumination system of one of claims 11 to 21, wherein the first and the at least second laser light beam are configured to be spectrally combined, polarization combined or coherently combined to form the combined laser light beam.

23. The surgical illumination system of claims one of 11 to 22, wherein the light source has at least three laser diodes configured to emit at least respective first, second and third laser light beams; a backlight element configured to emit a backlight beam; wherein the proximal portion of the light source optical fiber is configured to receive the at least first, second and third laser light beams and the backlight beam; and wherein the distal portion of the light source optical fiber is configured to emit the combined light beam from the light source.

24. The surgical illumination system of claim 23, wherein the backlight element comprises at least one LED, Preferably at least two LEDs.

25. The surgical illumination system of claim 24, wherein the at least one LED is configured to emit light with a color temperature between 4000K and 7000K.

26. The surgical illumination system of one of claims 24 or 25, wherein the intensity and / or the color temperature of the at least one LED, Preferably of the at least two LEDs, is adjustable.

27. The surgical illumination system of claim 23, wherein the backlight element comprises at least one additional laser diode, Preferably at least two additional laser diodes.

28. The surgical illumination system of claim 27, wherein the at least one additional laser diode is configured to emit light in a spectral range between about 380 nm to about 730 nm, excluding a wavelength range of about 450 nm to about 460 nm, Preferably excluding a wavelength range of about 440 nm to about 500 nm, excluding a wavelength range of about 510 nm to about 530 nm, Preferably excluding a wavelength range of about 510 nm to about 570 nm, or excluding a wavelength range of about 650 nm to about 670 nm, Preferably excluding a wavelength range of about 620 nm to about 670 nm.

29. The surgical illumination system of one of claims 23 to 28, wherein one of the at least three laser diodes is configured to emit light in a spectral range between about 440 nm to about 500 nm, Preferably in a spectral range between about 450 nm to about 460 nm, and / or another one of the at least three laser diodes is configured to emit light in a spectral range between about 510 nm to about 570 nm, Preferably in a spectral range between about 510 nm to about 530 nm, and / or another one of the at least three laser diodes is configured to emit light in a spectral range between about 620 nm to about 670 nm, Preferably in a spectral range between about 650 nm to about 670 nm.

30. The surgical illumination system of one of claims 23 to 29, wherein the color rendering index of the combined light beam is larger than 50, Preferably larger than 80, most Preferably larger than 85.

31. The surgical illumination system of one of claims 1 to 30, wherein the device optical fiber is disposable.

32. The surgical illumination system of one of claims 1 to 31, wherein the illumination microsurgical device includes a device connector at the distal portion of the device optical fiber, the device connector being removably coupled to the light source.

33. The surgical illumination system of one of claims 14 to 32, wherein the light source includes a source connector configured to receive the illumination microsurgical device and optically couple the device optical fiber to the fused optical fiber.

34. The surgical illumination system of one of claims 1 to 33, wherein the light source includes a light source housing holding each of the laser diodes, the light source including a control panel having at least one user input for controlling each of the laser diodes.

35. The surgical illumination system of one of claims 9 to 10 or 23 to 34, wherein the at least three laser diodes includes a red laser diode, a blue laser diode, and a green laser diode, the red laser diode configured to emit a red laser light beam in the red spectral range, the blue laser diode configured to emit a blue laser light beam in the blue spectral range, the green laser diode configured to emit a green laser light beam in the green spectral range.

36. The surgical illumination system of claim 35, wherein the light source includes a beam combiner configured to combine the red laser light beam, the blue laser light beam and the green laser light beam into the combined laser light beam and direct the combined laser light beam to a focal point.

37. The surgical illumination system of claims 35 or 36, wherein the red laser diode, the blue laser diode, and the green laser diode are independently controlled to change a color of the combined laser light beam.

38. The surgical illumination system of one of claims 1 to 37, wherein the illumination microsurgical device includes a surgical tool, the distal end of the device optical fiber integrated into the surgical tool.

39. The surgical illumination system of one of claims 1 to 38, wherein the illumination microsurgical device includes a cannula.

40. The surgical illumination system of claim 39, wherein the device optical fiber is attached to the cannula.

41. The surgical illumination system of one of claims 39 or 40, wherein the device optical fiber is attached to the outer surface of the cannula.

42. The surgical illumination system of claim 41, wherein the device optical fiber is fixed in a groove of the outer surface of the cannula.

