System and method for reducing post-occlusion surge

Abstract

According to certain embodiments, a surgical cassette for an ophthalmic surgical system includes a drip conduit in fluid communication with a handpiece for transporting fluid toward a surgical site. An aspiration conduit is in fluid communication with the handpiece for transporting fluid away from the surgical site. An aspiration pump generates vacuum pressure in the aspiration conduit to draw fluid through the aspiration conduit toward an exhaust reservoir. The reservoir is coupled to a pressure-vacuum source to manage reservoir pressure. A valve is in fluid communication with the aspiration conduit and the reservoir, providing one or more channels between the aspiration conduit and the reservoir. Each sensor detects pressure associated with the surgical site. A computer controls the valve in response to pressure detected by the one or more pressure sensors to mitigate pressure or volume changes.

Description

Technical Field

[0001] The present disclosure relates to ophthalmic surgical systems and methods, and more particularly to systems and methods for reducing post-obstruction surge during ophthalmic surgery.

Background Art

[0002] In cataract surgery, the cataractous lens is removed and replaced with an artificial intraocular lens (IOL). The cataractous lens is typically removed by fragmenting the lens and aspirating the lens fragments out of the eye. The lens can be fragmented using, for example, a phacoemulsification handpiece, a laser handpiece, or other suitable handpiece. During the procedure, the handpiece fragments the lens (using, for example, ultrasonic vibrations or laser energy), and the fragments are aspirated out of the eye through, for example, a needle. Throughout the procedure, a drip solution is pumped into the eye to maintain intraocular pressure (IOP) and prevent collapse of the eyeball.

[0003] A common complication during the fragmentation process results from needle blockage or occlusion. When the drip solution and emulsified tissue are aspirated through the hollow cutting needle, tissue pieces larger than the needle holes may clog the tip. When the tip clogs, a vacuum pressure is formed within the tip. Occlusion disruption occurs when the clog is removed, for example, when the tissue breaks freely and moves through the needle. When the clog is removed, the vacuum pressure in the anterior chamber drops rapidly, resulting in post-obstruction surge. In some cases, post-obstruction surge can cause a relatively large amount of fluid and tissue to be rapidly aspirated out of the eye, potentially causing the eye to collapse and / or the lens capsule to rupture. <00…​​​​​​​[Means for solving the problem]

[0005] In certain embodiments, a surgical cassette for an ophthalmic surgical system comprises an infusion conduit, a suction conduit, a suction pump, a reservoir, a valve, one or more pressure sensors, and a computer. The infusion conduit is in fluid communication with the handpiece and delivers fluid toward the surgical site. The suction conduit is in fluid communication with the handpiece and delivers fluid away from the surgical site. The suction pump generates vacuum pressure in the suction conduit to draw fluid through the suction conduit toward the discharge reservoir. The reservoir holds the fluid and, coupled with a pressure-vacuum source, manages the reservoir pressure. The valve is in fluid communication with the suction conduit and the reservoir and provides one or more channels between the suction conduit and the reservoir. Each sensor detects pressure associated with the surgical site. The computer controls the valve according to the pressure detected by one or more pressure sensors to mitigate pressure and / or volume changes.

[0006] The embodiments may not include any of the following features, or they may include one, some, or all of them.

[0007] In certain embodiments, the computer controls a valve to reduce the vacuum pressure in the suction conduit when the pressure associated with the surgical site is below a first pressure threshold.

[0008] In certain embodiments, the computer controls the valve to reduce the vacuum pressure by controlling the valve to provide one or more channels for fluid to pass from the reservoir to the suction conduit. In certain cases, the computer controls the valve to provide one or more channels, such as a first channel from the reservoir to the suction pump, or a second channel from the reservoir to the suction connector, and the suction connector is configured to be coupled to the handpiece. In other cases, the computer controls the valve to provide one or more channels, such as a first channel from the reservoir to the suction pump and a second channel from the reservoir to the suction connector, and the suction connector is configured to be coupled to the handpiece.

[0009] In certain embodiments, the first pressure threshold may have a value in the range of 0 to 207 mmHg.

[0010] In certain embodiments, the first pressure sensor detects when the pressure associated with the surgical site is below a first pressure threshold. In certain cases, the first pressure sensor comprises an infusion pressure sensor configured to detect the infusion pressure in an infusion conduit. In other cases, the first pressure sensor comprises an infusion pressure sensor configured to detect the infusion pressure at the surgical site. In yet other cases, the first pressure sensor comprises a handpiece pressure sensor located on the handpiece.

