JP3244191B2 - Cataract surgery device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cataract surgery apparatus using ultrasonic waves.

[0002]

2. Description of the Related Art Cataract surgery using ultrasonic waves is also called phacoemulsification. Conventional cataract surgery devices include devices of the following two types (1) and (2). Alternatively, in another cataract surgery device, these two types of devices (1) and (2) can be combined and switched for operation.

(1) The pressure (suction pressure) for sucking the already broken nucleus of the lens changes according to the amount of depression of a foot switch or the like, but the strength of the ultrasonic wave for breaking the nucleus is The value remains constant regardless of the amount of depression of the foot switch with the value set.

(2) Contrary to the device of the method (1), the intensity of the ultrasonic wave changes following the amount of depression of a foot switch or the like, but the intensity of the suction pressure remains at the set value. It is constant regardless of the amount of depression of the foot switch.

[0005] In the apparatus of the type (1), the hardness of the nucleus of the crystalline lens is almost constant, and the suction time is adjusted to shorten the operation time.

[0006] The device of the type (2) adjusts the crushing force when the hardness of the nucleus of the lens is uneven.

[0007]

In the method (1), the efficiency of crushing nuclei is low.

In the method (2), even if the operator steps on the foot switch to increase the ultrasonic waves for crushing the nucleus, the force for sucking the crushed nucleus remains at the initially set value. . Therefore, the crushed nuclei cannot be efficiently sucked.

An object of the present invention is to provide a cataract surgery apparatus capable of efficiently sucking crushed nuclei and shortening the operation time.

[0010]

SUMMARY OF THE INVENTION The present invention provides an ultrasonic probe (1) for generating ultrasonic waves, and an ultrasonic probe (1).
A suction unit (4) for sucking the crushed material (M) crushed in step (1), a foot switch (10) for generating an operation signal by an operator's operation, and an operation signal (O)
S), the control section (2) for generating control signals (CS1, CS2) to the ultrasonic probe (1) and the suction section (4), and the control section (2) controls the foot switch. Based on the operation signal of (10), the foot switch (1
Ultrasonic probe (1) according to the depression amount (D) of 0)
Wherein the intensity of the ultrasonic wave and the suction amount of the suction unit (4) increase and decrease.

Preferably, in the present invention, the control unit (2) comprises:
The intensity of the ultrasonic wave of the ultrasonic probe (1) is controlled so as to increase or decrease according to the depression amount (D) of the foot switch (10). When the intensity of the ultrasonic wave of the probe (1) becomes equal to or less than a predetermined intensity, the control is performed so that the suction force is substantially constant regardless of the depression amount (D) of the foot switch (10). It is a cataract surgery device characterized by being comprised.

Preferably, according to the present invention, the suction force, which is substantially constant irrespective of the depression amount (D) of the foot switch (10), is set to a value sufficient to suck the cortex (50) of the lens (22). A cataract surgery apparatus characterized in that:

[0013]

According to the operation, the intensity of the ultrasonic wave and the suction amount (also referred to as suction force) according to the depression amount (D) of the foot switch (10).
Increase and decrease at the same time. Thereby, the fragments of the nuclei crushed according to the hardness of the nuclei and efficiently crushed are sucked.
When the intensity of the ultrasonic wave is equal to or less than the predetermined intensity, the suction force becomes substantially constant regardless of the depression amount (D) of the foot switch. The residual cortex is suctioned by this constant suction force.

[0014]

1 shows a preferred embodiment of a cataract surgery apparatus according to the present invention.

The cataract surgery apparatus includes an ultrasonic probe 1, an output control unit 2, a suction unit 4, a perfusion control unit 6, a perfusion bottle 8,
A foot switch 10 is provided. The output control unit 2, the suction unit 4, and the perfusion control unit 6 constitute a main body 12.

The ultrasonic probe 1 is also called a handpiece, and has a casing 14, an insertion section 16, and a vibration section 18. The casing 14 is a part that the surgeon grasps by hand.
The insertion section 16 and the vibration section 18 are adapted to be inserted into the crystalline lens 22 through the incision 21 of the cornea 20 of the eye E as shown in FIG.

As shown in FIGS. 2 and 3, the insertion portion 16 has a cylindrical shape, through which a perfusate line 24, a suction line 26, and a line 28 pass. One end of the perfusate line 24 is connected to the inlet 30. The inlet 30 is provided on the distal end side of the insertion section 16. The other end of the perfusate line 24 is connected to the line 34 of the perfusion bottle 8 by the perfusion control unit 6.
It is connected to the. By the operation of the perfusion control unit 6, the amount of the perfusate L sent from the perfusion bottle 8 into the lens 22 via the line 34 and the perfusate line 24 can be adjusted or the supply can be stopped.

