Grieshaber & Co Ag Schaffhausen

Grieshaber Ophthalmic Research Foundation

Other

Iscience Interventional Corporation

Robert Christopher Stegmann

Hans Rudolf Grieshaber

Matthias Christian Grieshaber

Ronald Kenichi Yamamoto

Stanley R Conston

John R McKenzie

David J Kupiecki

Werner Maag

Hansgeorg Schaaf

Rudolf Demmerle

Candice D Pinson

John Mckenzie

The invention relates to a method and a device for treatment of glaucoma, wherein by means of an elongated catheter provided with a distal portion and a proximal portion, a tube-shaped implant is inserted and released in a Schlemm's canal with two opposite openings exposed by an incision and a folded up scleral flap. In a first phase, the distal portion inserted into the Schlemm's canal through the first opening, while a fluid or gaseous medium is injected at the same time, and exited through the second opening, which is, in circumferential direction, oppositely located. The implant detachably disposed at the protruding distal portion and, in a second phase, inserted, in circumferential direction, into the expanded Schlemm's canal up to the first opening. Subsequently, the distal portion, which protrudes from the first opening, is detached from the implant and, together with the catheter, removed.

Method and device for the treatment of glaucoma

The invention refers to a tube configured as an implant for insertion at least at one location into the exposed Schlemm's canal of an eye and which, for example, has been mechanically dilated. The elongated tube insertable into the Schlemm's canal includes a plurality openings that are arranged at the tube in axial direction distanced from each other by ring parts and that are in communication with the trabecular tissue the interior space of the tube and the aqueous humor veins of the episcleral vein system and further includes openings oriented in axial direction at a circular arc shaped segment corresponding to the cross section profile of the tube. To realize the natural trabecular aqueous humor drainage, the tube are inserted into the Schlemm's canal that either the openings in the segment are in communication with the aqueous humor veins or that segment with the openings are associated with the trabecular tissue.

Implant for the treatment of glaucoma

The invention relates to a method and device for the treatment of glaucoma, though insertion of an implant into the lumen of the Schlemm's canal to realize proper drainage of the aqueous humor, which implant is brought into its position in the Schlemm's canal by means of a catheter having a distal and a proximate portion and provided with a number of pores through which a gaseous or fluid medium which comes from a pressure source can emerge during insertion of the catheter carrying the implant into the Schlemm's canal, and while the catheter is being inserted into the Schlemm's canal the gaseous or fluid medium is released under pressure thereby expanding the Schlemm's canal and the implant and upon releasing the implant at its determined location, the catheter can be withdrawn from the Schlemm's canal.

A method is provided for increasing the outflow of fluid through Schlemm's canal that is useful for treatment of glaucoma. The implant is placed in Schlemm's canal by use of a flexible delivery instrument attached to the implant. The instrument and implant are positioned within the canal, the implant is released and the distal and proximal ends of the implant are connected to apply sufficient axial tensioning force on the inner wall of the canal to increase fluid permeability. In another embodiment a delivery instrument attached to the implant is positioned in the canal securing one of the distal or proximal ends of the implant within the canal. The implant provides sufficient axial tensioning force on the inner wall of the canal to increase fluid permeability of the inner wall of the canal. The other of the distal or proximal ends may be secured to maintain the tensioning force on the inner wall of the canal.

Ophthalmic implant for treatment of glaucoma

A device is disclosed for ophthalmologic microsurgery for improving the drainage of the aqueous humor in the eye of a living being, wherein the device has an endoscope connected to a monitor screen and includes a tube-shaped probe adapted for insertion into an eye, and one or more channels co-axially disposed therein and provided with optical elements for focusing and transmitting images from the viewing field in the eye, and wherein the probe houses a surgical tool which is movable in axial direction and about the longitudinal axis so that by means of the oscillating and/or vibrating tool a passageway can be opened in the tissue of the trabecular meshwork for connecting the anterior chamber with the Schlemm's canal.

Device for improving drainage of the aqueous humor within the eye of a living being

A method for improving the draining of aqueous humor in an eye of a living being and a device for widening the Schlemm's canal is described wherein a first incision is made in a lamellar section of the sclera to form a first scleral flap which is then folded upwards in the direction of the cornea, thereby creating a recess in the sclera. A second scleral flap is formed by incising a second lamellar section in the area of the recess and lifted upwardly in the direction of the first sclera flap, thereby exposing two opposite openings into the Schlemm's canal into which an expanding medium is injected into the Schlemm's canal; formation of a slitlike passageway connecting the aqueous humor-permeable Descemet-membrane with the subscleral space is realized by detaching the Descemet-membrane on the area of the Schwalbe's line by means of a slight pressure force; and subsequently, the first scleral flap folded back, after severance of the second scleral flap, for placement upon a support surface formed as a consequence of the incision of the second lamellar section. Subsequently, a viscous medium is injected into a subscleral space formed behind the first scleral flap and the first scleral flap is rejoined to the sclera.

Method of and device for improving the flow of aqueous humor within the eye

An ophthalmic surgical device for pulverizing the lens nucleus in the eye and for removing particles of the macerated lens nucleus from the eye of a living being, includes a housing which supports a mounting that receives at its forward end a guide tube. Set within the guide tube is a tubular probe which has one end carrying a cutting element and another end operatively connected to a motor for rotating the tubular probe together with the cutting element and/or moving the tubular probe together with the cutting element in axial direction relative to the stationary guide tube.

Ophthalmic surgical apparatus for pulverizing and removing the lens

An ophthalmic surgical device for macerating the lens nucleus in the eye and for removing particles of the macerated lens nucleus from the eye of a living being, includes a hand-held housing with a head piece attached at one axial end of the housing and supporting a guide tube. Disposed in the guide tube is a tubular probe which is operatively connected to a motor drive and projects beyond the guide tube with its tip to carry a cutting element in form of at least two rotatable wing-like blades oriented approximately transversely to the longitudinal axis of the guide tube. By means of the drive, the tubular probe is rotatable relative to the stationary guide tube about the longitudinal axis and movable at a high frequency in direction of the longitudinal axis.

Ophthalmic surgical apparatus for macerating and removing the lens

A method and an appliance for carrying out the method, by means of which the necessary outflow of the aqueous humour which is continuously being renewed in the eye is ensured, and thus the natural intraocular pressure is maintained, are proposed. For the treatment, the sclera (13) undergoes operative lamellar incision for partial exposure of the canal of Schlemm (15), and the portion (13') which is opened out is held by means which are not depicted. A medium is introduced into the canal of Schlemm (15) by means of a tube (20) which is introduced into the circular canal of Schlemm (15), by which means the upstream trabecular tissue (15') is hydraulically expanded and traumatically opened at several points (15') and, at the same time, the points (15') are wetted by the highly viscous medium.

Method and appliance for maintaining the natural intraocular pressure

A method and an apparatus for carrying out the method, in which the necessary outflow of the aqueous humor which is continuously being renewed in the eye is ensured, and thus the normal intraocular pressure is maintained. For the treatment, the sclera undergoes operative lamellar incision for partial exposure of Schlemm's canal, and the portion which is opened out is held by a device which is not depicted. A medium is introduced into Schlemm's canal by a tube which is introduced into the circular canal of Schlemm by which the upstream trabecular tissue is hydraulically expanded and traumatically opened at several points and, at the same time, the points are wetted by the highly viscous medium.

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Pretoria, South Africa

Robert Christopher Stegmann