[0011] In certain embodiments, the computer controls a valve to reduce the vacuum pressure in the suction conduit when the pressure associated with the surgical site is below a first pressure threshold. In certain cases, the computer controls the valve to stop the decrease in vacuum pressure in the suction conduit by controlling the valve to stop the passage of fluid after a predetermined period of time. In other cases, the computer controls the valve to stop the decrease in vacuum pressure in the suction conduit by controlling the valve to stop the passage of fluid when the valve's diverter reaches a closed angle.

[0012] The computer controls a valve to stop the decrease in vacuum pressure in the suction conduit by controlling the valve to stop the passage of fluid when the pressure associated with the surgical site reaches a second pressure threshold. In a particular case, the second pressure threshold has a value in the range of 0 to 760 mmHg. In a particular case, a second pressure sensor detects when the pressure associated with the surgical site reaches the second pressure threshold. The second pressure sensor may include a suction pressure sensor that detects the suction pressure in the suction conduit.

[0013] In certain embodiments, the surgical cassette further comprises an infusion pump in fluid communication with an infusion conduit and a reservoir. The infusion pump supplies infusion pressure to the reservoir.

[0014] In certain embodiments, a pressure-vacuum source maintains the reservoir pressure of the reservoir at a specific pressure having a value in the range of 0 to 500 mmHg.

[0015] In certain embodiments, the valve is located in the reservoir.

[0016] In certain embodiments, the valve is positioned along the suction conduit between the suction connector and the reservoir. The suction connector may be coupled to a handpiece.

[0017] In certain embodiments, a surgical cassette for an ophthalmic surgical system comprises an infusion conduit, a suction conduit, a suction pump, a reservoir, a valve, one or more pressure sensors, and a computer. The infusion conduit is in fluid communication with the handpiece and delivers fluid toward the surgical site. The suction conduit is in fluid communication with the handpiece and delivers fluid away from the surgical site. The suction pump generates vacuum pressure in the suction conduit, drawing fluid through the suction conduit toward the discharge reservoir. The reservoir holds the fluid and, coupled with a pressure-vacuum source, manages the reservoir pressure. The valve is in fluid communication with the suction conduit, the reservoir, and the suction pump, providing one or more channels between the suction conduit, the reservoir, and the suction pump. Each sensor detects pressure associated with the surgical site. The computer controls the valve according to the pressure detected by one or more pressure sensors to mitigate pressure and / or volume changes.

[0018] In certain embodiments, a method for surge reduction in an ophthalmic surgical system includes: transporting fluid toward the surgical site by an infusion conduit, the infusion conduit being in fluid communication with a handpiece; transporting fluid away from the surgical site by a suction conduit, the suction conduit being in fluid communication with a handpiece; generating vacuum pressure in the suction conduit by a suction pump to draw fluid through the suction conduit toward a discharge reservoir; providing one or more channels between the suction conduit and the reservoir by a valve, the reservoir being configured to be coupled to a pressure-vacuum source to manage the reservoir pressure of the reservoir, the valve being in fluid communication with the suction conduit and the reservoir; detecting pressure related to the surgical site by one or more pressure sensors; and controlling the valve by a computer in accordance with the pressure detected by one or more pressure sensors to reduce pressure and / or volume changes. [Brief explanation of the drawing]

[0019] [Figure 1] Figure 1 shows an example of an ophthalmic surgical system that may be used to perform ophthalmic procedures on the eye. [Figure 2] Figure 2 is a block diagram of the surgical console for the ophthalmic surgery system shown in Figure 1. [Figure 3] Figure 3 is a schematic diagram showing a fluid subsystem that can be used with the surgical consoles shown in Figures 1 and 2. [Figure 4A-4C] Figures 4A-4C show examples of operations that the valves in the fluid subsystem of Figure 3 can perform. [Figure 4D-4F] Figure 4D-4F shows examples of operations that the valves in the fluid subsystem of Figure 3 can perform. [Figures 5A-5C] Figures 5A-5C are diagrams illustrating examples of valve operations that can be controlled to perform the valve operations shown in Figures 4A-4C. [Figure 5D-5F] Figures 5D-5F show examples of valve operations that can be controlled to perform the valve operations shown in Figures 4D-4F. [Figure 6] This figure shows an example of a method that may be used by the fluid subsystem in Figure 3 to reduce post-occlusion surges. [Figure 7] This figure shows another example of a method that may be used by the fluid subsystem in Figure 3 to mitigate post-occlusion surges. [Modes for carrying out the invention]

