CA2581334A1 - Implant with intraocular pressure sensor for glaucoma treatment - Google Patents

Implant with intraocular pressure sensor for glaucoma treatment Download PDF

Info

Publication number
CA2581334A1
CA2581334A1 CA002581334A CA2581334A CA2581334A1 CA 2581334 A1 CA2581334 A1 CA 2581334A1 CA 002581334 A CA002581334 A CA 002581334A CA 2581334 A CA2581334 A CA 2581334A CA 2581334 A1 CA2581334 A1 CA 2581334A1
Authority
CA
Canada
Prior art keywords
eye
implant
sensor
intraocular pressure
delivery device
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002581334A
Other languages
French (fr)
Inventor
David Haffner
Hosheng Tu
Gharib Morteza
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Glaukos Corp
Original Assignee
Glaukos Corporation
David Haffner
Hosheng Tu
Gharib Morteza
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Glaukos Corporation, David Haffner, Hosheng Tu, Gharib Morteza filed Critical Glaukos Corporation
Publication of CA2581334A1 publication Critical patent/CA2581334A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00781Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/16Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers

Abstract

The invention discloses a trabecular stent and methods for treating glaucoma.
The stent may incorporate an intraocular pressure sensor comprising a compressible element that is implanted inside an anterior chamber of an eye, wherein at least one external dimension of the element correlates with intraocular pressure. In some embodiments, the sensor may be coupled to the stent. Also disclosed are methods of delivery of the stent and the sensor to the eye.

Description

IMPLANT WITH INTRAOCULAR PRESSURE SENSOR FOR
GLAUCOMA TREATMENT

Related Applications [0001] The present application is a continuation-in-part of U.S. Patent Application No.
10/626,181, filed July 24, 2003, entitled "Implant with Pressure Sensor for Glaucoma Treatment,"
which is a continuation application of U.S. Patent Application No. 09/847,523, filed May 2, 2001, entitled "Bifurcatable Trabecular Shunt for Glaucoma Treatment," now U.S.
Patent No. 6,666,841, and claims benefit from U.S. Provisional Application No. 60/505,680 filed September 24, 2003, entitled "Intraocular Pressure Sensor" the entireties of which are hereby incorporated by reference.
Background of the Invention [0002] The present invention generally relates to medical devices and methods for reducing intraocular pressure in the animal eye. More particularly, the present invention relates to the treatment of glaucoma by permitting aqueous humor to flow out of the anterior chamber through a surgically implanted pathway.
[0003] The human eye is a specialized sensory organ capable of light reception and able to receive visual images. The trabecular meshwork serves as a drainage channel and is located in the anterior chamber angle formed between the iris and the cornea. The trabecular meshwork maintains a balanced pressure in the anterior chamber of the eye by draining aqueous humor from the anterior chamber.
[0004] About two percent of people in the United States have glaucoma.
Glaucoma is a group of eye diseases encompassing a broad spectrum of clinical presentations, etiologies, and treatment modalities. Glaucoma causes pathological changes in the optic nerve, visible on the optic disk, and it causes corresponding visual field loss, resulting in blindness if untreated. Lowering intraocular pressure is the major treatment goal in all glaucomas.
[0005] In glaucomas associated with an elevation in eye pressure (intraocular hypertension), the source of resistance to outflow is mainly in the trabecular meshwork. The tissue of the trabecular meshwork allows the aqueous humor ("aqueous") to enter Schlemm's canal, which then empties into aqueous collector channels in the posterior wall of Schlemm's canal and then into aqueous veins, which form the episcleral venous system. Aqueous is a transparent liquid that fills the region between the cornea, at the front of the eye, and the lens. The aqueous is continuously secreted by the ciliary body around the lens, so there is a constant flow of aqueous from the ciliary body to the eye's front chamber. The eye's pressure is detennined by a balance between the production of aqueous and its exit through the trabecular meshwork (major route) or uveal scleral outflow (minor route). The trabecular meshwork is located between the outer rim of the iris and the back of the cornea, in the anterior chamber angle. The portion of the trabecular meshwork adjacent to Schlemm's canal (the juxtacanilicular meshwork) causes most of the resistance to aqueous outflow.
[0006] Glaucoma is grossly classified into two categories: closed-angle glaucoma, also known as angle closure glaucoma, and open-angle glaucoma. Closed-angle glaucoma is caused by closure of the anterior chamber angle by contact between the iris and the inner surface of the trabecular meshwork. Closure of this anatomical angle prevents normal drainage of aqueous from the anterior chamber of the eye. Open-angle glaucoma is any glaucoma in which the angle of the anterior chamber remains open, but the exit of aqueous through the trabecular meshwork is diminished. The exact cause for diminished filtration is unknown for most cases of open-angle glaucoma. Primary open-angle glaucoma is the most common of the glaucomas, and it is often asymptomatic in the early to moderately advanced stage. Patients may suffer substantial, irreversible vision loss prior to diagnosis and treatment. However, there are secondary open-angle glaucomas which may include edema or swelling of the trabecular spaces (e.g., from corticosteroid use), abnormal pigment dispersion, or diseases such as hyperthyroidism that produce vascular congestion.
[0007] All current therapies for glaucoma are directed at decreasing intraocular pressure.
Medical therapy includes topical ophthalmic drops or oral medications that reduce the production or increase the outflow of aqueous. However, these drug therapies for glaucoma are sometimes associated with significant side effects, such as headache, blurred vision, allergic reactions, death from cardiopulmonary complications, and potential interactions with other drugs. When drug therapy fails, surgical therapy is used. Surgical therapy for open-angle glaucoma consists of laser trabeculoplasty, trabeculectomy, and implantation of aqueous shunts after failure of trabeculectomy or if trabeculectomy is unlikely to succeed. Trabeculectomy is a major surgery that is widely used and is augmented with topically applied anticancer drugs, such as 5-flurouracil or mitomycin-C to decrease scarring and increase the likelihood of surgical success.
[0008] Approximately 100,000 trabeculectomies are performed on Medicare-age patients per year in the United States. This number would likely increase if the morbidity associated with trabeculectomy could be decreased. The current morbidity associated with trabeculectomy consists of failure (10-15%); infection (a life long risk of 2-5%); choroidal hemorrhage, a severe internal hemorrhage from low intraocular pressure, resulting in visual loss (1%); cataract formation; and hypotony maculopathy (potentially reversible visual loss from low intraocular pressure).
[0009] For these reasons, surgeons have tried for decades to develop a workable surgery for the trabecular meshwork.
[0010] The surgical techniques that have been tried and practiced are goniotomy/trabeculotomy and other mechanical disruptions of the trabecular meshwork, such as trabeculopuncture, goniophotoablation, laser trabecular ablation, and goniocurretage. These are all major operations and are briefly described below.
[0011] Goniotomy/Trabeculotomy: Goniotomy and trabeculotomy are simple and directed techniques of microsurgical dissection with mechanical disruption of the trabecular meshwork. These initially had early favorable responses in the treatment of open-angle glaucoma.
However, long-term review of surgical results showed only limited success in adults. In retrospect, these procedures probably failed due to cellular repair and fibrosis mechanisms and a process of "filling in." Filling in is a detrimental effect of collapsing and closing in of the created opening in the trabecular meshwork. Once the created openings close, the pressure builds back up and the surgery fails.
[0012] Trabeculopuncture: Q-switched Neodymiun (Nd) YAG lasers also have been investigated as an optically invasive technique for creating full-thickness holes in trabecular meshwork. However, the relatively small hole created by this trabeculopuncture technique exhibits a filling in effect and fails.
[0013] Goniophotoablation/Laser Trabecular Ablation: Goniophotoablation is disclosed by Berlin in U.S. Pat. No. 4,846,172 and involves the use of an excimer laser to treat glaucoma by ablating the trabecular meshwork. This was demonstrated not to succeed by clinical trial. Hill et al. used an Erbium:YAG laser to create full-thickness holes through trabecular meshwork (Hill et al., Lasers in Surgery and Medicine 11:341-346, 1991). This technique was investigated in a primate model and a limited human clinical trial at the University of California, Irvine. Although morbidity was zero in both trials, success rates did not warrant further human trials. Failure was again from filling in of surgically created defects in the trabecular meshwork by repair mechanisms. Neither of these is a viable surgical technique for the treatment of glaucoma.
[0014] Goniocurretage: This is an ab interno (from the inside), mechanically disruptive technique that uses an instrument similar to a cyclodialysis spatula with a microcurrette at the tip.
Initial results were similar to trabeculotomy: it failed due to repair mechanisms and a process of filling in.
[0015] Although trabeculectomy is the most commonly performed filtering surgery, viscocanulostomy (VC) and non-penetrating trabeculectomy (NPT) are two new variations of filtering surgery. These are ab extemo (from the outside), major ocular procedures in which Schlemm's canal is surgically exposed by making a large and very deep. scleral flap. In the VC
procedure, Schlemm's canal is cannulated and viscoelastic substance injected (which dilates Schlemm's canal and the aqueous collector channels). In the NPT procedure, the inner wall of Schlemm's canal is stripped off after surgically exposing the canal.
[0016] Trabeculectomy, VC, and NPT involve the formation of an opening or hole under the conjunctiva and scleral flap into the anterior chamber, such that aqueous is drained onto the surface of the eye or into the tissues located within the lateral wall of the eye. These surgical operations are major procedures with significant ocular morbidity. When trabeculectomy, VC, and NPT are thought to have a low chance for success, a number of implantable drainage devices have been used to ensure that the desired filtration and outflow of aqueous through the surgical opening will continue. The risk of placing a glaucoma drainage device also includes hemorrhage, infection, and diplopia (double vision).
[0017] Examples of implantable shunts and surgical methods for maintaining an opening for the release of aqueous from the anterior chamber of the eye to the sclera or space beneath the conjunctiva have been disclosed in, for example, U.S. Patent Nos.
6,059,772 to Hsia et al. and 6,050,970 to Baerveldt.
[0018] All of the above embodiments and variations thereof have numerous disadvantages and moderate success rates. They involve substantial trauma to the eye and require great surgical skill in creating a hole through the full thickness of the sclera into the subconjunctival space. The procedures are generally performed in an operating room and have a prolonged recovery time for vision.
[0019] The complications of existing filtration surgery have inspired ophthalmic surgeons to find other approaches to lowering intraocular pressure.
[0020] The trabecular meshwork and juxtacanilicular tissue together provide the majority of resistance to the outflow of aqueous and, as such, are logical targets for surgical removal in the treatment of open-angle glaucoma. In addition, minimal amounts of tissue are altered and existing physiologic outflow pathways are utilized.
[0021] As reported in Arch. Ophthalm. (2000) 118:412, glaucoma remains a leading cause of blindness, and filtration surgery remains an effective, important option in controlling the disease. However, modifying existing filtering surgery techniques in any profound way to increase their effectiveness appears to have reached a dead end. The article further states that the time has come to search for new surgical approaches that may provide better and safer care for patients with glaucoma.

