Surgical instrument with integrated pressure sensor for ophthalmic surgery

Abstract

Embodiments of this disclosure provide surgical instruments having a pressure sensor incorporated into or adjacent to the distal end of the surgical instrument to enable direct intraocular (IOP) reading of the eye. The surgical instrument may include a handheld device inserted into the eye to perform a surgical task.

Description

Technical Field

[0001] During ophthalmic surgical procedures such as vitreoretinal surgery or phacoemulsification surgery, perfusion fluid is injected into the eye to maintain a relatively constant intraocular pressure (IOP) while a specific substance (e.g., part of the vitreous or cataractous lens) is removed from the eye. Measurement of the IOP is important during these procedures to prevent collapse of the eye or a sudden pressure surge within the eye (e.g., a post-occlusion surge).

Background Art

[0002] Currently, during various types of ophthalmic surgical procedures, the IOP is estimated based on measurements from a pressure sensor located outside the patient's eye. For example, in certain instances, the pressure sensor of a surgical console may be utilized to estimate the IOP based on the pressure within one or more fluid lines operatively coupled to the pressure sensor. In certain other instances, the pressure sensor within the handpiece of a surgical tool may be utilized to estimate the IOP based on the pressure within one or more fluid lines disposed through the handpiece. Since these pressure sensors are located upstream of the eye, IOP control is affected, among other inaccuracies, by the time delay between pressure events occurring within the eye and pressure changes sensed at the surgical console or handpiece end. Additionally, the IOP measurements can be prone to inaccuracies caused by the unknown resistance of the fluid lines. For example, if the resistance of the perfusion line to the eye changes, it affects the accuracy of IOP sensing and thus the efficiency of IOP maintenance. These inaccuracies resulting from measuring the IOP away from the eye make the external IOP measurements undesirable.

Summary of the Invention

Means for Solving the Problems

[0003] The present disclosure generally relates to surgical instruments incorporating a pressure sensor for ophthalmic surgery.

[0004] A particular embodiment provides an internal illuminator comprising a handpiece and a probe coupled to the distal end of the handpiece, the probe including an optical fiber and a pressure sensor, wherein the pressure sensor is positioned near the distal end of the probe, the pressure sensor is configured to be inserted into the intraocular space of the eye, and the pressure sensor is configured to directly sense intraocular pressure (IOP) related to the intraocular space of the eye.

[0005] A particular embodiment provides an ophthalmic surgical instrument which includes a pressure sensor positioned near the distal end of the instrument, the pressure sensor being inserted into the intraocular space of the eye and configured to directly sense the intraocular pressure (IOP) associated with the intraocular space of the eye.

[0006] The following description and related drawings illustrate in detail specific exemplary features of one or more embodiments.

[0007] The accompanying drawings illustrate specific aspects of one or more embodiments and should therefore not be considered to limit the scope of this disclosure. [Brief explanation of the drawing]

[0008] [Figure 1] Figure 1 shows a schematic cross-sectional view of an eye having an internal illuminator into which one or more pressure sensors are inserted to provide direct intraocular pressure (IOP) measurements, according to some embodiments of the present disclosure. [Figure 2] Figure 2 shows a schematic cross-sectional side view of an internal illuminator in which one or more pressure sensors are integrated at the distal end, according to some embodiments of the present disclosure. [Figure 3A] Figure 3A shows a side perspective view of an internal illuminator in which one or more pressure sensors are integrated at the distal end, according to some embodiments of the present disclosure. [Figure 3B] Figure 3B shows a detailed partial side perspective view of the distal end portion of the tube of the internal illuminator shown in Figure 3A. [Figure 3C] Figure 3C shows a cross-sectional front view of the distal end face of the distal end portion shown in Figure 3B. [Figure 4A] Figure 4A shows a side perspective view of an internal illuminator with a pressure sensor integrated at its distal end, according to some embodiments of the present disclosure. [Figure 4B] Figure 4B shows a detailed partial side perspective view of the distal end portion of the tube of the internal illuminator shown in Figure 4A. [Figure 4C] Figure 4C shows a cross-sectional view of the internal illuminator tube near the distal end portion shown in Figure 4B. [Figure 5] Figure 5 shows a schematic cross-sectional view of an eye having a surgical instrument into which a pressure sensor is inserted to provide direct IOP measurements, according to some embodiments of the present disclosure. [Figure 6A] Figure 6A shows the distal end portion of a surgical instrument having a pressure sensor according to some embodiments of the present disclosure. [Figure 6B] Figure 6B shows another distal end portion of a surgical instrument having a pressure sensor according to some embodiments of the present disclosure. [Figure 7] Figure 7 shows schematic diagrams of surgical consoles and their components according to several embodiments of the present disclosure. [Modes for carrying out the invention]

[0009] To facilitate understanding, the same reference numerals are used wherever possible to indicate identical elements common to both drawings. Elements and features of one embodiment are considered to be usefully incorporated into other embodiments without further mention.

[0010] Features of the present invention may be discussed below with respect to specific embodiments and drawings, but all embodiments of the present invention may include one or more of the advantageous features discussed herein. In other words, one or more embodiments may be discussed as having certain advantageous features, and one or more such features may be used according to various other embodiments discussed herein. Similarly, exemplary embodiments may be discussed below as embodiments of devices, instruments, or methods, but it should be understood that such exemplary embodiments can be implemented in various devices, instruments, and methods. As described below, the drawings herein each illustrate apparatus and method for improving surgical visualization of a patient's eye by microscopy and reducing glare.

[0011] As used herein, the term “proximal” refers to the part of the device or device that is closest to the clinician using the device and furthest from the patient using the device during normal use. Conversely, the term “distal” refers to the part of the device or device that is furthest from the clinician using the device and closest to the patient using the device during normal use. For example, as used herein, the terms “distal” and “proximal” may refer to relative positions relating to an internal illuminator, microscope, or part thereof.

[0012] As used herein, the term "approximately" may refer to a variation of ±10% from the nominal value. It should be understood that such variation may be included in any value provided herein.

[0013] According to embodiments of this application, the pressure sensor is incorporated into or adjacent to the distal end of a surgical instrument to provide direct intraocular (IOP) readings from the anterior or posterior chamber. The surgical instrument may be a handheld device that can be inserted into the eye to perform a surgical task.

[0014] In some embodiments, the pressure sensor is incorporated into or adjacent to the distal end of an illumination device (e.g., an internal illuminator) to provide an IOP reading from the anterior chamber or posterior chamber of the eye.

[0015] In some embodiments, the pressure sensor is incorporated into or adjacent to the distal end of another surgical instrument (e.g., a phacoemulsification aspiration probe, a vitrectomy probe, a tissue manipulation device, or another surgical instrument in place of an illumination device) that can be inserted into or positioned adjacent to the anterior chamber or posterior chamber of the eye.

[0016] Examples of other surgical instruments into which one or more pressure sensors can be incorporated may include, but are not limited to, trocar cannulas, infusion cannulas, and other similar devices.

