Ocular pressure regulation

• US 8,808,220 B2
• Filed: 10/14/2010
• Issued: 08/19/2014
• Est. Priority Date: 11/14/2003
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Transcend Medical Incorporated (Alcon Incorporated)
• Inventors: Coroneo, Minas Theodore
• Primary Examiner(s): Wiest, Philip R
• Application Number:
  US12/905,003
• Publication Number:
  US 20110028884A1
• Time in Patent Office: 1,405 Days
• Field of Search: 604 7- 10, 604 27- 31, 604/48, 604/93.01, 604/117, 604289-291, 604/294, 604/503, 604/505, 606107-109, 606/167, 606/170
• US Class Current: 604/8
• CPC Class Codes: A61F 2/148 Implantation instruments specially adapted therefor
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

Disclosed are devices and methods of treating an ocular disorder including forming a self-sealing incision in a cornea into an anterior chamber of an eye; introducing through the incision a fluid drainage tube having a distal end, a proximal end and a longitudinal, internal lumen extending through the fluid drainage tube, wherein at least the proximal end passes through the anterior chamber; and implanting the distal end of the fluid drainage tube in fluid communication with the suprachoroidal space such that the proximal end of the fluid drainage tube remains in fluid communication with the anterior chamber.

Claims

1. A method of treating an ocular disorder, comprising:

forming a self-sealing incision in a cornea into an anterior chamber of an eye;

introducing through the incision a fluid drainage device having a distal end, a proximal end and a longitudinal, internal lumen extending through the fluid drainage device, wherein at least the proximal end passes through the anterior chamber; and

implanting the distal end of the fluid drainage device in fluid communication with the suprachoroidal space such that the proximal end of the fluid drainage device remains in fluid communication with the anterior chamber.

2. A method as in claim 1, wherein when the fluid drainage device is implanted, the proximal end of the fluid drainage device is located in the anterior chamber and the distal end of the fluid drainage device is located adjacent an inner surface of the sclera in fluid communication with the suprachoroidal space.

3. A method as in claim 1, wherein introducing through the incision a fluid drainage device comprises sequentially passing the distal end and then the proximal end into the anterior chamber as the fluid drainage device is being introduced.

4. A method as in claim 1, wherein the distal end and the proximal end of the fluid drainage device are sequentially passed such that the distal end and proximal end are concurrently located within the anterior chamber.

5. A method as in claim 1, wherein the distal end of the fluid drainage device is introduced through the incision prior to the proximal end of the fluid drainage device.

6. A method as in claim 1, further comprising passing the distal end and the proximal end of the fluid drainage device across the anterior chamber.

7. A method as in claim 1, wherein introducing through the incision a fluid drainage device comprises introducing the entire fluid drainage device into the anterior chamber of the eye.

8. A method as in claim 7, wherein introducing the entire fluid drainage device into the anterior chamber of the eye comprises passing the distal end and the proximal end of the fluid drainage device through the cornea.

9. A method as in claim 1, further comprising separating at least a portion of the ciliary body from at least a portion of the sclera from within the anterior chamber.

10. A method as in claim 9, wherein separating at least a portion of the ciliary body from at least a portion of the sclera comprises performing a cyclodialysis.

11. A method as in claim 10, wherein the cyclodialysis is performed using an ocular instrument separate from the fluid drainage device.

12. A method as in claim 1, wherein introducing through the incision a fluid drainage device comprises placing the fluid drainage device in the eye after separating at least a portion of the ciliary body from at least a portion of the sclera.

13. A method as in claim 1, further comprising applying laser energy to the trabecular meshwork of the eye.

14. A method as in claim 1, wherein forming a self-sealing incision is performed under direct visualization using a gonioscopy lens.

15. A method as in claim 1, wherein forming a self-sealing incision comprises creating a self-sealing incision in the cornea 180 degrees away from a planned insertion site of the fluid drainage device in the eye.

16. A method as in claim 1, wherein the incision is formed in the limbus of the cornea.

17. A method as in claim 1, further comprising filling the anterior chamber with a viscoelastic substance.

18. A method as in claim 1, further comprising injecting a viscoelastic substance into the anterior chamber of the eye prior to introducing the fluid drainage device through the self-sealing incision.

19. A method as in claim 1, further comprising injecting a viscoelastic substance into the eye such that the substance extends into the suprachoroidal space.

20. A method as in claim 1, further comprising using a viscoelastic substance to enlarge the suprachoroidal space.

21. A method as in claim 1, further comprising injecting a viscoelastic substance through an attachment between the ciliary body and the sclera.

22. A method as in claim 1, further comprising using a viscoelastic substance to enlarge an area of detachment of the ciliary body from the sclera.

23. A method as in claim 1, wherein the proximal end of the fluid drainage device provides a pathway into the internal lumen for aqueous humor to flow through the fluid drainage device from the anterior chamber to the suprachoroidal space and provide aqueous pressure regulation.

24. A method as in claim 1, wherein aqueous pressure of the eye is maintained at a pressure of not less than 10 mmHg.

25. A method as in claim 1, wherein the fluid drainage device includes an anchor, and further comprising placing the fluid drainage device in the eye such that the anchor is at least partially located on an inner surface of the sclera.

26. A method as in claim 1, wherein the fluid drainage device includes an anchor, and further comprising placing the fluid drainage device in the eye such that the anchor is at least partially located in the suprachoroidal space.

27. A method as in claim 1, wherein the fluid drainage device is substantially circular in cross-section.

28. A method as in claim 1, wherein the fluid drainage device comprises a tube.