Summary of the Invention [0022] There is a great clinical need for the treatment of glaucoma by a method that is faster, safer, and less expensive than currently available modalities, and by implanting a device having pressure sensing capability for transporting aqueous from the anterior chamber to Schlemm's canal.
[0023] Glaucoma surgical morbidity would greatly decrease if one were to bypass the focal resistance to outflow of aqueous only at the point of resistance, and to utilize remaining, healthy aqueous outflow mechanisms. This is in part because episcleral aqueous humor exerts a backpressure that prevents intraocular pressure from going too low, and one could thereby avoid hypotony. Thus, such a surgery would virtually eliminate the risk of hypotony-related maculopathy and choroidal hemorrhage. Furthermore, visual recovery would be very rapid, and the risk of infection would be very small, reflecting a reduction in incidence from 2-5%
to about 0.05%.
[0024] Techniques performed in accordance with embodiments herein may be referred to generally as "trabecular bypass surgery." Advantages of the present invention include lowering intraocular pressure in a manner which is simple, effective, disease site-specific, and can potentially be performed on an outpatient basis.
[0025] In accordance with one embodiment, trabecular bypass surgery (TBS) creates an opening, a slit, or a hole through trabecular meshwork with minor microsurgery. TBS has the advantage of a much lower risk of choroidal hemorrhage and infection than prior techniques, and it uses existing physiologic outflow mechanisms. In some aspects, this surgery can potentially be performed under topical or local anesthesia on an outpatient basis with rapid visual recovery. To prevent "filling in" of the hole, a biocompatible elongated device is placed within the hole and serves as a stent. U.S. Patent No. 6,638,239, the entire contents of which are incorporated herein by reference, discloses trabecular bypass surgery.
[0026] In accordance with one embodiment, a trabecular shunt for transporting aqueous humor is provided. The trabecular shunt includes a hollow, elongate tubular element, having an inlet section and an outlet section. In one embodiment, the outlet section includes two bifurcatable segments or elements, adapted to be positioned and stabilized inside Schlemm's canal. In another embodiment, the outlet section is an axially linear section prior to and during implantation, and becomes two bifurcated segments after implantation.
[0027] In one embodiment, the trabecular shunt is placed inside a delivery apparatus.
When the trabecular shunt is deployed from the delivery apparatus into the eye, the two bifurcatable elements of the outlet section bifurcate in substantially opposite directions.
In one embodiment, a deployment mechanism within the delivery apparatus includes a push-pull type plunger.
[0028) In another embodiment, a delivery applicator may be placed inside a lumen of the hollow, elongate tube of the trabecular shunt. The delivery applicator may include a deployment mechanism for causing the two bifurcatable elements of the outlet section to bifurcate.
In some embodiments, the delivery applicator may be a guidewire, an expandable basket, an inflatable balloon, or the like.
[0029] In accordance with another embodiment, at least one of the two bifurcatable elements is made of a shape-memory material, such as Nitinol or a shape-memory plastic. The shape-memory material has a preshape and a shape-transition temperature, such that the shape-memory trabecular shunt bifurcates to its preshape when it is heated to above the shape-transition temperature. The preshape of the two bifurcatable elements material may be at an angle with respect to the inlet section, preferably between about 70 degrees and about 110 degrees. An external heat source may be provided, which is adapted for heating the shape-memory material to above the shape-transition temperature of the shape-memory material.
[0030] In some embodiments, the trabecular shunt may be made of one or more of the following materials: polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene, expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, NylonTM, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, biodegradable materials, and biocompatible materials. Further, the outlet section of the trabecular shunt may be configured as a coil, mesh, spiral, or other appropriate configuration as will be apparent to those of skill in the art. Further, the outlet section of the trabecular shunt may be porous, semi-permeable, fishbone, and/or of a continuous, solid form. The outlet section of the trabecular shunt may have a cross-sectional shape that is elliptical (e.g., oval), round, circular, D-shape, semi-circular, or irregular (asymmetrical) shape.
[0031] In one embodiment, at least one of the two bifurcatable elements has a tapered distal end, adapted for insertion ease. The trabecular shunt may have its surface coated with a coating material selected from one or more of the following:
polytetrafluoroethylene (e.g., TeflonTM), polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like. The surface coating material may also provide a mechanism for site-specific therapies.
[0032] In one embodiment, the device of the invention may include a flow-restricting member for restricting at least one component in fluid. The flow-restricting member may be a filter comprising one or more filtration materials selected from the following:
expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, fluorinated material, or the like.
The flow-restricting member may advantageously be a filter selected from the following group of filter types: hydrophobic, hydrophilic, membrane, microporous, and non-woven.
The flow-restricting member acts to limit or prevent the reflux of any undesired component or contaminant of blood, such as red blood cells or serum protein, from the aqueous veins into the anterior chamber.
It is useful to restrict one or more of the following components or contaminants: platelets, red blood cells, white blood cells, viruses, bacteria, antigens, and toxins.
[0033] In some embodiments, the trabecular shunt may include a pressure sensor for measuring the pressure of the anterior chamber of an eye of a patient. The pressure sensor may further include an electromagnetic (e.g., radiofrequency) transmitter, for wirelessly transmitting pressure measurements to a pressure receiver outside the patient's body.
[0034] Some embodiments relate to an apparatus for measuring intraocular pressure.
The apparatus may comprise a compressible chamber sized to be placed in the anterior chamber of an eye. The chamber may be configured to change in at least a first dimension in response to a change in intraocular pressure such that the change in the first dimension is indicative of the change in intraocular pressure. In some embodiments, a second dimension of the compressible chamber remains substantially constant during the change in intraocular pressure.
[0035] Some embodiments relate to a method of measuring intraocular pressure, the method comprising measuring a dimension of a compressible chamber located in the anterior chamber of an eye, the chamber configured to change in the dimension in response to a change in intraocular pressure.
[0036] Some embodiments relate to a method of monitoring intraocular pressure, the method comprising placing a compressible chamber into the anterior chamber of an eye, the chamber configured to change in at least one dimension in response to a change in intraocular pressure. Some embodiments further comprise measuring the at least one dimension to determine intraocular pressure.
[0037] Some embodiments relate to an intraocular pressure sensor comprising a compressible element that is implanted inside an anterior chamber of an eye, wherein at least one external dimension of the element is correlated to compressing pressure reading. The compressible element is anchored to a tissue of the eye, preferably to an iris of the eye, wherein the element is positioned without obstruction of vision.
[0038] In one embodiment, the element further comprises an interior enclosure filled with a compressible fluid, wherein the compressible fluid is a gas. In another embodiment, the compressible element comprises a shape of a sphere, an ellipsoid shape, a torus shape or other convenient shape. In still another embodiment, at least a portion of the surface of the compressible element is rendered radiopaque.
[0039] Some embodiments relate to an intraocular pressure sensor comprising an implanted compressible element having at least one external dimension and an external measuring means for remotely viewing and measuring the at least one external dimension of the element. In one embodiment, the external measuring means is a slit lamp, an ultrasound imaging apparatus, a laser light apparatus, or the like. In an alternate embodiment, the intraocular pressure sensor comprises an implanted compressible element having at least one external dimension and a measuring means for viewing and measuring the at least one external dimension of the element, wherein the measuring means is implanted or is one component of an implanted stent in an eye.

10040] Some embodiments relate to a method for measuring an intraocular pressure of an eye, comprising: providing a compressible element that is implanted inside an anterior chamber of the eye, wherein at least one external dimension of the element is correlated to compressing pressure reading; implanting the element inside the eye; using an external measuring means for remotely viewing and measuring the at least one external dimension of the element; and calculating the intraocular pressure of the eye by correlating the measured external dimension to the compressing pressure reading.

[0041] Some embodiments relate to a method of providing a sensor and an implant in an eye for treatment and monitoring of glaucoma. The method may comprise providing a delivery device, the delivery device comprising at least one implant having an inlet and an outlet section, the inlet section being in fluid communication with the outlet section and configured to conduct fluid from the anterior chamber of an eye to Schlemm's canal. The method may further comprise positioning the at least one implant in the eye such that the inlet section is in the anterior chamber of the eye and the outlet section is in Schlemm's canal and positioning the sensor in the eye to measure the intraocular pressure of the eye.

[0042] Some embodiments relate to a trabecular stent system for glaucoma treatment, the stent system comprising: an elongate tubular implant extending between an anterior chamber and Schlemm's canal for transporting fluid from said anterior chamber to said Schlemm's canal of an eye; and an intraocular pressure sensor in association with the implant, said sensor comprising a compressible element, wherein at least one external dimension of the element is correlated to compressing pressure reading.

[0043] In another embodiment of the system for treating glaucoma, the system may comprise an implant that is configured such that, in use, the implant conducts fluid from the anterior chamber of an eye to the Schlemm's canal of the eye and a pressure sensor that is configured to be wholly implanted in the eye.

[0044] In a further embodiment, the trabecular stent system further comprises a signal transmitter, said transmitter transmitting a sensed signal from said sensor indicative of the sensed pressure to a receiver. In some embodiments, the receiver is located outside of the eye or inside the eye. In some embodiments, the signal comprises a radiofrequency signal.
[0045] Some embodiments relate to a system for treating glaucoma, comprising:
an intraocular pressure sensor, said sensor comprising a compressible element, wherein at least one external dimension of the element is correlated to compressing pressure reading; an elongate tubular implant for transporting fluid between an anterior chamber and Schlemm's canal; and a delivery applicator, said intraocular pressure sensor and said implant being positioned within said delivery applicator for delivering into the anterior chamber for implantation.

[0046] Among the advantages of trabecular bypass surgery in accordance with the invention is its simplicity. The microsurgery may potentially be performed on an outpatient basis with rapid visual recovery and greatly decreased morbidity. There is a lower risk of infection and choroidal hemorrhage, and there is a faster recovery, than with previous techniques.

[0047] Further features and advantages of the present invention will become apparent to one of skill in the art in view of the Detailed Description that follows, when considered together with the attached drawings and claims.
Brief Description of the Drawings [0048] FIG. 1 is a sagittal sectional view of an eye.

[0049] FIG. 2 is a cross-sectional view of the anterior chamber of an eye.

[0050] FIG. 3A is a side elevational view of a glaucoma device according to the present invention.

[0051] FIG. 3B is an end cross-sectional view through plane 1-1 of FIG. 3A.
[0052] FIG. 4A illustrates the trabecular shunt of FIG. 3A at a semi-deployment state.
[0053] FIG. 4B is an end cross-sectional view of section 2-2 of FIG. 4A.
[0054] FIG. 5A illustrates the trabecular shunt of FIG. 3A in a deployed state.
[0055] FIG. 5B is an end cross-sectional view of the trabecular shunt, section 3-3 of FIG. 5A.

[0056] FIG. 5C is an end cross-sectional view of a bifurcatable segment, section 4-4 of FIG. 5A.
[0057] FIG. 6 is a side cross-sectional view of the trabecular shunt.
[0058] FIG. 7A is a side cross-sectional view of an alternate embodiment of the trabecular shunt.

[0059] FIG. 7B is a side cross-sectional view of the trabecular shunt of FIG.
7A in a partially deployed state.

[0060] FIG. 7C is a side cross-sectional view of the trabecular shunt and a passive IOP
pressure sensor loaded in series in a delivery device.

[0061] FIG. 8A is a perspective view of the trabecular shunt placed inside Schlemm's canal.

[0062] FIG. 8B is a perspective view of the trabecular shunt coupled to a passive IOP
pressure sensor and placed inside Schlemm's canal.

[0063] FIG. 9 is a close-up sectional view of the eye, showing the anatomical diagram of trabecular meshwork and the anterior chamber of the eye.

[0064] FIG. 10 shows one embodiment of a passive IOP pressure sensor element.
[0065] FIG. 11 is a cross-sectional view, section 5-5 of FIG. 10.

[0066] FIG. 12 shows another embodiment of a passive IOP pressure sensor element.
[0067] FIG. 13 shows a block diagram for a glaucoma treatment system.
Detailed Description of the Preferred Embodiment [0068] FIGS. 1 to 13 illustrate an apparatus for the treatment of glaucoma by trabecular bypass surgery in accordance with the present invention.

[0069] FIG. 1 is a sagittal sectional view of an eye 10, while FIG. 2 is a close-up view, showing the relative anatomical locations of trabecular meshwork 21, the anterior chamber 20, and Schlemm's canal 22. Thick collagenous tissue known as sclera 11 covers the entire eye 10 except that portion covered by the cornea 12. The cornea 12 is a thin transparent tissue that focuses and transmits light into the eye and through the pupil 14, which is the circular hole in the center of the iris 13 (colored portion of the eye). The cornea 12 merges into the sclera 11 at a juncture referred to as the limbus 15. The ciliary body 16 extends along the interior of the sclera 11 and is coextensive with the choroid 17. The choroid 17 is a vascular layer of the eye 10, located between the sclera 11 and retina 18. The optic nerve 19 transmits visual information to the brain and is the anatomic structure that is progressively destroyed by glaucoma.
[0070] The anterior chamber 20 of the eye 10, which is bound anteriorly by the cornea 12 and posteriorly by the iris 13 and lens 26, is filled with aqueous. Aqueous is produced primarily by the ciliary body 16, then moves anteriorly through the pupil 14 and reaches the anterior chamber angle 25, formed between the iris 13 and the cornea 12. In a normal eye, the aqueous is removed from the anterior chamber 20 through the trabecular meshwork 21. Aqueous passes through trabecular meshwork 21 into Schlemm's canal 22 and thereafter through the aqueous veins 23, which merge with blood-carrying veins and into systemic venous circulation.
Intraocular pressure is maintained by the intricate balance between secretion and outflow of the aqueous in the manner described above. Glaucoma is, in most cases, characterized by the excessive buildup of aqueous in the anterior chamber 20, which leads to an increase in intraocular pressure.
Fluids are relatively incompressible, and pressure is directed relatively equally throughout the eye.

[0071] As shown in FIG. 2, the trabecular meshwork 21 is adjacent a small portion of the sclera 11. Traditional procedures that create a hole or opening for implanting a device through the tissues of the conjunctiva 24 and sclera 11 involve extensive surgery, as compared to surgery for implanting a device which ultimately resides entirely within the confines of the sclera 11 and cornea 12, as is performed in accordance with one aspect of the present invention. In one embodiment, an outflow pathway is created that may operate to facilitate the flow of aqueous through or beyond the trabecular meshwork 21. A device 31 for establishing an outflow pathway, positioned through the trabecular meshwork 21, is illustrated in FIG. 8.

[0072] In one embodiment, a method of placing a trabecular shunt into an opening through trabecular meshwork, the method comprises advancing and positioning a trabecular shunt having two distal bifurcatable elements through the opening. In a further embodiment, a method of placing a trabecular shunt into an opening through diseased trabecular meshwork for transporting aqueous humor at the level of the trabecular meshwork and using an existing outflow pathway, the method comprises advancing and positioning a trabecular shunt having a pressure sensor for measuring the pressure of the anterior chamber of the eye th.rough the opening. In one embodiment, the method may further comprise transmitting the measured pressure to a pressure receiver outside the body of the patient.

[0073] Abita et al. in U.S. Pat. No. 6,579,235, the entire contents of which are incorporated herein by reference, disclose a device and methods for measuring intraocular pressure of a patient including a sensor and an instrument external to the patient to determine the intraocular pressure.

[0074] Wolfgang et al. in U.S. Patent Application publication 2004/0116794, the entire contents of which are incorporated herein by reference, disclose a wireless intraocular pressure sensor device for detecting excessive intraocular pressure above a predetermined threshold pressure.

[0075] In a co-pending application Ser. No. 10/636,797 filed August 7, 2003, entitled "Implantable Ocular Pump to Reduce Intraocular Pressure," the entire contents of which are incorporated herein by reference, an implant and a pressure sensor feedback system for regulating intraocular pressure of an eye is disclosed.

[0076] Montegrande et al. in U.S. Patent Application publication 2003/0225318, the entire contents of which are incorporated herein by reference, disclose an intraocular pressure sensor for sensing pressure within an eye and for generating a sensor signal representative of the pressure.

[0077] Jeffries et al., U.S. Patent Application publication 2003/0078487, the entire contents of which are incorporated herein by reference, disclose an intraocular pressure measuring system that includes a pressure sensor and an external device that wirelessly communicates with the pressure sensor.

