Abstract: An accommodating intraocular lens (AIOL) can include a base lens having an anterior base lens component, an optical axis, and a posterior base lens component. The base lens can include a plurality of retaining structures formed in the anterior base lens component and/or the posterior base lens component. The base lens can include an optical chamber and a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber. The AIOL can include a fixed lens configured to be removably coupled with the base lens, the fixed lens having a lens portion and a plurality of tabs extending radially outward from the lens portion, each tab being configured to enter one of the plurality of retaining structures when the fixed lens is coupled to the base lens.

Abstract: An accommodating intraocular lens (AIOL) can include an accommodating lens structure having an accommodating optical power. The AIOL can include a secondary structure removably connected to the accommodating lens. In some embodiments, the accommodating lens structure is configured to adjust the accommodating optical power in response to radial forces from the capsule of a patient. The secondary structure can be a sensor assembly, a powered lens and/or a light-adjustable lens. In some embodiments, the accommodating lens structure comprises an outer fluid reservoir and a fluid accommodating lens in fluid communication with the outer fluid reservoir. The outer fluid reservoir can be configured to transfer fluid into the fluid accommodating lens in reaction to compressive forces on the outer fluid reservoir.

Abstract: A medical manipulation assembly includes a catheter and distal and proximal steering mechanisms. The catheter includes distal and proximal steerable portions with working channels configured to receive an instrument. The distal steering mechanism is operable to bend the distal steerable portion in a first plane relative to the proximal steerable portion in response to movement of a first portion of the distal steering mechanism about a first axis of rotation and to bend the distal steerable portion in a second plane relative to the proximal steerable portion in response to movement of a second portion of the distal steering mechanism about a second axis of rotation. The proximal steering mechanism is operable to bend the proximal steerable portion by rotational movement of the proximal steering mechanism. Distal pullwires extend between the distal steerable portion and steering mechanism and proximal pullwires extend between the proximal steerable portion and steering mechanism.

Abstract: The present technology relates to systems, device, and methods for delivering an AIOL into a patients eye. In some embodiments, a tip assembly for delivering an AIOL into a includes an injector tip configured to receive the AIOL. The injector tip can include a distal portion configured to be inserted at least partially into the patients eye. The tip assembly can also include a plunger assembly positionable at least partially within the injector tip. The plunger assembly can include a plunger tip configured to engage the AIOL and an outer member coupled to the plunger tip and positioned at least partially around the plunger tip. When the plunger assembly is actuated, the plunger tip can be configured to move distally relative to the outer member to displace the AIOL out of the injector tip and into the patients eye.

Abstract: A medical manipulation assembly comprises a catheter including distal and proximal steerable portions with working channels. The assembly further comprises a steerable sheath through which the steerable portions extend. A distal steering mechanism, including a first lumen extending along a longitudinal axis of the catheter, bends the distal steerable portion. A proximal steering mechanism, including a second lumen extending along the axis and defined by a wall, bends the proximal steerable portion by rotational movement of the proximal steering mechanism independently of the distal steerable portion. The wall is rotatable about the axis. Distal pullwires extend between the distal steerable portion and the distal steering mechanism. Proximal pullwires extend between the proximal steerable portion and the proximal steering mechanism.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: Methods and devices are provided for use in medical applications involving tissue removal. One exemplary powered scissors device includes a distal housing having a fixed cutting arm located thereon, an elongate member coupled to the distal housing and configured to introduce the distal housing to a target tissue site of the subject, a rotatable blade rotatably mounted to the distal housing, the rotatable blade having at least one cutting element configured to cooperate with the fixed arm to shear tissue therebetween, a crown gear located at a distal end of an inner drive tube, and a first spur gear configured to inter-engage with the crown gear and coupled with the rotatable blade to allow the crown gear to drive the rotatable blade.

Abstract: Various embodiments of a tissue cutting device and methods for using are described. In some variations devices include an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end; a first annular element at the distal end of the elongate tube, the first annular element having a cutting portion at its distal; and a second annular element at the distal end of the elongate tube and concentric with the first annular element, the second annular element having a cutting portion at its distal end, the first and second annular elements being rotatable relative to one another to cause the first annular element and the second annular element to pass each other to shear tissue.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: A bendable medical device such as for removing tissue from a subject is provided with a distal housing, an outer support tube, an inner drive tube, a coupler and a commutator portion. The coupler and commutator portion serve to axially constrain a distal end of the inner drive tube during bending, and to supply fluid for lubricating, cooling and irrigating the distal end of the device.

Abstract: Methods and devices are provided for use in medical applications involving tissue removal. One exemplary powered scissors device includes a distal housing having a fixed cutting arm located thereon, an elongate member coupled to the distal housing and configured to introduce the distal housing to a target tissue site of the subject, a rotatable blade rotatably mounted to the distal housing, the rotatable blade having at least one cutting element configured to cooperate with the fixed arm to shear tissue therebetween, a crown gear located at a distal end of an inner drive tube, and a first spur gear configured to inter-engage with the crown gear and coupled with the rotatable blade to allow the crown gear to drive the rotatable blade.

