Laser Posterior Capsulotomy with Fluid Separation
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Solution Overview
Problem
Current cataract surgery techniques face challenges in creating precise openings in the lens capsule, particularly for posterior capsulotomy and accurate placement of intraocular lenses, due to difficulties in visualization, capsule manipulation, and maintaining the anterior chamber, which affects the precision and stability of IOL placement, especially in cases with astigmatism correction.
Innovation Solution
The method involves performing laser-assisted cataract surgery by injecting fluid between the lens posterior capsule and the anterior hyaloid membrane to separate them, followed by posterior capsulotomy using a laser to create precise openings, and optionally performing anterior capsulotomy and nucleus removal, with the aid of ophthalmic viscosurgical devices and imaging techniques to ensure accurate incisions and IOL placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a sharp needle is used to perforate the lens anterior capsule in a circular fashion (can-opener capsulotomy), then access to the lens nucleus is provided, but the capsulotomy is difficult to produce manually and creates radial rips and extensions
Solution Approach 1:
The patent replaces the manual mechanical needle-based can-opener technique with a laser-based system. The laser delivery system uses optical energy to precisely perforate and incise the lens capsule, eliminating the need for manual needle manipulation and achieving superior precision in capsulotomy shape and location without radial rips or extensions.
Solution Approach 2:
The patent changes the fundamental parameter of the cutting mechanism from mechanical (needle) to optical (laser). This parameter change enables precise control over the capsulotomy characteristics, allowing for accurate formation of openings in the lens capsule without the limitations of manual mechanical techniques.
2Manufacturing precision
If manual continuous curvilinear capsulorhexis is performed to provide access to the lens nucleus, then a smooth continuous circular opening is created, but the reliance on capsule shape, symmetry, uniformity, and strength limits IOL placement accuracy
Solution Approach 1:
The patent replaces the manual mechanical capsulorhexis technique with a laser-based system that provides precise control over capsulotomy formation. The laser delivery system creates accurate openings while allowing for independent control of IOL placement, eliminating the dependency between capsule morphology and IOL positioning accuracy.
Solution Approach 2:
The patent introduces a laser delivery system as an intermediary between the surgical goal (capsulotomy formation) and the outcome (IOL placement). This intermediary system provides precise, controllable capsulotomies that do not rely on capsule properties, thereby improving IOL placement accuracy independently.
3Device complexity
If the lens posterior capsule is not separated from the anterior hyaloid membrane, then the surgical field remains compact, but precise posterior capsulotomy cannot be performed
Solution Approach 1:
The patent introduces ophthalmic viscosurgical devices (OVDs) as an intermediary substance to separate the lens posterior capsule from the anterior hyaloid membrane. This mediator creates a controlled interface that enables precise laser-based posterior capsulotomy while maintaining a manageable surgical field configuration.
Solution Approach 2:
The patent uses fluid-based OVDs to create a separation interface between the lens posterior capsule and anterior hyaloid membrane. This hydraulic approach allows for precise control of the surgical field and enables accurate posterior capsulotomy without excessive complexity.
4Manufacturing precision
If fluid is injected between the lens posterior capsule and anterior hyaloid membrane to separate them, then posterior capsulotomy precision is improved, but the surgical procedure becomes more complex
Solution Approach 1:
The patent uses OVDs as a temporary intermediary that facilitates the posterior capsulotomy procedure. While this adds a step, the mediator enables precise capsulotomy that would otherwise be unachievable, and the OVD can be removed or absorbed after serving its purpose.
Solution Approach 2:
The patent performs the separation of the lens posterior capsule from the anterior hyaloid membrane as a preliminary action before the posterior capsulotomy. This preparatory step simplifies the subsequent capsulotomy procedure by creating a clear working interface, making the overall process more manageable despite the additional initial step.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables precise and controlled formation of capsulotomies, improving the accuracy and stability of IOL placement, enhancing visual acuity and refractive outcomes by minimizing complications related to capsule manipulation and astigmatism correction.
Implementation Method 1
a laser beam is scanned in three dimensions... Short-pulsed laser light can be focused into eye tissue to produce dielectric breakdown to cause photodisruption around the focal point
Implementation Method 2
injecting fluid between the lens posterior capsule and the anterior hyaloid membrane to separate the lens posterior capsule and the anterior hyaloid membrane
Data Source
AI summary
Method and apparatus for performing a laser-assisted posterior capsulotomy and for performing laser eye surgery on an eye having a penetrated cornea are provided. A method for performing a posterior capsulotomy includes injecting fluid between the lens posterior capsule and the anterior hyaloids membrane to separate the lens posterior capsule and the anterior hyaloids membrane. With the lens posterior capsule separated from the anterior hyaloids membrane, a posterior capsulotomy is performed on the lens posterior capsule by using a laser to incise the lens posterior capsule.