|Publication number||US3902495 A|
|Publication date||Sep 2, 1975|
|Filing date||Jan 28, 1974|
|Priority date||Jan 28, 1974|
|Also published as||CA1068572A, CA1068572A1|
|Publication number||US 3902495 A, US 3902495A, US-A-3902495, US3902495 A, US3902495A|
|Inventors||Steven N Weiss, Alan Broadwin|
|Original Assignee||Cavitron Corp|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (8), Referenced by (141), Classifications (13), Legal Events (6)|
|External Links: USPTO, USPTO Assignment, Espacenet|
United States Patent [1 1 Weiss et al. Sept. 2, 1975 1 FLOW CONTROL SYSTEM  ABSTRACT  Inventors: Steven N. Weiss, New York; Alan A fluidic control system for use in irrigation and aspi-  Assignee: Cavitron Corporation, New York,
 Filed: Jan. 28, 1974  Appl. No.: 437,165
 US. Cl. 128/276; 128/24 A  Int. Cl. A61M U110  Field of Search 128/276, 24 A, 303.1, 305; 137/ 102 [5 6] References Cited UNITED STATES PATENTS 3,693,613 9/1972 Kelman 128/24 A 3,732,858 5/1973 Banko 128/305 X 3,736,938 6/1973 Evvard et al..... 128/24 A X 3,776,238 12/1973 Peyman et a1. 128/305 3,809,093 5/1974 Abraham 128/305 3,812,855 5/1974 Banko 128/276 3,815,604 6/1974 OMalley et al. 128/276 3,818,913 6/1974 Wallach 128/305 Broadwin, Brooklyn, both of NY.
Sperber ration of the anterior chamber of the eye during ultrasonic emulsification of a cataract therein. The system comprises a handpiece with an (ultrasonically vibrated) hollow tip, the hollow tip being connected to the fluid withdrawal or aspirating portion, while an annular passage around the tip is used to introduce fluid for irrigation purposes. The aspirating portion comprises a withdrawal hose attached to the output manifold of the handpiece in fluid communication with the hollow tip, a constant flow pump attached to the other ehd of the withdrawal hose, and a vacuum relief valve connected to the withdrawal hose intermediate the pump and the handpiece. The irrigation portion comchamber of the eye during removal of a cataract by insertion of the handpiece tip into the eye chamber.
12 Claims, 2 Drawing Figures FLOW CONTROL SYSTEM BACKGROUND OF THE INVENTION This application relates to an improvement in the control of fluid flow in a surgical device. More particularly this invention relates to an improvement in the fluid flow systems for a surgical device useful in cataract removal such as that shown by U.S. Pat. No. 3,589,363 issued June 29, 1971 to A. Banko and C. D. Kelman for a Material Removal Apparatus and Method Employing High Frequency Vibrations. The aforesaid patent describes an instrument for breaking apart and removing unwanted tissue and material especially a cataract located in the anterior chamber of the eye by ultrasonically fragmenting the cataract while simultaneously introducing fluid into the eye chamber, and withdrawing the fluid and fragmented cataract particles. Briefly the device described includes a handpiece having an operative tip vibrating in the ultrasonic range which is also hollow and is in turn surrounded by a tubular sleeve. In operation the tip of the handpiece including the surrounding tubular sleeve are inserted into the anterior chamber of the eye. Treatment fluid is introduced through the hollow sleeve at a constant low pressure. This introduction of fluid which is called irrigation is to provide a replacement for fluid withdrawn or lost from the eye chamber. The withdrawl of fluid and suspended material from the anterior chamber is specifically called aspiration and ideally there is no change in fluid content or anterior chamber pressure as a result of irrigation-aspiration. This of course is impossible to achieve since aspiration is intended to remove solids which until broken up sometimes tend to occlude or block the fluid withdrawal openings of the handpiece.
This problem with control of fluid content and pressure within the anterior chamber of the eye during irrigation-aspiration is discussed in detail in U.S. Pat. No. 3,693,613 issued Sept. 26, 1972 to Charles Kelman for a Surgical Handpiece and Flow Control System for Use Therewith, and commonly assigned herewith.
A handpiece described in the aforesaid U.S. Pat. as well as the instrumentation described in U.S. Pat. No. 3,589,363 provides a tool tip insertable in the anterior chamber of the eye with an annular nozzle for supply of fluid for irrigation, a hollow tool tip which is vibrated at about 40,000 cps to provide the energy to break up the cataract and allow fluid withdrawal for aspirating the reduced particles and fluid. When the handpiece is inserted into the eye, it is extremely important to maintain the fluid pressure of the chamber within a certain range and to prevent rapid fluctuations of the pressure and fluid content of the chamber. A collapse of the anterior chamber for lack of sufficient pressure could result in damage to soft tissues of the eye as well as possible damage of the eye posterior capsule itself from contact of the tissues with the vibrating tool tip. This problem of maintaining the proper pressure is a particularly difficult and sensitive one and is one of the problems which the apparatus shown in the aforesaid U.S. Pat. No. 3.693.613 was designed to solve. The system shown therein while satisfactory is quite obviously a rather complex apparatus which requires in terms of control, close and competent operation personnel. Thus as part of the operation to remove a cataract from the anterior chamber of the eye the handpiece is inserted into the chamber through a small incision and the fluid flow adjusted to the desired level principally by the height at which the irrigation fluid source is supported to provide a gravity flow into the eye, and the speed of a constant flow positive displacement pump in the piping from the eye to withdraw the aspirating stream. The surgeon then moves the cataract lens into the anterior chamber, applies the ultrasonic vibration to the tip of the handpiece in contact with the lens and proceeds to break up the lens.
