OCULAR IMPLANT SYSTEMS

• US 20130253405A1
• Filed: 03/05/2013
• Published: 09/26/2013
• Est. Priority Date: 04/08/2002
• Status: Abandoned Application

• Current Assignee: Glaukos Corporation
• Original Assignee: Glaukos Corporation
• Inventors: Tu, Hosheng
• Application Number:
  US13/786,402
• Publication Number:
  US 20130253405A1
• 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. An ocular implant system for implanting an ocular device into the eye, comprising:

a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, said fluid drainage device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea when in the deployed location; and

a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.

2. The device of claim 1, wherein the device is formed of a biocompatible elastomeric material.

3. The device of claim 1, wherein the fluid drainage device has an external diameter of 1 mm or less.

4. The device of claim 1, wherein the fluid drainage device has a length of less than 4 mm.

5. The device of claim 1, wherein at least a portion of the device has a curvature that matches the curvature of the eye.

6. An ocular device as in claim 1, wherein the entire device is cylindrical.

7. An ocular device as in claim 1, wherein the fluid drainage device is a tube.

8. The system of claim 1, wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.

9. The system of claim 1, wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.

10. The system of claim 1, wherein the delivery instrument comprises one or more of a blade, trocar and cannula.

11. The system of claim 10, wherein the blade, trocar or cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.

12. An ocular implant system for implanting an ocular device into the eye, comprising:

a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea when the device is in the deployed location, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.

13. The device of claim 12, wherein the device is formed of a biocompatible elastomeric material.

14. The device of claim 12, wherein the fluid drainage device has an external diameter of 1 mm or less.

15. The device of claim 12, wherein the fluid drainage device has a length of less than 4 mm.

16. An ocular device as in claim 12, wherein the entire device is cylindrical.

17. An ocular device as in claim 12, wherein the fluid drainage device is a tube.

18. The system of claim 12, wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.

19. The system of claim 12, wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.

20. The system of claim 12, wherein the delivery instrument comprises one or more of a trocar, blade or cannula.

21. The system of claim 20, wherein the trocar, blade or cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.

22. An ocular implant system for implanting an ocular device into the eye, comprising:

a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.

23. The device of claim 22, wherein the device is formed of a biocompatible elastomeric material.

24. The device of claim 22, wherein the fluid drainage device has an external diameter of 1 mm or less.

25. The device of claim 22, wherein the fluid drainage device has a length of less than 4 mm.

26. The device of claim 22, wherein sutures are not required to hold the device in the eye.

27. The device of claim 22, wherein the device is manufactured of a material that is sufficiently soft as to not erode choroid material when inserted into the eye.

28. An ocular device as in claim 22, wherein the entire device is cylindrical.

29. An ocular device as in claim 22, wherein the fluid drainage device is a tube.

30. The system of claim 22, wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.

31. The system of claim 22, wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.

32. The system of claim 22, wherein the delivery instrument comprises one or more of a blade, trocar and cannula.

33. The system of claim 32, wherein the blade, trocar or cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.

34. An ocular implant system for implanting an ocular device into the eye, comprising:

a fluid drainage device configured to be implanted in a deployed location in the eye via an incision in the cornea so that a first end of the fluid drainage device is positioned in the anterior chamber of the eye and a second end of the fluid drainage device is positioned in communication with the suprachoroidal space of the eye, the fluid drainage device having an internal lumen wherein a first opening at a first end of the internal lumen of the drainage device opens into the anterior chamber and a second opening at a second end of the internal lumen of the drainage device communicates with the suprachoroidal space when in the deployed location such that the internal lumen provides a direct fluid passageway from the anterior chamber towards the suprachoroidal space for aqueous pressure regulation when implanted in the deployed location in the eye and wherein the first end of the fluid drainage device is configured to be located inside the anterior chamber such that the first end is outside of the ciliary body and posterior of an inner surface of the cornea; and

a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.

35. An ocular device as in claim 34, wherein sutures are not required to hold the device in the eye.

36. An ocular device as in claim 34, wherein the fluid drainage device is cylindrical.

37. An ocular device as in claim 34, wherein the fluid drainage device has a length of 3 mm or more.

38. An ocular device as in claim 34, wherein the fluid drainage device has a length of about 3-4 mm.

39. An ocular device as in claim 34, wherein the fluid drainage device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera when in the deployed location.

