DEVICES AND METHODS FOR GLAUCOMA TREATMENT

• US 20070276315A1
• Filed: 08/08/2007
• Published: 11/29/2007
• Est. Priority Date: 04/08/2002
• Status: Active Grant

• Current Assignee: Glaukos Corporation
• Original Assignee: Glaukos Corporation
• Inventors: Tu, Hosheng, Haffner, David, Smedley, Gregory
• Granted Patent: US 7,879,001 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/9505 having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61F 2002/9583 Means for holding the stent on the balloon, e.g. using protrusions, adhesives or an outer sleeve
• CPC Class Codes: A61F 2002/9665 with additional retaining means
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

Intraocular stents and applicators are disclosed for treating glaucoma. The stents are configured to extend between the anterior chamber of the eye and Schlemm'"'"'s canal for enhancing outflow of aqueous from the anterior chamber so as to reduce intraocular pressure. The stents can have features for anchoring the stent into Schlemm'"'"'s canal as well as preventing the walls of Schlemm'"'"'s canal from closing the outlet of the stents. The applicators can be steerable so as to make implantation easier. Additionally, the applicators can be configured to hold a plurality of stents so that multiple stents can be implanted through one incision without removing the applicator from the incision between serial implantations.

Claims

1. A method of implanting a plurality of implants for treating glaucoma, comprising:

inserting an instrument into an eye through an incision;

providing a plurality of biocompatible implants that, when implanted, convey aqueous humor from an anterior chamber of the eye to a fluid outflow path of the eye so as to reduce intraocular pressure;

utilizing said instrument to deliver a first biocompatible implant through a wall of Schlemm'"'"'s canal at a first location; and

utilizing said instrument to deliver a second biocompatible implant through a wall of Schlemm'"'"'s canal at a second location, without removing said instrument from the eye between said deliveries of said implants;

wherein said deliveries of said implants comprises piercing eye tissue adjacent to Schlemm'"'"'s canal.

2. The method of claim 1, further comprising determining said locations with reference to morphological data on collector channel locations.

3. The method of claim 1, wherein the incision is a superiorly located limbal incision.

4. The method of claim 3, wherein the incision is between 10 o'"'"'clock and 2 o'"'"'clock.

5. The method of claim 1, further comprising performing cataract surgery through said incision.

6. The method of claim 1, further comprising determining said locations by imaging collector channel locations.

7. The method of claim 1, wherein said implants are delivered through a trabecular meshwork of said eye.

8. The method of claim 1, wherein said locations are angularly spaced along Schlemm'"'"'s canal by at least 20 degrees.

9. The method of claim 1, wherein the first and second locations are substantially at collector channels.

10. The method of claim 1, wherein said implants have different flow characteristics.

11. The method of claim 1, wherein one of said first and second locations is nasal and the other of said first and second locations is temporal.

12. The method of claim 1, wherein at least one of said first and second locations is at a collector channel.

13. The method of claim 1, wherein piercing eye tissue involves advancing a sharpened member of the instrument into said eye tissue.

14. The method of claim 13 additionally comprising advancing at least one of the implants over the sharpened member to the corresponding first or second location.

15. A method of implanting a plurality of implants for treating glaucoma, comprising:

inserting an instrument into an eye through an incision;

utilizing said instrument to deliver a first biocompatible implant through a wall of Schlemm'"'"'s canal at a first location; and

utilizing said instrument to deliver a second biocompatible implant through a wall of Schlemm'"'"'s canal at a second location;

wherein said locations are determined from morphological data on a collector channel and said first and second locations are angularly spaced along Schlemm'"'"'s canal by at least 20 degrees.

16. The method of claim 15, wherein at least one of said first and second locations is at a collector channel.

17. A method of implanting a plurality of implants for treating glaucoma, comprising:

inserting an instrument into an eye through an incision;

utilizing said instrument to pierce a wall of Schlemm'"'"'s canal and to deliver a first biocompatible implant through that wall of Schlemm'"'"'s canal at a first location; and

utilizing said instrument to pierce a wall of Schlemm'"'"'s canal and to deliver a second biocompatible implant through that wall of Schlemm'"'"'s canal at a second location;

wherein the first and second locations are substantially at collector channels.

18. The method of claim 17, wherein piercing eye tissue involves advancing a sharpened member of the instrument into said eye tissue.

19. The method of claim 18 additionally comprising advancing at least one of the implants over the sharpened member to the corresponding first or second location.

20. A method of implanting a plurality of implants for treating glaucoma, comprising:

inserting an instrument into an eye through an incision;

piercing through a wall of Schlemm'"'"'s canal at a first location;

utilizing said instrument to deliver a first biocompatible implant to the first location;

piercing through the wall of Schlemm'"'"'s canal at a second location; and

utilizing said instrument to deliver a second biocompatible implant to the second location;

wherein said implants have different flow characteristics.

21. The method of claim 20, wherein at least one of said first and second locations is at a collector channel.

22. The method of claim 20, wherein piercing eye tissue involves advancing a sharpened member of the instrument into said eye tissue.

23. The method of claim 22 additionally comprising advancing at least one of the implants over the sharpened member to the corresponding first or second location.

24. A method of implanting a plurality of implants for treating glaucoma, comprising:

inserting an instrument into an eye through an incision;

positioning said instrument at a first location and utilizing a cutting edge of said instrument to pierce eye tissue adjacent a posterior segment of the eye;

utilizing said instrument to deliver a first implant into the posterior segment of the eye at said first location; and

moving said instrument to a second location and utilizing said instrument to deliver a second implant into the posterior segment of the eye at the second location, without removing said instrument from the eye between said deliveries of said implants.

25. A method of treating an eye condition, the method comprising:

making an incision into a naturally-occurring space of an eye;

inserting an instrument through the incision;

serially dispensing a plurality of preloaded implants from the instrument into eye tissue at a respective plurality of locations within the eye, said dispensing comprising moving the instrument a respective plurality of times without removing the instrument from the incision; and

said dispensing further comprising piercing eye tissue using a trocar disposed in said instrument to allow delivery of said implants to respective said locations.

26. A method of treating glaucoma, comprising:

providing first and second biocompatible implants that, when implanted, convey aqueous humor from an anterior chamber of an eye to a fluid outflow path of the eye so as to reduce intraocular pressure;

implanting said first biocompatible implant in tissue at a first location to convey said aqueous humor and reduce intraocular eye pressure; and

implanting said second biocompatible implant in tissue at a second location to convey said aqueous humor and reduce intraocular eye pressure, said first and second locations being selected such that implanting the second implant significantly reduces the intraocular eye pressure relative to the reduction achieved by implanting only the first implant;

wherein said first and second locations are angularly spaced along Schlemm'"'"'s canal by at least 20 degrees.