Devices, systems and methods for posterior segment drainage

Patent metadata

Field	Value
Publication number	US-9345619-B2
Application number	US-201414481990-A
Country	US
Kind code	B2
Filing date	Sep 10, 2014
Priority date	Sep 10, 2014
Publication date	May 24, 2016
Grant date	May 24, 2016

Abstract

Described herein is a method of implanting a glaucoma drainage device in an eye having a vitreous chamber and a drainage site. The glaucoma drainage device comprises a tube including a lumen extending from an inlet end to an outlet end, and includes a control element that regulates the amount of fluid flow through the glaucoma drainage device. The method comprises implanting the glaucoma drainage device into pars plana tissue from the vitreous chamber, such that the device extends between the vitreous chamber and the drainage site.

First claim

We claim:

1. A method of implanting a glaucoma drainage device in an eye having a vitreous chamber and a drainage site, the glaucoma drainage device comprising a tube, the tube including a lumen extending from an inlet end to an outlet end, the drainage device including a control element that regulates the amount of fluid flow through the glaucoma drainage device, the method comprising:
implanting, from the vitreous chamber, the glaucoma drainage device into pars plana tissue to extend between the vitreous chamber and the drainage site;
further comprising inserting a cannula into the pars plana at a first location in the pars plana tissue; wherein implanting a glaucoma drainage device into the pars plana tissue includes advancing the glaucoma drainage device into the vitreous chamber through the cannula;
further comprising the steps of: providing a delivery device having a distal end;
advancing the distal end through the cannula until the distal end comes into contact with ocular tissue of the pars plana at a second location in the pars plana separate from the first location;
pushing the distal end through the ocular tissue at the second location so that the delivery device penetrates the tissue of the pars plana to form a tunnel;
advancing the glaucoma drainage device through the delivery device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the net end is located in the vitreous chamber.

2. The method of claim 1 wherein implanting a glaucoma drainage device into the pars plana tissue includes advancing the glaucoma drainage device through a second location in the pars plana, the second location being separate from the first location.

3. The method of claim 1 further comprising:
providing a tunneling instrument having a first distal end;
advancing the first distal end through the cannula until the first distal end comes into contact with ocular tissue of the pars plana at a second location separate from the first location;
pushing the first distal end through the ocular tissue at the second location so that the tunneling instrument advances through the ocular tissue of the pars plana to form a tunnel;
removing the tunneling instrument through the cannula;
placing a delivery device having a second distal end through the cannula so that the second distal end comes into contact with the tunnel at the second location in the pars plana;
advancing the glaucoma drainage device through the drainage device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the inlet end is located in the vitreous chamber.

4. The method of claim 1 further comprising:
providing a combination tunneling and delivery device, the combination device having a distal end;
inserting the combination device from outside the eye into the vitreous chamber through a first location in the pars plana tissue;
advancing the distal end into contact with the tissue of the pars plana at a second location separate from the first location;
advancing the distal end through the pars plana tissue at the second location to form a tunnel through ocular tissue;
advancing the glaucoma drainage device through the combination device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the inlet end is located in the vitreous chamber.

5. The method of claim 1 wherein implanting a glaucoma drainage device into the pars plana tissue between the vitreous chamber and drainage site includes:
advancing the outlet end through ocular tissue of the pars plana so that the glaucoma drainage device tunnels through the ocular tissue to form a tunnel through the pars plana;
advancing the glaucoma drainage device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the inlet end is located in the vitreous chamber.

6. The method of claim 5 further comprising:
placing the glaucoma delivery device into the vitreous chamber through a first location in the pars plana tissue; and
implanting the glaucoma drainage device at a second location in the pars plana separate from the first location.

7. The method of claim 1 further comprising:
placing the glaucoma delivery device into the vitreous chamber through a first location in the pars plana tissue; and
implanting the glaucoma drainage device at a second location in the pars plana separate from the first location.

8. The method of claim 1 further comprising:
providing a delivery device having a distal end;
advancing the distal end through a first location in the pars plana tissue into the posterior segment;
advancing the distal end until the distal end comes into contact with ocular tissue of the pars plana at a second location separate from the first location;
advancing the distal end through the ocular tissue at the second location forms a tunnel through the pars plana;
advancing the glaucoma drainage device through the delivery device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the inlet end is located in the vitreous chamber.

9. The method of claim 1 further comprising the step of:
providing a tunneling instrument having a first distal end;
advancing the first distal end through a first location in the pars plana;
advancing the first distal end through the posterior segment until the first distal end comes into contact with a second location in the pars plana separate from the first location;
advancing the tunneling instrument through ocular tissue at the second location of the pars plana to form a tunnel;
removing the tunneling instrument;
placing a delivery device having a second distal end through the first location in the pars plana;
advancing the second distal end through the posterior segment until the second distal end comes into contact with the tunnel at second location in the pars plana;
advancing the glaucoma drainage device through the delivery device into the tunnel; and
positioning the glaucoma drainage device in the tunnel so that a desired amount of the outlet end is located in the drainage site and a desired amount of the inlet end is located in the vitreous chamber.

10. A method of implanting a glaucoma drainage device in an eye having a vitreous chamber and a drainage site, the glaucoma drainage device comprising a tube, the tube including a lumen extending from an inlet end to an outlet end, the drainage device including a control element that regulates the amount of fluid flow through the glaucoma drainage device, the method comprising:
inserting a cannula into a first location of the pars plana;
and
implanting, from the vitreous chamber, the glaucoma drainage device into the pars plana tissue between the vitreous chamber and drainage site at a second location different from the first location, by advancing the glaucoma drainage device through the cannula into the vitreous chamber;
further comprising the steps of: providing a delivery device having a distal end;
advancing the distal end through the cannula until the distal end comes into contact with ocular tissue of the pars plana at the second location;
pushing the distal end through the ocular tissue at the second location in the pars plana so that the delivery device forms a tunn

Assignees

• Novartis Ag

Inventors

• Johnson Andrew
• Lind Casey

Classifications

• A61F9/00781 Primary

  Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment (drainage implants in general A61M27/002) · CPC title