METHOD OF AND DEVICE FOR IMPROVING THE FLOW OF AQUEOUS HUMOR WITHIN THE EYE

• US 20030139729A1
• Filed: 01/05/2000
• Published: 07/24/2003
• Est. Priority Date: 01/05/2000
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Grieshaber & Company AG Schaffhausen
• Inventors: GRIESHABER, HANS R., STEGMANN, PROF M.D. ROBERT
• Granted Patent: US 6,726,676 B2
• Time in Patent Office: Days
• US Class Current: 604/540
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

A method for improving the draining of aqueous humor in an eye of a living being and a device for widening the Schlemm'"'"'s canal is described wherein a first incision is made in a lamellar section of the sclera to form a first scleral flap which is then folded upwards in the direction of the cornea, thereby creating a recess in the sclera. A second scleral flap is formed by incising a second lamellar section in the area of the recess and lifted upwardly in the direction of the first sclera flap, thereby exposing two opposite openings into the Schlemm'"'"'s canal into which an expanding medium is injected into the Schlemm'"'"'s canal; formation of a slitlike passageway connecting the aqueous humor-permeable Descemet-membrane with the subscleral space is realized by detaching the Descemet-membrane on the area of the Schwalbe'"'"'s line by means of a slight pressure force; and subsequently, the first scleral flap folded back, after severance of the second scleral flap, for placement upon a support surface formed as a consequence of the incision of the second lamellar section. Subsequently, a viscous medium is injected into a subscleral space formed behind the first scleral flap and the first scleral flap is rejoined to the sclera.

Claims

1. A method for improving the draining of aqueous humor in an eye of a living being by conducting the aqueous humor in the area of the irido-corneal angle of the anterior chamber via the trabecular meshwork into Schlemms'"'"' canal and ultimately to the natural outflow pathways, said method comprising the steps of:

incising a first lamellar section of the sclera to form a first scleral flap;

lifting the first scleral flap upwards in the direction of the cornea, thereby creating a recess in the sclera;

incising a second lamellar section in the area of the recess to thereby form a second scleral flap and a support surface bounding the scleral flap;

lifting the second scleral flap upwards in the direction of the first sclera flap, thereby exposing two opposite openings into the Schlemm'"'"'s canal;

injecting an expanding medium through the openings into the Schlemm'"'"'s canal;

folding the first scleral flap back, after severance of the second scleral flap, for placement upon the support surface, thereby confining a subscleral space adjacent the first scleral flap;

injecting a viscous medium into the subscleral space; and

rejoining the first scleral flap to the sclera.

2. The method of claim 1, and further comprising the step of forming a passageway between the subscleral space and the anterior chamber by applying a pressure force against a peripheral edge of the aqueous humor-permeable Descemet'"'"'s membrane to detach the Descemet'"'"'s membrane from the cornea.

3. The method of claim 1 wherein severance of the second scleral flap is executed at any time after lifting the second scleral flap and before folding back the first scleral flap.

4. The method of claim 1 wherein the expanding medium is compressed and under pressure for accelerated injection into the Schlemm'"'"'s canal.

5. A device for expanding a surgically exposed Schlemm'"'"'s canal in an eye, comprising a probe insertable into the Schlemm'"'"'s canal for injecting a viscous medium to thereby generate a localized pressure buildup, said probe having an outlet port defined by a diameter and an axial length, with the length being sized at least twice the diameter.

6. The device of claim 5, and further comprising an adapter for connecting the probe to a pressure source for supply of expanding medium, said probe including a tube connected to the adapter and having a cross section selected from the group consisting of circular ring shape and elliptic shape.

7. The device of claim 6 wherein the adapter has an arcuate configuration, said tube having an inner axial bore which forms the outlet port and is in fluid communication with an interior space of the adapter for conduction of the expanding medium to the Schlemm'"'"'s canal.

8. The device of claim 6 wherein the adapter has an arcuate configuration, said tube having an outer periphery formed with an axial groove which forms the outlet port and is in fluid communication with an interior space of the adapter for conduction of the expanding medium to the Schlemm'"'"'s canal.

9. The device of claim 6 wherein the adapter has a T-shaped configuration and includes a vertical portion and a horizontal portion formed integrally with the vertical portion for attachment of two of said probe in opposite disposition, each of said probes having an inner axial bore which forms part of the outlet port and is in fluid communication with an inlet port in the vertical portion of the adapter.

10. The device of claim 9 wherein the vertical portion is connected to the pressure source via a feed conduit such that expanding medium is injected into the Schlemm'"'"'s canal via the inner axial bore of both probes simultaneously or sequentially.

11. The device of claim 5 wherein the probe has a length which is a multiple of its diameter and is freely movable with respect to disposition and orientation.

12. The device of claim 6 wherein the probe has a distal end and a proximal end which is connected to the adapter, said probe flaring outwardly from the distal end in the direction of the proximal end.

13. The device of claim 6 wherein the probe has a distal end and a proximal end and includes a transition piece which is secured to the proximal end of the probe for attachment to the adapter, said transition piece having a conical configuration or a circular arc shaped configuration.

14. The device of claim 6 wherein the probe is formed in one piece with the adapter.

15. The device of claim 6 wherein the probe is securely fixed in a complementary recess of the adapter.

16. The device of claim 5 wherein the probe is made of flexible plastic material.

17. The device of claim 5 wherein the probe is made of transparent plastic.

18. The device of claim 6 wherein the probe is a tube from metal.

19. The device of claim 18 wherein the metal is a flexible nickel titanium alloy.