• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    The invention relates to an ophthalmic surgical system (100), comprising: - a console (1) for receiving an irrigation fluid container (2) with irrigation fluid (3), - a cartridge (4) which can be inserted into the console for controlling the irrigation fluid to a surgical instrument (5) for an eye to be treated (6), - an irrigation fluid flow path (8) from the irrigation fluid reservoir to the cassette and to the surgical instrument, - a first fluid pump (10) having a first pumping chamber (11) with a first Volume and a first with a first elastic separating element (12) separated therefrom first drive chamber (13) having a second volume, - arranged parallel to the first fluid pump second fluid pump (20), which has a second pumping chamber (21) with a third volume and a having a second elastic separating element (22) thereof separated second drive chamber (23) having a fourth volume, wherein the first volume or da s third volume has a size in the range of 1 to 25 cm 3.
    公开号:CH712125B1
    申请号:CH01608/16
    申请日:2016-12-06
    公开日:2017-08-15
    发明作者:Kübler Christoph；Moll Friederike；Geller Nadine；Schuch Melanie
    申请人:Zeiss Carl Meditec Ag；
    IPC主号:
    专利说明:

    Description: The invention relates to an ophthalmic surgical system.
    For the treatment of an eyelid opacity, which is referred to in medicine as a cataract, there are several surgical techniques. The most widely used technique is phacoemulsification, in which a thin hollow needle is inserted into the eye lens and excited to ultrasonic vibrations. The vibrating hollow needle emulsifies in its immediate vicinity the lens such that the resulting lens particles can be sucked through a conduit by means of a pump. In this case, a flushing fluid (irrigation fluid) is supplied, wherein the aspiration of the lens particles and the fluid is carried out by an aspiration line. Once the lens has been completely emulsified and removed, a new artificial lens can be placed in the empty capsular bag so that a patient treated in this way can regain good vision.
    When crushing the eye lens by an ultrasonically vibrating hollow needle, it is unavoidable that during surgery, a relatively large lens particles so before the tip of the hollow needle comes to rest, that this needle tip or its suction is blocked. This condition is called occlusion. In such a case, a commonly used peristaltic pump in the aspiration line builds a multiple stronger suction pressure compared to an occlusion-free operation. In addition, a strong energy input for the movement of the hollow needle done, so that the hollow needle clogging lens particles is shattered. Alternatively, a reversal of the direction of the peristaltic pump can remove the lens particles from the needle tip again, so that again a conventional suction of the fluid and the small lens particles can be done. In such a moment, an occlusion is thus broken, whereby the previously applied high suppression decreases very rapidly. The resulting suction can lead to not only small lens particles and fluid are drawn to Aspirationsleitung, but also a part of the capsular bag comes into contact with the hollow needle. If the capsular bag is punctured, this leads to considerable complications for the patient, which must be avoided at all costs.
    In addition, in the wake of a large amount of fluid can be sucked out of the anterior chamber of the eye, so there is a risk that the eye collapses. Again, this can lead to significant complications for the patient, which must be avoided at all costs.
    Further systems for controlling a fluid are described in US 2015/0 164 690 A1, WO 93/18 802 A1 and US 2015/0 297 405 A1.
    It is an object of the invention to provide an ophthalmic surgical system with which the intraocular pressure is maintained at a low value of less than 50 mm Hg throughout the entire period of operation. The intraocular pressure should be kept almost constant during the operation, and this should also be achieved at the beginning and after the onset of an occlusion. This should be possible during a short as well as during a long operation. Furthermore, the system should be inexpensive.
    The object is solved by the subject of the independent claim. Advantageous developments of the invention are the subject of the dependent claims.
    The ophthalmosurgical system according to the invention comprises: a console for receiving an irrigation fluid container with irrigation fluid, a cassette insertable into the console for controlling the irrigation fluid to a surgical instrument for an eye to be treated, an irrigation fluid flow path from the irrigation fluid container the cassette and to the surgical instrument; a first fluid pump having a first pumping chamber with a first volume and a first drive chamber having a second volume separated with a first elastic separating element thereof, the first resilient separating element with its rim fixed in the first Wherein the first pumping chamber irrigation fluid from the irrigation fluid flow path can be fed and the first drive chamber on the basis of a predetermined pressure, a first drive fluid can be fed, with which an elastic deformation of the first elastic Trennelementes is achievable, whereby the first volume can be reduced and at the same time increase the second volume, - a second fluid pump arranged parallel to the first fluid pump, which has a second pumping chamber with a third volume and a second elastic separating element thereof second drive chamber with a fourth Volume, wherein the second elastic separator is fixedly mounted with its edge in the second fluid pump, wherein the second pumping irrigation fluid from Irrigationsfluid-flow path can be fed and the second drive chamber on the basis of a predetermined pressure, a second drive fluid can be fed, with which an elastic Deformation of the second elastic separating element is achievable, whereby the third volume can be reduced and at the same time increase the fourth volume, wherein the first pumping chamber and the second pumping chamber each having an inlet valve and an outlet valve n, wherein the first volume or the third volume has a size in the range of 1 to 25 cm3.
