Pressure control in phacoemulsification system.
Abstract
A surgical system comprising a source of pressurized irrigation fluid; an irrigation line fluidly coupled to the source of pressurized irrigation fluid; a handpiece fluidly coupled to the irrigation line; an irrigation pressure sensor located in or along the source of pressurized irrigation fluid or irrigation line; and a controller to control the source of pressurized irrigation fluid. The controller controls the source of pressurized irrigation fluid based on a reading of the irrigation pressure sensor and an estimated flow value modified by compensation factor.

Term
7 yearsleft in the term
Expires 11 October 2033.
- Priority
- Filed
- Granted
- Today
- Expires
22 claims: 1 independent, 21 dependent
- 1Un sistema quirúrgico, que comprende:una fuente de fluido de irrigación presurizada;una línea de irrigación acoplada fluidamente a la fuente de fluido de irrigación presurizada;una pieza de mano acoplada fluidamente a la línea de irrigación, la pieza de mano incluye un manguito de irrigación;un sensor de presión de irrigación ubicado en o a lo largo de la fuente de fluido de irrigación presurizada o línea de irrigación;y un controlador para controlar la fuente de fluido de irrigación presurizada;en donde el controlador controla la fuente de fluido de irrigación presurizada en base a una lectura del sensor de presión de irrigación y un valor de flujo estimado modificado por un factor de compensación, el factor de compensación en base a la compresión del manguito de irrigación restringe el flujo del fluido de irrigación.
- 2El sistema quirúrgico de conformidad con la reivindicación 1, en donde el factor de compensación se basa adicionalmente en una fuga por incisión.
- 3El sistema quirúrgico de conformidad con la reivindicación 1, que adicionalmente comprende:una pantalla;y un dispositivo de entrada de controlador.
- 4El sistema quirúrgico de conformidad con la reivindicación 3, en donde el dispositivo de entrada de controlador recibe un valor de presión infraocular deseado y el controlador controla la fuente de fluido de irrigación presurizada para mantener el valor de presión infraocular deseado.
- 5El sistema quirúrgico de conformidad con la reivindicación 3, en donde el dispositivo de entrada de controlador recibe un rango de presión infraocular deseado y el controlador controla la fuente de fluido de irrigación presurizada para mantener el rango de presión infraocular deseado.
- 6El sistema quirúrgico de conformidad con la reivindicación 3, en donde el dispositivo de entrada de controlador recibe el factor de compensación de un usuario.
- 7El sistema quirúrgico de conformidad con la reivindicación 3, en donde el dispositivo de entrada de controlador recibe información de la aguja y el magüito, y el controlador utiliza la información de la aguja y el manguito para seleccionar o calcular el factor de compensación.
- 8El sistema quirúrgico de conformidad con la reivindicación 7, en donde el controlador selecciona o calcula el factor de compensación con base en las características de flujo de fluidos de una combinación de aguja y manguito.
- 9El sistema quirúrgico de conformidad con la reivindicación 1, en donde el controlador calcula la presión intraocular de un ojo basándose en la lectura del sensor de presión de irrigación.
- 10El sistema quirúrgico de conformidad con la reivindicación 1, en donde el controlador calcula la presión intraocular de un ojo basándose en el valor de flujo estimado modificado por el factor de compensación.
- 11El sistema quirúrgico de conformidad con la reivindicación 1, que adicionalmente comprende:una línea de aspiración acoplada fluidamente a la pieza de mano: un sensor de presión de aspiración ubicado en o a lo largo de la línea de aspiración;y una bomba de aspiración configurada para extraer fluido a través de la línea de aspiración.
- 12El sistema quirúrgico de conformidad con la reivindicación 11, en donde el controlador calcula el valor de flujo estimado en base a una lectura del sensor de presión de aspiración, un presión de vacío de bomba lograda por la bomba de aspiración y una impedancia de la bomba de aspiración.
- 13El sistema quirúrgico de conformidad con la reivindicación 11, en donde el controlador utiliza una lectura del sensor de presión de aspiración para determinar si existe oclusión o si la oclusión se rompe.
- 14El sistema quirúrgico de conformidad con la reivindicación 13, en donde el controlador controla la fuente de fluido de irrigación presurizada a los efectos de acomodarla para los cambios en el flujo de fluidos que resultan de la oclusión o la ruptura de la oclusión.
- 15El sistema quirúrgico de conformidad con la reivindicación 1, que adicionalmente comprende un sensor de presión fuente para medir una presión de la fuente de fluido de irrigación presurizada.
- 16El sistema quirúrgico de conformidad con la reivindicación 15, en donde el controlador calcula el valor de flujo estimado en base a una lectura del sensor de presión de irrigación, el sensor de presión fuente y una impedancia de la línea de irrigación.
- 17El sistema quirúrgico de conformidad con la reivindicación 15, en donde el controlador calcula la presión infraocular de un ojo basándose en una lectura del sensor de presión fuente.
- 18El sistema quirúrgico de conformidad con la reivindicación 1, en donde la fuente de fluido de irrigación presurizada comprende:una bolsa flexible que contiene un fluido;y dos placas opuestas;la bolsa flexible está colocada entre las dos placas opuestas.
- 19El sistema quirúrgico de conformidad con la reivindicación 18, en donde el controlador calcula el valor de flujo estimado en base al traslado o movimiento de las dos placas opuestas.
- 20El sistema quirúrgico de conformidad con la reivindicación 1, en donde el factor de compensación se basa en una aguja y magüito seleccionados para un procedimiento.
- 21El sistema quirúrgico de conformidad con la reivindicación 1, en donde el controlador utiliza una lectura del sensor de presión de irrigación para determinar si existe una oclusión o si una oclusión se rompe.
- 22El sistema quirúrgico de conformidad con la reivindicación 21, en donde el controlador controla la fuente de fluido de irrigación presurizada a los efectos de acomodarla para los cambios en el flujo de fluidos que resultan de la oclusión o la ruptura de la oclusión. RESUMEN Un sistema quirúrgico que comprende una fuente de fluido de irrigación presurizada;una línea de irrigación acoplada fluidamente a la fuente de fluido de irrigación 5 presurizada;una pieza de mano acoplada fluidamente a la línea de irrigación;un sensor de presión de irrigación ubicado en o a lo largo de la fuente de fluido de irrigación presurizada o línea de irrigación;y un controlador para controlar la fuente de fluido de irrigación presurizada. El controlador controla la fuente de fluido de irrigación presurizada en base a una lectura del sensor de presión de irrigación y un valor de flujo estimado 10 modificado por factor de compensación. 1110 1180 2/2 1106 π θ8 ^^1110 Fig. 4 Fig. 5
Independent claims22
87 paragraphs in 3 sections, as filed
The present invention relates to phacoemulsification surgery and, more particularly, to the control of fluid flow during surgery.
