Glaucoma Implant Device

• US 20070123812A1
• Filed: 11/21/2006
• Published: 05/31/2007
• Est. Priority Date: 12/03/2004
• Status: Active Grant

• Current Assignee: InnFocus, Inc. (Santen Pharmaceutical Company Limited)
• Original Assignee: Innfocus, LLC
• Inventors: Pinchuk, Leonard, Parel, Jean-Marie, Fantes, Francisco
• Granted Patent: US 7,594,899 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61F 2210/0071 thermoplastic
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

A surgical method is provided for diverting aqueous humor from the anterior chamber of the eye. A surgical tool is provided having a hollow support member that supports a portion of an aqueous humor drainage device. The device has an elongate duct structure and preferably at least one fixation member that extends therefrom. The distal end of the hollow support member is inserted into the anterior chamber of the eye through an opening passing through the sclera. The aqueous humor drainage device is deployed from the hollow support member for placement into the eye. In one embodiment, the fixation member is realized by a tab that is spaced apart from the two ends of the elongate duct structure. In another embodiment, the fixation member is realized by a pair of tines that extend in traverse directions relative to the central axis of the elongate duct structure.

Claims

1. A surgical method for diverting aqueous humor from the anterior chamber of the eye, the surgical method comprising:

providing a tool having a hollow support member that supports a portion of an implantable aqueous humor drainage device therein, the aqueous humor drainage device having an elongate duct structure;

inserting a distal end of the hollow support member of the tool into the anterior chamber of the eye through an opening passing through the sclera; and

deploying the aqueous humor drainage device from the hollow support member such that a distal portion of the elongate duct structure is disposed within the anterior chamber of the eye, an intermediate portion of the elongate duct structure extends through the opening passing through the sclera, and the proximal portion of the elongate duct structure extends to space outside the anterior chamber of the eye.

2. A surgical method according to claim 1, further comprising:

fixing the proximal portion of the elongate duct structure to ocular tissue.

3. A surgical method according to claim 2, wherein:

the proximal portion of the elongate duct structure is fixed within a pouch created by separating a portion of Tenon'"'"'s membrane from the sclera.

4. A surgical method according to claim 3, wherein:

the pouch is disposed adjacent the limbus of the eye.

5. A surgical method according to claim 3, further comprising:

closing the pouch with sutures.

6. A surgical method according to claim 3, further comprising:

inserting a drug carrier into the pouch, wherein the drug carrier is loaded with at least one therapeutic agent that minimizes fibrosis of ocular tissue.

7. A surgical method according to claim 6, wherein:

said at least on therapeutic agent is selected from the group including;

Visudyne, Lucentis (rhuFab V2 AMD), Combretastatin A4 Prodrug, SnET2, H8, VEGF Trap, Cand5, LS 11 (Taporfin Sodium), AdPEDF, RetinoStat, Integrin, Panzem, Retaane, Anecortave Acetate, VEGFR-1 mRNA, ARGENT cell-signalling technology, Angiotensin II Inhibitor, Accutane for Blindness, Macugen (PEGylated aptamer), PTAMD, Optrin, AK-1003, NX 1838, Antagonists of avb3 and 5, Neovastat, Eos 200-F and any other VEGF inhibitor, mitomycin C, 5-fluorouracil, corticosteroids (corticosteroid triamcinolone acetonide is most common), modified toxins, methotrexate, adriamycin, radionuclides, protein kinase inhibitors (including staurosporin, which is a protein kinase C inhibitor, as well as a diindoloalkaloids and stimulators of the production or activation of TGF-beta, including tamoxifen and derivatives of functional equivalents, e.g., plasmin, heparin, compounds capable of reducing the level or inactivating the lipoprotein Lp(a) or the glycoprotein apolipoprotein(a) thereof), nitric oxide releasing compounds (e.g., nitroglycerin) or analogs or functional equivalents thereof, paclitaxel or analogs or functional equivalents, inhibitors of specific enzymes (such as the nuclear enzyme DNA topoisomerase II and DAN polymerase, RNA polyermase, adenl guanyl cyclase), superoxide dismutase inhibitors, terminal deoxynucleotidyl-transferas, reverse transcriptase, antisense oligonucleotides that suppress cell proliferation, angiogenesis inhibitors (e.g., endostatin, angiostatin and squalamine), rapamycin, cerivastatin, and flavopiridol and suramin and the like, peptidic or mimetic inhibitors (i.e., antagonists, agonists, or competitive or non-competitive inhibitors of cellular factors that may trigger proliferation of cells, pericytes (e.g., cytokines, for example, interleukins such as IL-1), growth factors (for example, PDGF, TGF-alpha or -beta, tumor necrosis factor, smooth muscle-and endothelioal- derived growth factors such as endothelin or FGF), homing receptors (for example, for platelets or leukocytes), and extracellular matrix receptors (for example, integrins), subfragments of heparin, triazolopyrimidine (for example, trapidil, which is a PDGF antagonist), lovastatin; and

