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GB2167305A - Ultrasonic transducer for dispersal of haemorrhages in eyes - Google Patents

Ultrasonic transducer for dispersal of haemorrhages in eyes Download PDF

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Publication number
GB2167305A
GB2167305A GB08429661A GB8429661A GB2167305A GB 2167305 A GB2167305 A GB 2167305A GB 08429661 A GB08429661 A GB 08429661A GB 8429661 A GB8429661 A GB 8429661A GB 2167305 A GB2167305 A GB 2167305A
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GB
United Kingdom
Prior art keywords
eye
transducer
transducer means
haemorrhage
vitreous humour
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
GB08429661A
Other versions
GB8429661D0 (en
GB2167305B (en
Inventor
Vernon Smith
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Individual
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Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to GB08429661A priority Critical patent/GB2167305B/en
Publication of GB8429661D0 publication Critical patent/GB8429661D0/en
Publication of GB2167305A publication Critical patent/GB2167305A/en
Application granted granted Critical
Publication of GB2167305B publication Critical patent/GB2167305B/en
Expired legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/12Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B2017/12004Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for haemostasis, for prevention of bleeding
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/22Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005Effects, e.g. on tissue
    • A61B2017/22007Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing
    • A61B2017/22008Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing used or promoted

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ophthalmology & Optometry (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Vascular Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Surgical Instruments (AREA)
  • Thermotherapy And Cooling Therapy Devices (AREA)

Abstract

Eye treatment apparatus for the in vivo dispersal of a haemorrhage (14) in the vitreous humour (15) of an eye (20) comprises a focussing ultrasonic transducer (10) adapted, when positioned adjacent the eye sclera (12), to emit an ultrasonic wave focussed within the vitreous humour (15) and sufficient to induce local micro-stirring to disperse the haemorrhage (14). The transducer is preferably housed in a hand-held probe (10). The beam is controlled to cause the micro-stirring or, at greater energies, cavitation of the vitreous humour, while leaving the other parts of the eye undamaged. <IMAGE>