As part of the application of the tip to the lens the opening in the tip through which aspiration proceeds is periodically occluded by lens material. During such occlusion, fluid is prevented from entering the hollow tip, although the constant flow pump continues to operate. The pump operation thus starts drawing a vacuum in the conduit between the handpiece tip and the pump. At the same time, the pressure from the gravity feed of irrigation fluid into the eye remains constant and increases fluid pressure in the anterior chamber of they eye, expanding it somewhat. However once the opening into the handpiece tip is uncapped by fragmentation of the occlusion, the high vacuum existing in the aspirating system tends to quickly withdraw fluid from the anterior chamber. This may rapidly decompress the anterior chamber and draw the enclosing tissues towards the handpiece tip. Besides the danger represented by the ultrasonic vibrations of the handpiece tip on contact with these tissues, the rapid decompression itself may be injurious to the tissues. The apparatus shown by the aforesaid U.S. Pat. No. 3,693,613 of course is designed to eliminate such pertubrations to the eye by monitoring and controlling flow. It would be advantageous to have a system which is not only failsafe by means of being simple rather than complex, but is also more easily regulated and controlled by normal operative personnel rather than trained technicians.
SUMMARY OF THE INVENTION Accordingly we have invented a fluidic flow system for use in the irrigation and aspiration ofa small elastic pressure responsive chamber. The system comprises: a fluid source under substantially constant pressure; fluid inflow means connected to the fluid source for limiting flow of the fluid from the source into the chamber thereby providing irrigation fluid at a predetermined limited flow rate and pressure into the chamber; fluid withdrawal means in fluid communication with the chamber for aspirating fluid from the chamber at a rate to eliminate transient pressure shocks to the chamber; a constant flow pump connected to the other end of the fluid withdrawal means, with the pump acting to draw fluid from the chamber through the withdrawal means; and the withdrawal means including a pressure differential relief valve intermediate the chamber and the pump, the relief valve responsively opening at a predetermined pressure differential which in combination with the parameters of the fluid withdrawal means limits the occurrence of pressure transients communicated to the chamber, whereby flow resistivity of the withdrawal means between the chamber and the valve attenuates the pressure changes transmitted to the chamber when the valve opens in response to the predetermined pressure differential between atmosphere and the pressure in the withdrawal means reaching the predetermined differential pressure. Preferably where the enclosed volume is the anterior chamber of the eye, the relief valve opens to atmosphere in response to a pressure differential of from 10 mm of mercury (Hg) to I mm Hg; the pressure of the fluid source is in the range of from to I00 mm Hg; the flow resistivity of the inflow means is from 0.042 to 18.5 mm Hg per ml per min; the flow resistivity of the fluid withdrawal means is from 0.35 to 21.5 mm Hg per ml per min; and the constant flow volume of the pump is from 5 to 50 ml per min. More particularly the preferred pressure, flow and flow resistivity ranges of the system according to the present invention comprise the following: a fluid source exerting a constant pressure of from 30 to 60 mm Hg; the inflow means having a flow resistivity of from 0.5 to 2.5 mm Hg. ml per min between the fluid source at one end and to the operative volume of the anterior chamber of an eye at the other end; the fluid withdrawal means having a flow resistivity of from 1.33 to 3.0 mm Hg. per ml per min. from the operative volume of the anterior chamber of the eye and to the atmosphere; the constant volume pump having a flow rate of from to ml per min; and the relief valve connected to the flow withdrawal means intermediate the pump and the eye chamber responsively opening the atmosphere at a pressure differential of between about 30 and 50 mm Hg.
It is therefore an object of this invention to provide a fluidic control system for use in irrigating and aspirating a small enclosed elastic volumetric space.
Another object of the present invention is to provide an effective flow control system for irrigating and aspirating the anterior chamber of the eye.
Yet another object of the present invention is to provide a flow control system for effectively limiting the transient pressure and flow changes as felt by the anterior chamber of the eye during irrigation and aspiration thereof.
Other objects and advantages of the system according to the present invention will be apparent from the brief description of the drawings and the preferred embodiment which follows.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 of the drawings is a diagram of the fluidic flow control system of the present invention; and
FIG. 2 of the drawings is an electrical circuit analog of the flow control system of FIG. 1.
DESCRIPTION OF THE PREFERRED EMBODIMENT In the US. Pat. No. 3,589,363 described hereinbefore and which is incorporated herein by reference. apparatus and method for the removal of material by employing high frequency vibration is shown and described. Briefly the aforesaid patent describes an instrument for breaking apart and removing unwanted material such as for surgically removing a cataract from the eye. The apparatus includes a handpiece having an operative tip vibrating at a frequency in the ultrasonic range (preferably about 40.000 cps) with an amplitude controllable up to several thousandths of an inch. The operative tip is itself hollow and is in turn surrounded by a tubular sleeve forming an annular passage. The inflow fluid for irrigating the anterior chamber of the eye is introduced into the chamber through the annular passage and the broken up material. small particles and fluid in the eye, is withdrawn at the same time through the hollow tip to aspirate the chamber.
Referring now to FIG. 1 of the drawings wherein a simplified diagram of a handpiece 12 is shown with an operative tip 14 having a hollow withdrawal means 16, and an annular passage 18 surrounding the tip 14 for introducing fluid into an anterior chamber 20 of an eye undergoing cataract surgery. For a more detailed description of the handpiece 12 described above. reference is made to the handpieces shown in the aforesaid US. Pat. Nos. 3.589.363 and 3.693.613 commonly assigned to the assignee herein.