prostaglandins E1 or I2.

8. A surgical method according to claim 1, wherein:

a portion of the aqueous humor drainage device is realized from a polymeric material that is loaded with at least one therapeutic agent that minimizes fibrosis of ocular tissue.

9. A surgical method according to claim 8, wherein:

said at least on therapeutic agent is selected from the group including;

Visudyne, Lucentis (rhuFab V2 AMD), Combretastatin A4 Prodrug, SnET2, H8, VEGF Trap, Cand5, LS 11 (Taporfin Sodium), AdPEDF, RetinoStat, Integrin, Panzem, Retaane, Anecortave Acetate, VEGFR-1 mRNA, ARGENT cell-signalling technology, Angiotensin II Inhibitor, Accutane for Blindness, Macugen (PEGylated aptamer), PTAMD, Optrin, AK-1003, NX 1838, Antagonists of avb3 and 5, Neovastat, Eos 200-F and any other VEGF inhibitor, mitomycin C, 5-fluorouracil, corticosteroids (corticosteroid triamcinolone acetonide is most common), modified toxins, methotrexate, adriamycin, radionuclides, protein kinase inhibitors (including staurosporin, which is a protein kinase C inhibitor, as well as a diindoloalkaloids and stimulators of the production or activation of TGF-beta, including tamoxifen and derivatives of functional equivalents, e.g., plasmin, heparin, compounds capable of reducing the level or inactivating the lipoprotein Lp(a) or the glycoprotein apolipoprotein(a) thereof), nitric oxide releasing compounds (e.g., nitroglycerin) or analogs or functional equivalents thereof, paclitaxel or analogs or functional equivalents, inhibitors of specific enzymes (such as the nuclear enzyme DNA topoisomerase II and DAN polymerase, RNA polyermase, adenl guanyl cyclase), superoxide dismutase inhibitors, terminal deoxynucleotidyl-transferas, reverse transcriptase, antisense oligonucleotides that suppress cell proliferation, angiogenesis inhibitors (e.g., endostatin, angiostatin and squalamine), rapamycin, cerivastatin, and flavopiridol and suramin and the like, peptidic or mimetic inhibitors (i.e., antagonists, agonists, or competitive or non-competitive inhibitors of cellular factors that may trigger proliferation of cells, pericytes (e.g., cytokines, for example, interleukins such as IL-1), growth factors (for example, PDGF, TGF-alpha or -beta, tumor necrosis factor, smooth muscle- and endothelioal-derived growth factors such as endothelin or FGF), homing receptors (for example, for platelets or leukocytes), and extracellular matrix receptors (for example, integrins), subfragments of heparin, triazolopyrimidine (for example, trapidil, which is a PDGF antagonist), lovastatin; and

prostaglandins E1 or I2.

10. A surgical method according to claim 1, wherein:

the hollow support member has a sharp tip that is used to create the opening through the sclera leading into the anterior chamber of the eye.

11. A surgical method according to claim 1, wherein:

the opening through the sclera into the anterior chamber of the eye is created with a needle that is separate and distinct from the surgical tool.

12. A surgical method according to claim 1, wherein:

the aqueous humor drainage device has at least one fixation member.

13. A surgical method according to claim 12, wherein:

the at least one fixation member comprises a tab that extends radially outward from said elongate duct structure.

14. A surgical method according to claim 12, wherein:

the at least one fixation member comprises a pair of tines that extend in directions transverse to a central axis of said elongate duct structure, wherein said tines are spaced apart along the length of said elongate duct structure for disposition about opposite sides of the sclera of the eye.