Tapered optical fibers for surgical instruments

Abstract

Embodiments disclosed herein relate to devices and systems for use in ophthalmic procedures. In some embodiments, handpiece devices are provided for use in conjunction with surgical systems. The handpiece device comprises a housing, a cable assembly, and a tapered optical fiber. The cable assembly is positioned through the distal end of the housing and is optically coupled to the tapered optical fiber. The tapered optical fiber has a diameter that decreases between its proximal and distal ends. In some embodiments, the tapered optical fiber includes a single-crystal fiber. In further embodiments, the tapered optical fiber includes a tapered sapphire core fiber.

Description

Technical Field

[0001] Cross-Reference to Related Applications This application claims the benefit of priority of U.S. Provisional Patent Application No. 63 / 581,700, filed on September 11, 2023, the entire content of which is incorporated herein by reference.

Background Art

[0002] In various ophthalmic procedures, laser light is used to perform surgery and / or treat the anatomy of a patient. For example, in laser phacoemulsification for emulsifying and resecting the lens of the eye for the purpose of cataract removal, a probe of a microsurgical instrument projects a beam of laser light. In a vitrectomy procedure, a surgeon inserts a microsurgical instrument such as a vitrectomy probe through one or more incisions created in the eye to cut and remove the vitreous from the inside. Microsurgical instruments utilized for such procedures may use laser light transmitted from a laser system through one or more optical fibers terminating distally within the probe to perform one or more functions of the procedure. In some cases, such as in the case of a vitrectomy procedure, the vitrectomy probe cuts the vitreous with laser light delivered from a laser system, and then aspirates and removes the cut biological material.

Summary of Invention

Means for Solving the Problems

[0003] This disclosure relates in general to optical fibers, and more particularly to components for energy delivery in surgical laser systems. In some embodiments, a handpiece device is provided for use in ophthalmic surgical procedures. The handpiece device comprises a housing and a cable assembly disposed within the housing, the cable assembly extending from a supply port at the proximal end of the housing. The cable assembly comprises an optical fiber disposed within the housing and optically connected to a tapered optical fiber having a diameter that decreases between the proximal and distal ends of the tapered optical fiber. The proximal end of the tapered optical fiber is optically coupled to the distal end of the optical fiber in the cable assembly.

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

[0005] In another embodiment, a surgical system is provided. The surgical system comprises a surgical console having a laser system and a handpiece device connected to the laser system. The handpiece device comprises a housing and a cable assembly disposed within the housing and extending from a supply port at the proximal end of the housing, wherein the cable assembly comprises an optical fiber having a proximal end and a distal end. The handpiece device also comprises a tapered optical fiber disposed within the housing and having a diameter that decreases between the proximal end and the distal end of the tapered optical fiber, the proximal end of the optical fiber being optically coupled to the laser system and the distal end of the optical fiber being optically coupled to the proximal end of the tapered optical fiber.

[0006] To allow for a more detailed understanding of the above-mentioned features of this disclosure, a more specific description of this disclosure, which has been briefly summarized above, can be obtained by referring to embodiments, some of which are shown in the accompanying drawings. However, it should be noted that the accompanying drawings show only exemplary embodiments and are therefore not intended to limit the scope of the invention, as other equally effective embodiments are also possible. [Brief explanation of the drawing]

[0007] [Figure 1A] Figure 1A shows a side view of an exemplary surgical system for use during ophthalmic surgical procedures according to a particular embodiment of the present disclosure. [Figure 1B] Figure 1B shows a perspective view of an exemplary handpiece device that may be implemented in the surgical system of Figure 1A according to a particular embodiment of the present disclosure. [Figure 1C] Figure 1C shows a longitudinal section view of an exemplary handpiece device that may be implemented in the surgical system of Figure 1A according to a particular embodiment of the present disclosure. [Figure 2A] Figure 2A shows a plan view of the distal end of the handpiece device shown in Figures 1B and 1C, according to a particular embodiment of the present disclosure. [Figure 2B-2D]Figures 2B to 2D show longitudinal cross-sectional views of the distal end of the handpiece device shown in Figures 1B and 1C, according to a particular embodiment of the present disclosure. [Figure 3] Figure 3 shows a longitudinal schematic view of an exemplary cable assembly that may be implemented in the surgical system of Figure 1A according to a particular embodiment of the present disclosure. [Figure 4] Figure 4 shows a longitudinal schematic view of another exemplary cable assembly that may be implemented in the surgical system of Figure 1A according to a particular embodiment of the present disclosure. [Modes for carrying out the invention]

[0008] For ease of understanding, the same reference numerals are used to indicate identical elements common to the drawings whenever possible. It is assumed that elements and features of one embodiment can be usefully incorporated into other embodiments without further detail.

[0009] In the following description, details are given as examples to facilitate understanding of the subject matter disclosed. However, it should be apparent to those skilled in the art that the disclosed implementations are illustrative and do not encompass all possible implementations. Therefore, it should be understood that references to the examples described are not intended to limit the scope of this disclosure. Any modifications and further alterations to the devices, apparatus, and methods described, as well as any further applications of the principles of this disclosure, are readily conceivable to those skilled in the art in which this disclosure relates. In particular, features, components, and / or steps described in relation to one implementation may be readily conceived in combination with features, components, and / or steps described in relation to other implementations of this disclosure.

[0010] Where used herein, the distal end, distal segment, or distal portion of a component refers to the end, segment, or portion closer to the patient's body during use of that component. Conversely, the proximal end, proximal segment, or proximal portion of a component refers to the end, segment, or portion further away from the patient's body, for example, closer to the surgical console.

[0011] Where used herein, the term “approximately” may refer to a variation of + / - 10% from the specified value. It should be understood that such variation may be included in any value provided herein.