[0078] FIG. 3A shows an embodiment of the trabecular shunt 31 constructed according to the principles of the invention. The trabecular shunt may comprise a biocompatible material, such as medical grade silicone, trade name SilasticTM, available from Dow Coming Corporation of Midland, Michigan; or polyurethane, trade name PellethaneTM, also available from Dow Coming Corporation. In some embodiments, other biocompatible materials (biomaterials) may be used, such as polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, polytetrafluoroethylene, expanded polytetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polyimide, polysilison, silicone, polyurethane, Nylon, polypropylene, hydroxyapetite, precious metal, Nitinol, stainless steel, or any mixture of these or other biocompatible materials. In a further embodiment, the trabecular shunt may comprise a composite biocompatible material, with a surface made of one or more of the above-mentioned biomaterials, and the surface is coated by a material selected from Teflon, polyimide, hydrogel, heparin, hydrophilic compound, anti-angiogenic factor, anti-proliferative factor, therapeutic drugs, and the like. Suitable anti-angiogenic or anti-proliferative factors may be selected from, for example, protamine, heparin, steroids, anti-invasive factor, retinoic acids and derivatives thereof, and paclitaxel or its analogues or derivatives thereof.
[0079] The trabecular shunt transports aqueous at the level of the trabecular meshwork and partially uses existing the outflow pathway for aqueous, i.e., utilizing the entire outflow pathway except for the trabecular meshwork, which is bypassed by the trabecular shunt 31. In this manner, aqueous is transported into Schlemm's canal and subsequently into the aqueous collectors and the aqueous veins so that the intraocular pressure is properly maintained within a therapeutic range.

[0080] In one embodiment, the trabecular shunt 31 comprises a hollow, elongated tubular element having an inlet section 32 and an outlet section 33, wherein the outlet section 33 may comprise two bifurcatable elements 34, 35 that are adapted to be bifurcated, positioned, and stabilized inside Schlemm's canal. The hollow elongated tubular element may comprise at least one lumen 36 for transporting aqueous from the anterior chamber 20 of an eye to the Schlemm's canal 22. A "bifurcatable" segment is defined in the present invention as a segment, or components thereof, that can change direction away or evert from a reference axis. The "bifurcating" operation may be achieved by mechanical forces and/or through the shape-memory property of a material.
[0081] For stabilization purposes, the outer surface of the outlet section 33 may comprise a stubbed surface, ribbed surface, a surface with pillars, textured surface, or the like. The outer surface of the trabecular shunt 31 is biocompatible and tissue-compatible so that the interaction between the outer surface of the shunt and the surrounding tissue of Schlemm's canal is minimal, and inflanunation is reduced. FIG. 3B shows an end cross-sectional view of section 1-1 of FIG. 3A. Each bifurcatable segment 34, 35 has its own end configuration. At least one of the two bifurcatable elements has a tapered distal end adapted for insertion ease.
The two bifurcatable elements 34, 35 are secured to the inlet section 32 at a joint 37. In an alternate embodiment, at least a slit 38, or scalloping, within the two bifurcatable elements 34, 35 may be located near the joint 37 for stress release when the two bifurcatable elements are bifurcated in two substantially opposite directions. Other stress-releasing mechanisms may also be utilized so as to make the bifurcation operation of the bifurcatable elements safe and effective. The outlet section 33 of the trabecular shunt 31 may possess a cross-sectional shape selected from the following: oval shape, round shape, circular shape, D-shape, semi-circular shape, irregular shape, or random shape.

[0082] In another embodiment, the trabecular shunt 31 may comprise a flow-restricting element for restricting at least one component in fluid, wherein the flow-restricting element may be a filter selected from a group of filtration materials comprising expanded polytetrafluoroethylene, cellulose, ceramic, glass, Nylon, plastic, and fluorinated material.
Furthermore, the flow-restricting element may be a filter selected from a group of filter types comprising a hydrophobic filter, hydrophilic filter, membrane filter, microporous filter, non-woven filter, and the like. In accordance with the present invention, components in blood that may be restricted by the flow-restricting element can include the following: platelet, red blood cell, white blood cell, virus, antigen, serum protein, and toxin. The flow-restricting element may also be in the form of, for example, a check valve, a slit valve, a micropump, a semi-permeable membrane, and the like. The purpose of the flow-restricting element is to keep an undesired foreign material from back flowing into the anterior chamber.

[0083] FIG. 4A shows the trabecular shunt of FIG. 3A in a semi-deployed state, while FIG. 4B shows an end cross-sectional view of section 2-2 of FIG. 4A. In one embodiment for shunt delivery, the trabecular shunt 31 is placed inside a hollow delivery apparatus 45. A delivery apparatus 45 comprises a distal end 47, wherein the two bifurcatable elements 34, 35 of the outlet section are self-bifurcatable in substantially two opposite directions when the trabecular shunt 31 is deployed out of the delivery apparatus 45. The slit 38 at the two bifurcatable elements 34, 35 comprises the separating regions 43A and 43B. The delivery apparatus 45 may comprise a deployment mechanism for deploying the trabecular shunt out of the delivery apparatus. In one embodiment, the deployment mechanism is a plunger. The delivery mechanism may be located at the handle of the delivery apparatus for deploying the trabecular shunt.
[0084] FIG. 5A shows the trabecular shunt of FIG. 3A at a deployed state. As the plunger is continuously pushed ahead, and the distal end 47 of the delivery apparatus 45 retreats, the two bifurcatable elements 34, 35 continue to deploy in two substantially opposite directions.
This may be accomplished by precontracting the two bifurcatable elements within the delivery apparatus before the delivery state. When the distal end of the delivery apparatus withdraws beyond the joint point 37 located between the inlet section 32 and the outlet section, the two bifurcatable elements are fully deployed with their separating regions 43A, 43B apart from each other. The outlet section of the trabecular shunt may be made of a material form selected from a group comprising coil form, mesh form, spiral form, porous form, semi-permeable form, fishbone form, continuous solid form, or any form that is effective and appropriate to evert the bifurcatable elements to be at one or more angles with respect to a reference axis of the inlet section.
[0085] FIG. 5B shows an end cross-sectional view of the trabecular shunt, section 3-3 of FIG. 5A, while FIG. 5C shows an end cross-sectional view of a bifurcatable segment, section 4-4 of FIG. 5A. The original outer contour of the trabecular shunt 31 is illustrated by a dashed line 49 in FIG. 5B. The lumen 36 of the hollow elongated tubular element is for aqueous to flow through the trabecular shunt. The shape of the end cross-section 35 is to provide a stenting capability when the elements are placed inside Schlemm's canal. The semicircular end cross-section of the bifurcatable elements 34, 35 allows aqueous to freely flow into aqueous collector channels in the external wall of Schlemm's canal.

[0086] FIG. 6 shows another preferred embodiment of the trabecular shunt constructed according to the principles of the invention. A delivery applicator 52 may be placed inside a lumen of the hollow elongated tubular element, wherein the delivery applicator 52 comprises a deployment mechanism for effecting the two bifurcatable elements 34, 35 of the outlet section to substantially two opposite directions. The delivery applicator may be selected from a group comprising a guidewire, an expandable basket, an inflatable balloon, or other expanding mechanism. In one embodiment, a delivery applicator 52 with an expandable basket comprises a plurality of expandable members 54A, 54B, 54C, 54D that all securely joined at a proximal joint 55A and at a distal joint point 55B. A distal end of a push-pull type wire 51 is also joined at the distal joint point 55B. The proximal joint 55A is located at the distal end of a compact guidewire 53 of the delivery applicator. Therefore, by pulling the push-pull wire 51 of the delivery applicator toward the operator, each of the expandable members 54A, 54B, 54C, 54D expand radially outwardly so as to effect the outward pushing action for the bifurcatable elements 34, 35.
[0087] U.S. Pat. No. 6,077,298 and U.S. Patent Application Ser. No.
09/452,963, filed December 2, 1999, the entire contents of which are incorporated herein by reference, disclose a medical device made of shape-memory Nitinol having a shape-transition temperature. The shape-memory material may be used in the construction of a trabecular shunt 31. In one embodiment, a trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal. At least one of the two bifurcatable elements may be made of a shape-memory material such as shape-memory Nitinol or shape-memory plastic material. In a preferred embodiment, the shape-memory Nitinol has a preshape and a shape-transition temperature, wherein the shape-memory Nitinol bifurcates to its preshape when the shape-memory Nitinol is heated to above the shape-transition temperature, the preshape of the shape-memory Nitinol being at an angle with respect to the inlet section.

[0088] The shape-transition temperature for the shape-memory Nitinol is preferably between about 39 C and about 90 C. The shape-transition temperature is more preferred between about 39 C and 45 C so as to minimize tissue damage. The angle between the inlet section and the outlet section is preferably between about 70 degrees and about 110 degrees so as to conform to the counter of Schlemm's canal. An external heat source may be provided and adapted for heating the shape-memory Nitinol to above the shape-transition temperature of the shape-memory Nitinol.
Examples of such external heat sources include a heating pad, a warm cloth, a bag of warm water, remotely deliverable heat, electromagnetic field, and the like. In another embodiment, the shape-memory Nitinol may be embedded within a biocompatible material selected from, for example, silicone, polyurethane, porous material, expanded polytetrafluoroethylene, semi-permeable membrane, elastomer, and mixture of the biocompatible material thereof. In general, the bifurcatable elements are relatively flexible and soft so that they do not impart undesired force or pressure onto the surrounding tissue during and after the deployment state.
[0089] For illustration purposes, a fishbone type outlet section is shown to render the bifurcatable elements flexible and soft during the deployment state. FIG. 7A
shows an embodiment of the trabecular shunt constructed according to principles of the invention.
The trabecular shunt comprises a plurality of fishbones and their intermediate spacing, such as the fishbones 61A, 61B
with a spacing 62A and the fishbones 61C, 61D with a spacing 62B. A delivery apparatus 45 may be used to deliver the self-bifurcatable elements 34, 35 having fishbones configuration.

[0090] FIG. 7B shows the trabecular shunt of FIG. 7A in a semi-deployed state.
As the distal end 47 of the delivery apparatus 45 is pulled away from the distal end 39 of the shunt 31, the self-bifurcatable elements 34, 35 tend to deploy to two opposite directions.
In the meantime, the spacing 62B between the two fishbones 61C and 61D starts to expand and enlarge so that minimal stress is exerted on the deployed bifurcated portion of the bifurcatable elements 34, 35.
[0091] The trabecular shunt of the present invention may have a length between about 0.5 mm to over a few millimeters. The outside diameter of the trabecular shunt may range from about 30 m to about 500 m or more. The lumen diameter is preferably in the range of about 20 m to about 150 m, or larger. The trabecular shunt may have a plurality of lumens to facilitate multiple-channel flow. The outlet section may be curved or angled at an angle between about 30 degrees to about 150 degrees, and preferably at about 70 degrees to about 110 degrees, with reference to the inlet section 32.

[0092] FIG. 8A is a perspective view illustrating the device 31 of the present invention positioned within the tissue of an eye 10. A hole or opening is created through the diseased trabecular meshwork 21. The outlet section of the device 31 is inserted into the hole, wherein the inlet section is exposed to the anterior chamber 20 while the outlet section is positioned at about an exterior surface 3 of the diseased trabecular meshwork 21. In a further embodiment, the outlet section may enter into Schlemm's canal or other existing outflow pathways. A
device as shown in FIG. 3 may be successfully used to maintain the opening through diseased trabecular meshwork.
[0093] In one embodiment, means for forming a hole/opening in the trabecular meshwork 21 may comprise using a microknife, a pointed guidewire, a sharpened applicator, a screw shaped applicator, an irrigating applicator, or a barbed applicator.
Alternatively, the trabecular meshwork may be dissected off with an instrument similar to a retinal pick or microcurrette. The opening may alternately be created by retrograde fiberoptic laser ablation.
[0094] In a preferred embodiment of the trabecular meshwork surgery, the patient is placed in the supine position, prepped, draped and anesthesia obtained. In one embodiment, a small (generally less than 1-mm) self-sealing incision is made. Through the cornea opposite the shunt placement site, an incision is made in the trabecular meshwork with an irrigating knife. The shunt is then advanced through the comeal incision across the anterior chamber held in a delivery apparatus or delivery applicator under gonioscopic (lens) or endoscopic guidance. The apparatus or applicator is withdrawn from the patient and the surgery is concluded. The delivery apparatus or applicator may be within a size range of 20 to 40 gauge, and preferably about 30 gauge.
[0095] In a further alternate embodiment, a method for increasing aqueous humor outflow in an eye of a patient to reduce intraocular pressure therein may comprise the following: (a) creating an opening in trabecular meshwork; (b) inserting a trabecular shunt into the opening, wherein the trabecular shunt comprises a hollow elongated tubular element having an inlet section and an outlet section, and wherein the outlet section comprises two bifurcatable elements adapted to be positioned and stabilized inside Schlemm's canal; and (c) bifurcating the two bifurcatable elements to substantially two opposite directions.

[0096] The method may further comprise placing the trabecular shunt inside a delivery apparatus during a delivery state, wherein the two bifurcatable elements are self-bifurcatable in two substantially opposite directions when the trabecular shunt is deployed from the delivery apparatus.
The method may further comprise placing a delivery applicator inside a lumen of a hollow elongated tubular element, wherein the delivery applicator comprises a deployment mechanism for causing the two bifurcatable elements to move in two substantially opposite directions.

[0097] The method may further comprise measuring and transmitting pressure of the anterior chamber of an eye, wherein the trabecular shunt comprises a pressure sensor for measuring and transmitting pressure. The means for measuring and transmitting pressure of an anterior chamber of an eye to an external receiver may be incorporated within a device that is placed inside the anterior chamber for sensing and transmitting the intraocular pressure.
Any suitable micro pressure sensor or pressure sensor chip known to those of skill in the art may be utilized.
[0098] As shown in FIG. 9, the trabecular meshwork 21 constitutes a small portion of the sclera 11. It is understandable that creating a hole or opening for implanting a device through the tissues of the conjunctiva 24 and sclera 11 is relatively a major surgery as compared to a surgery for implanting a device through the trabecular meshwork 21. In one embodiment, a passive IOP
sensor element 71 is secured to an iris 13 with at least one anchoring member 75 to prevent the element from randomly floating inside the anterior chamber. The sensor element is typically positioned out of the line of vision. In another embodiment, the IOP sensor element 71 may be coupled to the trabecular shunt 31, as shown in FIG. 8B. This may permit implantation of both the trabecular shunt 31 and the pressure sensor in a single procedure. The sensor may be coupled by any means know by those of skill in the art. For example, the sensor may be coupled to the trabecular shunt 31 by adhesive, soldering, etc. In some embodiments, the sensor may be integrally formed with the trabecular shunt 31.

