Direct visualization system for glaucoma treatment

• US 10,085,633 B2
• Filed: 04/18/2013
• Issued: 10/02/2018
• Est. Priority Date: 04/19/2012
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Novartis Ag
• Inventors: Schaller, Michael, Ianchulev, Tsontcho, Lilly, Richard S., Clauson, Luke, Lari, David
• Primary Examiner(s): Kremer, Matthew
• Application Number:
  US13/865,927
• Publication Number:
  US 20130281817A1
• Time in Patent Office: 1,993 Days
• Field of Search: None
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3735 Optical coherence tomography [OCT]
• CPC Class Codes: A61B 3/1005 for measuring distances inside the eye, e.g. thickness of the cornea A61B3/11 takes precedence
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

A direct visualization (DV) system and methods are disclosed for measuring one or more anatomical features of the eye, including a depth of the iridocorneal angle of the eye. The DV system can include a wire extending distally from a handle with the wire having one or more indicators for measuring anatomical features of the eye. The DV system can be deployed into the eye and used with minimal trauma to ocular tissues. Furthermore, the DV system can be used independently or alongside other ocular instruments, such as instruments having indicators corresponding to the DV system for correctly implanting ocular implants without the use of a gonio lens.

Claims

1. A method of measuring an eye, comprising:

forming an incision in a cornea of the eye into an anterior chamber of the eye;

introducing through the incision a distal end of a first device configured for measuring an anatomical feature of the eye, the first device comprising a handle with a wire extending out of a distal end of the handle and a distal end of the wire configured to be pressed against ocular tissue in the eye, the wire including a first series of symbols positioned along a length of the wire, the first device further comprising a spring coupled to a proximal end of the wire which biases the wire toward a distally outward direction relative to the handle, wherein the wire moves relative to the handle solely as a result of an applied force by the ocular tissue against the distal end of the wire, and wherein the wire extends along a longitudinal axis, and where the distal end of the wire has a transverse dimension relative to the longitudinal axis that is greater than a transverse dimension relative to the longitudinal axis at a location of the wire proximal to the distal end of the wire;

passing the distal end of the wire through the incision and across the anterior chamber of the eye;

positioning the distal end of the wire against the ocular tissue below a scleral spur and above an iris such that the applied force is generated between the ocular tissue and the distal end of the wire, wherein the applied force overcomes a spring force of the spring such that solely the applied force causes the wire to retract proximally into the handle; and

measuring the anatomical feature of the eye by identifying one or more symbols of the first series of symbols along the length of the wire relative to an anatomical landmark in the eye;

withdrawing the first device from the eye, the first device being designed for only the introducing, passing, positioning, measuring, and withdrawing steps; and

inserting an ocular implant coupled to a second device through the incision, the second device comprising an implant delivery applier that includes a second series of symbols that correspond to the first series of symbols positioned along the length of the wire.

2. The method of claim 1, further comprising determining a size of the implant based on the measuring and coupling the implant to a distal end of the implant delivery applier.

3. The method of claim 2, further comprising advancing the implant across the anterior chamber of the eye and implanting the implant into the eye such that the implant forms a fluid communication between the anterior chamber of the eye and a suprachoroidal or supraciliary space.

4. The method of claim 1, wherein each of the symbols of at least one of the first series of symbols and second series of symbols is a number.

5. The method of claim 1, wherein each of the symbols of at least one of the first series of symbols and second series of symbols corresponds to a reference point.

6. The method of claim 1, wherein the transverse dimension of distal end of the wire is a loop.

7. The method of claim 6, wherein the loop is deformable.