[0017] Other examples of surgical instruments into which one or more pressure sensors can be incorporated may include, but are not limited to, cutting probes, vitrectomy probes, phacoemulsification aspiration probes, laser probes, ablation probes, vacuum probes, flushing probes, scissors, forceps, spatulas, hooks, Sim's hooks, depressors, side port blades, side port knives, knives for micro incision coaxial surgery (MICS), endoscopic visualization probes, other ophthalmic devices, and / or combinations thereof. The surgical instrument may have configurable operating settings. The operating settings are parameters having values that can be selected by a user (e.g., a surgeon, a medical technician, or other medical professional).

[0018] In some embodiments, the pressure sensor is incorporated into or adjacent to the distal end of a surgical instrument and is coupled to a controller circuit for identifying pressure-related events such as an increase or decrease in intraocular pressure, high pressure, low pressure, or rupture or collapse of the eyeball.

[0019] In some embodiments, the pressure sensor is inserted into the eye and configured to interface (e.g., directly or in direct contact) with an intraocular space, such as an intraocular substance (e.g., fluid) of the eye and directly sense an IOP associated with the intraocular space of the eye. Thus, directly sensing the IOP refers to the sensing performed by the pressure sensor while interfacing with the intraocular space.

[0020] In some embodiments, the direct IOP reading / measurement generated by the pressure sensor (and / or the information obtained from the pressure sensor readings) can be visually displayed (e.g., on a stand-alone display, a head-up display, an in-microscope display, or a display integrated into a surgical tray or console), and / or can be audibly announced. In some embodiments, an alarm and / or safety measure may be actuated based on the direct IOP reading / measurement. Further, the direct IOP reading / measurement may be used in a feedback control loop for controlling the rate of infusion and / or aspiration during a surgical procedure of the anterior or posterior segment of the eye in some embodiments. In some embodiments, the direct IOP reading / measurement can be used to control and / or maintain the IOP of the eye, for example, by adjusting the rate of infusion and / or aspiration during a surgical procedure (e.g., of the anterior or posterior segment of the eye).

[0021] In some embodiments, examples of the pressure sensor can include, but are not limited to, a microelectromechanical systems (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gauge pressure sensor, a capacitive pressure sensor, a fiber-based pressure sensor, other small pressure sensors, and / or any combination thereof.

[0022] Referring here to Figure 1, schematic cross-sectional views of an eye 130 into which an internal illuminator 100 has been inserted, according to several embodiments of the present disclosure. The internal illuminator 100 comprises one or more miniature pressure sensors 120 for providing direct IOP measurements from within the eye 130. In addition to providing direct IOP measurements, the internal illuminator 100 is also configured to bring illumination into the intraocular space of the eye 130 to facilitate surgical procedures within it.

[0023] As shown in Figure 1, the internal illuminator 100 includes a handpiece 102 and a shaft or tube 104. The handpiece 102 is coupled to the proximal end of the tube 104. In some embodiments, the handpiece 102 provides a grippable portion of the internal illuminator 100 to a user (e.g., an ophthalmic surgeon) so that the user can manipulate the depth and position of the tube 104 within the eye 130, guide the light 112 propagated from the distal end 145 of the tube 104, and position the pressure sensor 120 within the eye 130.

[0024] In some embodiments, the tube 104 is a substantially hollow metal shaft or subcutaneous injection tube configured to be inserted into the eye 130 via an entry cannula 106 positioned through a scleral incision 116 of the eye 130. In some embodiments, the tube 104 is formed of stainless steel, aluminum, nitinol, other alloys, and / or other suitable surgical-grade metal materials. In some examples, the tube 104 is fixedly coupled to a handpiece 102. In other examples, the tube 104 is rotatable relative to the handpiece 102. That is, the handpiece 102 includes a portion having a circular cross-section configured to be rotatably coupled to the tube 104, allowing the user to rotate the tube 104 to adjust the incidence of light 112 into the eye 130 and / or adjust the position of the pressure sensor 120 within the eye 130. In another example, the handpiece 102 is fixedly coupled to the tube 104, allowing the user to rotate the tube 104 by rotating the handpiece 102. Although the tube 104 in Figure 1 is shown as a straight shaft, other embodiments may include tubes of other shapes. For example, a portion of the tube 104 may be curved or bent to bring light 112 to areas of the eye 130 that are difficult to illuminate with a straight tube 104. In some embodiments, the internal illuminator 100 and its components constitute an instrument kit for use in ophthalmic surgery.

[0025] In some embodiments, the internal illuminator 100 is configured to house a single optical fiber 110a, or multiple (e.g., bundled) optical fibers 110a optically coupled to a light source 108 at the distal ends of one or more fibers. In some embodiments, one or more optical fibers 110a may be directly or indirectly attached to the internal chamber of the internal illuminator 100 through the handpiece 102 and the tube 104. One or more optical fibers 110a are configured to guide light 112 from the distal end 145 of the tube 104 (see, for example, Figures 2, 3A-3C, and 4A-4C). For example, the distal end 145 of the tube 104 includes one or more openings through which the distal ends of the optical fibers 110a can propagate light 112 into the eye 130. In some embodiments, for example, the optical fiber 110a may include an optical fiber array (e.g., multiple optical fibers in a regular linear arrangement or a two-dimensional pattern arrangement) and / or one or more multi-core optical fibers (e.g., single-mode (SM) or multi-mode (MM) fibers having multiple cores). In particular, the hollow portion of the tube 104 includes an internal compartment configured to house one or more optical fibers 110a. One or more optical fibers 110a may include one or more polarization-retaining fibers, polarized optical fibers and / or any other optical fibers suitable for light transmission.

[0026] In some embodiments, the internal illuminator 100 is further configured to house one or more pressure sensors 120 and wires (or cables) 110b necessary for powering the pressure sensors 120 and / or for exchanging data / signals (e.g., transmitting and receiving) with, for example, a controller 114 (e.g., having a control circuit). In some embodiments, the wires 110b for the pressure sensors 120, together with the optical fibers 110a, may be directly or indirectly attached to the internal chamber of the internal illuminator 100 through the handpiece 102 and tube 104. In some embodiments, the wires 110b for the pressure sensors 120 are arranged longitudinally along the direction of the optical fibers 110a within the handpiece 102 and tube 104.

[0027] In some embodiments, the pressure sensor 120 may be exposed (for example, to the external environment outside the internal illuminator 100) through one or more openings in the distal end 145 of the tube 104, and when the internal illuminator 100 is inserted into the eye 130, it may be configured to perform pressure (e.g., IOP) measurements directly from inside the eye 130. For example, the distal end 145 of the tube 104 includes one or more openings through which the miniature pressure sensor 120 can come into direct contact with the fluid inside the eye 130. In some embodiments, one or more openings for the pressure sensor 120 (as shown in Figures 3A-3C) are positioned adjacent to openings through which the distal ends of one or more optical fibers 110a can propagate light 112 into the eye 130. In some embodiments, one or more openings for the pressure sensor 120 (as shown in Figures 4A-4C) are formed in the side wall of the tube 104 near the distal end 145.