    The system thus has a first fluid pump and a second fluid pump connected in parallel thereto. For example, when in the first fluid pump, the first pumping chamber is almost empty, the second fluid pump can be switched on. If the second fluid pump discharges irrigation fluid into the irrigation fluid flow path with its second pumping chamber, the first fluid pump can be refilled so that the first fluid pump can be switched on again after the second pumping chamber has been emptied. This means that a mutual actuation of the first fluid pump and the second fluid pump is possible. This makes it possible to achieve a volume flow with very small fluctuations during an operation. This means that a nearly constant intraocular pressure is achievable. The mutual actuation of the parallel-connected first and second fluid pump can be carried out until irrigating fluid is no longer contained in the irrigation fluid container. Thus, the system can be operated during a short as well as a very long operation without interrupting the Irrigationsfluidstromes.
    The fluid pumps each have an elastic separator, which is fixedly mounted with its edge in the respective fluid pump. A movement of the elastic separating element is effected by a drive fluid, which is provided in an associated drive chamber of the respective fluid pump. The elastic separating element is thus not moved by a plunger or a rod, as is the case with a piston, but by a drive fluid. This allows a jerk-free and very fast movement, ie without initial sticking with subsequent sliding as in a piston (also known as "stick-slip effect"). Such an elastic separating element can also be manufactured with a low mass, which enables a dynamic movement and thus a dynamic fluid change in the irrigation fluid flow path. Since the elastic separator is attached to the edge of the respective fluid pump, a good seal can be achieved. A movement of the elastic separating element at the edge of the fluid pump thus does not occur. Therefore, a lubricant for a good sliding, as would be required in a piston pump omitted. This is particularly advantageous since in the system according to the invention there is thus no danger that the irrigation fluid will be contaminated. Rather, it is ensured that the irrigation fluid can remain sterile when operating the fluid pumps. In addition, the good sealing effect by means of an elastic separating element allows any drive fluid to be used. It is conceivable that this is also irrigation fluid. However, it is also possible that it is compressed air from a stationary compressed air line. The good sealing effect by means of an elastic separating element ensures that there is no contact between Irrigationsfluid the pumping chamber and drive fluid of the drive chamber.
    The first volume of the first pumping chamber or the third volume of the third pumping chamber has a size in the range of 1 to 25 cm 3, preferably a size in the range of 1 to 15 cm 3 and particularly preferably a size in the range of 1 to 10 cm 3. This represents a relatively small volume. However, due to the possibility of providing a reciprocal operation of the fluid pump, a long operation without interruption is possible. A small first and third volume is also advantageous because a relatively small change in the volume flow in the irrigation fluid flow path causes a relatively large change in percent of the first and third volumes. This means a relatively high sensitivity in the detection of a change in volume flow. A small first volume and / or third volume also means that only small masses are to be conveyed, so that the system as a whole can be made small and compact and thus cost-effective.
    Preferably, the first volume has the same size as the third volume. Thus, a symmetrical structure with almost the same switching frequencies of the associated valves can be achieved.
    According to a development, the system according to the invention additionally comprises the following: an aspiration fluid flow path for supplying aspiration fluid from the eye to be treated to the console and the cassette insertable thereinto and from there to an aspiration fluid collecting container, a third fluid pump, which has a third pump chamber having a fifth volume and a third drive chamber having a sixth volume separated therefrom with a third elastic separator, the third elastic separator being fixedly mounted with its rim in the third fluid pump, the third pump chamber having aspiration fluid from the aspiration fluid flow path can be fed and the third drive chamber on the basis of a predetermined pressure, a third drive fluid can be fed, with which an elastic deformation of the third elastic separating element is reached, whereby the fifth volume ver-larger and at the same time the sixth Volume - make a - arranged parallel to the third fluid pump fourth fluid pump, which has a fourth pumping chamber with a seventh volume and a fourth elastic separating element thereof separated fourth drive chamber with an eighth volume, said fourth elastic separating element with its edge fixed in the fourth fluid pump is mounted, wherein the fourth pumping chamber Aspirationsfluid from Aspirationsfluid-flow path can be fed and the fourth drive chamber on the basis of a predetermined pressure, a fourth drive fluid can be supplied, with which an elastic deformation of the fourth elastic separating element is reached, whereby the seventh volume ver and at the same time reduce the eighth volume, wherein the third pumping chamber and the fourth pumping chamber each have an inlet valve and an outlet valve, wherein the fifth volume or the seventh volume has a size in the range of 1 to 25 cm3.