[0020] To facilitate an understanding of the principles of the present disclosure, reference is now made to the embodiments illustrated in the drawings and specific language is used to describe them. It should be understood, however, that no limitation of the scope of the present disclosure is intended. Any alternative and further modifications to the devices, apparatus, and methods described, as well as any further applications of the principles of the present disclosure, are fully contemplated as may normally occur to one of ordinary skill in the art to which the disclosure pertains. In particular, it is fully contemplated that features, components, and / or steps described with respect to one embodiment may be combined with features, components, and / or steps described with respect to other embodiments of the present disclosure. However, for the sake of brevity, numerous repetitions of these combinations are not separately described. For simplicity, in some cases, the same reference numbers are used throughout the drawings to refer to the same or similar parts.

[0021] The present disclosure generally relates to devices, systems, and methods for performing a lens fragmentation procedure. Reducing the post-occlusion surge during fragmentation can be important for the success of the procedure. The devices, systems, and methods disclosed herein include a valve and a reservoir for reducing the post-occlusion surge. When occlusion disruption is detected, the valve allows flow from the reservoir to increase the fluid volume and reduce the vacuum pressure in the suction path connected to the handpiece and pump, thereby reducing or preventing the post-occlusion surge. In such a manner, the valve can reduce pressure and / or volume changes, which can be expressed as pressure or volume changes using an inclusive "or". Pressurizing the reservoir can enable a more responsive reduction. Further, the valve can allow flow through one or more channels from the reservoir. When the pressure has sufficiently recovered, the valve can stop the reduction of the vacuum pressure.

[0022] FIG. 1 shows an example of an ophthalmic surgical system 10 that can be used to perform ophthalmic treatment on an eye. In the illustrated example, system 10 includes a console 100, a housing 102, a display screen 104, a foot pedal 108, a fluid subsystem 110, and a handpiece 112 that are coupled as shown and described in more detail with reference to FIG. 2.

[0023] FIG. 2 is a block diagram of the subsystems of the console 100 of FIG. 1. Console 100 includes a housing 102 that houses subsystems 106, 110, 116, and 120 that support computer 103, components 108, 112, 109, and 122. Foot pedal subsystem 106 receives inputs from foot pedal 108. Fluid subsystem 110 provides fluid control for handpiece 112, drip cannula 109, and vitrectomy handpiece 122. Handpiece subsystem 116 supports handpiece 112. For example, subsystem 116 can manage ultrasonic vibrations for a phacoemulsification (phaco) handpiece or supply laser energy to a laser handpiece. Pneumatic vitrectomy cutter subsystem 120 controls vitrectomy handpiece 122. Display screen 104 displays data provided by computer 103.

[0024] Figure 3 is a schematic diagram showing a fluid subsystem 110 that may be used with the surgical console 100 of Figures 1 and 2. Generally, the computer 103 controls a portion of the fluid subsystem 110 to maintain a target intraocular pressure (IOP) of the eye during ophthalmic procedures (which may have values ​​in the range of 0 to 110 millimercury (mmHg)). The computer 103 can determine the IOP from a measurement of pressure associated with the surgical site of the eye, i.e., “surgical site pressure”. Surgical site pressure is a pressure that indicates the intraocular pressure (IOP) of the eye (it does not necessarily have to be measured at the surgical site). For example, the fluid subsystem 110 may include a sensor that can directly measure the IOP of the eye at the eye's location or inside the eye. The fluid subsystem 110 can then receive the measurement of the surgical site pressure from the sensor. As another example, the infusion pressure measured in an infusion conduit and / or the suction pressure measured in an suction conduit may indicate the IOP. The surgical site pressure may not be the same as the IOP, and it can correspond to the IOP in that higher surgical site pressure indicates a higher IOP, and lower surgical site pressure indicates a lower IOP. The fluid subsystem 110 has various sensors 330, 365 (described later) that can measure the surgical site pressure.

