System for shaping and implanting biologic intraocular stent for increased aqueous outflow and lowering of intraocular pressure
A system for deploying an implant cut from a biological tissue into an eye of a patient including a delivery device and a nose cone assembly, a tubular shaft projecting from the distal end region of the nose cone and comprising a lumen. Related devices, systems, and methods are provided.
1. A system for deploying an implant cut from a biological tissue into an eye of a patient, the system comprising:
a delivery device comprising:
a proximal housing;
at least one actuator; and
a distal coupler; and
a nose cone assembly comprising:
a nose cone having a proximal end region and a distal end region;
a coupler on the proximal end region of the nose cone configured to reversibly engage with the distal coupler of the delivery device; and
a tubular shaft projecting from the distal end region of the nose cone and comprising a lumen, the tubular shaft comprising one or more fenestrations extending through a side wall of the shaft, the one or more fenestrations covered by a material that is translucent or transparent so as to reveal the lumen of the tubular shaft.
2. The system of claim 1 , wherein the one or more fenestrations form a metering system of the tubular shaft configured to identify depth of insertion of the tubular shaft and/or a length of the implant within the lumen.
3. The system of claim 1 , wherein the tubular shaft comprises an introducer tube and an outer tube, the introducer tube formed of an opaque material and the outer tube formed of the material that is translucent or transparent.
4. The system of claim 1 , wherein the tubular shaft comprises a distal end region distal to the one or more fenestrations.
5. The system of claim 4 , wherein the distal end region curves away from a longitudinal axis of a proximal end region of the tubular shaft such that a distal opening from the lumen surrounds an axis that is different from the longitudinal axis of the proximal end region.
6. The system of claim 4 , wherein the distal end region is formed of a translucent or transparent material.
7. The system of claim 1 , further comprising the implant.
8. The system of claim 7 , wherein the biological tissue of the implant is scleral or corneal biological tissue.
9. A device for minimal modification of a biologically-derived tissue, the device comprising two blades spaced apart by a gap, each blade having an inner face and at least one distal bevel forming a cutting edge, wherein the two blades are mounted at an angle relative to one another so that the inner faces are non-parallel and the distal bevels are parallel to one another, wherein the device is configured to cut the biologically-derived tissue into an elongated strip having a length and a width, wherein the length is greater than the width.
10. The device of claim 9 , wherein the distal bevels are orthogonal to the tissue.
11. The device of claim 9 , wherein the strip is configured for implantation in an eye of a patient.
12. The device of claim 9 , wherein the width is less than about 3 mm and the length is greater than about 3 mm.
13. The device of claim 9 , wherein the biologically-derived tissue comprises scleral tissue or corneal tissue harvested from a donor or the patient.
14. A cutting device for preparation of an implant for ab interno insertion of the implant into an eye, the cutting device configured to be moved between an open configuration for loading a patch of a material in the cutting device and a closed configuration, the cutting device comprising:
a lower component having an upper bearing surface configured to receive the patch of the material;
an upper component having a lower surface configured to abut against the patch of the material when the cutting device is in the closed configuration;
a cutting die moveably coupled to the upper component, the cutting die comprising a pair of blades and a spacer defining a gap between the blades; and
an actuator,
wherein the pair of blades is configured to move below the lower surface of the upper component to penetrate the patch of the material at two locations to form a strip of the material having a width narrower than a width of the patch of the material.
15. The system of claim 14 , wherein the upper component is movably coupled to the lower component around a hinge to move the cutting device between the open configuration and the closed configuration.
16. The system of claim 14 , wherein the gap defined by the spacer determines the width of the strip.
17. The system of claim 14 , wherein each blade of the pair of blades includes a single bevel edge or a dual bevel edge.
18. The system of claim 15 , wherein the actuator comprises a lever configured to move the pair of blades relative to the upper surface upon rotation of the lever around axis relative to the upper component.
19. The system of claim 14 , wherein each blade of the pair of blades has an inner face and at least one distal bevel forming a cutting edge.
20. The system of claim 19 , wherein the pair of blades is mounted so that a first blade of the pair of blades is at an angle relative to a second blade of the pair of blades and so that the inner faces of the first and second blades are non-parallel and the distal bevels of the first and second blades are parallel to one another.
21. The system of claim 20 , wherein the distal bevels are orthogonal to the upper surface.
22. The system of claim 14 , wherein the material comprises biologically-derived material suitable for transplant into the eye, and wherein the biologically-derived material comprises tissue harvested from a donor or from the eye.
23. The system of claim 18 , wherein rotation of the upper component relative to the lower component around the hinge articulates the upper component moving the cutting device between the open configuration and the closed configuration.
24. The system of claim 23 , wherein, when the upper component is rotated around the hinge to place the cutting device in the closed configuration, rotation of the lever around the axis extends the pair of blades below the lower surface.
25. The system of claim 24 , wherein the cutting die further comprises a return spring, the spring arranged to urge the cutting die upward away from the lower component and be compressed upon rotation of the lever toward the lower component.
26. The system of claim 25 , wherein motion of the lever relative to the upper component to compress the return spring after the cutting device is in the closed configuration provides feedback to a user about reaching an end of travel of the upper component.
27. The system of claim 14 , wherein the cutting die further comprises an ejection spring positioned between the blades to eject the strip of the material from between the pair of blades.
28. The system of claim 14 , wherein the upper bearing surface and/or the cutting die is removably attached from the cutting device for replacement.