[0028] In some embodiments, the internal illuminator 100 is operably coupled to and / or communicates with a surgical console 140 through a cable 110 configured to enclose one or more optical fibers 110a and one or more wires 110b. As shown in Figure 1, the handpiece 102 of the internal illuminator 100 is coupled to the distal end of the cable 110, while the proximal end of the cable 110 interfaces with the surgical console 140. One or more optical fibers 110a and one or more wires 110b for a miniature pressure sensor 120 are delivered from the internal illuminator 100 through the optical cable 110 to a light source 108 and a controller 114 in the surgical console 140, respectively.

[0029] In the illustrated example, the surgical console 140 includes a light source 108 and a controller 114. However, it should be noted that in some embodiments, the light source 108 and controller 114 may be located outside the surgical console 140. In some embodiments, in addition to housing the light source 108 and controller 114, the surgical console 140 may be configured to interface with and drive other surgical instruments and systems, including but not limited to various probe types of ophthalmic probes, such as laser probes (e.g., picosecond infrared laser probes, femtosecond laser probes), vitrectomy probes, phacoemulsification probes, flap cutters, and other ophthalmic surgical tools. During operation, the surgical console 140 may function to assist the user in performing various ophthalmic surgical procedures such as vitrectomy, phacoemulsification, cataract surgery, LASIK (laser corneal resection), and similar procedures.

[0030] In some embodiments, the light source 108 may be configured to generate light 112 and pass it through the proximal inlet point of the optical fiber 110a, thereby allowing the light 112 to propagate to the distal end 145 of the tube 104. In some embodiments, the light source 108 may include a high-brightness phosphor-based white LED and / or RGB LED. In some embodiments, two or more light sources 108 may be provided to simultaneously provide light 112 to the internal illuminator 100 by optical coupling. In some embodiments, a single light source 108 may be shared among two or more lighting components, for example, in free space or via a fiber splitter. In some embodiments, the light source 108 may include xenon, mercury vapor, halogen, and / or other light sources suitable for ophthalmic surgery. It should be noted that in some embodiments, the light source 108 may not be outside the handpiece 102. For example, in certain embodiments, the handpiece 102 may house the light source 108 within its housing or structure.

[0031] In some embodiments, the controller 114 may be configured to receive data / signals from the pressure sensor 120 via the electrical wiring cable 110b. These data / signals may correspond, for example, to readings of fluid pressure in the eye 130 (e.g., direct IOP measurements). The controller 114 is also configured to send output signals to other components coupled to the surgical console 140 (e.g., infusion and suction lines, valves, and pumps) to control and / or maintain a desired IOP in the eye 130 during surgery based on direct IOP measurements. The controller 114 is described in detail below with reference to Figure 7. It should be noted that in some embodiments, the controller 114 may not be located outside the handpiece 102. For example, in certain embodiments, the handpiece 102 may house the controller 114 within its housing or structure. In certain embodiments, the controller 114 or a separate power supply may be configured to power the pressure sensor 120 via the electrical wiring cable 110b.

[0032] According to embodiments of this disclosure, a pressure sensor 120 integrated into the distal end 145 of the tube 104 may be inserted into the eye 130 to provide direct IOP measurements of the eye 130, for example, during vitreoretinal and cataract surgery. Monitoring IOP within the eye 130 is important and necessary during ophthalmic surgery, such as vitreoretinal or cataract surgery. Lack of control over IOP can impair the effectiveness or ease of the procedure and, in some cases, can lead to tissue damage. For example, insufficient pressurization of the intraocular region can lead to collapse of the eyeball 130 with tissue damage. Conversely, excessive pressurization of the intraocular space can also lead to damage to fragile retina, optic nerve, or corneal tissue. Occasionally, and in some cases, it may be desirable to apply controlled high pressure for a short period of time, for example, to stop bleeding in the intraocular space.

[0033] Integrating a pressure sensor 120 positioned at the distal end 145 of tube 104 improves IOP control, thereby maintaining a stable state in the anterior or posterior chamber. The integration eliminates sensitivity to external factors during closed-loop control of IOP by direct measurement capability. Furthermore, integrating the pressure sensor 120 at the distal end 145 of tube 104 enables a faster response to undesirable pressure-related events occurring during surgery. For example, as the pressure sensor 120 provides a direct IOP measurement within the eye 130, in contrast to providing an upstream pressure estimate of the eye (e.g., in a surgical console), the internal illuminator 100 effectively eliminates inaccuracies and inefficiencies that would otherwise be introduced by the time delay between pressure-related events occurring within the eye 130 and the sensed upstream pressure changes, and / or any inaccuracies caused by fluid line resistance.

[0034] In vitreoretinal surgery and similar surgeries, internal illumination is used throughout the entire procedure, and the pressure sensor 120 is integrated into the distal end of the tube 104 of the internal illuminator 100. Therefore, according to embodiments of this application, the internal illuminator 100 provides the user with means for receiving direct IOP measurements of the eye 130 throughout the entire procedure. In addition, since the wire 110b for the pressure sensor 120 is arranged longitudinally together with the optical fiber 110a, the overall size of the internal illuminator 100 does not increase significantly even with the integration of the pressure sensor 120 into the internal illuminator. Thus, the internal illuminator 100 can maintain a relatively small incision in the eye 130 for insertion.

[0035] In addition, in cataract surgery and similar surgeries, the pressure sensor 120 that directly senses the IOP of the eye 130 eliminates the need to consider wound contraction characteristics and / or surgical instrument materials near the incision site when measuring pressure. Such wound contraction characteristics and instrument materials can significantly affect the pressure reading when the pressure is determined indirectly, leading to inaccurate assessment of IOP. For example, different materials for irrigation lines and / or suction lines of surgical instruments may have varying fluid resistances, thereby leading to different IOP readings.

[0036] Furthermore, unlike systems in which an operating injection or suction line is operably coupled to a pressure-sensing element, the internal illuminator 100 with an integrated pressure sensor 120 according to the embodiments of the present disclosure is not affected by inaccuracies in pressure readings caused by the proximity of the pressure-sensing element to an operating injection or suction line or by debris clogging the corresponding channel.

[0037] By directly monitoring IOP in real time, the user (e.g., a surgeon) and / or the surgical console can better control one or more pressure control tools and / or surgical tools (e.g., valves in one or more of the injection and / or suction lines) to maintain IOP within a predetermined range. For example, the surgeon and / or the surgical console can control IOP by adjusting the irrigation source pressure to a level appropriate for a combination of other settings (suction rate, vacuum limit, tip, sleeve, etc.) used in the ongoing procedure. The surgeon and / or the surgical console may evaluate and establish specific IOP levels based on the surgeon's experience with a particular instrument and / or stored values, procedures, programs, and applications, respectively.