[0099] FIG. 9 shows a trabecular stent system for glaucoma treatment, the stent system comprising: an elongate tubular implant 31 extending between an anterior chamber 20 and Schlenun's canal 22 for transporting fluid from said anterior chamber to said Schlemm's canal of an eye; and an intraocular pressure sensor 75 in association with the implant 31, said sensor comprising a compressible element, wherein at least one external dimension of the element is correlated to compressing pressure reading. The trabecular stent system further comprises a signal transmitter 74 (for example, a radiofrequency signal transmitter), said transmitter transmitting a sensed signal from said sensor 75 indicative of the sensed pressure to a receiver. The receiver may be located outside of the eye or inside the eye.

[0100] The IOP sensor element can comprise a biocompatible material, such as a medical grade silicone, for example, the material sold under the trademark SilasticTM, which is available from Dow Corning Corporation of Midland, Michigan, or polyurethane, which is sold under the trademark PellethaneTM, which is also available from Dow Corning Corporation. In an alternate embodiment, at least a portion of the sensor element can comprise other biocompatible materials (biomaterials), such as polyvinyl alcohol, polyvinyl pyrolidone, collagen, heparinized collagen, tetrafluoroethylene, fluorinated polymer, fluorinated elastomer, flexible fused silica, polyolefin, polyester, polysilicon, mixture of biocompatible materials, and the like. In a further alternate embodiment, a composite biocompatible material by surface coating the above-mentioned biomaterial can be used, wherein the coating material may be selected from a group consisting of polytetrafluoroethylene (PTFE), polyimide, hydrogel, heparin, therapeutic drugs, and the like.
[0101] Some embodiments relate to an intraocular pressure sensor comprising a compressible element that is implanted inside an anterior chamber of an eye, wherein at least one external dimension of the element is correlated to a compressing pressure reading, and an external measuring means for remotely viewing and measuring the at least one external dimension of the element. Some embodiments provide a pressure sensor element 71 in response to a remote sensing and measuring instrument for measuring the IOP indirectly. In this embodiment, the sensor element does not need supplemental energy or electromechanical means for powering the sensor element. It is thus a passive IOP sensing device.

[0102] FIG. 10 shows one embodiment of a passive IOP pressure sensor element 71, while FIG. 11 shows a cross-sectional view, section 5-5 of FIG. 10. The passive pressure sensor element 71 may be anchored or secured to a tissue of the eye. For example, the pressure sensor element 71 may be anchored to the iris 13 of the eye, as shown in FIG. 9. The element may be attached to a trabecular stent implant, as shown in FIG. 8B. The sensor element is sized, dimensioned and configured to be suitably implanted inside the eye out of the line of vision and visible to the external measuring means. Although FIG. 8B illustrates an embodiment in which the pressure sensor element 71 is located underneath (posterior to) the trabecular shunt 31, the pressure sensor element 71 may be placed at any location on the shunt 31. In one embodiment, the pressure sensor element 71 is located above the trabecular shunt 31 to permit external observation of the shunt 31. In one embodiment, the longest dimension of the element is less than about 1 cm, preferably less than about 5 mm. In other embodiments, however, the longest dimension of the element may be greater than about 1 cm or less than about 5 mm. In one embodiment, the sensor element is made of compressible membrane material that will respond to varying pressures in the eye.

[0103] In one preferred embodiment, the IOP pressure sensor element 71 comprises an enclosure with compressible fluid (for example, a gas) entrapped within the enclosure. The sensor element 71 has a length D2, a width DI and a depth D3 as shown in FIGS. 10 and 11. In some embodiments, the sensor element 71 is sized, constructed, and configured so the compressing pressure affects the change of the width D, (in the illustrated case, D, is equal to DZ) while not appreciably affecting dimension D3. The passive IOP sensor element 71 is precalibrated to show a correlation of the width D1 or length D2 as a function of the compressing pressure (designated as P). In another embodiment, the IOP sensor element 71 is precalibrated to provide a correlation of the width change (designated as ODI) as a function of the compressing pressure change (designated as AP).

[0104] In one embodiment, the edge portion 73 along the width D, is more pressure-sensitive than the central portion 72 along the width D1 enabling viewing the total width as a function of compressing pressure by a physician. In this embodiment, a greater pressure in the eye would result in a change of length in the width Di along the edge portion 73 of the sensor 71 than the change of the central portion 72. In some embodiments, the construction material at the edge portion can be different from that at the central portion. In another embodiment, the thickness at the edge portion 73 can be different from that at the central portion 72. In a further embodiment, the shape and size of the passive IOP sensor element 71 is suitably configured to yield the precalibrated correlation of the dimensions of the sensor 71 as a function of the compressing pressure (designated as P). Some embodiments relate to an IOP sensor element comprising a compressible enclosure, wherein compressible gas is enclosed within the enclosure, and wherein a dimension of the enclosure is correlated with a compressing pressure.

[0105] A compressible element of the ellipsoid shape has a major diameter D, and a minor diameter D3 (similar to the one shown in FIGS. 10 and 11 with D, = D2).
Place the element inside a compressing pressure chamber with a pressure reading. The dimension D, is read as a function of the compressing pressure P as follows:

Reading D1 length, mm Compressing pressure, # mmHg 1 5.0 10.0 2 4.9 11.5 3 4.8 13.2 Reading D, length, mm Compressing pressure, # mmHg 4 4.7 15.2 4.6 17.7 6 4.5 20.7 7 4.4 24.4 8 4.2 39.4 [0106] FIG. 12 shows another embodiment of a passive IOP pressure sensor element 76. In one embodiment, the IOP pressure sensor or sensor element may have unilateral expansion or shrinkage of primarily a single diameter that takes place with the sphere.
In another embodiment, two or more dimensions change in response to external pressure fluctuations.
In the ellipsoid enclosure, (such as the one shown in FIGS. 10 and 11) both the major diameter DI and the minor diameter D3 may change in response to external pressure fluctuations.
Measuring pressure with the ellipsoid involves taking a measurement, preferably, of the major or greater diameter Di. The major diameter of the ellipsoid is truly visible from any potential angle of projection by locating the single farthest distance between opposing outer surfaces on the ellipsoid on a line that passes through the center. The distance thus measured is plotted onto a calibration curve showing the major diameter vs. external pressure for the specific ellipsoid and the corresponding pressure reading.
[0107] In a preferred embodiment, the IOP pressure sensor is substantially a sphere in shape, rather than being elliptical. In this spheroid embodiment (not shown), the dimensions DI, D2, and D3 are substantially equal. This embodiment has the advantage of compressing substantially equally in all or nearly all dimensions in response to an increase in intraocular pressure, so one may perhaps easily measure a diameter in order to obtain a reading that correlates with IOP.

[0108] In the case of a compressible tubular wheel (such as a torus) as shown in FIG.
12, the thickness 78, the outer diameter 79, and the inner diameter 77 change as a function of external pressure. In one embodiment, the changes in the thickness, the outer diameter and the inner diameter are relatively uniform, wherein uniform changes in these dimensions assume that the bodies are sized and constructed so that pressure changes affect uniform and smooth dimensional changes in most or all dimensions. Measuring pressure with the torus involves measuring the outer diameter 79. The outer diameter of the torus is visible from any potential angle of projection by locating the single farthest distance between the opposing outer surfaces on the torus on a line that passes through the center. The distance thus measured is plotted onto a calibration curve showing the outer diameter vs. external pressure for the specific torus and the corresponding pressure reading. Alternately, the inner diameter can also be measured by viewing the maximum dimension and ensuring that the outside diameter is not mistakenly captured.

[0109] In one embodiment, the passive IOP sensor element is a sphere, a spherical ball, an ellipsoid ball, a torus type spherical tube or other dimensional element, preferably a nearly perfect sphere, whose sphere diameter changes in all directions uniformly with a change in external pressure. In a further embodiment, the sphere could be situated and viewed from any angle. The sphere could float in the eye, on a tether perhaps, and still be accurately sensed without elaborate positioning requirements. The spheres or element 71, 75 are biocompatible and suitable for implantation in an eye.

101101 In one embodiment, at least a part of the surface of the enclosure is rendered radiopaque for X-ray visualization. In another embodiment, at least a part of the surface of the enclosure is colored or coated with a visualizable material for external signal viewing. The external means for remotely viewing and measuring the at least one external dimension of the element can be a slit lamp, an ultrasound imaging apparatus, a laser light apparatus, the X-ray imaging apparatus or the like. The enclosure with enclosed gas is also visible by ultrasound.
[0111] FIG. 13 shows a block diagram for a glaucoma treatment system of the present invention. Some aspects of the invention relate to a system for treating glaucoma 81. The system may comprise an intraocular pressure sensor 71 that comprises a compressible element 86 with at least one external dimension of the element is configured to be correlated to the compressing pressure reading. The system may further comprise an elongate tubular implant 31 for transporting fluid between an anterior chamber and Schlemm's canal and a delivery applicator 82. The intraocular pressure sensor and the implant may be positioned within said delivery applicator for delivering into the anterior chamber for implantation. In some embodiments, the intraocular pressure sensor 71 and the implant 31 may be serially contained in the delivery applicator to permit application of the implant 31 and the sensor 71 in one procedure, as shown in FIG. 7C. This may permit implantation of the implant 31 and the sensor 71 without the need for discreet delivery applicators or incisions in the eye. The operation of the delivery applicator may be the similar to that described above with respect to the delivery applicator of the implant 31 in FIGS. 6-7B.

[0112] Some aspects of the invention relate to a trabecular stent system 83 for glaucoma treatment, the stent system may comprise an elongate tubular implant that is configured to extend between an anterior chamber and Schlemm's canal for transporting fluid from said anterior chamber to said Schlemm's canal of an eye. The system may also comprise an intraocular pressure sensor in association with the implant, and the sensor may comprise a compressible element that has at least one external dimension that is correlated to compressing pressure reading (as shown in a relationship figure in the block 86). The trabecular stent system may further comprise a signal transmitter (such as a radiofrequency transmitter 74), and the transmitter may transmit a sensed signal 84 from the sensor indicative of the sensed pressure to a receiver 85.
The receiver may be located either outside of the eye or inside the eye.

[0113] In a co-pending application Ser. No. 10/910,962, filed August 4, 2004, entitled "Implantable Ocular Pump to Reduce Intraocular Pressure," the entire contents of which are incorporated herein by reference, disclosed are energy sources for powering a micropump on a trabecular stent. In a co-pending application Ser. No. 10/636,797, filed August 7, 2003, entitled "Implantable Ocular Pump to Reduce Intraocular Pressure," the entire contents of which are incorporated herein by reference, disclosed is conversion of mechanical stress, such as a group comprising blink pressure pulses, ocular pressure pulses, body motion, head motions, and eye motions, to piezoelectricity..

[0114] Some embodiments relate to a method for measuring an intraocular pressure of an eye that may comprise the following: (a) provide a compressible element that is implanted inside an anterior chamber of the eye, wherein at least one external dimension of the element is correlated to compressing pressure reading; (b) implanting the element inside the eye;
(c) using an external measuring means for remotely viewing and measuring the at least one external dimension of the element; and (d) calculating the intraocular pressure of the eye by correlating the measured external dimension to the compressing pressure reading.
[0115] From the foregoing description, it should be appreciated that a novel approach for the surgical treatment of glaucoma has been disclosed for reducing IOP and sensing and measuring IOP from outside of the eye has been disclosed for measuring intraocular pressure.
While the invention has been described with reference to specific embodiments, the description is illustrative of the invention and is not to be construed as limiting the invention. Various modifications and applications of the invention may occur to those who are skilled in the art, without departing from the true spirit or scope of the invention. The breadth and scope of the invention should be defined only in accordance with the appended claims and their equivalents.

