Ocular delivery systems and methods
Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.
1. An implant-free method for treating conditions of the eye comprising:
advancing a conduit within an eye by actuating a drive assembly in a first direction; and
delivering a fluid through the conduit and into the eye by actuating the drive assembly in a second direction opposite the first direction.
2. The implant-free method of claim 1 , wherein the conduit has an outer diameter between about 150 and about 500 microns.
3. The implant-free method of claim 1 , wherein the eye conditions are glaucoma, pre-glaucoma, or ocular hypertension.
4. The implant-free method of claim 1 , wherein the conduit has an outer diameter between about 300 and about 500 microns.
5. The implant-free method of claim 1 , wherein the fluid comprises a viscoelastic fluid.
6. The implant-free method of claim 1 , wherein the fluid includes a drug.
7. The implant-free method of claim 6 , wherein the drug comprises a prostaglandin, beta blocker, miotic, alpha adrenergic agonist, or carbonic anhydrase inhibitor.
8. The implant-free method of claim 6 , wherein the drug comprises an anti-inflammatory.
9. The implant-free method of claim 6 , wherein the drug comprises an antimetabolite.
10. The implant-free method of claim 6 , wherein the drug comprises an anticoagulant or fibrinolytic compound.
11. The implant-free method of claim 6 , wherein the drug comprises a steroid.
12. The implant-free method of claim 6 , wherein the drug comprises prednisolone, prednisone, cortisone, cortisol, or triamcinolone.
13. The implant-free method of claim 6 , wherein the drug is configured for sustained release.
14. The implant-free method of claim 1 , wherein the volume of delivered fluid is at least about 8 μl.
15. The implant-free method of claim 1 , wherein the volume of delivered fluid is at least about 50 μl.
16. A device for treating conditions of the eye comprising:
a unitary handle having a fluid reservoir located entirely therein;
a conduit extendable from the unitary handle; and
a drive assembly,
wherein the conduit is configured to be advanced by actuating the drive assembly in a first direction, and wherein the fluid reservoir is configured to deliver a fluid through the conduit by actuating the drive assembly in a second direction opposite the first direction.
17. The device of claim 16 , further comprising a cannula, wherein the conduit is slidably disposed within the cannula.
18. The device of claim 17 , wherein the cannula comprises a distal curved portion.
19. The device of claim 17 , wherein the cannula comprises a distal straight portion.
20. The device of claim 16 , wherein the conduit has an outer diameter between about 150 and about 500 microns.
21. The device of claim 16 , wherein the conduit has an outer diameter between about 300 and about 500 microns.
22. The implant-free method of claim 5 , wherein the viscoelastic fluid comprises hyaluronic acid, chondroitin sulfate, cellulose, or salts, derivatives, or mixtures thereof.
23. The implant-free method of claim 22 , wherein the viscoelastic fluid comprises sodium hyaluronate.