[0025] The surgical site pressure may have a target range corresponding to the target IOP of the eye. For example, the infusion pressure may have a target range of 0 to 110 mmHg (e.g., values ​​within the range of 0 to 30, 30 to 70, or 70 to 110 mmHg), or the suction pressure may have a target range of -760 to 110 mmHg (e.g., values ​​within the range of -760 to -300, -300 to -100, or -100 to 110 mmHg). If the computer 103 determines that the surgical site pressure is outside the target range and the IOP is also outside the target range, the computer 103 controls the fluid subsystem 110 to return the pressure to the target range. For example, to mitigate post-occlusion surge, a first pressure threshold may indicate when the surgical site pressure falls below the first threshold, for example, in response to occlusion rupture, and a second pressure threshold may indicate when the surgical site pressure is acceptable, indicating that the surgical site pressure has recovered. In certain embodiments, the computer 103 controls the valve to reduce the vacuum pressure in the suction conduit when the surgical site pressure is below a first pressure threshold, and controls the valve to stop reducing the vacuum pressure when the surgical site pressure reaches a second pressure threshold, after a certain period of time has elapsed, or after the valve's diverter has reached a closed angle.

[0026] In the illustrated example, the fluid subsystem 110 has a cassette body 301 which can be housed by the surgical console 100 as a surgical cassette. The fluid subsystem 110 includes an infusion system 300 and a suction system 305, which are controlled by a computer 103 such as a controller 360. The infusion system 300 and the suction system 305 are in fluid communication with the handpiece 112. The parts that are in fluid communication with each other are parts in which fluid can flow between (to / from) the parts.

[0027] The console 100 may include one or more handpieces 112, including an ultrasonic-driven phaco handpiece, a laser handpiece, and / or other suitable handpieces. In certain embodiments, the handpiece 112 may be an ultrasonic-driven phaco handpiece. In the illustrated example, the phaco handpiece 112 includes an infusion section 320, a cutting needle 355, and a handpiece pressure sensor (HPS) 365. The infusion section 320 may be an infusion tip or infusion sleeve that provides fluid to the surgical site and surrounds the needle 355. The cutting needle 355 is a hollow needle that vibrates at a constant frequency to break up tissue. Fluid and tissue may be aspirated through the needle 355.

[0028] In certain embodiments, the handpiece 112 may be a laser handpiece. The laser handpiece uses laser energy to fragment the lens in order to facilitate the phacoemulsification process. In embodiments, the fluid subsystem 110 supports the laser handpiece in a similar manner to a phaco handpiece (for example, providing infusion and aspiration functions). In certain embodiments, the laser handpiece may include a sensor that measures surgical site pressure to provide measurements for post-occlusion relief.

[0029] The HPS365 is an infusion pressure sensor that detects the infusion pressure within the infusion conduit 302. In the illustrated example, the HPS365 is positioned on the handpiece 112 close to the surgical site, for example, less than 12 inches from the surgical site. Its proximity to the surgical site allows for rapid detection of pressure changes (which may occur during occlusion rupture) and enables real-time surge suppression. In some examples, the HPS365 detects pressure changes within 50 milliseconds of occlusion rupture, which can allow the controller 360 to respond to pressure deviations before the IOP is excessively adversely affected. Generally, the infusion pressure sensor may be positioned at any suitable location on the handpiece 112 (e.g., the proximal end, distal end, or near the infusion portion 320), at any suitable location along the infusion conduit, or at any suitable component that is in fluid communication with the surgical site (e.g., in a separate tube or probe).

[0030] The suction system 305 transports fluid away from the surgical site toward the discharge reservoir 340 by generating and maintaining a vacuum pressure (or negative pressure) within the suction conduit 303. Vacuum pressure can be described as negative pressure. Therefore, increasing the vacuum pressure can be described as increasing the negative pressure or decreasing the pressure, and decreasing the vacuum pressure can be described as decreasing the negative pressure or increasing the pressure.

[0031] The suction system 305 includes a suction conduit 303, a valve 337, a reservoir 333, a pressure-vacuum source 336, a suction pressure sensor (APS) 330, a suction pump 335, and a discharge reservoir 340, all of which are in fluid communication along the suction path as shown in the illustration. The suction conduit 303 provides fluid communication between the suction system 305 and the handpiece 112. In the illustrated example, the suction conduit 303 draws fluid from the needle 355 of the handpiece 112. The reservoir 333 stores fluid that can be used for surge mitigation. The pressure-vacuum source 336 maintains and regulates the reservoir pressure of the reservoir 333. For surge mitigation, the reservoir pressure may be in the range of 0 to 500 mmHg (e.g., values ​​in the range of 0 to 100, 100 to 400, or 400 to 500 mmHg). Examples of reservoir 333 include venturi, discharge, vent, irrigation, and other suitable reservoirs, and reservoir 333 may be implemented as one or more reservoirs.