    In Aspirationsfluid flow path thus a structure analogous to Irrigationsfluid-flow path is provided. A third fluid pump is disposed in parallel with a fourth fluid pump for pumping aspiration fluid from the eye to an aspiration fluid collection reservoir. The pumps are mutually operable and each have an elastic separating element, so that a tight separation between a respective pumping chamber and an associated drive chamber is possible. By the relatively small fifth volume or seventh volume, which has a size in the range of 1 to 25 cm3, preferably a size in the range of 1 to 15 cm3 and more preferably has a size in the range of 1 to 10 cm3, is a fast and dynamic response to a change in pressure in the aspiration line possible. For example, if a needle of the surgical instrument is occluded with a lens particle, aspiration fluid will no longer flow into the aspiration fluid flow path. After the constipation has broken open, this condition changes very rapidly, as fluid is suddenly sucked out of the eye. Once this is detected, this change can be well handled by means of a very dynamically operable third and fourth fluid pump, so that a nearly constant intraocular pressure can be achieved.
    Another advantage of this embodiment is that during the entire operating period suction without pulsation is possible. This represents a significant improvement compared to systems that promote the aspiration fluid with a peristaltic pump. Operation without pulsation is advantageous, since the eye to be treated can thus lie still during the entire duration of the operation and a surgeon can see a calm image when observed through a microscope.
    Preferably, the fifth volume has the same size as the seventh volume. Thus, a symmetrical structure with almost the same switching frequencies of the associated valves can be achieved.
    According to a further embodiment, a respective position of the first elastic separating element and the second elastic separating element by a respective first and second sensor is detected without contact. The knowledge of the position of the first and second elastic separating element allows an indirect statement about the volume flow in the irrigation fluid flow path. Thus, by means of the first and second drive fluid, the volume flow in the irrigation fluid flow path can be directly influenced. This is particularly important when occlusion breakthrough occurs and a rapid and dynamic change in the irrigation fluid flow rate is required to achieve near-constant intraocular pressure.
    Another advantage is that in such an indirect statement about the volume flow of air bubbles in the irrigation fluid are insignificant. In a pressure measurement or volumetric flow measurement, as is customary in ophthalmic surgical systems according to the prior art, air bubbles, in particular foam, however, have a very disturbing effect on the measurement result and can strongly falsify it. If, therefore, air bubbles can not be avoided in the irrigation fluid, according to the embodiment an accurate regulation of the volume flow in the irrigation fluid flow path and thus regulation of the pressure subsequently setting in the eye can nevertheless be achieved.
    Another possibility is that the respective position of the third elastic separating element and the fourth elastic separating element by a respective third and fourth sensor is detectable without contact. Thus, the advantages described above in detecting the position of the first elastic separating element and the second elastic separating element can be achieved even better. Thus, an indirect statement about the volume flow can also be made in the aspiration fluid flow path, whereby a fast and dynamic control of the volume flow in the aspiration fluid flow path can be achieved.
    According to a further embodiment, the irrigation fluid from the first and the second pumping chamber can be supplied simultaneously and at a first pressure to the irrigation fluid flow path in the direction of the surgical instrument. For example, if the first pumping chamber is nearly depleted, irrigation fluid may be supplied from the second pumping chamber into the irrigation fluid flow path just prior to the deflated condition of the first pumping chamber. Since the two pumping chambers are connected in parallel, the same pressure is present at the respective outlets of the two pumping chambers. Such an embodiment is advantageous, since thus a continuous control operation of the supplied irrigation fluid can be achieved and no fluctuation of the volume flow and the pressure in the irrigation fluid flow path occurs during mutual operation of the pump chambers.
    Furthermore, the aspiration fluid can be supplied with a second pressure at the same time in the third and in the fourth pumping chamber. Thus, the same advantages as in the previously described embodiment can also be achieved in the aspiration fluid flow path.
    In a further embodiment, the respective outlet valve is arranged to that above the respective inlet valve. This is advantageous since any air bubbles that may be present in the irrigation fluid or aspiration fluid can quickly escape upwards and can not accumulate in larger quantities in one of the pumping chambers.
    Preferably, the first and the second pumping chamber are arranged in the cassette and the first and the second drive chamber are arranged in the console. The first pumping chamber with the first volume and the second pumping chamber with the third volume each have a relatively small volume, so that the cassette can be made small and compact. Since the cassette is a consumer item, thus low consumption costs are possible. Such an embodiment of the inventive system thus allows a cost-effective operation.
    Additionally or alternatively, the third and the fourth pumping chamber may be arranged in the cassette and the third and the fourth drive chamber may be arranged in the console. This is also a small and compact design of the cassette and thus a cost-effective operation possible.
    Further advantages and features of the invention will be explained with reference to the following drawings, in which:
    Fig. 1 is a schematic representation of a first embodiment of the inventive system;
    2 shows a schematic illustration of switching states of inlet and outlet valves of the first and second pumping chambers of the system according to the invention;
    3 shows a schematic representation of switching states of inlet and outlet valves of the third and fourth pumping chambers of the system according to the invention; and
    4 shows schematic diagrams of pressure profiles and volume flow curves as a function of time in the system according to the invention.