43. The surgical illumination system of one of claims 39 or 40, wherein the cannula has a hollow interior, the device optical fiber routed through the hollow interior.

44. The surgical illumination system of one of claims 39 to 43, wherein the cannula comprises a cannula head and a cannula tube; and wherein the device optical fiber is attached, Preferably fused, to the cannula head.

45. The surgical illumination system of claim 44, wherein the cannula head is frosted and / or sandblasted and / or painted.

46. The surgical illumination system of one of claims 39 to 45, wherein the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber or wherein the device optical fiber is a circular hollow optical fiber.

47. The surgical illumination system of claim 46, wherein the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

48. The surgical illumination system of claim 46, wherein the circular hollow optical fiber is tapered.

49. The surgical illumination system of one of claims 39 to 48, wherein the cannula is made of a light transmitting material, Preferably made of silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

50. The surgical illumination system of one of claims 39 to 49, wherein the device optical fiber and / or the circular hollow optical fiber comprises a light transmitting material, Preferably comprises silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

51. The surgical illumination system of one of claim 1 to 50, wherein the illumination microsurgical device includes a probe configured to be inserted into a patient to position the distal portion of the device optical fiber relative to the patient.

52. The surgical illumination system of claim 51, wherein the probe includes a cannula at a distal end of the probe, the cannula having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter, the device optical fiber passing through the cannula.

53. The surgical illumination system of claim 51 or 52, wherein the distal portion of the device optical fiber is movable relative to a distal end of the probe to change an output angle of the laser light beam emitted from the illumination microsurgical device.

54. The surgical illumination system of claim 53, wherein the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the laser light beam and wherein the distal portion of the device optical fiber is located beyond the distal end of the probe to provide a wide output angle of the combined laser light beam.

55. The surgical illumination system of one of claims 51 to 54, wherein a distal end of the probe is beveled to form a shield to block the combined laser light beam in one direction more than another direction.

56. The surgical illumination system of one of claims 14 to 555, wherein the diode optical fiber, the fused optical fiber or the device optical fiber has a core diameter of 250 microns or less.

57. The surgical illumination system of one of claims 1 to 56, wherein each of the laser diodes has a discrete spectral range.

58. The surgical illumination system of one of claims 1 to 57, wherein one of the laser diodes has a generally blue spectral range that is within a safe region of the aphakic hazard level.

59. The surgical illumination system of one of claims 1 to 58, wherein the light source includes a despeckling mechanism, especially a mechanical, electronic or optical despeckling mechanism.

60. An illumination microsurgical device, comprising: a device optical fiber having a proximal portion configured to receive a combined laser light beam from at least two laser diodes of a light source and a distal portion configured to emit the combined laser light beam, the proximal portion including an aperture opening having a diameter of 200 microns or less;a device connector at the distal portion, the device connector configured to be removably coupled to the light source; and a surgical tool configured to be inserted into a patient, wherein the distal end of the device optical fiber is integrated into the surgical tool for insertion of the distal end of the optical fiber into the patient; wherein the device optical fiber, the device connector, and the surgical tool are disposable after use.

61. The illumination microsurgical device of claim 60, wherein the device connector is configured to be threadably coupled to a source connector of the light source to position the proximal portion of the device optical fiber to receive the laser light beam from the light source.

62. The illumination microsurgical device of one of claims 60 or 61, wherein the surgical tool includes a cannula.

63. The illumination microsurgical device of claim 62, wherein the device optical fiber is attached to the cannula.

64. The illumination microsurgical device of one of claims 62 or 63, wherein the device optical fiber is attached to the outer surface of the cannula.

65. The illumination microsurgical device of claim 64, wherein the device optical fiber is fixed in a groove of the outer surface of the cannula.

66. The illumination microsurgical device of one of claims 62 or 63, wherein the cannula has a hollow interior, the device optical fiber routed through the hollow interior.

67. The illumination microsurgical device of one of claims 62 to 66, wherein the cannula comprises a cannula head and a cannula tube; and wherein the device optical fiber is attached, Preferably fused, to the cannula head.

68. The illumination microsurgical device of claim 67, wherein the cannula head is frosted and / or sandblasted and / or painted.

69. The illumination microsurgical device of one of claims 62 to 68, wherein the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber or wherein the device optical fiber is a circular hollow optical fiber.