[0012] Embodiments disclosed herein generally relate to optical fibers for use in surgical systems, and more specifically to tapered optical fibers for use in surgical laser systems and connected microsurgical instruments. The methods, systems, and apparatus described herein may be used in combination with any suitable surgical instruments for ophthalmic procedures that have a light-emitting function (e.g., laser light, illumination light, etc.), such as those described below.

[0013] In surgical systems where laser light is used in ophthalmic surgery, such systems typically rely on the delivery of laser energy from a laser source to the patient via one or more optical cable assemblies. In such surgical systems, the optical cable assembly may comprise one or more optical fibers extending between the laser source and the microsurgical instrument. During use, the laser light delivered by one or more optical fibers can be projected from the probe of the microsurgical instrument for the surgical procedure. Various properties of one or more optical fibers can affect the delivery of the laser light and the implementation of such optical fibers in the microsurgical instrument. For example, both the diameter and material of one or more optical fibers can affect the efficiency of the optical fibers in laser light transmission, as well as the flexibility and durability of the corresponding optical cable assembly.

[0014] Microsurgical instruments typically used during such surgical procedures also provide suction through the probe during the procedure. Therefore, the diameter of the optical fiber can affect the implementation of optical fiber and / or optical cable assemblies with microsurgical instruments, including the length of the optical fiber through the instrument's probe and the maintenance of adequate space within the probe for suction. However, as surgical instruments with smaller gauge probes are increasingly implemented for ophthalmic procedures (for example, due to the potential for improved safety and shorter healing times), correspondingly smaller diameter optical fibers are required to deliver laser light to the probe and to continue providing suction through the probe of the microsurgical instrument. Therefore, for microsurgical instruments to provide both laser and suction functions, a balance is important between efficient transmission of laser light through the optical fiber and the maintenance of sufficient space within the probe (e.g., around the optical fiber) for suction.

[0015] In certain existing surgical systems, the optical cable assembly for delivering laser light comprises optical fibers with a 200 μm (micrometer) core. In such surgical systems, reducing the diameter of some optical fibers (e.g., reducing the optical fiber core to less than 200 μm) to accommodate smaller gauge probes within the connected microsurgical instruments can result in unacceptable optical transmission loss. For example, some optical fibers exhibit optical loss when used to deliver laser light over longer distances (e.g., distances longer than approximately 50 mm, such as about 2 meters). Furthermore, as the diameter of the optical fiber decreases, the durability of the optical fiber may also decrease, thereby shortening the service life of such components. On the other hand, optical fibers with a 200 μm (or larger) core, which are suitable for facilitating transmission over longer distances from the laser source, can be relatively rigid, potentially hindering the movement of the connected microsurgical instruments. In such cases, one or more optical fibers with a core of 200 μm (or more) can then pose ergonomic problems for end-users or surgeons operating microsurgical instruments.

[0016] Embodiments of this disclosure provide a system for laser light transmission over one or more optical fibers that reduces optical loss and the possibility of cable assembly failure when delivering laser light from a laser source to a probe of a microsurgical instrument. As will be discussed in more detail below, various techniques described herein implement tapered optical fibers that allow the laser light to be projected from the probe by the distal end of the optical fiber with a smaller diameter. For example, tapered optical fibers are used to transmit laser light through an optical fiber or portion of an optical fiber with a smaller diameter and may be placed within the probe of a microsurgical instrument to allow attraction and / or to improve flow through the probe. Tapered optical fibers may also be used to increase the flexibility of the optical fiber in a particular portion by reducing the diameter of a portion of the optical fiber placed near a microsurgical handpiece device.

[0017] In some embodiments, one or more optical fibers in an optical cable assembly extending between a laser source and a probe of a surgical instrument used under a microscope may be coupled together to provide specific characteristics to different parts of the optical cable assembly (e.g., a more flexible optical fiber coupled to an optical fiber that transmits better). When laser light is transmitted through the cores of two or more optical fibers, the cores of adjacent optical fibers are aligned when the fibers are coupled together to facilitate the transmission of laser light between the respective cores of the coupled optical fibers. However, due to tolerances in the diameter and centrality of the cores of each of the coupled optical fibers, some of the laser light transmitted between the coupled ends of adjacent optical fibers (e.g., the distal end of one optical fiber and the proximal end of the adjacent optical fiber at the coupling interface) may be partially delivered to the adhesive surrounding the cores of the optical fibers. In such cases, the energy diverted from the laser light may heat the adhesive of the optical fiber receiving the laser light, ultimately damaging and / or failing the optical cable assembly.

[0018] Embodiments of this disclosure include a technique for mounting tapered optical fibers at the coupling interface between adjacent optical fibers in an optical cable assembly. The tapered optical fiber, positioned at the coupling interface between adjacent coupled optical fibers, can help concentrate the delivery of laser light to a smaller area aligned with the core of the optical fiber receiving the laser light. By coupling adjacent optical fibers using tapered optical fibers, the technique described herein reduces the possibility of imperfect alignment and, consequently, the adhesion of the coupled optical fibers and / or the delivery of off-target laser energy to the optical cable assembly.

[0019] FIG. 1A illustrates an exemplary surgical system 100 for performing a laser-assisted ophthalmic surgical procedure, in accordance with certain embodiments of the present disclosure. In certain embodiments, the surgical system 100 may be the CONSTELLATION® Vision System available from Alcon Laboratories, Inc. (Fort Worth, Texas), or the CENTURION® Vision System available from Alcon Laboratories, Inc. (Fort Worth, Texas), or may comprise a surgical console similar to known and currently used ophthalmic surgical consoles, such as any other ophthalmic surgical console suitable for use with the principles described herein.