    1 shows a schematic representation of an embodiment of the inventive ophthalmic surgical system 100. The system 100 has a console 1, to which an irrigation fluid container 2 can be coupled with an irrigation fluid 3 contained therein. In addition, it has a cassette 4, which is insertable into the console 1. The cassette 4 serves to control the irrigation fluid 3 to a surgical instrument 5 for an eye 6 to be treated. The surgical instrument 5 is suitable for comminuting a lens 7 of the eye 6, for example by phacoemulsification, whereby the resulting lens particles and the irrigation fluid 3 are aspirated can be.
    The system 100 further includes an irrigation fluid flow path 8 extending from the irrigation fluid container 2 to the cassette 4 and thence to the surgical instrument 5. In addition, the system 100 includes a first fluid pump 10 having a first pumping chamber 11 having a first volume and a first driving chamber 13 having a second volume separated therefrom by a first resilient separating element 12. The first elastic separating element 12 is fixedly mounted in its edge 14 in the fluid pump 10.
    The irrigation fluid 3 can be supplied to the first pumping chamber 11 by means of the irrigation fluid flow path 8. The irrigation fluid 3 can flow to a first inlet valve 15, pass into the first pumping chamber 11 when the inlet valve 15 is open, and leave the first pumping chamber 11 again when the outlet valve 16 is open. The first drive chamber 13 arranged adjacent to the first pumping chamber 11 may be supplied with a first drive fluid 17 by means of a proportional valve 18. Depending on a differential pressure between the first drive fluid 17 in the first drive chamber 13 and the irrigation fluid 3 in the first pumping chamber 11, there is an elastic deformation of the first elastic separating element 12. If the pressure in the first drive chamber 13 is greater than the pressure in the first drive chamber first pumping chamber 11, the first volume of the first pumping chamber 11 decreases, at the same time increasing the second volume of the first drive chamber 13. Thus, when the inlet valve 15 is closed and the outlet valve 16 is opened, irrigation fluid 3 can be discharged from the first pumping chamber 11. The position of the first elastic separating element 12 can be detected by means of a first sensor 19, which is mounted outside the first fluid pump 10. Preferably, the first sensor 19 is an inductive or capacitive displacement sensor.
    The irrigation fluid flow path 8 is divided into the cassette 4 in a first partial path 81 and a second partial path 82, which are connected in parallel to each other. The irrigation fluid 3 can thus also enter the second partial path 82 and from there to a second fluid pump 20. After passing through a second inlet valve 25, it can enter a second pumping chamber 21 of the second fluid pump 20 and exit from the second pumping chamber 21 again when a second outlet valve 26 is opened.
    After the first outlet valve 16, the irrigation fluid can flow in a partial path 83, and after the second outlet valve 26, the irrigation fluid can flow in a partial path 84. The sub-paths 83 and 84 meet and unite so that the irrigation fluid continues to flow only in a single irrigation fluid flow path 8.
    Adjacent to the second pumping chamber 21, which has a third volume, a second drive chamber 23 is arranged, which has a fourth volume, wherein the second pumping chamber 21 and the second drive chamber 23 are separated by a second elastic separating element 22. The second elastic separating element 22 is fixedly mounted in its edge 24 in the second fluid pump 20. The second drive chamber 23 may be supplied on the basis of a predetermined pressure, a second drive fluid 27 by means of a proportional valve 28.
    Depending on the differential pressure between the second pumping chamber 21 and the second drive chamber 23, the second elastic separating element 22 arranged therebetween can be elastically deformed. For example, when the pressure in the second drive chamber 23 is greater than in the second pumping chamber 21, the fourth volume of the second drive chamber 23 increases, while at the same time the third volume of the second pumping chamber 21 decreases. As a result, irrigation fluid 3 can be conducted out of the second pumping chamber 21 into the partial path 84 of the irrigation fluid flow path 8. The position of the second elastic separating element 22 can be detected by a second sensor 29 preferably contactless, for example, inductive or capacitive.
    When irrigation fluid is passed through the first fluid pump 10 and / or the second fluid pump 20 after passing the outlet valves 16 and / or 26 into the irrigation fluid flow path 8, it reaches a surgical instrument 5. This instrument 5 may be, for example, a handpiece for a phacoemulsification with which a lens 7 of an eye 6 can be minced into small lens particles.