Claims (24)

1. A method of treating and monitoring of glaucoma, the method comprising:
providing a delivery device configured to be inserted into an eye of a patient;
providing at least one implant, the implant configured to be held within the delivery device, and the implant comprising:
an inlet and an outlet section, the inlet section being in fluid communication with the outlet section and configured to conduct fluid from the anterior chamber of an eye to Schlemm's canal of the eye;
providing a sensor configured to measure intraocular pressure and configured to be held within the delivery device;
positioning the at least one implant in the eye such that an end of the inlet section is in the anterior chamber of the eye and an end of the outlet section is in Schlemm's canal;
positioning the sensor in the eye to measure the intraocular pressure of the eye.
2. The method of Claim 1, wherein the at least one implant and the sensor are positioned substantially simultaneously.
3. The method of Claim 1, wherein the delivery device comprises a lumen extending through at least a portion thereof.
4. The method of Claim 1, wherein the delivery device comprises a tube.
5. The method of Claim 4, wherein the implant and sensor are preloaded in the tube.
6. The method of Claim 1, wherein at least one of either the sensor or the implant are preloaded in or on the delivery device.
7. The method of Claim 1, further comprising inserting the implant and the sensor into the eye through the same incision in the eye.
8. The method of Claim 1, wherein the sensor is in or on the implant.
9. The method of Claim 1, wherein positioning the at least one implant in the eye
10. A system for treating and monitoring of glaucoma, the system comprising:
a delivery device configured to be inserted into an eye of a patient;
at least one implant, the implant configured to be held within the delivery device, and the implant comprising:

an inlet and an outlet section, the inlet section being in fluid communication with the outlet section and configured to conduct fluid from the anterior chamber of an eye to Schlemm's canal of the eye;
a sensor configured to measure intraocular pressure and configured to be held within the delivery device.
11. A system for treating glaucoma, the system comprising:
an implant configured such that, in use, the implant conducts fluid from the anterior chamber of an eye to Schlemm's canal of the eye, the implant further configured to be held by a delivery device; and a pressure sensor configured to be held by a delivery device and further configured to be wholly implanted in the eye;

wherein the delivery device is configured to carry the implant and the sensor and to be inserted into the eye.
12. The system of Claim 11, wherein the pressure sensor is configured to produce a signal corresponding to an intraocular pressure.
13. The system of Claim 11, further comprising a receiver to receive a signal produced by the pressure sensor.
14. The system of Claim 11, wherein the sensor is configured to be placed in the anterior segment of the eye.
15. The system of Claim 14, wherein the pressure sensor is configured to be attached to the iris of the eye.
16. The system of Claim 11, wherein the pressure sensor is coupled to the implant.
17. The system of Claim 11, further comprising a delivery device.
18. The system of Claim 17, wherein at least one of the implant and the sensor is preloaded in or on the delivery device.
19. The system of Claim 17, wherein at least one implant and at least one sensor are serially preloaded in the delivery device.
20. An apparatus for measuring intraocular pressure, the apparatus comprising:
a compressible chamber sized to be placed in the anterior chamber of an eye, said chamber configured to change in at least a first dimension in response to a change in intraocular pressure, such that the change in the first dimension is indicative of the change in intraocular pressure.
21. The apparatus of Claim 20, wherein a second dimension of the compressible chamber remains substantially constant during said change in intraocular pressure.
22. A method of measuring intraocular pressure, the method comprising:
measuring a dimension of a compressible chamber located in the anterior chamber of an eye, said chamber configured to change in said dimension in response to a change in intraocular pressure.
23. A method of monitoring intraocular pressure, the method comprising:
placing a compressible chamber into the anterior chamber of an eye, said chamber configured to change in at least one dimension in response to a change in intraocular pressure.
24. The apparatus of Claim 23, further comprising measuring the at least one dimension to determine intraocular pressure.
CA002581334A 2004-09-24 2005-09-22 Implant with intraocular pressure sensor for glaucoma treatment Abandoned CA2581334A1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US10/950,175 2004-09-24
US10/950,175 US7678065B2 (en) 2001-05-02 2004-09-24 Implant with intraocular pressure sensor for glaucoma treatment
PCT/US2005/033900 WO2006036715A2 (en) 2004-09-24 2005-09-22 Implant and pressure sensor for glaucoma treatment

Publications (1)

Publication Number Publication Date
CA2581334A1 true CA2581334A1 (en) 2006-04-06

Family

ID=36119418

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002581334A Abandoned CA2581334A1 (en) 2004-09-24 2005-09-22 Implant with intraocular pressure sensor for glaucoma treatment

Country Status (4)

Country Link
US (3) US7678065B2 (en)
AU (1) AU2005289837A1 (en)
CA (1) CA2581334A1 (en)
WO (1) WO2006036715A2 (en)

Families Citing this family (112)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8313454B2 (en) 1997-11-20 2012-11-20 Optonol Ltd. Fluid drainage device, delivery device, and associated methods of use and manufacture
BR0010055A (en) 1999-04-26 2002-04-09 Gmp Vision Solutions Inc Bypass device and use thereof
US20050119737A1 (en) * 2000-01-12 2005-06-02 Bene Eric A. Ocular implant and methods for making and using same
US20030212383A1 (en) * 2001-01-05 2003-11-13 Dana Cote System and methods for reducing intraocular pressure
US7708711B2 (en) 2000-04-14 2010-05-04 Glaukos Corporation Ocular implant with therapeutic agents and methods thereof
US6638239B1 (en) 2000-04-14 2003-10-28 Glaukos Corporation Apparatus and method for treating glaucoma
US7135009B2 (en) 2001-04-07 2006-11-14 Glaukos Corporation Glaucoma stent and methods thereof for glaucoma treatment
US7867186B2 (en) 2002-04-08 2011-01-11 Glaukos Corporation Devices and methods for treatment of ocular disorders
US9603741B2 (en) 2000-05-19 2017-03-28 Michael S. Berlin Delivery system and method of use for the eye
US7431710B2 (en) 2002-04-08 2008-10-07 Glaukos Corporation Ocular implants with anchors and methods thereof
US7488303B1 (en) * 2002-09-21 2009-02-10 Glaukos Corporation Ocular implant with anchor and multiple openings
US7331984B2 (en) 2001-08-28 2008-02-19 Glaukos Corporation Glaucoma stent for treating glaucoma and methods of use
US7951155B2 (en) 2002-03-15 2011-05-31 Glaukos Corporation Combined treatment for cataract and glaucoma treatment
US9301875B2 (en) 2002-04-08 2016-04-05 Glaukos Corporation Ocular disorder treatment implants with multiple opening
WO2004062480A2 (en) * 2003-01-09 2004-07-29 The Regents Of The University Of California Implantable devices and methods for measuring intraocular, subconjunctival or subdermal pressure and/or analyte concentration
US20040225250A1 (en) 2003-05-05 2004-11-11 Michael Yablonski Internal shunt and method for treating glaucoma
US7291125B2 (en) 2003-11-14 2007-11-06 Transcend Medical, Inc. Ocular pressure regulation
US20060173399A1 (en) * 2005-02-01 2006-08-03 Rodgers M S MEMS flow module with pivoting-type baffle
US20060036207A1 (en) * 2004-02-24 2006-02-16 Koonmen James P System and method for treating glaucoma
US7226540B2 (en) * 2004-02-24 2007-06-05 Becton, Dickinson And Company MEMS filter module
US7384550B2 (en) * 2004-02-24 2008-06-10 Becton, Dickinson And Company Glaucoma implant having MEMS filter module
US20060206049A1 (en) * 2005-03-14 2006-09-14 Rodgers M S MEMS flow module with piston-type pressure regulating structure
US7364564B2 (en) * 2004-03-02 2008-04-29 Becton, Dickinson And Company Implant having MEMS flow module with movable, flow-controlling baffle
US7544176B2 (en) * 2005-06-21 2009-06-09 Becton, Dickinson And Company Glaucoma implant having MEMS flow module with flexing diaphragm for pressure regulation
US20060219627A1 (en) * 2005-03-31 2006-10-05 Rodgers M S MEMS filter module with concentric filtering walls
US20060247664A1 (en) * 2005-03-08 2006-11-02 California Institute Of Technology Micromachined tissue anchors for securing implants without sutures
US20110077579A1 (en) * 2005-03-24 2011-03-31 Harrison William V Cochlear implant with localized fluid transport
WO2006133400A2 (en) * 2005-06-08 2006-12-14 California Institute Of Technology Intravascular diagnostic and therapeutic sampling device
US9084662B2 (en) 2006-01-17 2015-07-21 Transcend Medical, Inc. Drug delivery treatment device
ES2762239T3 (en) 2006-01-17 2020-05-22 Alcon Inc Glaucoma treatment device
WO2007121485A2 (en) * 2006-04-18 2007-10-25 Cascade Ophthalmics Intraocular pressure attenuation device
US9381301B2 (en) * 2006-04-26 2016-07-05 Eastern Virginia Medical School Systems and methods for monitoring and controlling internal pressure of an eye or body part
US8267905B2 (en) 2006-05-01 2012-09-18 Neurosystec Corporation Apparatus and method for delivery of therapeutic and other types of agents
US7803148B2 (en) * 2006-06-09 2010-09-28 Neurosystec Corporation Flow-induced delivery from a drug mass
WO2008011125A2 (en) * 2006-07-20 2008-01-24 Neurosystec Corporation Devices, systems and methods for ophthalmic drug delivery
US7900518B2 (en) * 2006-08-29 2011-03-08 California Inst Of Techn Microfabricated implantable wireless pressure sensor for use in biomedical applications and pressure measurement and sensor implantation methods
US20080065002A1 (en) * 2006-09-07 2008-03-13 Neurosystec Corporation Catheter for Localized Drug Delivery and/or Electrical Stimulation
JP5748407B2 (en) * 2006-11-10 2015-07-15 グローコス コーポレーション Uveal sclera shunt
ES2284416B1 (en) * 2007-05-21 2009-02-16 Ahmed Galal Ahmed "DEVICE FOR CONTROL OF INTRAOCULAR PRESSURE".
EP2173289A4 (en) 2007-07-17 2010-11-24 Transcend Medical Inc Ocular implant with hydrogel expansion capabilities
US7740604B2 (en) 2007-09-24 2010-06-22 Ivantis, Inc. Ocular implants for placement in schlemm's canal
US20170360609A9 (en) 2007-09-24 2017-12-21 Ivantis, Inc. Methods and devices for increasing aqueous humor outflow
US20090082862A1 (en) 2007-09-24 2009-03-26 Schieber Andrew T Ocular Implant Architectures
US8734377B2 (en) 2007-09-24 2014-05-27 Ivantis, Inc. Ocular implants with asymmetric flexibility
US9510844B2 (en) * 2007-11-13 2016-12-06 Mgd Innovations, Llc Gland or duct diagnostic and treatment methods and related apparatus
WO2009064834A2 (en) * 2007-11-13 2009-05-22 Maskin Steven L Meibomian gland intraductal diagnostic and treatment methods and related apparatus
US8512404B2 (en) 2007-11-20 2013-08-20 Ivantis, Inc. Ocular implant delivery system and method
US8808222B2 (en) 2007-11-20 2014-08-19 Ivantis, Inc. Methods and apparatus for delivering ocular implants into the eye
FR2924913B1 (en) * 2007-12-18 2010-02-05 Alain Telandro SYSTEM FOR MEASURING OCULAR PRESSURE
US8109896B2 (en) 2008-02-11 2012-02-07 Optonol Ltd. Devices and methods for opening fluid passageways
JP2011513002A (en) 2008-03-05 2011-04-28 イバンティス インコーポレイテッド Method and apparatus for treating glaucoma
US20110082385A1 (en) * 2008-04-17 2011-04-07 Yale University Method for implanting intraocular pressure sensor
US8926524B2 (en) * 2008-06-02 2015-01-06 California Institute Of Technology System, apparatus and method for biomedical wireless pressure sensing
ES2330405B1 (en) * 2008-06-06 2010-09-21 Consejo Superior De Investigaciones Cientificas (Csic) (45%) SENSOR CONTACT LENS, SYSTEM FOR NON-INVASIVE MONITORING OF INTRAOCULAR PRESSURE AND METHOD TO PUT YOUR MEASUREMENT.
ES2640867T3 (en) 2008-06-25 2017-11-07 Novartis Ag Eye implant with ability to change shape
CN102238926B (en) * 2008-12-05 2015-09-16 伊万提斯公司 For ocular implants being transported to the method and apparatus in eyes
EP2548538B1 (en) 2009-01-28 2020-04-01 Alcon Inc. Implantation systems for ocular implants with stiffness qualities
US10206813B2 (en) 2009-05-18 2019-02-19 Dose Medical Corporation Implants with controlled drug delivery features and methods of using same
EP4289416A3 (en) * 2009-05-18 2024-01-03 Dose Medical Corporation Drug eluting ocular implant
AU2010271274B2 (en) 2009-07-09 2015-05-21 Alcon Inc. Single operator device for delivering an ocular implant
AU2010271218B2 (en) 2009-07-09 2017-02-02 Alcon Inc. Ocular implants and methods for delivering ocular implants into the eye
CN102711593A (en) 2009-09-18 2012-10-03 奥尔托梅姆斯有限公司 Implantable mems intraocular pressure sensor devices and methods for glaucoma monitoring
EP2490621A4 (en) 2009-10-23 2013-04-03 Ivantis Inc Ocular implant system and method
US8529492B2 (en) 2009-12-23 2013-09-10 Trascend Medical, Inc. Drug delivery devices and methods
WO2011082314A2 (en) 2009-12-30 2011-07-07 Brockman Holdings Llc System, device, and method for determination of intraocular pressure
US8545430B2 (en) 2010-06-09 2013-10-01 Transcend Medical, Inc. Expandable ocular devices
WO2011163505A1 (en) 2010-06-23 2011-12-29 Ivantis, Inc. Ocular implants deployed in schlemm's canal of the eye
US20120238857A1 (en) * 2010-09-16 2012-09-20 Orthomems, Inc. Expandable implantable pressure sensor for intraocular surgery
US9370444B2 (en) * 2010-10-12 2016-06-21 Emmett T. Cunningham, JR. Subconjunctival conformer device and uses thereof
US9668915B2 (en) 2010-11-24 2017-06-06 Dose Medical Corporation Drug eluting ocular implant
EP2517619B1 (en) 2011-04-27 2013-05-22 Istar Medical Improvements in or relating to glaucoma management and treatment
US10245178B1 (en) 2011-06-07 2019-04-02 Glaukos Corporation Anterior chamber drug-eluting ocular implant
US8657776B2 (en) 2011-06-14 2014-02-25 Ivantis, Inc. Ocular implants for delivery into the eye
WO2013011511A1 (en) 2011-07-18 2013-01-24 Mor Research Applications Ltd. A device for adjusting the intraocular pressure
EP4193907A1 (en) 2011-09-13 2023-06-14 Glaukos Corporation Intraocular physiological sensor
US8765210B2 (en) 2011-12-08 2014-07-01 Aquesys, Inc. Systems and methods for making gelatin shunts
US8663150B2 (en) 2011-12-19 2014-03-04 Ivantis, Inc. Delivering ocular implants into the eye
CA2868341C (en) 2012-03-26 2021-01-12 Glaukos Corporation System and method for delivering multiple ocular implants
US9358156B2 (en) 2012-04-18 2016-06-07 Invantis, Inc. Ocular implants for delivery into an anterior chamber of the eye
US10085633B2 (en) 2012-04-19 2018-10-02 Novartis Ag Direct visualization system for glaucoma treatment
US9241832B2 (en) 2012-04-24 2016-01-26 Transcend Medical, Inc. Delivery system for ocular implant
EP3228286A1 (en) 2012-09-17 2017-10-11 Novartis AG Expanding ocular impant devices
US9782293B2 (en) 2012-09-28 2017-10-10 Doci Innovations GmbH Implant for treating glaucoma
WO2014078288A1 (en) 2012-11-14 2014-05-22 Transcend Medical, Inc. Flow promoting ocular implant
DE102012221350A1 (en) 2012-11-22 2014-05-22 Universität Rostock Eye implant of eye implant arrangement for treating and monitoring glaucoma disease in eye, has pressure sensors that are provided in casing to detect intraocular pressure at eye, such that supply or disconnection of pump is effected
US10617558B2 (en) 2012-11-28 2020-04-14 Ivantis, Inc. Apparatus for delivering ocular implants into an anterior chamber of the eye
US9125723B2 (en) 2013-02-19 2015-09-08 Aquesys, Inc. Adjustable glaucoma implant
US10159600B2 (en) 2013-02-19 2018-12-25 Aquesys, Inc. Adjustable intraocular flow regulation
US9730638B2 (en) 2013-03-13 2017-08-15 Glaukos Corporation Intraocular physiological sensor
US10517759B2 (en) 2013-03-15 2019-12-31 Glaukos Corporation Glaucoma stent and methods thereof for glaucoma treatment
US9592151B2 (en) 2013-03-15 2017-03-14 Glaukos Corporation Systems and methods for delivering an ocular implant to the suprachoroidal space within an eye
US9987163B2 (en) 2013-04-16 2018-06-05 Novartis Ag Device for dispensing intraocular substances
US8967810B1 (en) * 2013-04-30 2015-03-03 Thomas C. Prager Methodology to identify the scleral spur
US20150342875A1 (en) 2014-05-29 2015-12-03 Dose Medical Corporation Implants with controlled drug delivery features and methods of using same
EP4242614A3 (en) 2014-07-01 2023-11-29 Injectsense, Inc. Hermetically sealed implant sensors with vertical stacking architecture
EP3164061A4 (en) 2014-07-01 2018-01-10 Injectsense, Inc. Methods and devices for implantation of intraocular pressure sensors
WO2016011056A1 (en) 2014-07-14 2016-01-21 Ivantis, Inc. Ocular implant delivery system and method
WO2016154066A2 (en) 2015-03-20 2016-09-29 Glaukos Corporation Gonioscopic devices
EP3313466A1 (en) 2015-06-24 2018-05-02 Healionics Corporation Injectable porous device for treatment of dry and wet age-related macular degeneration or diabetic retinopathy
EP4265231A3 (en) 2015-08-14 2023-12-20 Alcon Inc. Ocular implant with pressure sensor
WO2017040853A1 (en) 2015-09-02 2017-03-09 Glaukos Corporation Drug delivery implants with bi-directional delivery capacity
US11564833B2 (en) 2015-09-25 2023-01-31 Glaukos Corporation Punctal implants with controlled drug delivery features and methods of using same
CA3022830A1 (en) 2016-04-20 2017-10-26 Harold Alexander Heitzmann Bioresorbable ocular drug delivery device
US10603210B1 (en) 2017-02-02 2020-03-31 Mgd Innovations, Llc Meibomian gland probing with blood product injection
US10674906B2 (en) 2017-02-24 2020-06-09 Glaukos Corporation Gonioscopes
US11116625B2 (en) 2017-09-28 2021-09-14 Glaukos Corporation Apparatus and method for controlling placement of intraocular implants
WO2019068026A1 (en) 2017-09-29 2019-04-04 Glaukos Corporation Intraocular physiological sensor
AU2018346229A1 (en) 2017-10-06 2020-04-30 Glaukos Corporation Systems and methods for delivering multiple ocular implants
USD846738S1 (en) 2017-10-27 2019-04-23 Glaukos Corporation Implant delivery apparatus
DE102018203424A1 (en) * 2018-03-07 2019-09-12 Carl Zeiss Meditec Ag Shunt implant
JP2024503989A (en) 2021-01-11 2024-01-30 アルコン インコーポレイティド Systems and methods for viscoelastic delivery
CN115969312B (en) * 2023-03-22 2023-08-22 中国人民解放军总医院第一医学中心 Intraocular pressure monitoring device connected with glaucoma drainage valve

