US20050288619A1 - Biodegradable glaucoma implant - Google Patents
Biodegradable glaucoma implant Download PDFInfo
- Publication number
- US20050288619A1 US20050288619A1 US11/209,563 US20956305A US2005288619A1 US 20050288619 A1 US20050288619 A1 US 20050288619A1 US 20956305 A US20956305 A US 20956305A US 2005288619 A1 US2005288619 A1 US 2005288619A1
- Authority
- US
- United States
- Prior art keywords
- eye
- implant
- anterior chamber
- canal
- schlemm
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00781—Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/16—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers
Definitions
- the present invention generally relates to medical devices and methods for reducing intraocular pressure in the animal eye. More particularly, the present invention relates to the treatment of glaucoma by permitting aqueous humor to flow out of the anterior chamber through a surgically implanted pathway.
- the human eye is a specialized sensory organ capable of light reception and able to receive visual images.
- the trabecular meshwork serves as a drainage channel and is located in anterior chamber angle formed between the iris and the cornea.
- the trabecular meshwork maintains a balanced pressure in the anterior chamber of the eye by draining aqueous humor from the anterior chamber.
- Glaucoma is a group of eye diseases encompassing a broad spectrum of clinical presentations, etiologies, and treatment modalities. Glaucoma causes pathological changes in the optic nerve, visible on the optic disk, and it causes corresponding visual field loss, resulting in blindness if untreated. Lowering intraocular pressure is the major treatment goal in all glaucomas.
- aqueous humor aqueous humor
- Schlemm's canal aqueous collector channels in the posterior wall of Schlemm's canal and then into aqueous veins, which form the episcleral venous system.
- Aqueous humor is a transparent liquid that fills the region between the cornea, at the front of the eye, and the lens. The aqueous humor is continuously secreted by the ciliary body around the lens, so there is a constant flow of aqueous humor from the ciliary body to the eye's front chamber.
- the eye's pressure is determined by a balance between the production of aqueous and its exit through the trabecular meshwork (major route) or uveal scleral outflow (minor route).
- the trabecular meshwork is located between the outer rim of the iris and the back of the cornea, in the anterior chamber angle.
- the portion of the trabecular meshwork adjacent to Schlemm's canal causes most of the resistance to aqueous outflow.
- Glaucoma is grossly classified into two categories: closed-angle glaucoma, also known as angle closure glaucoma, and open-angle glaucoma. Closed-angle glaucoma is caused by closure of the anterior chamber angle by contact between the iris and the inner surface of the trabecular meshwork. Closure of this anatomical angle prevents normal drainage of aqueous humor from the anterior chamber of the eye. Open-angle glaucoma is any glaucoma in which the angle of the anterior chamber remains open, but the exit of aqueous through the trabecular meshwork is diminished. The exact cause for diminished filtration is unknown for most cases of open-angle glaucoma.
- Primary open-angle glaucoma is the most common of the glaucomas, and it is often asymptomatic in the early to moderately advanced stage. Patients may suffer substantial, irreversible vision loss prior to diagnosis and treatment.
- secondary open-angle glaucomas which may include edema or swelling of the trabecular spaces (e.g., from corticosteroid use), abnormal pigment dispersion, or diseases such as hyperthyroidism that produce vascular congestion.
- Surgical therapy for open-angle glaucoma consists of laser trabeculoplasty, trabeculectomy, and implantation of aqueous shunts after failure of trabeculectomy or if trabeculectomy is unlikely to succeed.
- Trabeculectomy is a major surgery that is widely used and is augmented with topically applied anticancer drugs, such as 5-flurouracil or mitomycin-C to decrease scarring and increase the likelihood of surgical success.
- trabeculectomies are performed on Medicare-age patients per year in the United States. This number would likely increase if the morbidity associated with trabeculectomy could be decreased.
- the current morbidity associated with trabeculectomy consists of failure (10-15%); infection (a life long risk of 2-5%); choroidal hemorrhage, a severe internal hemorrhage from low intraocular pressure, resulting in visual loss (1%); cataract formation; and hypotony maculopathy (potentially reversible visual loss from low intraocular pressure).
- goniotomy/trabeculotomy and other mechanical disruptions of the trabecular meshwork, such as trabeculopuncture, goniophotoablation, laser trabecular ablation, and goniocurretage. These are all major operations and are briefly described below.
- Goniotomy and trabeculotomy are simple and directed techniques of microsurgical dissection with mechanical disruption of the trabecular meshwork. These initially had early favorable responses in the treatment of open-angle glaucoma. However, long-term review of surgical results showed only limited success in adults. In retrospect, these procedures probably failed due to cellular repair and fibrosis mechanisms and a process of “filling in.” Filling in is a detrimental effect of collapsing and closing in of the created opening in the trabecular meshwork. Once the created openings close, the pressure builds back up and the surgery fails.
- Neodynium (Nd) YAG lasers also have been investigated as an optically invasive technique for creating full-thickness holes in trabecular meshwork.
- Nd Neodynium
- Goniophotoablation is disclosed by Berlin in U.S. Pat. No. 4,846,172 and involves the use of an excimer laser to treat glaucoma by ablating the trabecular meshwork. Additionally, an Erbium:YAG laser was used to create full-thickness holes through trabecular meshwork in a primate model and a limited human clinical trial at the University of California, Irvine. (Hill et al., Lasers in Surgery and Medicine 11:341-346, 1991). Although morbidity was zero in both trials, success rates did not warrant further human trials. Failure was again from filling in of surgically created defects in the trabecular meshwork by repair mechanisms.
- trabeculectomy is the most commonly performed filtering surgery
- viscocanulostomy (VC) and non-penetrating trabeculectomy (NPT) are two new variations of filtering surgery. These are ab externo (from the outside), major ocular procedures in which Schlemm's canal is surgically exposed by making a large and very deep scleral flap.
- Schlemm's canal is cannulated and viscoelastic substance injected (which dilates Schlemm's canal and the aqueous collector channels).
- NPT non-penetrating trabeculectomy
- Trabeculectomy, VC, and NPT involve the formation of an opening or hole under the conjunctiva and scleral flap into the anterior chamber, such that aqueous humor is drained onto the surface of the eye or into the tissues located within the lateral wall of the eye.
- These surgical operations are major procedures with significant ocular morbidity.
- a number of implantable drainage devices have been used to ensure that the desired filtration and outflow of aqueous humor through the surgical opening will continue.
- the risk of placing a glaucoma drainage device also includes hemorrhage, infection, and diplopia (double vision).
- implantable shunts and surgical methods for maintaining an opening for the release of aqueous humor from the anterior chamber of the eye to the sclera or space beneath the conjunctiva have been disclosed in, for example, U.S. Pat. No. 6,059,772 to Hsia et al., and U.S. Pat. No. 6,050,970 to Baerveldt.
- the trabecular meshwork and juxtacanilicular tissue together provide the majority of resistance to the outflow of aqueous and, as such, are logical targets for surgical removal in the treatment of open-angle glaucoma. In addition, minimal amounts of tissue are altered and existing physiologic outflow pathways are utilized.
- Glaucoma surgical morbidity would greatly decrease if one were to bypass the focal resistance to outflow of aqueous only at the point of resistance, and to utilize remaining, healthy aqueous outflow mechanisms. This is in part because episcleral aqueous humor exerts a backpressure that prevents intraocular pressure from going too low, and one could thereby avoid hypotony. Thus, such a surgery would virtually eliminate the risk of hypotony-related maculopathy and choroidal hemorrhage. Furthermore, visual recovery would be very rapid, and the risk of infection would be very small, reflecting a reduction in incidence from 2-5% to about 0.05%.
- trabecular bypass surgery Techniques performed in accordance with the aspects of the invention may be referred to generally as “trabecular bypass surgery.” Advantages of this surgery include lowering intraocular pressure in a manner which is simple, effective, disease site-specific, and can potentially be performed on an outpatient basis.
- Trabecular bypass surgery creates an opening, a slit, or a hole through trabecular meshwork with minor microsurgery.
- TBS has the advantage of a much lower risk of choroidal hemorrhage and infection than prior techniques, and it uses existing physiologic outflow mechanisms. In some aspects, this surgery can potentially be performed under topical or local anesthesia on an outpatient basis with rapid visual recovery.
- a biocompatible elongated device is placed within the hole and serves as a stent.
- a trabecular shunt for transporting aqueous humor.
- the trabecular shunt includes a hollow, elongate tubular element, having an inlet section and an outlet section.
- the outlet section includes two bifurcatable segments or elements, adapted to be positioned and stabilized inside Schlemm's canal.
- the trabecular shunt is placed inside a delivery apparatus.
- the two bifurcatable elements of the outlet section bifurcate in substantially opposite directions.
- a deployment mechanism within the delivery apparatus includes a push-pull type plunger.
- a delivery applicator may be placed inside a lumen of the hollow, elongate tube of the trabecular shunt.
- the delivery applicator may include a deployment mechanism for causing the two bifurcatable elements of the outlet section to bifurcate.
- the delivery applicator may be a guidewire, an expandable basket, an inflatable balloon, or the like.
- At least one of the two bifurcatable elements is made of a shape-memory material, such as Nitinol or a shape-memory plastic.
- the shape-memory material has a preshape and a shape-transition temperature, such that the shape-memory trabecular shunt bifurcates to its preshape when it is heated to above the shape-transition temperature.
- the preshape of the two bifurcatable elements material may be at an angle with respect to the inlet section, preferably between about 70 degrees and about 110 degrees.
- An external heat source may be provided, which is adapted for heating the shape-memory material to above the shape-transition temperature of the shape-memory material.
- the trabecular shunt may be made of one or more of the following materials: polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene , expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, NylonTM, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, biodegradable materials, and biocompatible materials.
- outlet section of the trabecular shunt may be configured as a coil, mesh, spiral, or other appropriate configuration as will apparent to those of skill in the art. Further, the outlet section of the trabecular shunt may be porous, semi-permeable, fishbone, and/or of a continuous, solid form. The outlet section of the trabecular shunt may have a cross-sectional shape that is elliptical (e.g., oval), round, circular, D-shape, semi-circular, or irregular (asymmetrical) shape.
- the trabecular shunt may have its surface coated with a coating material selected from one or more of the following: polytetrafluoroethylene (e.g., TeflonTM), polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like.
- the surface coating material may also provide a mechanism for site-specific therapies.
- the device may include a flow-restricting member for restricting at least one component in fluid.
- the flow-restricting member may be a filter comprising one or more filtration materials selected from the following: expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, fluorinated material, or the like.
- the flow-restricting member may advantageously be a filter selected from the following group of filter types: hydrophobic, hydrophilic, membrane, microporous, and non-woven.
- the flow-restricting member acts to limit or prevent the reflux of any undesired component or contaminant of blood, such as red blood cells or serum protein, from the aqueous veins into the anterior chamber. It is useful to restrict one or more of the following components or contaminants: platelets, red blood cells, white blood cells, viruses, bacteria, antigens, and toxins.
- the trabecular shunt may include a pressure sensor for measuring the pressure of the anterior chamber of an eye of a patient.
- the pressure sensor may further include an electromagnetic (e.g., radiofrequency) transmitter, for wirelessly transmitting pressure measurements to a pressure receiver outside the patient's body.
- microsurgery may potentially be performed on an outpatient basis with rapid visual recovery and greatly decreased morbidity. There is a lower risk of infection and choroidal hemorrhage, and there is a faster recovery, than with previous techniques.
- FIG. 1 is a sagittal sectional view of an eye.
- FIG. 2 is a cross-sectional view of the anterior chamber of an eye.
- FIG. 3A is an side elevational view of a glaucoma device.
- FIG. 3B is an end cross-sectional view through plane 1 - 1 of FIG. 3A .
- FIG. 4A illustrates the trabecular shunt of FIG. 3A at a semi-deployment state.
- FIG. 4B is an end cross-sectional view of section 2 - 2 of FIG. 4A .
- FIG. 5A illustrates the trabecular shunt of FIG. 3A in a deployed state.
- FIG. 5B is an end cross-sectional view of the trabecular shunt, section 3 - 3 of FIG. 5A .
- FIG. 5C is an end cross-sectional view of a bifurcatable segment, section 4 - 4 of FIG. 5A .
- FIG. 6 is a side cross-sectional view of the trabecular shunt.
- FIG. 7A is a side cross-sectional view of an alternate embodiment of the trabecular shunt.
- FIG. 7B is a side cross-sectional view of the trabecular shunt of FIG. 7A in a partially deployed state.
- FIG. 8 is a perspective view of the trabecular shunt placed inside Schlemm's canal.
- FIGS. 1 to 8 illustrate an apparatus for the treatment of glaucoma by trabecular bypass surgery.
- FIG. 1 is a sagittal sectional view of an eye 10
- FIG. 2 is a close-up view, showing the relative anatomical locations of trabecular meshwork 21 , the anterior chamber 20 , and Schlemm's canal 22 .
- Thick collagenous tissue known as sclera 11 covers the entire eye 10 except that portion covered by the cornea 12 .
- the cornea 12 is a thin transparent tissue that focuses and transmits light into the eye and through the pupil 14 , which is the circular hole in the center of the iris 13 (colored portion of the eye).
- the cornea 12 merges into the sclera 11 at a juncture referred to as the limbus 15 .
- the ciliary body 16 extends along the interior of the sclera 11 and is coextensive with the choroid 17 .
- the choroid 17 is a vascular layer of the eye 10 , located between the sclera 11 and retina 18 .
- the optic nerve 19 transmits visual information to the brain and is the anatomic structure that is progressively destroyed by glaucoma.
- the anterior chamber 20 of the eye 10 which is bound anteriorly by the cornea 12 and posteriorly by the iris 13 and lens 26 , is filled with aqueous humor (“aqueous”).
- aqueous aqueous humor
- Aqueous is produced primarily by the ciliary body 16 , then moves anteriorly through the pupil 14 and reaches the anterior chamber angle 25 , formed between the iris 13 and the cornea 12 .
- the aqueous is removed from the anterior chamber 20 through the trabecular meshwork 21 .
- Aqueous passes through trabecular meshwork 21 into Schlemm's canal 22 and thereafter through the aqueous veins 23 , which merge with blood-carrying veins and into the systemic venous circulation.
- Intraocular pressure is maintained by the intricate balance between secretion and outflow of the aqueous in the manner described above.
- Glaucoma is, in most cases, characterized by the excessive buildup of aqueous humor in the anterior chamber 20 , which leads to an increase in intraocular pressure. Fluids are relatively incompressible, and pressure is directed relatively equally throughout the eye.
- the trabecular meshwork 21 is adjacent a small portion of the sclera 11 .
- Traditional procedures that create a hole or opening for implanting a device through the tissues of the conjunctiva 24 and sclera 11 involve extensive surgery, as compared to surgery for implanting a device which ultimately resides entirely within the confines of the sclera 11 and cornea 12 , as is performed in accordance with one aspect.
- a device 31 for establishing an outflow pathway, positioned through the trabecular meshwork 21 is illustrated in FIG. 8 .
- a method of placing a trabecular shunt into an opening through trabecular meshwork comprises advancing and positioning a trabecular shunt having two distal bifurcatable elements through the opening.
- a method of placing a trabecular shunt into an opening through diseased trabecular meshwork for transporting aqueous humor at the level of the trabecular meshwork and using an existing outflow pathway comprises advancing and positioning a trabecular shunt having a pressure sensor for measuring the pressure of the anterior chamber of the eye through the opening.
- the method may further comprise transmitting the measured pressure to a pressure receiver outside the body of the patient.
- FIG. 3A shows an embodiment of the trabecular shunt 31 .
- the trabecular shunt may comprise a biocompatible material, such as medical grade silicone, trade name Silastic(, available from Dow Corning Corporation of Midland, Mich.; or polyurethane, trade name Pellethane(, also available from Dow Corning Corporation.
- biocompatible materials such as polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene, expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, Nylon, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, or any mixture of these or other biocompatible materials.
- biocompatible materials such as polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene, expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, Nylon, polypropylene, hydroxyapetite, precious metal, Nitinol,
- the trabecular shunt may comprise a composite biocompatible material, with a surface made of one or more of the above-mentioned biomaterials, and the surface is coated by a material selected from Teflon, polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like.
- Suitable anti-angiogenic or anti-proliferative factors may be selected from, for example, protamine, heparin, steroids, anti-invasive factor, retinoic acids and derivatives thereof, and paclitaxel or its analogues or derivatives thereof.