Irrigation fluid is introduced into the handpiece 12 via an inflow hose 22 which is connected at one end to the handpiece and at the other end to an administration set 23. that is a hose connected to an irrigation fluid supply bottle 24 suspended by an appropriate bracket (not shown) a fixed height I: over the level of the hand piece and eye. The fixed height h at which the fluid supply bottle is suspended acts to apply a fixed fluid pressure to fluid entering the hose 22 from the bottle to the eye. The selected height is such as to apply a pressure of from about l0 mm Hg to about I00 mm Hg to fluid entering the administration set and thereby furnish a fluid source having a constant preselected pressure level in relation to the handpiece.
More preferably the height at which the supply bottle is suspended is such as to apply a pressure head of from 30 mm Hg to 60 mm Hg. According to the present invention, this is the sole means for supplying the pressure head which forces the flow of fluid from the bottle through the administration set 23, the inflow hose 22 and the annular passage of the handpiece into the anterior chamber of the eye.
For purposes of this invention the pressure which is internally applied to the eye is of prime importance. For instance. as described in US Pat. No. 3.693.613. it is very important that pressure of the anterior chamber of the eye be maintained within a certain range of values to prevent damage thereto. A collapse of the anterior chamber due to reduced pressure could result in either the iris. the endothelium layer of the cornea. or the posterior capsule as well as other soft tissue. coming in contact with the operating tip of the handpiece. This problem of maintaining the proper pressure is a particularly difficult and sensitive one in the case of an operative site such as the anterior chamber, which is considerably smaller in volume than the volume of fluid necessary for continuous irrigation and aspirationv The anterior chamber of the eye is. of course, in the same pressure related system as the apparatus of this invention. In a cataract operation, pressure transients are periodically being induced at the tip of the handpiece due to the presence of a particle or part of the cataract. This initially prevents entry of aspirating fluid into the tip with resulting buildup of suction in the tip. and then sudden clearance of the occlusion blocking the handpiece tip. The apparatus shown in the US. Pat. No. 3.693.613 is designed to reduce and overcome this problem and as such is effective though expensive and complicated.
Basically the present invention provides an irrigation system which limits the fluid pressure to which the anterior chamber of the eye is subject by limiting the height at which the irrigation fluid supply is maintained in reference to the eye, and by further limiting the flow rate into the eye utilizing specified inflow means having a specified resistivity to flow. as well as relating the irrigation system to the fluid withdrawal or aspiration system. That portion of the fluidic system comprising the fluid withdrawal means, the constant flow pump and the differential pressure relief valve act in combination to limit fluid flow from the eye, and more importantly prevent sudden pressure changes or pressure transients from occuring by increasing the time period over which the pressure changes occur and by limiting the maximum pressure drop to which theeye would be exposed. This is accomplished by controlling the constant flow rate of the pump; by setting a predetermined limit to the pressure differential, the relief valve will open to atmosphere; and by controlling the flow resistivity of the fluid piping as herein described.
Referring back to FIG. 1 of the drawing the operative tip 14 of the handpiece is hollow and has an internal fluid withdrawal passage 30 constituting part of the fluid withdrawal system of the present invention utilized in aspirating the operative site of the eye. A fluid withdrawal pipe 32 is connected to the handpiece at one end and is in fluid communication with the fluid withdrawal passage. The other end of the fluid withdrawal pipe is connected to a constant flow pump 34 preferably a constant displacement, variable speed, peristaltic pump. The peristaltic feature acts to avoid any contact of the operating parts with the withdrawn fluid suspension. Intermediate the pump 34 and the handpiece, a relief valve 36 is connected by a T joint 38 to the fluid withdrawal pipe and is set to open to atmosphere should the pressure differential in the fluid withdrawal pipe exceed a predetermined pressure, which pressure may be from 30 mm Hg to 50 mm Hg. Preferably the pressure differential at which the relief valve opens is a pressure of about 40 mm Hg. Constant flow capacity of the pump is preferably a flow of from about ml per min to ml per minute. Flow resistivity of the fluid withdrawal means at these preferred conditions is from about l.33 mm Hg to about 3.0 mm Hg. Flow resistivity in the fluid inflow system is on the order of from about 0.5 to about 2.5 mm Hg per ml per min.
We have therefore described an effective, economical system for irrigating and aspirating the anterior chamber of the eye during an operation involving the insertion of a handpiece through a small incision in the eye and during which parts of the eye such as a cataract are reduced by the action of an ultrasonically vibrating tip. With reference to further understanding the operation of our invention reference is now made to FIG. 2 of the drawing which shows the electrical analog circuit which led to the fluidic control system of this invention. it must be further understood that each part of our invention functions in relation to a moderately uncontrollable set of conditions imposed by the needs of the operative site, i.e., anterior chamber of human eye and the size of the operative incision. The conditions in the anterior chamber of the eye are analogized by two electrical elements which are a resistive element 44 to account for flow resistivity through the incision, and a capacitor 45 to correspond to elasticity of the eye chamber, both elements being in parallel and connected to ground at one end and at the other end to the inflow irrigation system and the fluid withdrawal system. The fluid inflow system is analogized by a constant voltage source 46 corresponding to the fluid supply bottle set at a specified height to provide a constant pressure head; administration set resistance 47 corresponding to the flow resistivity thereof; an inflow resistance 48 corresponding to flow resistivity of the inflow hosing, and a resistance 50 corresponding to the flow resistivity of the fluid inflow manifold of the handpiece. For the fluid withdrawal system a pipe resistance 52 corresponds to the resistivity imposed in the fluid withdrawal piping, and of the handpiece by outflow manifold resistance 54.
The relief valve is analogized by a diode 56 and a zener diode 58 back to back in series at one end to the fluid withdrawal pipe and at the other end to ground (or atmosphere). The constant flow pump is analogized by inserting a hypothetical electrical current element 60 acting as a constant current source. In terms of the electrical analogues of the fluid parameters, resistance (R) is equivalent to flow resistance in pressure terms; voltage (V) is equivalent to a pressure source in mm Hg; and current amperes (I) is equivalent to flow in ml per min. Utilizing the above analogy we have been able to-conceive and build our invention and relate various known conditions in determining the operative parameters which are described hereinbefore.
