Delivery system and method of use for the eye
First Claim
1. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemni'"'"'s canal, said method comprising the steps of:
- identifying target tissues comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
analyzing obstructions located in target tissues;
stabilizing an anterior chamber of said eye;
inserting a probe into said anterior chamber of said eye;
positioning a distal end of said probe within an operable limit of said target tissues;
delivering laser energy from said probe sufficient to cause photoablation of portions of at least one of said trabecular meshwork, said juxtacanalicular trabecular meshwork and an inner wall of said Schlemm'"'"'s canal.
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Accused Products
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.
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Citations
73 Claims
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1. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemni'"'"'s canal, said method comprising the steps of:
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identifying target tissues comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
analyzing obstructions located in target tissues;
stabilizing an anterior chamber of said eye;
inserting a probe into said anterior chamber of said eye;
positioning a distal end of said probe within an operable limit of said target tissues;
delivering laser energy from said probe sufficient to cause photoablation of portions of at least one of said trabecular meshwork, said juxtacanalicular trabecular meshwork and an inner wall of said Schlemm'"'"'s canal.
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2. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemm'"'"'s canal, said method comprising the steps of:
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identifying target tissues comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
analyzing obstructions located in said target tissues;
stabilizing an anterior chamber of said eye;
inserting a probe into said anterior chamber of said eye;
positioning a distal end of said probe within an operable limit of said target tissues;
compressing a portion of said target tissues;
delivering laser energy from said probe sufficient to cause photoablation of portions of at least one of said trabecular meshwork, said juxtacanalicular trabecular meshwork and an inner wall of said Schlemm'"'"'s canal. - View Dependent Claims (3, 4, 5, 6, 59, 60, 61)
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7. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemm'"'"'s canal, said method comprising the steps of:
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advancing a probe into said eye to a position that is one of in contact with a target site and adjacent to said target site, said target site comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
delivering energy from said probe sufficient to cause photoablation of portions of at least a portion of each of said juxtacanalicular trabecular meshwork and an inner wall of said Schlemm'"'"'s canal. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15, 16, 53, 54, 55)
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17. A method of controlling an interior anatomy of an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemm'"'"'s canal, said method comprising the steps of:
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creating an opening in said eye;
filling an anterior chamber of said eye with a viscoelastic material through said opening;
sensing an interior pressure within said eye; and
adjusting said interior pressure to compress or decompress at least one of said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal.
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18. A method of reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemm'"'"'s canal, said method comprising the steps of
creating a pathway through said trabecular meshwork and an inner wall of said Schlemm'"'"'s canal; - and
inserting an implant device in said pathway, said implant device extending from said inner wall of Schlemm'"'"'s canal to one of an anterior chamber of said eye and into said trabecular meshwork. - View Dependent Claims (19)
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20. An apparatus for providing laser energy to target tissues of an eye, said target tissues comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork and a Schlemm'"'"'s canal, said apparatus comprising:
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a laser unit for generating laser energy; and
a laser probe for transmitting laser energy to said target tissues for photoablating a portion of said juxtacanalicular trabecular meshwork and an inner wall of said Schlemrn'"'"'s canal.
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21. An intraocular laser probe for manipulating or removing tissue, comprising:
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a tubular sleeve having a distal end and a proximal end for coupling to a laser energy unit;
an optical core being disposed within the tubular sleeve, the optical core having a distal tip for transmitting laser energy for causing photoablation of target tissues; and
a sensing device for sensing at least one parameter in said eye. - View Dependent Claims (32, 56, 57)
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22. A device for use in reducing intraocular pressure of an eye, said device to be implanted into said eye, comprising:
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a tubular portion having a distal end including a first engaging member for attached to an interior surface of a first structure located in said eye and having a proximal end including a plurality of second engaging members for attaching to a second structure located in said eye wherein said first structure is an inner wall of said Schlemm'"'"'s canal and said second structure is said trabecular meshwork.