[0032] Valve 337 controls the flow to and / or from reservoir 333 for handpiece 112. Valve 337 controls the vacuum pressure in suction conduit 303 by opening and / or closing the channel to mitigate the effects of post-occlusion surge. Examples of valve 337 include vent, discharge, rotary, variable vacuum relief, and other suitable valves, and valve 337 may be implemented as one or more valves. Valve 337 can be placed at any suitable location in the fluid subsystem 110. For example, valve 337 may be placed near the eye, such as adjacent to the suction connector, which can improve mitigation performance. As another example, valve 337 may be placed at the location of reservoir 333 or along the suction conduit 303 between the suction connector and reservoir 333. The operation of the valve will be described in more detail with reference to Figures 4A to 4F.

[0033] The APS330 detects the suction pressure in the suction conduit 303. The suction pump 335 generates vacuum pressure in the suction conduit 303 between the pump 335 and the eye, drawing fluid from the surgical site into the discharge reservoir 340. The pump 335 may be, for example, a dual-segment elastomer pump. The discharge reservoir 340 receives fluid from the surgical site. The discharge reservoir 340 may be a bag that receives fluid in the cassette body 301, or a crossing point of the conduits.

[0034] The controller 360 is a computer that controls parts of the fluid subsystem 110, such as valves (e.g., 337) and pumps (e.g., 335), in response to pressure sensors (e.g., 330, 365, eye position or intraocular sensors) to control the pressure in conduits 302, 303 in order to maintain a target pressure at the surgical site. In certain embodiments, the controller 360 controls valve 337 to reduce post-occlusion surge. In this embodiment, the computer 103 controls valve 337 to reduce the vacuum pressure in the suction conduit when the surgical site pressure is below a first pressure threshold, and controls the valve to stop reducing the vacuum pressure when the surgical site pressure reaches a second pressure threshold, after a certain period of time has elapsed, or after the valve's shunt reaches a closed angle.

[0035] The controller 360 can adjust the vacuum pressure in the suction conduit 303 by opening and / or closing the channel of the valve 337. The channel is opened by making the channel passage larger. A channel is fully open if it is opened to allow maximum flow rate; otherwise, the channel is partially open. The channel is closed by making the channel passage smaller. A channel is fully closed if it is closed to prevent fluid from passing through; otherwise, the channel is partially closed.

[0036] In some embodiments, the controller 360 adjusts the amount by which the channel is opened or closed (i.e., the size of the channel passage) based on the deviation between the detected pressure and the target pressure. For example, if the deviation is large, the passage can be made larger to allow more fluid to pass through. If the deviation is small, the passage can be made smaller to allow less fluid to pass through. In these examples, the passage can be made smaller as the deviation decreases as the detected pressure approaches the target pressure.

[0037] In certain embodiments, the controller 360 may have access to a memory that stores one or more pressure thresholds and may take action in response to the detected pressure reaching a pressure threshold. For example, when the detected pressure reaches a pressure threshold, the controller 360 controls a valve to adjust the pressure. In certain embodiments, a first pressure threshold may indicate that the pressure associated with the surgical site has rapidly decreased to an unacceptable level, such as in response to an occlusion rupture. In response, the controller 360 reduces the vacuum pressure in the suction conduit 303 to mitigate the rapid decrease in surgical site pressure. A second pressure threshold may indicate that the surgical site pressure has recovered. In response, the controller 360 stops reducing the vacuum pressure in the suction conduit 303.

[0038] The controller can determine the surgical site pressure from one or more suitable sensors. In certain embodiments, a decrease in infusion pressure may indicate a decrease in surgical site pressure, for example, in response to occlusion rupture. In the illustrated example, one or more infusion pressure sensors (e.g., HPS365) detect the infusion pressure in the infusion conduit 302. A first pressure threshold can define the infusion pressure at which the controller 360 should reduce the vacuum pressure, and may have any suitable value, for example, a value in the range of 0 to 207 mmHg (e.g., a value in the range of 0 to 35, 35 to 100, or 100 to 207 mmHg).

[0039] In certain embodiments, the suction pressure may indicate when an acceptable surgical site pressure has been reached in order to mitigate post-occlusion surges. In the illustrated example, a suction pressure sensor 330 detects the suction pressure. A second pressure threshold can define the suction pressure at which the controller 360 should stop reducing the vacuum pressure and may have any suitable value, for example, a value in the range of 0 to 760 mmHg (e.g., a value in the range of 0 to 30, 30 to 300, or 300 to 760 mmHg). In some embodiments, the second pressure threshold may be chosen so that the controller 360 stops reducing the vacuum pressure before reaching a target IOP range, since the vacuum pressure usually continues to decrease for a short time after the controller 360 has acted to stop reducing it.

