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. A device for delivering fluids to an eye comprising:
a cannula;
a handle disposed at a proximal end of the cannula and comprising a housing and a fluid reservoir at least partially housed therein, wherein the handle is capable of being held with a single hand of a user;
a flexible conduit slidably disposed within, and advanceable distally from, the cannula and around an arc of Schlemm's canal, the conduit comprising a lumen in fluid communication with the fluid reservoir; and
a loading component, wherein the fluid reservoir is finable via the loading component, and
wherein the device is configured to deliver fluid from the fluid reservoir to the eye via the conduit without a separate fluid delivery device in fluid communication with the conduit during fluid delivery.
2. The device of claim 1 , wherein the fluid reservoir is moveable within the housing.
3. The device of claim 1 , wherein the loading component comprises a coupling configured to reversibly couple to the separate fluid delivery device.
4. The device of claim 1 , wherein the cannula is configured to rotate.
5. The device of claim 1 , wherein a length of the handle is about 4 inches to about 10 inches.
6. The device of claim 1 , wherein an outer diameter of the conduit is about 150 microns to about 500 microns.
7. The device of claim 1 , wherein the conduit is configured to be advanced around a 180 degree arc of Schlemm's canal.
8. The device of claim 1 , wherein the handle further comprises an actuator for moving the conduit, wherein the actuator is accessible by a finger on the single hand of the user while holding the handle.
9. The device of claim 8 , wherein the device is configured to deliver fluid from the fluid reservoir by decreasing the volume of the fluid reservoir.
10. The device of claim 8 , wherein the actuator comprises a slide.
11. The device of claim 1 , wherein the conduit is configured to be advanced around about a 360 degree arc of Schlemm's canal.
12. A device for delivering fluids to an eye comprising:
a cannula;
a handle comprising a housing and a fluid reservoir at least partially housed and moveable therein, wherein the cannula is coupled to a distal end of the housing, wherein the handle is capable of being held by a single hand of a user; and
a flexible conduit slidably disposed within, and advanceable distally from, the cannula and around an arc of Schlemm's canal, the conduit comprising a lumen in fluid communication with the fluid reservoir,
wherein the handle further comprises an actuator configured to deliver fluid through the conduit to Schlemm's canal, the actuator comprises a slide, and movement of the slide correspondingly moves an elongate member to deliver fluid from the fluid reservoir into Schlemm's canal, and wherein the device is configured to deliver fluid from the fluid reservoir into Schlemm's canal via the conduit without a syringe in fluid communication with the conduit during fluid delivery.
13. The device of claim 12 , wherein the device is configured to deliver fluid from the fluid reservoir by decreasing a volume of the fluid reservoir.
14. The device of claim 12 , wherein the slide is coupled to the elongate member and the elongate member is positioned within the handle.
15. The device of claim 14 , wherein the elongate member comprises a lumen therethrough configured to deliver fluid to the conduit.
16. The device of claim 12 , wherein the conduit is configured to be advanced around a 90 degree arc of Schlemm's canal.
17. The device of claim 12 , wherein the conduit is configured to be advanced around a 180 degree arc of Schlemm's canal.
18. The device of claim 12 , wherein a length of the handle is about 4 inches to about 10 inches.
19. The device of claim 12 , wherein the device further comprises a loading component, and wherein the fluid reservoir is fillable via the loading component.
20. The device of claim 12 , wherein the conduit is configured to be advanced around about a 360 degree arc of Schlemm's canal.
21. A device for delivering fluids to an eye comprising:
a cannula;
a handle comprising a housing and a fluid reservoir at least partially housed and moveable therein, wherein the handle is capable of being held by a single hand of a user;
a flexible conduit slidably disposed within, and advanceable distally from, the cannula, and around an arc of Schlemm's canal; and
a loading component extending from the fluid reservoir and passing through the housing of the handle, wherein a portion of the loading component extends beyond the housing, and
wherein the device is configured to deliver fluid from the fluid reservoir to the eye via the conduit without a separate fluid delivery device in fluid communication with the fluid reservoir during fluid delivery.
22. The device of claim 21 , wherein the cannula is disposed at a distal end of the housing.
23. The device of claim 21 , wherein the portion of the loading component extending beyond the housing of the handle comprises a coupling on an end thereof, the coupling configured to reversibly couple to the separate fluid delivery device.
24. The device of claim 21 , wherein an outer diameter of the flexible conduit is about 150 microns to about 500 microns.
25. The device of claim 21 , wherein the handle further comprises a lock.
26. The device of claim 21 , wherein the device is configured to deliver fluid from the fluid reservoir by decreasing the volume of the fluid reservoir.
27. The device of claim 21 , wherein the cannula is configured to rotate.
28. The device of claim 21 , wherein the conduit is configured to be advanced around a 180 degree arc of Schlemm's canal.
29. The device of claim 21 , wherein a length of the handle is about 4 inches to about 10 inches.
30. The device of claim 21 , wherein the conduit is configured to be advanced around about a 360 degree arc of Schlemm's canal.