The system is able to accomplish the irrigationaspiration of the anterior chamber of the eye, while at the same time reducing transients introduced by occlusions of the fluid withdrawal or aspirating system. It can by seen be by our invention, we have provided a simplified though quite effective fluidic control system for use in conjunction with the operative system described herein and in the aforesaid U.S. Pat. No. 3,589,363 and which provides the safeguards, effectiveness, ease of use, and operative usefullness desired by the system shown in U.S. Pat. No. 3,693,613.
Our invention may be employed with certain modifications and variations. For instance, the irrigation portion of our system may be employed without the aspiration system. In this mode of employment flow of fluid into the eye is as previously described while flow of fluid out of the anterior chamber of the eye is through the opening or incision made therein for the insertion of the handpiece tip. A modification of the irrigation system is shown in the drawings in solid line, where a pressure means for relief of undue pressure head is employed. The pressure means comprises a pressure relief valve 39 connected to the inflow hose 22 by a tube 40. The pressure relief valve 39 is selected to prevent undue pressure from being applied through the irrigation system to the eye chamber. The analogous components shown in FIG. 2 of the drawings to such a pressure relief means incorporated in the irrigation system comprise a diode 64 connected to the circuit between resistors 48 and 50 and a zener diode 62 connected back to back with the diode 64. The zener diode anode is connected to ground (atmosphere). By this variation we are able to further limit the pressure which can be communicated to the eye chamber through the irrigation system.
Having thus described our preferred embodiment and wishing to cover those aspects of our invention which would be apparent to those skilled in the art, from the invention herein but without departing from either the spirit or scope thereof, we claim:
1. A fluidic flow system for use in irrigationaspiration of a small elastic pressure responsive chamber, said system compising a fluid source at a pressure of from about 10 to mm Hg, fluid inflow means connected to said fluid source and in fluid communication with said chamber for (introducing) conducting from said source into said chamber, thereby providing irrigation, said fluid inflow means having a flow resistivity of from about 0.42 to 18.5 mm. Hg. per ml per min, fluid withdrawal means in fluid communication with said chamber for aspirating fluid from said chamber, said fluid withdrawal means having a flow resistivity of from about 0.35 to 21.5 mm Hg. per ml per min., thereby aspirating said chamber at a rate to limit rapid pressure changes in said chamber, constant flow pump means connected to said fluid withdrawal means at a point remote from said chamber, said pump means having a flow rate of from about to 50 ml per min. and acting to draw fluid from said chamber into said fluid withdrawal means, and
pressure responsive valve means connected to said fluid withdrawal means intermediate said chamber and said pump means, said pressure responsive valve means opening said fluid withdrawal means to atmosphere at a predetermined pressure differential of between about and 100 min Hg. to thereby limit vacuum buildup in said fluid withdrawal means, said flow resistivities, flow rates and pressure differential act in combination to prevent excessive pressure and pressure transients in said chamber.
2. The fluidic flow system according to claim 1 wherein said chamber is the anterior chamber of the eye.
3. The fluid flow system according to claim 2 wherein said fluid supply pressure is about 45 mm Hg, the pressure response means opens at a pressure differential of about 40 mm Hg, said pump has a flow rate of about ml per min, the flow resistivity of said inflow means between said fluid source and said chamber opening is about 1.06 mm Hg per ml per min. and said fluid withdrawal means flow resistivity between said chamber and said pump is about 1.57 mm Hg per ml per min.
4. The fluidic flow system according to claim 1 wherein said fluid source pressure is in the range of from about to 60 mm Hg, said fluid inflow means has a flow resistivity of from about 0.5 to 2.5 mm Hg per ml per min. between said fluid source and said chamber, said fluid withdrawal means has a flow resistivity of from about 1.33 to 3.0 mm Hg per ml per min. between said chamber and said pump, said constant flow pump has a flow rate of from about 20 to 30 ml per min. and said pressure response means opens at a differential pressure between about 30 and 50 mm Hg.
5. The fluidic flow system according to claim 2 which additionally comprises a handpiece having an inflow manifold therethrough connected said fluid inflow means,
a hollow tip mounted on the distal portion of said handpiece, said hollow tip being in fluid communication with said fluid withdrawal means, and capable of being inserted into the chamber of the eye,
a fluid passage mounted adjacent said tip on said handpiece, said fluid passage being in fluid communication with said handpiece inflow manifold, said passage having an opening which is in fluid communication with the anterior chamber of the eye when the tip is inserted in the eye.
6. The fluidic flow system according to claim 5 wherein said hollow tip is ultrasonically vibrated.
7. The fluid flow system according to claim 6 wherein said fluid source is a fluid supply bottle supported at a 5 predetermined height about the level of the eye, thereby establishing a constant pressure, and said fluid inflow means comprises an administration set between said supply bottle and a fluid hose connected to said handpiece fluid inflow manifold.
