Surgery – Means for introducing or removing material from body for... – Material introduced into and removed from body through...
Reexamination Certificate
2003-03-17
2004-11-30
Tanner, Harry B. (Department: 3744)
Surgery
Means for introducing or removing material from body for...
Material introduced into and removed from body through...
C604S521000
Reexamination Certificate
active
06824525
ABSTRACT:
FIELD OF THE INVENTION
The present invention generally pertains to ophthalmic surgical procedures. More particularly, but not by way of limitation, the present invention pertains to combined anterior segment and posterior segment ophthalmic surgical procedures, as well as consumables utilized in such procedures.
DESCRIPTION OF THE RELATED ART
Ophthalmic surgical procedures are commonly classified as anterior segment surgical procedures, such as cataract surgery, and posterior segment procedures, such as vitreoretinal surgery. Traditionally, surgeons who performed anterior segment procedures did not typically perform posterior segment procedures, and vice versa. Therefore, two different sets of instrumentation and associated consumables were created for anterior segment surgery and posterior segment surgery. The Series 20000® Legacy® cataract surgical system, the Phaco-Emulsifier® aspirating unit, and their associated surgical cassettes, drainage bags, and tubing sets available from Alcon Laboratories, Inc. of Fort Worth, Tex. are examples of such anterior segment instrumentation and consumables. The Accurus® 400VS surgical system and its associated surgical cassettes, drainage bags, and tubing sets, are examples of such posterior segment instrumentation and consumables.
In posterior segment procedures involving phakic eyes, the crystalline lens may be surgically extracted. Such extraction is typically performed using posterior segment instrumentation (e.g. a vitrectomy probe) and consumables via a lensectomy. Due to the anatomical relationship of the lens to the scleratomies, a lensectomy requires the removal of the posterior lens capsule. The removal of the posterior lens capsule precludes the implantation of an intraocular lens (IOL) into the posterior chamber, the anatomically preferred location for IOL implantation. In addition, it is believed that the removal of the posterior lens capsule contributes to secondary complications such as cystoid macular edema.
Recently, a new procedure typically referred to as a combined anterior segment and posterior segment procedure, or “combined procedure”, has been developed. A posterior segment surgeon typically performs the combined procedure. In an uncomplicated combined procedure, the posterior segment surgeon first performs an anterior segment procedure, such as a cataract removal via phacoemulsification with posterior chamber IOL implantation, using an anterior segment surgical system and its associated consumables. The surgeon then immediately performs a posterior segment procedure using a separate posterior segment surgical system and its associated consumables. In more complicated combined procedures, the posterior chamber IOL implantation is often deferred until completion of the posterior segment procedure.
Even more recently, surgical systems have been developed that support both an anterior segment procedure and a posterior segment procedure via a single surgical console. An example of such a system is the Accurus® 600DS surgical system available from Alcon Laboratories, Inc. Two groups of consumables (surgical cassette, drainage bag, tubing sets) are currently available for use with this surgical system.
The first group of consumbables is the Accurus® Anterior Pak available from Alcon Laboratories, Inc., which is for use only in anterior segment procedures. A schematic representation of the consumables in the Accurus® Anterior Pak, in their assembled form, is shown in FIG.
