FLUID INFUSION METHODS FOR OCULAR DISORDER TREATMENT

• US 20140343475A1
• Filed: 12/20/2013
• Published: 11/20/2014
• Est. Priority Date: 03/07/2002
• Status: Active Grant

• Current Assignee: Glaukos Corporation
• Original Assignee: Glaukos Corporation
• Inventors: Smedley, Gregory T., Haffner, David S., Tu, Hosheng
• Granted Patent: US 9,220,632 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• 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: A61M 2210/0612 Eyes
• CPC Class Codes: A61M 27/002 Implant devices for drainage of body fluids from one part of the body to another intraocular A61F9/00781; middle ear A61F11/202
• CPC Class Codes: A61M 5/14 Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor

Abstract

Methods of treating ocular disorders are disclosed, such as a method that includes inserting an implant in eye tissue, using a delivery instrument, such that an inlet portion of the implant is in an anterior chamber of an eye and an outlet portion of the implant is in a physiological outflow pathway; removing the delivery instrument from the eye without removing the implant; and conducting fluid comprising a therapeutic substance through the implant and into the physiological outflow pathway. Another method includes inserting an instrument into a physiologic outflow pathway through which aqueous humor drains from an anterior chamber of an eye; separating first and second walls of tissues which comprise the physiologic outflow pathway by injecting a fluid comprising a drug from the instrument while the instrument remains in the physiologic outflow pathway; and withdrawing the instrument following the injection with said fluid remaining within the eye such that the drug has a therapeutic effect on the eye.

Claims

1. A method of treating glaucoma, comprising:

inserting an outflow element through an incision in an eye having an aqueous cavity, the outflow element having an inflow portion that is in fluid communication through an outflow element lumen with an outflow portion of the outflow element;

transporting the outflow portion through the anterior chamber from the incision to the trabecular meshwork;

advancing the outflow portion through the trabecular meshwork and into the aqueous cavity of the eye;

positioning the outflow element such that outflow portion is positioned at the aqueous cavity;

providing a delivery element having a delivery lumen;

coupling the delivery element to the outflow element, such that the outflow element lumen is confluent with the delivery lumen; and

infusing fluid through the delivery lumen to the outflow element lumen, such that fluid flows from the inflow portion to the outflow portion, and such that the fluid flows into the aqueous cavity;

wherein the aqueous cavity is selected from the group consisting of Schlemm'"'"'s canal, an aqueous collector channel, and an episcleral vein of the eye.

2. The method of claim 1, wherein said infusing of fluid is at a pressure sufficient to cause plastic deformation of at least a portion of the aqueous cavity.

3. A method of treating glaucoma, comprising:

inserting a delivery element through an incision in an eye, the delivery element having a lumen and an outflow portion that is in fluid communication with the lumen of the delivery element;

transporting the outflow portion through the anterior chamber from the incision to the trabecular meshwork;

advancing the outflow portion through the trabecular meshwork and into Schlemm'"'"'s canal of the eye; and

applying pressure to a fluid such that the fluid flows through the lumen of the delivery element and into Schlemm'"'"'s canal through the outflow portion.

4. The method of claim 3, wherein the fluid is other than aqueous humor.

5. The method of claim 3, wherein said fluid is at least one of salt solution or viscoelastic fluid.

6. The method of claim 3, wherein the fluid comprises a therapeutic substance selected from the group consisting of a pharmaceutical, a gene, a growth factor, and an enzyme.

7. The method of claim 3, wherein the fluid comprises a therapeutic substance selected from the group consisting of an antiglaucoma drug, a beta-adrenergic antagonist, a TGF-beta compound, and an antibiotic.

8. The method of claim 3, wherein said pressure is sufficient to cause plastic deformation of at least a portion of Schlemm'"'"'s canal.

9. The method of claim 8, wherein a temperature of said fluid is raised sufficiently to enhance said plastic deformation.

10. The method of claim 8, wherein a pH of said fluid is adjusted sufficiently to enhance said plastic deformation.

11. The method of claim 3, further comprising vibrating a tissue of said eye.

12. A method of treating glaucoma, comprising:

inserting a delivery element through an incision in an eye having an aqueous collector channel, the delivery element having a lumen and an outflow portion that is in fluid communication with the lumen of the delivery element;

transporting the outflow portion through the anterior chamber from the incision to the trabecular meshwork;

advancing the outflow portion through the trabecular meshwork and into an aqueous collector channel of the eye; and

applying pressure to a fluid such that the fluid flows through the lumen of the delivery element and into the aqueous collector channel through the outflow portion.

13. The method of claim 12, wherein the fluid is other than aqueous humor.

14. The method of claim 12, wherein said fluid is at least one of salt solution or viscoelastic fluid.

15. The method of claim 12, wherein the fluid comprises a therapeutic substance selected from the group consisting of a pharmaceutical, a gene, a growth factor, and an enzyme.

16. The method of claim 12, wherein the fluid comprises a therapeutic substance selected from the group consisting of an antiglaucoma drug, a beta-adrenergic antagonist, a TGF-beta compound, and an antibiotic.

17. The method of claim 12, wherein said pressure is sufficient to cause plastic deformation of at least a portion of the aqueous collector channel.

18. The method of claim 17, wherein a temperature of said fluid is raised sufficiently to enhance said plastic deformation.

19. The method of claim 17, wherein a pH of said fluid is adjusted sufficiently to enhance said plastic deformation.

20. The method of claim 12, further comprising vibrating a tissue of said eye.