10 8. The fluidic flow system according to claim 1 wherein said chamber is the anterior chamber of the eye, said eye chamber being characterized by being a small elastic pressure responsive volume, said system being further characterized by said fluid source applying a limited pressure of about mm Hg applied thereto to limit pressure imposed within the chamber of the eye,
9. A method of providing irrigationaspiration to a small elastic pressure responsive chamber, said method comprising,
supplying fluid to a chamber at a pressure of from about 30 to 60 mm Hg and a flow resistivity to said chamber of from about 0.5 to 2.5 mm Hg. per ml per min. pumping fluid from the chamber at a limited rate (into) through a flow withdrawal means at a flow rate of from about 5 to ml per min. subject to a flow resistivity of from about 0.35 to 21.5 mm Hg. per ml per min. responsively opening said flow withdrawal means to ambiant pressure in response to a per determined pressure differential of between about 10 and 100 mm Hg. between pressure on said withdrawal means and pressure. slowing fluid flow from the chamber in order to prevent pressure transmient from occuring between said flow withdrawal means and the chamber immediately after said opening. 10. The method of claim 9 wherein said step of pumping fluid from the chamber comprises applying a flow resistivity in the flow withdrawal means of from about 1.33 to 3.0 mm Hgs per ml per min. at a constant pumping rate of from about 20 to 30 ml per min. while simultaneously limiting 45 the pressure differential between about 30 and 50 mm Hg. 11. The method of claim 9 including the step of supplying fluid to the anterior chamber of the eye.
12. A method of providing irrigation-aspiration to the 50 anterior chamber of the eye, said method comprising, supplying fluid to said chamber at a pressure of about 45 mm Hg. and a flow resistivity to said chamber of 1 mm Hg. per ml per min. pumping fluid from the chamber at a limited rate through a flow withdrawal means at a flow rate of about 25 ml per min.
subject to a flow resistivity of about 1.6 mm Hg. per ml per min.
responsively opening said flow withdrawal means to ambiant pressure in response to a predetermined pressure differential of about 40 mm Hg. between pressure on said withdrawal means and ambi nt pressure.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US3693613 *||Dec 9, 1970||Sep 26, 1972||Cavitron Corp||Surgical handpiece and flow control system for use therewith|
|US3732858 *||Feb 14, 1969||May 15, 1973||Surgical Design Corp||Apparatus for removing blood clots, cataracts and other objects from the eye|
|US3736938 *||Nov 15, 1971||Jun 5, 1973||Nasa||Ophthalmic method and apparatus|
|US3776238 *||Aug 24, 1971||Dec 4, 1973||Univ California||Ophthalmic instrument|
|US3809093 *||Apr 14, 1972||May 7, 1974||Abraham S||Surgical tool|
|US3812855 *||Dec 15, 1971||May 28, 1974||Surgical Design Corp||System for controlling fluid and suction pressure|
|US3815604 *||Jun 19, 1972||Jun 11, 1974||R Heintz||Apparatus for intraocular surgery|
|US3818913 *||Aug 30, 1972||Jun 25, 1974||Wallach M||Surgical apparatus for removal of tissue|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US4011870 *||Mar 5, 1976||Mar 15, 1977||Michael Goldstein||Needle instrument|
|US4014333 *||Sep 22, 1975||Mar 29, 1977||Mcintyre David J||Instrument for aspirating and irrigating during ophthalmic surgery|
|US4033349 *||Apr 13, 1976||Jul 5, 1977||The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration||Corneal seal device|
|US4041947 *||Jun 23, 1975||Aug 16, 1977||Cavitron Corporation||Flow control system|
|US4056855 *||Apr 7, 1976||Nov 8, 1977||Charles Kelman||Intraocular lens and method of implanting same|
|US4136700 *||Jun 14, 1976||Jan 30, 1979||Cavitron Corporation||Neurosonic aspirator|
|US4184491 *||Aug 31, 1977||Jan 22, 1980||The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration||Intra-ocular pressure normalization technique and equipment|
|US4314560 *||Nov 28, 1979||Feb 9, 1982||Helfgott Maxwell A||Powered handpiece for endophthalmic surgery|
|US4363326 *||Dec 22, 1980||Dec 14, 1982||Advanced Diagnostic Research Corporation||Ultrasonic apparatus for needle insertion|
|US4493694 *||May 25, 1984||Jan 15, 1985||Cooper Lasersonics, Inc.||Surgical pre-aspirator|
|US4504264 *||Sep 24, 1982||Mar 12, 1985||Kelman Charles D||Apparatus for and method of removal of material using ultrasonic vibraton|
|US4516398 *||Jun 5, 1984||May 14, 1985||Cooper Lasersonics, Inc.||Method of use of an ultrasonic surgical pre-aspirator having a orifice by-pass|
|US4650461 *||Feb 18, 1986||Mar 17, 1987||Woods Randall L||Extracapasular cortex irrigation and extraction|
|US4670006 *||Sep 12, 1986||Jun 2, 1987||Sinnett Kevin B||Fluid and air infusion device|
|US4689040 *||Apr 29, 1985||Aug 25, 1987||Thompson Robert J||Tip for a phacoemulsification needle|