[0020] As illustrated, the surgical system 100 comprises a laser system 102 having one or more laser sources connected to a handpiece device 112 via a cable assembly 111. The surgical system 100 may also comprise an aspiration system 108 having a vacuum source in fluid communication with the handpiece device 112 to provide aspiration through the handpiece device 112. In certain embodiments, the laser system 102 and / or the aspiration system 108 may be part of, or integrated into, the aforementioned surgical console. The aspiration system 108 may also be connected to the handpiece device 112 via the cable assembly 111. In some embodiments, the cable assembly 111 may comprise one or more cables connected together. In some embodiments, the cable assembly 111 comprises one or more optical fibers for delivering laser light from the laser system 102 to the handpiece device 112. In some embodiments, the cable assembly 111 may further comprise a vacuum line for providing aspiration to the handpiece device 112.

[0021] In certain embodiments, the handpiece device 112 may include a vitrectomy probe for laser-assisted procedures, such as cutting vitreous fibrous material within a patient's eye. Figure 1A shows the probe 110 of the handpiece device 112 inserted into the vitreous humor of a patient's eye 125 for performing an ophthalmic surgical procedure. As the probe 110 moves through the vitreous humor, laser light is emitted within the probe 110 by one or more optical fibers of the cable assembly 111. A user, such as a surgeon, may switch the laser light between the ON and OFF positions using a switch on the handpiece device 112, a foot pedal connected to a surgical system 100, or other means. The switch and / or foot pedal may also be configured to control suction by the handpiece device 112, such as for removing vitreous humor separated from the intraocular space of the eye 125 during vitreoretinal procedures. In other embodiments, the handpiece device 112 may be configured such that laser light delivered to the handpiece device 112 by one or more optical fibers of the cable assembly 111 is used to perform other laser-assisted ophthalmic procedures such as excision (for example, to treat the anterior segment of the eye 125) and phacoemulsification. In other words, the handpiece device 112 shown in Figure 1A is for illustrative purposes only. In particular, the handpiece device 112 exemplifies a vitrectomy handpiece device having a probe 110 that enters the vitreous humor, but the embodiments herein are equally applicable to handpiece devices used for other surgical procedures such as photocoagulation, photoemulsification, and / or phacoemulsification.

[0022] Figure 1B is a perspective view of an exemplary handpiece device 112 that may be implemented in the surgical system 100 described above, according to a particular embodiment of the present disclosure. The handpiece device 112 comprises a probe 110 and a housing 120. The probe 110 is partially and longitudinally positioned through the distal end 121 of the housing 120 and may be directly or indirectly attached to the distal end 121 of the housing 120 within an internal chamber of the housing 120.

[0023] The housing 120 further comprises one or more ports 123 at a proximal end 124 of the housing 120 such that one or more supply lines are routed into an internal chamber of the housing 120 (for example, one supply port 123 is shown in FIG. 1B). For example, the supply port 123 may provide a connection between the housing 120 and a cable assembly 111 disposed through the proximal end 124 of the housing 120. The supply port 123 may also provide a connection to a suction system 108 for suction by the handpiece device 112. In some embodiments, the handpiece device 112 may be sterilized and used for two or more surgical procedures, or the handpiece device 112 may be a single-use device. In examples where the handpiece device 112 is a single-use device, the cable assembly 111 is connected to the housing 120 via the supply port 123 before each surgical procedure and disconnected from the housing 120 after each surgical procedure.

[0024] In some embodiments, the housing 120 may have an outer surface configured to be held by a user such as a surgeon. For example, the housing 120 may be ergonomically shaped to substantially fit a user's hand. As shown in FIG. 1B, the outer surface may be textured, or one or more gripping mechanisms (such as one or more grooves and / or ridges) may be formed thereon. The housing 120 may be made of any material commonly used for such instruments and suitable for ophthalmic surgery. For example, the housing 120 may be formed from lightweight aluminum, a polymer, or other suitable materials.

[0025] The distal end of the cable assembly 111 is coupled to the handpiece device 112. In some embodiments, the proximal end of the cable assembly 111 may be coupled to a laser system 102 having a light source (e.g., a laser light source, an illumination light source, etc.). One or more optical fibers of the cable assembly 111 are configured to deliver laser light provided by the laser source to the handpiece device 112. In some embodiments, the proximal end of the cable assembly 111 may also be connected to a vacuum source, such as a vacuum source of a suction system 108, to provide suction to the handpiece device 112.

[0026] In certain embodiments, the cable assembly 111 has a length of about 1 meter to about 3 meters, for example, about 2 meters, but in some embodiments it may have a longer or shorter length. In some embodiments, the cable assembly 111 comprises one or more optical fibers 113. In some embodiments, the optical fiber 113 comprises a core and a cladding layer surrounding the core in the circumferential direction. Generally, one or more optical fibers 113 of the cable assembly 111 may be arranged within a cable coating that further supports and protects each of the one or more optical fibers 113.

[0027] In certain embodiments, the core of the optical fiber 113 may comprise any transparent material such as fused silica or glass. In some embodiments, the optical fiber 113 may comprise germanate glass (e.g., GeO2), fluoride glass (e.g., ZBLAN, aluminum fluoride, etc.), or other materials. In some embodiments, the core of the optical fiber 113 may be doped. For example, the core of the optical fiber 113 may be germanium-doped silica. Doping the core of the optical fiber 113 with germanium or a similar dopant increases the refractive index of the core of the optical fiber 113 compared to the refractive index of the cladding, thereby achieving laser light guiding properties within the core of the optical fiber 113. The cladding may also comprise transparent materials such as fused silica or glass. In some embodiments, the cladding is doped in addition to, or instead of, the core. For example, a cladding that may comprise fused silica is doped with a dopant that reduces the refractive index of the cladding relative to the refractive index of the core. Examples of dopants include fluorine (F), chlorine (Cl), and boron (B). When doped, the cladding has a lower refractive index than the core, thus enabling light guiding properties within the core.

