Electrosurgical method and systems for treating glaucoma

• US 20070161981A1
• Filed: 01/06/2006
• Published: 07/12/2007
• Est. Priority Date: 01/06/2006
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Dahla, Robert, Sanders, Norman
• Application Number:
  US11/327,553
• Publication Number:
  US 20070161981A1
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• 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 9/0079 using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves

Abstract

An electrosurgical method for treating open angle and narrow angle glaucoma, comprising positioning an active electrode in close proximity to a drainage angle of the eye, the active electrode disposed on a distal end of a shaft; and applying a high frequency voltage difference between the active electrode and a return electrode sufficient to ablate and coagulate target tissue in the vicinity of the drainage angle, to create drainage canals with prolonged patency.

Claims

1. An electrosurgical method for treating glaucoma, comprising:

positioning an active electrode in close proximity to a drainage angle of the eye, the active electrode disposed on a distal end of a shaft; and

applying a high frequency voltage difference between the active electrode and a return electrode sufficient to ablate target tissue in the vicinity of the drainage angle.

2. The method of claim 1, wherein the high frequency voltage is sufficient to generate plasma between the active and return electrodes.

3. The method of claim 1, wherein an electrically conductive fluid is present at least on the active electrode.

4. The method of claim 3, wherein the electrically conductive fluid is selected from the group consisting of isotonic saline, ringer lactate solution, a conductive gel, intra-cellular body fluid and other conductive body fluid.

5. The method of claim 3, wherein the electrically conductive fluid comprises a conductive fluid bridge between the active and return electrode.

6. The method of claim 3, wherein plasma is generated from the electrically conductive fluid.

7. The method of claim 3, wherein the active electrode is connected to a regulated power supply.

8. The method of claim 3, wherein the electrically conductive fluid is discharged from a lumen integrated with the shaft.

9. The method of claim 3, wherein the high frequency voltage is sufficient to vaporize the electrically conductive fluid.

10. The method of claim 1, wherein the return electrode is prevented from contacting tissue in the vicinity of the drainage angle.

11. The method of claim 1, wherein the active electrode contacts tissue in the vicinity of the drainage angle.

12. The method of claim 1, wherein the shaft is translated axially and radially over the target tissue.

13. The method of claim 1, wherein ablating the target tissue relieves intraocular pressure within the eye.

14. The method of claim 1, wherein ablating the target tissue includes volumetrically removing tissue.

15. The method of claim 1, wherein the target tissue comprises tissue in the iris and the trabecular meshwork.

16. The method of claim 15, wherein ablating the tissue comprise forming a drainage canal in the tissue between the iris and the Schlemm canal in the eye.

17. The method of claim 15, wherein ablating the tissue comprises creating drainage canals within the iris, the canals defined by stabilized borders for resisting scar formation and closure.

18. The method of claim 15, wherein ablating the target tissue comprises forming a defect in the drainage angle, the defect defined by a self-sealing borders for prolonged patency.

19. The method of claim 18, wherein the defect maintains patency between the drainage angle and the Schlemm canal in the eye.

20. The method of claim 19, wherein the defect is from about 0.2 mm to about 0.3 mm in diameter.

21. The method of claim 2, wherein plasma is directed intermittingly to the target tissue for about 0.5 seconds on each instance.

22. The method of claim 1, including adjusting the voltage sufficient to coagulate portions of the target tissue.

23. The method of claim 18, including adjusting the voltage sufficient to coagulate the self-sealing borders.

24. The method of claim 1, wherein the active electrode is selected from a group consisting of a pointed filament electrode, a pointed electrode, a wire electrode, a screen electrode and suction a suction electrode.

26. The method of claim 18, wherein formation of the defects relieve the symptoms of narrow angle glaucoma.

25. The method of clam 16, wherein formation of the drainage canals to relieve symptoms of open angle glaucoma.