Method and apparatus for treating an ocular disorder
Embodiments of the claimed invention are directed to the treatment of glaucoma (or conditions of elevated intraocular pressure) using a novel ab interno trabeculotomy procedure that uses a flexible device. At least one advantage of the present method is that it does not require a conjunctival or scleral incision, which in turn improves patient recovery time and healing.
1. A method for performing a trabeculotomy ab intern, the method comprising the steps of
making at least one corneal incision,
placing a surgical instrument with a cutting edge through the corneal incision,
making an incision into the trabecular meshwork to access the lumen of Schlemm's canal,
placing the distal end of a device into the anterior chamber,
advancing the device within Schlemm's canal,
pulling the distal end of the device into the anterior chamber,
applying tension to the device within the canal by applying tension between the ends of the device within Schlemm's canal thereby rupturing the trabecular meshwork in the area cannulated by the device, and
withdrawing the device through the corneal incision.
2. The method of claim 1 , wherein the device is advanced along the full circumference of Schlemm's canal.
3. The method of claim 1 , where the device is advanced along Schlemm's canal for approximately 180 degrees and repeating the procedure to the remaining 180 degrees of the canal.
4. The method of claim 1 , where the device is inserted into Schlemm's canal while being visualized by a gonioprism.
5. The method of claim 1 , where the device is inserted into Schlemm's canal while being visualized by an endoscope placed in the anterior chamber.
6. The method of claim 1 , where the device comprises a lumen to inject fluid during cannulation of Schlemm's canal.
7. The method of claim 1 , where the device comprises a lighted tip to facilitate visualization of the tip location during cannulation of Schlemm's canal.
8. The method of claim 1 , where the device comprises a fiber optic.
9. The method of claim 1 , where the device comprises a curved tip.
10. The method of claim 9 , where the curved tip has a radius ranging from 2 to 4 mm.
11. The method of claim 1 , wherein the corneal incision is made to insert the distal end of the device into the anterior chamber, and a second corneal incision is made to retrieve the distal tip of the device.
12. The method of claim 1 where the corneal incision is made in the temporal quadrant of the eye.