40. An ocular device as in claim 34, wherein the entire device is cylindrical.

41. An ocular device as in claim 34, wherein the fluid drainage device is a tube.

42. The system of claim 34, wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.

43. The system of claim 34, wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.

44. The system of claim 34, wherein the delivery instrument comprises one or more of a blade, trocar and cannula.

45. The system of claim 44, wherein the blade, trocar or cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.

46. An ocular implant system, comprising:

an ocular implant comprising an elongated body having a proximal end region, a distal end region, and an internal lumen communicating with an inlet port in the proximal end region and an outlet port in the distal end region, the ocular implant configured to be introduced into the anterior chamber of the eye via an incision in the cornea and positioned in a deployed location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with the suprachoroidal space and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space; and

a delivery instrument comprising an elongated member that removably couples to the ocular implant, wherein the delivery instrument is configured to introduce the ocular implant into the anterior chamber through the corneal incision, advance the ocular implant through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the ocular implant from the elongated member and into the deployed location.

47. A system as in claim 46, wherein the ocular implant is a tube.

48. A system as in claim 46, wherein the ocular implant is cylindrical.

49. A system as in claim 46, wherein the elongated member of the delivery instrument is a cannula.

50. A system as in claim 46, wherein the delivery instrument is configured to introduce the ocular implant into the anterior chamber through a self-sealing corneal incision.

51. A system as in claim 46, wherein the elongated member of the delivery instrument is sized to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.

52. The system of claim 46, wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.

53. The system of claim 46, wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.

54. The system of claim 46, wherein the delivery instrument comprises one or more of a blade, trocar and cannula.

55. The system of claim 54, wherein the blade, trocar or cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.

56. A system for implanting device into the eye, comprising:

a device configured to be implanted in the eye in such that a first end of the device is in communication with the choroid, the device having lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in the eye in an implantation location such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, said device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the device has a second end configured to reside in the anterior chamber; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form the opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.

57. The system of claim 56, wherein the device is formed of a biocompatible elastomer.

58. The system of claim 56, wherein the device is foldable and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

59. The system of claim 56, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

60. The system of claim 56, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

61. The system of claim 56, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

62. The system of claim 56, wherein at least a portion of the device has a curvature.

63. The system of claim 62, wherein the curvature matches the curvature of at least a portion of the eye.

64. The system of claim 56, wherein the device is at least partially cylindrical.

65. The system of claim 56, wherein the device is a tube.

66. The system of claim 56, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

67. The system of claim 56, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route.

68. The system of claim 67, wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.

69. The system of claim 56, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

70. The system of claim 56, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

71. The system of claim 56, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

72. The system of claim 56, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

73. The system of claim 72, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

74. The system of claim 72, wherein the member is configured to form the opening in eye tissue.

75. The system of claim 56, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

76. The system of claim 56, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

77. The system of claim 56, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

78. The system of claim 56, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

79. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.

80. The system of claim 79, wherein the device is formed of a biocompatible elastomer.

81. The system of claim 79, wherein the device is foldable and wherein at least a portion of the device has a diameter such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

82. The system of claim 79, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

83. The system of claim 79, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

84. The system of claim 79, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

85. The system of claim 79, wherein the device is cylindrical.

86. The system of claim 79, wherein the device is a tube.

87. The system of claim 79, wherein the wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

88. The system of claim 79, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

89. The system of claim 79, wherein the first end is located so as to be in communication with a uveal scleral outflow route.

90. The system of claim 89, wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.

91. The system of claim 79, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

92. The system of claim 79, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

93. The system of claim 79, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

94. The system of claim 93, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

95. The system of claim 93, wherein the member is configured to form the opening in eye tissue.

96. The system of claim 79, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

97. The system of claim 79, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

98. The system of claim 79, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

99. The system of claim 79, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

100. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.

101. The system of claim 100, wherein the device is formed of a biocompatible elastomer.

102. The system of claim 100, wherein the device is foldable, and wherein at least a portion of the device has a diameter such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

103. The system of claim 100, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

104. The system of claim 100, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

105. The system of claim 100, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

106. The system of claim 100, wherein the structure of the device secures the device in the eye.

107. The system of claim 100, wherein the device is manufactured of a biocompatible material that is sufficiently soft as to not erode choroid material when inserted into the eye.

108. The system of claim 100, wherein the device is manufactured of a biocompatible material such that inflammation arising due to irritation between the outer surface of the device and the surrounding tissue is minimized, and wherein the surrounding tissue comprises the choroid.