[0038] According to certain embodiments of this disclosure, the pressure sensor 120 may take less than 3 milliseconds (msec) to detect a pressure change within the eye 130. Detecting the pressure change within or less of the first 3 msec (msec) enables the surgical console 140 to provide a fast response to compensate for the pressure change, thereby significantly reducing the risk of damage, and even rupture or collapse, to the eye 130. In some embodiments, algorithms used in prior predicate devices, including all of the various algorithms for Active Surge Mitigation and / or Active Sentry Systems developed by Alcon, Inc. (Fort Worth, Texas), may be readily applicable to pressure management (e.g., pressure compensation and control) by the systems and methods described herein.

[0039] Figure 2 shows a schematic cross-sectional side view of an exemplary internal illuminator 200 in which one or more miniature pressure sensors 220 are integrated at the distal end of the internal illuminator 200, according to some embodiments of the present disclosure. In some embodiments, the internal illuminator 200 may substantially correspond to the internal illuminator 100 of Figure 1. For example, the internal illuminator 200 may include a handpiece 202, a tube 204, a cable 210, and a pressure sensor 220, which may substantially correspond to the handpiece 102, tube 104, cable 110, and pressure sensor 120 of the internal illuminator 100 of Figure 1, respectively. Therefore, details of the handpiece 202, tube 204, cable 210, and pressure sensor 220 have been omitted for brevity.

[0040] As shown in Figure 2, one or more optical fibers 232 (large dashed lines) are arranged through the tube 204, handpiece 202, and cable 210 of the internal illuminator 200 to propagate illumination light, such as that generated by an illumination light source, to the distal end 245 of the tube 204 to which the optical fibers 232 terminate. As further shown, a pressure sensor 220 is positioned at the distal end 245 to facilitate direct measurement of IOP inside the patient's eye. Thus, in some embodiments, the pressure sensor 220 may be operably coupled to one or more wires 222 (small dashed lines) at the distal end 245 of the tube 204. Such wires 222 may extend through the tube 204, handpiece 202, and cable 210 together with the optical fibers 232 to facilitate operation of the miniature pressure sensor 220 and to be coupled to a controller, such as a controller integrated with a surgical console. As shown in Figure 2, an adapter 298, such as a plug, may be used to connect the cable 210 from the internal illuminator 200 to the surgical console.

[0041] The increase in diameter of the conduit 204 for housing the wire 222, the handpiece 202, and / or cable 210 may be minimal compared to conventional internal illuminators, since such components are already configured to integrate one or more optical fibers and / or wires to drive the probe function. In one particular example, in a handheld illuminating device (e.g., an internal illuminator), the increase in the total diameter of the cable for housing such wire 222 for the pressure sensor 220, optical fiber 232, and other wires of the internal illuminator 200 may be 0.5 millimeters (mm) or less. In some embodiments, the integration results in a substantially zero increase in diameter and minimizes additional electrical wiring.

[0042] Figures 3A, 3B, and 3C show various diagrams of an internal illuminator 300 in which one or more miniature pressure sensors 320 are integrated at its distal end, according to some embodiments of the present disclosure.

[0043] Figure 3A shows a side perspective view of an internal illuminator 300 according to some embodiments of the present disclosure. As shown in Figure 3A, the internal illuminator 300 includes a handpiece 302 and a shaft or tube 304. The handpiece 302 is coupled to the proximal end of the tube 304. In some embodiments, the handpiece 302 and tube 304 may substantially correspond to the handpiece 102 and tube 104 of Figure 1, respectively. In some embodiments, the handpiece 302 and tube 304 may be formed from one or more surgical-grade metal materials, such as stainless steel, titanium, nitinol, aluminum, or platinum.

[0044] In the illustrated example, the internal illuminator 300 includes a bundle 324 extending through the internal illuminator 300. The bundle 324 includes one or more optical fibers 332 and wires (e.g., wire 322 as shown in Figure 3B) for a pressure sensor 320 arranged longitudinally (e.g., in the z direction) within the handpiece 302 and the tube 304.

[0045] The optical fiber 332 is configured to receive light 312 from one or more light sources (e.g., light source 108 in Figure 1) and to propagate the received light 312 to the distal end 345 of the tube 304, where the light 312 is emitted. Each of the optical fibers 332 may or may not include cladding. In some embodiments, one or more of the optical fibers 332 are sapphire fibers or other light-transmitting materials. In some embodiments, one or more of the optical fibers 332 may have a uniform material composition along the length of the optical fiber 332. In other embodiments, one or more of the optical fibers 332 may have a first region having a first material composition and a second region having a second material composition, the first and second material compositions being different from each other in one or more embodiments. In some embodiments, one or more of the optical fibers 332 may be single-core fibers. In other embodiments, one or more of the optical fibers 332 may be multi-core fibers.

[0046] In some embodiments, the light source may generate unpolarized light 312, which is received by the internal illuminator 300 and propagated through its optical fiber 332. In such embodiments, the optical fiber 332 can polarize and maintain the polarization of the received light 312 as it propagates the light 312 to the distal end 345 of the tube 304 from which the light 312 is emitted.

[0047] In some embodiments, a light source may provide polarization 312, which is received and propagated by an optical fiber 332 in an internal illuminator 300. In such embodiments, the optical fiber 332 can maintain and / or change the polarization of the received light 312. In certain examples, the optical fiber 332 can receive linearly polarized light 312 from a light source. In certain examples, the optical fiber 332 may be configured to circularly or elliptically polarize the received light 312 and maintain the circular polarization of the light 312 as it propagates through the internal illuminator 300. Alternatively, the optical fiber 332 may be configured to maintain the linear polarization of the light 312 received from the light source as it propagates through the internal illuminator 300 to the distal end 345 of the tube 304 from which the light 312 is emitted.

[0048] In some embodiments, the diameter of each optical fiber 332 may be about 0.1 mm to about 1.0 mm, for example about 0.2 mm to about 0.8 mm, for example about 0.3 mm to about 0.7 mm, for example about 0.4 mm to about 0.6 mm, for example about 0.5 mm, but other suitable dimensions are also possible. In the illustrated example, the internal illuminator 300 includes three optical fibers 332, but the internal illuminator 300 may include any suitable number (two or fewer or four or more) optical fibers 332 to provide, for example, desired illumination characteristics.

[0049] In some embodiments, the pressure sensor 320 is located at the distal end 345 of the pipe 304 and connected to a wire 322 positioned longitudinally (e.g., in the z-direction) along the optical fiber 332 in the bundle 324. In some embodiments, the pressure sensor 320 may substantially correspond to the pressure sensor 120 in Figure 1.

[0050] Figure 3B is a detailed partial side perspective view of the distal end portion 344 of the tube 304 shown in Figure 3A. Note that the distal end portion 344 of the tube 304 may also be the distal end portion of the internal illuminator 300, and the distal end portion 345 of the tube 304 may also be the distal end portion of the internal illuminator 300. As shown in Figure 3B, the bundle 324 includes an optical fiber 332 and an electric wire 322 for the pressure sensor 320.