The human eye works to provide vision by transmitting light through a transparent outer part called the cornea and focusing the image through a crystalline lens in the retina. The quality of the focused image depends on many factors including the size and shape of the eye, and the transparency of the cornea and lens. When age or disease causes the lens to become less transparent, vision deteriorates because the light that can be transmitted to the retina decreases. This deficiency in the lens of the eye is medically known as cataract. An accepted treatment for this condition is the surgical removal of the lens and the replacement of the lens function by an artificial intraocular lens (IOL).
In the United States, most cataract lenses are removed by a surgical technique called phacoemulsification. A typical surgical instrument suitable for phacoemulsification procedures in lenses with cataracts includes an ultrasound handpiece for phacoemulsification, a coupled hollow cutting needle surrounded by an irrigation sleeve and an electronic control console. The handpiece is coupled to the control console by means of an electric cable and a flexible pipe. Through the electric cable, the console varies the level of energy transmitted by the handpiece to the attached cutting needle. The flexible tubing supplies irrigation fluid to the surgical site and extracts aspiration fluid from the eye to
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Through the handpiece.
During a phacoemulsification procedure, the tip of the cutting needle and the end of the irrigation sleeve are inserted into the anterior segment of the eye through a small incision in the outer tissue of the eye. The surgeon puts the tip of the cutting needle in contact with the lens of the eye, so that the vibrating tip fragments the lens. The resulting fragments are aspirated from the eye through the inner surface of the cutting needle, together with the irrigation fluid supplied to the eye during the procedure, and into a waste deposit.
During the procedure, the irrigation fluid is infused into the eye, passing between the irrigation sleeve and the cutting needle and exiting the eye through the tip of the irrigation sleeve and / or through one or more of one of the ports or openings formed in the irrigation sleeve near its end. Irrigation fluid is essential, as it prevents the eye from collapsing during the removal of the emulsifying critalin. The irrigation fluid also protects the eye tissues from the heat generated by the vibration of the ultrasonic cutting needle. Also, the irrigation fluid suspends the fragments of the emulsified lens so that they are aspirated from the eye.
Conventional systems employ fluid filled bottles or bags hung on intravenous (IV) posts as a source of irrigation fluid. The speed of the irrigation fluid as well as the fluid pressure in the eye are regulated by controlling the height of the intravenous post above the surgical site. For example, raising the intravenous pole results in a corresponding increase in head pressure and an increase in fluid pressure in the eye, resulting in a corresponding increase in the speed of the irrigation fluid. Also, lowering the intravenous pole results in the corresponding decrease in pressure in the eye and the corresponding rate of irrigation flow to the eye.
The speed of the aspiration flow of the eye fluids is usually regulated with an aspiration pump. The pump produces a suction flow through the inner surface of the cutting needle. The suction flow results in the creation of a vacuum in the suction line. The suction and / or vacuum flow are established to achieve the desired operation for lens removal. The height of the intravenous pole and the irrigation pump are regulated to achieve the correct balance in the infraocular chamber in order to maintain a relatively constant fluid pressure at the surgical site within the eye.
While a constant fluid pressure in the eye is desirable during the phacoemulsification procedure, a common phenomenon occurs during a phacoemulsification process due to the variation in flow velocities throughout the surgical procedure. The variation of flow rates results in the variation of pressure losses in the irrigation flow path from the supply of irrigation flow to the eye, which causes pressure changes in the anterior chamber (also called intraocular pressure or IOP) . Higher flow rates result in higher pressure losses and lower IOP. As the IOP falls, the operating space within the eye decreases.
Another common complication during the phacoemulsification procedure arises from the blockage, or occlusion, of the aspiration needle. Since the irrigation fluid and emulsified tissue are aspirated from the inside of the eye through the hollow cutting needle, pieces of tissue larger than the diameter of the needle surface can become clogged at the tip of the needle. While the tip is clogged, the vacuum pressure increases at the tip. The resulting pressure drop in the anterior chamber in the eye when the obstruction is removed is known as post occlusion collapse. This post-occlusion collapse, in some cases, can cause a relatively large amount of fluid and tissue to aspirate from the eye too quickly, causing a possible collapse of the eye and / or the lens capsule to break.
Several techniques have been tried to reduce this collapse, such as purging the suction line or otherwise limiting the increase in negative pressure in the aspiration system. However, there is still a need for better phacoemulsification devices, including irrigation systems that reduce post-occlusion collapse and keep IOP stable during flow variation conditions.
SUMMARY OF THE INVENTION
In an embodiment consistent with the principles of the present invention, the present invention is a surgical system comprising a source of pressurized irrigation fluid; an irrigation line fluidly coupled to the source of pressurized irrigation fluid; a handpiece fluidly coupled to the irrigation line; an irrigation pressure sensor located in or along the source of pressurized irrigation fluid or irrigation line; and a controller to control the source of pressurized irrigation fluid. The controller controls the source of pressurized irrigation fluid based on a reading of the irrigation pressure sensor and an estimated flow value modified by a compensation factor.
The surgical system may also include a screen and a controller input device. The controller inlet device can receive a desired infraocular pressure value and the controller can control the source of pressurized irrigation fluid in order to maintain the desired infraocular pressure value. The controller inlet device can receive a desired infraocular pressure range and the controller can control the source of pressurized irrigation fluid in order to maintain the desired infraocular pressure range. The controller can calculate the infraocular pressure of an eye based on the reading of the irrigation pressure sensor, a source pressure sensor or the suction pressure sensor, or the estimated flow value modified by the compensation factor. The controller can also calculate the estimated flow value based on a reading of the irrigation pressure sensor, the source pressure sensor and an impedance of the irrigation line.
The system may also include a suction line fluidly coupled to the handpiece; a suction pressure sensor located on or along the suction line; and a suction pump configured to extract fluid through the suction line. In that case, the controller can calculate the estimated flow value based on a reading of the suction pressure sensor, a maximum pump vacuum achieved by the suction pump and an impedance of the suction pump.
The system may also include a flexible bag containing a fluid and two opposite plates. The flexible bag can be placed between the two opposite plates. In this case, the controller can calculate the estimated flow value based on the movement or movement of the two opposite plates.
In some embodiments, the compensation factor may be based on the filtration of the incision and / or compression of the cuff, a needle and magule selected for the procedure, or characteristics of the flow of the needle and cuff combination. The controller's input device can receive information from the needle and the maguito, and the controller uses the information from the needle and sleeve to select or calculate the compensation factor. The controller input device can receive the compensation factor as an input from the user.
The controller can use a suction pressure sensor reading to determine if there is occlusion or if the occlusion is broken. In this case, the controller can control the source of pressurized irrigation fluid for the purpose of accommodating it for changes in fluid flow resulting from occlusion or rupture of occlusion. The controller can use an irrigation pressure sensor reading to determine if there is occlusion or if the occlusion collapses. In this case, the controller can control the source of pressurized irrigation fluid for the purpose of accommodating it for changes in fluid flow resulting from occlusion or rupture of occlusion.
In other embodiments of the present invention, a surgical system comprises: a source of pressurized irrigation fluid, the source of pressurized irrigation fluid comprising a flexible bag located between two opposing plates, the flexible bag containing a fluid; a position sensor located on or on one of the two opposite plates, the position sensor for determining the distance between the two opposite plates; an actuator for moving at least one of the two opposite plates so as to squeeze the flexible bag; and a controller to control the relative movement of the opposite plates. The controller receives the position sensor reading, determines the distance between the plates and provides an estimate of the amount of fluid in the flexible bag.
In other embodiments of the present invention, a surgical system comprises:
a source of pressurized irrigation fluid, the source of pressurized irrigation fluid comprising a flexible bag located between two opposite plates, the flexible bag containing a fluid, an articulated plate located on the surface of one of the two opposite plates; a source pressure sensor located between a face of the articulated plate and a face of one of the two opposite plates, such that the face of the articulated plate presses the source pressure sensor against the face of one of the two opposite plates.
It is understood that both the foregoing general description and the detailed description that follows are merely examples and explanations and are intended to provide another explanation of the invention as claimed. The following description, as well as the practice of the invention, establish and suggest additional advantages and purposes of the invention.
In an embodiment consistent with the principles of the present invention, a method of controlling a surgical system that has a fluid flow path comprises: receiving a pressure reading from an irrigation pressure sensor located along the flow path of fluids; calculate an estimated fluid flow through the surgical system; modify the estimated fluid flow with a compensation factor; and control a source of pressurized irrigation fluid based on the pressure reading and the estimated fluid flow according to the modification of the compensation factor.
In other embodiments of the present invention, the method may also comprise one or more of the following: receiving a desired infraocular pressure value; and control the source of pressurized irrigation fluid for the purpose of maintaining the intraocular pressure value; receive a desired infraocular pressure range; and control the source of desired irrigation fluid for the purpose of maintaining the desired infraocular pressure range; calculate the intraocular pressure of an eye based on the reading of the irrigation pressure sensor; calculate the intraocular pressure of an eye based on the estimated flow value modified by the compensation factor; receive a reading of a suction pressure sensor located along the fluid path, a maximum pump vacuum achievable by the suction pump, and an impedance of the suction pump; and estimate the flow based on the difference between the reading of the suction pressure sensor and the maximum pump vacuum attainable by the suction pump; receive a reading of the irrigation pressure sensor, a reading of the source pressure sensor and an impedance of the fluid flow path between the source pressure sensor and the irrigation pressure sensor; and estimate the flow based on the difference between the reading of the irrigation pressure sensor and the source pressure sensor; receive a compensation factor from a user; receive information from the needle and sleeve; and use the needle and sleeve information to select or calculate the compensation factor; receive a pressure reading from a suction pressure sensor located along the fluid path; and use the pressure reading of the suction pressure sensor to determine if there is occlusion or if the occlusion collapsed; accommodate changes in fluid flow that result from occlusion or collapse of occlusion; receive a pressure reading from the irrigation pressure sensor; and use the pressure reading of the irrigation pressure sensor to determine if there is occlusion or if the occlusion collapses.
In other embodiments consistent with the principles of the present invention, a method for calculating the incision filtration comprises; calculate the flow of irrigation fluid; calculate the flow of aspiration fluid; and subtracting the calculated aspiration fluid flow from the calculated irrigation fluid flow, where the calculated irrigation fluid flow and the calculated aspiration fluid flow are determined by the difference in pressure measurements.
BRIEF DESCRIPTION OF THE FIGURES
The accompanying drawings, which are incorporated and form part of the present specification, illustrate various embodiments of the invention and, together with the description, explain the principles of the invention.
Figure 1 is a diagram of the fluid path components of a phacoemulsification system, including a pressurized irrigation source in accordance with the principles of the present invention.
Figure 2 is a source of pressurized irrigation fluid in accordance with the principles of the present invention.
Figures 3 and 4 represent an articulated pressure sensor arrangement for a source of pressurized irrigation fluid in accordance with the principles of the present invention.
Figure 5 is a diagram of the system components in a control system of a source of pressurized irrigation fluid.
DETAILED DESCRIPTION OF THE PREFERRED MODES
A detailed reference is now made to embodiments exemplifying the present invention, examples of which are illustrated in the accompanying drawings. When possible, the same reference numbers will be used in all drawings to refer to these parts or similar parts.
Figure 1 is a diagram of the fluid path components of a phacoemulsification system, including a pressurized irrigation source in accordance with the principles of the present invention. Figure 1 depicts the fluid path in the eye 1145 during cataract surgery. The components include a source of pressurized irrigation fluid 1105, a source pressure sensor 1110, an irrigation pressure sensor 1130, a three-way valve 1135, an irrigation line 1140, a handpiece 1150, a suction line 1155, a suction pressure sensor 1160, a bleed valve 1165, a pump 1170, a reservoir 1175 and a drain bag 1180. Irrigation line 1140 provides irrigation fluid to eye 1145 during cataract surgery. Suction line 1155 removes fluid and particles of emulsified lens from the eye during cataract surgery.
When the irrigation fluid leaves the source of pressurized irrigation fluid 1105, it is transported through the irrigation line 1140 to the eye 1145. An irrigation pressure sensor 1130 measures the pressure of the irrigation fluid in the irrigation line 1140 The irrigation pressure sensor 1130 can be located anywhere along the irrigation line 1140 or the irrigation fluid path. If located near the eye 1145, the irrigation pressure sensor may also be incorporated into the irrigation path of the handpiece 1150. In some instances, the irrigation line 1140 may pass through and include a path in a fluidic cartridge . In this case, the irrigation pressure sensor 1130 can be located in the fluidic cartridge. For the purposes of the present description, the irrigation line 1140 may comprise a flexible pipe, a path through a fluid cartridge, a rigid pipe or other fluid paths that carry irrigation fluid from the source of pressurized irrigation fluid 1105 to through handpiece 1150 to eye 1145. The source pressure sensor 1110 also measures the pressure of the irrigation fluid at the source of pressurized irrigation fluid 1105. A three-way valve 1135 is provided for controlling on / off irrigation and to provide a path to the drainage bag 1180. The irrigation pressure sensor 1130 and the source pressure sensor 1110 are implemented with any of the various sensors of fluid pressure available in the market. Irrigation pressure sensor 1130 and / or source pressure sensor 1110 provide pressure information to a controller (illustrated in Figure 5) that operates the source of pressurized irrigation fluid 1105. The source of pressurized irrigation 1105 controls the pressure and / or the flow rate of the irrigation fluid leaving it.
In some embodiments of the present invention, the source of pressurized irrigation fluid 1105 includes a flexible bag containing irrigation fluid. In this case, the bag can be squeezed to pressurize the fluid it contains. For example, the bag can be located between two opposite plates that press together to pressurize the contents of the bag (as described in more detail in Figure 2). In another example, a flexible band surrounds the bag and adjusts to tighten the bag and pressurize its contents. In other embodiments of the present invention, the source of pressurized irrigation fluid 1105 includes a bottle or other container that can be pressurized. In other embodiments of the present invention, the source of pressurized irrigation fluid 1105 is pressurized using a pump or compressed gas.
The source pressure sensor 1110 can be a single pressure sensor or a variety of pressure sensors. The source pressure sensor 1110 may be in contact with the source of pressurized irrigation fluid 1105 to determine the pressure of its content. For example, when the source of pressurized irrigation fluid 1105 is a flexible bag located between two opposite plates, the source pressure sensor 1110 may be located on one of the plates adjacent to the bag. As the plates move, the pressurization bag and the source pressure sensor 1110 measures the pressure. In this case, the source pressure sensor 1110 may be a variety of sensors located on the plate or a single sensor located on the plate. In another example, an articulated plate can be used, as described in more detail in Figure 4.
Figure 2 depicts a source of pressurized irrigation fluid 1105 such as a flexible bag 1109 (for example, an intravenous bag) located between two opposite plates 1106 and 1107. One of the two plates 1106 or 1107 may be fixed while the other is moved to compress or tighten the flexible bag 1109. For example, the plate 1106 may be fixed and the plate 1107 may be moved to compress the flexible bag 1109. In Figure 3, the plate 1106 has a variety of source pressure sensors 1110 located on a surface facing the flexible bag 1109. In this way, a reading of each of the four source pressure sensors 1110 illustrated can lead to A more accurate pressure reading. In this example, a reading of each of the four source pressure sensors 1110 can be taken and the readings are averaged or an irregular reading is ruled out. In Figure 4, a source pressure sensor 1110 (or a variety of sensors) is located on a plate 1106 below an articulated plate 1108. The flat surface of the articulated plate 1108 makes contact with the source pressure sensor 1110. In In some cases, the surface of flexible bag 1109 may wrinkle or fold when pressed between plates 1106 and 1107. These wrinkles or folds can lead to incorrect pressure readings if a wrinkle or crease is found in the source pressure sensor 1110. Using a variety of sensors as shown in Figure 3 is a way to request this problem.
Using an articulated plate 1108 is another way. When using an articulated plate
1108, a flat uniform surface is always in contact with the source pressure sensor 1110.
Figure 5 is a block diagram showing some components of a phacoemulsification machine. Figure 5 shows an irrigation line 1140, an irrigation pressure sensor 1130 in, along or associated with the irrigation line 1140, a suction line 1155, a suction pressure sensor 1160 in, along of or associated with the suction line 1155, a handpiece 1150, a controller 1230, a flow command input device 1210 (for example, a pedal), a screen 1220, an associated controller input device 1240 to enter data or commands to program the system.
Irrigation line 1140 extends between a source of pressurized irrigation fluid 1105 and handpiece 1150, and brings the fluid to handline 1150 to irrigate the eye during a surgical procedure (as illustrated in Figure 1) . In one example, the sterile fluid is a saline fluid, however, other fluids can be used . At least a portion of the irrigation line 1140 may be formed by a flexible pipe, and in some embodiments, the path 1140 is formed by multiple segments, some of which are rigid and others are flexible.
The irrigation pressure sensor 1130 is associated with the irrigation line 1140 and its function is to measure the irrigation pressure in the irrigation line 1140. In some embodiments, the sensor 1130 is a pressure sensor configured to detect the pressure conditions current. Sensor 1130 sends signals indicating the pressure detected to controller 1230. Once received, controller 1230 processes the signals it received to determine if the measured pressure is greater or less than the desired pressure or if it is within a predefined desired pressure range. Although described as a pressure sensor, the irrigation pressure sensor 1130 may be another type of sensor, such as a flow sensor that detects the actual fluid flow and may include additional sensors to monitor other parameters. In some embodiments, sensor 1130 includes its own processing function and the processed information is then communicated to controller 1230.
The suction line 1155 extends from the handpiece to the drain tank 1180 (as illustrated in Figure 1). The suction line 1155 removes the fluid used to rinse the eye as well as any emulsified particle.
The suction pressure sensor 1160 is associated with the suction line 1155 and its function is to measure the pressure of the waste fluid in the suction line 1155. Like the sensor 1130 described above, the sensor 1160 can be a configured pressure sensor to detect current pressure conditions. Send signals indicating the pressure detected to the 1230 controller. Sensor 1160, like sensor 1130, can be any suitable type of sensor, such as a flow sensor that detects the actual fluid flow and may include additional sensors to monitor other parameters.
Handpiece 1145 may be an ultrasonic handpiece that brings irrigation fluid to the surgical site. The handpiece is configured as is known in the art to be able to receive and operate with different needles or equipment depending on the application and the procedure being carried out. It should be noted that although the handpiece is mentioned, the principles of the invention are intended to cover the use of virectomy cutting handpieces and other handpieces known in the art. For ease of reference only, the present application will only refer to handpiece 1145 and it is recognized that the system works similarly with other handpieces.
In the example illustrated, the fluid command input device 1210 is generally a pedal. You can receive inputs that indicate the desired flow rate, the desired pressure and other fluid characteristics. It is configured to control the operational configuration of the machine through a plurality of important control settings, including control of the speed or pressure of the irrigation flow within each of the important control settings. In some embodiments, the fluid command input device is not a pedal, but another input device located anywhere else on the machine.
