OCULAR IMPLANT SYSTEM
The invention relates generally to medical devices and methods for reducing the intraocular pressure in an animal eye and, more particularly, to stent type devices for permitting aqueous outflow from the eye's anterior chamber and associated methods thereof for the treatment of glaucoma. Some aspects provide a self-trephining glaucoma stent and methods thereof which advantageously allow for a “one-step” procedure in which the incision and placement of the stent are accomplished by a single device and operation. This desirably allows for a faster, safer, and less expensive surgical procedure.
1 . An ocular implant system for implanting an ocular device into the eye, comprising:
a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, said fluid drainage device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea when in the deployed location; and
a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.
2 . The device of claim 1 , wherein the device is formed of a biocompatible elastomeric material.
3 . The device of claim 1 , wherein at least a portion of the device has a curvature that matches the curvature of the eye.
4 . An ocular device as in claim 1 , wherein the entire device is cylindrical.
5 . An ocular device as in claim 1 , wherein the fluid drainage device is a tube.
6 . The system of claim 1 , wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.
7 . The system of claim 1 , wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.
8 . The system of claim 1 , wherein the device has a length sufficient to extend from the anterior chamber to a uveal scleral outflow pathway when implanted.
9 . The system of claim 1 , wherein the delivery instrument comprises a cannula.
10 . The system of claim 9 , wherein the cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.
11 . An ocular implant system for implanting an ocular device into the eye, comprising:
a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea when the device is in the deployed location, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.
12 . The device of claim 11 , wherein the device is formed of a biocompatible elastomeric material.
13 . An ocular device as in claim 11 , wherein the entire device is cylindrical.
14 . An ocular device as in claim 11 , wherein the fluid drainage device is a tube.
15 . The system of claim 11 , wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.
16 . The system of claim 11 , wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.
17 . The system of claim 11 , wherein the device has a length sufficient to extend from the anterior chamber to a uveal scleral outflow pathway when implanted.
18 . The system of claim 11 , wherein the delivery instrument further comprises a cannula.
19 . The system of claim 18 , wherein the cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.
20 . An ocular implant system for implanting an ocular device into the eye, comprising:
a fluid drainage device configured to be deployed in the eye so as to locate a first end of the fluid drainage device in communication with the suprachoroidal space, the fluid drainage device having an internal lumen wherein a first end of the lumen of the drainage device communicates with the suprachoroidal space and a second end of the lumen of the drainage device opens into the anterior chamber when implanted in a deployed location in the eye such that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space, so as to provide aqueous pressure regulation by draining aqueous humor from the anterior chamber towards the suprachoroidal space via the internal lumen, wherein the fluid drainage device has a second end configured to be located inside the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.
21 . The device of claim 20 , wherein the device is formed of a biocompatible elastomeric material.
22 . The device of claim 20 , wherein sutures are not required to hold the device in the eye.
23 . The device of claim 20 , wherein the device is manufactured of a material that is sufficiently soft as to not erode choroid material when inserted into the eye.
24 . An ocular device as in claim 20 , wherein the entire device is cylindrical.
25 . An ocular device as in claim 20 , wherein the fluid drainage device is a tube.
26 . The system of claim 20 , wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.
27 . The system of claim 20 , wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.
28 . The system of claim 20 , wherein the device has a length sufficient to extend from the anterior chamber to a uveal scleral outflow pathway when implanted.
29 . The system of claim 20 , wherein the delivery instrument comprises a cannula.
30 . The system of claim 29 , wherein the cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.
31 . An ocular implant system for implanting an ocular device into the eye, comprising:
a fluid drainage device configured to be implanted in a deployed location in the eye via an incision in the cornea so that a first end of the fluid drainage device is positioned in the anterior chamber of the eye and a second end of the fluid drainage device is positioned in communication with the suprachoroidal space of the eye, the fluid drainage device having an internal lumen wherein a first opening at a first end of the internal lumen of the drainage device opens into the anterior chamber and a second opening at a second end of the internal lumen of the drainage device communicates with the suprachoroidal space when in the deployed location such that the internal lumen provides a direct fluid passageway from the anterior chamber towards the suprachoroidal space for aqueous pressure regulation when implanted in the deployed location in the eye and wherein the first end of the fluid drainage device is configured to be located inside the anterior chamber such that the first end is outside of the ciliary body and posterior of an inner surface of the cornea; and
a delivery instrument comprising an elongated member that removably couples to the fluid drainage device, wherein the delivery instrument is configured to introduce the fluid drainage device into the anterior chamber through the corneal incision, advance the fluid drainage device through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the fluid drainage device from the elongated member and into the deployed location.