[0028] In certain embodiments, the optical fiber 113 comprises a hollow-core fiber that can guide light through a hollow region / air core within the fiber. In some embodiments, the optical fiber 113 may be a hollow-core fiber, a hollow-core photonic crystal fiber, or an anti-resonant hollow-core fiber, all constructed with a silver reflective coating.

[0029] Figure 1C shows a longitudinal cross-sectional view of the handpiece device 112, in which the optical fiber 113 of the cable assembly 111 is coupled to a tapered optical fiber 128 located within the housing 120. As described above, the distal end 127 of the optical fiber 113 extends into the housing 120 from the proximal end 124 of the housing 120. In certain embodiments, the core of the optical fiber 113 may have a diameter of about 170 μm to about 280 μm, for example, about 200 μm to about 250 μm, for example, about 200 μm, but in some embodiments, it may have a larger or smaller diameter. In certain embodiments, the core and cladding of the optical fiber 113 may have a coupling diameter of approximately 180 μm to approximately 400 μm, for example, approximately 180 μm to approximately 250 μm, or approximately 250 μm to approximately 400 μm, or approximately 200 μm to approximately 300 μm, for example, approximately 230 μm, but in some embodiments, they may have a larger or smaller coupling diameter.

[0030] In some embodiments, the optical fiber 113 is coupled to a tapered optical fiber 128 to enable the transmission of laser light from the housing 120 through the probe 110 of the handpiece device 112. As shown in Figure 1C (and Figure 2D, which is further described below and shows a magnified detail of a selected portion of Figure 1C), the proximal end 129 of the tapered optical fiber 128 connects to the distal end 127 of the optical fiber 113 at a coupling interface 132 within the housing 120. As will be described in more detail below (see, for example, Figures 2C and 2D), the distal portion of the tapered optical fiber 128 has a diameter smaller than the diameter of the core and / or cladding of the optical fiber 113, thereby allowing the tapered optical fiber 128 to partially extend into the probe 110. As described above, in some embodiments, the tapered optical fiber 128 partially positioned within the probe 110 is configured to project a laser beam from its distal tip into the interior of the probe 110 (for example, for laser-assisted ophthalmic functions such as vitreous dissection).

[0031] In the housing 120, the handpiece device 112 further comprises a distal end 127 of an optical fiber 113 and a ferrule 126 positioned around it, adjacent to a ferrule 130 positioned at the proximal end 129 of a tapered optical fiber 128. In some embodiments, the distal end 127 of the optical fiber 113 and the ferrule 126 positioned thereon are in optical contact (e.g., butt-coupled) with the proximal end 129 of the tapered optical fiber 128 and its ferrule 130 so that laser light can be transmitted from the optical fiber 113 of the cable assembly 111 to the tapered optical fiber 128.

[0032] In some embodiments, a small gap may be formed at the coupling interface 132 between the butt coupling ends of the optical fiber 113 and the tapered optical fiber 128. In certain embodiments, portions of the optical fiber 113, the tapered optical fiber 128, and the ferrules 126, 130 at the coupling interface 132 are further arranged within a sleeve 131 to maintain the optical connection between the optical fiber 113 and the tapered optical fiber 128. In some embodiments, the sleeve 131 includes a cylindrical tube configured to tightly fasten the coupling ends of the ferrules 126, 130 and the ends of the optical fiber 113 and the tapered optical fiber 128 at the coupling interface 132. The ferrules 126, 130 and the sleeve 131 help protect and align the coupling ends of the optical fiber 113 and the tapered optical fiber 128, thereby reducing transmission loss at the coupling interface 132. In some embodiments, the ferrules 126, 130 may be or include metal tubes, ceramic tubes, sapphire tubes, or other materials.

[0033] As described above, in some embodiments, the handpiece device 112 is for single-use applications, and therefore the user can connect a new handpiece device 112 to the cable assembly 111 before each surgical procedure. In some embodiments, the distal end 127 of the optical fiber 113 and the ferrule 126 positioned thereon are configured to be detachably connected to the proximal end 129 and ferrule 130 of the tapered optical fiber 128, so that the distal end 127 and ferrule 126 can be separated and removed from the housing 120. To disconnect the cable assembly 111 from the handpiece device 112, the user pulls the distal end 127 of the optical fiber 113 and the ferrule 126 out of the sleeve 131 and the proximal end 124 of the housing 120. To connect the cable assembly 111 to the new handpiece device 112, the user then inserts the distal end of the optical fiber 113 and the ferrule 126 positioned thereon into the sleeve 131 of the new handpiece device 112, thereby joining the optical fiber 113 and the tapered optical fiber 128 together in the new handpiece device 112.

[0034] Figure 2A shows a plan view of the probe 110 and the distal end 121 of the housing 120. As shown, the probe 110 may be an elongated laser-cutting member that can be inserted into the eye (for example, through an insertion probe to perform a laser-assisted ophthalmic procedure that may be aspiration or non-aspiration). Thus, the probe 110 may be formed of a material suitable for minimally invasive ophthalmic surgery. In some embodiments, the probe 110 comprises one or more sections formed of a material configured to transmit laser light, visible light, ultraviolet light, infrared light, or any other type of light. For example, the probe 110 may comprise one or more sections formed of a translucent or transparent material such as plastic and / or polymer material. The probe 110 may further comprise one or more sections formed of a more conventional surgical-grade material such as stainless steel and / or aluminum.

