Methods, apparatuses, and systems for reducing intraocular pressure as a means of preventing or treating open-angle glaucoma

• US 9,913,678 B2
• Filed: 11/07/2013
• Issued: 03/13/2018
• Est. Priority Date: 07/18/2005
• Status: Active Grant

• Current Assignee: TearScience Inc. (Johnson & Johnson)
• Original Assignee: TearScience Inc. (Johnson & Johnson)
• Inventors: Friedland, Beth, Korb, Donald R., Grenon, Steve, Jans, John, Gausmann, Keith, Willis, Timothy R.
• Primary Examiner(s): Smith, Kaitlyn
• Application Number:
  US14/074,123
• Publication Number:
  US 20140066821A1
• Time in Patent Office: 1,587 Days
• Field of Search: None
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/10 Power sources therefor
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61F 2007/0004 Eyes or part of the face surrounding the eyes
• CPC Class Codes: A61F 2007/0059 with an open fluid circuit
• CPC Class Codes: A61F 2007/0071 using a resistor, e.g. near the spot to be heated
• 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: A61H 1/008 Apparatus for applying pressure or blows almost perpendicular to the body or limb axis, e.g. chiropractic devices for repositioning vertebrae, correcting deformation
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Embodiments include methods, apparatuses, and systems for reducing elevated intraocular pressure (IOP) in a patient to either prevent or treat open-angle glaucoma. Heat is applied to the trabecular meshwork in the patient'"'"'s eye without damaging proteins in the trabecular meshwork. The application of heat to the trabecular meshwork has the effect of relaxing or loosening protein clogs or other inhibitors in the trabecular meshwork, which are either reducing or obstructing of the outflow of aqueous humor, thereby increasing the patient'"'"'s IOP and causing ocular hypertension (OHT). By loosening or relaxing clogs or other inhibitors in the trabecular meshwork, the outflow path for aqueous humor is increased or restored, which can lower IOP and either prevent or treat glaucoma. Force may also be applied to the patient'"'"'s eye to apply pressure to the trabecular meshwork to further assist in the loosening or relaxing of clogs or other inhibitors in the trabecular meshwork.

Claims

1. A method of lowering a patient'"'"'s intraocular pressure, comprising the steps of:

measuring an intraocular pressure level of a patient'"'"'s eye;

transferring a regulated heat from a heating device to a trabecular meshwork of the patient'"'"'s eye to provide a temperature level at the trabecular meshwork sufficient to loosen or relax one or more clogs in the trabecular meshwork to improve or restore an outflow path for aqueous humor through the trabecular meshwork;

maintaining the regulated heat transfer to the trabecular meshwork for a period of time sufficient to loosen or relax the one or more clogs in the trabecular meshwork to improve or restore the outflow path for aqueous humor through the trabecular meshwork;

preferentially directing a force to a circumference area of the patient'"'"'s sclera in a line towards the trabecular meshwork, wherein preferentially directing the force to the circumference area of the patient'"'"'s sclera in a line towards the trabecular meshwork comprises preferentially directing the force to the circumference area of the sclera in a line towards the trabecular meshwork and outside or out of line with a pupil and an iris; and

wherein the steps of transferring the regulated heat and maintaining the regulated heat transfer are performed based on the intraocular pressure level in the patient'"'"'s eye.

2. The method of claim 1, wherein transferring the regulated heat to the trabecular meshwork comprises transferring the regulated heat through the sclera and a cornea of the patient'"'"'s eye and to the trabecular meshwork.

3. The method of claim 2, wherein transferring the regulated heat to the trabecular meshwork comprises directing the regulated heat in a direction in line with the trabecular meshwork and out of line with the iris and the pupil of the patient'"'"'s eye.

4. The method of claim 2, further comprising measuring the intraocular pressure level of the patient'"'"'s eye after performing the steps of transferring the regulated heat and maintaining the regulated heat transfer.

5. The method of claim 1, wherein the measuring the intraocular pressure level of the patient'"'"'s eye is performed prior to a first time the steps of transferring the regulated heat and maintaining the regulated heat transfer are performed.

6. The method of claim 5, further comprising:

diagnosing the intraocular pressure level in the patient'"'"'s eye; and

performing the steps of transferring the regulated heat and maintaining the regulated heat transfer based on the diagnosing of the intraocular pressure level in the patient'"'"'s eye.

7. The method of claim 1, further comprising measuring the intraocular pressure level of the patient'"'"'s eye after performing the steps of transferring the regulated heat and maintaining the regulated heat transfer.

8. The method of claim 1, further comprising discontinuing the transfer of the regulated heat to the trabecular meshwork.

9. The method of claim 8, further comprising, after the step of discontinuing the transfer of the regulated heat to the trabecular meshwork:

measuring the intraocular pressure level of the patient'"'"'s eye;

diagnosing the intraocular pressure level in the patient'"'"'s eye; and

determining if the steps of transferring the regulated heat and maintaining the regulated heat transfer should be performed again based on the diagnosis.

10. The method of claim 1, wherein the period of time is between 10 and 120 minutes.

11. The method of claim 1, wherein the temperature level of the regulated heat transfer is such that the regulated heat reaching the trabecular meshwork is above body temperature.

12. The method of claim 11, wherein the temperature level of the regulated heat reaching the trabecular meshwork is between approximately 40 to 44 degrees Celsius.

13. The method of claim 1, wherein the transferring the regulated heat further comprises applying heat to an outer eyelid of the patient'"'"'s eye such that the heat is transferred through the outer eyelid and through the sclera and lens of the patient'"'"'s eye to the trabecular meshwork.

14. The method of claim 13, wherein the temperature of the heat applied to the outer eyelid of the patient'"'"'s eye is between approximately 40 and 48 degrees Celsius.

15. The method of claim 1, wherein the transferring the regulated heat further comprises applying the regulated heat to the sclera of the patient'"'"'s eye such that the regulated heat is transferred through the sclera and a cornea of the patient'"'"'s eye to the trabecular meshwork.

16. The method of claim 15, wherein the temperature level of the regulated heat applied to the sclera of the patient'"'"'s eye is between approximately 38 and 45 degrees Celsius.

17. The method of claim 1, wherein the preferentially directed force assists in loosening or relaxing the one or more clogs in the trabecular meshwork to improve or restore the outflow path for aqueous humor through the trabecular meshwork.

18. The method of claim 17, wherein the preferentially directed force is directed to the circumference area of the patient'"'"'s sclera in a line towards the trabecular meshwork for a period of time.

19. The method of claim 18, wherein the period of time is between approximately 10 and 120 minutes.

20. The method of claim 17, wherein the preferentially directed force is applied simultaneously with the regulated heat transfer.

21. The method of claim 17, wherein the preferentially directed force is applied after discontinuing the transfer of the regulated heat to the trabecular meshwork.

22. The method of claim 1, wherein the preferentially directed force is a massaging force.

23. The method of claim 1, wherein the transferring the regulated heat to the trabecular meshwork further comprises transferring diffuse heat to the trabecular meshwork.

24. The method of claim 1, wherein the transferring the regulated heat further comprises applying the regulated heat between an inner surface of the patient'"'"'s eyelid and eyeball such that the regulated heat is transferred to the trabecular meshwork.

25. The method of claim 1, wherein the preferentially directed force is a milking force.