The input device of controller 1240 allows a user to enter data and commands that affect system programming. In this mode, the controller input device 1240 is associated with the display 1220. However, it could be directly associated with the controller in a manner known in the art. For example, in some embodiments, the controller input device 1240 is a standard computer keyboard, a standard pointing device, such as a mouse or trackball, a touch screen or other input device.
As is apparent from Figure 5, the controller 1230 communicates with the display 1220, the flow command input device 1210, the handpiece 1150, the irrigation pressure sensor 1130, the suction pressure sensor 1160 and the input device of the 1240 controller. It is configured or programmed to control the pressurized irrigation system based on preset programs or sequences.
In use, controller 1230 is configured to receive signals from the irrigation pressure sensor 1130 and process the signals to determine if the detected irrigation pressure is not within an accepted range or is greater or less than the accepted thresholds. If the 1230 controller detects an unacceptable irrigation pressure, it controls the pressurized irrigation system to correct the pressure to the desired range. In the same way, in another example, the controller 1230 is configured to receive signals from the suction pressure sensor 1160 and process the signals to determine if the detected pressure is not within an accepted range or is greater or less than the thresholds accepted. If the 1230 controller detects an unacceptable pressure, it controls the pressurized irrigation system to correct the pressure to the desired range. In this way, the irrigation pressure sensor 1130 and / or the suction pressure sensor 1160 can be used to control fluid pressure in the eye (IOP).
Returning to Figure 1, the suction pressure sensor 1160 measures the pressure of the suction line 1155 or the suction path. The suction pressure sensor 1160 can be located anywhere along the suction line 1155 or the suction path. If it is located near the eye 1145, the suction pressure sensor can be located in the handpiece 1150. The suction pressure sensor 1160 is implemented with any of the various fluid pressure sensors available in the market. Suction pressure sensor 1160 provides pressure information to a controller (illustrated in Figure 5) that operates the source of pressurized irrigation fluid 1105.
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A handpiece 1150 is placed in the eye 1145 during the phacoemulsification procedure. The handpiece 1150 has a hollow needle that is vibrated with ultrasound in the eye to break the diseased lens. A sleeve placed around the needle provides the irrigation fluid of the irrigation line 1140. The irrigation fluid passes through the space between the outside of the needle and the inside of the sleeve. Fluid and lens particles are aspirated through the hollow needle. In this way, the inner passage of the hollow needle is fluidly coupled to the suction line 1155. The pump 1170 extracts the aspirated fluid from the eye 1145. An aspiration pressure sensor 1160 measures the pressure in the aspiration line. Optionally, a purge valve can be used to purge the vacuum created by pump 1170. The aspirated fluid passes through the tank 1175 and to the drainage bag 1180.
During the phacoemulsification procedure, the needle tip on the handpiece 1150 can be blocked with a particle of the lens. This creates a condition called occlusion. During an occlusion, less fluid is usually aspirated from the eye and the vacuum pressure in the suction line 1155 increases as a result of the occlusion. Therefore, during an occlusion, the suction pressure sensor 1160 detects the increase in vacuum in the suction line 1155. When the occlusion is broken (which happens when the ultrasonic needle breaks the lens of the lens that causes the occlusion) a collapse occurs. The increase in vacuum in the suction line 1155 creates a sudden demand for fluid from the eye, resulting in a rapid decrease in IOP and a decrease in the depth of the operating space within the eye. This can lead to a dangerous situation in which several eye structures can be damaged.
After the rupture of the occlusion, the suction pressure sensor 1160 detects a pressure drop in the suction line 1155. Similarly, the irrigation pressure sensor 1130 also detects a pressure drop in the line. of irrigation 1140 that occurs as a result of the rupture of the occlusion. The controller 1230 can use the signals from the irrigation pressure sensor 1130 and / or the suction pressure sensor 1160 to control the irrigation source 1105, as described in more detail below.
The pressurized irrigation system of the present invention is capable of responding to the collapse caused by the rupture of the occlusion by increasing the irrigation pressure in the irrigation line 1140. When a rupture and collapse of the occlusion occurs, the source of pressurized irrigation fluid 1105 increases the pressure of the irrigation fluid in response. Increasing the irrigation pressure of the source of pressurized irrigation fluid 1105 meets the demand for added fluid caused by rupture of the occlusion. In this way, the pressure and the resulting operating space in the eye 1145 can be maintained at a relatively constant value that the surgeon can choose.
In the same way, when an occlusion occurs, the irrigation pressure may increase as the fluid drawn from the eye decreases. An increase in the pressure of the irrigation fluid detected by the irrigation pressure sensor 1130 can be used to control the source of pressurized irrigation fluid 1105 to regulate the pressure in the eye 1145, i.e. keep the pressure in the eye 1145 within of an acceptable range. In that case, the suction pressure sensor 1160 can also detect the presence of an occlusion and the controller 1230 can use a reading of it to control the pressurized irrigation source 1105. In this case, the pressure in the fluid source of Pressurized irrigation 1105 does not increase but remains the same or decreases.
Generally, the control of the source of pressurized irrigation fluid 1105 is based on two parameters: (1) a pressure reading and (2) an estimate of the irrigation flow based on the flow through the system (or a measurement of the flow real through the system). The pressure reading can be from the irrigation pressure sensor 1130 (i.e. the pressure in the irrigation line), the suction pressure sensor 1160 (i.e. the pressure in the suction line) or the pressure sensor source 1110 (that is, the source of pressurized irrigation).
In one embodiment of the present invention, control of the source of pressurized irrigation fluid 1105 may be based on the pressure and flow of irrigation through the system, as modified by the compensation factor (as described in detail below). Irrigation pressure can be used to control the rupture of the occlusion and to maintain a constant IOP. Irrigation flow also determines IOP. The flow through the system modified by the compensation factor (equivalent to the irrigation flow) can be used to control the filtration of the incision and compression of the sleeve. Together, these parameters can be used to maintain a constant IOP during the procedure.
The estimated flow through the system is generally the flow of fluid from the pressurized irrigation source 1105 through the irrigation line 1140, through the handpiece 1150, to the eye 1145, out of the eye 1145, through the handpiece 1150, through the suction line 1155 and to the drainage bag 1180. In the operation, fluid from the system can also be lost by filtration through the eye 1145 or the wound through which the needle of the handpiece 1150 is inserted (also called incision filtration). In this way, the total fluid flow in the system is equal to the fluid that flows through the eye minus the fluid that is lost due to a filtration of the incision.
