Delivery system and method of use for the eye

• US 10,383,689 B2
• Filed: 08/12/2003
• Issued: 08/20/2019
• Est. Priority Date: 05/19/2000
• Status: Expired due to Term

• Current Assignee: Michael S. Berlin
• Original Assignee: Michael S. Berlin
• Inventors: Berlin, Michael S.
• Primary Examiner(s): shay, david
• Application Number:
  US10/640,464
• Publication Number:
  US 20040082939A1
• Time in Patent Office: 5,852 Days
• Field of Search: 606 3- 6, 606 10- 19
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00066 intensity
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00321 Head or parts thereof
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00904 Automatic detection of target tissue
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/2255 Optical elements at the distal end of probe tips
• CPC Class Codes: A61F 2/14 Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
• CPC Class Codes: A61F 2/15 Implant having one or more holes, e.g. for nutrient transport, for facilitating handling
• CPC Class Codes: A61F 2009/00844 : Feedback systems
• CPC Class Codes: A61F 2009/00868 : Ciliary muscles or trabecular meshwork
• CPC Class Codes: A61F 2009/00891 : Glaucoma
• CPC Class Codes: A61F 9/00 : Methods 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 caps with means for protecting the eyes A42B1/018; visors for helmets A42B3/22; retractors A61B17/02; manipulators specially adapted for use in surgery A61B34/70; appliances to aid invalids to move about A61H3/00; exercisers for the eyes A61H5/00; eye baths A61H35/02; sunglasses or goggles having the same features as spectacles G02C
• CPC Class Codes: A61F 9/00781 : Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002
• CPC Class Codes: A61F 9/008 : using laser
• CPC Class Codes: A61F 9/00802 : for photoablation

Abstract

A method and delivery system are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm'"'"'s canal of an eye for reducing elevated intraocular pressure. Pulsed laser radiation is delivered from the distal end of a fiber-optic probe sufficient to cause photoablation of selected portions of the trabecular meshwork, the juxtacanalicular trabecular meshwork and an inner wall of Schlemm'"'"'s canal in the target site. The fiber-optic probe may be advanced so as to create an aperture in the inner wall of Schlemm'"'"'s canal in which fluid from the anterior chamber of the eye flows. The method and delivery system may further be used on any tissue types in the body.

Claims

1. An apparatus for performing a procedure on an eye, said eye having a target tissue region comprising a trabecular meshwork and a Schlemm'"'"'s canal having an inner wall, the apparatus comprising:

a laser to deliver a plurality of pulses of laser energy having a duration and fluence sufficient to cause photoablation of said trabecular meshwork and said inner wall of said Schlemm'"'"'s canal;

an elongate probe comprising a longitudinal axis and an optical fiber having a beveled distal end inclined to the longitudinal axis to uniformly compress a portion of said trabecular meshwork with a transocular ab interno approach, wherein said elongate probe is sized and shaped to extend across the eye from a corneal incision to the trabecular meshwork and uniformly compress the trabecular meshwork with said transocular ab interno approach, said optical fiber configured to deliver the plurality of pulses from said beveled distal end to the target tissue region comprising the trabecular meshwork and Schlemm'"'"'s canal, and receive light from the target tissue region through said beveled distal end;

a detector coupled to said elongate probe with said optical fiber to receive backscattered light from said target tissue region through said beveled distal end of said optical fiber;

wherein said elongate probe is coupled to said laser to deliver said plurality of pulses from the beveled distal end of said optical fiber to said portion of said trabecular meshwork and thereby produce an aperture through said trabecular meshwork and into said Schlemm'"'"'s canal by photoablation with said plurality of pulses.

2. The apparatus of claim 1, wherein said laser produces ultraviolet laser energy having a wavelength in a range from 193 to 355 nanometers.

3. The apparatus of claim 2, wherein said laser comprises a xenon chloride excimer laser.

4. The apparatus of claim 1, further comprising a laser control switch for controlling said laser.

5. The apparatus of claim 1, wherein said optical fiber is encased in a sleeve.

6. The apparatus of claim 1, wherein said optical fiber consists of a single optical fiber.

7. The apparatus of claim 6, wherein the single optical fiber is encapsulated in an encapsulating sheath.

8. The apparatus of claim 7, wherein the encapsulating sheath is configured to stiffen the single optical fiber.