|US4750488 *||Feb 27, 1987||Jun 14, 1988||Sonomed Technology, Inc.||Vibration apparatus preferably for endoscopic ultrasonic aspirator|
|US4750902 *||May 19, 1986||Jun 14, 1988||Sonomed Technology, Inc.||Endoscopic ultrasonic aspirators|
|US4832685 *||Oct 6, 1987||May 23, 1989||Coopervision, Inc.||Fluid flow control system and connecting fitting therefor|
|US4921476 *||May 2, 1988||May 1, 1990||Cavitron, Inc.||Method for preventing clogging of a surgical aspirator|
|US4921477 *||Jun 21, 1989||May 1, 1990||The Cooper Companies, Inc.||Surgical irrigation and aspiration system with dampening device|
|US4922902 *||Dec 16, 1987||May 8, 1990||Valleylab, Inc.||Method for removing cellular material with endoscopic ultrasonic aspirator|
|US4924851 *||Jan 5, 1989||May 15, 1990||Societe Dite Sinergy S.A.||Surgical apparatus|
|US4935005 *||Feb 1, 1989||Jun 19, 1990||Nestle, S.A.||Opthalmic fluid flow control system|
|US5084012 *||Mar 22, 1991||Jan 28, 1992||Kelman Charles D||Apparatus and method for irrigation and aspiration of interior regions of the human eye|
|US5160317 *||Jan 3, 1991||Nov 3, 1992||Costin John A||Computer controlled smart phacoemulsification method and apparatus|
|US5185002 *||Jun 28, 1991||Feb 9, 1993||Alcon Surgical, Inc.||Transducer apparatus having water hammer dampening means|
|US5197947 *||Oct 24, 1991||Mar 30, 1993||University Of New Mexico||Powered clysis and clyser|
|US5279547 *||Dec 20, 1991||Jan 18, 1994||Alcon Surgical Inc.||Computer controlled smart phacoemulsification method and apparatus|
|US5318570 *||Jun 11, 1991||Jun 7, 1994||Advanced Osseous Technologies, Inc.||Ultrasonic tool|
|US5324297 *||Mar 5, 1991||Jun 28, 1994||Advanced Osseous Technologies, Inc.||Ultrasonic tool connector|
|US5328456 *||Apr 23, 1993||Jul 12, 1994||Nidek Co., Ltd.||Irrigation and aspiration apparatus|
|US5334183 *||Apr 9, 1992||Aug 2, 1994||Valleylab, Inc.||Endoscopic electrosurgical apparatus|
|US5370602 *||Jul 29, 1993||Dec 6, 1994||American Cyanamid Company||Phacoemulsification probe circuit with pulse width Modulating drive|
|US5382251 *||Feb 14, 1992||Jan 17, 1995||Biomet, Inc.||Plug pulling method|
|US5417654 *||Feb 2, 1994||May 23, 1995||Alcon Laboratories, Inc.||Elongated curved cavitation-generating tip for disintegrating tissue|
|US5476448 *||Oct 19, 1994||Dec 19, 1995||Urich; Alex||Apparatus for suppressing a vacuum surge in eye surgery|
|US5520633 *||Nov 8, 1993||May 28, 1996||Costin; John A.||Computer controlled smart phacoemulsification method and apparatus|
|US5562612 *||Mar 9, 1995||Oct 8, 1996||Charles D. Kelman||Apparatus and method for reverse flow irrigation and aspiration of interior regions of the human eye|
|US5685841 *||Aug 14, 1995||Nov 11, 1997||Mackool; Richard J.||Support for fluid infusion tube for use during eye surgery|
|US5722945 *||Apr 1, 1996||Mar 3, 1998||Aziz Yehia Anis||Removal of tissue|
|US5827292 *||Feb 12, 1996||Oct 27, 1998||Anis; Aziz Yehia||Removal of tissue|
|US5921999 *||Jun 3, 1997||Jul 13, 1999||Dileo; Frank||System and method employing a pie-zoelectric crystal and transverse oscillation to perform a capsulotomy|
|US5941887 *||Sep 3, 1996||Aug 24, 1999||Bausch & Lomb Surgical, Inc.||Sleeve for a surgical instrument|
|US5984904 *||Aug 22, 1996||Nov 16, 1999||Bausch & Lomb Surgical, Inc.||Sleeve for a surgical instrument|
|US6013048 *||Nov 7, 1997||Jan 11, 2000||Mentor Corporation||Ultrasonic assisted liposuction system|
|US6203516||Aug 21, 1997||Mar 20, 2001||Bausch & Lomb Surgical, Inc.||Phacoemulsification device and method for using dual loop frequency and power control|
|US6283937 *||Jun 29, 1999||Sep 4, 2001||Nidek Co. Ltd.||Irrigation/aspiration apparatus|
|US6352519||May 18, 2000||Mar 5, 2002||Aziz Yehia Anis||Removal of tissue|
|US6599271||Apr 13, 2000||Jul 29, 2003||Syntec, Inc.||Ophthalmic flow converter|
|US6702761||Mar 6, 2001||Mar 9, 2004||Fonar Corporation||Vibration assisted needle device|
|US7008383||Dec 4, 2003||Mar 7, 2006||Fonar Corporation||Method of conducting a needle biopsy procedure|
|US7303566 *||Jun 20, 2003||Dec 4, 2007||Makoto Kishimoto||Decompression-compensating instrument for ocular surgery, instrument for ocular surgery provided with the same and method of ocular surgery|
|US7357779||Mar 23, 2001||Apr 15, 2008||Graham David Barrett||Aspiration flow modulation device|
|US7572242||Aug 19, 2005||Aug 11, 2009||Alcon, Inc.||Method of operating an ultrasound handpiece|
|US7625388||Feb 28, 2005||Dec 1, 2009||Alcon, Inc.||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US7645255||Feb 28, 2005||Jan 12, 2010||Alcon, Inc.||Method of controlling a surgical system based on irrigation flow|
|US7645256||Jul 18, 2005||Jan 12, 2010||Alcon, Inc.||Ultrasound handpiece|
|US7651490||Aug 12, 2004||Jan 26, 2010||Alcon, Inc.||Ultrasonic handpiece|
|US7713202||Jul 26, 2005||May 11, 2010||Alcon, Inc.||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US7727193||Jul 26, 2005||Jun 1, 2010||Alcon, Inc.||Method of controlling a surgical system based on a rate of change of an operating parameter|