32 . An ocular device as in claim 31 , wherein sutures are not required to hold the device in the eye.
33 . An ocular device as in claim 31 , wherein the fluid drainage device is cylindrical.
34 . An ocular device as in claim 31 , wherein the fluid drainage device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera when in the deployed location.
35 . An ocular device as in claim 31 , wherein the entire device is cylindrical.
36 . An ocular device as in claim 31 , wherein the fluid drainage device is a tube.
37 . The system of claim 31 , wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.
38 . The system of claim 31 , wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.
39 . The system of claim 31 , wherein the device has a length sufficient to extend from the anterior chamber to a uveal scleral outflow pathway when implanted.
40 . The system of claim 31 , wherein the delivery instrument comprises a cannula.
41 . The system of claim 40 , wherein the cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.
42 . An ocular implant system, comprising:
an ocular implant comprising an elongated body having a proximal end region, a distal end region, and an internal lumen communicating with an inlet port in the proximal end region and an outlet port in the distal end region, the ocular implant configured to be introduced into the anterior chamber of the eye via an incision in the cornea and positioned in a deployed location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with the suprachoroidal space and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the internal lumen provides a fluid passageway from the anterior chamber towards the suprachoroidal space; and
a delivery instrument comprising an elongated member that removably couples to the ocular implant, wherein the delivery instrument is configured to introduce the ocular implant into the anterior chamber through the corneal incision, advance the ocular implant through the anterior chamber, detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera, advance the implant through the internal space, and detach the ocular implant from the elongated member and into the deployed location.
43 . A system as in claim 42 , wherein the ocular implant is a tube.
44 . A system as in claim 42 , wherein the ocular implant is cylindrical.
45 . A system as in claim 42 , wherein the elongated member of the delivery instrument is a cannula.
46 . A system as in claim 42 , wherein the delivery instrument is configured to introduce the ocular implant into the anterior chamber through a self-sealing corneal incision.
47 . A system as in claim 42 , wherein the elongated member of the delivery instrument is sized to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.
48 . The system of claim 42 , wherein, when the device is in communication with the suprachoroidal space, at least a portion of the device is in contact with the choroid.
49 . The system of claim 42 , wherein the device has a length sufficient to extend from the anterior chamber to the choroid when implanted.
50 . The system of claim 42 , wherein the device has a length sufficient to extend from the anterior chamber to a uveal scleral outflow pathway when implanted.
51 . The system of claim 42 , wherein the delivery instrument comprises a cannula.
52 . The system of claim 51 , wherein the cannula is configured to detach the at least a portion of the ciliary body from the sclera to form the internal space between the ciliary body and the sclera.
53 . A system for implanting a device into the eye, comprising:
a device configured to be implanted in the eye such that a first end of the device is in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, said device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the device has a second end configured to reside in the anterior chamber when in an implantation location; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
54 . The system of claim 53 , wherein the device is formed of a biocompatible elastomer.
55 . The system of claim 53 , wherein the device is elastomeric.
56 . The system of claim 53 , wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm's canal.
57 . The system of claim 53 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
58 . The system of claim 53 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
59 . The system of claim 53 , wherein at least a portion of the device has a curvature.
60 . The system of claim 59 , wherein the curvature matches the curvature of at least a portion of the eye.
61 . The system of claim 53 , wherein the device is at least partially cylindrical.
62 . The system of claim 53 , wherein the device is a tube.
63 . The system of claim 53 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.
64 . The system of claim 53 , wherein the first end of the device is configured to be located so as to be in communication with a uveal scleral outflow route.
65 . The system of claim 64 , wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.