Family Cites Families (277)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2031754A (en) * 1932-11-04 1936-02-25 Ernest J Sweetland Extensible coupling
US3788327A (en) 1971-03-30 1974-01-29 H Donowitz Surgical implant device
US4037604A (en) 1976-01-05 1977-07-26 Newkirk John B Artifical biological drainage device
US4168697A (en) 1977-01-17 1979-09-25 Cantekin Erdem I Middle ear ventilating tube and method
US4113088A (en) 1977-06-06 1978-09-12 Binkhorst Richard D Sterile package
US4175563A (en) 1977-10-05 1979-11-27 Arenberg Irving K Biological drainage shunt
US4402681A (en) 1980-08-23 1983-09-06 Haas Joseph S Artificial implant valve for the regulation of intraocular pressure
US4366582A (en) * 1980-12-01 1983-01-04 Faulkner Gerald D Posterior chamber intraocular lens
NO147900C (en) 1981-03-12 1983-07-06 Finn Skjaerpe MICROSURGICAL INSTRUMENT.
US4428746A (en) 1981-07-29 1984-01-31 Antonio Mendez Glaucoma treatment device
US4468216A (en) 1982-05-20 1984-08-28 Rudolph Muto Irrigation suction catheter
US4554918A (en) 1982-07-28 1985-11-26 White Thomas C Ocular pressure relief device
JPS5985153A (en) * 1982-11-08 1984-05-17 Hitachi Ltd Redundancy controller
US4521210A (en) 1982-12-27 1985-06-04 Wong Vernon G Eye implant for relieving glaucoma, and device and method for use therewith
US4560383A (en) 1983-10-27 1985-12-24 Leiske Larry G Anterior chamber intraocular lens
US4634418A (en) 1984-04-06 1987-01-06 Binder Perry S Hydrogel seton
US4787885A (en) 1984-04-06 1988-11-29 Binder Perry S Hydrogel seton
US4604087A (en) 1985-02-26 1986-08-05 Joseph Neil H Aqueous humor drainage device
US4820626A (en) 1985-06-06 1989-04-11 Thomas Jefferson University Method of treating a synthetic or naturally occuring surface with microvascular endothelial cells, and the treated surface itself
US4632842A (en) 1985-06-20 1986-12-30 Atrium Medical Corporation Glow discharge process for producing implantable devices
US4718907A (en) 1985-06-20 1988-01-12 Atrium Medical Corporation Vascular prosthesis having fluorinated coating with varying F/C ratio
US4883864A (en) 1985-09-06 1989-11-28 Minnesota Mining And Manufacturing Company Modified collagen compound and method of preparation
US4733665C2 (en) 1985-11-07 2002-01-29 Expandable Grafts Partnership Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft
NZ215409A (en) 1986-03-07 1989-02-24 Anthony Christopher Be Molteno Implant for drainage of aqueous humour in glaucoma
CH670760A5 (en) 1986-06-02 1989-07-14 Sulzer Ag
US4722724A (en) 1986-06-23 1988-02-02 Stanley Schocket Anterior chamber tube shunt to an encircling band, and related surgical procedure
US4863457A (en) 1986-11-24 1989-09-05 Lee David A Drug delivery device
US4846793A (en) 1987-03-18 1989-07-11 Endocon, Inc. Injector for implanting multiple pellet medicaments
US4846172A (en) 1987-05-26 1989-07-11 Berlin Michael S Laser-delivery eye-treatment method
US4900300A (en) 1987-07-06 1990-02-13 Lee David A Surgical instrument
US4886488A (en) 1987-08-06 1989-12-12 White Thomas C Glaucoma drainage the lacrimal system and method
AU2308988A (en) 1987-08-06 1989-03-01 Thomas C. White Glaucoma drainage in the lacrimal system
US4870953A (en) 1987-11-13 1989-10-03 Donmicheal T Anthony Intravascular ultrasonic catheter/probe and method for treating intravascular blockage
US4853224A (en) 1987-12-22 1989-08-01 Visionex Biodegradable ocular implants
US4997652A (en) * 1987-12-22 1991-03-05 Visionex Biodegradable ocular implants
US4936825A (en) 1988-04-11 1990-06-26 Ungerleider Bruce A Method for reducing intraocular pressure caused by glaucoma
CA1334168C (en) * 1988-04-26 1995-01-31 Louis M. De Santis Antiglaucoma compositions containing combinations of .alpha.-2 agonists and .beta. blockers
US5005577A (en) 1988-08-23 1991-04-09 Frenkel Ronald E P Intraocular lens pressure monitoring device
US5785674A (en) 1988-10-07 1998-07-28 Mateen; Ahmed Abdul Device and method for treating glaucoma
US5681275A (en) 1988-10-07 1997-10-28 Ahmed; Abdul Mateen Ophthalmological device with adaptable multiple distribution plates
US5098443A (en) * 1989-03-23 1992-03-24 University Of Miami Method of implanting intraocular and intraorbital implantable devices for the controlled release of pharmacological agents
FR2651668B1 (en) 1989-09-12 1991-12-27 Leon Claude MICROSCOPE-ENDOSCOPE ASSEMBLY USEFUL IN PARTICULAR IN SURGERY.
US4946436A (en) 1989-11-17 1990-08-07 Smith Stewart G Pressure-relieving device and process for implanting
USRE35390E (en) 1989-11-17 1996-12-03 Smith; Stewart G. Pressure relieving device and process for implanting
US5164188A (en) 1989-11-22 1992-11-17 Visionex, Inc. Biodegradable ocular implants
US4968296A (en) 1989-12-20 1990-11-06 Robert Ritch Transscleral drainage implant device for the treatment of glaucoma
US5092837A (en) 1989-12-20 1992-03-03 Robert Ritch Method for the treatment of glaucoma
US5073163A (en) 1990-01-29 1991-12-17 Lippman Myron E Apparatus for treating glaucoma
US5180362A (en) 1990-04-03 1993-01-19 Worst J G F Gonio seton
US5129895A (en) 1990-05-16 1992-07-14 Sunrise Technologies, Inc. Laser sclerostomy procedure
US5041081A (en) 1990-05-18 1991-08-20 Odrich Ronald B Ocular implant for controlling glaucoma
US5127901A (en) 1990-05-18 1992-07-07 Odrich Ronald B Implant with subconjunctival arch
US5397300A (en) 1990-05-31 1995-03-14 Iovision, Inc. Glaucoma implant
US5178604A (en) 1990-05-31 1993-01-12 Iovision, Inc. Glaucoma implant
US5476445A (en) 1990-05-31 1995-12-19 Iovision, Inc. Glaucoma implant with a temporary flow restricting seal
US5725529A (en) * 1990-09-25 1998-03-10 Innovasive Devices, Inc. Bone fastener
US5454796A (en) 1991-04-09 1995-10-03 Hood Laboratories Device and method for controlling intraocular fluid pressure
US5312394A (en) 1991-04-29 1994-05-17 Hugh Beckman Apparatus and method for surgically performing a filtering operation on an eye for glaucoma
US5246451A (en) 1991-04-30 1993-09-21 Medtronic, Inc. Vascular prosthesis and method
US6007511A (en) 1991-05-08 1999-12-28 Prywes; Arnold S. Shunt valve and therapeutic delivery system for treatment of glaucoma and methods and apparatus for its installation
US5300020A (en) 1991-05-31 1994-04-05 Medflex Corporation Surgically implantable device for glaucoma relief
US5171213A (en) 1991-08-14 1992-12-15 Price Jr Francis W Technique for fistulization of the eye and an eye filtration prosthesis useful therefor
EP0601055B1 (en) 1991-08-16 2000-06-07 GALIN, Miles A. Medicament coated refractive anterior chamber ocular implant
US5500013A (en) 1991-10-04 1996-03-19 Scimed Life Systems, Inc. Biodegradable drug delivery vascular stent
GB2260585A (en) 1991-10-09 1993-04-21 Avdel Systems Ltd Self-plugging blind rivet
US5360399A (en) 1992-01-10 1994-11-01 Robert Stegmann Method and apparatus for maintaining the normal intraocular pressure
US5207685A (en) * 1992-02-11 1993-05-04 Cinberg James Z Tympanic ventilation tube and related technique
US5334137A (en) 1992-02-21 1994-08-02 Eagle Vision, Inc. Lacrimal fluid control device
US5346464A (en) 1992-03-10 1994-09-13 Camras Carl B Method and apparatus for reducing intraocular pressure
US5663205A (en) 1992-05-22 1997-09-02 Senju Pharmaceutical Co. Ltd. Pharmaceutical composition for use in glaucoma treatment
US5370641A (en) 1992-05-22 1994-12-06 O'donnell, Jr.; Francis E. Laser trabeculodissection
US5629008A (en) 1992-06-02 1997-05-13 C.R. Bard, Inc. Method and device for long-term delivery of drugs
DE4219299C2 (en) 1992-06-12 1994-03-24 Leica Mikroskopie & Syst microscope
US5767079A (en) 1992-07-08 1998-06-16 Celtrix Pharmaceuticals, Inc. Method of treating ophthalmic disorders using TGF -β
US6197056B1 (en) 1992-07-15 2001-03-06 Ras Holding Corp. Segmented scleral band for treatment of presbyopia and other eye disorders
US5290295A (en) 1992-07-15 1994-03-01 Querals & Fine, Inc. Insertion tool for an intraluminal graft procedure
US5318513A (en) 1992-09-24 1994-06-07 Leib Martin L Canalicular balloon fixation stent
US5370607A (en) 1992-10-28 1994-12-06 Annuit Coeptis, Inc. Glaucoma implant device and method for implanting same
WO1994013234A1 (en) 1992-12-17 1994-06-23 Michael Andrew Coote Implant device and method for treatment of glaucoma
US5338291A (en) 1993-02-03 1994-08-16 Pudenz-Schulte Medical Research Corporation Glaucoma shunt and method for draining aqueous humor
SG49754A1 (en) 1993-03-16 1998-06-15 Photogenesis Inc Method for preparation and transplantation of volute grafts and surgical instrument therefor
US5342370A (en) 1993-03-19 1994-08-30 University Of Miami Method and apparatus for implanting an artifical meshwork in glaucoma surgery
IL105828A (en) 1993-05-28 1999-06-20 Medinol Ltd Medical stent
US5731294A (en) 1993-07-27 1998-03-24 Hybridon, Inc. Inhibition of neovasularization using VEGF-specific oligonucleotides
US6184250B1 (en) * 1993-08-03 2001-02-06 Alcon Laboratories, Inc. Use of cloprostenol and fluprostenol analogues to treat glaucoma and ocular hypertension
US5735892A (en) 1993-08-18 1998-04-07 W. L. Gore & Associates, Inc. Intraluminal stent graft
FR2710269A1 (en) 1993-09-22 1995-03-31 Voir Vivre Implantable device for the treatment of edemas.
FI934513A (en) 1993-10-13 1995-04-14 Leiras Oy Anordning Foer injection with implant
US5639278A (en) 1993-10-21 1997-06-17 Corvita Corporation Expandable supportive bifurcated endoluminal grafts
US5443505A (en) 1993-11-15 1995-08-22 Oculex Pharmaceuticals, Inc. Biocompatible ocular implants
US5743868A (en) 1994-02-14 1998-04-28 Brown; Reay H. Corneal pressure-regulating implant device
US5516522A (en) 1994-03-14 1996-05-14 Board Of Supervisors Of Louisiana State University Biodegradable porous device for long-term drug delivery with constant rate release and method of making the same
US6165210A (en) 1994-04-01 2000-12-26 Gore Enterprise Holdings, Inc. Self-expandable helical intravascular stent and stent-graft
AU704591B2 (en) 1994-04-04 1999-04-29 William R. Freeman Use of phosphonylmethoxyalkyl nucleosides for the treatment of raised intraocular pressure
US5716394A (en) 1994-04-29 1998-02-10 W. L. Gore & Associates, Inc. Blood contact surfaces using extracellular matrix synthesized in vitro
IL109499A (en) 1994-05-02 1998-01-04 Univ Ramot Implant device for draining excess intraocular fluid
FR2721499B1 (en) 1994-06-22 1997-01-03 Opsia Trabeculectomy implant.
US6177427B1 (en) * 1994-06-28 2001-01-23 Alcon Laboratories, Inc. Treatment of glaucoma and ocular hypertension
US6102045A (en) 1994-07-22 2000-08-15 Premier Laser Systems, Inc. Method and apparatus for lowering the intraocular pressure of an eye
US5520631A (en) 1994-07-22 1996-05-28 Wound Healing Of Oklahoma Method and apparatus for lowering the intraocular pressure of an eye
US5704907A (en) 1994-07-22 1998-01-06 Wound Healing Of Oklahoma Method and apparatus for lowering the intraocular pressure of an eye
US5599534A (en) * 1994-08-09 1997-02-04 University Of Nebraska Reversible gel-forming composition for sustained delivery of bio-affecting substances, and method of use
US5665114A (en) 1994-08-12 1997-09-09 Meadox Medicals, Inc. Tubular expanded polytetrafluoroethylene implantable prostheses
SE9402816D0 (en) 1994-08-24 1994-08-24 Pharmacia Ab Method and meams for drug administration
DE4433104C1 (en) 1994-09-16 1996-05-02 Fraunhofer Ges Forschung Device for measuring mechanical properties of biological tissue
US5702419A (en) 1994-09-21 1997-12-30 Wake Forest University Expandable, intraluminal stents
US6063396A (en) 1994-10-26 2000-05-16 Houston Biotechnology Incorporated Methods and compositions for the modulation of cell proliferation and wound healing
US6063116A (en) 1994-10-26 2000-05-16 Medarex, Inc. Modulation of cell proliferation and wound healing
US5643321A (en) 1994-11-10 1997-07-01 Innovasive Devices Suture anchor assembly and methods
JP3642812B2 (en) 1994-11-17 2005-04-27 株式会社町田製作所 Medical observation device
US5601094A (en) 1994-11-22 1997-02-11 Reiss; George R. Ophthalmic shunt
US5602143A (en) 1994-12-08 1997-02-11 Allergan Method for reducing intraocular pressure in the mammalian eye by administration of guanylate cyclase inhibitors
US6228873B1 (en) 1994-12-09 2001-05-08 The Regents Of The University Of California Method for enhancing outflow of aqueous humor in treatment of glaucoma
US5725493A (en) 1994-12-12 1998-03-10 Avery; Robert Logan Intravitreal medicine delivery
US5433701A (en) 1994-12-21 1995-07-18 Rubinstein; Mark H. Apparatus for reducing ocular pressure
US5891084A (en) * 1994-12-27 1999-04-06 Lee; Vincent W. Multiple chamber catheter delivery system
US5558630A (en) 1994-12-30 1996-09-24 Fisher; Bret L. Intrascleral implant and method for the regulation of intraocular pressure
GB2296663A (en) 1995-01-03 1996-07-10 Ahmed Salih Mahmud Drainage device for alleviating excess ophthalmic fluid pressure
WO1996020742A1 (en) 1995-01-06 1996-07-11 Wong Vernon G Improve eye implant for relief of glaucoma
JPH10513455A (en) 1995-02-10 1998-12-22 ザ ユニバーシティ オブ トロント イノベーションズ ファウンデーション Deprenyl compounds for the treatment of glaucoma
US6059772A (en) 1995-03-10 2000-05-09 Candela Corporation Apparatus and method for treating glaucoma using a gonioscopic laser trabecular ablation procedure
BE1009278A3 (en) 1995-04-12 1997-01-07 Corvita Europ Guardian self-expandable medical device introduced in cavite body, and medical device with a stake as.
US5626558A (en) 1995-05-05 1997-05-06 Suson; John Adjustable flow rate glaucoma shunt and method of using same
US5968058A (en) 1996-03-27 1999-10-19 Optonol Ltd. Device for and method of implanting an intraocular implant
CN1283324C (en) 1995-05-14 2006-11-08 奥普通诺尔有限公司 Intraocular implant, delivery device, and method of implantation
IL113723A (en) 1995-05-14 2002-11-10 Optonol Ltd Intraocular implant
WO1996037167A1 (en) 1995-05-25 1996-11-28 Raychem Corporation Stent assembly
US5723005A (en) 1995-06-07 1998-03-03 Herrick Family Limited Partnership Punctum plug having a collapsible flared section and method
AU5776696A (en) 1995-06-08 1997-01-09 Bard Galway Limited Bifurcated endovascular stent
US6194415B1 (en) * 1995-06-28 2001-02-27 Allergan Sales, Inc. Method of using (2-imidazolin-2-ylamino) quinoxoalines in treating neural injury
US5934285A (en) 1995-07-27 1999-08-10 Michiel S. Kritzinger Method for reducing irregular astigmatism and debris/epithelium in the interface during lamellar corneal flap/cap surgery
US5766243A (en) 1995-08-21 1998-06-16 Oasis Medical, Inc. Abrasive polished canalicular implant
US6099558A (en) 1995-10-10 2000-08-08 Edwards Lifesciences Corp. Intraluminal grafting of a bifuricated artery
US5547993A (en) 1995-10-24 1996-08-20 Mitsubishi Chemical Corporation Therapeutic agent for glaucoma
US5836939A (en) 1995-10-25 1998-11-17 Plc Medical Systems, Inc. Surgical laser handpiece
US5651783A (en) 1995-12-20 1997-07-29 Reynard; Michael Fiber optic sleeve for surgical instruments
AU1201297A (en) 1995-12-21 1997-07-17 Pharmacia & Upjohn Ab Ophthalmic treatment
US5798380A (en) 1996-02-21 1998-08-25 Wisconsin Alumni Research Foundation Cytoskeletal active agents for glaucoma therapy
US6299895B1 (en) 1997-03-24 2001-10-09 Neurotech S.A. Device and method for treating ophthalmic diseases
US5807302A (en) 1996-04-01 1998-09-15 Wandel; Thaddeus Treatment of glaucoma
US6629981B2 (en) 2000-07-06 2003-10-07 Endocare, Inc. Stent delivery system
US5830179A (en) 1996-04-09 1998-11-03 Endocare, Inc. Urological stent therapy system and method
US5865831A (en) 1996-04-17 1999-02-02 Premier Laser Systems, Inc. Laser surgical procedures for treatment of glaucoma