- the main purpose of the trabecular shunt is for transporting aqueous humor at the level of the trabecular meshwork and partially using existing the outflow pathway for aqueous humor, i.e., utilizing the entire outflow pathway except for the trabecular meshwork, which is bypassed by the trabecular shunt 31 .
- aqueous humor is transported into Schlemm's canal and subsequently into the aqueous collectors and the aqueous veins so that the intraocular pressure is properly maintained within a therapeutic range.
- the trabecular shunt 31 comprises a hollow, elongated tubular element having an inlet section 32 and an outlet section 33 , wherein the outlet section 33 may comprise two bifurcatable elements 34 , 35 that are adapted to be bifurcated, positioned, and stabilized inside Schlemm's canal.
- the hollow elongated tubular element may comprise at least one lumen 36 for transporting aqueous from the anterior chamber 20 of an eye to the Schlemm's canal 22 .
- a “bifurcatable” segment is defined as a segment, or components thereof, that can change direction away or evert from a reference axis. The “bifurcating” operation may be achieved by mechanical forces and/or through the shape-memory property of a material.
- the outer surface of the outlet section 33 may comprise a stubbed surface, ribbed surface, surface with pillars, textured surface, or the like.
- the outer surface of the trabecular shunt 31 is biocompatible and tissue-compatible so that the interaction between the outer surface of the shunt and the surrounding tissue of Schlemm's canal is minimal, and inflammation is reduced.
- FIG. 3B shows an end cross-sectional view of section 1 - 1 of FIG. 3A .
- Each bifurcatable segment 34 , 35 has its own end configuration. At least one of the two bifurcatable elements has a tapered distal end adapted for insertion ease.
- the two bifurcatable elements 34 , 35 are secured to the inlet section 32 at a joint 37 .
- At least a slit 38 , or scalloping, within the two bifurcatable elements 34 , 35 may be located near the joint 37 for stress release when the two bifurcatable elements are bifurcated in two substantially opposite directions.
- Other stress-releasing mechanisms may also be utilized so as to make the bifurcation operation of the bifurcatable elements safe and effective.
- the outlet section 33 of the trabecular shunt 31 may possess a cross-sectional shape selected from the following: oval shape, round shape, circular shape, D-shape, semi-circular shape, irregular shape, or random shape.
- the trabecular shunt 31 may comprise a flow-restricting element for restricting at least one component in fluid
- the flow-restricting element may be a filter selected from a group of filtration materials comprising expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, and fluorinated material.
- the flow-restricting element may be a filter selected from a group of filter types comprising a hydrophobic filter, hydrophilic filter, membrane filter, microporous filter, non-woven filter, and the like.
- Components in blood that may be restricted by the flow-restricting element can include the following: platelet, red blood cell, white blood cell, virus, antigen, serum protein, and toxin.
- the flow-restricting element may also be in the form of, for example, a check valve, a slit valve, a micropump, a semi-permeable membrane, and the like.
- the purpose of the flow-restricting element is to keep an undesired foreign material from back flowing into the anterior chamber.
- FIG. 4A shows the trabecular shunt of FIG. 3A in a semi-deployed state
- FIG. 4B shows an end cross-sectional view of section 2 - 2 of FIG. 4A
- the trabecular shunt 31 is placed inside a hollow delivery apparatus 45 .
- a delivery apparatus 45 comprises a distal end 47 , wherein the two bifurcatable elements 34 , 35 of the outlet section are self-bifurcatable in substantially two opposite directions when the trabecular shunt 31 is deployed out of the delivery apparatus 45 .
- the slit 38 at the two bifurcatable elements 34 , 35 comprises the separating regions 43 A and 43 B.
- the delivery apparatus 45 may comprise a deployment mechanism-for deploying the trabecular shunt out of the delivery apparatus.
- the deployment mechanism is a plunger.
- the delivery mechanism may be located at the handle of the delivery apparatus for deploying the trabecular shunt.
- FIG. 5A shows the trabecular shunt of FIG. 3A at a deployed state.
- the two bifurcatable elements 34 , 35 continue to deploy in two substantially opposite directions. This may be accomplished by precontracting the two bifurcatable elements within the delivery apparatus before the delivery state.
- the distal end of the delivery apparatus withdraws beyond the joint point 37 located between the inlet section 32 and the outlet section, the two bifurcatable elements are fully deployed with their separating regions 43 A, 43 B apart from each other.
- the outlet section of the preferred trabecular shunts may be made of a material form selected from a group comprising coil form, mesh form, spiral form, porous form, semi-permeable form, fishbone form (i.e., having interlocking splines and/or fenestrations in a side wall, as illustrated in FIG. 7A ), continuous solid form, or may be made from any form that is effective and appropriate to evert the bifurcatable elements to be at one or more angles with respect to a reference axis of the inlet section.
- FIG. 5B shows an end cross-sectional view of the trabecular shunt, section 3 - 3 of FIG. 5A
- FIG. 5C shows an end cross-sectional view of a bifurcatable segment, section 4 - 4 of FIG. 5A
- the original outer contour of the trabecular shunt 31 is illustrated by a dashed line 49 in FIG. 5B
- the lumen 36 of the hollow elongated tubular element is for aqueous to flow through the trabecular shunt.
- the shape of the end cross-section 35 is to provide a stenting capability when the elements are placed inside Schlemm's canal.
- the semicircular end cross-section of the bifurcatable elements 34 , 35 allows aqueous to freely flow into aqueous collector channels in the external wall of Schlemm's canal.
- FIG. 6 shows another preferred embodiment of the trabecular shunt.
- a delivery applicator 52 may be placed inside a lumen of the hollow elongated tubular element, wherein the delivery applicator comprises a deployment mechanism for causing the two bifurcatable elements 34 , 35 of the outlet section to move part from each other.
- the delivery applicator may be selected from a group consisting of a guidewire, an expandable basket, an inflatable balloon, or other expanding mechanism.
- a delivery applicator 52 with an expandable basket comprises a plurality of expandable members 54 A, 54 B, 54 C, 54 D that all securely joined at a proximal joint 55 A and at a distal joint point 55 B.
- a distal end of a push-pull type wire 51 is also joined at the distal joint point 55 B.
- the proximal joint 55 A is located at the distal end of a compact guidewire 53 of the delivery applicator. Therefore, by pulling the push-pull wire 51 of the delivery applicator toward the operator, each of the expandable members 54 A, 54 B, 54 C, 54 D expand radially outwardly so as to effect the outward pushing action for the bifurcatable elements 34 , 35 .
- a trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal. At least one of the two bifurcatable elements may be made of a shape-memory material such as shape-memory Nitinol or shape-memory plastic material.
- the shape-memory Nitinol has a preshape and a shape-transition temperature, wherein the shape-memory Nitinol bifurcates to its preshape when the shape-memory Nitinol is heated to above the shape-transition temperature, the preshape of the shape-memory Nitinol being at an angle with respect to the inlet section.
- the shape-transition temperature for the shape-memory Nitinol is preferably between about 39° C. and about 90° C.
- the shape-transition temperature is more preferred between about 39° C. and 45° C. so as to minimize tissue damage.
- the angle is preferably between about 70 degrees and about 110 degrees so as to conform to the contour of Schlemm's canal.
- An external heat source may be provided and adapted for heating the shape-memory Nitinol to above the shape-transition temperature of the shape-memory Nitinol. Examples of such external heat sources include a heating pad, a warm cloth, a bag of warm water, remotely deliverable heat, electromagnetic field, and the like.
- the shape-memory Nitinol may be embedded within a biocompatible material selected from, for example, silicone, polyurethane, porous material, expanded polytetrafluoroethylene, semi-permeable membrane, elastomer, and mixture of the biocompatible material thereof.
- a biocompatible material selected from, for example, silicone, polyurethane, porous material, expanded polytetrafluoroethylene, semi-permeable membrane, elastomer, and mixture of the biocompatible material thereof.
- the bifurcatable elements are relatively flexible and soft so that they do not impart undesired force or pressure onto the surrounding tissue during and after the deployment state.
- FIG. 7A shows an embodiment of the trabecular shunt.
- the trabecular shunt comprises a plurality of fishbones and their intermediate spacing, such as the fishbones 61 A, 61 B with a spacing 62 A and the fishbones 61 C, 61 D with a spacing 62 B.
- a delivery apparatus 45 may be used to deliver the self-bifurcatable elements 34 , 35 having fishbones configuration.
- FIG. 7B shows the trabecular shunt of FIG. 7A in a semi-deployed state.
- the distal end 47 of the delivery apparatus 45 is pulled away from the distal end 39 of the shunt 31 .
- the self-bifurcatable elements 34 , 35 tend to deploy to two opposite directions.
- the spacing 62 B between the two fishbones 61 C and 61 D starts to expand and enlarge so that minimal stress is exerted on the deployed bifurcated portion of the bifurcatable elements 34 , 35 .
- the trabecular shunt may have a length between about 0.5 mm to over a few millimeters.
- the outside diameter of the trabecular shunt may range from about 30 ⁇ m to about 500 ⁇ m or more.
- the lumen diameter is preferably in the range of about 20 ⁇ m to about 150 ⁇ m, or larger.
- the trabecular shunt may have a plurality of lumens to facilitate multiple-channel flow.
- the outlet section may be curved or angled at an angle between about 30 degrees to about 150 degrees, and preferably at about 70 degrees to about 110 degrees, with reference to the inlet section 32 .
- FIG. 8 is a perspective view illustrating the device 31 positioned within the tissue of an eye 10 .
- a hole or opening is created through the diseased trabecular meshwork 21 .
- the outlet section of the device 31 is inserted into the hole, wherein the inlet section is exposed to the anterior chamber 20 while the outlet section is positioned at about an exterior surface 3 of the diseased trabecular meshwork 21 .
- the outlet section may enter into Schlemm's canal or other existing outflow pathways.
- a device as shown in FIG. 3 may be successfully used to maintain the opening through diseased trabecular meshwork.
- means for forming a hole/opening in the trabecular mesh 21 may comprise using a microknife, a pointed guidewire, a sharpened applicator, a screw shaped applicator, an irrigating applicator, or a barbed applicator.
- the trabecular meshwork may be dissected off with an instrument similar to a retinal pick or microcurrette. The opening may alternately be created by retrograde fiberoptic laser ablation.
- the patient is placed in the supine position, prepped, draped and anesthesia obtained.
- a small (generally less than 1-mm) self-sealing incision is made.
- an incision is made in the trabecular meshwork with an irrigating knife.
- the shunt is then advanced through the corneal incision across the anterior chamber held in a delivery apparatus or delivery applicator under gonioscopic (lens) or endoscopic guidance.
- the apparatus or applicator is withdrawn from the patient and the surgery is concluded.
- the delivery apparatus or applicator may be within a size range of 20 to 40 gauge, and preferably about 30 gauge.
- a method for increasing aqueous humor outflow in an eye of a patient to reduce intraocular pressure therein comprises: (a) creating an opening in trabecular meshwork using a knife or laser, etc; (b) inserting a trabecular shunt into the opening, such as by using a delivery device, wherein the trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, and wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal; and (c) bifurcating the two bifurcatable elements to two opposing directions.
- the method may further comprise placing the trabecular shunt inside a delivery apparatus, wherein the two bifurcatable elements are self-bifurcatable in two opposing directions when the trabecular shunt is deployed from the delivery apparatus.
- the method may further comprise placing a delivery applicator inside a lumen of a hollow elongated tubular element, wherein the delivery applicator comprises a deployment mechanism for causing the two bifurcatable elements to move in two opposing directions.
- the method may further comprise measuring and transmitting pressure of the anterior chamber of an eye, wherein the trabecular shunt comprises a pressure sensor for measuring and transmitting pressure.
- the means for measuring and transmitting pressure of an anterior chamber of an eye to an external receiver may be incorporated within a device that is placed inside the anterior chamber for sensing and transmitting the intraocular pressure. Any suitable micro pressure sensor or pressure sensor chip known to those of skill in the art may be utilized.
Abstract
A trabecular shunt and methods for treating glaucoma are disclosed. One of the methods comprises transporting fluid from the anterior chamber of an eye to Schlemm's canal through an implant, the implant extending between the anterior chamber and Schlemm's canal; sensing an intraocular pressure using a sensor incorporated into the implant; and transmitting a signal indicative of the sensed pressure to an external receiver.
Description
- This application is a continuation application of U.S. patent application Ser. No. 10/626,181, filed Jul. 24, 2003, entitled “Implant with Pressure Sensor for Glaucoma Treatment,” which is a continuation application of U.S. patent application Ser. No. 09/847,523, filed May 2, 2001, and entitled “Bifurcatable Trabecular Shunt for Glaucoma Treatment,” now U.S. Pat. No. 6,666,841, the entirety of each of which is hereby incorporated by reference.
- The present invention generally relates to medical devices and methods for reducing intraocular pressure in the animal eye. More particularly, the present invention relates to the treatment of glaucoma by permitting aqueous humor to flow out of the anterior chamber through a surgically implanted pathway.
- The human eye is a specialized sensory organ capable of light reception and able to receive visual images. The trabecular meshwork serves as a drainage channel and is located in anterior chamber angle formed between the iris and the cornea. The trabecular meshwork maintains a balanced pressure in the anterior chamber of the eye by draining aqueous humor from the anterior chamber.
- About two percent of people in the United States have glaucoma. Glaucoma is a group of eye diseases encompassing a broad spectrum of clinical presentations, etiologies, and treatment modalities. Glaucoma causes pathological changes in the optic nerve, visible on the optic disk, and it causes corresponding visual field loss, resulting in blindness if untreated. Lowering intraocular pressure is the major treatment goal in all glaucomas.
- In glaucomas associated with an elevation in eye pressure (intraocular hypertension), the source of resistance to outflow is mainly in the trabecular meshwork. The tissue of the trabecular meshwork allows the aqueous humor (“aqueous”) to enter Schlemm's canal, which then empties into aqueous collector channels in the posterior wall of Schlemm's canal and then into aqueous veins, which form the episcleral venous system. Aqueous humor is a transparent liquid that fills the region between the cornea, at the front of the eye, and the lens. The aqueous humor is continuously secreted by the ciliary body around the lens, so there is a constant flow of aqueous humor from the ciliary body to the eye's front chamber. The eye's pressure is determined by a balance between the production of aqueous and its exit through the trabecular meshwork (major route) or uveal scleral outflow (minor route). The trabecular meshwork is located between the outer rim of the iris and the back of the cornea, in the anterior chamber angle. The portion of the trabecular meshwork adjacent to Schlemm's canal (the juxtacanilicular meshwork) causes most of the resistance to aqueous outflow.
- Glaucoma is grossly classified into two categories: closed-angle glaucoma, also known as angle closure glaucoma, and open-angle glaucoma. Closed-angle glaucoma is caused by closure of the anterior chamber angle by contact between the iris and the inner surface of the trabecular meshwork. Closure of this anatomical angle prevents normal drainage of aqueous humor from the anterior chamber of the eye. Open-angle glaucoma is any glaucoma in which the angle of the anterior chamber remains open, but the exit of aqueous through the trabecular meshwork is diminished. The exact cause for diminished filtration is unknown for most cases of open-angle glaucoma. Primary open-angle glaucoma is the most common of the glaucomas, and it is often asymptomatic in the early to moderately advanced stage. Patients may suffer substantial, irreversible vision loss prior to diagnosis and treatment. However, there are secondary open-angle glaucomas which may include edema or swelling of the trabecular spaces (e.g., from corticosteroid use), abnormal pigment dispersion, or diseases such as hyperthyroidism that produce vascular congestion.
- All current therapies for glaucoma are directed at decreasing intraocular pressure. Medical therapy includes topical ophthalmic drops or oral medications that reduce the production or increase the outflow of aqueous. However, these drug therapies for glaucoma are sometimes associated with significant side effects, such as headache, blurred vision, allergic reactions, death from cardiopulmonary complications, and potential interactions with other drugs. When drug therapy fails, surgical therapy is used. Surgical therapy for open-angle glaucoma consists of laser trabeculoplasty, trabeculectomy, and implantation of aqueous shunts after failure of trabeculectomy or if trabeculectomy is unlikely to succeed. Trabeculectomy is a major surgery that is widely used and is augmented with topically applied anticancer drugs, such as 5-flurouracil or mitomycin-C to decrease scarring and increase the likelihood of surgical success.
- Approximately 100,000 trabeculectomies are performed on Medicare-age patients per year in the United States. This number would likely increase if the morbidity associated with trabeculectomy could be decreased. The current morbidity associated with trabeculectomy consists of failure (10-15%); infection (a life long risk of 2-5%); choroidal hemorrhage, a severe internal hemorrhage from low intraocular pressure, resulting in visual loss (1%); cataract formation; and hypotony maculopathy (potentially reversible visual loss from low intraocular pressure).