    During the crushing of the eye lens 7, the particles are sucked off together with the supplied irrigation fluid. This takes place according to the invention by means of a third fluid pump 30 and a fourth fluid pump 40 connected in parallel thereto. The lens particles and the irrigation fluid contaminated during the comminution of the lens, which is then referred to as the aspiration fluid, pass along an aspiration fluid flow path 9, which merges into one first partial path 91 and a second partial path 92, with an open inlet valve 35 to the third fluid pump 30th
    The third fluid pump 30 has a third pumping chamber 31 and a third drive chamber 33 arranged adjacent thereto, which are separated from one another by means of a third elastic separating element 32. The third elastic separating element 32 is fixedly connected to the third fluid pump 30 at its edge 34. A third drive fluid 37 may be directed to the third drive chamber 33 by means of a proportional valve 38. If the aspiration fluid flows into the third pumping chamber 31 when the inlet valve 35 is open, this can be conveyed out of the third pumping chamber 30 due to a correspondingly high pressure in the third drive chamber 33 and thereby elastically deformed third separating element 32, if the inlet valve 35 is closed and the outlet valve 36 is open. The position of the third elastic separating element 32 can be detected by means of a third sensor 39. The pumped aspiration fluid enters a partial path 93 and from there to an aspiration fluid collection container 50th
    These relationships also apply analogously to the fourth fluid pump 40. The aspiration fluid can flow along the sub-path 92 with an open inlet valve 45 into a fourth pumping chamber 41 with a seventh volume. Adjacent to the fourth pumping chamber 41 is a fourth drive chamber 43 having an eighth volume into which a fourth drive fluid 47 can flow by means of a proportional valve 48. If the pressure in the fourth drive chamber 43 is greater than in the fourth pumping chamber 41, the fourth elastic separating element 42 deforms accordingly, so that the seventh volume is reduced and the eighth volume is increased. The path change of the fourth elastic separating element 42 can be detected by means of a sensor 49. With a closed inlet valve 45 with the outlet valve 46 open, the aspiration fluid from the fourth fluid pump 40 can then flow out into a partial path 94. The two sub-paths 93 and 94 then reunite, whereupon the aspiration fluid is directed to the aspiration fluid sump 50.
    The intake valves 15 and 25 are located spatially below the exhaust valves 16 and 26. This also applies to the intake valves 35 and 45, which are located below the exhaust valves 36 and 46. This can be achieved in a simple manner that air bubbles in the irrigation fluid or in the Aspirationsfluid are quickly dissipated up and no foam can accumulate in a pumping chamber.
    The illustration in Fig. 1 is very schematic, wherein the pumping chambers 10, 20, 30 and 40 are shown with a rectangular cross-section. In reality, these pumping chambers 10, 20, 30 and 40 may have a round or oval cross section, so that the respective elastic separating element 12, 22, 32 and 42 in an elastic deformation well on an inner wall of the respective pumping chamber 10, 20, 30 and 40 can invest in order to push out the fluid contained therein well.
    Fig. 2 shows a schematic representation of switching states of the inlet valve 15 and the outlet valve 16 for the first pumping chamber 11 of the first fluid pump 10 and switching states of the inlet valve 25 and the associated outlet valve 26 for the second pumping chamber 21 of the second fluid pump 20. Die Pumping chambers 11 and 21 are each filled with an irrigation fluid. The level with the irrigation fluid is indicated by the height of the top hatch line of the horizontal hatch lines in the respective pumping chamber. If the irrigation fluid is contained in the respective pumping chamber at a low pressure, the distance between the horizontally extending hatching lines in the respective pumping chamber is relatively large. If the irrigation fluid is contained in the respective pumping chamber at a high pressure, the distance between the horizontally extending hatching lines in the respective pumping chamber is relatively small.
    It is assumed that in a first switching state IZ1 the first pumping chamber 11 is filled with irrigation fluid at a predetermined pressure p (IRR1). The first intake valve 15 is closed and the first exhaust valve 16 is opened. In the first drive chamber 13 (not shown in FIG. 2), a predetermined pressure is applied so that irrigation fluid can flow at a pressure p (IRR1) into the partial path 83 of the irrigation fluid flow path and thence to the surgical handpiece. The second pumping chamber 21 is filled only with very little irrigation fluid 3. The second intake valve 25 is closed, as well as the second exhaust valve 26 is closed. In a switching state IZ2, the second inlet valve 25 is opened so that irrigation fluid can flow from the irrigation fluid container 2 into the second pumping chamber 21. For this purpose, the pressure in the second drive chamber 23 is set to be lower than the pressure in the second pumping chamber 21. Thus, in the second pumping chamber 21, a suppression and irrigation fluid is sucked. If a predetermined amount of Irrigationsfluid has flowed, which is detected at the position of the elastic separating element 22 by means of the second sensor 29, the second inlet valve 25 is closed, see switching state IZ3. Then, the pressure in the second drive chamber 23 is increased so that a predetermined irrigation pressure p (IRR1) is established in the second pumping chamber 21, see switching state IZ4. In the switching state IZ5, the second outlet valve 26 is opened so that irrigation fluid with the pressure p (IRR1) can flow into the partial path 84. For a brief moment, which can last, for example, 20 milliseconds, thus Irrigationsfluid flows with the same pressure p (IRR1) in the third sub-path 83 and in the fourth sub-path 84. During the switching states IZ1 to IZ5 the irrigation fluid contained in the first pumping chamber 11 flows out.