The vibrating section 18 has a cylindrical shape, and is coaxially attached to the insertion section 16. The vibration unit 18 is the output control unit 2
Are electrically connected to a high-frequency oscillation source 40 via a line 28. The high-frequency oscillation source 40 is, for example, a high-frequency pulse oscillation source, and vibrates the vibrating section 18 by oscillating a frequency of 27 to 55 Hz / sec. The nucleus 46 shown in FIG. 3 is crushed by the vibration of the vibrating part 18. The vibrating section 18 is formed in a cylindrical shape with the laminated piezo elements as a core, for example. The suction port 42 of the vibrating part 18 is formed obliquely.

As shown in FIG. 2, a suction passage 48 is formed in the vibrating portion 18 in the axial direction. The suction passage 48 is connected to the suction unit 4 via the suction line 26. The crushed material M (see FIG. 2) of the nucleus 46 crushed by the vibrating part 18 and the remaining cortex 50 shown in FIG. 3 are stored in the storage tank (not shown) of the suction part 4 through the suction passage 48 and the suction line 26. )
Can be transferred to

A foot switch 10 is connected to the output control unit 2 shown in FIG. The output control unit 2 forms a control signal CS1 to the high-frequency oscillation source 40 and a control signal CS2 to the suction unit 4 based on the operation signal OS of the foot switch 10. The operation signal OS of the foot switch 10 changes according to the depression amount D of the step portion 11 of the foot switch 10 shown in FIG. Based on the operation signal OS corresponding to the depression amount D, the output control unit 2 can increase or decrease both the intensity of the ultrasonic wave oscillated by the ultrasonic probe 1 and the suction force of the suction unit 4. The strength of the ultrasonic wave and the magnitude of the suction force may be detected by the foot switch or the main body 12.

In the embodiment, preferably, as shown in FIG. 5, the relationship between the magnitude of the depression amount D of the depression portion 11 of the foot switch 10 and the magnitude of the ultrasonic wave and the suction force is set. The depression amount D is large in the right direction along the horizontal axis. Both the strength of the ultrasonic wave and the suction force are large in the upward direction along the vertical axis. The intensity of the ultrasonic wave is indicated by a solid line P. The strength of the suction force is shown by a broken line W. The depression amount D of the foot switch and the intensity (P) of the ultrasonic wave have a linear relationship. On the other hand, the relationship between the depression amount D of the foot switch and the magnitude (W) of the suction force is linear in a range larger than the predetermined depression amount D1. However, the suction force is constant in the range of the depression amount D1 or less, as indicated by the substantially constant value W1. In other words, when the intensity of the ultrasonic wave is equal to or less than ST, the suction force is substantially constant W1.

The substantially constant suction force W1 below the predetermined depression amount D1 is a value sufficient to suck the residual cortex 50 of the crystalline lens 22 shown in FIG. As an example, the suction force W1 is about 40 mmHg.

Next, cataract surgery by the cataract surgery apparatus of the present invention will be described.

The operator holds the casing 14 of FIG. 1 and inserts the insertion portion 16 of the ultrasonic probe 1 through the incision 21 of the cornea 20 of the eye E. Then, as shown in FIG. 3, the vibrating part 18 and a part of the insertion part 16 are inserted into the crystalline lens 22.

First, the operation of crushing and removing the nucleus 46 of the lens 22 will be described. The operator starts stepping on the step portion 11 of the foot switch 10 of FIG. 4 with his / her foot, and depresses the step portion 11 more than the step amount D1 shown in FIG. As a result, as shown in FIG. 5, both the strength of the ultrasonic wave and the suction force increase linearly according to the amount of depression. That is, by increasing the intensity of the ultrasonic waves, the crushing force of the nucleus 46 is increased according to the hardness of the nucleus 46, so that the nucleus 46 can be crushed quickly and the suction force increases in real time. Crushed material M
Can be quickly sucked into the suction part 4 through the suction passage 48 and the suction line 26 in FIG. The suction force at this time is, for example, 40 to 650 mmHg. Thereby, the crushed nucleus M of the crushed nucleus can be efficiently removed from the crystalline lens 22. In order to prevent low intraocular pressure during this removal and the lens 22 from being crushed, the perfusate L from the perfusion bottle 8 of FIG. 1 is supplied from the supply port 30 shown in FIG.
Supply 0.