- For these reasons, surgeons have tried for decades to develop a workable surgery for the trabecular meshwork.
- The surgical techniques that have been tried and practiced are goniotomy/trabeculotomy and other mechanical disruptions of the trabecular meshwork, such as trabeculopuncture, goniophotoablation, laser trabecular ablation, and goniocurretage. These are all major operations and are briefly described below.
- Goniotomy/Trabeculotomy:
- Goniotomy and trabeculotomy are simple and directed techniques of microsurgical dissection with mechanical disruption of the trabecular meshwork. These initially had early favorable responses in the treatment of open-angle glaucoma. However, long-term review of surgical results showed only limited success in adults. In retrospect, these procedures probably failed due to cellular repair and fibrosis mechanisms and a process of “filling in.” Filling in is a detrimental effect of collapsing and closing in of the created opening in the trabecular meshwork. Once the created openings close, the pressure builds back up and the surgery fails.
- Trabeculopuncture:
- Q-switched Neodynium (Nd) YAG lasers also have been investigated as an optically invasive technique for creating full-thickness holes in trabecular meshwork. However, the relatively small hole created by this trabeculopuncture technique exhibits a filling-in effect and fails.
- Goniophotoablation/Laser Trabecular Ablation:
- Goniophotoablation is disclosed by Berlin in U.S. Pat. No. 4,846,172 and involves the use of an excimer laser to treat glaucoma by ablating the trabecular meshwork. Additionally, an Erbium:YAG laser was used to create full-thickness holes through trabecular meshwork in a primate model and a limited human clinical trial at the University of California, Irvine. (Hill et al., Lasers in Surgery and Medicine 11:341-346, 1991). Although morbidity was zero in both trials, success rates did not warrant further human trials. Failure was again from filling in of surgically created defects in the trabecular meshwork by repair mechanisms.
- Goniocurretage:
- This is an ab interno (from the inside), mechanically disruptive technique that uses an instrument similar to a cyclodialysis spatula with a microcurrette at the tip. Initial results were similar to trabeculotomy: it failed due to repair mechanisms and a process of filling in.
- Although trabeculectomy is the most commonly performed filtering surgery, viscocanulostomy (VC) and non-penetrating trabeculectomy (NPT) are two new variations of filtering surgery. These are ab externo (from the outside), major ocular procedures in which Schlemm's canal is surgically exposed by making a large and very deep scleral flap. In the VC procedure, Schlemm's canal is cannulated and viscoelastic substance injected (which dilates Schlemm's canal and the aqueous collector channels). In the NPT procedure, the inner wall of Schlemm's canal is stripped off after surgically exposing the canal.
- Trabeculectomy, VC, and NPT involve the formation of an opening or hole under the conjunctiva and scleral flap into the anterior chamber, such that aqueous humor is drained onto the surface of the eye or into the tissues located within the lateral wall of the eye. These surgical operations are major procedures with significant ocular morbidity. When trabeculectomy, VC, and NPT are thought to have a low chance for success, a number of implantable drainage devices have been used to ensure that the desired filtration and outflow of aqueous humor through the surgical opening will continue. The risk of placing a glaucoma drainage device also includes hemorrhage, infection, and diplopia (double vision).
- Examples of implantable shunts and surgical methods for maintaining an opening for the release of aqueous humor from the anterior chamber of the eye to the sclera or space beneath the conjunctiva have been disclosed in, for example, U.S. Pat. No. 6,059,772 to Hsia et al., and U.S. Pat. No. 6,050,970 to Baerveldt.
- All of the above embodiments and variations thereof have numerous disadvantages and moderate success rates. They involve substantial trauma to the eye and require great surgical skill in creating a hole through the full thickness of the sclera into the subconjunctival space. The procedures are generally performed in an operating room and have a prolonged recovery time for vision.
- The complications of existing filtration surgery have prompted ophthalmic surgeons to find other approaches to lowering intraocular pressure.
- The trabecular meshwork and juxtacanilicular tissue together provide the majority of resistance to the outflow of aqueous and, as such, are logical targets for surgical removal in the treatment of open-angle glaucoma. In addition, minimal amounts of tissue are altered and existing physiologic outflow pathways are utilized.
- As reported in Arch. Ophthalm. (2000) 118:412, glaucoma remains a leading cause of blindness, and filtration surgery remains an effective, important option in controlling the disease. However, modifying existing filtering surgery techniques in any profound way to increase their effectiveness appears to have reached a dead end. The article further states that the time has come to search for new surgical approaches that may provide better and safer care for patients with glaucoma.
- Therefore, there is a great clinical need for the treatment of glaucoma by a method that is faster, safer, and less expensive than currently available modalities.
- Glaucoma surgical morbidity would greatly decrease if one were to bypass the focal resistance to outflow of aqueous only at the point of resistance, and to utilize remaining, healthy aqueous outflow mechanisms. This is in part because episcleral aqueous humor exerts a backpressure that prevents intraocular pressure from going too low, and one could thereby avoid hypotony. Thus, such a surgery would virtually eliminate the risk of hypotony-related maculopathy and choroidal hemorrhage. Furthermore, visual recovery would be very rapid, and the risk of infection would be very small, reflecting a reduction in incidence from 2-5% to about 0.05%.
- Techniques performed in accordance with the aspects of the invention may be referred to generally as “trabecular bypass surgery.” Advantages of this surgery include lowering intraocular pressure in a manner which is simple, effective, disease site-specific, and can potentially be performed on an outpatient basis.
- Trabecular bypass surgery (TBS) creates an opening, a slit, or a hole through trabecular meshwork with minor microsurgery. TBS has the advantage of a much lower risk of choroidal hemorrhage and infection than prior techniques, and it uses existing physiologic outflow mechanisms. In some aspects, this surgery can potentially be performed under topical or local anesthesia on an outpatient basis with rapid visual recovery. To prevent “filling in” of the hole, a biocompatible elongated device is placed within the hole and serves as a stent. U.S. patent application Ser. No. 09/549,350, filed Apr. 14, 2000, the entire contents of which are incorporated herein by reference, discloses trabecular bypass surgery.
- In accordance with some embodiments, a trabecular shunt for transporting aqueous humor is provided. The trabecular shunt includes a hollow, elongate tubular element, having an inlet section and an outlet section. The outlet section includes two bifurcatable segments or elements, adapted to be positioned and stabilized inside Schlemm's canal.
- In one aspect, the trabecular shunt is placed inside a delivery apparatus. When the trabecular shunt is deployed from the delivery apparatus into the eye, the two bifurcatable elements of the outlet section bifurcate in substantially opposite directions. In one embodiment, a deployment mechanism within the delivery apparatus includes a push-pull type plunger.
- In another aspect, a delivery applicator may be placed inside a lumen of the hollow, elongate tube of the trabecular shunt. The delivery applicator may include a deployment mechanism for causing the two bifurcatable elements of the outlet section to bifurcate. In some embodiments, the delivery applicator may be a guidewire, an expandable basket, an inflatable balloon, or the like.
- In accordance with another feature, at least one of the two bifurcatable elements is made of a shape-memory material, such as Nitinol or a shape-memory plastic. The shape-memory material has a preshape and a shape-transition temperature, such that the shape-memory trabecular shunt bifurcates to its preshape when it is heated to above the shape-transition temperature. The preshape of the two bifurcatable elements material may be at an angle with respect to the inlet section, preferably between about 70 degrees and about 110 degrees. An external heat source may be provided, which is adapted for heating the shape-memory material to above the shape-transition temperature of the shape-memory material.
- In some aspects, the trabecular shunt may be made of one or more of the following materials: polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene , expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, Nylon™, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, biodegradable materials, and biocompatible materials. Further, the outlet section of the trabecular shunt may be configured as a coil, mesh, spiral, or other appropriate configuration as will apparent to those of skill in the art. Further, the outlet section of the trabecular shunt may be porous, semi-permeable, fishbone, and/or of a continuous, solid form. The outlet section of the trabecular shunt may have a cross-sectional shape that is elliptical (e.g., oval), round, circular, D-shape, semi-circular, or irregular (asymmetrical) shape.
- In one embodiment, at least one of the two bifurcatable elements has a tapered distal end, adapted for insertion ease. The trabecular shunt may have its surface coated with a coating material selected from one or more of the following: polytetrafluoroethylene (e.g., Teflon™), polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like. The surface coating material may also provide a mechanism for site-specific therapies.
- In one embodiment, the device may include a flow-restricting member for restricting at least one component in fluid. The flow-restricting member may be a filter comprising one or more filtration materials selected from the following: expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, fluorinated material, or the like. The flow-restricting member may advantageously be a filter selected from the following group of filter types: hydrophobic, hydrophilic, membrane, microporous, and non-woven. The flow-restricting member acts to limit or prevent the reflux of any undesired component or contaminant of blood, such as red blood cells or serum protein, from the aqueous veins into the anterior chamber. It is useful to restrict one or more of the following components or contaminants: platelets, red blood cells, white blood cells, viruses, bacteria, antigens, and toxins.
- The trabecular shunt may include a pressure sensor for measuring the pressure of the anterior chamber of an eye of a patient. The pressure sensor may further include an electromagnetic (e.g., radiofrequency) transmitter, for wirelessly transmitting pressure measurements to a pressure receiver outside the patient's body.
- Among the advantages of trabecular bypass surgery is its simplicity. The microsurgery may potentially be performed on an outpatient basis with rapid visual recovery and greatly decreased morbidity. There is a lower risk of infection and choroidal hemorrhage, and there is a faster recovery, than with previous techniques.
- Further features and advantages of the invention will become apparent to one of skill in the art in view of the Detailed Description that follows, when considered together with the attached drawings and claims.
-
FIG. 1 is a sagittal sectional view of an eye. -
FIG. 2 is a cross-sectional view of the anterior chamber of an eye. -
FIG. 3A is an side elevational view of a glaucoma device. -
FIG. 3B is an end cross-sectional view through plane 1-1 ofFIG. 3A . -
FIG. 4A illustrates the trabecular shunt ofFIG. 3A at a semi-deployment state. -
FIG. 4B is an end cross-sectional view of section 2-2 ofFIG. 4A . -
FIG. 5A illustrates the trabecular shunt ofFIG. 3A in a deployed state. -
FIG. 5B is an end cross-sectional view of the trabecular shunt, section 3-3 ofFIG. 5A . -
FIG. 5C is an end cross-sectional view of a bifurcatable segment, section 4-4 ofFIG. 5A . -
FIG. 6 is a side cross-sectional view of the trabecular shunt. -
FIG. 7A is a side cross-sectional view of an alternate embodiment of the trabecular shunt. -
FIG. 7B is a side cross-sectional view of the trabecular shunt ofFIG. 7A in a partially deployed state. -
FIG. 8 is a perspective view of the trabecular shunt placed inside Schlemm's canal. - FIGS. 1 to 8 illustrate an apparatus for the treatment of glaucoma by trabecular bypass surgery.
-
FIG. 1 is a sagittal sectional view of aneye 10, whileFIG. 2 is a close-up view, showing the relative anatomical locations oftrabecular meshwork 21, theanterior chamber 20, and Schlemm'scanal 22. Thick collagenous tissue known assclera 11 covers theentire eye 10 except that portion covered by thecornea 12. Thecornea 12 is a thin transparent tissue that focuses and transmits light into the eye and through thepupil 14, which is the circular hole in the center of the iris 13 (colored portion of the eye). Thecornea 12 merges into the sclera 11 at a juncture referred to as thelimbus 15. Theciliary body 16 extends along the interior of thesclera 11 and is coextensive with thechoroid 17. Thechoroid 17 is a vascular layer of theeye 10, located between the sclera 11 andretina 18. Theoptic nerve 19 transmits visual information to the brain and is the anatomic structure that is progressively destroyed by glaucoma. - The
anterior chamber 20 of theeye 10, which is bound anteriorly by thecornea 12 and posteriorly by theiris 13 andlens 26, is filled with aqueous humor (“aqueous”). Aqueous is produced primarily by theciliary body 16, then moves anteriorly through thepupil 14 and reaches theanterior chamber angle 25, formed between theiris 13 and thecornea 12. In a normal eye, the aqueous is removed from theanterior chamber 20 through thetrabecular meshwork 21. Aqueous passes throughtrabecular meshwork 21 into Schlemm'scanal 22 and thereafter through theaqueous veins 23, which merge with blood-carrying veins and into the systemic venous circulation. Intraocular pressure is maintained by the intricate balance between secretion and outflow of the aqueous in the manner described above. Glaucoma is, in most cases, characterized by the excessive buildup of aqueous humor in theanterior chamber 20, which leads to an increase in intraocular pressure. Fluids are relatively incompressible, and pressure is directed relatively equally throughout the eye. - As shown in
FIG. 2 , thetrabecular meshwork 21 is adjacent a small portion of thesclera 11. Traditional procedures that create a hole or opening for implanting a device through the tissues of theconjunctiva 24 andsclera 11 involve extensive surgery, as compared to surgery for implanting a device which ultimately resides entirely within the confines of thesclera 11 andcornea 12, as is performed in accordance with one aspect. Adevice 31 for establishing an outflow pathway, positioned through thetrabecular meshwork 21, is illustrated inFIG. 8 . - In one embodiment, a method of placing a trabecular shunt into an opening through trabecular meshwork, the method comprises advancing and positioning a trabecular shunt having two distal bifurcatable elements through the opening. In a further embodiment, a method of placing a trabecular shunt into an opening through diseased trabecular meshwork for transporting aqueous humor at the level of the trabecular meshwork and using an existing outflow pathway, the method comprises advancing and positioning a trabecular shunt having a pressure sensor for measuring the pressure of the anterior chamber of the eye through the opening. In one embodiment, the method may further comprise transmitting the measured pressure to a pressure receiver outside the body of the patient.