109. The system of claim 100, wherein the device is at least partially cylindrical.

110. The system of claim 100, wherein the device is a tube.

111. The system of claim 100, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

112. The system of claim 100, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

113. The system of claim 100, wherein the first end is located so as to be in communication with a uveal scleral outflow route.

114. The system of claim 113, wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.

115. The system of claim 100, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

116. The system of claim 100, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

117. The system of claim 100, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

118. The system of claim 117, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

119. The system of claim 117, wherein the member is configured to form the opening in eye tissue.

120. The system of claim 100, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

121. The system of claim 100, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

122. The system of claim 100, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

123. The system of claim 100, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

124. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in an implantation location in the eye via an incision in the cornea so that a first end of the device is positioned in the anterior chamber of the eye and a second end of the device is positioned in communication with the choroid, the device having a lumen wherein a first opening at a first end of the lumen of the device opens into the anterior chamber and a second opening at a second end of the lumen of the device communicates with the choroid when in the implantation location such that the lumen provides a direct flow pathway from the anterior chamber towards the choroid for intraocular pressure balancing when implanted in the implantation location in the eye and wherein the first end of the device is configured to reside in the anterior chamber; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.

125. The system of claim 124, wherein the structure of the device secures the device in the eye.

126. The system of claim 124, wherein the device is cylindrical.

127. The system of claim 124, wherein the device is foldable, and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

128. The system of claim 124, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

129. The system of claim 124, wherein the device is elastomeric.

130. The system of claim 124, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

131. The system of claim 124, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

132. The system of claim 124, wherein the device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera confines of the sclera and cornea when in the implantation location.

133. The system of claim 124, wherein the device is at least partially cylindrical.

134. The system of claim 124, wherein the device is a tube.

135. The system of claim 124, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

136. The system of claim 124, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

137. The system of claim 124, wherein the first end is located so as to be in communication with a uveal scleral outflow route.

138. The system of claim 137, wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.

139. The system of claim 124, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

140. The system of claim 124, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

141. The system of claim 124, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

142. The system of claim 141, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

143. The system of claim 141, wherein the member is configured to form the opening in eye tissue.

144. The system of claim 124, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

145. The system of claim 124, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

146. The system of claim 124, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

147. The system of claim 124, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

148. A system, comprising:

an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in an implantation location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with the choroid and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the choroid; and

a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation location.

149. A system as in claim 148, wherein the implant is a tube.

150. A system as in claim 148, wherein the implant is cylindrical.

151. A system as in claim 148, wherein the delivery apparatus comprises a cannula.

152. A system as in claim 148, wherein the delivery apparatus is configured to introduce the implant into the anterior chamber through a self-sealing corneal incision.

153. A system as in claim 148, wherein the elongate tip of the delivery apparatus is configured to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.

154. The system of claim 148, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

155. The system of claim 148, wherein the first end is located so as to be in communication with a uveal scleral outflow route.

156. The system of claim 155, wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.

157. The system of claim 148, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

158. The system of claim 148, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

159. The system of claim 148, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

160. The system of claim 159, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

161. The system of claim 159, wherein the member is configured to form the opening in eye tissue.

162. The system of claim 148, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

163. The system of claim 148, wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

164. A system for implanting a device into the eye, comprising:

a device configured to be implanted in the eye such that a first end of the device is in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route through the lumen, said device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the device has a second end configured to reside in the anterior chamber; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.

165. The device of claim 164, wherein the device is formed of a biocompatible elastomer.

166. The system of claim 164, wherein the device is foldable and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

167. The device of claim 164, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

168. The system of claim 164, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

169. The system of claim 164, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

170. The system of claim 164, wherein at least a portion of the device has a curvature.

171. The system of claim 170, wherein the curvature matches the curvature of at least a portion of the eye.

172. The system of claim 164, wherein the device is at least partially cylindrical.

173. The system of claim 164, wherein the device is a tube.

174. The system of claim 164, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

175. The system of claim 164, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

176. The system of claim 164, such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

177. The system of claim 164, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

178. The system of claim 164, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

179. The system of claim 164, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

182. The system of claim 164, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

183. The system of claim 164, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus further comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

181. The system of claim 181, wherein the member is configured to form the opening in eye tissue.

180. The system of claim 181, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

184. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.

