Delivery system and method of use for the eye

• US 9,833,357 B2
• Filed: 10/07/2016
• Issued: 12/05/2017
• Est. Priority Date: 05/19/2000
• Status: Expired due to Fees

• Current Assignee: Ivantis Inc. (Alcon Incorporated)
• Original Assignee: Michael S. Berlin
• Inventors: Berlin, Michael S.
• Primary Examiner(s): Wiest, Philip R
• Application Number:
  US15/288,993
• Publication Number:
  US 20170020732A1
• Time in Patent Office: 424 Days
• Field of Search: 604 27, 604294, 604246, 604286, 604523, 606107-109, 606151, 606167, 600398, 623 11, 623 41, 623 111, 623 135
• CPC Class Codes: A61F 2009/00868 Ciliary muscles or trabecular meshwork
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• 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: A61F 9/00802 for photoablation

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.

Claims

1. A method of treating glaucoma of a patient'"'"'s eye, the eye comprising an anterior chamber, a trabecular meshwork and a Schlemm'"'"'s canal, the Schlemm'"'"'s canal comprising an outer wall and an inner wall, the method comprising:

positioning an intraocular implant to extend through the trabecular meshwork of the eye, the implant having a proximal portion comprising a proximal opening configured to reside in the anterior chamber of the eye, a distal portion comprising a distal opening configured to reside in the Schlemm'"'"'s canal of the eye, a middle portion comprising a substantially straight passageway extending from the proximal opening to the distal opening, the middle portion dimensioned to extend across the inner wall of the Schlemm'"'"'s canal and the trabecular meshwork, the distal portion comprising a contact surface to contact an inner wall of the Schlemm'"'"'s canal, the distal portion sized and shaped to substantially inhibit contact with collector channels on the outer wall of the Schlemm'"'"'s canal when the contact surface of the distal portion engages the inner wall of the Schlemm'"'"'s canal and self-retains the implant with engagement of the inner wall of the Schlemm'"'"'s canal; and

wherein fluid is conducted, through the substantially straight passageway, from the opening on the proximal portion of the implant to the opening on the distal portion of the implant, such that fluid flows from the anterior chamber to the Schlemm'"'"'s canal through the implant.

2. The method of claim 1, wherein the distal portion is sized and shaped to inhibit contact with the collector channels opposite the distal opening when engaging the inner wall of the Schlemm'"'"'s canal.

3. The method of claim 1, wherein the distal opening is located on a distal end of the distal portion.

4. The method of claim 1, wherein the proximal portion comprises a feature to contact the trabecular meshwork.

5. The method of claim 4, wherein the feature comprises a plurality of projections.

6. The method of claim 4, wherein the feature comprises a flange.

7. The method of claim 6, wherein a distance between a surface of the flange on the proximal portion and the contact surface on the distal portion is sized to allow engagement of the trabecular meshwork with the surface of the flange when the contact surface of the distal portion engages the inner wall of the Schlemm'"'"'s canal.

8. The method of claim 1, wherein the distal portion comprises a plurality of foldable legs for engaging the inner wall of the Schlemm'"'"'s canal.

9. The method of claim 1, further comprising providing an inserter device that is configured to carry the intraocular implant and puncture the trabecular meshwork and position the distal portion of the intraocular implant within the Schlemm'"'"'s canal.

10. The method of claim 1, further comprising inserting the intraocular implant through a corneal incision.

11. The method of claim 1, wherein the outer cross-sectional dimension of the middle portion is less than an outer cross-sectional dimension of the proximal portion.

12. The method of claim 1, wherein the middle portion comprises an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion.

13. An intraocular implant for placement in a patient'"'"'s eye to conduct fluid from the eye to treat glaucoma, the eye having a trabecular meshwork, an anterior chamber and a Schlemm'"'"'s canal, the Schlemm'"'"'s canal comprising an outer wall and an inner wall, the implant configured to be positioned such that the implant extends through the trabecular meshwork of the eye, the implant comprising:

a proximal portion comprising a proximal opening configured to reside in the anterior chamber of an eye;

a distal portion comprising a distal opening configured to reside in the Schlemm'"'"'s canal of the eye;

a middle portion comprising a substantially straight passageway extending from the proximal opening to the distal opening, the middle portion dimensioned to extend across the inner wall of the Schlemm'"'"'s canal and the trabecular meshwork, the distal portion comprising a contact surface to contact an inner wall of the Schlemm'"'"'s canal, the distal portion sized and shaped to substantially inhibit contact with collector channels on the outer wall of the Schlemm'"'"'s canal when the contact surface of the distal portion engages the inner wall of the Schlemm'"'"'s canal and self-retains the implant with engagement of the inner wall of the Schlemm'"'"'s canal; and

wherein the substantially straight passageway is configured to conduct fluid from the opening on the proximal portion of the implant to the opening on the distal portion of the implant, such that fluid flows from the anterior chamber to the Schlemm'"'"'s canal through the implant.

14. The intraocular implant of claim 13, wherein the distal portion is sized and shaped to inhibit contact with the collector channels opposite the distal opening when engaging the inner wall of the Schlemm'"'"'s canal.

15. The intraocular implant of claim 13, wherein the distal opening is located on a distal end of the distal portion.

16. The intraocular implant of claim 13, wherein the proximal portion comprises a feature to contact the trabecular meshwork.

17. The intraocular implant of claim 16, wherein the feature comprises a plurality of projections.

18. The intraocular implant of claim 16, wherein the feature comprises a flange.

19. The intraocular implant of claim 18, wherein a distance between a surface of the flange on the proximal portion and the contact surface on the distal portion is sized to allow engagement of the trabecular meshwork with the surface of the flange when the contact surface of the distal portion engages the inner wall of the Schlemm'"'"'s canal.

20. The intraocular implant of claim 13, wherein the distal portion comprises a plurality of foldable legs for engaging the inner wall of the Schlemm'"'"'s canal.

21. The intraocular implant of claim 13, further comprising providing an inserter device that is configured to carry the intraocular implant and position the distal portion of the intraocular implant within the Schlemm'"'"'s canal.

22. The intraocular implant of claim 13, further comprising inserting the intraocular implant through a corneal incision.

23. The intraocular implant of claim 13, wherein the middle portion comprises an outer cross-sectional dimension that is less than an outer cross-sectional dimension of the proximal portion.

24. The intraocular implant of claim 13, wherein the middle portion comprises an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion.