Devices and methods for glaucoma treatment

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 .- 42 . (canceled) 
     
     
         43 . An instrument for delivering multiple ocular implants for treating an ophthalmic condition and dispensing the ocular implants within an eye of a subject, the instrument comprising:
 an injection sheath defining a lumen and comprising a distal holding section, the distal-holding section sized to be introduced into the eye through an incision in the eye;   a plurality of ocular implants positioned in the lumen, each of said implants adapted to convey aqueous humour from an anterior chamber of the eye to a fluid outflow path of the eye so as to reduce elevated intraocular pressure, each of said implants comprising a waist portion sized to bypass a trabecular mesh disposed between the anterior chamber and the fluid outflow path,; wherein a length of the waist portion is less than 400 μm;   a trocar extending through each of the plurality of implants, wherein a distal tip of said trocar is sufficiently sharp to cut through the trabecular mesh; and   a holding member disposed between a pair of immediately adjacent implants of the plurality of implants,   wherein the holding member is disposed on the trocar.   
     
     
         44 . The instrument of  claim 43 , further comprising:
 a handle attached to the injection sheath;   a stent delivery button disposed on the handle; and   an actuator, wherein the stent delivery button is configured to cause the actuator to discharge, from the insertion sheath, one implant at a time.   
     
     
         45 . The instrument of  claim 43 , wherein each of said implants further comprises a central lumen and one or more side-ports, the central lumen extending from a proximal-most surface of a proximal head to a distal-most surface of to distal tapered base portion, each of the one or more side-ports extending between the central lumen and an outer surface of the distal tapered base portion. 
     
     
         46 . The instrument of  claim 45 , wherein the trocar extends through a central lumen of each of said implants. 
     
     
         47 . The instrument of  claim 43 , wherein the implants are arranged in series within the lumen. 
     
     
         48 . The instrument of  claim 43 , wherein each of the plurality of implants is slidably mounted on the trocar. 
     
     
         49 . The instrument of  claim 44 , wherein the actuator is configured to slide at least one of the implants off of the trocar. 
     
     
         50 . The instrument of  claim 44 , wherein the actuator comprises a pusher adapted for evenly pushing each of the plurality of implants, one at a time, out of the insertion sheath. 
     
     
         51 . The instrument of  claim 50 , wherein the pusher is connected with the stent delivery button, the actuator being configured to move the pusher a predetermined distance each time the stent delivery button is pressed. 
     
     
         52 . The instrument of  claim 43 , wherein the holding member is elastically deformable. 
     
     
         53 . An instrument for delivering multiple ocular implants for treating an ophthalmic condition and dispensing the ocular implants within an eye of a subject, the instrument comprising:
 an insertion sheath defining a lumen, a distal portion of the insertion sheath sized to be introduced into the eye through an incision in the eye;   a trocar disposed in said lumen, said trocar comprising a distal tip having a cutting end sufficiently sharp to cut through eye tissue; and   a plurality of biocompatible ocular implants positioned in the lumen and mounted on the trocar, each of said implants adapted to convey aqueous humour from an anterior chamber of the eye to a fluid outflow path of the eye so as to reduce elevated intraocular pressure,   wherein the trocar comprises a holding member disposed between a pair of immediately adjacent implants of the plurality of biocompatible ocular implants.   
     
     
         54 . The instrument of  claim 53 , further comprising:
 a handle attached to the injection sheath;   a stent delivery button disposed on the handle; and   an actuator, wherein the stent delivery button is configured to cause the actuator to discharge, from the insertion sheath, one implant at a time.   
     
     
         55 . The instrument of  claim 53 , wherein each of said implants further comprises a central lumen and one or more side-ports, the central lumen extending from a proximal-most surface of a head to a distal-most surface of a base portion, each of the one or more side-ports extending between the central lumen and an outer surface of the base portion. 
     
     
         56 . The instrument of  claim 54 , wherein the actuator comprises a pusher adapted for evenly pushing each of the plurality of implants, one at a time, out of the insertion sheath. 
     
     
         57 . The instrument of  claim 56 , wherein the pusher is connected with the stent delivery button, the actuator being configured to move the pusher a predetermined distance each time the stent delivery button is pressed. 
     
     
         58 . The instrument of  claim 53 , wherein the holding member is elastically deformable. 
     
     
         59 . An instrument for delivering multiple ocular implants for treating an ophthalmic condition and dispensing the ocular implants within an eye of a subject, the instrument comprising:
 an injection sheath defining a lumen, a distal portion of said injection sheath sized to be introduced into an anterior chamber of the eye;   a trocar disposed in said lumen, said trocar comprising a distal tip being configured to penetrate through trabecular mesh of the eye; and   a plurality of ocular implants mounted on the trocar and positioned in the distal portion of the injection sheath, wherein the trocar comprises a holding member positioned between each adjacent pair of the plurality of ocular implants, wherein each of said implants is adapted to convey aqueous humour from an anterior chamber of the eye to a fluid outflow path of the eye so as to reduce elevated intraocular pressure.   
     
     
         60 . The instrument of  claim 59 , further comprising:
 a handle attached to the injection sheath;   a stent delivery button disposed on the handle; and   an actuator, wherein the stent delivery button is configured to cause the actuator to discharge, from the insertion sheath, one implant at a time.   
     
     
         61 . The instrument of  claim 60 , wherein the actuator comprises a pusher adapted for evenly pushing each of the plurality of implants, one at a time, out of the insertion sheath. 
     
     
         62 . The instrument of  claim 59 , wherein the holding member is elastically deformable.