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US 8,123,729 B2Granted
Treatment of ocular disease
AssigneeiScience Interventional Corporation
InventorsRonald K. Yamamoto, Stanley R. Conston, Michael F. Nash, Paul S. Koch
Life of this patent
Estimating the term…
Abstract
The invention relates to a novel apparatus for the treatment of ocular disease, particularly glaucoma. The apparatus consists of a locating device to locate Schlemm's Canal within the anterior portion of the eye and a surgical tool to access the canal for treatment. The apparatus allows for guided, minimally invasive surgical access to Schlemm's Canal to enable surgical procedures to be performed on the canal and trabecular meshwork to reduce intraocular pressure. The apparatus may also deliver devices or substances to Schlemm's Canal in the treatment of glaucoma.
Claims64
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an ultrasound imaging transducer;
- and
- wherein the tissue contacting surface of the locating device is curved to approximate a curve of the exterior surface on an anterior of the patient's eye.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the microsurgical device comprises a microcannula;
- and
- wherein a distal portion of the microcannula is curved with a radius of approximately 12-14 mm to accommodate a curvature of Schlemm's Canal.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the microsurgical device comprises a microcannula;
- and
- wherein the microcannula has an outer diameter of less than 200 microns.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the microsurgical device comprises a microcannula;
- and
- an inflatable dilating balloon mounted on a distal end of the microcannula.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device comprising a microcannula;
- a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- and
- a device having an inflatable dilating balloon mounted on a distal end of the device, wherein the distal end of the device is configured for insertion through the microcannula.
2 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm'Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- and
- an implant configured for implantation by the microsurgical device into Schlemm's Canal to maintain flow of aqueous humor.
2 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an optical detector;
- and
- wherein the optical detector comprises a high intensity white light illumination source.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an optical detector;
- and
- wherein the optical detector comprises an optically coherent illumination source.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an optical detector;
- and
- wherein the optical detector comprises a fiber optic device.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an optical detector;
- and
- wherein the optical detector utilizes detection via visible wavelengths of light.
3 more elements
An apparatus for treating ocular disease in a patient, the apparatus comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately parallel to the tissue contacting surface of the locating device;
- wherein the locating device comprises an optical detector;
- and
- wherein the optical detector utilizes detection via infrared wavelengths.
3 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- wherein the tissue contacting surface of the locating device is curved to approximate a curve of the exterior surface on an anterior of the patient's eye.
2 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- wherein the microsurgical device comprises a microcannula;
- and
- wherein a distal portion of the microcannula is curved with a radius of approximately 12-14 mm to accommodate a curvature of Schlemm's Canal.
4 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- wherein the microsurgical device comprises a microcannula;
- and
- wherein the microcannula has an outer diameter of less than 200 microns.
4 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device comprising a microcannula;
- a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- and
- an inflatable dilating balloon mounted on a distal end of the microcannula.
3 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device comprising a microcannula;
- a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- and
- a device having an inflatable dilating balloon mounted on a distal end of the device, wherein the distal end of the device is configured for insertion through the microcannula.
3 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a handle, the handle having a longitudinal axis;
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device being coupled to the handle such that the tissue contacting surface is approximately perpendicular to the longitudinal axis of the handle, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye and for indicating when Schlemm's Canal is located in a imaging plane that extends distally from the tissue contacting surface of the locating device;
- a microsurgical device;
- a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device being configured to access Schlemm's Canal within the imaging plane of the locating device and to deliver the microsurgical device into Schlemm's Canal along a path spaced apart distally from the tissue contacting surface of the locating device and approximately perpendicular to the longitudinal axis of the handle of the apparatus;
- and
- an implant configured for implantation by the microsurgical device into Schlemm's Canal to maintain flow of aqueous humor.
3 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device having a cantilever beam that extends axially with respect to the tissue contacting surface of the locating device, a guiding sleeve coupled to the cantilever beam, an angle adjustment mechanism for adjusting an angle of the guiding sleeve with respect to the tissue contacting surface of the locating device and a mechanism for advancing the microsurgical device through the guiding sleeve and into Schlemm's Canal within the patient's eye
- wherein the microsurgical device comprises a microcannula slidably positioned within the guide sleeve;
- and
- wherein the mechanism for advancing the microsurgical device through the guiding sleeve and into Schlemm's Canal within the patient's eye comprises a thumbwheel configured to engage a lead screw connected to the microcannula.
3 more elements
An apparatus for treating ocular disease in a patient, comprising:
- a locating device, the locating device having a tissue contacting surface configured for contacting an exterior surface of the patient's eye, the locating device adapted for non-invasively locating Schlemm's Canal within the patient's eye;
- a microsurgical device;
- and a surgical access device physically coupled to the locating device for guiding the microsurgical device in relation to the locating device, the surgical access device having a cantilever beam that extends axially with respect to the tissue contacting surface of the locating device, a guiding sleeve coupled to the cantilever beam, an angle adjustment mechanism for adjusting an angle of the guiding sleeve with respect to the tissue contacting surface of the locating device and a mechanism for advancing the microsurgical device through the guiding sleeve and into Schlemm's Canal within the patient's eye;
- wherein the microsurgical device comprises a microcannula slidably positioned within the guide sleeve and an inflatable dilating balloon mounted on a distal end of the microcannula.
1 more element
Dependencies are inferred from the claim text.