66 . The system of claim 53 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
67 . The system of claim 53 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
68 . The system of claim 53 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
69 . The system of claim 53 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
70 . The system of claim 69 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
71 . The system of claim 69 , wherein the member is configured to form the opening in eye tissue.
72 . The system of claim 53 , wherein the first end of the device is configured to be located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
73 . The system of claim 53 , wherein the first end of the device is configured to be located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
74 . The system of claim 53 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
75 . The system of claim 53 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
76 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
77 . The system of claim 76 , wherein the device is formed of a biocompatible elastomer.
78 . The system of claim 76 , wherein the device is elastomeric.
79 . The system of claim 76 , wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm's canal.
80 . The system of claim 76 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
81 . The system of claim 76 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
82 . The system of claim 76 , wherein the device is at least partially cylindrical.
83 . The system of claim 76 , wherein the device is a tube.
84 . The system of claim 76 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
85 . The system of claim 76 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.
86 . The system of claim 76 , wherein the first end is located so as to be in communication with a uveal scleral outflow route.
87 . The system of claim 86 , wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.
88 . The system of claim 76 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
89 . The system of claim 76 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
90 . The system of claim 89 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
91 . The system of claim 89 , wherein the member is configured to form the opening in eye tissue.
92 . The system of claim 76 , wherein the first end of the device is located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
93 . The system of claim 76 , wherein the first end of the device is configured to be located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
94 . The system of claim 76 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
95 . The system of claim 76 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
96 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid via the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
97 . The system of claim 96 , wherein the device is formed of a biocompatible elastomer.
98 . The system of claim 96 , wherein the device is elastomeric.
99 . The system of claim 96 , wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm's canal.
100 . The system of claim 95 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
101 . The system of claim 96 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
102 . The system of claim 96 , wherein the structure of the device secures the device in the eye.
103 . The system of claim 96 , wherein the device is manufactured of a biocompatible material.
104 . The system of claim 96 , wherein the device is at least partially cylindrical.
105 . The system of claim 96 , wherein the device is a tube.
106 . The system of claim 96 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
107 . The system of claim 96 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.
108 . The system of claim 96 , wherein the first end is located so as to be in communication with a uveal scleral outflow route.
109 . The system of claim 108 , wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.
110 . The system of claim 96 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
111 . The system of claim 96 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
112 . The system of claim 111 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
113 . The system of claim 111 , wherein the member is configured to form the opening in eye tissue.
114 . The system of claim 96 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
115 . The system of claim 96 , wherein the first end of the device is configured to be located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
116 . The system of claim 96 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
117 . The system of claim 96 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
118 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in an implantation location in the eye via an incision in the cornea so that a first end of the device is positioned in the anterior chamber of the eye and a second end of the device is positioned in communication with the choroid, the device having a lumen wherein a first opening at a first end of the lumen of the device opens into the anterior chamber and a second opening at a second end of the lumen of the device communicates with the choroid when in the implantation location such that the lumen provides a direct flow pathway from the anterior chamber towards the choroid for intraocular pressure balancing when implanted in the implantation location in the eye, wherein the first end of the device is configured to reside in the anterior chamber; and
a delivery-apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
119 . The system of claim 118 , wherein the structure of the device secures the device in the eye.
120 . The system of claim 118 , wherein the device is cylindrical.
121 . The system of claim 118 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
122 . The system of claim 118 , wherein the device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera when in the implantation location.
123 . The system of claim 118 , wherein the entire device is cylindrical.
124 . The system of claim 118 , wherein the device is a tube.
125 . The system of claim 118 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
126 . The system of claim 118 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.
127 . The system of claim 118 , wherein the first end is located so as to be in communication with the uveal scleral outflow route.
128 . The system of claim 127 , wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.
129 . The system of claim 118 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
130 . The system of claim 118 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
131 . The system of claim 130 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
132 . The system of claim 130 , wherein the member is configured to form the opening in eye tissue.
133 . The system of claim 118 , wherein the first end of the device is located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
134 . The system of claim 118 , wherein the first end of the device is configured to be located so as to be in communication with the uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
135 . The system of claim 118 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
136 . The system of claim 118 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
137 . A system, comprising:
an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in an implantation location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with the choroid and at least a portion of the implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the choroid; and
a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the implant through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the device through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation-location.