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23. An intraocular laser probe for manipulating or removing tissue, comprising:
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a tubular sleeve having a distal end and a proximal end for coupling to a laser light unit for providing laser light sufficient to cause photoablation of tissue, the tubular sleeve having a central axis extending between the distal end and the proximal end, the distal end of the tubular sleeve being inclined with respect to the central axis; and
an optical core being disposed within the tubular sleeve for transmitting the laser light, the optical core having a distal tip at the distal end of the tubular sleeve, the distal tip having a predetermined shape for controlling a spot size of the laser light on the target tissue. - View Dependent Claims (24, 25, 26)
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27. An intraocular laser probe for manipulating or removing tissue, comprising:
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a tubular sleeve having a distal end and a proximal end for coupling to a laser light unit for providing laser light sufficient to cause photoablation of a target tissue, the tubular sleeve having a central axis extending between the distal end and the proximal end, the distal end of the tubular sleeve being inclined with respect to the central axis; and
an optical core being disposed within the tubular sleeve for transmitting the laser light, the optical core having a distal tip at the distal end of the tubular sleeve, the distal tip having an inclined shape with respect to the center axis for controlling a spot size of the laser light on the target tissue; and
an optical control device for adjusting the spot size of the laser light, the optical control device being abutted and adapted to mate with the inclined shape of the distal tip. - View Dependent Claims (28, 29, 30, 31)
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33. An apparatus for providing photoablative laser energy to target tissues of an eye, said apparatus comprising:
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a probe containing a fiber-optic element, a handset, coupled to said probe, for controlling operation of said probe;
a servo device coupled to said handset for controlling pressure in said eye;
a laser unit coupled to said handset for supplying photoablative laser energy to said eye through said fiber-optic element;
a first controller coupled to said handset for supplying at least one of aqueous fluids and viscoelastic materials to said probe for delivery to said eye; and
a second controller coupled to said handset for removing waste evacuated through said probe. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 72, 73)
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52. A method of controlling a laser delivery system for photoablating target tissues of an eye with photoablative laser radiation having a fluence and a repetition rate, said method comprising the steps of:
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monitoring a sensed temperature adjacent to said target tissues during photoablation;
comparing said sensed temperature to a predetermined temperature;
in response to said step of comparing, if said sensed temperature is greater than said predetermined temperature, adjusting said repetition rate of said laser radiation.
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58. An intraocular laser probe for manipulating or removing tissue, comprising:
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a tubular sleeve having a distal end and a proximal end for coupling to a laser energy unit;
an optical core being disposed within the tubular sleeve, the optical core having a distal tip for transmitting laser energy for causing photoablation of target tissues;
means for reflecting light pulses from said tissue;
means for generating a signal based on said light pulses wherein said signal comprises data describing a position of said probe in relation to said tissue.
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62. A method for photoablating tissue in a body comprising:
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advancing a probe said body to a position that is one of in contact with a target site and adjacent to said target site;
delivering energy from said probe sufficient to cause photoablation of portions said tissue;
sensing with said probe at least one of temperature and pressure. - View Dependent Claims (63, 64, 65, 66, 67)
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68. An apparatus for providing photoablative laser energy to target tissues comprising:
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a probe having an optical core for transmission of photoablative laser energy;
a handset coupled to said probe;
a sensing device for sensing at least one of pressure, temperature and physical contact of said prove with said target tissues. - View Dependent Claims (69)
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70. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork, a Schwalbe'"'"'s line and a Schlemm'"'"'s canal, said method comprising the steps of:
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identifying target tissues comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
stabilizing an anterior chamber of said eye;
selecting a fiber tip for use on a probe, said fiber tip having a unique energy distribution;
inserting said probe into said anterior chamber of said eye;
identifying said Schwalbe'"'"'s line;
positioning said probe at said Schwalbe'"'"'s line;
delivering laser energy from said probe sufficient to cause photoablation said target tissues.
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71. A method for reducing intraocular pressure in an eye, said eye comprising a trabecular meshwork, a juxtacanalicular trabecular meshwork, and a Schlemm'"'"'s canal, said method comprising the steps of:
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identifying target tissues comprising said trabecular meshwork, said juxtacanalicular trabecular meshwork and said Schlemm'"'"'s canal;
stabilizing an anterior chamber of said eye;
selecting a fiber tip for use on a probe, said fiber tip having a unique energy distribution;
inserting said probe into said anterior chamber of said eye;
identifying an anatomical landmark in said eye;
positioning said probe at said anatomical landmark;
delivering laser energy from said probe sufficient to cause photoablation of said target tissues.
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Specification