Description

SPECIFICATION Apparatus for dispersal of haemorrhages in eyes The present invention relstes to eye treatment apparatus for the in vivo dispersal of haemorrhages and other lesions in the vitreous humour of eyes, especially useful in the treatment of human eyes. Vitreous haemorrhages have conventionally been treated either by drugs or by the surgical procedure of vitrectomy. Both methods have low success rates, and vitrectomy involves considerable risks to the eye. It is therefore an object of the invention to provide an apparatus for an alternative, non-invasive, treatment.
The invention, in a first aspect, provides an eye treatment apparatus for the in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising focussing ultrasonic transducer means adapted, when positioned adjacent the eye sclera, to emit an ultrasonic wave focussed within the vitreous humour sufficient to induce local micro-stirring to disperse the haemorrhage. The transducer means preferably comprises a transducer housed at one end of a probe, advantageously handheld, and adapted for engagement with a portion of the eye sclera by way of a coupling means.
The invention, in a second aspect, provides an eye treatment apparatus for the in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising a focussing ultrasonic transducer having an emitter of ultrasonic waves, and a control system connected to the transducer for controlling the transducer so that the emitter, when positioned adjacent the eye sclera, emits an ultrasonic wave focussed within the vitreous humour sufficient to induce local micro-stirring to disperse the haemorrhage. The transducer and the emitter are preferably housed at one end of a probe.
The control system advantageously comprises an RF signal generator, a power amplifier for amplifying an RF signal therefrom, and an output transformer for matching the impedances of the power amplifier output and the transducer input so that the concentration of the ultrasonic waves at the focal point is sufficient to cause said dispersal.
The micro-stirring and, at rather larger energies, cavitation, of the vitreous humour have been found to disperse haemorrhages adequately.
The preferred frequency range of the transducer means is from about 1MHz to 3MHz.
Within this range, the frequency is sufficiently high to produce a concentration of ultrasonic energy at the focal region to disperse haemorrhages, yet not so high that excessive energy is absorbed by the eye tissue outside the said region, or that the degree of cavitation is reduced due to the scarcity of small nuclei.
The preferred power range of the transducer means is from about 0.5w to 5w. The power in this range is sufficient to disperse the haemorrhage upon energization of the transducer means for a period of the order of 30 seconds. Moreover, such a power range produced an intensity at the surface of the transducer means adjacent the eye sclera well below that likely to destroy eye tissue.
Most haemorrhages which require operation occur close to the centre of the eye, i.e.
some distance from the concentration of blood vessels near the back of the eye. In a human eye the centre is approximately 1 Omm from the sclera, so the preferred focal length of the transducer for application to the human eye is in the range of 8 to 14mm and advan tageously approximately 11 mum.
The transducer preferably has a fixed focus, and may take the form of a planar disc resonant in the thickness direction, or, more suitably, a part-spherical shell or bowl resonant in the thickness direction.
In order that the invention should be better understood, some preferred embodiments will now be described, by way of illustration, with reference to the accompanying schematic drawings, wherein: Figure 1 is a diagram of an eye treatment apparatus for the in vivo dispersal of haemorrhages in eyes, including a hand-held probe and a control system; and Figure 2 is a partial section through a human eye showing the apparatus of Figure 1 coupled to its outer surface.
As shown in Figure 1, the eye treatment apparatus comprises a the hand-held probe 10 and a control system 22, 23, 24. The probe 10 is capable of steam sterilization and comprises a handle 17 connected via a curved tube 18 to a head 19. The head 19 has a plastics flashover protection ring mounted in an internally-threaded ferrule; the ferrule being screwed on to the tube 18. A part-spherical, bowl-shaped, piezo-electric, ceramic, fixed-focus, ultrasonic transducer 21 is mounted within the probe head 19 for resonant vibration in the direction of its thickness, so that a spherical wave is, upon energization, emitted from a wave transmitting surface of the transducer which forms an emitter. The outer diameter of the head 19 is preferably about 10 mm, accommodating a transducer 21 having a chord diameter of about 7 mm.The resonant frequency of the transducer 21, which is preferably limited to the range of 1 MHz to 3 MHz, in one example is in a range of 1.5 to 2.5 MHz with a maximum output power of 5 watts, and the resultant beam is focussed with an acoustic focal length of 1 lmm. For use on human eyes, the focal length should lie in the range 8 to 14mm. The transducer 21 is air backed so as to give a high acoustic impedance to its rear face, concentrating the available acoustic energy in a forward direction.