Abstract: A medical device for removing tissue from a subject is provided with a distal housing, an elongate member, a first rotatable member and first and second tissue shearing edges. The distal housing is configured with at least one tissue engaging opening. The elongate member is coupled to the distal housing and configured to introduce the distal housing to a target tissue site. The first rotatable member is located at least partially within the distal housing. The first and second tissue shearing edges are configured to cooperate to shear tissue therebetween. The first rotatable member is configured to engage tissue from the target tissue site, rotate towards the second tissue shearing edge. A first axis of the first rotatable member is offset from the longitudinal axis of the elongate member, lies in a common plane and forms an angle therewith of between 0 and 90 degrees. Methods are also disclosed.

Abstract: A medical manipulation assembly comprises an elongated distal steerable portion with a distal working channel extending through the elongated distal steerable portion. The assembly also comprises an elongated proximal steerable portion arranged proximally of the elongated distal assembly portion. A proximal working channel extends through the elongated proximal steerable portion. The assembly also comprises a distal steering mechanism to bend the distal steerable portion in response to movement of the distal steering mechanism. The assembly also comprises a proximal steering mechanism to bend the proximal steerable portion, independently of the distal steerable portion, in response to rotational movement of the proximal steering mechanism. The assembly also comprises distal pullwire(s) extending between the elongated distal steerable portion and the distal steering mechanism and proximal pullwire(s) extending between the elongated proximal steerable portion and the proximal steering mechanism.

Abstract: Catheter control systems which facilitate the tracking of an angle of deflection of a catheter distal end can be used for any number of procedures where catheter orientation relative to the body is desirable, e.g., in transseptal access procedures where an accurate angle of puncture of the septal wall is desirable. Such control systems may comprise a steerable handle which is oriented relative to the catheter steerable section to provide for consistent catheter articulation upon corresponding manipulation of the steering ring. Another variation may utilize an orientation indicator to track the deflectable distal end. For instance, an orientation marker as visualized through an imaging hood on the distal end may correspond to identical orientation markers on the control handle such that articulation of a steering mechanism in a direction relative to the orientation markers deflects the catheter distal end in a corresponding direction relative to the visualized orientation markers.

Abstract: A bendable medical device such as for removing tissue from a subject is provided with a distal housing, an outer support tube, an inner drive tube, a coupler and a commutator portion. The coupler and commutator portion serve to axially constrain a distal end of the inner drive tube during bending, and to supply fluid for lubricating, cooling and irrigating the distal end of the device.

Abstract: A method for removing at least part of a brain tumor may first involve contacting a forward-facing tissue cutter disposed at the distal end of a tissue removal device with the brain tumor. The tissue removal device may include a shaft having a diameter no greater than about 10 mm, and in some embodiments the tissue cutter does not extend laterally beyond the diameter of the shaft. The method may next involve cutting tissue from the brain tumor, using the tissue cutter. The method may then involve moving the cut tissue through a channel of the shaft in a direction from the distal end of the tissue removal device toward a proximal end of the device.

Abstract: A medical device such as for removing tissue from a subject is provided with a distal housing configured with a tissue cutter assembly, an elongate member coupled to the distal housing and having an outer tube and an inner drive tube with a crown gear located on a distal end thereof, first and second rotatable members each rotatably mounted to the tissue cutter assembly, a first drive gear train coupled between the crown gear and the first rotatable member, and a second drive gear train coupled between the crown gear and the second rotatable member. The first and second drive gear trains are configured to drive the first and second rotatable members, respectively, in opposite directions. Concave and convex gear tooth profiles are also disclosed for improved performance of the first and second drive gear trains.

Abstract: A medical device for removing tissue from a subject is provided with a distal housing, an elongate member, a first rotatable member and first and second tissue shearing surfaces. The distal housing is configured with at least one tissue engaging opening. The elongate member is coupled to the distal housing and configured to introduce the distal housing to a target tissue site. The first rotatable member is located at least partially within the distal housing. The first and second tissue shearing surfaces are located and configured to cooperate with first and second sides of a first blade to shear tissue therebetween. The first rotatable member is configured to engage tissue from the target tissue site, rotate towards the first and second tissue shearing surfaces and inwardly to direct tissue from the target tissue site through the tissue engaging opening and into an interior portion of the distal housing.

Abstract: A medical device for removing or manipulating tissue of a subject is provided with a distal housing having an end effector, and an elongate member configured to introduce the distal housing to a target tissue site of the subject. The elongate member may have proximal and distal portions interconnected by a joint mechanism that is configured to allow the two portions to articulate relative to one another. In some embodiments, the joint mechanism includes one or more nested crown gear(s) configured to drive associated spur gear(s) to accomplish the articulation. In some embodiments, the end effector is a powered scissors device.

Abstract: Catheter control systems which facilitate the tracking of an angle of deflection of a catheter distal end can be used for any number of procedures where catheter orientation relative to the body is desirable, e.g., in transseptal access procedures where an accurate angle of puncture of the septal wall is desirable. Such control systems may comprise a steerable handle which is oriented relative to the catheter steerable section to provide for consistent catheter articulation upon corresponding manipulation of the steering ring. Another variation may utilize an orientation indicator to track the deflectable distal end. For instance, an orientation marker as visualized through an imaging hood on the distal end may correspond to identical orientation markers on the control handle such that articulation of a steering mechanism in a direction relative to the orientation markers deflects the catheter distal end in a corresponding direction relative to the visualized orientation markers.