1
. The Accurus® Anterior Pak includes a surgical cassette
10
having a vacuum chamber
12
, an irrigation inlet
14
, an irrigation outlet
16
, and an aspiration port
18
. As shown schematically in
FIG. 1
, a series of manifolds
22
fluidly couple vacuum chamber
12
, irrigation inlet
14
, irrigation outlet
16
, and an aspiration port
18
. Cassette
10
is disposed in a cassette receiving mechanism (not shown) in the Accurus® surgical system. As shown schematically in
FIG. 1
, the cassette receiving mechanism includes a series of occluder valves
24
and microreflux valves
26
for opening and closing various portions of manifolds
22
. Cassette
10
further includes a pump manifold
20
that is used to drain aspirated fluid from vacuum chamber
12
into a drain bag (not shown) connected to cassette
10
. A bottle
28
containing a conventional ophthalmic infusion fluid
30
, such as saline solution or BSS PLUS® intraocular irrigating solution available from Alcon Laboratories, Inc., is disposed above cassette
10
. Bottle
28
is not part of the Accurus® Anterior Pak. Bottle
28
is fluidly coupled to irrigation inlet
14
via tubing
32
. A conventional drip chamber
34
may be fluidly coupled between bottle
28
and tubing
32
. Tubing
36
is fluidly coupled to irrigation outlet
16
. The distal end
38
of tubing
36
is for fluidly coupling to a conventional irrigation handpiece, the irrigation inlet of a conventional irrigation/aspiration handpiece, or the irrigation inlet of a conventional ultrasonic handpiece. Tubing
40
is fluidly coupled to aspiration port
18
. The distal end
42
of tubing
40
is for fluidly coupling to the aspiration port of a conventional ultrasonic handpiece, or to the aspiration port of a conventional irrigation/aspiration handpiece. Tubing
32
,
36
, and
40
are preferably conventional medical grade flexible tubing.
The second group of consumbables is the Total Plus™ Pak available from Alcon Laboratories, Inc., which is for use only in posterior segment procedures. A schematic representation of the consumables in the Total Plus™ Pak, in their assembled form, is shown in FIG.
2
. The Total Plus™ Pak includes a surgical cassette
50
having a vacuum chamber
52
, a first aspiration port
54
, and a second aspiration port
56
. As shown schematically in
FIG. 2
, a first manifold
58
fluidly couples vacuum chamber
52
and port
54
, and a second manifold
60
fluidly couples vacuum chamber
52
and port
56
. Cassette
50
is disposed in a cassette receiving mechanism (not shown) in the Accurus® surgical system. As shown schematically in
FIG. 2
, the cassette receiving mechanism includes a series of occluder valves
62
and microreflux valves
64
for opening and closing various portions of manifolds
58
and
60
. Cassette
50
further includes a pump manifold
66
that is used to drain aspirated fluid from vacuum chamber
52
into a drain bag (not shown) connected to cassette
50
. Tubing
68
is fluidly coupled to aspiration port
54
. The distal end
70
of tubing
68
is for fluidly coupling to a conventional extrusion handpiece or a conventional ultrasonic handpiece used for pars plana lensectomy. Tubing
72
is fluidly coupled to aspiration port
56
. The distal end
74
of tubing
72
is for fluidly coupling to the aspiration port of a conventional vitrectomy probe. A bottle
28
containing a conventional ophthalmic infusion fluid
30
, such as saline solution or BSS PLUS® intraocular irrigating solution, is disposed above cassette
10
. Bottle
28
is not part of the Total Plus™ Pak. Bottle
28
is fluidly coupled to tubing
76
. A conventional drip chamber
78
may be fluidly coupled between bottle
30
and tubing
76
. A stopcock
80
is fluidly coupled to tubing
76
, and a stopcock
82
is fluidly coupled to stopcock
80
. Stopcocks
80
and
82
are preferably conventional three-way stopcocks. An outlet
84
of stopcock
82
is for fluidly coupling to a conventional infusion cannula. An inlet
86
of stopcock
80
is for fluidly coupling to a source of pressurized air that can be used to perform a fluid/air exchange during a posterior segment procedure. An inlet
88
of stopcock
82
is for fluidly coupling to a source of pressurized gas, such a perfluorocarbon gas, that can be used to perform a fluid/gas exchange, or an air/gas exchange, during a posterior segment procedure. Tubing
68
,
72
, and
76
are preferably conventional medical grade flexible tubing.
Therefore, the Accurus® 600DS surgical system, and its associated consumbables, greatly simplify the combined anterior segment and
Nazarifar Nader
Steppe Dennis L.
Alcon Universal Ltd.
Lee W. David
Tanner Harry B.
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