[0040] In the example above, a first pressure threshold defined in terms of infusion pressure and a second pressure threshold defined in terms of suction pressure are used, but the first and second thresholds may be defined in terms of using an appropriate type of pressure from any appropriate sensor indicating pressure at the surgical site (e.g., suction pressure, infusion pressure, or intraocular pressure). In addition, the first and / or second thresholds may be defined with respect to the same or different types of pressure; for example, both thresholds may be defined with respect to suction pressure.

[0041] Figures 4A to 4F show examples of operations that a valve, such as valve 337, may be controlled to perform. In certain embodiments, the controller may move a flow divider to an opening angle to open a channel of a rotary valve. As fluid flows through the channel and the pressure decreases, the flow divider may move in the opposite direction. When the flow divider reaches a closing angle indicating a decrease to a desired pressure, the controller may close the channel. The opening and closing angles may be selected based on the operation of a particular valve in a particular fluid subsystem 110, in particular the pressure achieved when the flow divider is at a particular angle in the particular fluid subsystem 110. These angles can be determined by operating the flow divider at different angles in the fluid subsystem 110 and observing the resulting pressure.

[0042] (1) Venting the reservoir. During venting (for example, for surge reduction), the channel from reservoir 333 to the suction pump 335 and / or the channel from reservoir 333 to the suction connector may be opened. Figure 4A shows channels for dual venting, from reservoir 333 through reservoir passage 390 to suction pump 335 through pump passage 392, and from reservoir 333 through reservoir passage 390 to suction connector through suction connector passage 394. Figure 4B shows channels for reservoir discharge or recirculation into the reservoir-driven suction path, from reservoir 333 through reservoir passage 390 to suction pump 335 through pump passage 392. Figure 4C shows channels for suction or recirculation by reservoir driving, from reservoir 333 through reservoir passage 390 to suction connector through suction connector passage 394.

[0043] The selection of which channel to open can be made according to any appropriate factor. For example, if there is a large deviation between the detected pressure and the pressure threshold, both channels can be opened to increase flow and vent the stored vacuum more quickly. A large deviation may be, for example, a value of 0 to 35 mmHg (e.g., a value within the range of 0 to 10, 10 to 20, or 20 to 35 mmHg).

[0044] (2) Reservoir maintenance. In one example of maintaining the fluid level in reservoir 333 so that valve 337 supports different flows in different channels, the channel from the suction connector to reservoir 333 and the channel from reservoir 333 to suction pump 335 may be opened. A pressure-vacuum source 336 may enable a vacuum in reservoir 333 to facilitate flow from the suction connector. Figure 4D shows channels for reservoir-driven suction using a discharge pump, from the suction connector via suction connector passage 394 to reservoir 333 via reservoir passage 390, and from reservoir 333 via reservoir passage 390 to suction pump 335 via pump passage 392.

[0045] (3) Suction pump-connector channel. A channel between the suction connector and the suction pump 335 (for example, from the suction connector to the suction pump 335 and / or from the suction pump 335 to the suction connector) may be open. Figure 4E shows a channel for suction directly driven by pumping, from the suction connector via the suction connector passage 394 to the suction pump 335 via the pump passage 392. Figure 4F shows a channel for pump-driven recirculation, from the suction pump 335 via the pump passage 392 to the suction connector via the suction connector passage 394. In certain embodiments, any channel to the reservoir 333 may be closed and / or the pressure-vacuum source 336 may be disabled to prevent fluid from entering or leaving the reservoir 333.

[0046] Figures 5A to 5F show examples of the operation of valve 337a, which can be controlled to perform the valve operations shown in Figures 4A to 4F. Valve 337a may be any suitable valve, for example, a single-channel valve capable of providing a dual path.

[0047] Figure 6 shows an example of a method 410 that may be used by the fluid subsystem 110 of Figure 3 to mitigate post-occlusion surge. The method begins in step 412, where the controller 360 monitors the pressure associated with the surgical site. The controller 360 may use any suitable sensor, e.g., a sensor of the fluid subsystem 110, or an ocular or intraocular sensor that directly measures the IOP of the eye, to measure the surgical site pressure in steps 412 and 418. In a particular example, the controller 360 may use an infusion sensor (e.g., HPS365) to measure the infusion pressure as the surgical site pressure. In step 414, the controller 360 determines whether the surgical site pressure has fallen below a first pressure threshold, indicating, for example, that an occlusion rupture has occurred. If no such decrease exists, the method returns to step 412, where the controller 360 continues to monitor the surgical site pressure. If such a decrease exists, the method proceeds to step 416.