With such a transducer, the beam intensity at the focal point is of the order of 100 times that at the emitting surface.
A coaxial RF cable 16, threaded through the handle 17 and the tube 18 connects the transducer 21 to the electronic control system 22,23,24 which is external to the probe.
The electronic control system comprises a variable frequency signal generator 22; a variable power, tuned, narrow-band RF amplifier 23; and an output matching transformer 24 for matching the impedance of the RF power amplifier 23 output to the probe transducer 21 input impedance. The control system further includes a control timer (not shown) with a range of 0-60 seconds, for initiating irradiation upon actuation of a footswitch (not shown) and automatically terminating irradiation after a predetermined interval. The control system also monitors the power applied to the transducer, and is set manually to switch the power off when the time-integrated power, i.e. total applied energy, reaches a preset threshold.
With reference to Figure 2, the apparatus described above with reference to Figure 1 finds greatest application in the treatment of the human eye. A human eye 20 has a cornea 13 which contains vitreous humour 15 bounded by sclera 12. It is possible for a haemorrhage, consisting of blood particles 14, to be localised at a region close to the centre of the eye and this will affect adversely the vision of the eye.
The apparatus described above is for dispersing such haemorrhages.
It has been found that above a certain energy ultrasonic waves in a liquid, such as the vitreous humour of a human eye cause microstirring, and this in itself can be sufficient to disperse a haemorrhage in the vitreous humour. Once dispersed, natural processes acting in the eye are able to carry away the dispersed matter and clear the vitreous humour.
Increased energy levels cause more vigorous microstirring and also the cavitation of the liquid. Cavitation is the developing of bubbles of vapour around microscopic nuclei, which expand and then suddenly contract releasing shock waves. These shock waves are particularly effective at dispersing a haemorrhage.
The apparatus described above with refs?r- ence to Figure 1 operates on these principles.
In use, the probe 10 is held so that its outer, wavetransmitting surface lies adjacent the outer surface of the eye sclera 12, preferably in the pars plana region. A coupling medium 11, such as a diagnostic probe gel or a saline solution is placed between the transmitting surface and the sclera 12. The control timer is set at the required treatment time which, for may, for example, be 30 seconds, a time which has been found to be sufficient to disperse haemorrhages with no adverse effect on the sclera. The footswitch is then actuated to operate the transducer 21, which emits spherical ultrasonic waves fo cussed in the vitreous humour at the haemor rhage. As described above, these waves cause micro-stirring or, at increased energy levels, cavitation which disperses the haemor rhage.After the pre-set time, the timer halts the emission of ultrasonic waves and the treatment is halted.
The emitted beam does not damage the scleral tissue, since its effect is limited to the region of the eye close to the focal region of the transducer 21. In fact, for a bowl-shaped transducer 21 of the type described, the point of maximum beam intensity is located close to the centre of curvature, and on the side nearer the transducer. Since the cornea 13 is easily rendered opaque by ultrasonic radiation, and since it also absorbs and de-focusses the beam, this region of the eye should be avoided, even by the unfocussed portions of the beam. The probe may be moved over the eye to locate the precise point at which the focussed beam will most effectively disperse the haemorrhage.
An alternative to the bowl-shaped transducer is a planar disc transducer, also resonant in the thickness direction. The focussing of the emitted beam is then achieved with the provision of either a superimposed plastics lens, for use with liquid coupling means 11, or a liquid-filled acoustic cone acting itself as the coupling means 11. Variable focus transducers are also envisaged, the focal length being variable to suit the distance of the haemorrhage from the eye surface.
Clearly, the dimensions of the probe and the type of ultrasonic transducer means and the electronic control system are dictated by the nature of the haemorrhaged eye to be treated, and in particular the invention is not limited to a probe for the treatment of human eyes; animal eyes of different sizes may also be treated.
Although the invention has been illustrated in the form of a hand-held probe containing a transducer, it is envisaged that the transducer means could alternatively take the form of a fixed ultrasonic wave transmitter with a movable waveguide acting as the wave emitter.
The transducer means is not necessarily handheld, since the treatment could be performed by means of an automatically moveable probe or other ultrasonic wave emitter.
The invention has been described in relation to the dispersal of haemhorrhages in the eye.
However, the apparatus of the invention is applicable also, in a similar manner, to the treatment of other lesions in the vitreous humour such as vitreous opacities due to massive vitreous retraction.

Claims (3)

1. Eye treatment apparatus for the in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising focussing ultrasonic transducer means adapted, when positioned adajcent the eye sclera, to emit an ultrasonic wave focussed within the vitreous humour sufficient to induce local microstirring to disperse the haemorrhage.
2. Apparatus according to claim 1, wherein the transducer means comprises a transducer housed at one end of a probe and adapted for engagement with a portion of the eye sclera by way of a coupling means.
3. Eye treatment apparatus for the in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising a focussing ultrasonic transducer means having an emitter of ultrasonic waves, and a control system connected to the transducer means for controlling the transducer means so that the emitter, when positioned adjacent and outside the eye sclera, emits an ultrasonic wave focussed within the vitreous humour sufficient to induce local micro-stirring to disperse the haemorrhage.
3. Eye treatment apparatus for the in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising a focussing ultrasonic transducer means having an emitter of ultrasonic waves, and a control system connected to the transducer means for controlling the transducer means so that the emitter, when positioned adjacent the eye sclera, emits an ultrasonic wave focussed within the vitreous humour sufficient to induce local microstirring to disperse the haemorrhage.
4. Apparatus according to claim 3, wherein the transducer means and the emitter are housed at one end of a probe.
5. Apparatus according to claim 3 or claim 4, wherein the control system comprises an RF signal generator, a power amplifier for amplifying an RF signal therefrom, and an output transformer for matching the impedances of the power amplifier output and the transducer input so that the concentration of the ultrasonic waves at the focal point is sufficient to cause said dispersal.
6. Apparatus according to claim 2 or 4, wherein the probe is a hand-held probe.
7. Apparatus according to any preceding claim, wherein the frequency range of the transducer means is from about 1MHz to 3MHz.
8. Apparatus according to any preceding claim, wherein the power range of the transducer means is from about 0.5W to 5W.
9. Apparatus according to any preceding claim, wherein the focal length of the transducer means is in the range of 8 to 14mm.
10. Apparatus according to claim 9, wherein the said focal length is approximately 11 mum.
11. Apparatus according to claim 2 or any claim appendant thereto, wherein the transducer has a fixed focus.
12. Apparatus according to claim 11, wherein the transducer comprises a planar disc resonant in the thickness direction.
13. Apparatus according to claim 11, wherein the transducer comprises a partspherical shell or bowl resonant in the thickness direction.
14. Eye treatment apparatus substantially as described herein with reference to the accompanying drawings.
CLAIMS Amendments to the claims have been filed, and have the following effect: Claims 1-3 above have been deleted or textually amended.
New or textually amended claims have been filed as follows:
1. Eye treatment apparatus for the non-invasive in vivo dispersal of a haemorrhage in the vitreous humour of an eye, comprising focussing ultrasonic transducer means adapted, when positioned adjacent and outside the eye sclera, to emit an ultrasonic wave focussed within the vitreous humour sufficient to induce local micro-stirring to disperse the haemorrhage.
2. Apparatus according to claim 1, wherein the transducer means comprises a transducer housed at one end of a probe and adapted for engagement with a portion of the eye sclera by way of a coupling means.
GB08429661A 1984-11-23 1984-11-23 Apparatus for dispersal of haemorrhages in eyes Expired GB2167305B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB08429661A GB2167305B (en) 1984-11-23 1984-11-23 Apparatus for dispersal of haemorrhages in eyes

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Application Number Priority Date Filing Date Title
GB08429661A GB2167305B (en) 1984-11-23 1984-11-23 Apparatus for dispersal of haemorrhages in eyes

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GB8429661D0 GB8429661D0 (en) 1985-01-03
GB2167305A true GB2167305A (en) 1986-05-29
GB2167305B GB2167305B (en) 1988-11-30

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4970656A (en) * 1986-11-07 1990-11-13 Alcon Laboratories, Inc. Analog drive for ultrasonic probe with tunable phase angle
US5001649A (en) * 1987-04-06 1991-03-19 Alcon Laboratories, Inc. Linear power control for ultrasonic probe with tuned reactance
FR2685211A1 (en) * 1991-12-20 1993-06-25 Technomed Int Sa Ultrasound therapy apparatus emitting ultrasonic waves producing thermal effects and cavitation effects
WO1993012742A1 (en) * 1991-12-20 1993-07-08 Technomed International Ultrasonic therapy apparatus delivering ultrasonic waves with thermal and cavitational effects
WO1997018851A1 (en) * 1995-11-24 1997-05-29 Ekos Corporation Hemostasis material and apparatus
US7955281B2 (en) 2006-09-07 2011-06-07 Nivasonix, Llc External ultrasound lipoplasty
US8262591B2 (en) 2006-09-07 2012-09-11 Nivasonix, Llc External ultrasound lipoplasty
WO2022040493A1 (en) * 2020-08-21 2022-02-24 Yau Gary Lloyd Ka Tao Ultrasonic treatment of vitreous opacities

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9615969B2 (en) 2012-12-18 2017-04-11 Novartis Ag Multi-port vitrectomy probe with dual cutting edges
US9693898B2 (en) 2014-11-19 2017-07-04 Novartis Ag Double-acting vitreous probe with contoured port

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1215881A (en) * 1967-07-25 1970-12-16 Cavitron Corp Improvements in or relating to material removal apparatus employing high frequency vibrations
US3601084A (en) * 1969-11-21 1971-08-24 Branson Instr Ultrasonic-vibration-transmitting member
US4063557A (en) * 1976-04-01 1977-12-20 Cavitron Corporation Ultrasonic aspirator
GB1515236A (en) * 1975-06-13 1978-06-21 Fibra Sonics Ultrasonic medical machines
EP0005719A1 (en) * 1978-04-21 1979-12-12 Cavitron Corporation Ultrasonic resonant vibrator
GB1591637A (en) * 1977-03-15 1981-06-24 Fibra Sonics Ultrasonic instruments
GB2118045A (en) * 1982-04-13 1983-10-26 Go G Med Inst Apparatus for the fragmentation and aspiration of ocular tissues

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1215881A (en) * 1967-07-25 1970-12-16 Cavitron Corp Improvements in or relating to material removal apparatus employing high frequency vibrations
US3601084A (en) * 1969-11-21 1971-08-24 Branson Instr Ultrasonic-vibration-transmitting member
GB1515236A (en) * 1975-06-13 1978-06-21 Fibra Sonics Ultrasonic medical machines
US4063557A (en) * 1976-04-01 1977-12-20 Cavitron Corporation Ultrasonic aspirator
GB1591637A (en) * 1977-03-15 1981-06-24 Fibra Sonics Ultrasonic instruments
EP0005719A1 (en) * 1978-04-21 1979-12-12 Cavitron Corporation Ultrasonic resonant vibrator
GB2118045A (en) * 1982-04-13 1983-10-26 Go G Med Inst Apparatus for the fragmentation and aspiration of ocular tissues

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4970656A (en) * 1986-11-07 1990-11-13 Alcon Laboratories, Inc. Analog drive for ultrasonic probe with tunable phase angle
US5001649A (en) * 1987-04-06 1991-03-19 Alcon Laboratories, Inc. Linear power control for ultrasonic probe with tuned reactance
FR2685211A1 (en) * 1991-12-20 1993-06-25 Technomed Int Sa Ultrasound therapy apparatus emitting ultrasonic waves producing thermal effects and cavitation effects
WO1993012742A1 (en) * 1991-12-20 1993-07-08 Technomed International Ultrasonic therapy apparatus delivering ultrasonic waves with thermal and cavitational effects
US5601526A (en) * 1991-12-20 1997-02-11 Technomed Medical Systems Ultrasound therapy apparatus delivering ultrasound waves having thermal and cavitation effects
JP3533217B2 (en) 1991-12-20 2004-05-31 テクノメド メディカル システム Ultrasound therapy device that outputs ultrasonic waves having thermal effect and cavitation effect
WO1997018851A1 (en) * 1995-11-24 1997-05-29 Ekos Corporation Hemostasis material and apparatus
US7955281B2 (en) 2006-09-07 2011-06-07 Nivasonix, Llc External ultrasound lipoplasty
US8262591B2 (en) 2006-09-07 2012-09-11 Nivasonix, Llc External ultrasound lipoplasty
WO2022040493A1 (en) * 2020-08-21 2022-02-24 Yau Gary Lloyd Ka Tao Ultrasonic treatment of vitreous opacities
EP4199869A4 (en) * 2020-08-21 2024-12-18 Yau, Gary Lloyd Ka Tao ULTRASOUND TREATMENT OF VITRINE OPACITIES

Also Published As

Publication number Publication date
GB8429661D0 (en) 1985-01-03
GB2167305B (en) 1988-11-30

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