-
FIG. 3A shows an embodiment of thetrabecular shunt 31. The trabecular shunt may comprise a biocompatible material, such as medical grade silicone, trade name Silastic(, available from Dow Corning Corporation of Midland, Mich.; or polyurethane, trade name Pellethane(, also available from Dow Corning Corporation. In some embodiments, other biocompatible materials (biomaterials) may be used, such as polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene, expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, Nylon, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, or any mixture of these or other biocompatible materials. In a further embodiment, the trabecular shunt may comprise a composite biocompatible material, with a surface made of one or more of the above-mentioned biomaterials, and the surface is coated by a material selected from Teflon, polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like. Suitable anti-angiogenic or anti-proliferative factors may be selected from, for example, protamine, heparin, steroids, anti-invasive factor, retinoic acids and derivatives thereof, and paclitaxel or its analogues or derivatives thereof. - The main purpose of the trabecular shunt is for transporting aqueous humor at the level of the trabecular meshwork and partially using existing the outflow pathway for aqueous humor, i.e., utilizing the entire outflow pathway except for the trabecular meshwork, which is bypassed by the
trabecular shunt 31. In this manner, aqueous humor is transported into Schlemm's canal and subsequently into the aqueous collectors and the aqueous veins so that the intraocular pressure is properly maintained within a therapeutic range. - In one embodiment, the
trabecular shunt 31 comprises a hollow, elongated tubular element having aninlet section 32 and anoutlet section 33, wherein theoutlet section 33 may comprise twobifurcatable elements lumen 36 for transporting aqueous from theanterior chamber 20 of an eye to the Schlemm'scanal 22. A “bifurcatable” segment is defined as a segment, or components thereof, that can change direction away or evert from a reference axis. The “bifurcating” operation may be achieved by mechanical forces and/or through the shape-memory property of a material. - For stabilization purposes, the outer surface of the
outlet section 33 may comprise a stubbed surface, ribbed surface, surface with pillars, textured surface, or the like. The outer surface of thetrabecular shunt 31 is biocompatible and tissue-compatible so that the interaction between the outer surface of the shunt and the surrounding tissue of Schlemm's canal is minimal, and inflammation is reduced.FIG. 3B shows an end cross-sectional view of section 1-1 ofFIG. 3A . Eachbifurcatable segment bifurcatable elements inlet section 32 at a joint 37. In an alternate embodiment, at least aslit 38, or scalloping, within the twobifurcatable elements outlet section 33 of thetrabecular shunt 31 may possess a cross-sectional shape selected from the following: oval shape, round shape, circular shape, D-shape, semi-circular shape, irregular shape, or random shape. - In another preferred embodiment, the
trabecular shunt 31 may comprise a flow-restricting element for restricting at least one component in fluid, wherein the flow-restricting element may be a filter selected from a group of filtration materials comprising expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, and fluorinated material. Furthermore, the flow-restricting element may be a filter selected from a group of filter types comprising a hydrophobic filter, hydrophilic filter, membrane filter, microporous filter, non-woven filter, and the like. Components in blood that may be restricted by the flow-restricting element can include the following: platelet, red blood cell, white blood cell, virus, antigen, serum protein, and toxin. The flow-restricting element may also be in the form of, for example, a check valve, a slit valve, a micropump, a semi-permeable membrane, and the like. The purpose of the flow-restricting element is to keep an undesired foreign material from back flowing into the anterior chamber. -
FIG. 4A shows the trabecular shunt ofFIG. 3A in a semi-deployed state, whileFIG. 4B shows an end cross-sectional view of section 2-2 ofFIG. 4A . In one embodiment for shunt delivery, thetrabecular shunt 31 is placed inside ahollow delivery apparatus 45. Adelivery apparatus 45 comprises adistal end 47, wherein the twobifurcatable elements trabecular shunt 31 is deployed out of thedelivery apparatus 45. Theslit 38 at the twobifurcatable elements regions delivery apparatus 45 may comprise a deployment mechanism-for deploying the trabecular shunt out of the delivery apparatus. In one embodiment, the deployment mechanism is a plunger. The delivery mechanism may be located at the handle of the delivery apparatus for deploying the trabecular shunt. -
FIG. 5A shows the trabecular shunt ofFIG. 3A at a deployed state. As the plunger is continuously pushed ahead, and thedistal end 47 of thedelivery apparatus 45 retreats, the twobifurcatable elements joint point 37 located between theinlet section 32 and the outlet section, the two bifurcatable elements are fully deployed with theirseparating regions FIG. 7A ), continuous solid form, or may be made from any form that is effective and appropriate to evert the bifurcatable elements to be at one or more angles with respect to a reference axis of the inlet section. -
FIG. 5B shows an end cross-sectional view of the trabecular shunt, section 3-3 ofFIG. 5A , whileFIG. 5C shows an end cross-sectional view of a bifurcatable segment, section 4-4 ofFIG. 5A . The original outer contour of thetrabecular shunt 31 is illustrated by a dashedline 49 inFIG. 5B . Thelumen 36 of the hollow elongated tubular element is for aqueous to flow through the trabecular shunt. The shape of theend cross-section 35 is to provide a stenting capability when the elements are placed inside Schlemm's canal. The semicircular end cross-section of thebifurcatable elements -
FIG. 6 shows another preferred embodiment of the trabecular shunt. Adelivery applicator 52 may be placed inside a lumen of the hollow elongated tubular element, wherein the delivery applicator comprises a deployment mechanism for causing the twobifurcatable elements delivery applicator 52 with an expandable basket comprises a plurality ofexpandable members joint point 55B. A distal end of a push-pull type wire 51 is also joined at the distaljoint point 55B. The proximal joint 55A is located at the distal end of acompact guidewire 53 of the delivery applicator. Therefore, by pulling the push-pull wire 51 of the delivery applicator toward the operator, each of theexpandable members bifurcatable elements - U.S. Pat. No. 6,077,298 and U.S. patent application Ser. No. 09/452,963, filed Dec. 2, 1999, both of which are incorporated herein by reference in their entirety, disclose a medical device made of shape-memory Nitinol having a shape-transition temperature. In a further embodiment, a trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal. At least one of the two bifurcatable elements may be made of a shape-memory material such as shape-memory Nitinol or shape-memory plastic material. In a preferred embodiment, the shape-memory Nitinol has a preshape and a shape-transition temperature, wherein the shape-memory Nitinol bifurcates to its preshape when the shape-memory Nitinol is heated to above the shape-transition temperature, the preshape of the shape-memory Nitinol being at an angle with respect to the inlet section.
- The shape-transition temperature for the shape-memory Nitinol is preferably between about 39° C. and about 90° C. The shape-transition temperature is more preferred between about 39° C. and 45° C. so as to minimize tissue damage. The angle is preferably between about 70 degrees and about 110 degrees so as to conform to the contour of Schlemm's canal. An external heat source may be provided and adapted for heating the shape-memory Nitinol to above the shape-transition temperature of the shape-memory Nitinol. Examples of such external heat sources include a heating pad, a warm cloth, a bag of warm water, remotely deliverable heat, electromagnetic field, and the like. In another embodiment, the shape-memory Nitinol may be embedded within a biocompatible material selected from, for example, silicone, polyurethane, porous material, expanded polytetrafluoroethylene, semi-permeable membrane, elastomer, and mixture of the biocompatible material thereof. In general, the bifurcatable elements are relatively flexible and soft so that they do not impart undesired force or pressure onto the surrounding tissue during and after the deployment state.
- For illustration purposes, a fishbone-type outlet section is shown to render the bifurcatable elements flexible and soft during the deployment state.
FIG. 7A shows an embodiment of the trabecular shunt. The trabecular shunt comprises a plurality of fishbones and their intermediate spacing, such as thefishbones spacing 62A and thefishbones spacing 62B. Adelivery apparatus 45 may be used to deliver the self-bifurcatable elements -
FIG. 7B shows the trabecular shunt ofFIG. 7A in a semi-deployed state. As thedistal end 47 of thedelivery apparatus 45 is pulled away from thedistal end 39 of theshunt 31, the self-bifurcatable elements spacing 62B between the twofishbones bifurcatable elements - The trabecular shunt may have a length between about 0.5 mm to over a few millimeters. The outside diameter of the trabecular shunt may range from about 30 μm to about 500 μm or more. The lumen diameter is preferably in the range of about 20 μm to about 150 μm, or larger. The trabecular shunt may have a plurality of lumens to facilitate multiple-channel flow. The outlet section may be curved or angled at an angle between about 30 degrees to about 150 degrees, and preferably at about 70 degrees to about 110 degrees, with reference to the
inlet section 32. -
FIG. 8 is a perspective view illustrating thedevice 31 positioned within the tissue of aneye 10. A hole or opening is created through thediseased trabecular meshwork 21. The outlet section of thedevice 31 is inserted into the hole, wherein the inlet section is exposed to theanterior chamber 20 while the outlet section is positioned at about anexterior surface 3 of thediseased trabecular meshwork 21. In a further embodiment, the outlet section may enter into Schlemm's canal or other existing outflow pathways. A device as shown inFIG. 3 may be successfully used to maintain the opening through diseased trabecular meshwork. - In one embodiment, means for forming a hole/opening in the
trabecular mesh 21 may comprise using a microknife, a pointed guidewire, a sharpened applicator, a screw shaped applicator, an irrigating applicator, or a barbed applicator. Alternatively, the trabecular meshwork may be dissected off with an instrument similar to a retinal pick or microcurrette. The opening may alternately be created by retrograde fiberoptic laser ablation. - In a preferred embodiment of the trabecular meshwork surgery, the patient is placed in the supine position, prepped, draped and anesthesia obtained. In one embodiment, a small (generally less than 1-mm) self-sealing incision is made. Through the cornea opposite the shunt placement site, an incision is made in the trabecular meshwork with an irrigating knife. The shunt is then advanced through the corneal incision across the anterior chamber held in a delivery apparatus or delivery applicator under gonioscopic (lens) or endoscopic guidance. The apparatus or applicator is withdrawn from the patient and the surgery is concluded. The delivery apparatus or applicator may be within a size range of 20 to 40 gauge, and preferably about 30 gauge.
- In a further embodiment, a method for increasing aqueous humor outflow in an eye of a patient to reduce intraocular pressure therein, the method comprises: (a) creating an opening in trabecular meshwork using a knife or laser, etc; (b) inserting a trabecular shunt into the opening, such as by using a delivery device, wherein the trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, and wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal; and (c) bifurcating the two bifurcatable elements to two opposing directions.
- The method may further comprise placing the trabecular shunt inside a delivery apparatus, wherein the two bifurcatable elements are self-bifurcatable in two opposing directions when the trabecular shunt is deployed from the delivery apparatus. The method may further comprise placing a delivery applicator inside a lumen of a hollow elongated tubular element, wherein the delivery applicator comprises a deployment mechanism for causing the two bifurcatable elements to move in two opposing directions.
- The method may further comprise measuring and transmitting pressure of the anterior chamber of an eye, wherein the trabecular shunt comprises a pressure sensor for measuring and transmitting pressure. The means for measuring and transmitting pressure of an anterior chamber of an eye to an external receiver may be incorporated within a device that is placed inside the anterior chamber for sensing and transmitting the intraocular pressure. Any suitable micro pressure sensor or pressure sensor chip known to those of skill in the art may be utilized.
- From the foregoing description, it should be appreciated that a novel device and methods for the surgical treatment of glaucoma have been disclosed for reducing intraocular pressure. While the invention has been described with reference to specific embodiments, the description is illustrative and is not to be construed as limiting the invention. Various modifications and applications of the invention may occur to those who are skilled in the art, without departing from the true spirit or scope of the invention. The breadth and scope of the invention should be defined only in accordance with the appended claims and their equivalents.
Claims (9)
1. A method of treating glaucoma, comprising:
providing an implant comprising a biodegradable material;
inserting the implant through an incision in an eye into the anterior chamber of the eye;
transporting the implant from the incision through the anterior chamber of the eye to Schlemm's canal of the eye; and
positioning the implant such that an inflow portion of the implant is positioned to bypass the trabecular meshwork of the eye and receive fluid from the anterior chamber, and an outflow portion of the implant is positioned in Schlemm's canal;
wherein a diameter of the outflow portion when positioned in Schlemm's canal is substantially the same as a diameter of the inflow portion when positioned in the anterior chamber.
2. The method of claim 1 , wherein the incision is in the cornea of the eye.
3. The method of claim 1 , wherein the transporting the implant further comprises extending a portion of the implant through the trabecular meshwork of the eye.
4. The device of claim 1 , wherein a diameter of the outlet section when positioned in Schlemm's canal is configured to be substantially the same as a diameter of the inlet section when positioned in the trabecular meshwork.
5. A device for treating glaucoma comprising an implant having an inlet section with an inlet opening configured to receive fluid from the anterior chamber of an eye and an outlet section with an outlet opening configured to deliver fluid from the outlet section to Schlemm's canal of the eye, said inlet opening being in fluid communication with the outlet opening, said inlet section being disposed at an angle relative to the outlet section such that the implant is generally L-shaped.
6. A device for treating glaucoma comprising an implant having an inlet section with an inlet opening configured to receive fluid from the anterior chamber of an eye and an outlet section with an outlet opening configured to deliver fluid from the implant to Schlemm's canal of the eye, said outlet section having a blunt end.
7. A device for treating glaucoma comprising an implant having an inlet section configured to receive fluid from the anterior chamber of an eye and an outlet section configured to deliver fluid from the inlet section to Schlemm's canal of the eye, said implant comprising a biodegradable material, and wherein a diameter of the outlet section when positioned in Schlemm's canal is configured to be substantially the same as a diameter of the inlet section when positioned in the anterior chamber.
8. A method of treating glaucoma, comprising:
providing an implant comprising a biodegradable material and having an inflow portion configured to receive fluid from the anterior chamber of an eye and an outflow portion configured to deliver fluid from the inflow portion to Schlemm's canal of the eye, said inflow portion being disposed relative to the outflow portion such that the implant is generally L-shaped;
inserting the implant through an incision in an eye into the anterior chamber of the eye;
transporting the implant from the incision through the anterior chamber of the eye to Schlemm's canal of the eye; and
positioning the implant such that an inflow portion of the implant is positioned to receive fluid from the anterior chamber, and an outflow portion of the implant is positioned in Schlemm's canal.