    Then, the first exhaust valve 16 is closed, see switching state IZ6, so that no irrigation fluid can flow more of the first pumping chamber 11 in the partial path 83. This occurs at the moment when the irrigation fluid in the first pumping chamber 11 has almost completely flowed out. However, the irrigation fluid continues to flow from the second pump chamber 21 at the pressure p (IRR1) into the partial path 84 of the irrigation flow path and thence to the surgical handpiece 5.
    In the switching state IZ7, the first inlet valve 15 is opened, wherein in the first drive chamber 13, a lower pressure than in the first pumping chamber 11 is applied, so that irrigation fluid from the Irrigationsfluidbehälter 2 can flow into the first pumping chamber 11 by suction. If the first pumping chamber 11 contains sufficient irrigation fluid, which can be detected at the position of the first elastic separating element 12 by means of the first sensor 19, the first inlet valve 15 is closed in the switching state IZ8. Then, in the switching state IZ9, such a pressure is applied in the first drive chamber 13 that a predetermined pressure p (IRR1) prevails in the first pumping chamber 11. In the switching state IZ10, the first outlet valve 16 is then opened so that irrigation fluid can flow into the third partial path 83.
    During the switching states IZ5 to IZ10, the second outlet valve 26 is opened, so that irrigation fluid with the pressure p (IRR1) flows into the fourth partial path 84. The opening of the first exhaust valve 16 in the switching state IZ10 takes place at the moment when almost no irrigation fluid is contained in the second pumping chamber 21. This can be detected by the position of the second elastic separating element 22 by means of the second sensor 29.
    The switching state IZ10 is only for a short period of time, for example 20 milliseconds. This is followed again by the first switching state IZ1 in that the second outlet valve 26 is closed.
    The switching cycles IZ1 to IZ10 can be repeated until the irrigation fluid container 2 is emptied.
    Fig. 3 shows a schematic representation of switching states of the inlet valve 35 and the outlet valve 36 of the third pumping chamber 31 of the third fluid pump 30 and switching states of the inlet valve 45 and the associated outlet valve 46 of the fourth pumping chamber 41 of the fourth fluid pump 40. The pumping chambers 31st and 41 are each filled with an aspiration fluid. The level with the aspiration fluid is indicated by the height of the top hatch line of the horizontal hatch lines in the respective pumping chamber. If the aspiration fluid is contained in the respective pumping chamber at a low pressure, the distance between the horizontally extending hatching lines in the respective pumping chamber is relatively large. If the aspiration fluid is contained in the respective pumping chamber at a high pressure, the distance between the horizontally extending hatching lines in the respective pumping chamber is relatively small.
    In the switching state AZ1, the third intake valve 35 is opened and the third exhaust valve 36 is closed. In the third drive chamber 33 is a lower pressure than in the third pumping chamber 31, so aspiration fluid is sucked from the eye 6 to the surgical handpiece 5 and from there along the Aspirationsfluid-flow path 9 in the third pumping chamber 31. The fourth pumping chamber 41 is filled with aspiration fluid, wherein in the switching state AZ1 the fourth inlet valve 45 and the fourth outlet valve 46 are closed.
    In the next switching state AZ2, the fourth outlet valve 46 is opened and a predetermined pressure is applied in the fourth drive chamber 43, so that aspiration fluid from the fourth pumping chamber 43 through the fourth outlet valve 46 and from there into the partial path 94 to the Aspirationsfluid-collecting container 50 can. Meanwhile, the third pumping chamber 31 fills more and more with Aspirationsfluid. When the fourth pumping chamber 41 is almost depleted, the fourth exhaust valve 46 is closed in the third switching state AZ3. The third pumping chamber 31 still fills with aspiration fluid or is almost filled with it. In the fourth pumping chamber 41 aspiration fluid is hardly contained, see switching state AZ4. If then the third pumping chamber 31 is almost completely or completely filled with aspiration fluid, which can be detected by the third sensor 39, the fourth inlet valve 45 is opened in the fifth switching state AZ5, so that aspiration fluid not only along the sub-path 91, but also along the sub-path 92 can flow. This state that the third inlet valve 35 and the fourth inlet valve 45 are simultaneously opened and aspiration fluid is aspirated at the predetermined pressure p (ASP1) is applied only for a period of about 20 milliseconds. Then, in the switching state AZ6, the third intake valve 35 is closed, and the fourth intake valve 45 remains open to suck in aspiration fluid. In the third pumping chamber 31, a higher pressure is applied to the aspiration fluid therein.
    In the switching state AZ7, the third outlet valve 36 is opened to allow the aspiration fluid from the third pumping chamber 31 to flow into the partial path 93 and from there to the aspiration fluid collecting tank 50. When the third pumping chamber 31 is almost empty, the third exhaust valve 36 is closed in the switching state AZ8. The fourth pumping chamber 41 fills with aspiration fluid, see switching state AZ9. In the switching state AZ10, the third inlet valve 35 is opened, during a period of about 20 milliseconds the fourth inlet valve 45 still remains open. In this switching state AZ10, aspiration fluid is thus aspirated by the third pumping chamber 31 and by the fourth pumping chamber 41. This simultaneous suction allows a transition to the subsequent switching state AZ1 without pulsation or pressure surge in the aspiration fluid flow path.