|US7758538||Jul 26, 2005||Jul 20, 2010||Alcon, Inc.||Method of controlling a surgical system based on irrigation flow|
|US7811255||Feb 28, 2005||Oct 12, 2010||Alcon, Inc.||Method of controlling a surgical system based on a rate of change of an operating parameter|
|US8034018||Dec 20, 2007||Oct 11, 2011||Bausch & Lomb Incorporated||Surgical system having means for stopping vacuum pump|
|US8048020||Jun 3, 2010||Nov 1, 2011||Alcon, Inc.||Method of controlling a surgical system based on irrigation flow|
|US8070711||Dec 9, 2009||Dec 6, 2011||Alcon Research, Ltd.||Thermal management algorithm for phacoemulsification system|
|US8172786||Jul 16, 2009||May 8, 2012||Alcon Research, Ltd.||Method of operating an ultrasound handpiece|
|US8241242||Mar 30, 2005||Aug 14, 2012||Abbott Medical Optics Inc.||Phacoaspiration flow restrictor with bypass tube|
|US8246579||Dec 20, 2007||Aug 21, 2012||Bausch & Lomb Incorporated||Surgical system having means for pressurizing venting valve|
|US8257307||Oct 12, 2009||Sep 4, 2012||Alcon Research, Ltd.||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US8277830||Oct 4, 2011||Oct 2, 2012||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US8298578||Oct 4, 2011||Oct 30, 2012||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US8303530||May 10, 2007||Nov 6, 2012||Novartis Ag||Method of operating an ultrasound handpiece|
|US8399006||Jan 29, 2010||Mar 19, 2013||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US8403851||Jan 22, 2010||Mar 26, 2013||Novartis Ag||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US8414605||Jul 8, 2011||Apr 9, 2013||Alcon Research, Ltd.||Vacuum level control of power for phacoemulsification hand piece|
|US8430838||Jan 6, 2010||Apr 30, 2013||Novartis Ag||Method of controlling a surgical system based on irrigation flow|
|US8486052||Dec 27, 2010||Jul 16, 2013||The Johns Hopkins University School Of Medicine||Reservoir device for intraocular drug delivery|
|US8523812||Sep 3, 2010||Sep 3, 2013||Alcon Research, Ltd.||Method of controlling a surgical system based on a rate of change of an operating parameter|
|US8579851||Dec 20, 2007||Nov 12, 2013||Bausch & Lomb Incorporated||Surgical system having means for isolating vacuum pump|
|US8579929||Sep 3, 2010||Nov 12, 2013||Alcon Research, Ltd.||Torsional ultrasound hand piece that eliminates chatter|
|US8623040||Jul 1, 2009||Jan 7, 2014||Alcon Research, Ltd.||Phacoemulsification hook tip|
|US8623395||Aug 5, 2011||Jan 7, 2014||Forsight Vision4, Inc.||Implantable therapeutic device|
|US8721594||Jun 19, 2007||May 13, 2014||Alcon Research, Ltd.||Post-occlusion chamber collapse canceling system for a surgical apparatus and method of use|
|US8771301||Sep 11, 2009||Jul 8, 2014||Alcon Research, Ltd.||Ultrasonic handpiece|
|US8784357||Sep 15, 2010||Jul 22, 2014||Alcon Research, Ltd.||Phacoemulsification hand piece with two independent transducers|
|US8795712||May 7, 2013||Aug 5, 2014||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US8808727||Mar 15, 2013||Aug 19, 2014||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US8814894||Sep 11, 2009||Aug 26, 2014||Novartis Ag||Ultrasound handpiece|
|US8882678||Mar 12, 2010||Nov 11, 2014||Atrium Medical Corporation||Pleural drainage system and method of use|
|US8905963||May 7, 2013||Dec 9, 2014||Forsight Vision4, Inc.||Injector apparatus and method for drug delivery|
|US8974412||Aug 3, 2012||Mar 10, 2015||Novartis Ag||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US8992493||Jan 28, 2011||Mar 31, 2015||Atrium Medical Corporation||Chest drainage systems and methods|
|US9033911||Aug 5, 2011||May 19, 2015||Forsight Vision4, Inc.||Injector apparatus and method for drug delivery|
|US9066779||Jan 3, 2014||Jun 30, 2015||Forsight Vision4, Inc.||Implantable therapeutic device|
|US9180046||Jul 15, 2013||Nov 10, 2015||The Johns Hopkins University School Of Medicine||Reservoir device for intraocular drug delivery|
|US9233021||Oct 24, 2013||Jan 12, 2016||Alcon Research, Ltd.||Phacoemulsification hook tip|
|US9282989||Oct 31, 2012||Mar 15, 2016||Novartis Ag||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US9314599||Sep 8, 2014||Apr 19, 2016||Atrium Medical Corporation||Pleural drainage system and method of use|
|US9417238||Nov 14, 2013||Aug 16, 2016||Forsight Vision4, Inc.||Posterior segment drug delivery|
|US9474756||Aug 6, 2015||Oct 25, 2016||Forsight Vision4, Inc.||Stable and soluble formulations of receptor tyrosine kinase inhibitors, and methods of preparation thereof|
|US9480782 *||Jan 9, 2014||Nov 1, 2016||R. Ashley Burrow||Surgical aspiration and irrigation|
|US9492315||Aug 5, 2011||Nov 15, 2016||Forsight Vision4, Inc.||Implantable therapeutic device|
|US9522082||Mar 3, 2016||Dec 20, 2016||The Johns Hopkins University||Reservoir device for intraocular drug delivery|
|US9526654||Mar 27, 2014||Dec 27, 2016||Forsight Vision4, Inc.||Ophthalmic implant for delivering therapeutic substances|