US5932299A (en) 1996-04-23 1999-08-03 Katoot; Mohammad W. Method for modifying the surface of an object
US6530896B1 (en) * 1996-05-13 2003-03-11 James B. Elliott Apparatus and method for introducing an implant
US5670161A (en) 1996-05-28 1997-09-23 Healy; Kevin E. Biodegradable stent
US5681323A (en) 1996-07-15 1997-10-28 Arick; Daniel S. Emergency cricothyrotomy tube insertion
US6544193B2 (en) 1996-09-04 2003-04-08 Marcio Marc Abreu Noninvasive measurement of chemical substances
US5830139A (en) 1996-09-04 1998-11-03 Abreu; Marcio M. Tonometer system for measuring intraocular pressure by applanation and/or indentation
US6120460A (en) 1996-09-04 2000-09-19 Abreu; Marcio Marc Method and apparatus for signal acquisition, processing and transmission for evaluation of bodily functions
US5886822A (en) 1996-10-08 1999-03-23 The Microoptical Corporation Image combining system for eyeglasses and face masks
US6007510A (en) 1996-10-25 1999-12-28 Anamed, Inc. Implantable devices and methods for controlling the flow of fluids within the body
US5925342A (en) 1996-11-13 1999-07-20 Allergan Method for reducing intraocular pressure in the mammalian eye by administration of potassium channel blockers
AUPO394496A0 (en) 1996-11-29 1997-01-02 Lions Eye Institute Biological microfistula tube and implantation method and apparatus
US6261256B1 (en) 1996-12-20 2001-07-17 Abdul Mateen Ahmed Pocket medical valve & method
US5713844A (en) 1997-01-10 1998-02-03 Peyman; Gholam A. Device and method for regulating intraocular pressure
GB9700390D0 (en) 1997-01-10 1997-02-26 Biocompatibles Ltd Device for use in the eye
US6780165B2 (en) 1997-01-22 2004-08-24 Advanced Medical Optics Micro-burst ultrasonic power delivery
DE19705815C2 (en) 1997-02-15 1999-02-11 Heidelberg Engineering Optisch Medical device for microsurgery on the eye
FR2759577B1 (en) 1997-02-17 1999-08-06 Corneal Ind DEEP SCLERECTOMY IMPLANT
US6071286A (en) 1997-02-19 2000-06-06 Mawad; Michel E. Combination angioplasty balloon/stent deployment device
US5893837A (en) 1997-02-28 1999-04-13 Staar Surgical Company, Inc. Glaucoma drain implanting device and method
US6059812A (en) 1997-03-21 2000-05-09 Schneider (Usa) Inc. Self-expanding medical device for centering radioactive treatment sources in body vessels
JP3827429B2 (en) 1997-04-03 2006-09-27 オリンパス株式会社 Surgical microscope
US5882327A (en) 1997-04-17 1999-03-16 Jacob; Jean T. Long-term glaucoma drainage implant
US6033418A (en) * 1997-04-25 2000-03-07 New Jersey Institute Of Technology Method and device for corneal shaping and refractive correction
US6050970A (en) 1997-05-08 2000-04-18 Pharmacia & Upjohn Company Method and apparatus for inserting a glaucoma implant in an anterior and posterior segment of the eye
DE19728069C1 (en) 1997-07-01 1999-02-11 Acritec Gmbh Device for measuring intraocular pressure
US5752928A (en) 1997-07-14 1998-05-19 Rdo Medical, Inc. Glaucoma pressure regulator
US5980928A (en) 1997-07-29 1999-11-09 Terry; Paul B. Implant for preventing conjunctivitis in cattle
US5830171A (en) 1997-08-12 1998-11-03 Odyssey Medical, Inc. Punctal occluder
EP0898947A3 (en) 1997-08-15 1999-09-08 GRIESHABER & CO. AG SCHAFFHAUSEN Method and apparatus to improve the outflow of the aqueous humor of an eye
US6004302A (en) 1997-08-28 1999-12-21 Brierley; Lawrence A. Cannula
US6274138B1 (en) 1997-09-03 2001-08-14 Incyte Genomics, Inc. Human mitochondrial malate dehydrogenase
US6159458A (en) 1997-11-04 2000-12-12 Insite Vision Sustained release ophthalmic compositions containing water soluble medicaments
US6203513B1 (en) 1997-11-20 2001-03-20 Optonol Ltd. Flow regulating implant, method of manufacture, and delivery device
US8313454B2 (en) 1997-11-20 2012-11-20 Optonol Ltd. Fluid drainage device, delivery device, and associated methods of use and manufacture
EP1039847A1 (en) 1997-12-15 2000-10-04 Prolifix Medical, Inc. Vascular stent for reduction of restenosis
US6050999A (en) * 1997-12-18 2000-04-18 Keravision, Inc. Corneal implant introducer and method of use
US6168575B1 (en) 1998-01-29 2001-01-02 David Pyam Soltanpour Method and apparatus for controlling intraocular pressure
EP1071414A1 (en) 1998-04-24 2001-01-31 Mitokor Compounds and methods for treating mitochondria-associated diseases
US6231853B1 (en) 1998-06-01 2001-05-15 Incyte Pharmaceuticals, Inc. Human glutathione peroxidase-6
US6077299A (en) 1998-06-22 2000-06-20 Eyetronic, Llc Non-invasively adjustable valve implant for the drainage of aqueous humor in glaucoma
US6378526B1 (en) * 1998-08-03 2002-04-30 Insite Vision, Incorporated Methods of ophthalmic administration
DE19840047B4 (en) 1998-09-02 2004-07-08 Neuhann, Thomas, Prof.Dr.med. Device for the targeted improvement and / or permanent guarantee of the permeability for eye chamber water through the trabecular mechanism in the Schlemm's Canal
KR100300527B1 (en) 1998-09-03 2001-10-27 윤덕용 Remote pressure monitoring device of sealed type and manufacture method for the same
US6241721B1 (en) 1998-10-09 2001-06-05 Colette Cozean Laser surgical procedures for treatment of glaucoma
US6254612B1 (en) 1998-10-22 2001-07-03 Cordis Neurovascular, Inc. Hydraulic stent deployment system
US6370641B1 (en) * 1999-01-26 2002-04-09 Dell Usa, L.P. Method and apparatus for determining the drive letter assignment of a CD-ROM drive during initial system setup of a computer system
US6348042B1 (en) * 1999-02-02 2002-02-19 W. Lee Warren, Jr. Bioactive shunt
US6193656B1 (en) 1999-02-08 2001-02-27 Robert E. Jeffries Intraocular pressure monitoring/measuring apparatus and method
US6231597B1 (en) 1999-02-16 2001-05-15 Mark E. Deem Apparatus and methods for selectively stenting a portion of a vessel wall
US6217895B1 (en) * 1999-03-22 2001-04-17 Control Delivery Systems Method for treating and/or preventing retinal diseases with sustained release corticosteroids
US20050119601A9 (en) * 1999-04-26 2005-06-02 Lynch Mary G. Shunt device and method for treating glaucoma
BR0010055A (en) 1999-04-26 2002-04-09 Gmp Vision Solutions Inc Bypass device and use thereof
US6342058B1 (en) 1999-05-14 2002-01-29 Valdemar Portney Iris fixated intraocular lens and instrument for attaching same to an iris
US6558342B1 (en) 1999-06-02 2003-05-06 Optonol Ltd. Flow control device, introducer and method of implanting
US6306120B1 (en) 1999-06-07 2001-10-23 Ben Gee Tan Applicator and method for delivery of mitomycin to eye tissues during glaucoma filtering surgery
US6201001B1 (en) * 1999-08-02 2001-03-13 Abbott Laboratories Imidazole antiproliferative agents
US7033603B2 (en) * 1999-08-06 2006-04-25 Board Of Regents The University Of Texas Drug releasing biodegradable fiber for delivery of therapeutics
US6596296B1 (en) 1999-08-06 2003-07-22 Board Of Regents, The University Of Texas System Drug releasing biodegradable fiber implant
US6187016B1 (en) 1999-09-14 2001-02-13 Daniel G. Hedges Stent retrieval device
DE19945879C2 (en) 1999-09-24 2002-01-03 Acritec Gmbh Device for measuring the intraocular pressure with a foldable implant
ATE283013T1 (en) 1999-10-21 2004-12-15 Alcon Inc MEDICATION DELIVERY DEVICE
US6416777B1 (en) 1999-10-21 2002-07-09 Alcon Universal Ltd. Ophthalmic drug delivery device
US6331313B1 (en) 1999-10-22 2001-12-18 Oculex Pharmaceticals, Inc. Controlled-release biocompatible ocular drug delivery implant devices and methods
US6579235B1 (en) * 1999-11-01 2003-06-17 The Johns Hopkins University Method for monitoring intraocular pressure using a passive intraocular pressure sensor and patient worn monitoring recorder
US6287313B1 (en) 1999-11-23 2001-09-11 Sdgi Holdings, Inc. Screw delivery system and method
DE29920949U1 (en) 1999-11-29 2000-04-27 Bugge Mogens Suction tube for surgical purposes
US20020072673A1 (en) 1999-12-10 2002-06-13 Yamamoto Ronald K. Treatment of ocular disease
US6939299B1 (en) 1999-12-13 2005-09-06 Kurt Petersen Implantable continuous intraocular pressure sensor
US6450937B1 (en) 1999-12-17 2002-09-17 C. R. Bard, Inc. Needle for implanting brachytherapy seeds
US6726676B2 (en) 2000-01-05 2004-04-27 Grieshaber & Co. Ag Schaffhausen Method of and device for improving the flow of aqueous humor within the eye
PL362931A1 (en) 2000-01-12 2004-11-02 Becton, Dickinson And Company Systems and methods for reducing intraocular pressure
US20050119737A1 (en) 2000-01-12 2005-06-02 Bene Eric A. Ocular implant and methods for making and using same
US6589203B1 (en) 2000-01-26 2003-07-08 Peter Mitrev Glaucoma drainage device implant
US6375642B1 (en) 2000-02-15 2002-04-23 Grieshaber & Co. Ag Schaffhausen Method of and device for improving a drainage of aqueous humor within the eye
US6471666B1 (en) 2000-02-24 2002-10-29 Steven A. Odrich Injectable glaucoma device
US6638239B1 (en) 2000-04-14 2003-10-28 Glaukos Corporation Apparatus and method for treating glaucoma
US20040111050A1 (en) 2000-04-14 2004-06-10 Gregory Smedley Implantable ocular pump to reduce intraocular pressure
US20020143284A1 (en) 2001-04-03 2002-10-03 Hosheng Tu Drug-releasing trabecular implant for glaucoma treatment
US7135009B2 (en) 2001-04-07 2006-11-14 Glaukos Corporation Glaucoma stent and methods thereof for glaucoma treatment
US20030060752A1 (en) 2000-04-14 2003-03-27 Olav Bergheim Glaucoma device and methods thereof
US7708711B2 (en) 2000-04-14 2010-05-04 Glaukos Corporation Ocular implant with therapeutic agents and methods thereof
US20050049578A1 (en) * 2000-04-14 2005-03-03 Hosheng Tu Implantable ocular pump to reduce intraocular pressure
US7867186B2 (en) 2002-04-08 2011-01-11 Glaukos Corporation Devices and methods for treatment of ocular disorders
US6533768B1 (en) 2000-04-14 2003-03-18 The Regents Of The University Of California Device for glaucoma treatment and methods thereof
AU2001259085A1 (en) * 2000-04-17 2001-10-30 Childrens Hospital Research Foundation Treatment of ocular neovascularization and related diseases
CA2446143C (en) * 2000-05-19 2010-01-19 Michael S. Berlin Delivery system and method of use for the eye
US6582453B1 (en) 2000-07-14 2003-06-24 Opus Medical, Inc. Method and apparatus for attaching connective tissues to bone using a suture anchoring device
US6749568B2 (en) 2000-08-21 2004-06-15 Cleveland Clinic Foundation Intraocular pressure measurement system including a sensor mounted in a contact lens
US6699211B2 (en) 2000-08-22 2004-03-02 James A. Savage Method and apparatus for treatment of glaucoma
US6428501B1 (en) 2000-09-19 2002-08-06 K2 Limited Partnership U/A/D Surgical instrument sleeve
US6730056B1 (en) 2000-09-21 2004-05-04 Motorola, Inc. Eye implant for treating glaucoma and method for manufacturing same
US6595945B2 (en) 2001-01-09 2003-07-22 J. David Brown Glaucoma treatment device and method
WO2002058551A2 (en) 2001-01-22 2002-08-01 Integrated Sensing Systems, Inc. Wireless mems capacitive sensor for physiologic parameter measurement
JP2004525695A (en) 2001-03-16 2004-08-26 グローコス コーポレーション Applicator and method for positioning trabecular shunt for glaucoma treatment
US6981958B1 (en) 2001-05-02 2006-01-03 Glaukos Corporation Implant with pressure sensor for glaucoma treatment
US6666841B2 (en) 2001-05-02 2003-12-23 Glaukos Corporation Bifurcatable trabecular shunt for glaucoma treatment
US7431710B2 (en) * 2002-04-08 2008-10-07 Glaukos Corporation Ocular implants with anchors and methods thereof
AU2002305400A1 (en) 2001-05-03 2002-11-18 Glaukos Corporation Medical device and methods of use for glaucoma treatment
CA2457137A1 (en) 2001-08-16 2003-02-27 Gmp Vision Solutions, Inc. Improved shunt device and method for treating glaucoma
US7331984B2 (en) 2001-08-28 2008-02-19 Glaukos Corporation Glaucoma stent for treating glaucoma and methods of use
US20030097151A1 (en) 2001-10-25 2003-05-22 Smedley Gregory T. Apparatus and mitochondrial treatment for glaucoma
US7163543B2 (en) 2001-11-08 2007-01-16 Glaukos Corporation Combined treatment for cataract and glaucoma treatment
US20030093084A1 (en) 2001-11-13 2003-05-15 Optonol Ltd. Delivery devices for flow regulating implants
WO2003073968A2 (en) 2002-02-28 2003-09-12 Gmp Vision Solutions, Inc. Device and method for monitoring aqueous flow within the eye
US7186232B1 (en) 2002-03-07 2007-03-06 Glaukoa Corporation Fluid infusion methods for glaucoma treatment
US20030229303A1 (en) 2002-03-22 2003-12-11 Haffner David S. Expandable glaucoma implant and methods of use
US20040024345A1 (en) 2002-04-19 2004-02-05 Morteza Gharib Glaucoma implant with valveless flow bias
US20050159660A1 (en) 2002-05-31 2005-07-21 Valentino Montegrande Intraocular pressure sensor
US20070123767A1 (en) 2002-05-31 2007-05-31 Valentino Montegrande Intraocular pressure sensor and method of use
US20030236483A1 (en) 2002-06-25 2003-12-25 Ren David H Dual drainage ocular shunt for glaucoma
CN100591372C (en) 2002-07-19 2010-02-24 耶鲁大学 Uveoscleral drainage device
US6890300B2 (en) 2002-08-27 2005-05-10 Board Of Trustees Of Michigan State University Implantable microscale pressure sensor system for pressure monitoring and management
US7615010B1 (en) 2002-10-03 2009-11-10 Integrated Sensing Systems, Inc. System for monitoring the physiologic parameters of patients with congestive heart failure
US7131945B2 (en) 2002-10-16 2006-11-07 California Institute Of Technology Optically powered and optically data-transmitting wireless intraocular pressure sensor device
USD490152S1 (en) 2003-02-28 2004-05-18 Glaukos Corporation Surgical handpiece
US20040225250A1 (en) 2003-05-05 2004-11-11 Michael Yablonski Internal shunt and method for treating glaucoma
CA2529495C (en) 2003-06-16 2013-02-05 Solx, Inc. Shunt for the treatment of glaucoma
US20060069340A1 (en) * 2003-06-16 2006-03-30 Solx, Inc. Shunt for the treatment of glaucoma
US7291125B2 (en) 2003-11-14 2007-11-06 Transcend Medical, Inc. Ocular pressure regulation
CA2536188A1 (en) * 2003-11-20 2005-06-09 Angiotech International Ag Electrical devices and anti-scarring agents
US20090043321A1 (en) * 2004-04-29 2009-02-12 Iscience Interventional Corporation Apparatus And Method For Surgical Enhancement Of Aqueous Humor Drainage
US20080058704A1 (en) * 2004-04-29 2008-03-06 Michael Hee Apparatus and Method for Ocular Treatment
US20100173866A1 (en) 2004-04-29 2010-07-08 Iscience Interventional Corporation Apparatus and method for ocular treatment
US7252006B2 (en) 2004-06-07 2007-08-07 California Institute Of Technology Implantable mechanical pressure sensor and method of manufacturing the same
US9084662B2 (en) 2006-01-17 2015-07-21 Transcend Medical, Inc. Drug delivery treatment device
ES2762239T3 (en) 2006-01-17 2020-05-22 Alcon Inc Glaucoma treatment device
US20070202186A1 (en) 2006-02-22 2007-08-30 Iscience Interventional Corporation Apparatus and formulations for suprachoroidal drug delivery
WO2007121485A2 (en) * 2006-04-18 2007-10-25 Cascade Ophthalmics Intraocular pressure attenuation device
US9381301B2 (en) 2006-04-26 2016-07-05 Eastern Virginia Medical School Systems and methods for monitoring and controlling internal pressure of an eye or body part
WO2008154502A1 (en) 2007-06-07 2008-12-18 Yale University Uveoscleral drainage device
EP2173289A4 (en) 2007-07-17 2010-11-24 Transcend Medical Inc Ocular implant with hydrogel expansion capabilities
WO2009026499A1 (en) * 2007-08-23 2009-02-26 Purdue Research Foundation Intra-occular pressure sensor
US20100152565A1 (en) 2008-07-15 2010-06-17 Thomas Gordon A Non-invasive tonometer
US20100161004A1 (en) 2008-12-22 2010-06-24 Integrated Sensing Systems, Inc. Wireless dynamic power control of an implantable sensing device and methods therefor

