Ocular implant systems

Abstract

Intraocular stents and applicators are disclosed for treating glaucoma. The stents are configured to extend between the anterior chamber of the eye and Schlemm's canal for enhancing outflow of aqueous from the anterior chamber so as to reduce intraocular pressure. The stents can have features for anchoring the stent into Schlemm's canal as well as preventing the walls of Schlemm's canal from closing the outlet of the stents. The applicators can be steerable so as to make implantation easier. Additionally, the applicators can be configured to hold a plurality of stents so that multiple stents can be implanted through one incision without removing the applicator from the incision between serial implantations.

1 . A system for implanting device into the eye, comprising:
 a device configured to be implanted in the eye in such that a first end of the device is in communication with the choroid, the device having lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in the eye in an implantation location such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, said device configured to be inserted into the eye through a self-sealing incision in the cornea and wherein the device has a second end configured to reside in the anterior chamber; and   a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form the opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.   
     
     
         2 - 10 . (canceled) 
     
     
         11 . The system of  claim 1 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid. 
     
     
         12 - 20 . (canceled) 
     
     
         21 . The system of  claim 1 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed. 
     
     
         22 . (canceled) 
     
     
         23 . (canceled) 
     
     
         24 . A system for implanting a device into the eye, comprising:
 a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with the choroid, the device having a lumen wherein a first end of the lumen of the device communicates with the choroid and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the choroid, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the choroid through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and   a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in the eye tissue, and release the device from the elongate tip and into the implantation location.   
     
     
         25 - 32 . (canceled) 
     
     
         33 . The system of  claim 24 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid. 
     
     
         34 . (canceled) 
     
     
         35 . (canceled) 
     
     
         36 . The system of  claim 24 , wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea. 
     
     
         37 - 41 . (canceled) 
     
     
         42 . The system of  claim 24 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed. 
     
     
         43 - 92 . (canceled) 
     
     
         93 . A system, comprising:
 an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in an implantation location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with the choroid and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the choroid; and   a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the device through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation location.   
     
     
         94 . A system as in  claim 93 , wherein the implant is a tube. 
     
     
         95 . (canceled) 
     
     
         96 . A system as in  claim 93 , wherein the delivery apparatus comprises a cannula. 
     
     
         97 . A system as in  claim 93 , wherein the delivery apparatus is configured to introduce the implant into the anterior chamber through a self-sealing corneal incision. 
     
     
         98 . (canceled) 
     
     
         99 . The system of  claim 93 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid. 
     
     
         100 . (canceled) 
     
     
         101 . (canceled) 
     
     
         102 . The system of  claim 93 , wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea. 
     
     
         103 . (canceled) 
     
     
         104 . (canceled) 
     
     
         105 . (canceled) 
     
     
         106 . (canceled) 
     
     
         107 . (canceled) 
     
     
         108 . The system of  claim 93 , wherein the first end of the device is located so as to be in communication with a uveal scleral outflow route, wherein the delivery apparatus comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed. 
     
     
         109 - 128 . (canceled) 
     
     
         129 . A system for implanting a device into the eye, comprising:
 a device for establishing an outflow pathway configured to be implanted in the eye so as to locate a first end of the device in communication with a uveal scleral outflow route, the device having a lumen wherein a first end of the lumen of the device communicates with the uveal scleral outflow route and a second end of the lumen of the device opens into the anterior chamber when implanted in an implantation location in the eye such that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral outflow route, so as to provide intraocular pressure balancing by providing aqueous humor outflow from the anterior chamber towards the uveal scleral outflow route through the lumen, wherein the device has a second end configured to reside in the anterior chamber, wherein the device is configured to be implanted into the eye through an incision in the cornea; and   a delivery apparatus comprising an elongate tip that is removably attached to the device, wherein the delivery apparatus is configured to introduce the device into the anterior chamber through the corneal incision, advance the device through the anterior chamber, form an opening in eye tissue, advance the implant through the opening formed in eye tissue, and release the device from the elongate tip and into the implantation location.   
     
     
         130 - 135 . (canceled) 
     
     
         136 . The system of  claim 129 , wherein the device is a tube. 
     
     
         137 . (canceled) 
     
     
         138 . The system of  claim 129 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid. 
     
     
         139 . The system of  claim 129 , wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea. 
     
     
         140 - 144 . (canceled) 
     
     
         145 . The system of  claim 129 , wherein the second end of the device resides entirely within the confines of the sclera and the cornea upon implantation, wherein the delivery apparatus further comprises a trocar, blade or cannula, and wherein the trocar, blade or cannula is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed. 
     
     
         146 - 185 . (canceled) 
     
     
         186 . An ocular implant system, comprising:
 an implant comprising an elongated device having a second end region, a first end region, and an lumen communicating with an inlet port in the second end region and an outlet port in the first end region, the implant configured to be advanced into the anterior chamber of the eye via an incision in the cornea and positioned in an implantation location wherein the inlet port is in the anterior chamber of the eye and the outlet port is in communication with a uveal scleral outflow route and at least a portion of implant is in contact with an inner surface of sclera of the eye so that the lumen provides a flow pathway from the anterior chamber towards the uveal scleral, outflow route; and   a delivery apparatus comprising an elongate tip that is removably attached to the implant, wherein the delivery apparatus is configured to advance the implant through the corneal incision and into the anterior chamber, advance the implant through the anterior chamber, advance the implant through an opening formed in eye tissue, and release the implant from the elongate tip and into the implantation location.   
     
     
         187 . A system as in  claim 186 , wherein the implant is a tube. 
     
     
         188 . (canceled) 
     
     
         189 . A system as in  claim 186 , wherein the delivery apparatus comprises a cannula. 
     
     
         190 . A system as in  claim 186 , wherein the delivery apparatus is configured to introduce the ocular implant into the anterior chamber through a self-sealing corneal incision. 
     
     
         191 . (canceled) 
     
     
         192 . The system of  claim 186 , wherein, when the device is in communication with the choroid, at least a portion of the device is in contact with the choroid. 
     
     
         193 . The system of  claim 186 , wherein the second end is positioned such that the second end is outside of the ciliary body and posterior of an inner surface of the cornea. 
     
     
         194 . (canceled) 
     
     
         195 . The system of  claim 186 , wherein the delivery apparatus comprises a member selected from the group consisting of a cutting device, a trocar, a guidewire, a cannula, a blade, a trephine, a punch, and an ocular tissue drill. 
     
     
         196 . The system of  claim 195 , wherein the member is configured to detach at least a portion of the ciliary body from the sclera to form an internal space between the ciliary body and the sclera into which the device may be placed. 
     
     
         197 . (canceled)