Systems and methods for pulsed posterior vitreous detachment creation
This disclosure relates to a tissue separation system to separate the posterior vitreous cortex from the inner limiting membrane in the eye, and to the separation of other body tissues. A system includes a flexible elongate member having a proximal end and a distal end. The flexible elongate member is coupled to a fluid reservoir and has a lumen configured to deliver fluid from the reservoir for use in a surgical procedure and further includes a pump system coupled to the proximal end of the flexible elongate member and to the fluid reservoir, configured to pressurize the fluid to a pressure suitable for separating tissues. The system also includes a control system arranged to control the pump system to provide a series of pulses of fluid through the flexible elongate member and out from the distal end thereof to suitably separate the tissues during the surgical procedure.
1. A method of performing a posterior vitreous detachment, the method comprising:
receiving a command from a user of a surgical system to initiate a detachment process;
wherein the surgical system comprises a surgical console and a handpiece fluidly coupled to the surgical console;
wherein the surgical console comprises a fluid reservoir; and
wherein the handpiece comprises a handle portion configured to be grasped by a user and a flexible elongate lumen coupled to a distal end of the handle portion;
forcing a first pulse of fluid from the fluid reservoir through the flexible elongate lumen to a surgical site to separate a vitreous from a retina; and
forcing a second pulse of the fluid from the fluid reservoir through the flexible elongate lumen to the surgical site to further separate the vitreous from the retina, without repositioning the handpiece between the first and second pulses.
2. The method of claim 1 , wherein the first pulse of the fluid contains one of:
air;
salt solution;
perfluoro-n-octane; or
a viscoelastic polymer.
3. The method of claim 1 , wherein the first pulse of the fluid has a volume of about 100 microliters or less.
4. The method of claim 1 , further comprising:
receiving a first selection from the user that indicates a pulse volume; and
receiving a second selection from the user that indicates a pulse pressure, and
wherein the first pulse of the fluid has the pulse volume and wherein forcing the first pulse of the fluid comprises forcing the first pulse of the fluid at the pulse pressure.
5. The method of claim 4 , wherein the first selection from the user is received through a button, toggle switch, or slider on the handpiece.
6. The method of claim 4 , wherein the first selection from the user is received through a foot pedal system.
7. The method of claim 1 , wherein the first pulse and the second pulse are forced through the flexible elongate lumen having a proximal end and a nozzle at a distal end.
8. The method of claim 1 , further comprising directing a series of pulses toward the vitreous through a first side port of a distal end of the flexible elongate lumen and directing the series of pulses toward the retina through a second side port of the distal end of the flexible elongate lumen.
9. The method of claim 1 , further comprising inserting a distal end of a separation device into a posterior segment of an eye prior to receiving the command from the user of the surgical system to initiate the detachment process.
10. The method of claim 1 , wherein forcing the second pulse of the fluid from the reservoir of the surgical system through the flexible elongate lumen to the surgical site to further separate the vitreous tissue from the retina comprises injecting a series of pulses between a posterior vitreous cortex and an inner limiting membrane (ILM).
11. The method of claim 10 , further comprising making a small cut in the vitreous cortex to insert the handpiece between the posterior vitreous cortex and the ILM prior to injecting the series of pulses between the posterior vitreous cortex and the ILM.