    After the switching state AZ10 again follows the switching state AZ1 as described above.
    Fig. 4 shows schematic diagrams of pressure curves and flow curves as a function of time for the irrigation fluid flow path and the aspiration fluid flow path. Diagram 200 shows the history
    权利要求:
    Claims (9)
    [1]
    a pressure in the irrigation fluid flow path. The diagram 300 shows the course of an intraocular pressure. The diagram 400 shows the course of a pressure in the aspiration fluid flow path. Diagram 500 shows the course of a volumetric flow in the irrigation fluid flow path. Diagram 600 shows the course of a volume flow in the aspiration fluid flow path. In the following explanations, the reference numerals drawn in the diagrams are indicated in each case. At the beginning, it is assumed that, for example, in the first pumping chamber 11 of the first fluid pump 10 there is a stationary pressure, see 201, wherein no irrigation fluid is still flowing, see 501. The intraocular pressure has a constant resting value, see 301, and in the aspiration fluid Flow path is an overpressure, see 401, so that nothing is sucked. In the aspiration fluid flow path, there is still no volumetric flow, see 601. At time T1, the outlet valve 16 is opened, whereby a pressure of corresponding volumetric flow is established by the drive chamber 13, see 202 and 502, until the irrigation fluid reaches the predetermined pressure See FIG. 203 and FIG. 503. The third inlet valve 35 is opened so that aspiration fluid is drawn from the third pumping chamber 31, see 602, whereupon the negative pressure in the aspiration fluid flow path increases, 402 until a predetermined amount p (FIG. ASP1), see 403, with a corresponding volumetric flow, see 603. In prior art systems where the irrigation fluid is provided only by the hydrostatic pressure of an irrigation fluid reservoir, it decreases with the onset of aspiration suction pressure the intraocular pressure decreases, see in diagram 300 the dashed line and there 302. The pressure ni mmt by an amount 303, which corresponds to the product of the hydraulic resistance of the irrigation tubing to the eye and the volume flow in the irrigation line. However, in the system of this invention, at time T1, the pressure in the irrigation fluid flow path is increased by that amount, see 202 and 203, so that intraocular pressure remains unchanged during aspiration, see reference numeral 304. Occurrence in the aspiration fluid flow path, for example in a needle of the surgical instrument 5, occlusion through a lens particle, the volume flow in the aspiration fluid flow path rapidly drops to zero, see 604. To break up the occlusion, the pressure in the aspiration fluid flow path is increased, see 404 [0056] In prior art systems, with the onset of occlusion, the intraocular pressure increases again and even increases to a higher value in the short term than at rest, see 305 which can be very dangerous for the patient. In the system according to the invention, however, such a pressure is predetermined in a drive chamber of the first or second fluid pump active in this moment that the pressure in the adjacent pumping chamber decreases inversely to the previously known profile according to FIG. 305, see 204. The irrigation pressure thus drops below the short term hydrostatic pressure in a conventional suspension of Irrigationsfluidbehälters and then reaches again this hydrostatic pressure. It is thereby achieved that the intraocular pressure remains constant even at the beginning of an occlusion, see 306. The volumetric flows in the irrigation fluid flow path and aspiration fluid flow path remain unchanged during the subsequent occlusion, see 505 and 605. If then the occlusion 405, aspiration fluid may re-enter the aspiration fluid flow path, see 606, and reach the third pumping chamber 31 or the fourth pumping chamber 41, depending on whether the inlet valve 35 or inlet valve 45 is currently open. At this moment, the negative pressure in the pumping chamber that is being filled decreases, so that the differential pressure between the pumping chamber and the driving chamber is reduced. This causes a movement of the associated elastic separating element, which is detected by the associated sensor of the fluid pump. Thereupon, in the irrigation fluid flow path, the drive chamber of the fluid pump active in this moment is actuated such that the pressure in the irrigation fluid flow path increases according to a predetermined profile, see 205 and with respect to the volume flow 506. This leads to no or only a very small decrease 308. This decrease is significantly weaker than in a prior art system, see 308. After this occlusion disruption, the drive chambers are again actuated as they were before occlusion. claims
    An ophthalmic surgical system (100), comprising: - a console (1) for receiving an irrigation fluid reservoir (2) with irrigation fluid (3), - a cassette (4) for controlling the irrigation fluid (2-3 ) to a surgical instrument (5) for an eye to be treated (6), - an irrigation fluid flow path (8) from the irrigation fluid container (2) to the cassette (4) and to the surgical instrument (5), a first fluid pump ( 10), which has a first pumping chamber (11) with a first volume and a first drive chamber (13) having a second volume separated therefrom by a first elastic separating element (12), wherein the first elastic separating element (12) is provided with its edge (14 ) is fixedly mounted in the first fluid pump (10), wherein the first pumping chamber (11) Irrigationsfluid (3) from Irrigationsfluid-flow path (8) can be fed and the first drive chamber (13) on the basis of a predetermined pressure, a first Antriebsfl 17), with which an elastic deformation of the first elastic separating element (12) can be achieved, whereby the first volume can be reduced and at the same time the second volume can be enlarged, - a second fluid pump (20) arranged parallel to the first fluid pump (10) ) having a second pumping chamber (21) with a third volume and a second drive chamber (23) having a fourth volume separated therefrom with a second elastic separating element (22), the second elastic separating element (22) having its edge (24) is fixedly mounted in the second fluid pump (20), wherein the second pumping chamber (21) irrigation fluid (3) from the irrigation fluid flow path (8) can be supplied and the second drive chamber (23) on the basis of a predetermined pressure, a second drive fluid (27) can be fed, with which an elastic deformation of the second elastic separating element (22) can be reached, whereby the third volume is reduced and gl eichzeitig can increase the fourth volume, wherein the first pumping chamber (11) and the second pumping chamber (21) each have an inlet valve (15, 25; 35, 45) and an outlet valve (16, 26; 36, 46), wherein the first volume or the third volume has a size in the range of 1 to 25 cm 3.
