# US 11,076,992 B2 · Methods of transverse placement in ELT

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- Number: US 11,076,992 B2
- Document ID: US11076992B2
- Status: Granted
- Kind: B2
- Application number: 16/389,460
- Filed: 2019-04-19
- Published: 2020-10-22
- Granted: 2021-08-03
- Earliest claimed: 2019-04-19
- Assignees: ELT Sight, Inc.
- Applicants: Elt Sight, Inc.
- Inventors: Johannes Junger; Markus Enders
- Web page: https://patentgrep.com/patent/US11076992B2

## CPC

- A61F 9/00802: {for photoablation}
- A61F 2009/00868: {Ciliary muscles or trabecular meshwork}
- A61F 2009/00891: {Glaucoma}
- A61F: FILTERS 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 (dental prosthetics A61C)

## Abstract

Glaucoma patients suffer from increased intraocular pressure due to blocked fluid flow from the anterior chamber of the eye. Methods of the invention include inserting a probe into an eye of a subject having glaucoma, adjusting placement of the probe to a position transverse to Schlemm's canal in the eye, and applying a plurality of shots from an excimer laser source while the probe is in the transverse position, thereby treating glaucoma by creating a plurality of perforations in Schlemm's canal and/or the trabecular meshwork. By providing a laser probe at a position transverse to Schlemm's canal, energy from the laser is delivered to a greater amount of surface area than if the laser was arranged in a parallel or perpendicular position to Schlemm's canal, resulting in optimal formation of perforations. The perforations allow for drainage of fluid and increased outflow of aqueous humor in the eye.

## Claims

### Claim 1

A method of delivering laser energy to a surface of a trabecular meshwork of an eye to treat glaucoma comprising:
inserting a probe into an eye of a subject having glaucoma;
adjusting placement of the probe to a position transverse to Schlemm's canal in the eye; and
creating a plurality of perforations having transverse placement in the trabecular meshwork relative to the Schlemm's canal of the eye by applying a plurality of shots from an excimer laser source, wherein the plurality of perforations are created in the trabecular meshwork in order to treat the glaucoma.

### Claim 2 (depends on 1)

The method of claim 1, wherein a light source aids in adjusting placement of the probe.

### Claim 3 (depends on 2)

The method of claim 2, wherein the light source is a Gonio lens, endoscope, or other illumination source.

### Claim 4 (depends on 1)

The method of claim 1, wherein the plurality of shots comprises 10 shots per eye.

### Claim 5 (depends on 1)

The method of claim 1, wherein the plurality of shots comprises greater than 10 shots per eye.

### Claim 6 (depends on 1)

The method of claim 1, wherein each perforation has a diameter of 200 μm.

### Claim 7 (depends on 1)

The method of claim 1, wherein the probe is inserted into an incision in the eye.

### Claim 8 (depends on 7)

The method of claim 7, wherein the incision has a length of about ⅛ inch or smaller.

### Claim 9 (depends on 1)

The method of claim 1, further comprising administering anesthesia to the subject before inserting the probe.

### Claim 10 (depends on 1)

The method of claim 1, further comprising analyzing effectiveness of the shot by visualizing drainage of aqueous humor and bloody reflux.

### Claim 11 (depends on 1)

The method of claim 1, wherein the probe is a fiber probe.

### Claim 12 (depends on 11)

The method of claim 11, wherein a delivery tip of the fiber probe comprises an optical fiber jacketed in a metal.

### Claim 13 (depends on 12)

The method of claim 12, wherein the metal is stainless steel.

### Claim 14 (depends on 12)

The method of claim 12, wherein the delivery tip is beveled.

### Claim 15 (depends on 1)

The method of claim 1, wherein the excimer laser source comprises a xenon chloride laser.

### Claim 16 (depends on 1)

The method of claim 1, further comprising physically contacting the trabecular meshwork with the probe, wherein the plurality of perforations are created while the probe is physically contacting the trabecular meshwork.

### Claim 17 (depends on 1)

The method of claim 1, wherein at least one of the plurality of perforations creates a fluid path from a front chamber of the eye through the trabecular meshwork to the Schlemm's canal.

### Claim 18 (depends on 1)

The method of claim 1, further comprising removing the probe after the creating of the plurality of perforations.

### Claim 19

A method of delivering laser energy to a surface of a trabecular meshwork of an eye to treat glaucoma comprising:
inserting a probe into an eye of a subject having glaucoma;
adjusting placement of the probe to a position transverse to Schlemm's canal in the eye;
physically contacting the trabecular meshwork with the probe; and
creating a plurality of perforations having transverse placement in the trabecular meshwork relative to the Schlemm's canal of the eye by applying a plurality of shots from an excimer laser source, wherein the plurality of perforations are created in the trabecular meshwork in order to treat the glaucoma.