[0051] As shown in Figure 3B, the lens (or window) 360 is positioned in an opening 352 within the distal end 345 of the tube 304. Each optical fiber 332 terminates at or substantially near the boundary 346 between the bundle 324 and the lens 360. The boundary 346 and / or lens 360 may be configured to facilitate the propagation of a desired illumination pattern from the optical fiber 332 toward a target site, for example, a target site within the patient's eye. In some embodiments, a pressure sensor 320 extends beyond the boundary 346 through the opening 352 to sense IOPs related to the intraocular space of the eye.

[0052] In some embodiments, the distal end 348 of the bundle 324 may contact the proximal end face 354 of the lens 360 under positive pressure at the boundary 346. In other embodiments, one or more light-transmitting elements or materials may be located at the boundary 346 between the distal end 348 and the lens 360. In some implementations, the lens 360 may be a GRIN (grain-indexed) lens, a spherical lens, or an aspherical lens. In yet another implementation, the lens 360 may be a group of lenses formed from an optically transparent material.

[0053] The lens 360 may include one or more lenses formed from glass or ceramic that is visibly transparent. For example, the materials used to form one or more lenses of the lens 360 may include fused silica, borosilicate, or sapphire. In some implementations, the lens 360 may include a single-element cylindrical GRIN rod lens, which is capable of receiving one or more illumination beams 312 from the optical fiber 332 and relaying the received illumination beams 312 toward the distal end 345 of the tube 304. In some cases, the distal end 345 of the tube 304 may also correspond to the distal end of the lens 360. In other examples, a protective window may be placed between the distal end of the lens 360 and the distal end 345 of the tube 304. In yet another implementation, the window may extend beyond the distal end 345 of the tube 304.

[0054] As described above with reference to Figure 3A, the pressure sensor 320 is located at the distal end 345 of the tube 304. More specifically, in the example of Figure 3B, the pressure sensor 320 is located through the distal end face 356 of the lens 360, thus exposing the pressure sensor 320 to the external environment (e.g., outside the internal illuminator 300). Thus, in Figure 3B, the wire 322 extends through the lens 360 beyond the distal end 348 and boundary 346 to connect with the pressure sensor 320. In such an example, the wire 322 and the pressure sensor 320 may be located through one or more feature portions formed in the lens 360, such as the opening 326, which will be described below with reference to Figure 3C. By exposing the pressure sensor 320 to the external environment, the pressure sensor 320 can come into contact with the substance (e.g., fluid) inside the patient's eye to perform direct IOP measurements during ophthalmic surgical procedures. In certain cases, the pressure sensor 320 may interface with the intraocular space, such as intraocular material, to directly sense IOPs related to the intraocular space within the eye (e.g., by direct or in direct contact).

[0055] Figure 3C shows a cross-sectional front view of the distal end 345 of the tube 304 of the internal illuminator 300 shown in Figure 3B. As shown, each pressure sensor 320 is positioned (e.g., embedded) within an opening 326 of the lens 360 and exposed to the distal end face 356 of the lens 360. The opening 326 may extend across the entire thickness of the lens 360 (e.g., in the z direction) to facilitate external exposure of the pressure sensors 320. In such embodiments, a wire 322 may extend through the opening 326 of the lens 360 to connect to the pressure sensors 320. Thus, unlike the optical fiber 332, the pressure sensors 320 are not covered or shielded by the lens 360 and are configured to be in direct contact with the intraocular fluid to provide direct IOP measurements.

[0056] In some embodiments, the pressure sensor 320 is not located within or through the lens 360, and the lens 360 covers only a portion of the bundle 324 having the optical fiber 332. In such embodiments, the pressure sensor 320 may be located in the space between the lens 360 and the tube 304. In such embodiments, the pressure sensor 320 is exposed at the distal end 345 of the tube 304, and the wire 322 extends beyond the boundary 346 into the space between the lens 360 and the tube 304 to connect with the pressure sensor 320. In such embodiments, a filler material such as adhesive may be used to fill the space between the lens 360 and the tube 304 and to hold the pressure sensor 320 and the wire 322 in place.

[0057] As further shown in Figure 3C, the optical fiber 332 is housed in an optional sleeve 334. In some embodiments, the sleeve 334 may include a filling material to fill the space not occupied by the optical fiber 332. In some embodiments, the pressure sensor 320 and the wire 322 are housed in a second optional sleeve 336 located around or adjacent to the sleeve 334. In some embodiments, the sleeve 336 may also include a filling material to fill the space not occupied by the pressure sensor 320 and the wire 322. In some embodiments, the optical fiber 332 and the pressure sensor 320 may be housed together with the wire 322 in a single sleeve, which may include a filling material to fill the space not occupied by the optical fiber 332, the pressure sensor 320, and the wire 322. In some embodiments, the optical fiber 332 and / or the pressure sensor 320 are coupled to the side wall of the tube 304 or are freely housed in the tube 404 without a sleeve.

[0058] While three optical fibers 332 are shown in the illustrated examples in Figures 3B and 3C, the scope of this disclosure is not limited in this way. Rather, in other implementations, the internal illuminator 300 may include fewer optical fibers 332, while other implementations may include four or more optical fibers 332. In some implementations, the internal illuminator 300 may include two, four, or more optical fibers 332, and in some examples, the optical fibers 332 may form a 2x2 array.

[0059] Furthermore, while three pressure sensors 320 are shown in the examples in Figures 3B and 3C, the scope of this disclosure is not limited in this way. Rather, in other implementations, the internal illuminator 300 may include fewer pressure sensors 320, while other implementations may include four or more pressure sensors 320. In some implementations, the internal illuminator 300 may include one, two, four, or more pressure sensors 320 to provide, for example, direct IOP measurements.

[0060] In certain embodiments, the diameter of tube 304 may be about 1.5 mm or less, for example, about 0.8 mm or less, but other suitable dimensions are also possible. In certain embodiments, the diameter of tube 304 may be about 0.5 mm or less. Generally, tube 304 can be sized to easily pass through a corresponding entry cannula, such as a trocar cannula, and enter the intraocular space of the patient's eye. In certain embodiments, the diameter of tube 304 corresponds to gauge sizes such as about 21-Ga (gauge), 22-Ga, 23-Ga, 24-Ga, 25-Ga, 26-Ga, 27-Ga, 28-Ga, 29-Ga, and 30-Ga. In certain embodiments, the diameter of each miniature pressure sensor 320 may be about 0.25 to 1.55 mm, but other suitable dimensions are also possible.

[0061] Therefore, the surgeon and / or surgical console is provided with means for directly measuring IOP inside the eye, and as a result, necessary adjustments can be made (for example, in response to rapid changes in IOP during surgery) to more efficiently and safely control and / or maintain the IOP of the eye.

[0062] Figures 4A, 4B, and 4C show various diagrams of an internal illuminator 400 with a miniature pressure sensor 420 integrated at its distal end, according to several embodiments of the present disclosure.