The estimated fluid flow can be based on a number of different calculations. For example, the flow can be estimated by any of the following:
(1) A differential pressure measurement to calculate the flow can be based on the reading of the suction pressure sensor plus the impedance of the pump plus the maximum vacuum reached by the suction pump. The flow can be calculated by the difference between the suction pressure measured in the suction pressure sensor 1160, the maximum vacuum that can be created by the pump 1170 and the impedance of the pump. The impedance of the pump 1170 is a known parameter and the maximum vacuum that the pump creates can be measured accurately, as can the suction pressure (with the suction pressure sensor 1160). In this way, the flow is estimated by the difference between the two pressures in the fluid path and the impedance of said path. In this case, the two pressures are the pressure measurement with the suction pressure sensor 1160 and the maximum pressure that the pump 1170 can reach. In this example the impedance is the impedance of the pump 1170.
(2) A differential pressure measurement to calculate the flow can be based on the source pressure measured with the source pressure sensor 1110, the irrigation pressure measured with the irrigation pressure sensor 1130 and the impedance of the irrigation line (or irrigation path) from irrigation source 1105 to irrigation pressure sensor 1130. The flow can be calculated with the pressure difference between the irrigation source 1105 and the irrigation pressure sensor 1130, and the impedance of the irrigation line 1140 between the irrigation source and the irrigation pressure sensor. In this way, the flow is estimated by the difference between the two pressures in the fluid path and the impedance of said path.
(3) When the source of pressurized irrigation fluid 1105 is a flexible bag 1109 located between two opposite plates 1106 and 1107 (as shown in Figure 2), the transfer of plates 1106 and 1107 corresponds to the flow of fluid through the system. The fluid flow and / or the volume of fluid used during the procedure can be estimated directly from the position of the plates
1106 and 1107. Generally, during a procedure, plates 1106 and
1107 they are moved towards them to squeeze the fluid out of the flexible bag 1109 at a desired pressure or flow rate. The total fluid leaving the flexible bag 1109 is directly related to the position of the opposite plates 1106 and 1107. The closer the plates 1106 and 1107 are, the more fluid out of the flexible bag 1109. In this way, the position of the plates 1106 and 1107 can also be used to indicate the amount of fluid remaining in the flexible bag 1109 and to indicate to the surgeon the fluid level in the flexible bag 1109 (for example, showing in fluid level in the 1220 screen).
Actual fluid flow through the system can also be affected by two different factors: incision filtration and cuff compression. As noted above, handpiece 1150 has a sleeve around the needle. The sleeve provides the irrigation fluid from the irrigation line 1140 to the eye 1145. The irrigation fluid passes through the space between the outside of the needle and the inside of the sleeve. Fluid and lens particles are aspirated through the hollow needle. During the procedure, the cuff and needle are inserted into the eye through a small incision. In this way, the cuff comes into contact with the ocular tissue of the incision (or wound). Filtration of the incision describes the amount of fluid that leaves the eye through the wound (or through the space between the cuff and the eye tissue through which the wound is formed). During a procedure, fluid may flow out of the eye through the wound. This loss of fluid leaves the system (that is, the fluid that leaves the eye does not pass through the suction line 1155). Infiltration of the incision generally results in the loss of a small amount of fluid, therefore, decreases the total flow in the system. Mathematically expressed, irrigation flow = aspiration flow + incision filtration.
The compression of the sleeve generally describes the condition in which the sleeve contracts or compresses against the needle when inserted into the incision. Cuff compression occurs more frequently with smaller incisions and may or may not result in less filtering of the incision. The compression of the sleeve can restrict the flow of fluid in the system. Since contracting the sleeve increases the resistance of the flow in the system, the flow may decrease when the compression sleeve is present.
Generally, losses due to incision filtration and cuff compression depend on the type of needle and cuff being used as well as the surgeon's technique. The flow profiles of various combinations of needles and sleeves can be determined experimentally and the resulting information can be incorporated into an algorithm or database for use in controlling the source of pressurized irrigation fluid 1105. Alternatively, said experimental information may be aggregated to provide a range of different compensation factors (as described in the following paragraph). The techniques of surgeons differ considerably among the population of ophthalmologists. During a procedure, some surgeons may move the needle so as to generate greater compression of the cuff. Surgeons also prefer different sizes of needles and sleeves, as well as different sizes of incision. These surgeon-specific factors also influence the filtering of the incision and compression of the cuff.
A compensation factor can be implemented to compensate for these two different variables that result in decreased flow through the system: incision filtration and cuff compression. Incision filtration can be compensated with an estimated rate of incision filtration factor (which can be implemented as a deviation that is set as the default). The compression of the sleeve can be compensated with an estimated compression factor. The estimated rate of filtration of the incision along with the compression factor of the cuff can make up the compensation factor. The surgeon may affect the compensation factor. The compensation factor may be a deviation that acts either to increase or decrease the pressure at the source of pressurized irrigation fluid 1105. For example, the compensation factor can be an integer from zero to seven (zero being no compensation and seven being the maximum compensation).
Irrigation flow can be estimated from the flow estimated by the system and the compensation factor. Since the irrigation flow is generally equal to the aspiration flow plus the filtering of the incision. Therefore, the irrigation pressure can be estimated from the compensation factor and the flow estimated by the system.
Generally, to compensate for the decrease in flow (or losses) resulting from the filtration of the incision and compression of the sleeve, the pressure at the source of pressurized irrigation fluid 1105 is slightly increased. Such an increase in pressure can be implemented with a algorithm based on the compensation factor. In the previous example, a surgeon can select a compensation factor from three to moderately compensate for incision filtration and cuff compression. In this example, the setting of a compensation factor between three may correspond to a slight increase in pressure at the source of pressurized irrigation fluid 1105. In other words, the reference pressure at the source of pressurized irrigation fluid 1105 is slightly increased to compensate for these factors.
In another example, the compensation factor can be implemented with a predetermined deviation value that can be adjusted by the surgeon. A nominal record may be the default deviation value in the algorithm. The surgeon can adjust this default value by a factor (from zero for no compensation and 2 for double compensation). The predetermined deviation value can be determined with the experimental information regarding the flow characteristics of various needle and sleeve combinations. Some needle and sleeve combinations are much more common than others, so the most common combinations can be used to determine the predetermined deviation value. In other instances, the sum of this information can be used to determine the default deviation value.