[0035] In certain embodiments, the probe 110 has a length L1 of about 15 mm to about 30 mm, but in some embodiments it may have a longer or shorter length. In some embodiments, the handpiece device 112 further comprises a reinforcing member 230 fixedly or slidably coupled to at least a portion of the probe 110 and substantially surrounding at least a portion of the probe 110. For example, the reinforcing member 230 may be slidably coupled to the outer surface 236 of the probe 110 (shown in Figures 2B to 2C) and may extend from or retract into the housing 120. The reinforcing member 230 may be adjustable relative to the probe 110, allowing the user to position the reinforcing member 230 at different points along the length L1 of the probe 110 outside the housing 120. Thus, by repositioning the reinforcing member 230 relative to the distal tip 216, the user can selectively adjust the level of stiffness of the probe 110, thereby manipulating the amount of support provided to the probe 110 and stabilizing the handpiece device 112 while using the instrument.

[0036] Figure 2B shows a longitudinal section of the distal end 121 of the housing 120 in which the probe 110 and tapered optical fiber 128 are arranged, according to a particular embodiment of the present disclosure. Figure 2C shows a magnified longitudinal section of the extension of the tapered optical fiber 128 into the probe 110, according to a particular embodiment of the present disclosure. Figure 2D shows a longitudinal section of the coupling between the tapered optical fiber 128 and the optical fiber 113 at the coupling interface 132, according to a particular embodiment of the present disclosure. For clarity, Figures 2B to 2D are described together in this specification.

[0037] As shown in Figure 2B, the probe 110 comprises a lumen 260 and a port 222 near the distal tip 216. The lumen 260 may have an inner diameter D1 in the range of about 220 μm to about 500 μm. In some embodiments, the lumen 260 has a substantially circular cross-section. However, lumen 260 having a non-circular cross-section (e.g., square or octagonal) is also conceivable. In some embodiments, the port 222 is sized and shaped to allow vitreous collagen fibers to enter the lumen 260 during vitrectomy. Vitreous collagen fibers can be drawn into the lumen 260 through the port 222. In some embodiments, the distal end 242 of a tapered optical fiber 128 is positioned so that the tapered optical fiber 128 projects a laser beam across the port 222 to cut vitreous collagen fibers located in the lumen 260. In other specific embodiments, the port 222 may be positioned such that the distal end 242 of the tapered optical fiber 128 projects a laser beam from the distal tip 216 of the probe 110.

[0038] As shown in Figure 2C, the tapered optical fiber 128 can be rigidly suspended within the lumen 260 such that the tapered optical fiber 128 is separated from the inner sidewall of the probe 110 and surrounded circumferentially by an annular gap 228. In some embodiments, the position of the tapered optical fiber 128 is maintained by an adhesive placed around the tapered optical fiber 128 adjacent to the distal end of the ferrule 130, as shown in Figure 2C. The annular gap 228 formed between the tapered optical fiber 128 and the inner sidewall of the probe 110 provides a coaxial path for aspirating vitreous collagen fibers excised, cut, and / or detached through the probe 110. In some embodiments, the tapered optical fiber 128 can be centrally positioned within the lumen 260 such that the radial distance between the inner sidewall and the tapered optical fiber 128 is uniform along the circumference of the tapered optical fiber 128.

[0039] In certain embodiments, the tapered optical fiber 128 has a length of approximately 30 mm to approximately 50 mm, for example, approximately 35 mm to approximately 43 mm, for example, approximately 40 mm, but in some embodiments it may have a longer or shorter length. As shown in Figures 2A and 2B, the distal end 242 of the tapered optical fiber 128 can be terminated at any point along the length L1 of the probe 110 to allow for optimal cutting and aspiration of the vitreous fibers. In some embodiments, the distal end 242 of the tapered optical fiber 128 is terminated at a point distal to the proximal end 224 of the port 222 in the lumen 260. In other specific embodiments, the distal end 242 of the tapered optical fiber 128 is terminated at a point substantially aligned with the proximal end 224 of the port 222 in the lumen 260. In yet another embodiment, the distal end 242 of the tapered optical fiber 128 is terminated at a point proximal to the proximal end 224 of the port 222 in the lumen 260.

[0040] As described above, the tapered optical fiber 128 includes a tapered diameter such that the diameter D2 of a portion of the tapered optical fiber 128 placed within the probe 110 is smaller than the diameter D3 of a portion of the tapered optical fiber 128 placed within the housing 120, and therefore may be similarly smaller than the diameter of the distal end 127 of the optical fiber 113. By reducing the diameter of the portion of the tapered optical fiber 128 within the probe 110, the annular gap 228 surrounding the tapered optical fiber 128 circumferentially within the probe 110 is correspondingly increased, and / or the annular gap 228 of the probe 110 for smaller gauges is maintained. Increasing the size of the annular gap 228 of the probe 110 allows for sufficient flow through the lumen 260, which is beneficial for aspirating fluid or vitreous material separated by the laser beam projected from the tapered optical fiber 128. Having a sufficient annular gap 228 within the probe 110 is also advantageous in preventing and / or reducing the possibility of obstruction occurring within the probe 110 during such suction.

[0041] In some embodiments, the diameter D3 of the proximal end 129 of the tapered optical fiber 128 at the coupling interface 132 may substantially coincide with the diameter of the distal end 127 of the optical fiber 113, and may be, for example, about 180 μm to about 300 μm, for example, about 200 μm to about 250 μm, for example, about 200 μm, but in some embodiments, it may have a larger or smaller diameter. The diameter of the tapered optical fiber 128 tapers, i.e., decreases, from the proximal end 129 as the tapered optical fiber 128 approaches the probe 110. In certain embodiments, the diameter D2 of the portion of the tapered optical fiber 128 placed in the lumen 260 of the probe 110 may be about 50 μm to about 150 μm, for example, about 80 μm to about 120 μm, for example, about 100 μm, but in some embodiments, it may have a larger or smaller diameter depending on the size of the lumen 260.