[0063] Referring to Figure 4, a side perspective view of an internal illuminator 400 according to several embodiments of the present disclosure is shown. As shown, the internal illuminator 400 includes a handpiece 402 and a shaft or tube 404. The handpiece 402 is coupled to the proximal end of the tube 404. In some embodiments, the handpiece 402 and tube 404 may substantially correspond to the handpiece 102 and tube 104 of Figure 1, respectively. In some embodiments, the handpiece 402 and tube 404 may be formed from one or more surgical-grade metal materials, such as stainless steel, titanium, nitinol, aluminum, or platinum.

[0064] Like other internal illuminators described herein, the internal illuminator 400 includes a bundle 424 extending through the internal illuminator 400. The bundle 424 includes one or more optical fibers 432 and wires 422 (as shown in Figure 4B) for the pressure sensor 420, arranged longitudinally (e.g., in the z direction) within the handpiece 402 and the tube 404.

[0065] The optical fiber 432 is configured to receive light 412 from one or more light sources (e.g., light source 108 in Figure 1), propagate the received light 412 to the distal end 445 of the tube 404, where the light 412 is emitted. In some embodiments, the optical fiber 432 may substantially correspond to the optical fiber 332 in Figures 3A-3C, and these details have been omitted for brevity. In the illustrated example, the internal illuminator 400 includes three optical fibers 432, but the internal illuminator 400 may include any appropriate number (two or fewer or four or more) of optical fibers 432 to provide the desired illumination, for example.

[0066] In the example shown in Figure 4A, the pressure sensor 420 is positioned at an opening 426 on the side wall of the pipe 404 near the distal end 445 of the pipe 404 and connected to a wire 422 positioned longitudinally (e.g., in the z-direction) along the optical fiber 432 in the bundle 424. In some embodiments, the pressure sensor 420 may substantially correspond to the pressure sensor 120 in Figure 1.

[0067] Figure 4B is a detailed partial side perspective view of the distal end portion 444 of the tube 404 shown in Figure 4A. Note that the distal end portion 444 of the tube 404 may also be the distal end portion of the internal illuminator 400, and the distal end portion 445 of the tube 404 may also be the distal end portion of the internal illuminator 400. As shown in Figure 4B, the bundle 424 includes optical fibers 432 and wires 422 for the miniature pressure sensor 420.

[0068] As shown in Figure 4B, the lens (or window) 460 is positioned in an opening 452 within the distal end 445 of the tube 404. Each optical fiber 432 terminates at or substantially near the boundary 446 between the bundle 424 and the lens 460. The boundary 446 and / or the lens 460 may be configured to facilitate the propagation of a desired illumination pattern from the optical fibers 432 to a target site, for example, a target site in the patient's eye.

[0069] In some embodiments, the distal end 448 of the bundle 424 may be in positive pressure contact with the proximal end face 454 of the lens 460 at the boundary 446. In other configurations, one or more light-transmitting elements or materials may be located at the boundary 446 between the distal end face 448 and the lens 460. The lens 460 may substantially correspond to the lens 360 in Figures 3A-3C, the details of which have been omitted for brevity.

[0070] Figure 4C shows a cross-sectional view of the tube 404 of the internal illuminator 400 along the line 4C-4C as shown in Figure 4B. As shown in Figure 4C, the bundle 424 includes optical fibers 432 arranged in an optional sleeve 434. In some embodiments, the sleeve 434 may include a filling material to fill the space not occupied by the optical fibers 432. In some embodiments, the optical fibers 432 are coupled to the side wall of the tube 404 or are freely arranged within the tube 404 without a sleeve.

[0071] In some embodiments, the optical fiber 432 may substantially correspond to the optical fiber 332 in Figures 3B and 3C. Details of the optical fiber 432 are omitted for brevity. Although three optical fibers 432 are shown in the illustrated examples, the scope of this disclosure is not so limited. Rather, in other implementations, the internal illuminator 400 may include fewer optical fibers 432, while other implementations may include four or more optical fibers 432. In some implementations, the internal illuminator 400 may include two, four, or more optical fibers 432, and in some examples, the optical fibers 432 may form a 2×2 array.

[0072] As shown in Figure 4C, the pressure sensor 420 is located in an opening (or window) 426 on the side wall of the tube 404 near the distal end 445. The opening 426 may extend through the entire thickness of the side wall of the tube 404 to facilitate external exposure of the pressure sensor 420, thereby allowing direct contact with intraocular material (e.g., fluid) during ophthalmic procedures for direct IOP measurements. In certain examples, the pressure sensor 420 may interface with (e.g., directly or in direct contact with) the intraocular space, e.g., intraocular material, to directly sense IOP related to the intraocular space within the eye. A wire 422 is coupled to the pressure sensor 420 within the tube 404. In some embodiments, the wire 422 may extend through at least a portion of the sleeve 434 and be arranged longitudinally (e.g., in the z-direction) together with the optical fiber 432. In some embodiments, as shown in Figure 4C, the wire 422 may extend through the tube 404 outside the sleeve 434. In such embodiments, the electric wire 422 may extend through a second sleeve within the pipe 404 and / or be adhered to the side wall of the pipe 404.

[0073] Although Figures 4B and 4C show a single pressure sensor 420, the scope of this disclosure is not limited in this way. Rather, in other embodiments, the internal illuminator 400 may include two or more pressure sensors 420. In some implementations, the internal illuminator 400 may include one, two, four, or more pressure sensors 420. In embodiments where multiple pressure sensors 420 are used, each pressure sensor 420 may be located in a separate opening (window) on the side wall of the pipe 404.

[0074] In certain embodiments, the diameter of tube 404 may be about 1.5 mm or less, for example, about 0.8 mm or less, but other suitable dimensions are also possible. In certain embodiments, the diameter of tube 404 may be about 0.5 mm or less. Generally, tube 404 can be sized to easily pass through a corresponding entry cannula, such as a trocar cannula, and enter the intraocular space of the patient's eye. In certain embodiments, the diameter of tube 404 corresponds to gauge sizes such as about 21-Ga, 22-Ga, 23-Ga, 24-Ga, 25-Ga, 26-Ga, 27-Ga, 28-Ga, 29-Ga, and 30-Ga. In certain embodiments, the diameter of each pressure sensor 420 may be about 0.25 to 1.55 mm, but other suitable dimensions are also possible.

[0075] Therefore, the surgeon and / or surgical console is provided with means for directly measuring IOP inside the eye, and as a result, necessary adjustments can be made (for example, in response to rapid changes in IOP during surgery) to more efficiently and safely control and / or maintain the IOP of the eye.

[0076] As described above with reference to internal illuminators, the pressure-sensing features presented herein are not limited to such devices. For example, the pressure-sensing features presented herein may be integrated with other ophthalmic surgical instruments and / or devices inserted into the eye to provide substantially the same advantages as conventional systems. Such ophthalmic surgical instruments and / or devices may include probes and other tools for performing procedures related to vitrectomy, corneal reconstruction, trabeculectomy, goniotomy, cataract surgery, etc. Accordingly, Figure 5 demonstrates a surgical instrument 500 in which one or more pressure sensors 520 are integrated at the distal end, according to several embodiments of this application.