[0048] In step 416, the controller 360 begins to reduce the vacuum pressure to return the surgical site pressure to the target range. In certain examples, the controller 360 may reduce the vacuum pressure by opening one or more channels of valve 337, allowing fluid to flow from reservoir 333 to suction conduit 303. In step 418, the controller 360 monitors the surgical site pressure. In certain examples, the controller 360 may measure the suction pressure as the surgical site pressure using a suction pressure sensor 330.

[0049] In step 420, the controller 360 determines whether the surgical site pressure has reached a second pressure threshold (e.g., equal to or greater than it). If the surgical site pressure has not reached the second pressure threshold, the method returns to step 418 to continue monitoring the surgical site pressure. If the surgical site pressure has reached the second pressure threshold, the method proceeds to step 422, where the controller stops reducing the vacuum pressure in step 410. In certain embodiments, the controller 360 stops reducing the vacuum pressure by closing one or more channels. The method for reducing post-occlusion surge then terminates.

[0050] Figure 7 shows another example of method 510 that may be used by the fluid subsystem 110 in Figure 3 to mitigate post-occlusion surge. Steps 512 and 514 are similar to steps 412 and 414 in Figure 5.

[0051] In certain embodiments, the fluid subsystem 110 performs steps 516a and 518a, and in other embodiments, the fluid subsystem 110 performs steps 516b and 518b. In certain embodiments, in step 516a, the controller 360 opens one or more channels of valve 337 to allow fluid to flow through in order to reduce the vacuum pressure. After a predetermined period, the controller 360 closes one or more channels in step 518a. The predetermined period may have any appropriate value, for example, 1 millisecond to 10 seconds.

[0052] In other embodiments, in step 516b, the controller 360 moves the flow divider of valve 337 to an open angle in the rotational direction to open one or more channels to allow fluid to flow through in order to reduce the vacuum pressure. As the pressure decreases, the flow divider moves in the opposite direction. After the flow divider reaches a closed angle, the controller 360 closes one or more channels in step 518b. The open and closed angles may be selected based on the operation of a particular valve 337 in a particular fluid subsystem 110, specifically based on the pressure achieved when the flow divider is at a particular angle in the fluid subsystem 110.

[0053] The controller 360 waits for a certain period before continuing normal operation in step 520. The waiting period allows the fluid subsystem 110 to normalize after the blockage is broken. The waiting period can have any appropriate value, for example, less than 10 seconds. After that, the method for mitigating the post-blockage surge is terminated.

[0054] Components of the systems and apparatus disclosed herein (such as computer 103 or controller 360) may include interfaces, logic, and / or memory, any of which may include hardware and / or software. Interfaces may receive inputs to a component, transmit outputs from a component, and / or process inputs and / or outputs. Logic may perform operations of a component. Logic may include one or more electronic devices that process data, for example, by executing instructions to produce an output from an input. Examples of such electronic devices include computers, processors, or microprocessors (e.g., central processing units (CPUs)), and computer chips. Logic may include computer software that encodes instructions that can be executed by the electronic devices to perform operations. Examples of computer software include computer programs, applications, and operating systems.

[0055] Memory may include tangible, computer-readable and / or computer-executable storage media capable of storing information. Examples of memory include computer memory (e.g., random-access memory (RAM) or read-only memory (ROM)), mass storage media (e.g., hard disks), removable storage media (e.g., compact discs (CDs) or digital video or multi-purpose discs (DVDs)), databases and / or network storage (e.g., servers), and / or other computer-readable media. Certain embodiments may involve memory encoded using computer software.

[0056] While this disclosure describes specific embodiments, modifications to the embodiments (such as changes, substitutions, additions, omissions, and / or other alterations) will be obvious to those skilled in the art. Therefore, modifications to the embodiments can be made without departing from the scope of the invention. For example, modifications can be made to the systems and apparatus disclosed herein. The components of the systems and apparatus may be integrated or separated, or the operation of the systems and apparatus may be performed by more, fewer, or other components. As another example, modifications can be made to the methods disclosed herein. The methods may include more, fewer, or other steps, and the steps may be performed in any suitable order.