[0042] In some embodiments, the tapered optical fiber 128 includes a single-crystal optical fiber at least partially disposed within a cable coating that protects the tapered optical fiber 128 from surface contamination. In some embodiments, the single-crystal optical fiber of the tapered optical fiber 128 is a single-crystal sapphire optical fiber made from α-Al2O3. In other embodiments, the single-crystal optical fiber of the tapered optical fiber 128 is Ti:sapphire, Y3Al5O 12 It can be made from (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF4-BaF2-LaF3-AlF3-NaF(ZBLAN). However, as will be discussed further below, any material capable of propagating laser light 241 and its wavelength may and is assumed to be used. In such embodiments, as opposed to optical fibers having both a core and a cladding layer, single-crystal optical fibers do not have a cladding layer and therefore may generally have a smaller diameter and / or be thinner than optical fibers with a cladding layer, while still being able to propagate laser light with similar or better efficiency.

[0043] Compared to amorphous silica or germanium oxide fibers, single-crystal optical fibers offer higher thermal conductivity and therefore the advantage of propagating laser light 241 with greater efficiency. In addition to providing a larger annular gap 228 within the lumen 260, the smaller diameter fiber at the distal end 242 of the tapered optical fiber 128 concentrates the projection of the laser beam from the distal tip 216 onto a smaller surface area, thereby enabling smaller spot size cutting by the handpiece device 112 for greater precision. In some cases, the smaller diameter fiber at the distal end 242 of the tapered optical fiber 128 also allows the laser beam to be projected with less energy, which may be beneficial for certain ophthalmic procedures.

[0044] The tapered optical fiber 128 may be configured to act as an optical waveguide for propagating laser light 241. The tapered optical fiber 128 may be configured to project laser light 241 from its distal end 242. In other embodiments, the properties of the laser light 241 propagating through the tapered optical fiber 128 are such that the laser light 241 causes the destruction of vitreous collagen fibers in the path of the laser light 241. Destruction refers to the destruction of tissue due to the rapid ionization of molecules in that tissue. In certain embodiments, the laser light 241 propagating in the tapered optical fiber 128 has a wavelength of about 2.0 μm to about 3.5 μm, for example, about 2.5 μm to about 3.3 μm. However, the techniques disclosed herein can implement any suitable type of laser light for ophthalmic surgery.

[0045] Figure 3 shows a plan view of an exemplary tapered optical fiber used to couple an optical fiber 113 of a cable assembly 111 with an adjacent optical fiber, according to a particular embodiment of the present disclosure. In some embodiments, the distal end 306 of a delivery fiber 308 from a laser system 102 is configured to focus the delivered laser light 241 onto the core of the optical fiber 113, thereby transmitting the laser light 241 through the optical fiber 113 to the tapered optical fiber 128. As described above, in some cases, the laser light transmitted between the coupled ends of adjacent optical fibers may be partially delivered to an adhesive surrounding the core of an optical fiber receiving the laser light, such as the optical fiber 113 receiving the laser light from the delivery fiber 308 in the illustrated example. Such heating of the adhesive may damage or fail the optical fiber 113.

[0046] As shown in Figure 3, in some embodiments, a first tapered optical fiber segment 302 having a tapered shape similar to that of the tapered optical fiber 128 can therefore be implemented at the coupling interface between the proximal end 304 of the optical fiber 113 and the distal end 306 of the delivery fiber 308. The first tapered optical fiber segment 302 can help concentrate the energy delivery of the laser beam 241 to a smaller area aligned with the core of the optical fiber 113. By coupling the optical fiber 113 and the delivery fiber 308 of the laser system 102 with the first tapered optical fiber segment 302, the possibility of misalignment (and resulting overheating) between the delivery fiber 308 and the adhesive of the optical fiber 113 at the proximal end 304 is reduced.

[0047] To limit the possibility of damage to the first tapered optical fiber segment 302 itself, the first tapered optical fiber segment 302 includes a proximal end 310 having a larger diameter than the diameter of the distal end 306 of the delivery fiber 308. In some embodiments, when the proximal end 310 of the first tapered optical fiber segment 302 is coupled to the distal end 306 of the delivery fiber 308 having a diameter of about 200 μm, the proximal end 310 of the first tapered optical fiber segment 302 may have a diameter of about 200 μm to about 300 μm, for example, about 230 μm to 270 μm, for example, about 250 μm, but in some embodiments, it may have a larger or smaller diameter. By implementing the proximal end 310 of the first tapered optical fiber segment 302 with a larger diameter, the possibility of the first tapered optical fiber segment 302 itself being damaged by the excess energy of the laser light 241 delivered by the delivery fiber 308 is limited.

[0048] Similar to the tapered optical fiber 128, the diameter of the first tapered optical fiber segment 302 decreases towards the distal end 312 of the first tapered optical fiber segment 302, allowing the laser beam 241 to be focused and delivered over a smaller area. In some embodiments, when the proximal end 304 of an optical fiber 113 having a diameter of about 200 μm in the core (e.g., about 230 μm including the cladding) is coupled to the distal end 312 of the first tapered optical fiber segment 302, the distal end 312 may have a diameter of, for example, about 150 μm to about 230 μm, for example, about 160 μm to about 200 μm, or for example, 180 μm, but in some embodiments, it may have a larger or smaller diameter.