9. A method of treating glaucoma, comprising:
providing an implant comprising a biodegradable material and having an inflow portion configured to receive fluid from the anterior chamber of an eye and an outflow portion configured to deliver fluid from the inflow portion to Schlemm's canal of the eye, said outflow portion having a blunt end;
inserting the implant through an incision in an eye into the anterior chamber of the eye;
transporting the implant from the incision through the anterior chamber of the eye to Schlemm's canal of the eye; and
positioning the implant such that an inflow portion of the implant is positioned to receive fluid from the anterior chamber, and an outflow portion of the implant is positioned in Schlemm's canal.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/209,563 US20050288619A1 (en) | 2001-05-02 | 2005-08-23 | Biodegradable glaucoma implant |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/847,523 US6666841B2 (en) | 2001-05-02 | 2001-05-02 | Bifurcatable trabecular shunt for glaucoma treatment |
US10/626,181 US6981958B1 (en) | 2001-05-02 | 2003-07-24 | Implant with pressure sensor for glaucoma treatment |
US11/209,563 US20050288619A1 (en) | 2001-05-02 | 2005-08-23 | Biodegradable glaucoma implant |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/626,181 Continuation US6981958B1 (en) | 2001-04-07 | 2003-07-24 | Implant with pressure sensor for glaucoma treatment |
Publications (1)
Publication Number | Publication Date |
---|---|
US20050288619A1 true US20050288619A1 (en) | 2005-12-29 |
Family
ID=34890607
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/626,181 Expired - Lifetime US6981958B1 (en) | 2001-04-07 | 2003-07-24 | Implant with pressure sensor for glaucoma treatment |
US11/121,584 Abandoned US20090076436A2 (en) | 2001-05-02 | 2005-05-04 | Ocular implants with deployable structure |
US11/209,563 Abandoned US20050288619A1 (en) | 2001-05-02 | 2005-08-23 | Biodegradable glaucoma implant |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/626,181 Expired - Lifetime US6981958B1 (en) | 2001-04-07 | 2003-07-24 | Implant with pressure sensor for glaucoma treatment |
US11/121,584 Abandoned US20090076436A2 (en) | 2001-05-02 | 2005-05-04 | Ocular implants with deployable structure |
Country Status (1)
Country | Link |
---|---|
US (3) | US6981958B1 (en) |
Cited By (74)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050090874A1 (en) * | 2001-06-15 | 2005-04-28 | Wu Naijuan J. | Thin film optical detectors for retinal implantation and methods for making and using same |
US7740604B2 (en) | 2007-09-24 | 2010-06-22 | Ivantis, Inc. | Ocular implants for placement in schlemm's canal |
US7815592B2 (en) | 2003-11-14 | 2010-10-19 | Transcend Medical, Inc. | Ocular pressure regulation |
KR101050437B1 (en) * | 2003-06-10 | 2011-07-19 | 카오 코퍼레이션 | Process for producing fatty acids with low trans-fatty acid content |
US8167939B2 (en) | 2009-01-28 | 2012-05-01 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US20120165720A1 (en) * | 2010-11-15 | 2012-06-28 | Aquesys, Inc. | Intraocular shunts |
US8267882B2 (en) | 2008-03-05 | 2012-09-18 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US8337509B2 (en) | 2007-11-20 | 2012-12-25 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US8372026B2 (en) | 2007-09-24 | 2013-02-12 | Ivantis, Inc. | Ocular implant architectures |
WO2013049107A2 (en) * | 2011-09-27 | 2013-04-04 | The Regents Of The University Of Colorado, A Body Corporate | Intraocular encapsulation of oxygenic bacteria |
US8425449B2 (en) | 2009-07-09 | 2013-04-23 | Ivantis, Inc. | Ocular implants and methods for delivering ocular implants into the eye |
US8444588B2 (en) | 2003-05-05 | 2013-05-21 | Transcend Medical, Inc. | Internal shunt and method for treating glaucoma |
US8512404B2 (en) | 2007-11-20 | 2013-08-20 | Ivantis, Inc. | Ocular implant delivery system and method |
US8529492B2 (en) | 2009-12-23 | 2013-09-10 | Trascend Medical, Inc. | Drug delivery devices and methods |
US8617139B2 (en) | 2008-06-25 | 2013-12-31 | Transcend Medical, Inc. | Ocular implant with shape change capabilities |
US8657776B2 (en) | 2011-06-14 | 2014-02-25 | Ivantis, Inc. | Ocular implants for delivery into the eye |
US8663303B2 (en) | 2010-11-15 | 2014-03-04 | Aquesys, Inc. | Methods for deploying an intraocular shunt from a deployment device and into an eye |
US8663150B2 (en) | 2011-12-19 | 2014-03-04 | Ivantis, Inc. | Delivering ocular implants into the eye |
US8672870B2 (en) | 2007-07-17 | 2014-03-18 | Transcend Medical, Inc. | Ocular implant with hydrogel expansion capabilities |
US8721656B2 (en) | 2006-01-17 | 2014-05-13 | Transcend Medical, Inc. | Glaucoma treatment device |
US8734377B2 (en) | 2007-09-24 | 2014-05-27 | Ivantis, Inc. | Ocular implants with asymmetric flexibility |
US20140148752A1 (en) * | 2011-07-18 | 2014-05-29 | Mor Research Applications Ltd. | A device for adjusting the intraocular pressure |
US8758290B2 (en) | 2010-11-15 | 2014-06-24 | Aquesys, Inc. | Devices and methods for implanting a shunt in the suprachoroidal space |
US8765210B2 (en) | 2011-12-08 | 2014-07-01 | Aquesys, Inc. | Systems and methods for making gelatin shunts |
US8801766B2 (en) | 2010-11-15 | 2014-08-12 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US8808222B2 (en) | 2007-11-20 | 2014-08-19 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US8828070B2 (en) | 2010-11-15 | 2014-09-09 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US8852137B2 (en) | 2010-11-15 | 2014-10-07 | Aquesys, Inc. | Methods for implanting a soft gel shunt in the suprachoroidal space |
US8852136B2 (en) | 2011-12-08 | 2014-10-07 | Aquesys, Inc. | Methods for placing a shunt into the intra-scleral space |
US8852256B2 (en) | 2010-11-15 | 2014-10-07 | Aquesys, Inc. | Methods for intraocular shunt placement |
US8974511B2 (en) | 2010-11-15 | 2015-03-10 | Aquesys, Inc. | Methods for treating closed angle glaucoma |
US9017276B2 (en) | 2010-11-15 | 2015-04-28 | Aquesys, Inc. | Shunt placement through the sclera |
US9084662B2 (en) | 2006-01-17 | 2015-07-21 | Transcend Medical, Inc. | Drug delivery treatment device |
US9095411B2 (en) | 2010-11-15 | 2015-08-04 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US9155656B2 (en) | 2012-04-24 | 2015-10-13 | Transcend Medical, Inc. | Delivery system for ocular implant |
US9173775B2 (en) | 2012-03-26 | 2015-11-03 | Glaukos Corporation | System for delivering multiple ocular implants |
US9358156B2 (en) | 2012-04-18 | 2016-06-07 | Invantis, Inc. | Ocular implants for delivery into an anterior chamber of the eye |
US9480598B2 (en) | 2012-09-17 | 2016-11-01 | Novartis Ag | Expanding ocular implant devices and methods |
US9492320B2 (en) | 1999-04-26 | 2016-11-15 | Glaukos Corporation | Shunt device and method for treating ocular disorders |
US9510973B2 (en) | 2010-06-23 | 2016-12-06 | Ivantis, Inc. | Ocular implants deployed in schlemm's canal of the eye |
US9579234B2 (en) | 2009-10-23 | 2017-02-28 | Ivantis, Inc. | Ocular implant system and method |
US9693899B2 (en) | 2009-07-09 | 2017-07-04 | Ivantis, Inc. | Single operator device for delivering an ocular implant |
US9763829B2 (en) | 2012-11-14 | 2017-09-19 | Novartis Ag | Flow promoting ocular implant |
US9855167B2 (en) | 2012-03-20 | 2018-01-02 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US9987163B2 (en) | 2013-04-16 | 2018-06-05 | Novartis Ag | Device for dispensing intraocular substances |
US9987472B2 (en) | 2001-04-07 | 2018-06-05 | Glaukos Corporation | Ocular implant delivery systems |
US9993368B2 (en) | 2000-04-14 | 2018-06-12 | Glaukos Corporation | System and method for treating an ocular disorder |
US10085633B2 (en) | 2012-04-19 | 2018-10-02 | Novartis Ag | Direct visualization system for glaucoma treatment |
US10159601B2 (en) | 2000-05-19 | 2018-12-25 | Ivantis, Inc. | Delivery system and method of use for the eye |
US10195078B2 (en) | 2013-02-19 | 2019-02-05 | Aquesys, Inc. | Adjustable intraocular flow regulation |
US10285856B2 (en) | 2001-08-28 | 2019-05-14 | Glaukos Corporation | Implant delivery system and methods thereof for treating ocular disorders |
US10299958B2 (en) | 2015-03-31 | 2019-05-28 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US10314742B2 (en) | 2006-06-26 | 2019-06-11 | Sight Sciences, Inc. | Intraocular implants and methods and kits therefor |
US10406029B2 (en) | 2001-04-07 | 2019-09-10 | Glaukos Corporation | Ocular system with anchoring implant and therapeutic agent |
US10406030B2 (en) | 2010-02-05 | 2019-09-10 | Sight Sciences, Inc. | Intraocular implants and related kits and methods |
US10485701B2 (en) | 2002-04-08 | 2019-11-26 | Glaukos Corporation | Devices and methods for glaucoma treatment |
US10517759B2 (en) | 2013-03-15 | 2019-12-31 | Glaukos Corporation | Glaucoma stent and methods thereof for glaucoma treatment |
US10617558B2 (en) | 2012-11-28 | 2020-04-14 | Ivantis, Inc. | Apparatus for delivering ocular implants into an anterior chamber of the eye |
US10709547B2 (en) | 2014-07-14 | 2020-07-14 | Ivantis, Inc. | Ocular implant delivery system and method |
US10959941B2 (en) | 2014-05-29 | 2021-03-30 | Glaukos Corporation | Implants with controlled drug delivery features and methods of using same |
US11019997B2 (en) | 2015-03-20 | 2021-06-01 | Glaukos Corporation | Gonioscopic devices |
US11116625B2 (en) | 2017-09-28 | 2021-09-14 | Glaukos Corporation | Apparatus and method for controlling placement of intraocular implants |
USD938585S1 (en) | 2017-10-27 | 2021-12-14 | Glaukos Corporation | Implant delivery apparatus |
US11197779B2 (en) | 2015-08-14 | 2021-12-14 | Ivantis, Inc. | Ocular implant with pressure sensor and delivery system |
US11253394B2 (en) | 2013-03-15 | 2022-02-22 | Dose Medical Corporation | Controlled drug delivery ocular implants and methods of using same |
US11318043B2 (en) | 2016-04-20 | 2022-05-03 | Dose Medical Corporation | Bioresorbable ocular drug delivery device |
US11376040B2 (en) | 2017-10-06 | 2022-07-05 | Glaukos Corporation | Systems and methods for delivering multiple ocular implants |
US11504270B1 (en) | 2019-09-27 | 2022-11-22 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11523938B2 (en) | 2013-03-15 | 2022-12-13 | Glaukos Corporation | Systems and methods for delivering an ocular implant to the suprachoroidal space within an eye |
US11540940B2 (en) | 2021-01-11 | 2023-01-03 | Alcon Inc. | Systems and methods for viscoelastic delivery |
US11564833B2 (en) | 2015-09-25 | 2023-01-31 | Glaukos Corporation | Punctal implants with controlled drug delivery features and methods of using same |
US11744458B2 (en) | 2017-02-24 | 2023-09-05 | Glaukos Corporation | Gonioscopes |
US11744734B2 (en) | 2007-09-24 | 2023-09-05 | Alcon Inc. | Method of implanting an ocular implant |
US11925578B2 (en) | 2015-09-02 | 2024-03-12 | Glaukos Corporation | Drug delivery implants with bi-directional delivery capacity |
Families Citing this family (91)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8313454B2 (en) | 1997-11-20 | 2012-11-20 | Optonol Ltd. | Fluid drainage device, delivery device, and associated methods of use and manufacture |
US7229469B1 (en) | 1999-10-02 | 2007-06-12 | Quantumcor, Inc. | Methods for treating and repairing mitral valve annulus |
US20050119737A1 (en) * | 2000-01-12 | 2005-06-02 | Bene Eric A. | Ocular implant and methods for making and using same |
US7708711B2 (en) | 2000-04-14 | 2010-05-04 | Glaukos Corporation | Ocular implant with therapeutic agents and methods thereof |
US20040111050A1 (en) * | 2000-04-14 | 2004-06-10 | Gregory Smedley | Implantable ocular pump to reduce intraocular pressure |
US6962573B1 (en) | 2000-10-18 | 2005-11-08 | Wilcox Michael J | C-shaped cross section tubular ophthalmic implant for reduction of intraocular pressure in glaucomatous eyes and method of use |
US6881198B2 (en) * | 2001-01-09 | 2005-04-19 | J. David Brown | Glaucoma treatment device and method |
US6981958B1 (en) * | 2001-05-02 | 2006-01-03 | Glaukos Corporation | Implant with pressure sensor for glaucoma treatment |
US7488303B1 (en) * | 2002-09-21 | 2009-02-10 | Glaukos Corporation | Ocular implant with anchor and multiple openings |
US7678065B2 (en) * | 2001-05-02 | 2010-03-16 | Glaukos Corporation | Implant with intraocular pressure sensor for glaucoma treatment |
AU2002305400A1 (en) * | 2001-05-03 | 2002-11-18 | Glaukos Corporation | Medical device and methods of use for glaucoma treatment |
US7186232B1 (en) | 2002-03-07 | 2007-03-06 | Glaukoa Corporation | Fluid infusion methods for glaucoma treatment |
US7951155B2 (en) * | 2002-03-15 | 2011-05-31 | Glaukos Corporation | Combined treatment for cataract and glaucoma treatment |
US9301875B2 (en) * | 2002-04-08 | 2016-04-05 | Glaukos Corporation | Ocular disorder treatment implants with multiple opening |
US7384550B2 (en) * | 2004-02-24 | 2008-06-10 | Becton, Dickinson And Company | Glaucoma implant having MEMS filter module |
US7544176B2 (en) * | 2005-06-21 | 2009-06-09 | Becton, Dickinson And Company | Glaucoma implant having MEMS flow module with flexing diaphragm for pressure regulation |
US20060206049A1 (en) * | 2005-03-14 | 2006-09-14 | Rodgers M S | MEMS flow module with piston-type pressure regulating structure |
US7364564B2 (en) * | 2004-03-02 | 2008-04-29 | Becton, Dickinson And Company | Implant having MEMS flow module with movable, flow-controlling baffle |
US20060036207A1 (en) * | 2004-02-24 | 2006-02-16 | Koonmen James P | System and method for treating glaucoma |
US20060173399A1 (en) * | 2005-02-01 | 2006-08-03 | Rodgers M S | MEMS flow module with pivoting-type baffle |
US20060219627A1 (en) * | 2005-03-31 | 2006-10-05 | Rodgers M S | MEMS filter module with concentric filtering walls |
US7226540B2 (en) * | 2004-02-24 | 2007-06-05 | Becton, Dickinson And Company | MEMS filter module |
JP2008504938A (en) | 2004-07-02 | 2008-02-21 | レイザー,エリオット | Treatment medium delivery apparatus and method for delivering treatment medium to eyes using the delivery apparatus |
DE102005003632A1 (en) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Catheter for the transvascular implantation of heart valve prostheses |
US7914569B2 (en) | 2005-05-13 | 2011-03-29 | Medtronics Corevalve Llc | Heart valve prosthesis and methods of manufacture and use |
CA2613241A1 (en) | 2005-06-21 | 2007-01-04 | Cardiomems, Inc. | Method of manufacturing implantable wireless sensor for in vivo pressure measurement |
BRPI0709672B8 (en) | 2006-03-31 | 2021-06-22 | 3088922 Inc | ocular implant insertable into an ocular lumen and method of delivering a therapeutic agent to an eye |
US20080108933A1 (en) * | 2006-06-30 | 2008-05-08 | Dao-Yi Yu | Methods, Systems and Apparatus for Relieving Pressure in an Organ |
US8308701B2 (en) | 2010-11-15 | 2012-11-13 | Aquesys, Inc. | Methods for deploying intraocular shunts |
US8721702B2 (en) | 2010-11-15 | 2014-05-13 | Aquesys, Inc. | Intraocular shunt deployment devices |
US8834564B2 (en) | 2006-09-19 | 2014-09-16 | Medtronic, Inc. | Sinus-engaging valve fixation member |
US11304800B2 (en) | 2006-09-19 | 2022-04-19 | Medtronic Ventor Technologies Ltd. | Sinus-engaging valve fixation member |
US8414643B2 (en) | 2006-09-19 | 2013-04-09 | Medtronic Ventor Technologies Ltd. | Sinus-engaging valve fixation member |
US8187266B2 (en) * | 2006-09-29 | 2012-05-29 | Quantumcor, Inc. | Surgical probe and methods for targeted treatment of heart structures |
