# US 8,425,473 B2 · Subretinal access device > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,425,473 B2 - Document ID: US8425473B2 - Status: Granted - Kind: B2 - Application number: 12/359,157 - Filed: 2009-01-23 - Published: 2010-07-29 - Granted: 2013-04-23 - Earliest claimed: 2009-01-23 - Assignees: iScience Interventional Corporation - Applicants: Friedrich Ho; Stanley R. Conston; Ronald K. Yamamoto - Inventors: Friedrich Ho; Stanley R. Conston; Ronald K. Yamamoto - Web page: https://patentgrep.com/patent/US8425473B2 ## CPC - A61F 9/007: Methods or devices for eye surgery - A61F 9/008: using laser - A61B 1/313: for introducing through surgical openings, e.g. laparoscopes - A61B 3/102: {for optical coherence tomography [OCT]} - A61B 3/12: for looking at the eye fundus, e.g. ophthalmoscopes (A61B3/13 takes precedence) - A61B 5/0066: {Optical coherence imaging} - A61B 17/3421: {Cannulas} - A61B 2017/306: {holding by means of suction} - A61F 9/0017: {implantable in, or in contact with, the eye, e.g. ocular inserts} - A61F 2009/00863: {Retina} - A61F 2009/00874: {Vitreous} - 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) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The invention provides surgical devices that provide access to the sub-retinal space using delicate traction to hold the sensory retina to create and maintain a patent sub-retinal space of sufficient size to introduce and perform treatments on the eye. Such treatments may include the introduction of illumination or imaging agents or tools, surgical tools, the infusion of pharmaceutical or biological agents, and the placement of grafts, transplants or implants and the closure of the site through the delivery of a sealant. ## Claims ### Claim 1 An apparatus for use with an eye comprising: a first elongated tubular member having a proximal and a distal end and a lumen passing from said proximal end to said distal end wherein said distal end is shaped and dimensioned for access to the tissue of the retina; a second elongated tubular member having a proximal end and a distal end, disposed within said lumen of said first tubular member, said second tubular member having a passage therethrough from said proximal end to said distal end; an annular space within the lumen of said first elongated tubular member, annularly surrounding said second elongated tubular member; and a blocking member disposed within said annular space, said blocking member having a configuration to allow passage of gases and fluids, and to block entry of tissues into said first elongated tubular member through said annular space with a blocking member distal end that extends beyond said annular space at the distal end of said first elongated tubular member to prevent injury to tissue within the eye by being caused to compress and retract into the distal end of said first elongated tubular member upon reduction of pressure within said annular space; the distal end of said second elongated tubular member having a pointed tip; said distal end of said first elongated tubular member being open-ended and adapted to seal upon placement from within the eye in contact of said distal end of said first elongated tubular member with the surface of a tissue layer and upon reduction of pressure within said annular space to allow said pointed tip of said second elongated tubular member to pierce said tissue layer, whereby upon withdrawal of said first elongated tubular member sealed to said tissue layer, said tissue layer detaches from other tissues underlying said tissue layer to form a pocket under said tissue layer accessible to penetration into said pocket by the pointed tip of said second elongated tubular member through said tissue layer without damage to said underlying other tissues. ### Claim 2 An apparatus for use with an eye comprising: a first elongated tubular member having a proximal and a distal end and a lumen passing from said proximal end to said distal end wherein said distal end is shaped and dimensioned for access to the tissue of the retina; a second elongated tubular member having a proximal end and a distal end, disposed within said lumen of said first tubular member, said second tubular member having a passage therethrough from said proximal end to said distal end; an annular space within the lumen of said first elongated tubular member, annularly surrounding said second elongated tubular member; and a blocking member disposed within said annular space, said blocking member having a configuration to allow passage of gases and fluids, and to block entry of tissues into said first elongated tubular member through said annular space upon reduction of pressure within said annular space with a blocking member distal end that is disposed flush to the distal end of said first elongated tubular member; the distal end of said second elongated tubular member having a pointed tip; said distal end of said first elongated tubular member being open-ended and adapted to seal upon placement from within the eye in contact of said distal end of said first elongated tubular member with the surface of a tissue layer and upon reduction of pressure within said annular space to allow said pointed tip of said second elongated tubular member to pierce said tissue layer, whereby upon withdrawal of said first elongated tubular member sealed to said tissue layer, said tissue layer detaches from other tissues underlying said tissue layer to form a pocket under said tissue layer accessible to penetration into said pocket by the pointed tip of said second elongated tubular member through said tissue layer without damage to said underlying other tissues. ### Claim 3 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said passage in said second elongated