[0049] The optical fiber 113 further comprises a second tapered optical fiber segment 314 positioned between the distal end 127 of the optical fiber 113 and the proximal end 129 of the tapered optical fiber 128 to assist in the delivery of laser light 241 to the tapered optical fiber 128 through the optical fiber 113. In some embodiments, when the distal end 127 of the optical fiber 113, which has a diameter of about 200 μm in the core (about 230 μm including the cladding), is coupled with the proximal end 316 of the second tapered optical fiber segment 314, the proximal end 316 of the second tapered optical fiber segment 314 may have a diameter of about 180 μm to about 260 μm, for example, about 200 μm to about 240 μm, for example, about 220 μm, but in some embodiments it may have a larger or smaller diameter.

[0050] Similar to the first tapered optical fiber segment 302, the diameter of the second tapered optical fiber segment 314 decreases towards the distal end 318 of the second tapered optical fiber segment 314 to concentrate the delivery of the laser beam 241. In some embodiments, when the proximal end 129 of a tapered optical fiber 128 having a diameter of about 200 μm is coupled to the distal end 318 of the second tapered optical fiber segment 314, the distal end 312 of the second tapered optical fiber segment 314 may have a diameter of about 110 μm to about 200 μm, for example, about 130 μm to 180 μm, or about 150 μm, although in some embodiments it may have a larger or smaller diameter.

[0051] In some embodiments, the first and second tapered optical fiber segments 302, 314 may have a length L2 of 8 mm to 20 mm, for example about 10 mm to 15 mm, for example about 12 mm, but in some embodiments they may have longer or shorter lengths. In some embodiments, the first and second tapered optical fiber segments 302, 314 may include single-crystal optical fibers (e.g., sapphire core fibers) similar to the tapered optical fiber 128 described above, while the optical fiber 113 may include an optical fiber having a core and cladding, such as a germanium oxide glass optical fiber. By using a germanium oxide glass optical fiber for the optical fiber 113, the cable assembly 111 (and the optical fiber 113 placed therein) can be made more flexible than a corresponding sapphire core fiber of the same diameter.

[0052] Figure 4 shows an exemplary optical fiber that may be implemented in the surgical system 100 described in Figure 1A according to a particular embodiment of the present disclosure. Even with the use of first and second tapered optical fiber segments 302, 314 to assist in the alignment between the coupled optical fibers, some amount of optical loss may occur at the coupling interface between the optical fiber 113 and the first and second tapered optical fiber segments 302, 314, respectively. Optical loss may also be experienced at the coupling interface between the optical fiber 113 and the tapered optical fiber 128 in the handpiece device 112 described above. As shown in Figure 4, in a further embodiment, the optical fiber 113 and the tapered optical fiber 128 may be formed as a single integrated optical fiber 400 extending between the laser system 102 of the surgical system 100 and the probe 110 of the handpiece device 112 for propagating laser light 241 and without the need to couple any optical fibers.

[0053] In some embodiments, the optical fiber 400 comprises a proximal portion 406 coupled to the laser system 102 at a proximal end 408, and a distal portion 410 extending into the handpiece device 112 and terminating at a distal end 404 in the probe 110 near the distal tip 216. In some embodiments, the optical fiber 400 has a length of about 1 meter to about 3 meters, for example, about 2 meters, but in some embodiments it may have a longer or shorter length. Similar to the tapered optical fiber 128, the optical fiber 400 may include a single-crystal optical fiber such as a tapered sapphire core fiber placed in a cable jacket. Alternatively, the optical fiber 400 may include an optical fiber made of any of the other materials described above with respect to the tapered optical fiber 128.

[0054] As mentioned above, sapphire core fibers with a diameter of less than 200 μm may exhibit excessive transmission loss. However, sapphire core fibers with a diameter of 200 μm or more are relatively rigid, which can create ergonomic problems for users / surgeons using a handpiece device 112 connected to the distal end 404 of the optical fiber 113. Similar to the tapered optical fiber 128, the sapphire core fiber in the optical fiber 400 provides an optical fiber 400 with a tapered shape. To improve transmission through the optical fiber 400, the optical fiber 400 may have a tapered shape in the proximal portion 406 of the optical fiber 400, which initially has a larger diameter to facilitate the transmission of laser light. Then, the optical fiber 400 may tapere to a smaller diameter towards the distal portion 410 as the optical fiber 400 approaches the handpiece device 112, providing the optical fiber 400 with improved flexibility in the vicinity of the handpiece device 112.

[0055] In certain embodiments, the proximal portion 406 of the optical fiber 400 may have a diameter of about 250 μm to about 500 μm, for example, about 350 μm to about 450 μm, or for example, about 400 μm, but in some embodiments, it may have a larger or smaller diameter. In some embodiments, the distal portion 410 of the optical fiber 400 may have a diameter of about 50 μm to about 200 μm, for example, about 80 μm to about 120 μm, or for example, about 100 μm, but in some embodiments, it may have a larger or smaller diameter. Similar to the tapered optical fiber 128, the tapered shape may allow the optical fiber 400 to have a sufficiently small diameter near the distal end 404 located in the probe 110 of the handpiece device 112, providing similar advantages as described above.

[0056] In summary, embodiments of the present disclosure include devices and systems for use in performing laser-assisted ophthalmic surgery. In particular, the handpiece devices and systems described above may include projecting laser light from tapered optical fibers (e.g., sapphire core fibers made of sapphire material) partially positioned within the probe of the handpiece device, thereby enabling improved transmission characteristics of laser light through smaller gauge probes. In some embodiments, the use of tapered optical fibers in a laser vitrectomy probe for cleaving collagen fibers in the vitreous humor also allows the probe to maintain appropriate suction function for simultaneous removal of the cleaved vitreous humor during surgery. Furthermore, the use of tapered optical fibers at the optical interface between the optical fibers of a cable assembly and the laser system (or laser source therein) and / or the handpiece device can reduce the risk of damage to the cable assembly and increase the service life of the cable assembly. In some embodiments, the optical fibers of a cable assembly (e.g., hollow core fibers, or those made of germanate glass or fluoride glass) are coupled to the tapered optical fiber to efficiently deliver laser light to the tapered optical fiber in the handpiece device. Furthermore, some of the embodiments described herein improve the transmission of laser light to the handpiece device via a more robust, easier-to-handle single-crystal optical fiber, while still maintaining sufficient ergonomics for the connected handpiece device to be operated by the user. Thus, the embodiments described enable the performance of more efficient, less invasive, and safer ophthalmic procedures.