138 . A system as in claim 137 , wherein the implant is a tube.
139 . A system as in claim 137 , wherein the implant is cylindrical.
140 . A system as in claim 137 , wherein the delivery apparatus comprises a cannula.
141 . A system as in claim 137 , wherein the delivery apparatus is configured to introduce the implant into the anterior chamber through a self-sealing corneal incision.
142 . A system as in claim 137 , wherein the elongate tip of the delivery apparatus is configured to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.
143 . The system of claim 137 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid.
144 . The system of claim 137 , wherein the first end is located so as to be in communication with a uveal scleral outflow route.
145 . The system of claim 144 , wherein the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route.
146 . The system of claim 137 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
147 . The system of claim 137 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, guidewire, cannula, blade, trephine, punch, hot tip, and ocular tissue drill.
148 . The system of claim 147 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
149 . The system of claim 147 , wherein the member is configured to form the opening in eye tissue.
150 . The system of claim 137 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
151 . The system of claim 137 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the delivery apparatus further comprises a blade or cannula configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
152 . A system for implanting a device into the eye, comprising:
a device configured to be implanted in the eye such that a first end of the device is in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route through the lumen, said device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the device has a second end configured to reside in the anterior chamber; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
153 . The system of claim 152 , wherein the device is formed of a biocompatible elastomer.
154 . The system of claim 152 , wherein the device is elastomeric.
155 . The system of claim 152 , wherein at least a portion of the device has an outer dimension such that the device can be placed within a diameter of Schlemm's canal.
156 . The system of claim 152 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
157 . The system of claim 152 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
158 . The system of claim 152 , wherein at least a portion of the device has a curvature.
159 . The system of claim 158 , wherein the curvature matches the curvature of at least a portion of the eye.
160 . The system of claim 152 , wherein the device is at least partially cylindrical.
161 . The system of claim 152 , wherein the device is a tube.
162 . The system of claim 152 , wherein, when the device is in communication with the uveal scleral outflow route, at least a portion of the device is in contact with the choroid.
163 . The system of claim 152 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
164 . The system of claim 152 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
165 . The system of claim 152 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
166 . The system of claim 152 , wherein the delivery apparatus comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
167 . The system of claim 166 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
168 . The system of claim 166 , wherein the member is configured to form the opening in eye tissue.
169 . The system of claim 152 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
170 . The system of claim 152 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
171 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide aqueous pressure balancing by providing aqueous outflow from the anterior chamber towards the uveal scleral outflow route via the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
172 . The system of claim 171 , wherein the device is formed of a biocompatible elastomer.
173 . The system of claim 171 , wherein the device is elastomeric.
174 . The system of claim 171 , wherein at least a portion of the device has an outer dimension such that the device can be placed within a diameter of Schlemm's canal.
175 . The system of claim 171 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
176 . The system of claim 171 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
177 . An ocular system as in claim 171 , wherein the device is at least partially cylindrical.
178 . An ocular system as in claim 171 , wherein the device is a tube.
179 . The system of claim 171 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
180 . The system of claim 171 , wherein, when the device is in communication with the uveal scleral outflow route, at least a portion of the device is in contact with the choroid.
181 . The system of claim 171 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
182 . The system of claim 171 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
183 . The system of claim 182 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
184 . The system of claim 182 , wherein the member is configured to form the opening in eye tissue.
185 . The system of claim 171 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
186 . The system of claim 171 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
187 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route via the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
188 . The system of claim 187 , wherein the device is formed of a biocompatible elastomer.
189 . The system of claim 187 , wherein the device is elastomeric.
190 . The system of claim 187 , wherein at least a portion of the device has an outer dimension sized such that the device can be placed within a diameter of Schlemm's canal.
191 . The system of claim 187 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
192 . The system of claim 187 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
193 . The system of claim 187 , wherein the structure of the device secures the device in the eye.
194 . The system of claim 187 , wherein the device is manufactured of a biocompatible material.