In another example, the surgeon can enter the type of sleeve and needle through an input device of the 1240 controller. A barcode reader can be used to scan the barcode of the surgical pack that also includes the sleeve and the needle. When the 1230 controller receives the needle and sleeve information, it can determine the flow characteristics associated with the needle and the sleeve (or search the flow characteristics in a database) and select the appropriate compensation factor. Likewise, the physician's preferences and / or the information of previous procedures can be used to select the appropriate compensation factor. For example, the parametric information from previous procedures can be used to determine the physician's technique and adjust, modify or select the compensation factor.
Regardless of how the compensation factor is determined, the compensation factor can be used to compensate for flow losses. The compensation factor can be used to control the source of pressurized irrigation fluid 1105 so as to provide an amount of fluid equal to the fluid that is lost by filtering the incision. The compensation factor can be used to control the source of pressurized irrigation fluid 1105 so as to provide a slight increase in pressure to overcome the resistance of the increased flow caused by compression of the sleeve. Also, since the irrigation flow determines the IOP, the compensation factor is used to adjust the IOP as well as to compensate for the flow losses.
Therefore, the control of the source of pressurized irrigation fluid 1105 can be based on the pressure and irrigation flow by the system modified by the compensation factor. Irrigation pressure can be used to control the rupture of the occlusion and to maintain a relatively constant IOP. The flow through the system modified by the compensation factor can be used to compensate for incision filtration and cuff compression and maintain a relatively constant IOP. Together, these parameters can be used to maintain a relatively constant IOP during the procedure.
The IOP estimate can be based on the irrigation pressure sensor. The pressure drop between the irrigation pressure sensor and the eye is known because the characteristics of the passage between the irrigation pressure sensor and the eye are known. For example, if the irrigation pressure sensor is placed in a fluidic cartridge connected to the handpiece 1150 through an irrigation line length 1140, then both the flow impedance of the irrigation line length 1140 and The irrigation path to the handpiece 1150 is known (or can be measured). The IOP can be determined from the reading of the irrigation pressure sensor. The IOP reading can also be affected by the compression of the cuff (because the cuff is in the irrigation path between the irrigation pressure sensor and the eye) and the incision seepage. The compensation factor can be used to adjust the IOP for these losses (or changes in impedance).
In one embodiment of the present invention, a surgeon selects a desired IOP. The source of pressurized irrigation fluid 1105 is then controlled to maintain the desired IOP. Since the IOP is based on a reading of the irrigation pressure sensor, the irrigation pressure sensor 1130 can be used to control the source of pressurized irrigation fluid 1105. In conjunction with the irrigation pressure, the flow through the system modified by the compensation factor can also be used to control the source of pressurized irrigation fluid 1105. The irrigation flow also determines the IOP. The flow through the system modified by the compensation factor is equivalent to the irrigation flow. When there is occlusion (detected by the irrigation pressure sensor 1130 or the suction pressure sensor 1160), the IOP can be maintained with this control scheme. In a rupture of the occlusion (detected by the irrigation pressure sensor 1130 or the suction pressure sensor 1160), the source of pressurized irrigation fluid 1105 can be controlled to maintain a relatively constant IOP.
Alternatively, the source pressure sensor 1110 or the suction pressure sensor 1160 can be used instead of the irrigation pressure sensor 1130 in the preceding control scheme.
The control of the source of pressurized irrigation fluid 1105 can also be described in three different states: steady state (when the needle is not occluded and the flow through the system is relatively constant); occluded state (when the ajuga is occluded and the flow through the system is little or not); and rupture or collapse of the occlusion (when a rapid and sudden flow passes through the system). An example of each state is described.
For example, in steady state, the source of pressurized irrigation fluid 1105 is controlled to keep the IOP selected. Irrigation pressure sensor 1130 is used to provide an estimate of the IOP. Controller 1230 receives a pressure reading from irrigation pressure sensor 1130. Controller 1230 also receives the desired IOP. The controller directs the operation of the source of pressurized irrigation fluid 1105 in order to maintain the desired IOP. In steady state, the controller generally directs the source of pressurized irrigation fluid 1105 to provide fluid at a relatively constant pressure to maintain the IOP. Also, the controller calculates the estimated fluid flow value modified by the compensation factor. In this example, at steady state, the flow can be estimated with a differential pressure measurement or by plate transfer. In the case of a differential pressure measurement, the 1230 controller receives the necessary pressure reading (s) for the differential pressure measurement and performs the calculation. In the case of plate transfer, the controller 1230 receives the readings of the position sensors or the like and determines the plate transfer. The controller also receives the compensation factor (as an input by the surgeon, for example). Since the flow of irrigation fluid (flow estimated by the system modified by the compensation factor) is related to the IOP, controller 1230 directs the operation of the source of pressurized irrigation fluid 1105 to maintain a flow rate consistent with the desired IOP. The net result is that the compensation factor is used to adjust the fluid pressure at the source of pressurized irrigation fluid 1105 to compensate for flow losses.
When an occlusion occurs, the tip of the needle is totally or partially clogged with a crystalline particle. In occluded state, the flow through the system decreases. Irrigation pressure sensor 1130 provides an estimate of the IOP. Controller 1230 receives a pressure reading from irrigation pressure sensor 1130. Controller 1230 also receives the desired IOP. The controller directs the operation of the source of pressurized irrigation fluid 1105 in order to maintain the desired IOP. In the occluded state, the controller generally directs the source of pressurized irrigation fluid 1105 to provide fluid at a relatively constant pressure to maintain the IOP. Maintaining the pressure in an occluded state probably means that plates 1106 and 1107 keep flexible bag 1109 at a relatively constant pressure. Also, the controller calculates the estimated fluid flow value modified by the compensation factor, as detailed above. Since the flow of irrigation fluid (flow estimated by the system modified by the compensation factor) is related to the IOP, controller 1230 directs the operation of the source of pressurized irrigation fluid 1105 to maintain a flow rate consistent with the desired IOP. The net result is that the compensation factor is used to adjust the fluid pressure at the source of pressurized irrigation fluid 1105 to compensate for the loss of flow (eg, incision filtration).