[0057] While vitreous and phacoemulsification surgeries are discussed as examples of surgical procedures that can benefit from the embodiments described herein, the advantages of the surgical devices and systems described herein may also benefit other ophthalmic procedures that have a light-emitting function (e.g., laser light, illumination light, etc.).

[0058] The foregoing relates to embodiments of the present disclosure, but other and further embodiments of the present disclosure may be devised without departing from its basic scope, the scope of which will be determined by the following claims.

Claims

1. Housing and A cable assembly disposed within the housing and extending from a supply port located at the proximal end of the housing, wherein the cable assembly comprises an optical fiber. A tapered optical fiber is disposed within the housing and has a diameter that decreases between the proximal end and the distal end of the tapered optical fiber. In a handpiece device equipped with, A handpiece device in which the proximal end of the tapered optical fiber is optically coupled to the distal end of the optical fiber.

2. The handpiece device according to claim 1, further comprising a probe disposed through an opening at the distal end of the housing, wherein the probe has a lumen extending through the probe, and the distal end of the tapered optical fiber is disposed within the lumen.

3. The handpiece device according to claim 2, wherein the lumen further comprises an annular gap surrounding the tapered optical fiber in the circumferential direction, and the annular gap is configured to provide a coaxial path for the probe to draw water through the lumen.

4. The handpiece device according to claim 1, wherein the diameter of the distal end of the tapered optical fiber is approximately 50 μm to approximately 150 μm.

5. The handpiece device according to claim 1, wherein the diameter of the proximal end of the tapered optical fiber is approximately 180 μm to approximately 250 μm.

6. The handpiece device according to claim 1, wherein the optical fiber of the cable assembly has a diameter of about 180 μm to about 400 μm.

7. The tapered optical fiber is α-Al ２ O ３ (sapphire), Ti:sapphire, Y ３ Al ５ O １２ (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF ４ -BaF ２ -LaF ３ -AlF ３ -NaF (ZBLAN), the handpiece device according to claim 1, comprising a single-crystal fiber formed from a material containing the same.

8. An optical fiber having a proximal end and a distal end, A first tapered optical fiber having a distal end and a proximal end, wherein the distal end of the first tapered optical fiber is optically coupled to the proximal end of the optical fiber. The first tapered optical fiber has a first diameter that decreases from the proximal end to the distal end of the first tapered optical fiber, A first tapered optical fiber wherein the diameter of the distal end of the first tapered optical fiber is smaller than the diameter of the proximal end of the optical fiber, A second tapered optical fiber, wherein the proximal end of the second tapered optical fiber is optically coupled to the distal end of the optical fiber. A cable assembly for a surgical system, equipped with the following features.

9. The cable assembly according to claim 8, wherein the second tapered optical fiber has a second diameter that decreases from the proximal end to the distal end of the second tapered optical fiber, and the diameter of the proximal end of the second tapered optical fiber is greater than the diameter of the distal end of the optical fiber.

10. The cable assembly according to claim 8, wherein the distal end of the second tapered optical fiber is configured to optically couple with the proximal end of a third optical fiber disposed within a handpiece device, and the diameter of the proximal end of the third optical fiber is greater than or equal to the diameter of the distal end of the second tapered optical fiber.

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

12. At least one of the first tapered optical fiber and the second tapered optical fiber is α-Al ２ O ３ (Sapphire), Ti: Sapphire, Y ３ Al ５ O １２ (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF ４ -BaF ２ -LaF ３ -AlF ３ The cable assembly according to claim 11, comprising a single-crystal fiber made of a material containing -NaF(ZBLAN).

13. A surgical console equipped with a laser system, It is a handpiece device, Housing and A cable assembly disposed within the housing and extending from a supply port located at the proximal end of the housing, wherein the cable assembly comprises an optical fiber having a proximal end and a distal end, A tapered optical fiber disposed within the housing and having a diameter that decreases between the proximal end and the distal end of the tapered optical fiber, The proximal end of the optical fiber is optically coupled to the laser system, and the distal end of the optical fiber is optically coupled to the proximal end of the tapered optical fiber, and A handpiece device equipped with A surgical system equipped with [the following features].

14. The surgical console further includes a suction system, The handpiece device further comprises a probe disposed through an opening at the distal end of the housing, wherein the probe has a lumen extending through the probe, and the distal end of the tapered optical fiber is disposed within the lumen. The surgical system according to claim 13, wherein the lumen is in fluid communication with the suction system and further comprises an annular gap surrounding the tapered optical fiber in the circumferential direction, the annular gap being configured to provide a coaxial path for suction of the probe through the lumen.

15. The tapered optical fiber is α-Al ２ O ３ (Sapphire), Ti: Sapphire, Y ３ Al ５ O １２ (YAG), Ho:YAG, Yb:YAG, Nd:YAG, Er:YAG, Ce:YAG, Cr:YAG, or ZrF ４ -BaF ２ -LaF ３ -AlF ３ The surgical system according to claim 13, comprising a single-crystal fiber composed of a material containing -NaF(ZBLAN).

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