Lacrimal silicone stent with very large diameter segment insertable transnasally

• US 6,083,188 A
• Filed: 02/04/1998
• Issued: 07/04/2000
• Est. Priority Date: 02/04/1998
• Status: Expired due to Term

• Current Assignee: Bruce B Becker
• Original Assignee: Bruce B Becker
• Inventors: Becker, Bruce B.
• Primary Examiner(s): Polutta, Mark O.
• Assistant Examiner(s): WILLIAMS, CATHERINE SERKE
• Application Number:
  US09/018,439
• Time in Patent Office: 881 Days
• Field of Search: 604/8, 604/264, 604/523, 623/11, 623/12
• US Class Current: 604/8
• CPC Class Codes: A61F 9/00772 Apparatus for restoration of tear ducts

Abstract

A lacrimal silicone stent has a very large diameter segment with a diameter greater than the largest diameter stent which can be pulled through the canaliculi readily without damaging the canaliculi, a thin central segment, a moderate diameter segment, and a distal segment with a lumen extending partway from its end. A lumen can also be provided in the very large diameter segment to enhance its flexibility. In addition, a lumina may be provided in the moderate diameter segment when it is formed as an extruded tube. Except for the lumina, the stent is solid. The stent may be molded in one piece, but it may also be made of molded and extruded segments which are fused together. To install the stent, according to a first method a sheath is inserted through the lacrimal system from the eye, through a DCR ostium into the nasal cavity. The distal segment is threaded into the sheath which is used to pull the distal segment back through the lacrimal system and out the superior canaliculus and punctum. A probe is inserted through a sidewall of the distal segment into the lumen. The probe is then pushed through the inferior punctum, the inferior canaliculus, the common canaliculus, the lacrimal sac and the DCR ostium into the nasal cavity. The probe is removed, and the stent is then pulled until the very large diameter segment is deployed transnasally through the DCR ostium. According to a second method, the distal segment of the stent is swaged on the probe which is used to feed the distal end of the stent through the sheath and help pull the very large diameter segment transnasally to stent the ostium.

Claims

1. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter segment, which at all times during said insertion of said stent has an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent.

2. Lacrimal stent apparatus of claim 1, wherein said very large diameter end segment has an outer diameter greater than 0.053 inch.

3. Lacrimal stent apparatus of claim 1, wherein said very large diameter segment is an end segment, and wherein said one or more segments comprise a relatively thin central segment, one end of which is connected to an end of said very large diameter end segment, and a moderate diameter segment, one end of which is connected to the other end of said central segment.

4. Lacrimal stent apparatus of claim 3, further comprising short transition segments between said central segment and said very large diameter end segment and said moderate diameter segment, respectively.

5. Lacrimal stent apparatus of claim 3, wherein a distal segment is connected to a second end of said moderate diameter segment.

6. Lacrimal stent apparatus of claim 5, wherein said distal segment has a lumen extending from the distal end of said distal segment for a portion of the length of said distal segment, the remainder of said distal segment being solid.

7. Lacrimal stent apparatus of claim 1, wherein said very large diameter segment is of such length that it is adapted to extend from said patient'"'"'s canaliculi through said ostium into said nasal cavity.

12. Lacrimal stent apparatus of claim 4, wherein said short transition segments and said central segment form a portion of said member with the largest variation in diameter, said portion being molded as a single piece.

13. Lacrimal stent apparatus of claim 4, wherein said entire member is molded as a single piece.

8. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter end segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent, said one or more segments comprising a relatively thin central segment, one end of which is connected to an end of said very large diameter end segment, a moderate diameter segment, one end of which is connected to the other end of said central segment, and a distal segment connected to a second end of said moderate diameter segment, said distal segment having a lumen extending from the distal end of said distal segment for a portion of the length of said distal segment, the remainder of the length of said soft silicone member being lumen free and solid.

9. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter end segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent, said one or more segments comprising a relatively thin central segment, one end of which is connected to an end of said very large diameter end segment, a moderate diameter segment, one end of which is connected to the other end of said central segment, and a distal segment connected to a second end of said moderate diameter segment, said distal segment having a lumen extending from the distal end of said distal segment for a portion of the length of said distal segment, said soft silicone member being lumen free and solid except for the location of said lumen, wherein said very large diameter end segment has an outer diameter of 0.075 inch and a length of 12 cm., said central segment has an outer diameter of 0.03 inch and a length of 20 mm., said moderate diameter segment has an outer diameter of 0.045 inch and a length of 15 cm., said distal segment has an outer diameter of 0.03 inch and a length of 7 cm., and said lumen has an inner diameter of 0.013 inch and a length of 3 cm.

10. Lacrimal stent apparatus of claim 9, wherein said silicone member further comprises a pair of transition segments between said central segment and said very large diameter end segment and said moderate diameter segment, respectively, said transition segments being 3 mm. in length.

11. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter end segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said very large diameter end segment having a lumen extending from the proximate end of said very large diameter segment for a portion of the length of said very large diameter segment, the remainder of the length of said very large diameter segment being lumen free and solid, whereby the flexibility of said very large diameter segment is enhanced.

14. Lacrimal stent apparatus adapted to be inserted in a patient'"'"'s lacrimal system, comprising an elongated soft silicone member having a distal end and a lumen formed in said distal member from said distal end of said member and extending for a small portion of the length of said member, the remainder of said member being lumen free and solid.

15. Lacrimal stent apparatus of claim 14, wherein said member further comprises one very large diameter segment with an outer diameter which is larger than the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi.

16. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent, said very large diameter segment being lumen free and solid.

17. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said segment being of such length that it is adapted to extend from said patient'"'"'s canaliculi through said ostium into said nasal cavity, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent.

18. Lacrimal stent apparatus adapted to be inserted in an ostium surgically formed between a patient'"'"'s lacrimal sac and nasal cavity, said stent apparatus comprising:

an elongated soft silicone member having a very large diameter noninflatable segment with an outer diameter which is larger than the diameter of the largest diameter stent which can be pulled readily through the patient'"'"'s canaliculi without damaging the canaliculi, said member also including one or more segments, the outer diameters of which are smaller than said diameter of the largest diameter stent.