When a rupture of the occlusion occurs, the crystalline particle at the tip of the needle moves and the fluid leaves the eye through the lumen of the needle. During the rupture of the occlusion, the flow through the system increases. Irrigation pressure sensor 1130 provides an estimate of the IOP. Controller 1230 receives a pressure reading from irrigation pressure sensor 1130. Controller 1230 also receives the desired IOP. The controller directs the operation of the source of pressurized irrigation fluid 1105 in order to maintain the desired IOP. During rupture of the occlusion, the controller generally directs the source of pressurized irrigation fluid 1105 to provide fluid at a higher pressure to maintain the IOP. Maintaining pressure during rupture of occlusion probably means that plates 1106 and 1107 exert a force on flexible bag 1109 to increase pressure in the irrigation line, so as to provide the fluid flow necessary to meet the demand for collapse fluid. Also, the controller calculates the estimated fluid flow value modified by the compensation factor, as detailed above. Since the flow of irrigation fluid (flow estimated by the system modified by the compensation factor) is related to the IOP, controller 1230 directs the operation of the source of pressurized irrigation fluid 1105 to maintain a flow rate consistent with the desired IOP. The net result is that the compensation factor is used to adjust the fluid pressure at the source of pressurized irrigation fluid 1105 to compensate for the loss of flow (eg, incision filtration).
In another embodiment of the present invention, the filtration of the incision can be determined as the difference between the flow of irrigation fluid and the flow of aspiration fluid. The flow of irrigation fluid can be measured directly with a flow sensor, can be calculated using a differential pressure measurement or can be calculated based on the transfer of the plates. The readings of the source pressure sensor 1110 and the irrigation pressure sensor 1130 can be used to perform a differential pressure measurement. In this case, the flow impedance between the source pressure sensor 1110 and the irrigation pressure sensor 1130 is known (or can be measured). The difference in the pressure readings measured by the source pressure sensor 1110 and the irrigation pressure sensor 1130 can be calculated and the flow determined. In the case of plate transfer, the flow can be estimated from the position and / or movement of the plates 1106 and 1107.
The flow of the suction fluid can also be calculated using a differential pressure measurement. The flow can be calculated by the difference between the suction pressure measured in the suction pressure sensor 1160, the maximum vacuum that can be created by the pump 1170 and the impedance of the pump. The impedance of the pump 1170 is a known parameter and the maximum vacuum that the pump creates can be measured accurately, as can the suction pressure (with the suction pressure sensor 1160). In this way, the flow is estimated by the difference between the two pressures in the fluid path and the impedance of said path. In this case, the two pressures are the pressure measurement with the suction pressure sensor 1160 and the maximum pressure that the pump 1170 can reach. In this example the impedance is the impedance of the pump 1170.
Using the calculated values of irrigation flow and aspiration flow, the filtering of the incision can be found as the difference between the irrigation flow and the aspiration flow. This calculation of the incision filtration can then be used to more precisely determine the compensation factor. In one embodiment of the present invention, the compensation factor is determined dynamically based on the filtration of the calculated incision.
Finally, it should be noted that the position of the plates 1106 and 1107 can be used to indicate the volume of fluid, used during the procedure, which is left in the flexible bag 1109. As indicated above, the relative position of the opposite plates 1106 and 1107 Indicates the volume of fluid that came out of flexible bag 1109. In some cases, a new bag of irrigation fluid may need to be installed in the source of pressurized irrigation fluid 1105 if the existing flexible bag 1109 has little fluid. Since the relative position of the opposing plates 1106 and 1107 indicates the volume of fluid used, and since the total volume of fluid in the flexible bag 1109 is known, these two parameters can be used to indicate to the surgeon the level of fluid in the flexible bag 1109 (for example, showing the fluid level in the display 1220). If the fluid level is low, you can warn the surgeon so that a new flexible bag 1109 or fluid can be installed in the source of pressurized irrigation fluid 1105.
From the foregoing, it can be seen that the present invention provides an improved phacoemulsification system. The present invention provides active control of pressure in the eye during the surgical procedure. The present invention is illustrated herein with examples and a person skilled in the art can make various modifications.
Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention described herein. It is intended that the specification and examples be considered as examples only, establishing the true scope and spirit of the invention by the following claims.
Contents3
3 sheets
Sheet 1 Sheet 2 Sheet 3
24 members in 13 offices
Priority claims9
| Document | Office | Kind | Date |
|---|---|---|---|
| 13657234 | United States of America | – | |
| 201213657234 | United States of America | A | |
| 201213657234 | United States of America | A | |
| 2013064434 | United States of America | W | |
| 2013064434 | United States of America | W | |
| 13657234 | – | – | – |
| PCTUS2013064434 | – | – | – |
| US201213657234 | – | – | – |
| WO2013US64434 | – | – | – |
Members24
| Document | Office | Kind | |
|---|---|---|---|
| US2014114237A1 | United States of America | A1 | |
| CA2881401A1 | Canada | A1 | |
| WO2014066061A1 | World Intellectual Property Organization (WIPO) | A1 | |
| AU2013335088A1 | Australia | A1 | |
| PH12015500336A1 | Philippines | A1 | |
| EP2869863A1 | European Patent Office (EPO) | A1 | |
| CN104640581A | China | A | |
| KR20150080481A | Republic of Korea | A | |
| MX2015003205A | Mexico | A | |
| US9119699B2 | United States of America | B2 | |
| EP2869863A4 | European Patent Office (EPO) | A4 | |
| JP2015532171A | Japan | A | |
| EP2869863B1 | European Patent Office (EPO) | B1 | |
| RU2015119232A | Russian Federation | A | |
| ES2606837T3 | Spain | T3 | |
| AU2013335088B2 | Australia | B2 | |
| BR112015008307A2 | Brazil | A2 | |
| CN104640581B | China | B | |
| BR112015008307A8 | Brazil | A8 | |
| JP6352934B2 | Japan | B2 | |
| MX364039BThis record | Mexico | B | |
| KR102182495B1 | Republic of Korea | B1 | |
| CA2881401C | Canada | C | |
| BR112015008307B1 | Brazil | B1 |
1 legal event, as the office reported them to INPADOC
Events
| Event | Code | |
|---|---|---|
| Grant or registrationFG | FG |
Numbers
- Publication
- 364039
- Publication, DOCDB
- 364039
- Publication, EPODOC
- MX364039
- Application
- 2015003205
- Application, DOCDB
- 2015003205
- Application, EPODOC
- MX20150003205
Titles2
- Spanish
- CONTROL DE LA PRESION EN UN SISTEMA DE FACOEMULSIFICACION.
- English
- PRESSURE CONTROL IN A PHACOEMULSIFICATION SYSTEM.
Classification
- CPC, 7
- A61F9/00736
- A61M3/0216
- A61M2210/0612
- A61M1/74
- A61M3/0202
- A61M3/0201
- A61M3/0258
- IPC, 3
- A61M3 02
- A61F9 007
- A61M1 00