    [2]
    The system (100) of claim 1, comprising: - an aspiration fluid flow path (9) for delivering aspiration fluid from the eye (6) to be treated to and from the console (1) and cassette (4) insertable therefrom an aspiration fluid sump (50), a third fluid pump (30) having a third pump chamber (31) with a fifth volume and a third drive chamber (33) having a sixth volume separated therefrom with a third resilient separator (32); wherein the third elastic separating element (32) with its edge (34) is fixedly mounted in the third fluid pump (30), wherein the third pumping chamber (31) Aspirationsfluid from Aspirationsfluid-flow path (9) can be supplied and the third drive chamber (33) the base of a predetermined pressure, a third drive fluid (37) can be fed, with which an elastic deformation of the third elastic separating element (32) can be reached, thereby increasing the fifth volume and simultaneously reducing the sixth volume, - a fourth fluid pump (40) arranged parallel to the third fluid pump (30), which has a fourth pumping chamber (41) with a seventh volume and a fourth drive chamber (43) connected to a fourth elastic separating element (42) ) having an eighth volume, wherein the fourth elastic separator (42) is fixedly mounted with its rim (44) in the fourth fluid pump (40), wherein the fourth pumping chamber (41) aspirating fluid from the aspiration fluid flow path (9) can be fed and the fourth drive chamber (43) can be supplied with a fourth drive fluid (47) on the basis of a predetermined pressure, with which an elastic deformation of the fourth elastic separation element (42) can be achieved, whereby the seventh volume can be increased and at the same time the eighth volume reduced, wherein the third pumping chamber (31) and the fourth pumping chamber (41) each have an inlet valve (15, 25; 35, 45) and an outlet valve (16, 26, 36, 46), wherein the fifth volume or the seventh volume has a size in the range of 1 to 25 cm 3.
    [3]
    3. System (100) according to claim 1, wherein a respective position of the first elastic separating element (12) and the second elastic separating element (22) by a respective first sensor (19) and a second sensor (29) is detectable without contact.
    [4]
    4. System (100) according to claim 2, wherein the respective position of the third elastic separating element (32) and the fourth elastic separating element (42) by a respective third sensor (39) and a fourth sensor (49) is detectable without contact.
    [5]
    The system (100) according to any one of claims 1 to 4, wherein the irrigation fluid (3) from the first pumping chamber (11) and the second pumping chamber (21) simultaneously and at a first pressure (plRR1) the irrigation fluid flow path (8). in the direction of the surgical instrument (5) can be fed.
    [6]
    6. System (100) according to any one of claims 2 to 5, wherein the aspiration fluid at a second pressure (pASP1) simultaneously in the third pumping chamber (31) and in the fourth pumping chamber (41) can be fed.
    [7]
    7. System (100) according to one of the preceding claims, wherein the respective outlet valve (16, 26, 36, 46) spatially above the respective inlet valve (15, 25, 35, 45) is arranged.
    [8]
    A system (100) according to any one of claims 1 to 7, wherein the first pumping chamber (11) and the second pumping chamber (21) are disposed in the cassette (4) and the first drive chamber (13) and the second drive chamber (23). in the console (1) are arranged.
    [9]
    A system (100) according to any one of claims 2 to 8, wherein the third pumping chamber (31) and the fourth pumping chamber (41) are disposed in the cassette (4) and the third drive chamber (33) and the fourth drive chamber (43). in the console (1) are arranged.
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    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    DE102016201297.5A|DE102016201297B3|2016-01-28|2016-01-28|Ophthalmic surgical system|
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