tubular member is in communication with a device for introducing fluids, suspensions, sealants, adhesives, viscous solids or gases, or aspirating fluids, suspensions, viscous solids or gases, through said passage. ### Claim 4 (depends on 3) The apparatus according to claim 3 wherein said second elongated tubular member comprises a polymer. ### Claim 5 (depends on 4) The apparatus according to claim 4 wherein said polymer comprises a polyimide. ### Claim 6 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering a sealant in the form of autologous blood. ### Claim 7 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering a sealant in the form of fibrin glue. ### Claim 8 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering a biocompatible synthetic adhesive. ### Claim 9 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering liquids through said passage. ### Claim 10 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering tissues through said passage. ### Claim 11 (depends on 10) The apparatus according to claim 10 wherein said tissues comprise cellular grafts. ### Claim 12 (depends on 10) The apparatus according to claim 10 wherein said tissues comprise retinal pigment epithelial tissues. ### Claim 13 (depends on 10) The apparatus according to claim 10 wherein said tissues comprise sensory retina tissues. ### Claim 14 (depends on 10) The apparatus according to claim 10 wherein said tissues comprise stem cells. ### Claim 15 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering pharmaceutical agents through said passage. ### Claim 16 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of a delivering biologic agent through said passage. ### Claim 17 (depends on 16) The apparatus according to claim 16 wherein said biologic agent comprises a radionuclide. ### Claim 18 (depends on 16) The apparatus according to claim 16 wherein said biologic agent comprises a gene therapy product. ### Claim 19 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of delivering gases through said passage. ### Claim 20 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of aspirating liquids through said passage. ### Claim 21 (depends on 3) The apparatus according to claim 3 wherein said device in communication with said passage is capable of aspirating gases through said passage. ### Claim 22 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said annular space in said first elongated tubular member is in communication with a device for introducing fluids, suspensions, viscous solids or gases, or aspirating fluids, suspensions, viscous solids or gases, through said passage. ### Claim 23 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein the distal end of said second elongated tubular member is adapted to extend beyond the open distal end of said first elongated tubular member. ### Claim 24 (depends on 23) The apparatus according to claim 23 wherein said second elongated tubular member is adapted to extend beyond the open distal end of said first elongated tubular member by about 0.0015 inch to about 0.125 inch. ### Claim 25 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said second elongated tubular member is slidably disposed within said first elongated tubular member. ### Claim 26 (depends on 25) The apparatus according to claim 25 wherein said second elongated tubular member is retractable into the lumen of said first elongated tubular member. ### Claim 27 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said first or second elongated tubular member comprises a metal. ### Claim 28 (depends on 27) The apparatus according to claim 27 wherein said metal comprises stainless steel. ### Claim 29 (depends on 27) The apparatus according to claim 27 wherein said second elongated tubular member comprises a nickel-titanium alloy. ### Claim 30 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said passage accommodates a surgical instrument or tool. ### Claim 31 (depends on 30) The apparatus according to claim 30 wherein said tool comprises an imaging instrument. ### Claim 32 (depends on 31) The apparatus according to claim 31 wherein said imaging instrument comprises an endoscope. ### Claim 33 (depends on 30) The apparatus according to claim 30 wherein said instrument comprises a microsurgical instrument. ### Claim 34 (depends on 30) The apparatus according to claim 30 wherein said instrument or tool is used for removal of blood clots from tissues or vessels. ### Claim 35 (depends on 30) The apparatus according to claim 30 wherein said instrument comprises a fiber optic instrument. ### Claim 36 (depends on 35) The apparatus according to claim 35 wherein said fiber optic instrument is an imaging instrument. ### Claim 37 (depends on 35) The apparatus according to claim 35 wherein said fiber optic instrument is adapted to deliver energy at a target site. ### Claim 38 (depends on 37) The apparatus according to claim 37 wherein said fiber optic instrument is adapted to deliver laser energy for ablation of tissues or vessels. ### Claim 39 (depends on 37) The apparatus according to claim 37 wherein said fiber optic instrument is adapted to deliver radio frequency energy for ablation of tissues or vessels. ### Claim 40 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein said first elongated tubular member is suitably sized to pass through a sclerostomy port. ### Claim 41 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein the distal end of said second elongated tubular member is shaped and dimensioned for access to the tissue of the retinal pigment epithelium. ### Claim 42 (depends on 1, 2) The apparatus according to claim 1 or 2 wherein the distal end of said second elongated tubular member is shaped and dimensioned for access to the tissue of the sub-retinal space.