Also Published As

Publication number Publication date
US20050119636A1 (en) 2005-06-02
AU2005289837A1 (en) 2006-04-06
WO2006036715A3 (en) 2007-06-07
US7678065B2 (en) 2010-03-16
US20100106073A1 (en) 2010-04-29
WO2006036715A2 (en) 2006-04-06
AU2005289837A2 (en) 2006-04-06
US20120259195A1 (en) 2012-10-11
US8142364B2 (en) 2012-03-27

Similar Documents

Publication Publication Date Title
US7678065B2 (en) Implant with intraocular pressure sensor for glaucoma treatment
US6981958B1 (en) Implant with pressure sensor for glaucoma treatment
US6666841B2 (en) Bifurcatable trabecular shunt for glaucoma treatment
US20210154449A1 (en) Ocular implant delivery system and methods thereof
US7488303B1 (en) Ocular implant with anchor and multiple openings
US20070282244A1 (en) Glaucoma implant with anchor
US20030060752A1 (en) Glaucoma device and methods thereof
AU2002258754A1 (en) Glaucoma stent and methods thereof for glaucoma treatment
WO2002036052A1 (en) Glaucoma treatment device
WO2002102274A2 (en) Glaucoma device and methods thereof
CA2718294A1 (en) Non-linear delivery device and ocular implant for lowering intraocular pressure

Legal Events

Date Code Title Description
FZDE Discontinued