|US9549850||Apr 26, 2013||Jan 24, 2017||Novartis Ag||Partial venting system for occlusion surge mitigation|
|US9561321||Nov 27, 2012||Feb 7, 2017||Alcon Research, Ltd.||Selectively moveable valve elements for aspiration and irrigation circuits|
|US20030078591 *||Mar 23, 2001||Apr 24, 2003||Barrett Graham David||Aspiration flow modulation device|
|US20040000187 *||Jun 12, 2003||Jan 1, 2004||Mitsuyuki Kobayashi||Evaporative emission leak detection system with brushless motor|
|US20050209560 *||Feb 28, 2005||Sep 22, 2005||Alcon, Inc.||Method of controlling a surgical system based on a rate of change of an operating parameter|
|US20050209561 *||Apr 5, 2004||Sep 22, 2005||Raphael Gordon||Method of detecting surgical events|
|US20050228425 *||Feb 28, 2005||Oct 13, 2005||Alcon, Inc.||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US20050261628 *||Jul 26, 2005||Nov 24, 2005||Alcon, Inc.||Method of controlling a surgical system based on a rate of change of an operating parameter|
|US20050261715 *||Jul 26, 2005||Nov 24, 2005||Alcon, Inc.||Method of controlling a surgical system based on a load on the cutting tip of a handpiece|
|US20050267504 *||Jul 26, 2005||Dec 1, 2005||Alcon, Inc.||Method of controlling a surgical system based on irrigation flow|
|US20050277869 *||Aug 19, 2005||Dec 15, 2005||Alcon, Inc.||Method of operating an ultrasound handpiece|
|US20060036180 *||Aug 12, 2004||Feb 16, 2006||Mikhail Boukhny||Ultrasonic handpiece|
|US20060041220 *||Jul 18, 2005||Feb 23, 2006||Alcon, Inc.||Ultrasound handpiece|
|US20060058811 *||Jun 20, 2003||Mar 16, 2006||Makoto Kishimoto||Decompression-compensating instrument for ocular surgery, instrument for ocular surgery provided with same and method of ocular surgery|
|US20060078448 *||Oct 11, 2005||Apr 13, 2006||Holden Hugo R||Phacoemulsification machine with post-occlusion surge control system and related method|
|US20060224163 *||Mar 30, 2005||Oct 5, 2006||Sutton Thomas B||Phaco aspiration flow restrictor with bypass tube|
|US20080172076 *||Nov 1, 2006||Jul 17, 2008||Alcon, Inc.||Ultrasound apparatus and method of use|
|US20080281253 *||May 10, 2007||Nov 13, 2008||Injev Valentine P||Method of Operating an Ultrasound Handpiece|
|US20080319374 *||Jun 19, 2007||Dec 25, 2008||Jaime Zacharias||Post-occlusion chamber collapse canceling system for a surgical apparatus and method of use|
|US20090163852 *||Dec 20, 2007||Jun 25, 2009||Cull Laurence J||Surgical System Having Means for Isolating Vacuum Pump|
|US20090163863 *||Dec 20, 2007||Jun 25, 2009||Mark Ian Lutwyche||Surgical System Having Means for Stopping Vacuum Pump|
|US20090306583 *||Jul 16, 2009||Dec 10, 2009||Mikhail Boukhny||Method of Operating An Ultrasound Handpiece|
|US20100004585 *||Sep 11, 2009||Jan 7, 2010||Mikhail Boukhny||Ultrasonic Handpiece|
|US20100036256 *||Aug 8, 2008||Feb 11, 2010||Mikhail Boukhny||Offset ultrasonic hand piece|
|US20100036406 *||Oct 12, 2009||Feb 11, 2010||Alcon, Inc.||Method of Controlling a Surgical System Based on a Load on the Cutting Tip of a Handpiece|
|US20100094321 *||Oct 10, 2008||Apr 15, 2010||Takayuki Akahoshi||Ultrasound Handpiece|
|US20100130914 *||Jan 6, 2010||May 27, 2010||Alcon, Inc.||Method Of Controlling A Surgical System Based On Irrigation Flow|
|US20100324581 *||Sep 3, 2010||Dec 23, 2010||Alcon, Inc.||Torsional Ultrasound Hand Piece That Eliminates Chatter|
|US20110015563 *||Sep 3, 2010||Jan 20, 2011||Alcon, Inc.||Method Of Controlling A Surgical System Based On A Rate Of Change Of An Operating Parameter|
|US20110071415 *||Mar 12, 2010||Mar 24, 2011||Atrium Medical Corporation||Pleural drainage system and method of use|
|US20110137232 *||Dec 9, 2009||Jun 9, 2011||Alcon Research, Ltd.||Thermal Management Algorithm For Phacoemulsification System|
|US20140221909 *||Jan 9, 2014||Aug 7, 2014||R. Ashley Burrow||Surgical Aspiration and Irrigation|
|USD698019||Mar 5, 2013||Jan 21, 2014||Alcon Research, Ltd.||Ophthalmic surgical cassette|
|CN101932348B||Dec 18, 2008||Aug 28, 2013||博士伦公司||Surgical system having means for pressurizing venting valve|
|WO1992016246A1 *||Oct 31, 1991||Oct 1, 1992||Kelman Charles D||Apparatus, method for eye irrigation and aspiration|
|WO2001070152A1 *||Mar 23, 2001||Sep 27, 2001||Graham David Barrett||An aspiration flow modulation device|
|WO2011112291A1 *||Jan 28, 2011||Sep 15, 2011||Atrium Medical Corporation||Chest drainage systems and methods|
|U.S. Classification||604/22, 604/119, 606/128, 604/28|
|International Classification||A61M1/00, A61F9/00, A61M3/02|
|Cooperative Classification||A61M1/0058, A61M3/0233, A61F9/00, A61M2001/0033, A61M3/0241|
|Jul 21, 1989||AS||Assignment|
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|Jan 23, 1989||AS||Assignment|
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|May 11, 1984||AS||Assignment|
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|May 11, 1984||AS02||Assignment of assignor's interest|
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Effective date: 19840313