70. The illumination microsurgical device of claim 69, wherein the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

71. The illumination microsurgical device of claim 69, wherein the circular hollow optical fiber is tapered.

72. The illumination microsurgical device of one of claims 62 to 71, wherein the cannula is made of a light transmitting material, Preferably made of silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

73. The illumination microsurgical device of one of claims 62 to 72, wherein the device optical fiber and / or the circular hollow optical fiber comprises a light transmitting material, Preferably comprises silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

74. The illumination microsurgical device of one of claims 60 to 73, wherein the surgical tool includes a probe configured to be inserted into the patient to position the distal portion of the device optical fiber relative to the patient.

75. The illumination microsurgical device of one of claims 60 to 74, wherein the probe includes a cannula at a distal end of the probe, the cannula having an outer diameter of at most 250 microns and an inner diameter less than the outer diameter, the device optical fiber passing through the cannula.

76. The illumination microsurgical device of one of claims 60 to 75, wherein the distal portion of the device optical fiber is movable relative to a distal end of the probe to change an output angle of the combined laser light beam emitted from the illumination microsurgical device.

77. The illumination microsurgical device of claim 76, wherein the distal portion of the device optical fiber is located interior of the probe to provide a narrow output angle of the combined laser light beam and wherein the distal portion of the device optical fiber is located beyond the distal end of the probe to provide a wide output angle of the combined laser light beam.

78. The illumination microsurgical device of one of claims 60 to 76, wherein a distal end of the probe is beveled to form a shield to block the combined laser light beam in one direction more than another direction.

79. A method of manufacturing a surgical illumination system comprising: providing a light source having at least two laser diodes configured to emit at least a respective first and a second laser light beam to a light source optical fiber as a combined laser light beam; coupling an illumination microsurgical device to the light source to receive the combined laser light beam, the illumination microsurgical device including a device optical fiber transmitting the combined laser light beam from a proximal portion to a distal portion, the proximal portion of the device optical fiber having an aperture opening; andemitting the combined laser light beam at a distal portion of the light source optical fiber with a spot site, wherein the spot size of the combined laser light beam at the distal portion of the light source optical fiber is less than the size of the aperture opening at the proximal portion of the device optical fiber.

80. The method of claim 79, wherein the illumination microsurgical device is removable coupled to the light source and disposable after use.

81. The method of one of claims 79 or 80, wherein the at least two laser diodes include a red laser diode configured to emit a red laser light beam in the red spectral range, a blue laser diode configured to emit a blue laser light beam in the blue spectral range, and a green laser diode configured to emit a green laser light beam in the green spectral range, said emitting the combined laser light beam at the distal portion of the light source optical fiber comprises emitting the red laser light beam at the distal portion of the light source optical fiber, emitting the blue laser light beam at the distal portion of the light source optical fiber, and emitting the green laser light beam at the distal portion of the light source optical fiber.

82. A cannula for use in a surgical illumination system of one of claims 1 to 59 or for use in an illumination microsurgical device of one of claims 60 to 78; wherein the cannula comprises - a cannula head; - a cannula tube; and - a device optical fiber attached to the cannula.

83. The cannula of claim 82, wherein the device optical fiber is attached to the outer surface of the cannula.

84. The cannula of claim 83, wherein the device optical fiber is fixed in a groove of the outer surface of the cannula.

85. The cannula of claim 82, wherein the cannula has a hollow interior, the device optical fiber routed through the hollow interior.

86. The cannula of one of claims 82 to 85, wherein the device optical fiber is attached, Preferably fused, to the cannula head.

87. The cannula of one of claims 82 to 86, wherein the cannula head is frosted and / or sandblasted and / or painted.

88. The cannula of one of claims 82 to 87, wherein the device optical fiber is attached, Preferably fused, to a circular hollow optical fiber or wherein the device optical fiber is a circular hollow optical fiber.

89. The cannula of claim 88, wherein the device optical fiber is attached to the circular hollow optical fiber by a connecting fiber, Preferably by fusing to a connecting fiber.

90. The cannula of claim 88, wherein the circular hollow optical fiber is tapered.

91. The cannula of one of claims 82 to 90, wherein the cannula is made of a light transmitting material, Preferably made of silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

92. The cannula of one of claims 82 to 91, wherein the device optical fiber and / or the circular hollow optical fiber comprises a light transmitting material, Preferably comprises silica, and / or acryl and / or transparent ceramic, Preferably a polycrystalline ceramic.

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