185. The system of claim 184, wherein the device is formed of a biocompatible elastomer.

186. The system of claim 184, wherein the device is foldable and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

187. The system of claim 184, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

188. The system of claim 184, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

189. The system of claim 184, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

190. The system of claim 184, wherein the device is at least partially cylindrical.

191. The system of claim 184, wherein the device is a tube.

192. The system of claim 184, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

193. The system of claim 184, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

194. The system of claim 184, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

195. The system of claim 184, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

196. The system of claim 184, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

197. The system of claim 196, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

198. The system of claim 196, wherein the member is configured to form the opening in eye tissue.

199. The system of claim 184, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

200. The system of claim 184, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus further comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

201. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.

202. The system of claim 201, wherein the device is formed of a biocompatible elastomer.

203. The system of claim 201, wherein the device is foldable and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

204. The system of claim 201, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

205. The system of claim 201, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

206. The system of claim 201, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

207. The system of claim 201, wherein the structure of the device secures the device in the eye.

208. The system of claim 201, wherein the device is manufactured of a biocompatible material that is sufficiently soft as to not erode choroid material when inserted into the eye.

209. The system of claim 201, wherein the device is manufactured of a biocompatible material such that inflammation arising due to irritation between the outer surface of the device and the surrounding tissue is minimized, and wherein the surrounding tissue comprises the choroid.

210. The system of claim 201, wherein the device is at least partially cylindrical.

211. The system of claim 201, wherein the device is a tube.

212. The system of claim 201, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

213. The system of claim 201, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

214. The system of claim 201, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

215. The system of claim 201, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

216. The system of claim 201, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

217. The system of claim 216, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

218. The system of claim 216, wherein the member is configured to form the opening in eye tissue.

219. The system of claim 201, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

220. The system of claim 201, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a guidewire wherein the guidewire is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

221. A system for implanting a device into the eye, comprising:

a device for establishing an outflow pathway configured to be implanted in a implantation location in the eye via an incision in the cornea so that a first end of the device is positioned in the anterior chamber of the eye and a second end of the device is positioned in communication with a uveal scleral outflow route, the device having a lumen wherein a first opening at a first end of the lumen of the device opens into the anterior chamber and a second opening at a second end of the lumen of the device communicates with the uveal scleral outflow route when in the implantation location such that the lumen provides a direct flow pathway from the anterior chamber towards the uveal scleral outflow route for intraocular pressure balancing when implanted in the implantation location in the eye and wherein the first end of the device is configured to reside in the anterior chamber; and

a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.

222. The system of claim 221, wherein the structure of the device secures the device in the eye.

223. The system of claim 221, wherein the device is cylindrical.

224. The system of claim 221, wherein the device is foldable and wherein at least a portion of the device has a diameter sized such that the at least a portion of the device can be placed within a diameter of Schlemm'"'"'s canal upon being folded.

225. The system of claim 221, wherein the device is foldable, and wherein the device is sized to be inserted through a corneal incision of less than about 1 mm.

226. The system of claim 221, wherein the device is elastomeric and is dimensioned to be placed between the anterior chamber and Schlemm'"'"'s canal through the trabecular meshwork wherein the device is elastomeric.

227. The system of claim 221, wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm'"'"'s canal or within a collector duct.

228. The system of claim 221, wherein the device has a length that extends from the anterior chamber to the choroid when implanted.

229. The system of claim 221, wherein the fluid drainage device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera confines of the sclera and cornea when in the implantation location.

230. The system of claim 221, wherein the entire device is cylindrical.

231. The system of claim 221, wherein the device is a tube.

232. The system of claim 221, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.

233. The system of claim 221, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

234. The system of claim 221, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

235. The system of claim 221, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

236. The system of claim 221, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

237. The system of claim 236, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

238. The system of claim 236, wherein the member is configured to form the opening in eye tissue.

239. The system of claim 221, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

240. The system of claim 221, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus further comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

241. An ocular implant system, comprising:

an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in an implantation location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with a uveal scleral outflow route and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route; and

a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the implant through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation location.

242. A system as in claim 241, wherein the implant is a tube.

243. A system as in claim 241, wherein the implant is cylindrical.

244. A system as in claim 241, wherein the delivery apparatus comprises a cannula.

245. A system as in claim 241, wherein the delivery apparatus is configured to introduce the ocular implant into the anterior chamber through a self-sealing corneal incision.

246. A system as in claim 241, wherein the elongate tip of the delivery apparatus is configured to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.

247. The system of claim 241, wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.

248. The system of claim 241, wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.

249. The system of claim 241, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.

250. The system of claim 241, wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.

251. The system of claim 250, wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.

252. The system of claim 250, wherein the member is configured to form the opening in eye tissue.