[0077] As shown in Figure 5, the pressure sensor 520 may be integrated into the distal end portion 545 of the surgical instrument 500. The pressure sensor 520 may be coupled to a power supply and / or controller 560 (e.g., a power supply and / or controller integrated into a surgical console) by one or more wires 522 extending through an internal chamber 523 of the surgical instrument 500. In some embodiments, the pressure sensor 520 may be coupled to external wires of the surgical instrument 500. In some embodiments, the pressure sensor 520 may be wirelessly powered by a battery pack which may be integrated on the surgical instrument 500 (e.g., at the rear end). In some embodiments, the pressure sensor 520 may transmit and / or receive data / signals via a wireless transceiver.

[0078] In some embodiments, the surgical instrument 500 is configured to perform surgical functions. For example, the surgical instrument 500 may include tools for manipulating ocular tissue during ophthalmic surgical procedures. Examples of tools for manipulating ocular tissue include, but are not limited to, forceps, spatulas, hooks, Sinski hooks, and compression devices. In certain embodiments, the surgical instrument 500 may include tools for cutting ocular tissue during ophthalmic surgical procedures. Examples of tools for cutting ocular tissue include, but are not limited to, scissors, side port blades, side port knives, and knives for microincision coaxial surgery (MICS). In certain embodiments, the surgical instrument 500 may include probes for performing certain types of ophthalmic surgery, such as cutting probes, vitrectomy probes, phacoemulsification probes, laser probes, ablation probes, vacuum probes, and flushing probes. In certain embodiments, the surgical instrument 500 may include visualization devices such as endoscopic visualization probes. In certain embodiments, the surgical instrument 500 may include entry cannulas such as trocar cannulas. In certain embodiments, the surgical instrument 500 includes an injection cannula. Further ophthalmic devices and / or combinations thereof are possible.

[0079] While the distal end of the surgical instrument 500 is inserted into the eye during surgery and performing its surgical function, the pressure sensor 520 may interface with (e.g., directly or in direct contact with) the intraocular space, such as intraocular material, to directly sense the IOP associated with the intraocular space of the eye. Thus, the surgeon and / or surgical console are provided with means for directly measuring IOP inside the eye, and as a result, necessary adjustments can be made (e.g., in response to rapid changes in IOP during surgery) to more efficiently and safely control and / or maintain the IOP of the eye.

[0080] Figure 6A shows the distal end portion 645A of a surgical instrument 600 according to some embodiments of the present disclosure. In some embodiments, the surgical instrument 600 may substantially correspond to the surgical instrument 500 of Figure 5. In some embodiments, the distal end portion 645A may correspond to the distal end portion 545 of Figure 5. As shown in Figure 6A, the pressure sensor 620A is integrated into the distal tip of the surgical instrument and coupled to a wire 622A embedded in the internal chamber 623A of the surgical instrument.

[0081] Figure 6B shows the distal end portion 645B of a surgical instrument 601 according to some embodiments of the present disclosure. In some embodiments, the surgical instrument 601 may substantially correspond to the surgical instrument 500 of Figure 5. In some embodiments, the distal end portion 645B may correspond to the distal end portion 545 of Figure 5. As shown in Figure 6B, the pressure sensor 620B is integrated into an opening on the side wall of the surgical instrument and coupled to a wire 622B embedded in the internal chamber 623B of the surgical instrument.

[0082] Figure 7 shows a schematic diagram of a surgical console 740 according to embodiments disclosed herein. In some embodiments, the surgical console 740 may substantially correspond to the surgical console 140 of Figure 1.

[0083] As shown in Figure 7, the surgical console 740 includes, but is not limited to, a control module 762, a user interface 764, interconnects 766, and at least one I / O device interface 768 that allows various I / O (input / output) devices (e.g., keyboard, display, mouse device, pen input, etc.) to be connected to the surgical console 740. The surgical console 740 may also include an illumination source 708 (e.g., a continuous illumination source and / or a strobe illumination source) coupled by cable 710a to an optical fiber 732 of an internal illuminator (e.g., internal illuminator 100 in Figure 1). In some embodiments, the surgical console 740 may be operably coupled to an illumination source (e.g., a continuous illumination source and / or a strobe illumination source) outside the surgical console 740. The surgical console 740 may further include one or more pressure management tools 786 for managing the IOP of the eye, for example, by exhausting and / or controlling the rate of injection and / or suction. In some embodiments, the pressure management tool 786 includes, for example, a pump, vacuum, and / or other device for controlling injection and / or suction via a probe that can be inserted into the patient's eye. In some embodiments, the surgical console 740 may include a display within the user interface 764 to display information to the user, including surgical procedure parameters and device settings (the display may incorporate a touchscreen for receiving user input).

[0084] The control module 762 includes a processor 714 (e.g., a controller), memory 770, and storage 772. The processor 714 (e.g., a control circuit) is configured to retrieve and execute programming instructions stored in memory 770. Similarly, the processor 714 may retrieve and store application data residing in memory 770. The interconnect 766 transmits programming instructions and application data between the processor 714, I / O device interface 768, user interface 764, memory 770, storage 772, illumination source 708, pressure management tool 786, etc. The processor 714 may include a single CPU (central processing unit), multiple CPUs, a single CPU with multiple processing cores, etc. Memory 770 may be random access memory, and storage 772 may be a disk drive. Furthermore, memory 770 and / or storage 772 may be any type of readily available memory, such as random access memory (RAM), read-only memory (ROM), floppy disks, hard disks, solid-state memory, flash memory, magnetic memory, or any other form of local or remote digital storage. In certain embodiments, memory 770 and / or storage 772 may include instructions, which, when executed by processor 714, cause pressure management tool 786 to manage the patient's eye IOP (e.g., adjust, control, increase, decrease, etc.) based on direct IOP measurements. For example, memory 770 may include pressure management module 784, which may include computer-executable instructions, which, when executed by processor 714, cause processor 714 to control pressure management tool 786 to manage the patient's eye IOP based on IOP measurements reflected in signals received from one or more pressure sensors 720.

[0085] In particular, the processor 714 can receive signals from one or more pressure sensors 720 through electrical wiring 710b. These signals correspond, for example, to readings of intraocular fluid pressure (e.g., IOP). The processor 714 is also configured to transmit output signals to the pressure management tool 786 via interconnect 766. For example, these output signals enable the processor 714 to control the operation of the pressure management tool 786 (e.g., exhaust valves, output valves, injection and suction valves and pumps, vacuum sources, etc.) based on signals from one or more pressure sensors 720 in order to maintain or control the intraocular pressure of the eye.

[0086] In the embodiment shown in Figure 7, the processor 714 may include an integrated circuit capable of performing logical functions. Thus, the processor 714 is in the form of a standard integrated circuit package with power pins, input pins, and output pins. In various embodiments, the processor 714 may control one or more valve or pump controllers, or other target device controllers. In such cases, the processor 714 may perform specific control functions targeted at a particular device, such as one or more valves, infusion pumps, and / or suction pumps. In other embodiments, the processor 714 is a microprocessor. In such cases, the processor 714 is programmable to function to control valves and infusion and / or suction pumps, as well as other components coupled to a surgical console. In other cases, the processor 714 is not a programmable microprocessor, but rather a dedicated controller configured to control different valves and pumps performing different functions.