After the above-described nuclear emulsification, the soft residual cortex 5 shown in FIG.
Remove 0. In this case, for example, the suction port 42 of the vibrating part 18 is inserted into the residual cortex 50. Then, as shown in FIG. 5, the depression amount of the foot switch is set to D1 or less. Thereby, the suction force becomes substantially constant value W1, and the soft residual cortex 50 can be sucked into the suction section 4 through the suction passage 48 and the line 26 in FIG. In this case, the perfusion solution L of FIG. 1 is supplied into the lens 22 from the supply port 30 via the lines 34 and 24 in order to prevent the intraocular pressure from being collapsed due to low intraocular pressure.

After removing the nucleus 46 and residual cortex 50, an artificial lens is implanted.

As described above, in the cataract surgery apparatus of the present invention, the intensity of the ultrasonic wave for crushing the nucleus is adjusted according to the hardness of the nucleus, and the crushed nucleus is sucked in accordance with the intensity of the ultrasonic wave. To change the suction pressure. Moreover, the residual cortex is softer than the nucleus and can be aspirated without necessarily crushing by applying ultrasonic waves. This residual cortex is the amount of depression D
Suction can be performed with a constant suction force in a range of 1 or less.

Incidentally, the present invention is not limited to the above embodiment. For example, there are individual differences in the hardness of the nucleus and the like. For this reason, it is better if the operation can be switched by a manual operation so as to operate according to the methods (1) and (2) of the prior art described above.

[0030]

According to the first aspect of the present invention, both the strength and the suction force of the ultrasonic wave increase and decrease. For this reason, for example, even if the intensity of ultrasonic waves is increased according to the hardness of the nucleus of the lens and the amount of crushing is increased, the suction force increases with this,
The increased crushed material can be suctioned sufficiently efficiently. Therefore, the ultrasonic emulsification suction operation time can be significantly reduced.

According to the second aspect of the present invention, the operation for cataract can be completed by removing the residual cortex of the lens, for example, without switching to the suction mode in which the suction force is constant, and the operation can be performed quickly. .

According to the third aspect of the present invention, it is possible to safely aspirate not only the nucleus of the lens but also the residual cortex by controlling the amount of depression.

[Brief description of the drawings]

FIG. 1 is a view showing a preferred embodiment of a cataract surgery apparatus according to the present invention.

FIG. 2 is a diagram showing a part of an ultrasonic probe in a preferred embodiment of the cataract surgery apparatus of the present invention.

FIG. 3 is a diagram showing a state where the ultrasonic probe of FIG. 2 is inserted into a nucleus of a crystalline lens.

FIG. 4 is a view showing an example of a foot switch of the cataract surgery apparatus of the present invention.

FIG. 5 is a diagram showing the relationship between the depression amount of a foot switch, the strength of ultrasonic waves, and the magnitude of suction force (suction amount) in the present invention.

FIG. 6 is a diagram showing a state where the ultrasonic probe of FIG. 2 is inserted into a cortex of a crystalline lens.

[Description of Signs] 1 Ultrasonic probe 2 Output control unit (control unit) 4 Suction unit 6 Perfusion control unit 8 Perfusion bottle 10 Foot switch 16 Insertion unit 18 Vibration unit 22 Crystal lens 24 Line 26 Suction line 30 Supply port 40 High frequency oscillation source 42 suction port 46 nucleus 50 residual cortex ◆

Claims (2)

(57) [Claims] An ultrasonic probe for generating an ultrasonic wave (1)
A suction unit (4) for sucking the crushed material (M) crushed by the ultrasonic probe (1); a foot switch (10) for generating an operation signal by an operation of an operator; and an operation of the foot switch (10). Based on the signal (OS)
A control unit (2) for forming control signals (CS1, CS2) to the ultrasonic probe (1) and the suction unit (4), and the control unit (2) controls the foot switch (10) based on the signal (OS), see contains a range of suction amount increases or decreases both the ultrasonic intensity and the suction portion (4) of the depression amount (D) ultrasonic probe (1) according to the foot switch (10) , The control unit (2) determines the ultrasonic intensity of the ultrasonic probe (1).
About the depressed amount of the foot switch (10)
Control is performed so as to increase or decrease according to (D).
Regarding the suction amount of (4), the ultrasonic probe (1)
When the sound wave intensity falls below the specified level, the foots
Almost constant regardless of the depression amount (D) of the switch (10)
The system must be configured to perform control so as to provide suction power.
A cataract surgery device characterized by the following . 2. The amount of depression of a foot switch (10).
The suction force that is almost constant regardless of (D) is the lens (2
2) set to a value sufficient to aspirate the cortex (50)
The cataract surgical device according to claim 1, wherein
Place.