APPARATUS AND METHOD FOR CONTROLLING PLACEMENT OF INTRAOCULAR IMPLANTS

• US 20190091012A1
• Filed: 09/28/2018
• Published: 03/28/2019
• Est. Priority Date: 09/28/2017
• Status: Active Grant

• Current Assignee: Glaukos Corporation
• Original Assignee: Glaukos Corporation
• Inventors: Kalina, JR., Charles Raymond
• Granted Patent: US 11,116,625 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 3/117 for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61F 2/1664 for manual insertion during surgery, e.g. forceps-like instruments
• CPC Class Codes: A61F 2009/0052 the instrument being supported on the patient's eye
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2250/0067 Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61F 9/0008 Introducing ophthalmic products into the ocular cavity or retaining products therein putting in contact lenses A61F9/0061; introducing or retaining media in cavities of the body in general A61M31/00
• 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 1/80 Suction pumps A61M1/64, A61M1/71, A61M60/00 take precedence
• CPC Class Codes: A61M 60/31 for enhancement of in vivo organ perfusion, e.g. retroperfusion
• CPC Class Codes: A61M 60/35 for specific surgeries, e.g. for Fontan procedure
• CPC Class Codes: A61M 60/405 the force acting on the blood contacting member being hydraulic or pneumatic

Abstract

Some embodiments disclosed herein relate to devices and methods for controlling placement of intraocular implants within a patient'"'"'s eye including but not limited to placement within or near the collector ducts of Schlemm'"'"'s canal located behind the trabecular meshwork. In some embodiments, a handheld peristaltic rotor device having a compression element can be positioned on a corneal surface of the eye and rotated to create a peristaltic movement of blood in one or more episcleral veins to generate blood reflux within Schlemm'"'"'s canal such that one or more collector ducts, or channels, of Schlemm'"'"'s canal can be located. In some embodiments, an implant can be implanted near the identified location of the one or more collector ducts, or channels.

Claims

1. A method of positioning intraocular implants at or near collector ducts of Schlemm'"'"'s canal of an eye, the method comprising:

positioning a handheld peristaltic rotor device on a corneal surface of an eye, the handheld peristaltic rotor device comprising a rotor having a plurality of compression elements;

rotating the rotor such that the plurality of compression elements create a peristaltic movement of blood from one or more occluded episcleral veins to Schlemm'"'"'s canal,

identifying a location of at least one collector duct of the eye based on the refluxed blood within Schlemm'"'"'s canal;

delivering an implant through an incision in the eye; and

placing an implant within the eye such that the implant is located at or near the identified location of the at least one collector duct.

2. The method of claim 1, wherein placing the implant within the eye comprises positioning an inlet end of the implant in an anterior chamber of the eye and positioning an outlet end of the implant proximal to the identified location of the collector duct.

3. The method of claim 2, wherein positioning the outlet end of the implant proximal to the identified location of the collector duct comprises positioning the outlet end within 1 mm of the identified location.

4. The method of claim 1, further comprising placing a second implant within the eye such that the second implant is located at or near the identified location of a second collector duct.

5. The method of claim 1, further comprising maintaining a fluid passageway from the anterior chamber to the collector duct through the implant.

6. The method of claim 1, further comprising delivering a therapeutic agent to the at least one collector duct.

7. A method of identifying a location of one or more collector ducts of Schlemm'"'"'s canal of an eye, the method comprising:

positioning a handheld peristaltic rotor device on a surface of an eye, the handheld rotor device comprising a rotor having a compression element;

rotating the rotor such that the compression element of the rotor induces a peristaltic movement of blood into Schlemm'"'"'s canal from one or more occluded episcleral veins, and

identifying a location of at least one collector duct of the eye based at least in part on the refluxed blood.

8. The method of claim 7, further comprising administering a drug to the identified location of the collector duct.

9. The method of claim 7, wherein rotating the rotor comprises manual rotation.

10. The method of claim 7, wherein rotating the rotor comprises winding a spring by manually rotating the rotor in a clockwise direction and then releasing the rotor to cause the spring to unwind and the rotor to rotate in a counter-clockwise direction.

11. A handheld peristaltic rotor device for locating collector ducts of Schlemm'"'"'s canal of an eye, the handheld peristaltic rotor device comprising:

a rotor having a proximal portion and a distal open end, the distal open end comprising a distal rim surface and a corneal clearance portion;

a plurality of compression elements protruding from the distal rim surface;

wherein the rotor and the plurality of compression elements are configured to cause a blood reflux into Schlemm'"'"'s canal from one or more occluded episcleral surface region of an eye by positioning the rotor on the episcleral surface of the eye and rotating the rotor.

12. The rotor device of claim 11, wherein the corneal clearance portion is configured to substantially conform to the episcleral surface region of the eye.

13. The rotor device of claim 11, wherein the rotor comprises a plurality of anti-suction vents configured to allow passage of air from a distal surface to an external surface of the rotor.

14. The rotor device of claim 11, wherein the plurality of compression elements comprises a plurality of concentric spiral protrusions.

15. The rotor device of claim 11, wherein the plurality of compression elements taper in height along their length.

16. The rotor device of claim 11, wherein the plurality of compression elements are formed of a compliant polymeric material.

17. The rotor device of claim 11, further comprising a handle connected to the proximal portion of the rotor to facilitate manual rotation of the rotor.

18. The rotor device of claim 11, further comprising an optical portion comprising a magnifying lens to facilitate visualization of reflux.

19. The rotor device of claim 18, wherein the optical portion is detachably coupled to the proximal portion of the rotor.

20. The rotor device of claim 18, further comprising a spring having a first end coupled to the optical portion and a second end coupled to the proximal portion of the rotor, wherein the spring is configured to cause rotation of the rotor.