[0087] The surgical console 740 may be configured to drive one or more surgical instruments 790, which may include various probe types of ophthalmic probes, including internal illuminators, laser probes (e.g., picosecond infrared laser probes, femtosecond laser probes), vitrectomy probes, phacoemulsification probes, flap cutters, and other ophthalmic surgical tools. During operation, the surgical console 740 may function to assist the surgeon in performing various ophthalmic surgical procedures such as vitrectomy, phacoemulsification, cataract surgery, LASIK, and similar procedures. In some embodiments, the surgical instruments 790 may also include one or more valves as well as infusion pumps and lines.

[0088] In embodiments in which the surgical instrument 790 includes a vitrectomy device, the surgical console 740 may include one or more modules or components that power the vitrectomy device for the purpose of breaking (e.g., cutting) the vitreous humor. For example, in certain embodiments, the surgical console 740 may include a pneumatic module that uses a compressed gas such as nitrogen to power the vitrectomy device. In certain other embodiments, the surgical console 740 may include a laser light source for generating laser light used by the vitrectomy device to break the vitreous humor (see, for example, U.S. Patent Application Publication No. 2019 / 0201238).

[0089] In some embodiments, the surgical tool 790 may include an ultrasonic phacoemulsification probe. For example, the surgical instrument 790 may include an ultrasonic phacoemulsification probe capable of emulsifying or destroying the lens during cataract surgery. As another example, the surgical instrument 790 may be configured to emit laser light for lens emulsification. In embodiments in which the surgical instrument 790 is an ultrasonic phacoemulsification probe, the surgical console 740 includes one or more modules or components that power the ultrasonic phacoemulsification probe to emulsify the lens during cataract surgery. In some embodiments, the surgical instrument 790 may include a picosecond infrared laser (pIRL).

[0090] In some embodiments, the surgical instrument 790 may be configured to emit laser light, such as femtosecond laser light, used for incising and / or cutting flaps during ophthalmic surgery. A suitable exemplary femtosecond laser is the WaveLight® S200 laser, available from Alcon, Inc. (Fort Worth, Texas). In some embodiments, the surgical instrument 790 may be a laser, for example, an excimer laser for optical corneal refractive surgery and / or LASIK procedures (e.g., laser ablation of the cornea). A suitable exemplary excimer laser is the WaveLight® EX500 laser, available from Alcon, Inc. (Fort Worth, Texas).

[0091] In some embodiments, the surgical instrument 790 may include an internal illuminator. In such embodiments, the optical fiber 732 is positioned through the internal illuminator to be introduced into the patient's eye and can propagate light from the illumination source 708 to it.

[0092] In some embodiments, one or more of the pressure sensors 720 may be integrated into at least one distal portion of a surgical instrument 790. This facilitates positioning the pressure sensor 720 within the eye to directly sense IOPs related to the intraocular space of the eye. In some embodiments, one or more pressure sensors 720 may interface (e.g., directly or in direct contact) with the intraocular space, such as material within the intraocular space, through an opening in the distal portion of at least one surgical instrument 790.

[0093] The surgical instrument 790 may be operably coupled to the surgical console 740 via one or more ports of the surgical console 740. It should be noted that the surgical instrument 790 may also be operably coupled to the surgical console 740 via several different tubes or cables configured to interface with ports of the surgical console 740. For example, such tubes or cables may include pneumatic lines, fiber optic cables, ultrasonic power lines for powering the surgical instrument 790 for cutting purposes, and suction or vacuum lines for transporting aspirated material back to the surgical console 740.

[0094] The above description is provided so that those skilled in the art may implement the various embodiments described herein. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments. Accordingly, the claims are not intended to be limited to the embodiments shown herein, and the entire scope consistent with the language of the claims should be recognized. Those skilled in the art will understand that the surgical instruments shown herein (e.g., internal illuminators and auxiliary surgical instruments) may include more components than those shown in the simplified diagrams herein. The surgical instruments described herein include only components useful for illustrating some notable features of the implementations within the claims.

Claims

1. It is an internal light fixture, Handpiece and A probe coupled to the distal end of the handpiece, the probe including an optical fiber and a pressure sensor, The pressure sensor is positioned near the distal end of the probe. The pressure sensor is configured to be inserted into the intraocular space of the eye. The pressure sensor is configured to directly sense intraocular pressure (IOP) related to the intraocular space of the eye, and includes the probe, Includes internal lighting fixtures.

2. The internal illuminator according to claim 1, wherein the pressure sensor includes at least one of a micro-electromechanical system (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gauge pressure sensor, and a capacitive pressure sensor.

3. The distal end of the probe includes an opening configured to allow light from the distal end of the optical fiber to propagate, The internal illuminator according to claim 1, wherein the pressure sensor is configured to sense the IOP through the opening.

4. The distal end of the probe includes a first opening configured to allow light from the distal end of the optical fiber to propagate. The internal illuminator according to claim 1, wherein the distal end of the probe includes a second opening configured for the pressure sensor to sense the IOP.

5. The internal illuminator according to claim 4, wherein the second opening is located in the side wall of the probe adjacent to the distal end.

6. The internal illuminator according to claim 1, wherein the pressure sensor is coupled to one or more wires extending substantially along the longitudinal direction of the optical fiber in the probe.

7. The internal illuminator according to claim 1, which is coupled to a light source configured to transmit light through the optical fiber.

8. The internal illuminator according to claim 1, which is coupled to a surgical console that supplies power to the pressure sensor.

9. An instrument used in ophthalmic surgery, A pressure sensor positioned near the distal end of the aforementioned device, It is inserted into the intraocular space of the eye, Directly senses intraocular pressure (IOP) related to the intraocular space of the eye. A pressure sensor, configured in such a way, Apparatus, including.

10. The apparatus according to claim 9, further comprising a power supply coupled to the apparatus for supplying power to the pressure sensor.

11. The apparatus according to claim 9, wherein the pressure sensor includes at least one of a micro-electromechanical system (MEMS) pressure sensor, a piezoelectric pressure sensor, a potentiometric pressure sensor, an inductive pressure sensor, a strain gauge pressure sensor, and a capacitive pressure sensor.

12. The apparatus according to claim 9, wherein the pressure sensor is located at the tip or side wall of the distal end of the apparatus.

13. The apparatus according to claim 9, comprising at least one of forceps, a spatula, a hook, or a compression device.

14. The apparatus according to claim 9, comprising at least one of scissors or a knife.

15. The apparatus according to claim 9, comprising at least one of a vitrectomy probe, an ultrasonic phacoemulsification probe, a laser probe, a vacuum probe, an endoscopic visualization probe, or an internal illuminator.

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