Delivery system and method of use for the eye
DCFirst Claim
1. A method, of maintaining an opening in a trabecular meshwork of a patient'"'"'s eye to conduct fluid from an anterior chamber to Schlemm'"'"'s canal of the eye, comprising:
- positioning an intraocular implant through an opening in the trabecular meshwork of the eye, the implant having a proximal portion configured to reside in the anterior chamber of the eye, a distal portion configured to reside in Schlemm'"'"'s canal of the eye, a middle portion having an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion and a cross-sectional dimension of the proximal portion, and a passageway extending from a proximal end of the implant to a distal end of the implant, the middle portion dimensioned to extend across the inner wall of Schlemm'"'"'s canal and the trabecular meshwork, the distal portion comprising a contact surface to contact an inner wall of Schlemm'"'"'s canal, the distal portion configured to substantially inhibit contact with the outer wall of Schlemm'"'"'s canal when the contact surface of the distal portion engages the inner wall of Schlemm'"'"'s canal and self-retains the implant with the inner wall of Schlemm'"'"'s canal; and
wherein fluid is conducted through the passageway from an opening on the proximal portion of the implant to an opening on the distal portion of the implant, such that fluid flows from the anterior chamber into Schlemm'"'"'s canal through the implant.
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Abstract
A method and delivery system are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm'"'"'s canal of an eye for reducing elevated intraocular pressure. Pulsed laser radiation is delivered from the distal end of a fiber-optic probe sufficient to cause photoablation of selected portions of the trabecular meshwork, the juxtacanalicular trabecular meshwork and an inner wall of Schlemm'"'"'s canal in the target site. The fiber-optic probe may be advanced so as to create an aperture in the inner wall of Schlemm'"'"'s canal in which fluid from the anterior chamber of the eye flows. The method and delivery system may further be used on any tissue types in the body.
197 Citations
35 Claims
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1. A method, of maintaining an opening in a trabecular meshwork of a patient'"'"'s eye to conduct fluid from an anterior chamber to Schlemm'"'"'s canal of the eye, comprising:
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positioning an intraocular implant through an opening in the trabecular meshwork of the eye, the implant having a proximal portion configured to reside in the anterior chamber of the eye, a distal portion configured to reside in Schlemm'"'"'s canal of the eye, a middle portion having an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion and a cross-sectional dimension of the proximal portion, and a passageway extending from a proximal end of the implant to a distal end of the implant, the middle portion dimensioned to extend across the inner wall of Schlemm'"'"'s canal and the trabecular meshwork, the distal portion comprising a contact surface to contact an inner wall of Schlemm'"'"'s canal, the distal portion configured to substantially inhibit contact with the outer wall of Schlemm'"'"'s canal when the contact surface of the distal portion engages the inner wall of Schlemm'"'"'s canal and self-retains the implant with the inner wall of Schlemm'"'"'s canal; and wherein fluid is conducted through the passageway from an opening on the proximal portion of the implant to an opening on the distal portion of the implant, such that fluid flows from the anterior chamber into Schlemm'"'"'s canal through the implant. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. An intraocular implant for placement in an eye to conduct fluid from the eye, the eye having a trabecular meshwork, an anterior chamber and a Schlemm'"'"'s canal, the implant comprising:
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a proximal portion, sized and shaped to reside in an anterior chamber of an eye, the proximal portion comprising a flange having a surface oriented to contact the trabecular meshwork and an opening to receive fluid from the anterior chamber when placed; a distal portion, sized and shaped to reside in Schlemm'"'"'s canal of the eye, the distal portion comprising a contact surface to contact an inner wall of Schlemm'"'"'s canal and retain the implant with the inner wall of Schlemm'"'"'s canal, the distal portion comprising an opening to release fluid into Schlemm'"'"'s canal, the distal portion configured to substantially inhibit contact with the outer wall of Schlemm'"'"'s canal when the contact surface of the distal portion engages the inner wall of Schlemm'"'"'s canal and self-retains the implant with the inner wall of Schlemm'"'"'s canal; a middle portion, extending from the proximal portion to the distal portion, the middle portion sized and shaped to extend through a trabecular meshwork of an eye when the proximal portion resides in the anterior chamber and the distal portion resides in Schlemm'"'"'s canal; and a substantially straight passageway, extending through the intraocular implant between a proximal end and a distal end of the intraocular implant, the passageway being configured such that when the implant is positioned in the eye, the passageway conducts fluid from the anterior chamber, through the implant, and to Schlemm'"'"'s canal. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. An intraocular implant for placement in an eye having a Schlemm'"'"'s canal with an inner wall, the implant comprising:
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a proximal portion, sized and shaped to reside in an anterior chamber of an eye; a distal portion, sized and shaped to reside in Schlemm'"'"'s canal of the eye, the distal portion having an expandable portion that, upon positioning of the implant within the eye and expansion of the expandable portion, increases an outer cross-sectional dimension of the distal portion, wherein the expandable portion engages the inner wall of Schlemm'"'"'s canal when the implant is positioned with the expandable portion expanded and wherein the distal portion is configured to substantially inhibit contact with an outer wall of Schlemm'"'"'s canal when placed; a middle portion, sized and shaped to extend through a trabecular meshwork of the eye when the proximal portion resides in the anterior chamber and the distal portion resides in Schlemm'"'"'s canal; and a passageway, extending through the implant between a proximal end and a distal end of the implant, the passageway being configured such that when the implant is positioned in the eye, the passageway conducts fluid from the anterior chamber, through the implant, and to Schlemm'"'"'s canal. - View Dependent Claims (26, 27, 28)
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29. A system, for reducing intraocular pressure of an eye having a Schlemm'"'"'s canal, comprising:
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an intraocular implant, having a proximal portion sized and shaped to reside within an anterior chamber of an eye, a middle portion, a distal portion sized and shaped to reside within a natural aqueous outflow space of the eye, the distal portion having an outer cross-sectional dimension that, when implanted within the eye, is greater than an outer cross-sectional dimension of the middle portion; and an inserter device that is configured to carry the intraocular implant, the intraocular implant being configured to be movable with respect to the inserter device; wherein, when the intraocular implant is implanted within the eye, the inserter device guides the intraocular implant into position such that fluid is conducted through the intraocular implant from the anterior chamber to Schlemm'"'"'s canal and wherein the distal portion is sized and shaped to engage a wall of Schlemm'"'"'s canal and wherein engagement of the wall of Sclemm'"'"'s canal is limited to engagement of an inner wall of Schlemm'"'"'s canal. - View Dependent Claims (30, 31, 32)
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33. A method, of treating glaucoma of an eye having a Schlemm'"'"'s canal, the method comprising:
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advancing a distal portion of an inserter device through an anterior chamber of an eye toward a trabecular meshwork of the eye; and advancing an intraocular implant along the inserter device and into position within the trabecular meshwork; wherein, when positioned in the trabecular meshwork, the implant conducts fluid from the anterior chamber through a substantially straight passageway of the implant, the substantially straight passageway extending from a proximal end of the implant to a distal end of the implant, and wherein a distal portion of the implant engages a wall of Schlemm'"'"'s canal and wherein engagement of the wall of Schlemm'"'"'s canal is limited to an inner wall of Schlemm'"'"'s canal. - View Dependent Claims (34, 35)
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Specification