[0057] To assist the Patent Office and readers in interpreting the claims, the applicant wishes to note that, unless the words “means for” or “step for” are expressly used in any particular claim, neither the claim nor any claim element is intended to evoke 35 U.S.C. § 112(f). The use of other terms in the claims (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “member,” “apparatus,” “machine,” “system,” “processor,” or “controller”) is understood by the applicant to refer to structures known to those skilled in the art in the relevant art and is not intended to evoke 35 U.S.C. § 112(f).

Claims

1. It is a surgical system, An intravenous infusion tube, which is connected to the handpiece and configured to deliver fluid toward the surgical site, A suction conduit is configured to communicate with the handpiece and transport fluid away from the surgical site, A suction pump is configured to generate vacuum pressure within the suction conduit and draw fluid through the suction conduit toward the discharge reservoir. A reservoir configured to hold fluid at a controlled reservoir pressure, A rotary valve located in the reservoir, It has one or more first channels that provide fluid communication between the reservoir and the suction conduit, and one or more second channels that provide fluid communication between the reservoir and the suction pump, The arrangement of at least one of the rotary valves provides a dual vent by providing fluid communication between the reservoir and the suction conduit and between the reservoir and the suction pump. Rotary valve and A first pressure sensor configured to detect pressure related to the surgical site, A computer configured to control the rotary valve in accordance with the pressure detected by the first pressure sensor, Equipped with, The first pressure sensor is positioned between the intravenous infusion tube and the surgical site. Surgical system.

2. The aforementioned computer, The system according to claim 1, further configured to control the rotary valve to reduce the vacuum pressure in the suction conduit when the pressure associated with the surgical site is below a first pressure threshold.

3. The aforementioned computer, The system according to claim 2, further configured to control the rotary valve to reduce the vacuum pressure by controlling the rotary valve that allows fluid to pass from the reservoir to the suction conduit.

4. The system according to claim 3, wherein controlling the rotary valve to allow fluid to pass from the reservoir to the suction conduit provides one channel of at least one first channel from the reservoir to the suction connector, and the suction connector is configured to be coupled to the handpiece.

5. The aforementioned computer, The system according to claim 3, further configured to control the rotary valve to simultaneously provide the one or more first channels between the suction conduit and the reservoir, and the one or more second channels between the reservoir and the suction pump, for dual venting.

6. The system according to claim 2, wherein the first pressure threshold has a value in the range of 0 to 207 mmHg.

7. The system according to claim 2, wherein the first pressure sensor detects when the pressure associated with the surgical site is less than a first pressure threshold.

8. The system according to claim 7, wherein the first pressure sensor comprises a drip pressure sensor configured to detect the drip pressure in the drip conduit.

9. The system according to claim 7, wherein the first pressure sensor comprises an intravenous pressure sensor configured to detect intravenous pressure at the surgical site.

10. The system according to claim 7, wherein the first pressure sensor is located in the handpiece.

11. The aforementioned computer, The system according to claim 2, further configured to control the rotary valve to stop the decrease in the vacuum pressure in the suction conduit by controlling the rotary valve to stop the passage of the fluid after a predetermined period of time.

12. The aforementioned computer, The system according to claim 2, further configured to control the rotary valve to stop the decrease in the vacuum pressure in the suction conduit by controlling the rotary valve so that when the flow divider of the rotary valve shows a decrease to a predetermined pressure, the rotary valve reaches a closed angle, and the controller closes the first channel, the passage of the fluid stops.

13. The aforementioned computer, The system according to claim 2, further configured to control the rotary valve to stop the decrease in the vacuum pressure in the suction conduit by controlling the rotary valve to stop the passage of the fluid when the pressure associated with the surgical site reaches a second pressure threshold.

14. The system according to claim 13, wherein the second pressure threshold has a value in the range of 0 to 760 mmHg.

15. The system according to claim 13, further comprising a second pressure sensor, the second pressure sensor detecting when the pressure associated with the surgical site reaches a second pressure threshold.

16. The system according to claim 15, wherein the second pressure sensor is a suction pressure sensor configured to detect the suction pressure in the suction conduit.

17. The system according to claim 1, wherein the reservoir pressure of the reservoir is maintained by a valve at a specific pressure in the range of 0 to 500 mmHg.

18. The system according to claim 1, wherein the rotary valve is positioned along the suction conduit between the suction connector and the reservoir, and the suction connector is configured to be coupled to the handpiece.

19. The system according to claim 1, wherein the computer is further configured to disable a pressure-vacuum source coupled to the reservoir.

Images