Delivery system and method of use for the eye
A method and delivery system are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm's canal of an eye for reducing elevated intraocular pressure. Pulsed laser radiation is delivered from the distal end of a fiber-optic probe sufficient to cause photoablation of selected portions of the trabecular meshwork, the juxtacanalicular trabecular meshwork and an inner wall of Schlemm's canal in the target site. The fiber-optic probe may be advanced so as to create an aperture in the inner wall of Schlemm's canal in which fluid from the anterior chamber of the eye flows. The method and delivery system may further be used on any tissue types in the body.
1. A method, of maintaining an opening in a trabecular meshwork of a patient's eye to conduct fluid from an anterior chamber into Schlemm's canal of the eye, comprising:
positioning an intraocular implant through an opening in the trabecular meshwork of the eye, the implant having a proximal portion configured to reside in the anterior chamber of the eye, the proximal portion comprising a proximal opening, a distal portion configured to reside in Schlemm's canal of the eye, the distal portion comprising a proximally-facing surface and a distal opening, and a passageway extending in a straight line from the proximal opening to the distal opening;
engaging an inner wall of Schlemm's canal with the proximally-facing surface of the distal portion to self-retain the intraocular implant in the inner wall of Schlemm's canal; and
conducting fluid, through the passageway, from the proximal opening of the implant to the distal opening of the implant, such that fluid flows from the anterior chamber into Schlemm's canal through the implant.
2. The method of claim 1 further comprising engaging the trabecular meshwork with a distally-facing surface or the proximal portion to self-retain the intraocular implant in the inner wall of Schlemm's canal.
3. The method of claim 1 wherein the distal portion is sized and shaped to allow bidirectional fluid flow in Schlemm's canal when disposed in Schlemm's canal.
4. The method or claim 1 wherein the proximal portion further comprises a flange, the method further comprising engaging the flange with the trabecular meshwork in the anterior chamber to self-retain the intraocular implant in the inner wall or Schlemm's canal.
5. The method of claim 4 , wherein the flange comprises a distally facing surface, the method further comprising capturing the trabecular meshwork and the inner wall of Schlemm's canal between the distally facing surface and the proximally facing surface.
6. The method of claim 5 , wherein the proximally facing surface and the distally facing surface simultaneously contact the trabecular meshwork and the inner wall of Schlemm's canal.
7. The method of claim 1 , wherein the implant further comprises a middle portion having an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion.
8. The method of claim 1 , further comprising:
inserting an inserter device into the anterior chamber, the implant being inside a tube of the inserter device;
advancing the implant through an opening in a distal end of the tube of the inserter device; and
pushing the distal end of the implant into and through the inner wall of Schlemm's canal.
9. The method of claim 8 wherein the advancing step comprises advancing a shall within the inserter device to advance the implant distally through the tube of the inserter device.
10. The method of claim 1 , further comprising advancing a cutting tool into the trabecular meshwork prior to the positioning step.
11. An intraocular implant for reducing intraocular pressure in an eye, the implant comprising:
a proximal portion sized and shaped to reside within an anterior chamber of the eye, the proximal portion comprising a proximal opening;
a distal portion sized and shaped to reside within Schlemm's canal of the eye, the distal portion comprising a proximally-facing surface and a distal opening, the proximally-facing surface configured to engage an inner wall of Schlemm's canal to self-retain the intraocular implant in the inner wall of Schlemm's canal; and
a passageway extending in a straight line from the proximal opening to the distal opening to conduct fluid from the anterior chamber to Schlemm's canal.
12. The intraocular implant of claim 11 , wherein the proximal portion further comprises a distally-facing surface configured to engage the trabecular meshwork within the anterior chamber to self-retain the intraocular implant in the inner wall of Schlemm's canal.
13. The intraocular implant of claim 11 , wherein the proximal portion further comprises a flange configured to engage the trabecular meshwork within the anterior chamber to self-retain the intraocular implant in the inner wall of Schlemm's canal.
14. The intraocular implant of claim 11 , further comprising a middle portion having an outer cross-sectional dimension that is less than a cross-sectional dimension of the distal portion.
15. The intraocular implant of claim 14 , wherein the cross-sectional dimension of the middle portion is less than a cross-sectional dimension of the proximal portion.