195 . The system of claim 187 , wherein the device is at least partially cylindrical.
196 . The system of claim 187 , wherein the device is a tube.
197 . The system of claim 187 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation
198 . The system of claim 187 , wherein, when the device is in communication with the uveal scleral outflow route, at least a portion of the device is in contact with the choroid.
199 . The system of claim 187 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
200 . The system of claim 187 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
201 . The system of claim 200 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
202 . The system of claim 200 , wherein the member is configured to form the opening in eye tissue.
203 . The system of claim 187 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
204 . The system of claim 187 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
205 . A system for implanting a device into the eye, comprising:
a device for establishing an outflow pathway configured to be implanted in a location in the eye via an incision in the cornea so that a first end of the device is positioned in the anterior chamber of the eye and a second end of the device is positioned in communication with a uveal scleral outflow route, the device having a lumen wherein a first opening at a first end of the lumen of the device opens into the anterior chamber and a second opening at a second end of the lumen of the device communicates with the uveal scleral outflow route when in the implanted location such that the lumen provides a direct flow pathway from the anterior chamber towards the uveal scleral outflow route for intraocular pressure balancing when implanted in the implantation location in the eye and wherein the first end of the device is configured to reside in the anterior chamber; and
a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the device through the anterior chamber, advance the device through an opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.
206 . The system of claim 205 , wherein the structure of the device secures the device in the eye.
207 . The system of claim 205 , wherein the device is cylindrical.
208 . The system of claim 205 , wherein the device is elastomeric.
209 . The system of claim 205 , wherein at least a portion of the device has an outer dimension such that the device can be placed within a diameter of Schlemm's canal.
210 . The system of claim 205 , wherein the device has an external diameter sized such that the device can be inserted through a corneal incision of less than about 1 mm.
211 . The system of claim 205 , wherein the device has a length that extends from the anterior chamber to the choroid when implanted.
212 . The system of claim 205 , wherein the device is positioned entirely within the interior of the eye radially inward of an outer globular boundary defined by an outer surface of the sclera when in the implanted location.
213 . The system of claim 205 , wherein the entire device is cylindrical.
214 . The system of claim 205 , wherein the device is a tube.
215 . The system of claim 205 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation.
216 . The system of claim 205 , wherein, when the device is in communication with the uveal scleral outflow route, at least a portion of the device is in contact with the choroid.
217 . The system of claim 205 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
218 . The system of claim 205 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
219 . The system of claim 218 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
220 . The system of claim 218 , wherein the member is configured to form the opening in eye tissue.
221 . The system of claim 205 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
222 . The system of claim 205 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, and wherein the delivery apparatus further comprises a blade or cannula that is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
223 . A system, comprising:
an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in a location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with a uveal scleral outflow route and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route; and
a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the implant through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation-location.
224 . A system as in claim 223 , wherein the implant is a tube.
225 . A system as in claim 223 , wherein the implant is cylindrical.
226 . A system as in claim 223 , wherein the delivery apparatus comprises a cannula.
227 . A system as in claim 223 , wherein the delivery apparatus is configured to introduce the implant into the anterior chamber through a self-sealing corneal incision.
228 . A system as in claim 223 , wherein the elongate tip of the delivery apparatus is configured to deliver the implant across the anterior chamber to a delivery site positioned 180 degrees from the incision.
229 . The system of claim 223 , wherein, when the device is in communication with the uveal scleral outflow route, at least a portion of the device is in contact with the choroid.
230 . The system of claim 223 , wherein the delivery apparatus is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera.
231 . The system of claim 223 , wherein the delivery apparatus further comprises at least one member selected from the group consisting of: a cutting device, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill.
232 . The system of claim 231 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed.
233 . The system of claim 231 , wherein the member is configured to form the opening in eye tissue.
234 . The system of claim 76 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
235 . The system of claim 96 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
236 . The system of claim 118 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
237 . The system of claim 137 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
238 . The system of claim 171 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
239 . The system of claim 187 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
240 . The system of claim 205 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.
241 . The system of claim 223 , wherein the device is configured to be positioned in the anterior chamber such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea.