Phacoemulsification Performance Evaluation With IOP Impact Index
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Solution Overview
Problem
Maintaining intraocular pressure (IOP) during cataract removal operations, such as phacoemulsification, is challenging due to the combination of irrigation and aspiration, which can affect the well-being of the eye and requires a method to assess the risk to the eye.
Innovation Solution
A clinical index is calculated by integrating the deviation of IOP from a target value, along with the amount of ultrasonic energy and balanced salt solution used, to provide a comprehensive assessment of the operation's impact on the eye, displayed to the user.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If irrigation and aspiration are used during cataract removal, then the cataract can be effectively removed and the lens capsule can be cleaned, but the intraocular pressure becomes difficult to maintain within the safe range
Solution Approach 1:
The system continuously monitors intraocular pressure during the surgical procedure and provides real-time feedback to the control mechanism. This feedback loop enables dynamic adjustment of irrigation and aspiration rates to maintain IOP within the safe range of 20-200 mmHg, resolving the contradiction between effective cataract removal and pressure stability
Solution Approach 2:
The irrigation and aspiration parameters are made dynamically adjustable during the procedure rather than fixed. The system can adapt the flow rates in real-time based on current IOP conditions, surgical stage, and patient response, allowing effective lens removal while maintaining pressure within safe limits
2Productivity
If the tip of the needle vibrates at ultrasonic frequency to emulsify the cataract, then the cataract can be effectively broken down, but the tip may become blocked by lens particles
Solution Approach 1:
The ultrasonic vibration is applied in periodic cycles rather than continuously, with alternating phases of emulsification and aspiration. This periodic action prevents particle accumulation at the tip by regularly clearing emulsified material, maintaining both effective breakdown and continuous flow
Solution Approach 2:
The system maintains continuous operation by coordinating ultrasonic emulsification with simultaneous or alternating aspiration. The useful actions of breaking down the cataract and removing particles are performed in continuous sequence without interruption, preventing tip blockage while maintaining emulsification effectiveness
3Loss of information
If a clinical index is calculated by integrating multiple parameters including IOP deviation, ultrasonic energy, and balanced salt solution flow, then a comprehensive assessment of surgical impact can be provided, but the system complexity increases
Solution Approach 1:
Multiple separate measurement functions (IOP monitoring, ultrasonic energy measurement, BSS flow measurement) are merged into a unified clinical index calculation system. This integration consolidates the complexity into a single comprehensive metric that provides complete surgical impact assessment without requiring separate evaluation of each parameter
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
The clinical index effectively quantifies the potential damage to the eye by providing a non-decreasing measure that helps in minimizing deviations from the target IOP and optimizing surgical procedures.
Implementation Method 1
The tip of the needle vibrates at ultrasonic frequency, which emulsifies the cataract lens
Implementation Method 2
a pump aspirates particles and fluid from the eye through the tip
Implementation Method 3
the aspirated fluids are replaced with irrigation of a balanced salt solution to maintain the intraocular pressure
Data Source
AI summary
A method, ophthalmic surgical system, and a computer program product for assessing and providing a clinical index during an ophthalmic procedure performed on a patient, the method including: providing an ophthalmic surgical system and at least one sensor coupled with the ophthalmic surgical system for sensing a parameter within an eye of the patient; obtaining a first sequence of measured values, the first sequence of values indicating measurements taken by the at least one sensor at a plurality of points in time during the medical procedure; assessing the clinical index based at least on a function of the first sequence of measured values, the function involving a deviation of each value of the first sequence of measured values from a target; and providing to a user of the medical system an indication of the clinical index.