US8090426B2 (en) | 2006-10-27 | 2012-01-03 | Felder Robin A | Microelectronic biosensor plug |
JP5748407B2 (en) | 2006-11-10 | 2015-07-15 | グローコス コーポレーション | Uveal sclera shunt |
US8894582B2 (en) | 2007-01-26 | 2014-11-25 | Endotronix, Inc. | Cardiac pressure monitoring device |
US10003862B2 (en) | 2007-03-15 | 2018-06-19 | Endotronix, Inc. | Wireless sensor reader |
US20080281212A1 (en) * | 2007-03-15 | 2008-11-13 | Nunez Anthony I | Transseptal monitoring device |
US8154389B2 (en) | 2007-03-15 | 2012-04-10 | Endotronix, Inc. | Wireless sensor reader |
US8570186B2 (en) | 2011-04-25 | 2013-10-29 | Endotronix, Inc. | Wireless sensor reader |
US8493187B2 (en) | 2007-03-15 | 2013-07-23 | Endotronix, Inc. | Wireless sensor reader |
US7896915B2 (en) | 2007-04-13 | 2011-03-01 | Jenavalve Technology, Inc. | Medical device for treating a heart valve insufficiency |
US20080277332A1 (en) * | 2007-05-11 | 2008-11-13 | Becton, Dickinson And Company | Micromachined membrane filter device for a glaucoma implant and method for making the same |
EP2205193A2 (en) * | 2007-09-07 | 2010-07-14 | QLT Plug Delivery, Inc. | Lacrimal implant detection |
AU2008300013A1 (en) | 2007-09-07 | 2009-03-19 | Qlt Inc. | Drug cores for sustained release of therapeutic agents |
JP5524841B2 (en) * | 2007-09-07 | 2014-06-18 | キュー エル ティー インク. | Lacrimal implant and related methods |
AU2016203606B2 (en) * | 2007-09-24 | 2017-09-21 | Alcon Inc. | Ocular implants and methods |
EP3572044B1 (en) | 2008-01-24 | 2021-07-28 | Medtronic, Inc. | Stents for prosthetic heart valves |
US8157853B2 (en) | 2008-01-24 | 2012-04-17 | Medtronic, Inc. | Delivery systems and methods of implantation for prosthetic heart valves |
US8109896B2 (en) * | 2008-02-11 | 2012-02-07 | Optonol Ltd. | Devices and methods for opening fluid passageways |
BR112012021347A2 (en) | 2008-02-26 | 2019-09-24 | Jenavalve Tecnology Inc | stent for positioning and anchoring a valve prosthesis at an implantation site in a patient's heart |
US9044318B2 (en) | 2008-02-26 | 2015-06-02 | Jenavalve Technology Gmbh | Stent for the positioning and anchoring of a valvular prosthesis |
US20110082385A1 (en) * | 2008-04-17 | 2011-04-07 | Yale University | Method for implanting intraocular pressure sensor |
CH700161A2 (en) * | 2008-12-22 | 2010-06-30 | Grieshaber Ophthalmic Res Foun | IMPLANT FOR INTRODUCING into Schlemm's canal AN EYE. |
CH700142A1 (en) * | 2008-12-22 | 2010-06-30 | Grieshaber Ophthalmic Res Foun | Implant for insertion into Schlemm's canal of eye for use during glaucoma surgery, has connecting parts inserted into lumen of canal in circumferential direction together with ring parts and openings and comprising curved surfaces |
US20110105990A1 (en) * | 2009-11-04 | 2011-05-05 | Silvestrini Thomas A | Zonal drug delivery device and method |
WO2011082314A2 (en) | 2009-12-30 | 2011-07-07 | Brockman Holdings Llc | System, device, and method for determination of intraocular pressure |
US8652204B2 (en) | 2010-04-01 | 2014-02-18 | Medtronic, Inc. | Transcatheter valve with torsion spring fixation and related systems and methods |
CA2799459A1 (en) | 2010-05-25 | 2011-12-01 | Jenavalve Technology Inc. | Prosthetic heart valve and transcatheter delivered endoprosthesis comprising a prosthetic heart valve and a stent |
US8545430B2 (en) | 2010-06-09 | 2013-10-01 | Transcend Medical, Inc. | Expandable ocular devices |
US8585629B2 (en) | 2010-11-15 | 2013-11-19 | Aquesys, Inc. | Systems for deploying intraocular shunts |
US9668915B2 (en) | 2010-11-24 | 2017-06-06 | Dose Medical Corporation | Drug eluting ocular implant |
WO2012113450A1 (en) | 2011-02-23 | 2012-08-30 | Grieshaber Ophthalmic Research Foundaton | Implant for treating glaucoma |
US10245178B1 (en) | 2011-06-07 | 2019-04-02 | Glaukos Corporation | Anterior chamber drug-eluting ocular implant |
US9974685B2 (en) | 2011-08-29 | 2018-05-22 | Mati Therapeutics | Drug delivery system and methods of treating open angle glaucoma and ocular hypertension |
CA2846384C (en) | 2011-08-29 | 2020-12-15 | Qlt Inc. | Sustained release delivery of active agents to treat glaucoma and ocular hypertension |
EP4193907A1 (en) | 2011-09-13 | 2023-06-14 | Glaukos Corporation | Intraocular physiological sensor |
US9610195B2 (en) | 2013-02-27 | 2017-04-04 | Aquesys, Inc. | Intraocular shunt implantation methods and devices |
US20140066833A1 (en) * | 2012-08-28 | 2014-03-06 | Clearlix Ltd. | Expandable fluid drainage implants and associated delivery devices and methods |
EP2895059B1 (en) | 2012-09-14 | 2019-11-06 | Endotronix, Inc. | Delivery system |
US9730638B2 (en) | 2013-03-13 | 2017-08-15 | Glaukos Corporation | Intraocular physiological sensor |
US20150057583A1 (en) * | 2013-08-24 | 2015-02-26 | Alcon Research, Ltd. | Trabecular meshwork stimulation device |
US9867694B2 (en) | 2013-08-30 | 2018-01-16 | Jenavalve Technology Inc. | Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame |
KR20150034010A (en) * | 2013-09-25 | 2015-04-02 | 사회복지법인 삼성생명공익재단 | An Apparatus for Treating Ocular Diseases Induced by Increased Intraocular Pressure |
EP4242614A3 (en) | 2014-07-01 | 2023-11-29 | Injectsense, Inc. | Hermetically sealed implant sensors with vertical stacking architecture |
EP3164061A4 (en) | 2014-07-01 | 2018-01-10 | Injectsense, Inc. | Methods and devices for implantation of intraocular pressure sensors |
EP3240510A4 (en) | 2014-12-31 | 2018-09-19 | Microoptx Inc. | Glaucoma treatment devices and methods |
EP3288495B1 (en) | 2015-05-01 | 2019-09-25 | JenaValve Technology, Inc. | Device with reduced pacemaker rate in heart valve replacement |
US9996712B2 (en) | 2015-09-02 | 2018-06-12 | Endotronix, Inc. | Self test device and method for wireless sensor reader |
WO2017059272A1 (en) | 2015-09-30 | 2017-04-06 | Microoptx Inc. | Dry eye treatment devices and methods |
US20180369017A1 (en) * | 2015-12-15 | 2018-12-27 | Ivantis, Inc. | Ocular implant and delivery system |
EP4183371A1 (en) | 2016-05-13 | 2023-05-24 | JenaValve Technology, Inc. | Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system |
CA3024891A1 (en) | 2016-05-31 | 2017-12-07 | Qura, Inc. | Implantable intraocular pressure sensors and methods of use |
WO2018138658A1 (en) | 2017-01-27 | 2018-08-02 | Jenavalve Technology, Inc. | Heart valve mimicry |
EP3585252A1 (en) | 2017-02-24 | 2020-01-01 | Endotronix, Inc. | Wireless sensor reader assembly |
US11615257B2 (en) | 2017-02-24 | 2023-03-28 | Endotronix, Inc. | Method for communicating with implant devices |
EP3612084A1 (en) | 2017-04-20 | 2020-02-26 | Endotronix, Inc. | Anchoring system for a catheter delivered device |
EP3654835A1 (en) | 2017-07-19 | 2020-05-27 | Endotronix, Inc. | Physiological monitoring system |
WO2019046837A1 (en) | 2017-09-02 | 2019-03-07 | Precision Drone Services Intellectual Property, Llc | Seed distribution assembly for an aerial vehicle |
DE102020002231B4 (en) | 2020-04-09 | 2022-02-17 | aixtent GmbH | Method of manufacturing an implant for insertion into Schlemm's canal of an eye, implant and arrangement with an implant |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6605053B1 (en) * | 1999-09-10 | 2003-08-12 | Percardia, Inc. | Conduit designs and related methods for optimal flow control |
US6881198B2 (en) * | 2001-01-09 | 2005-04-19 | J. David Brown | Glaucoma treatment device and method |
Family Cites Families (148)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3788327A (en) | 1971-03-30 | 1974-01-29 | H Donowitz | Surgical implant device |
US4037604A (en) | 1976-01-05 | 1977-07-26 | Newkirk John B | Artifical biological drainage device |
US4168697A (en) | 1977-01-17 | 1979-09-25 | Cantekin Erdem I | Middle ear ventilating tube and method |
US4175563A (en) | 1977-10-05 | 1979-11-27 | Arenberg Irving K | Biological drainage shunt |
US4402681A (en) | 1980-08-23 | 1983-09-06 | Haas Joseph S | Artificial implant valve for the regulation of intraocular pressure |
NO147900C (en) | 1981-03-12 | 1983-07-06 | Finn Skjaerpe | MICROSURGICAL INSTRUMENT. |
US4428746A (en) | 1981-07-29 | 1984-01-31 | Antonio Mendez | Glaucoma treatment device |
US4554918A (en) | 1982-07-28 | 1985-11-26 | White Thomas C | Ocular pressure relief device |
JPS5985153A (en) * | 1982-11-08 | 1984-05-17 | Hitachi Ltd | Redundancy controller |
US4521210A (en) | 1982-12-27 | 1985-06-04 | Wong Vernon G | Eye implant for relieving glaucoma, and device and method for use therewith |
US4634418A (en) | 1984-04-06 | 1987-01-06 | Binder Perry S | Hydrogel seton |
US4787885A (en) | 1984-04-06 | 1988-11-29 | Binder Perry S | Hydrogel seton |
US4604087A (en) | 1985-02-26 | 1986-08-05 | Joseph Neil H | Aqueous humor drainage device |
US4820626A (en) | 1985-06-06 | 1989-04-11 | Thomas Jefferson University | Method of treating a synthetic or naturally occuring surface with microvascular endothelial cells, and the treated surface itself |
US4718907A (en) | 1985-06-20 | 1988-01-12 | Atrium Medical Corporation | Vascular prosthesis having fluorinated coating with varying F/C ratio |
US4632842A (en) | 1985-06-20 | 1986-12-30 | Atrium Medical Corporation | Glow discharge process for producing implantable devices |
US4733665C2 (en) | 1985-11-07 | 2002-01-29 | Expandable Grafts Partnership | Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft |
NZ215409A (en) | 1986-03-07 | 1989-02-24 | Anthony Christopher Be Molteno | Implant for drainage of aqueous humour in glaucoma |
CH670760A5 (en) | 1986-06-02 | 1989-07-14 | Sulzer Ag | |
US4722724A (en) | 1986-06-23 | 1988-02-02 | Stanley Schocket | Anterior chamber tube shunt to an encircling band, and related surgical procedure |
US4863457A (en) | 1986-11-24 | 1989-09-05 | Lee David A | Drug delivery device |
US4846172A (en) | 1987-05-26 | 1989-07-11 | Berlin Michael S | Laser-delivery eye-treatment method |
US4900300A (en) | 1987-07-06 | 1990-02-13 | Lee David A | Surgical instrument |
US4886488A (en) | 1987-08-06 | 1989-12-12 | White Thomas C | Glaucoma drainage the lacrimal system and method |
US4997652A (en) * | 1987-12-22 | 1991-03-05 | Visionex | Biodegradable ocular implants |
US4936825A (en) | 1988-04-11 | 1990-06-26 | Ungerleider Bruce A | Method for reducing intraocular pressure caused by glaucoma |
US5005577A (en) * | 1988-08-23 | 1991-04-09 | Frenkel Ronald E P | Intraocular lens pressure monitoring device |
US5785674A (en) | 1988-10-07 | 1998-07-28 | Mateen; Ahmed Abdul | Device and method for treating glaucoma |
US5681275A (en) | 1988-10-07 | 1997-10-28 | Ahmed; Abdul Mateen | Ophthalmological device with adaptable multiple distribution plates |
FR2648251B1 (en) * | 1989-06-09 | 1991-09-13 | Labo Electronique Physique | LEARNING METHOD AND NEURON NETWORK STRUCTURE |
FR2651668B1 (en) | 1989-09-12 | 1991-12-27 | Leon Claude | MICROSCOPE-ENDOSCOPE ASSEMBLY USEFUL IN PARTICULAR IN SURGERY. |
USRE35390E (en) | 1989-11-17 | 1996-12-03 | Smith; Stewart G. | Pressure relieving device and process for implanting |
US4946436A (en) | 1989-11-17 | 1990-08-07 | Smith Stewart G | Pressure-relieving device and process for implanting |
US4968296A (en) | 1989-12-20 | 1990-11-06 | Robert Ritch | Transscleral drainage implant device for the treatment of glaucoma |
US5092837A (en) | 1989-12-20 | 1992-03-03 | Robert Ritch | Method for the treatment of glaucoma |
US5073163A (en) | 1990-01-29 | 1991-12-17 | Lippman Myron E | Apparatus for treating glaucoma |
US5180362A (en) | 1990-04-03 | 1993-01-19 | Worst J G F | Gonio seton |
US5129895A (en) | 1990-05-16 | 1992-07-14 | Sunrise Technologies, Inc. | Laser sclerostomy procedure |
US5041081A (en) | 1990-05-18 | 1991-08-20 | Odrich Ronald B | Ocular implant for controlling glaucoma |
US5127901A (en) | 1990-05-18 | 1992-07-07 | Odrich Ronald B | Implant with subconjunctival arch |
US5178604A (en) | 1990-05-31 | 1993-01-12 | Iovision, Inc. | Glaucoma implant |
US5476445A (en) | 1990-05-31 | 1995-12-19 | Iovision, Inc. | Glaucoma implant with a temporary flow restricting seal |
US5397300A (en) | 1990-05-31 | 1995-03-14 | Iovision, Inc. | Glaucoma implant |
US5454796A (en) | 1991-04-09 | 1995-10-03 | Hood Laboratories | Device and method for controlling intraocular fluid pressure |
US5312394A (en) | 1991-04-29 | 1994-05-17 | Hugh Beckman | Apparatus and method for surgically performing a filtering operation on an eye for glaucoma |
US5246451A (en) | 1991-04-30 | 1993-09-21 | Medtronic, Inc. | Vascular prosthesis and method |
US6007511A (en) | 1991-05-08 | 1999-12-28 | Prywes; Arnold S. | Shunt valve and therapeutic delivery system for treatment of glaucoma and methods and apparatus for its installation |
US5300020A (en) | 1991-05-31 | 1994-04-05 | Medflex Corporation | Surgically implantable device for glaucoma relief |
US5171213A (en) | 1991-08-14 | 1992-12-15 | Price Jr Francis W | Technique for fistulization of the eye and an eye filtration prosthesis useful therefor |
US5360399A (en) | 1992-01-10 | 1994-11-01 | Robert Stegmann | Method and apparatus for maintaining the normal intraocular pressure |
US5207685A (en) * | 1992-02-11 | 1993-05-04 | Cinberg James Z | Tympanic ventilation tube and related technique |
US5334137A (en) | 1992-02-21 | 1994-08-02 | Eagle Vision, Inc. | Lacrimal fluid control device |
US5346464A (en) | 1992-03-10 | 1994-09-13 | Camras Carl B | Method and apparatus for reducing intraocular pressure |
US5370641A (en) | 1992-05-22 | 1994-12-06 | O'donnell, Jr.; Francis E. | Laser trabeculodissection |
DE4219299C2 (en) | 1992-06-12 | 1994-03-24 | Leica Mikroskopie & Syst | microscope |
US5290295A (en) | 1992-07-15 | 1994-03-01 | Querals & Fine, Inc. | Insertion tool for an intraluminal graft procedure |
US6197056B1 (en) * | 1992-07-15 | 2001-03-06 | Ras Holding Corp. | Segmented scleral band for treatment of presbyopia and other eye disorders |
US5318513A (en) | 1992-09-24 | 1994-06-07 | Leib Martin L | Canalicular balloon fixation stent |
US5370607A (en) | 1992-10-28 | 1994-12-06 | Annuit Coeptis, Inc. | Glaucoma implant device and method for implanting same |
US5338291A (en) | 1993-02-03 | 1994-08-16 | Pudenz-Schulte Medical Research Corporation | Glaucoma shunt and method for draining aqueous humor |
US5342370A (en) | 1993-03-19 | 1994-08-30 | University Of Miami | Method and apparatus for implanting an artifical meshwork in glaucoma surgery |
IL105828A (en) | 1993-05-28 | 1999-06-20 | Medinol Ltd | Medical stent |
US5735892A (en) | 1993-08-18 | 1998-04-07 | W. L. Gore & Associates, Inc. | Intraluminal stent graft |
US5639278A (en) | 1993-10-21 | 1997-06-17 | Corvita Corporation | Expandable supportive bifurcated endoluminal grafts |
US5443505A (en) * | 1993-11-15 | 1995-08-22 | Oculex Pharmaceuticals, Inc. | Biocompatible ocular implants |
US5743868A (en) | 1994-02-14 | 1998-04-28 | Brown; Reay H. | Corneal pressure-regulating implant device |
US5516522A (en) | 1994-03-14 | 1996-05-14 | Board Of Supervisors Of Louisiana State University | Biodegradable porous device for long-term drug delivery with constant rate release and method of making the same |
US5716394A (en) | 1994-04-29 | 1998-02-10 | W. L. Gore & Associates, Inc. | Blood contact surfaces using extracellular matrix synthesized in vitro |
IL109499A (en) | 1994-05-02 | 1998-01-04 | Univ Ramot | Implant device for draining excess intraocular fluid |
FR2721499B1 (en) | 1994-06-22 | 1997-01-03 | Opsia | Trabeculectomy implant. |
US5704907A (en) | 1994-07-22 | 1998-01-06 | Wound Healing Of Oklahoma | Method and apparatus for lowering the intraocular pressure of an eye |
US5520631A (en) | 1994-07-22 | 1996-05-28 | Wound Healing Of Oklahoma | Method and apparatus for lowering the intraocular pressure of an eye |
US5665114A (en) | 1994-08-12 | 1997-09-09 | Meadox Medicals, Inc. | Tubular expanded polytetrafluoroethylene implantable prostheses |
US5702419A (en) | 1994-09-21 | 1997-12-30 | Wake Forest University | Expandable, intraluminal stents |
US6063396A (en) * | 1994-10-26 | 2000-05-16 | Houston Biotechnology Incorporated | Methods and compositions for the modulation of cell proliferation and wound healing |
US6063116A (en) * | 1994-10-26 | 2000-05-16 | Medarex, Inc. | Modulation of cell proliferation and wound healing |
JP3642812B2 (en) | 1994-11-17 | 2005-04-27 | 株式会社町田製作所 | Medical observation device |
US5601094A (en) | 1994-11-22 | 1997-02-11 | Reiss; George R. | Ophthalmic shunt |
US6228873B1 (en) * | 1994-12-09 | 2001-05-08 | The Regents Of The University Of California | Method for enhancing outflow of aqueous humor in treatment of glaucoma |
US5725493A (en) * | 1994-12-12 | 1998-03-10 | Avery; Robert Logan | Intravitreal medicine delivery |
US5433701A (en) | 1994-12-21 | 1995-07-18 | Rubinstein; Mark H. | Apparatus for reducing ocular pressure |
US5558630A (en) | 1994-12-30 | 1996-09-24 | Fisher; Bret L. | Intrascleral implant and method for the regulation of intraocular pressure |
JPH10513455A (en) | 1995-02-10 | 1998-12-22 | ザ ユニバーシティ オブ トロント イノベーションズ ファウンデーション | Deprenyl compounds for the treatment of glaucoma |
US6059772A (en) * | 1995-03-10 | 2000-05-09 | Candela Corporation | Apparatus and method for treating glaucoma using a gonioscopic laser trabecular ablation procedure |
BE1009278A3 (en) | 1995-04-12 | 1997-01-07 | Corvita Europ | Guardian self-expandable medical device introduced in cavite body, and medical device with a stake as. |
US5626558A (en) | 1995-05-05 | 1997-05-06 | Suson; John | Adjustable flow rate glaucoma shunt and method of using same |
US5968058A (en) | 1996-03-27 | 1999-10-19 | Optonol Ltd. | Device for and method of implanting an intraocular implant |
IL113723A (en) | 1995-05-14 | 2002-11-10 | Optonol Ltd | Intraocular implant |
CN1283324C (en) | 1995-05-14 | 2006-11-08 | 奥普通诺尔有限公司 | Intraocular implant, delivery device, and method of implantation |
US5723005A (en) | 1995-06-07 | 1998-03-03 | Herrick Family Limited Partnership | Punctum plug having a collapsible flared section and method |
AU5776696A (en) | 1995-06-08 | 1997-01-09 | Bard Galway Limited | Bifurcated endovascular stent |
US5766243A (en) | 1995-08-21 | 1998-06-16 | Oasis Medical, Inc. | Abrasive polished canalicular implant |
US6099558A (en) | 1995-10-10 | 2000-08-08 | Edwards Lifesciences Corp. | Intraluminal grafting of a bifuricated artery |
US5836939A (en) | 1995-10-25 | 1998-11-17 | Plc Medical Systems, Inc. | Surgical laser handpiece |
US5651783A (en) | 1995-12-20 | 1997-07-29 | Reynard; Michael | Fiber optic sleeve for surgical instruments |
US5807302A (en) | 1996-04-01 | 1998-09-15 | Wandel; Thaddeus | Treatment of glaucoma |
US5865831A (en) | 1996-04-17 | 1999-02-02 | Premier Laser Systems, Inc. | Laser surgical procedures for treatment of glaucoma |
US5932299A (en) | 1996-04-23 | 1999-08-03 | Katoot; Mohammad W. | Method for modifying the surface of an object |
US6530896B1 (en) * | 1996-05-13 | 2003-03-11 | James B. Elliott | Apparatus and method for introducing an implant |
US5670161A (en) | 1996-05-28 | 1997-09-23 | Healy; Kevin E. | Biodegradable stent |
US5830139A (en) | 1996-09-04 | 1998-11-03 | Abreu; Marcio M. | Tonometer system for measuring intraocular pressure by applanation and/or indentation |
US5886822A (en) | 1996-10-08 | 1999-03-23 | The Microoptical Corporation | Image combining system for eyeglasses and face masks |
US6007510A (en) | 1996-10-25 | 1999-12-28 | Anamed, Inc. | Implantable devices and methods for controlling the flow of fluids within the body |
AUPO394496A0 (en) * | 1996-11-29 | 1997-01-02 | Lions Eye Institute | Biological microfistula tube and implantation method and apparatus |
US5713844A (en) | 1997-01-10 | 1998-02-03 | Peyman; Gholam A. | Device and method for regulating intraocular pressure |
US6071286A (en) * | 1997-02-19 | 2000-06-06 | Mawad; Michel E. | Combination angioplasty balloon/stent deployment device |
US5893837A (en) | 1997-02-28 | 1999-04-13 | Staar Surgical Company, Inc. | Glaucoma drain implanting device and method |
US6059812A (en) * | 1997-03-21 | 2000-05-09 | Schneider (Usa) Inc. | Self-expanding medical device for centering radioactive treatment sources in body vessels |
US5882327A (en) | 1997-04-17 | 1999-03-16 | Jacob; Jean T. | Long-term glaucoma drainage implant |
US6050970A (en) * | 1997-05-08 | 2000-04-18 | Pharmacia & Upjohn Company | Method and apparatus for inserting a glaucoma implant in an anterior and posterior segment of the eye |
US5752928A (en) | 1997-07-14 | 1998-05-19 | Rdo Medical, Inc. | Glaucoma pressure regulator |
US5830171A (en) | 1997-08-12 | 1998-11-03 | Odyssey Medical, Inc. | Punctal occluder |
EP0898947A3 (en) * | 1997-08-15 | 1999-09-08 | GRIESHABER & CO. AG SCHAFFHAUSEN | Method and apparatus to improve the outflow of the aqueous humor of an eye |
US6004302A (en) | 1997-08-28 | 1999-12-21 | Brierley; Lawrence A. | Cannula |
US6203513B1 (en) * | 1997-11-20 | 2001-03-20 | Optonol Ltd. | Flow regulating implant, method of manufacture, and delivery device |
US6050999A (en) * | 1997-12-18 | 2000-04-18 | Keravision, Inc. | Corneal implant introducer and method of use |
US6168575B1 (en) * | 1998-01-29 | 2001-01-02 | David Pyam Soltanpour | Method and apparatus for controlling intraocular pressure |
US6077299A (en) * | 1998-06-22 | 2000-06-20 | Eyetronic, Llc | Non-invasively adjustable valve implant for the drainage of aqueous humor in glaucoma |
US6241721B1 (en) * | 1998-10-09 | 2001-06-05 | Colette Cozean | Laser surgical procedures for treatment of glaucoma |
US6348042B1 (en) * | 1999-02-02 | 2002-02-19 | W. Lee Warren, Jr. | Bioactive shunt |
US6193656B1 (en) * | 1999-02-08 | 2001-02-27 | Robert E. Jeffries | Intraocular pressure monitoring/measuring apparatus and method |
US6231597B1 (en) * | 1999-02-16 | 2001-05-15 | Mark E. Deem | Apparatus and methods for selectively stenting a portion of a vessel wall |
US6217895B1 (en) * | 1999-03-22 | 2001-04-17 | Control Delivery Systems | Method for treating and/or preventing retinal diseases with sustained release corticosteroids |
US6074305A (en) * | 1999-03-24 | 2000-06-13 | Schnapp; Abraham | Implement for playing, walking and training |
US20050119601A9 (en) * | 1999-04-26 | 2005-06-02 | Lynch Mary G. | Shunt device and method for treating glaucoma |
BR0010055A (en) * | 1999-04-26 | 2002-04-09 | Gmp Vision Solutions Inc | Bypass device and use thereof |
US6342058B1 (en) * | 1999-05-14 | 2002-01-29 | Valdemar Portney | Iris fixated intraocular lens and instrument for attaching same to an iris |
US7033603B2 (en) * | 1999-08-06 | 2006-04-25 | Board Of Regents The University Of Texas | Drug releasing biodegradable fiber for delivery of therapeutics |
US6187016B1 (en) * | 1999-09-14 | 2001-02-13 | Daniel G. Hedges | Stent retrieval device |
US6579235B1 (en) * | 1999-11-01 | 2003-06-17 | The Johns Hopkins University | Method for monitoring intraocular pressure using a passive intraocular pressure sensor and patient worn monitoring recorder |
US20020072673A1 (en) * | 1999-12-10 | 2002-06-13 | Yamamoto Ronald K. | Treatment of ocular disease |
US6726676B2 (en) * | 2000-01-05 | 2004-04-27 | Grieshaber & Co. Ag Schaffhausen | Method of and device for improving the flow of aqueous humor within the eye |
US6375642B1 (en) * | 2000-02-15 | 2002-04-23 | Grieshaber & Co. Ag Schaffhausen | Method of and device for improving a drainage of aqueous humor within the eye |
US6638239B1 (en) * | 2000-04-14 | 2003-10-28 | Glaukos Corporation | Apparatus and method for treating glaucoma |
US20030060752A1 (en) * | 2000-04-14 | 2003-03-27 | Olav Bergheim | Glaucoma device and methods thereof |
US20050049578A1 (en) * | 2000-04-14 | 2005-03-03 | Hosheng Tu | Implantable ocular pump to reduce intraocular pressure |
US6533768B1 (en) * | 2000-04-14 | 2003-03-18 | The Regents Of The University Of California | Device for glaucoma treatment and methods thereof |
US7867186B2 (en) * | 2002-04-08 | 2011-01-11 | Glaukos Corporation | Devices and methods for treatment of ocular disorders |
CA2446143C (en) * | 2000-05-19 | 2010-01-19 | Michael S. Berlin | Delivery system and method of use for the eye |
US6699211B2 (en) * | 2000-08-22 | 2004-03-02 | James A. Savage | Method and apparatus for treatment of glaucoma |
US6730056B1 (en) * | 2000-09-21 | 2004-05-04 | Motorola, Inc. | Eye implant for treating glaucoma and method for manufacturing same |
US6666841B2 (en) * | 2001-05-02 | 2003-12-23 | Glaukos Corporation | Bifurcatable trabecular shunt for glaucoma treatment |
US6981958B1 (en) * | 2001-05-02 | 2006-01-03 | Glaukos Corporation | Implant with pressure sensor for glaucoma treatment |
US7331984B2 (en) * | 2001-08-28 | 2008-02-19 | Glaukos Corporation | Glaucoma stent for treating glaucoma and methods of use |
US20030097151A1 (en) * | 2001-10-25 | 2003-05-22 | Smedley Gregory T. | Apparatus and mitochondrial treatment for glaucoma |
US7163543B2 (en) * | 2001-11-08 | 2007-01-16 | Glaukos Corporation | Combined treatment for cataract and glaucoma treatment |
US20040024345A1 (en) * | 2002-04-19 | 2004-02-05 | Morteza Gharib | Glaucoma implant with valveless flow bias |
USD490152S1 (en) * | 2003-02-28 | 2004-05-18 | Glaukos Corporation | Surgical handpiece |
-
2003
- 2003-07-24 US US10/626,181 patent/US6981958B1/en not_active Expired - Lifetime
-
2005
- 2005-05-04 US US11/121,584 patent/US20090076436A2/en not_active Abandoned
- 2005-08-23 US US11/209,563 patent/US20050288619A1/en not_active Abandoned
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6605053B1 (en) * | 1999-09-10 | 2003-08-12 | Percardia, Inc. | Conduit designs and related methods for optimal flow control |
US6881198B2 (en) * | 2001-01-09 | 2005-04-19 | J. David Brown | Glaucoma treatment device and method |
Cited By (173)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10492950B2 (en) | 1999-04-26 | 2019-12-03 | Glaukos Corporation | Shunt device and method for treating ocular disorders |
US9492320B2 (en) | 1999-04-26 | 2016-11-15 | Glaukos Corporation | Shunt device and method for treating ocular disorders |
US9827143B2 (en) | 1999-04-26 | 2017-11-28 | Glaukos Corporation | Shunt device and method for treating ocular disorders |
US10568762B2 (en) | 1999-04-26 | 2020-02-25 | Glaukos Corporation | Stent for treating ocular disorders |
US9993368B2 (en) | 2000-04-14 | 2018-06-12 | Glaukos Corporation | System and method for treating an ocular disorder |
US10485702B2 (en) | 2000-04-14 | 2019-11-26 | Glaukos Corporation | System and method for treating an ocular disorder |
US10335314B2 (en) | 2000-05-19 | 2019-07-02 | Ivantis, Inc. | Delivery system and method of use for the eye |
US10159601B2 (en) | 2000-05-19 | 2018-12-25 | Ivantis, Inc. | Delivery system and method of use for the eye |
US10390993B1 (en) | 2000-05-19 | 2019-08-27 | Ivantis, Inc. | Delivery system and method of use for the eye |
US10687978B2 (en) | 2000-05-19 | 2020-06-23 | Ivantis, Inc. | Delivery system and method of use for the eye |
US10828473B2 (en) | 2001-04-07 | 2020-11-10 | Glaukos Corporation | Ocular implant delivery system and methods thereof |
US9987472B2 (en) | 2001-04-07 | 2018-06-05 | Glaukos Corporation | Ocular implant delivery systems |
US10406029B2 (en) | 2001-04-07 | 2019-09-10 | Glaukos Corporation | Ocular system with anchoring implant and therapeutic agent |
US20050090874A1 (en) * | 2001-06-15 | 2005-04-28 | Wu Naijuan J. | Thin film optical detectors for retinal implantation and methods for making and using same |
US7067327B2 (en) * | 2001-06-15 | 2006-06-27 | The University Of Houston System | Thin film optical detectors for retinal implantation and methods for making and using same |
US10285856B2 (en) | 2001-08-28 | 2019-05-14 | Glaukos Corporation | Implant delivery system and methods thereof for treating ocular disorders |
US10485701B2 (en) | 2002-04-08 | 2019-11-26 | Glaukos Corporation | Devices and methods for glaucoma treatment |
US8444588B2 (en) | 2003-05-05 | 2013-05-21 | Transcend Medical, Inc. | Internal shunt and method for treating glaucoma |
US9844462B2 (en) | 2003-05-05 | 2017-12-19 | Novartis Ag | Internal shunt and method for treating glaucoma |
US8945038B2 (en) | 2003-05-05 | 2015-02-03 | Transcend Medical, Inc. | Internal shunt and method for treating glaucoma |
KR101050437B1 (en) * | 2003-06-10 | 2011-07-19 | 카오 코퍼레이션 | Process for producing fatty acids with low trans-fatty acid content |
US8758289B2 (en) | 2003-11-14 | 2014-06-24 | Transcend Medical, Inc. | Ocular pressure regulation |
US8771218B2 (en) | 2003-11-14 | 2014-07-08 | Transcend Medical, Inc. | Ocular pressure regulation |
US9351873B2 (en) | 2003-11-14 | 2016-05-31 | Transcend Medical, Inc. | Ocular pressure regulation |
US8486000B2 (en) | 2003-11-14 | 2013-07-16 | Transcend Medical, Inc. | Ocular pressure regulation |
US10226380B2 (en) | 2003-11-14 | 2019-03-12 | Novartis Ag | Ocular pressure regulation |
US7815592B2 (en) | 2003-11-14 | 2010-10-19 | Transcend Medical, Inc. | Ocular pressure regulation |
US8128588B2 (en) | 2003-11-14 | 2012-03-06 | Transcend Medical, Inc. | Ocular pressure regulation |
US7850638B2 (en) | 2003-11-14 | 2010-12-14 | Transcend Medical, Inc. | Ocular pressure regulation |
US8728021B2 (en) | 2003-11-14 | 2014-05-20 | Transcend Medical, Inc. | Ocular pressure regulation |
US8808220B2 (en) | 2003-11-14 | 2014-08-19 | Transcend Medical, Inc. | Ocular pressure regulation |
US8721656B2 (en) | 2006-01-17 | 2014-05-13 | Transcend Medical, Inc. | Glaucoma treatment device |
US8801649B2 (en) | 2006-01-17 | 2014-08-12 | Transcend Medical, Inc. | Glaucoma treatment device |
US9084662B2 (en) | 2006-01-17 | 2015-07-21 | Transcend Medical, Inc. | Drug delivery treatment device |
US8734378B2 (en) | 2006-01-17 | 2014-05-27 | Transcend Medical, Inc. | Glaucoma treatment device |
US9789000B2 (en) | 2006-01-17 | 2017-10-17 | Novartis Ag | Glaucoma treatment device |
US9668917B2 (en) | 2006-01-17 | 2017-06-06 | Novartis Ag | Drug delivery treatment device |
US8814819B2 (en) | 2006-01-17 | 2014-08-26 | Transcend Medical, Inc. | Glaucoma treatment device |
US9421130B2 (en) | 2006-01-17 | 2016-08-23 | Novartis Ag. | Glaucoma treatment device |
US11786402B2 (en) | 2006-01-17 | 2023-10-17 | Alcon Inc. | Glaucoma treatment device |
US9398977B2 (en) | 2006-01-17 | 2016-07-26 | Transcend Medical, Inc. | Glaucoma treatment device |
US10905590B2 (en) | 2006-01-17 | 2021-02-02 | Alcon Inc. | Glaucoma treatment device |
US10314742B2 (en) | 2006-06-26 | 2019-06-11 | Sight Sciences, Inc. | Intraocular implants and methods and kits therefor |
US11865041B2 (en) | 2006-06-26 | 2024-01-09 | Sight Sciences, Inc. | Intraocular implants and methods and kits therefor |
US10398597B2 (en) | 2006-06-26 | 2019-09-03 | Sight Sciences, Inc. | Intraocular implants and methods and kits therefor |
US11389328B2 (en) | 2006-06-26 | 2022-07-19 | Sight Sciences, Inc. | Intraocular implants and methods and kits therefor |
US8672870B2 (en) | 2007-07-17 | 2014-03-18 | Transcend Medical, Inc. | Ocular implant with hydrogel expansion capabilities |
US9585789B2 (en) | 2007-07-17 | 2017-03-07 | Novartis Ag | Ocular implant with hydrogel expansion capabilities |
US9610196B2 (en) | 2007-09-24 | 2017-04-04 | Ivantis, Inc. | Ocular implants with asymmetric flexibility |
US11744734B2 (en) | 2007-09-24 | 2023-09-05 | Alcon Inc. | Method of implanting an ocular implant |
US8372026B2 (en) | 2007-09-24 | 2013-02-12 | Ivantis, Inc. | Ocular implant architectures |
US9402767B2 (en) | 2007-09-24 | 2016-08-02 | Ivantis, Inc. | Ocular implant architectures |
US7740604B2 (en) | 2007-09-24 | 2010-06-22 | Ivantis, Inc. | Ocular implants for placement in schlemm's canal |
US8734377B2 (en) | 2007-09-24 | 2014-05-27 | Ivantis, Inc. | Ocular implants with asymmetric flexibility |
US8414518B2 (en) | 2007-09-24 | 2013-04-09 | Ivantis, Inc. | Glaucoma treatment method |
US9039650B2 (en) | 2007-09-24 | 2015-05-26 | Ivantis, Inc. | Ocular implants with asymmetric flexibility |
US8961447B2 (en) | 2007-09-24 | 2015-02-24 | Ivantis, Inc. | Glaucoma treatment method |
US8282592B2 (en) | 2007-09-24 | 2012-10-09 | Ivantis, Inc. | Glaucoma treatment method |
US9050169B2 (en) | 2007-11-20 | 2015-06-09 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US8337509B2 (en) | 2007-11-20 | 2012-12-25 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US8512404B2 (en) | 2007-11-20 | 2013-08-20 | Ivantis, Inc. | Ocular implant delivery system and method |
US8808222B2 (en) | 2007-11-20 | 2014-08-19 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US9351874B2 (en) | 2007-11-20 | 2016-05-31 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US9226852B2 (en) | 2007-11-20 | 2016-01-05 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US8551166B2 (en) | 2007-11-20 | 2013-10-08 | Ivantis, Inc. | Methods and apparatus for delivering ocular implants into the eye |
US9693902B2 (en) | 2008-03-05 | 2017-07-04 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US9066783B2 (en) | 2008-03-05 | 2015-06-30 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US11504275B2 (en) | 2008-03-05 | 2022-11-22 | Alcon Inc. | Methods and apparatus for treating glaucoma |
US8529494B2 (en) | 2008-03-05 | 2013-09-10 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US10537474B2 (en) | 2008-03-05 | 2020-01-21 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US8267882B2 (en) | 2008-03-05 | 2012-09-18 | Ivantis, Inc. | Methods and apparatus for treating glaucoma |
US8617139B2 (en) | 2008-06-25 | 2013-12-31 | Transcend Medical, Inc. | Ocular implant with shape change capabilities |
US10016301B2 (en) | 2008-06-25 | 2018-07-10 | Novartis Ag | Ocular implant with shape change capabilities |
US9763828B2 (en) | 2009-01-28 | 2017-09-19 | Novartis Ag | Ocular implant with stiffness qualities, methods of implantation and system |
US10531983B2 (en) | 2009-01-28 | 2020-01-14 | Novartis Ag | Ocular implant with stiffness qualities, methods of implantation and system |
US8574294B2 (en) | 2009-01-28 | 2013-11-05 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US11344448B2 (en) | 2009-01-28 | 2022-05-31 | Alcon Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US8377122B2 (en) | 2009-01-28 | 2013-02-19 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US8167939B2 (en) | 2009-01-28 | 2012-05-01 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US8262726B2 (en) | 2009-01-28 | 2012-09-11 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US11839571B2 (en) | 2009-01-28 | 2023-12-12 | Alcon Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US8172899B2 (en) | 2009-01-28 | 2012-05-08 | Transcend Medical, Inc. | Ocular implant with stiffness qualities, methods of implantation and system |
US11426306B2 (en) | 2009-05-18 | 2022-08-30 | Dose Medical Corporation | Implants with controlled drug delivery features and methods of using same |
US10492949B2 (en) | 2009-07-09 | 2019-12-03 | Ivantis, Inc. | Single operator device for delivering an ocular implant |
US9693899B2 (en) | 2009-07-09 | 2017-07-04 | Ivantis, Inc. | Single operator device for delivering an ocular implant |
US10406025B2 (en) | 2009-07-09 | 2019-09-10 | Ivantis, Inc. | Ocular implants and methods for delivering ocular implants into the eye |
US11596546B2 (en) | 2009-07-09 | 2023-03-07 | Alcon Inc. | Ocular implants and methods for delivering ocular implants into the eye |
US11918514B2 (en) | 2009-07-09 | 2024-03-05 | Alcon Inc. | Single operator device for delivering an ocular implant |
US8425449B2 (en) | 2009-07-09 | 2013-04-23 | Ivantis, Inc. | Ocular implants and methods for delivering ocular implants into the eye |
US9211213B2 (en) | 2009-07-09 | 2015-12-15 | Ivantis, Inc. | Ocular implants and methods for delivering ocular implants into the eye |
US11464675B2 (en) | 2009-07-09 | 2022-10-11 | Alcon Inc. | Single operator device for delivering an ocular implant |
US9579234B2 (en) | 2009-10-23 | 2017-02-28 | Ivantis, Inc. | Ocular implant system and method |
US8529492B2 (en) | 2009-12-23 | 2013-09-10 | Trascend Medical, Inc. | Drug delivery devices and methods |
US9549846B2 (en) | 2009-12-23 | 2017-01-24 | Novartis Ag | Drug delivery devices and methods |
US9089392B2 (en) | 2009-12-23 | 2015-07-28 | Transcend Medical, Inc. | Drug delivery devices and methods |
US11166847B2 (en) | 2010-02-05 | 2021-11-09 | Sight Sciences, Inc. | Intraocular implants and related kits and methods |
US10406030B2 (en) | 2010-02-05 | 2019-09-10 | Sight Sciences, Inc. | Intraocular implants and related kits and methods |
US9510973B2 (en) | 2010-06-23 | 2016-12-06 | Ivantis, Inc. | Ocular implants deployed in schlemm's canal of the eye |
US9095411B2 (en) | 2010-11-15 | 2015-08-04 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US8852256B2 (en) | 2010-11-15 | 2014-10-07 | Aquesys, Inc. | Methods for intraocular shunt placement |
US8828070B2 (en) | 2010-11-15 | 2014-09-09 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US8758290B2 (en) | 2010-11-15 | 2014-06-24 | Aquesys, Inc. | Devices and methods for implanting a shunt in the suprachoroidal space |
US8974511B2 (en) | 2010-11-15 | 2015-03-10 | Aquesys, Inc. | Methods for treating closed angle glaucoma |
US20120165720A1 (en) * | 2010-11-15 | 2012-06-28 | Aquesys, Inc. | Intraocular shunts |
US8663303B2 (en) | 2010-11-15 | 2014-03-04 | Aquesys, Inc. | Methods for deploying an intraocular shunt from a deployment device and into an eye |
US8852137B2 (en) | 2010-11-15 | 2014-10-07 | Aquesys, Inc. | Methods for implanting a soft gel shunt in the suprachoroidal space |
US9017276B2 (en) | 2010-11-15 | 2015-04-28 | Aquesys, Inc. | Shunt placement through the sclera |
US8801766B2 (en) | 2010-11-15 | 2014-08-12 | Aquesys, Inc. | Devices for deploying intraocular shunts |
US8657776B2 (en) | 2011-06-14 | 2014-02-25 | Ivantis, Inc. | Ocular implants for delivery into the eye |
US10363168B2 (en) | 2011-06-14 | 2019-07-30 | Ivantis, Inc. | Ocular implants for delivery into the eye |
US9155655B2 (en) | 2011-06-14 | 2015-10-13 | Ivantis, Inc. | Ocular implants for delivery into the eye |
US10307292B2 (en) * | 2011-07-18 | 2019-06-04 | Mor Research Applications Ltd | Device for adjusting the intraocular pressure |
US20140148752A1 (en) * | 2011-07-18 | 2014-05-29 | Mor Research Applications Ltd. | A device for adjusting the intraocular pressure |
US8883189B2 (en) | 2011-09-27 | 2014-11-11 | The Regents Of The University Of Colorado, A Body Corporate | Intraocular encapsulation of oxygenic bacteria |
WO2013049107A3 (en) * | 2011-09-27 | 2013-07-04 | The Regents Of The University Of Colorado, A Body Corporate | Intraocular encapsulation of oxygenic bacteria |
WO2013049107A2 (en) * | 2011-09-27 | 2013-04-04 | The Regents Of The University Of Colorado, A Body Corporate | Intraocular encapsulation of oxygenic bacteria |
US8852136B2 (en) | 2011-12-08 | 2014-10-07 | Aquesys, Inc. | Methods for placing a shunt into the intra-scleral space |
US8765210B2 (en) | 2011-12-08 | 2014-07-01 | Aquesys, Inc. | Systems and methods for making gelatin shunts |
US9931243B2 (en) | 2011-12-19 | 2018-04-03 | Ivantis, Inc. | Delivering ocular implants into the eye |
US8663150B2 (en) | 2011-12-19 | 2014-03-04 | Ivantis, Inc. | Delivering ocular implants into the eye |
US9066750B2 (en) | 2011-12-19 | 2015-06-30 | Ivantis, Inc. | Delivering ocular implants into the eye |
US11135088B2 (en) | 2011-12-19 | 2021-10-05 | Ivantis Inc. | Delivering ocular implants into the eye |
US10179066B2 (en) | 2012-03-20 | 2019-01-15 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11617679B2 (en) | 2012-03-20 | 2023-04-04 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11389327B2 (en) | 2012-03-20 | 2022-07-19 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11344447B2 (en) | 2012-03-20 | 2022-05-31 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US9895258B2 (en) | 2012-03-20 | 2018-02-20 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US9855167B2 (en) | 2012-03-20 | 2018-01-02 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US10857027B2 (en) | 2012-03-20 | 2020-12-08 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US10888453B2 (en) | 2012-03-20 | 2021-01-12 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11471324B2 (en) | 2012-03-20 | 2022-10-18 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11116660B2 (en) | 2012-03-20 | 2021-09-14 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US10271989B2 (en) | 2012-03-26 | 2019-04-30 | Glaukos Corporation | System and method for delivering multiple ocular implants |
US9554940B2 (en) | 2012-03-26 | 2017-01-31 | Glaukos Corporation | System and method for delivering multiple ocular implants |
US9173775B2 (en) | 2012-03-26 | 2015-11-03 | Glaukos Corporation | System for delivering multiple ocular implants |
US11197780B2 (en) | 2012-03-26 | 2021-12-14 | Glaukos Corporation | System and method for delivering multiple ocular implants |
US9358156B2 (en) | 2012-04-18 | 2016-06-07 | Invantis, Inc. | Ocular implants for delivery into an anterior chamber of the eye |
US11026836B2 (en) | 2012-04-18 | 2021-06-08 | Ivantis, Inc. | Ocular implants for delivery into an anterior chamber of the eye |
US10085633B2 (en) | 2012-04-19 | 2018-10-02 | Novartis Ag | Direct visualization system for glaucoma treatment |
US9241832B2 (en) | 2012-04-24 | 2016-01-26 | Transcend Medical, Inc. | Delivery system for ocular implant |
US10912676B2 (en) | 2012-04-24 | 2021-02-09 | Alcon Inc. | Delivery system for ocular implant |
US9155656B2 (en) | 2012-04-24 | 2015-10-13 | Transcend Medical, Inc. | Delivery system for ocular implant |
US9907697B2 (en) | 2012-04-24 | 2018-03-06 | Novartis Ag | Delivery system for ocular implant |
US9480598B2 (en) | 2012-09-17 | 2016-11-01 | Novartis Ag | Expanding ocular implant devices and methods |
US9763829B2 (en) | 2012-11-14 | 2017-09-19 | Novartis Ag | Flow promoting ocular implant |
US11712369B2 (en) | 2012-11-28 | 2023-08-01 | Alcon Inc. | Apparatus for delivering ocular implants into an anterior chamber of the eye |
US10617558B2 (en) | 2012-11-28 | 2020-04-14 | Ivantis, Inc. | Apparatus for delivering ocular implants into an anterior chamber of the eye |
US10195079B2 (en) | 2013-02-19 | 2019-02-05 | Aquesys, Inc. | Adjustable intraocular implant |
US10195078B2 (en) | 2013-02-19 | 2019-02-05 | Aquesys, Inc. | Adjustable intraocular flow regulation |
US11523938B2 (en) | 2013-03-15 | 2022-12-13 | Glaukos Corporation | Systems and methods for delivering an ocular implant to the suprachoroidal space within an eye |
US11253394B2 (en) | 2013-03-15 | 2022-02-22 | Dose Medical Corporation | Controlled drug delivery ocular implants and methods of using same |
US10517759B2 (en) | 2013-03-15 | 2019-12-31 | Glaukos Corporation | Glaucoma stent and methods thereof for glaucoma treatment |
US11559430B2 (en) | 2013-03-15 | 2023-01-24 | Glaukos Corporation | Glaucoma stent and methods thereof for glaucoma treatment |
US9987163B2 (en) | 2013-04-16 | 2018-06-05 | Novartis Ag | Device for dispensing intraocular substances |
US10959941B2 (en) | 2014-05-29 | 2021-03-30 | Glaukos Corporation | Implants with controlled drug delivery features and methods of using same |
US10709547B2 (en) | 2014-07-14 | 2020-07-14 | Ivantis, Inc. | Ocular implant delivery system and method |
US11019996B2 (en) | 2015-03-20 | 2021-06-01 | Glaukos Corporation | Gonioscopic devices |
US11019997B2 (en) | 2015-03-20 | 2021-06-01 | Glaukos Corporation | Gonioscopic devices |
US11826104B2 (en) | 2015-03-20 | 2023-11-28 | Glaukos Corporation | Gonioscopic devices |
US11872158B2 (en) | 2015-03-31 | 2024-01-16 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US10299958B2 (en) | 2015-03-31 | 2019-05-28 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11090188B2 (en) | 2015-03-31 | 2021-08-17 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11197779B2 (en) | 2015-08-14 | 2021-12-14 | Ivantis, Inc. | Ocular implant with pressure sensor and delivery system |
US11925578B2 (en) | 2015-09-02 | 2024-03-12 | Glaukos Corporation | Drug delivery implants with bi-directional delivery capacity |
US11564833B2 (en) | 2015-09-25 | 2023-01-31 | Glaukos Corporation | Punctal implants with controlled drug delivery features and methods of using same |
US11318043B2 (en) | 2016-04-20 | 2022-05-03 | Dose Medical Corporation | Bioresorbable ocular drug delivery device |
US11744458B2 (en) | 2017-02-24 | 2023-09-05 | Glaukos Corporation | Gonioscopes |
US11116625B2 (en) | 2017-09-28 | 2021-09-14 | Glaukos Corporation | Apparatus and method for controlling placement of intraocular implants |
US11376040B2 (en) | 2017-10-06 | 2022-07-05 | Glaukos Corporation | Systems and methods for delivering multiple ocular implants |
USD938585S1 (en) | 2017-10-27 | 2021-12-14 | Glaukos Corporation | Implant delivery apparatus |
US11857460B2 (en) | 2019-09-27 | 2024-01-02 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11504270B1 (en) | 2019-09-27 | 2022-11-22 | Sight Sciences, Inc. | Ocular delivery systems and methods |
US11540940B2 (en) | 2021-01-11 | 2023-01-03 | Alcon Inc. | Systems and methods for viscoelastic delivery |
Also Published As
Publication number | Publication date |
---|---|
US20090076436A2 (en) | 2009-03-19 |
US6981958B1 (en) | 2006-01-03 |
US20050192527A1 (en) | 2005-09-01 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6981958B1 (en) | Implant with pressure sensor for glaucoma treatment | |
US6666841B2 (en) | Bifurcatable trabecular shunt for glaucoma treatment | |
US20210154449A1 (en) | Ocular implant delivery system and methods thereof | |
US8142364B2 (en) | Method of monitoring intraocular pressure and treating an ocular disorder | |
US6736791B1 (en) | Glaucoma treatment device | |
AU2001245698B2 (en) | Device for glaucoma treatment and methods thereof | |
US20030060752A1 (en) | Glaucoma device and methods thereof | |
WO2002036052A1 (en) | Glaucoma treatment device | |
WO2002102274A2 (en) | Glaucoma device and methods thereof | |
AU2001245698A1 (en) | Device for glaucoma treatment and methods thereof | |
AU2002258754A1 (en) | Glaucoma stent and methods thereof for glaucoma treatment |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: EXPRESSLY ABANDONED -- DURING EXAMINATION |