# US 2014/0194859 A1 · System and method of performing femtosecond laser accomodative capsulotomy > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0194859 A1 - Document ID: US20140194859A1 - Status: Published application - Kind: A1 - Application number: 13/834,789 - Filed: 2013-03-15 - Published: 2014-07-10 - Earliest claimed: 2013-01-10 - Inventors: Pravoslava IANCHULEV - Web page: https://patentgrep.com/patent/US20140194859A1 ## CPC - A61F 9/00825: {for photodisruption} - A61B 34/30: Surgical robots - A61F 9/00736: {Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments (A61F9/008 takes precedence)} - A61B 34/32: operating autonomously - A61F 2009/0087: {Lens} - A61F 2009/00887: {Cataract} - A61F: FILTERS 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 (dental prosthetics A61C) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Disclosed is a system and method for making a first incision in an anterior capsule of a capsular bag, the first incision being less than or equal to approximately 3.5 mm in diameter and making a second incision in the anterior capsule, the second incision being less than or equal to approximately 3.0 mm in diameter. The first incision and the second incision are positioned off-center from a center portion of the anterior capsule. The method includes performing lens fragmentation of a lens in the capsular bag to yield lens material, inserting a first instrument into the first incision, inserting a second first instrument into the second incision and removing the lens material via one of the first instrument and the second instrument and through one of the first incision and the second incision. The tensile structure of the anterior portion of the capsular bag is maintained such that accommodation exists within the eye after insertion of the intraocular lens. ## Claims ### Claim 1 A method of performing a capsulotomy in which each incision is sized and positioned to maintain at least a portion of capsular tensile strength and integrity within a central area of an anterior capsule of a capsular bag, the method comprising: making an incision in the anterior capsule of the capsular bag, the incision being less than 3.5 mm in diameter, wherein the method comprises making no more than three total, non-overlapping incisions in the anterior capsule such that at least a portion of the central anterior capsule is preserved to maintain tensile strength and accommodative capacity; performing endocapsular lens fragmentation of a lens in the capsular bag to yield lens material; inserting an instrument into the incision; and removing the lens material via the instrument and through the incision. ### Claim 2 (depends on 1) The method of claim 1, wherein the instrument comprises a tip that is one of flexible and extendible to allow intraocular directional angulation within the capsular bag. ### Claim 3 (depends on 1) The method of claim 1, further comprising polishing the anterior capsule. ### Claim 4 (depends on 3) The method of claim 3, further comprising implanting a new lens through the incision. ### Claim 5 (depends on 1) The method of claim 1, wherein the incision is off-center from a center portion of the anterior capsule. ### Claim 6 (depends on 1) The method of claim 1, further comprising making a second incision in the anterior capsule of the capsular bag, wherein the second incision is less than or equal to 3.0 mm in diameter, wherein the first incision and the second incision are positioned off-center from a center portion of the anterior capsule. ### Claim 7 (canceled) ### Claim 8 (depends on 1) The method of claim 1, wherein making the incision in the anterior capsule of the capsular bag is performed using a laser. ### Claim 9 (depends on 8) The method of claim 8, wherein the laser is a femtosecond laser. ### Claim 10 (depends on 1) The method of claim 1, further comprising irrigating within the capsular bag. ### Claim 11 (depends on 1) The method of claim 1, further comprising polishing a portion of an inner surface of the capsular bag. ### Claim 12 A method comprising: making a first incision in an anterior capsule of a capsular bag, the first incision being less than or equal to approximately 3.5 mm in diameter; making a second incision in the anterior capsule, the second incision being less than or equal to approximately 3.0 mm in diameter, wherein the first incision and the second incision are positioned off-center from a center portion of the anterior capsule; performing lens fragmentation of a lens in the capsular bag to yield lens material; inserting a first instrument into the first incision; inserting a second first instrument into the second incision; and removing the lens material via one of the first instrument and the second instrument and through one of the first incision and the second incision. ### Claim 13 (depends on 12) The method of claim 12, further comprising: polishing the anterior capsule; and implanting a new lens through at least one of the first incision and the second incision. ### Claim 14 (depends on 6) The method of claim 6, further comprising performing pre-treatment of the lens for removal of the lens material through one of the first incision and the second incision. ### Claim 15 (depends on 12) The method of claim 12, wherein one of the first instrument and the second instrument comprises a tip that is one of flexible and extendible to allow intraocular directional angulation within the capsular bag. ### Claim 16 (depends on 12) The method of claim 12, wherein making the first incision and making the second incision are performed using a laser. ### Claim 17 (depends on 16) The method of claim 16, wherein the laser is a femtosecond laser. ### Claim 18 (depends on 12) The method of claim 12, wherein making the first incision and making the second incision result in maintaining at least a portion of capsular tensile strength and integrity across the anterior capsule. ### Claim 19 (depends on 1) The method of claim 1, wherein the at least a portion of capsular tensile strength and integrity within the central 6 mm area of the anterior capsule that is maintained is of at least 2 diopters. ### Claim 20 (depends on 12) The method of claim 12, further comprising: polishing at least a portion of an interior surface of the capsular bag. ### Claim 21 A system comprising: a processor; a laser; and a computer readable medium storing instructions, which, when executed by the processor, cause the processor in connection with the laser to perform operations comprising: making a first incision in an anterior capsule of a capsular bag, the first incision being approximately equal to or less than 3.5 mm in diameter; and making a second incision in the anterior capsule, the second incision being approximately equal to or less than 3.5 mm in diameter, wherein the first incision and the second incision are positioned to maintain at least a portion of capsular tensile strength and integrity across the anterior capsule. ### Claim 22 (depends on 21) The system of claim 21, wherein at least one of the first incision and the second incision is positioned off center from a center portion of the anterior capsule. ### Claim 23 A device comprising: a neck portion having a tip end and a control end, the neck portion having a first channel for irrigating an eye during a surgery and a second channel for aspirating material from the eye during the surgery; a flexible and extendable tip portion connected to the tip end of the neck portion; a tip portion control mechanism connected to the flexible and extendable tip and connected to a user control system; an irrigation opening positioned generally at the tip portion and connected through the first channel with an irrigation system that causes material to flow through the first channel and through the irrigation opening into the eye; an aspiration opening, positioned on the flexible and extendable tip portion, which aspirates lens material from the eye through the second channel to an aspiration system; and a movable member connected to the user control such that user movement of the movable member causes the control medium to perform one of lateral movement and extension or contraction of the flexible and extendable tip portion from a point beyond an incision entry point in the eye. ### Claim 24 A method comprising: via an automated, computer-guided system: making an incision in an anterior capsule of a capsular bag, the incision being less than approximately 3.5 mm in diameter, wherein at least one of a size, a position, and a shape of the incision are chosen based on feedback associated with a capsular tensile strength across the anterior capsule; and performing endocapsular lens fragmentation of a lens in the capsular bag to yield lens material. ### Claim 25 (depends on 24) The method of claim 24, further comprising aspirating the lens material via the incision and inserting an intraocular lens into the capsular bag via the incision. ### Claim 26 (depends on 24) The method of claim 24, wherein the automated, computer-guided system comprises a laser and wherein the position of the incision is off-center in the anterior capsule. ### Claim 27 (depends on 24) The method of claim 24, wherein the automated, computer-guided system is programmed to choose a position for the incision in an off center position if the feedback indicates that the off center position would preserve the capsular tensile strength across the anterior capsule.