System and method for treating an ocular disorder

• US 10,485,702 B2
• Filed: 06/08/2018
• Issued: 11/26/2019
• Est. Priority Date: 04/14/2000
• Status: Expired due to Term

• Current Assignee: Glaukos Corporation
• Original Assignee: Glaukos Corporation
• Inventors: Bergheim, Olav B., Gharib, Morteza, Hill, Richard A.
• Primary Examiner(s): Wiest, Philip R
• Application Number:
  US16/003,919
• Publication Number:
  US 20190046355A1
• Time in Patent Office: 536 Days
• Field of Search: 604 8, 604 9
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 2250/0067 Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts
• CPC Class Codes: A61F 9/007 Methods or devices for eye surgery
• 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: A61K 9/0051 Ocular inserts, ocular implants
• CPC Class Codes: A61M 2210/0612 Eyes
• CPC Class Codes: A61M 27/002 Implant devices for drainage of body fluids from one part of the body to another intraocular A61F9/00781; middle ear A61F11/202
• CPC Class Codes: A61P 27/06 Antiglaucoma agents or miotics
• CPC Class Codes: Y10S 623/905 Eye

Abstract

Surgical methods and related medical devices for treating ocular disorders are disclosed. Some methods relate to delivering an implant within an eye, and involve providing an elongate guide device, such as, a flexible guide member or a guide wire. A distal end of the guide device can be advanced into an anterior chamber of an eye, or through at least a portion of a site of resistance along a physiologic outflow pathway of the eye, or from an anterior chamber of the eye to a location proximate a physiologic outflow pathway of the eye. The implant is advanced along the guide device toward the guide device distal end, and is positioned to conduct aqueous humor between the anterior chamber and the physiologic outflow pathway.

Claims

1. A method of treating glaucoma comprising:

forming an incision in a cornea of an eye;

inserting a delivery applicator through the incision in the cornea and across at least a portion of an anterior chamber of the eye in an ab interno manner under gonioscopic guidance, the delivery applicator comprising an elongate member having a distal end portion configured to retain an implant therein, the distal end portion comprising a cutting member configured to penetrate a trabecular meshwork of the eye for receipt of the implant in Schlemm'"'"'s canal;

penetrating the trabecular meshwork using the cutting member of the delivery applicator;

guiding the implant into Schlemm'"'"'s canal such that a distal section of the implant extends along a length of Schlemm'"'"'s canal and such that a proximal end of the implant is positioned in the anterior chamber; and

removing the delivery applicator from the eye,

wherein the implant comprises flexible material that is at curved along its distal section,

wherein the implant is sized and shaped so as to slide in place in Schlemm'"'"'s canal without undue suturing, and

wherein the implant has at least one opening positioned along its distal section.

2. The method of claim 1, wherein the incision is a self-sealing incision.

3. The method of claim 1, wherein implant is made of a biocompatible, elastic material.

4. The method of claim 1, wherein the implant has a generally tubular shape.

5. The method of claim 1, wherein the implant comprises a one-way valve.

6. The method of claim 1, wherein the implant comprises one or more retention features.

7. A method of treating glaucoma comprising:

forming an incision in a cornea of an eye;

inserting a delivery applicator through the incision in the cornea and across at least a portion of an anterior chamber of the eye, the delivery applicator comprising an elongate member having a distal end portion configured to retain an elongated seton therein, the delivery applicator being sharpened;

penetrating a trabecular meshwork of the eye using the delivery applicator;

guiding the elongated seton into Schlemm'"'"'s canal of the eye such that a distal section of the elongated seton extends along a length of Schlemm'"'"'s canal and such that an inlet section of the elongated seton is positioned in the anterior chamber; and

removing the delivery applicator from the eye,

wherein the distal section of the elongated seton is curved at an angle between 30 degrees and 150 degrees with reference to the inlet section of the elongated seton, and

wherein the elongated seton has at least one opening positioned along its distal section.

8. The method of claim 7, wherein the incision is a self-sealing incision.

9. The method of claim 7, wherein seton is made of a biocompatible, elastic material.

10. The method of claim 7, wherein the seton has a generally tubular shape.

11. The method of claim 7, wherein the seton comprises a one-way valve.

12. The method of claim 7, wherein the seton comprises one or more retention features.

13. The method of claim 7, wherein the seton comprises an opening along its distal section.

14. A method of treating glaucoma comprising:

forming an incision in a cornea of an eye;

inserting a delivery applicator through the incision in the cornea and across at least a portion of an anterior chamber of the eye in an ab interno manner under gonioscopic guidance, the delivery applicator comprising an elongate member having a distal end portion configured to retain an implant therein, the distal end portion comprising a cutting member configured to form an opening in the trabecular meshwork of the eye for receipt of the implant;

forming an opening in a trabecular meshwork using the cutting member of the delivery applicator;

delivering the implant out of the elongate member of the delivery applicator such that a distal section of the implant is positioned in Schlemm'"'"'s canal of the eye so as to extend along a length of Schlemm'"'"'s canal and such that a proximal end of the implant is positioned in the anterior chamber; and

removing the delivery applicator from the eye,

wherein the implant is made of relatively soft material that is at least somewhat curved at its distal section to fit into and along Schlemm'"'"'s canal,

wherein the implant is sized and shaped so as to stabilize the implant in place without undue suturing, and

wherein the implant has at least one opening positioned along its distal section.

15. The method of claim 14, wherein the incision is a self-sealing incision.

16. The method of claim 14, wherein implant is made of a biocompatible, elastic material.

17. The method of claim 14, wherein the implant has a generally tubular shape.

18. The method of claim 14, wherein the implant comprises a one-way valve.

19. The method of claim 14, wherein the implant comprises one or more retention features.