Minimally invasive implantable ophthalmic drainage device and delivery system thereof
The minimally invasive ophthalmic drainage implant delivery system addresses the challenges of controlled delivery and stability by using a switch mechanism and nickel-titanium alloys for precise deployment and fixation, enhancing surgical efficacy and patient comfort.
Patent Information
- Application Number
- PCT/CN2025/103031
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-12-10
- Filing Date
- 2025-06-24
- Publication Date
- 2026-01-02
AI Technical Summary
Current implantable ophthalmic drainage devices face challenges such as difficulty in controlled delivery, risk of postoperative complications, and instability due to improper positioning and manufacturing limitations, particularly in suprachoroidal implantation, which can lead to increased intraocular pressure and side effects.
A minimally invasive ophthalmic drainage implant delivery system with a switch mechanism for precise deployment, combined with nickel-titanium shape memory alloys and retention rings for fixation, and a delivery system featuring a puncture needle, buckle, and ejector pin for controlled release, along with a rotating wheel for accurate positioning.
Facilitates precise and stable implantation of ophthalmic drainage devices, reducing postoperative complications and improving patient comfort by ensuring accurate placement and reducing the risk of device slippage and complications.
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Figure CN2025103031_02012026_PF_FP_ABST
Abstract
Description
MINIMALLY INVASIVE IMPLANTABLE OPHTHALMIC DRAINAGE DEVICE AND DELIVERY SYSTEM THEREOFCROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit ofChinese Application 202410849071.2, filed on June 27, 2024; Chinese Application 202411134121.5, filed on August 19, 2024; Chinese Application 202422222191.8, filed on September 11, 2024; Chinese Application 202411268481.4, filed on September 11, 2024; and Chinese Application 202411811188.8, filed on December 10, 2024 the entire contents of which are incorporated herein by reference for all purposes.FIELD OF INVENTION
[0002] This disclosure relates generally tomedical instruments, and more specifically to minimally invasive, implantable ophthalmic drainage devices and delivery systems thereof.BACKGROUND
[0003] Glaucoma is a group of irreversible blinding eye diseases characterized by pathologically high intraocular pressure (IOP) , visual field defects, optic disc depression, atrophy, and / or decreased vision. It is one of the three major causes of human blindness. Glaucoma can be divided into three categories: primary glaucoma, secondary glaucoma, and congenital glaucoma.
[0004] A cause of glaucoma is the obstruction of aqueous humor circulation, leading to increased IOP. Aqueous humor is a substance for maintaining intraocular pressure. The elevated eye pressure causes optic nerve damage through mechanical compression and ischemia, manifesting as visual field defects, vision decline, and optic disc atrophy.
[0005] The intraocular cavity can be divided into the anterior chamber, posterior chamber, and vitreous cavity. The anterior and posterior chambers are generally separated by the ciliary body. Aqueous humor is produced by the ciliary body, reaches the posterior chamber, passes through the pupil to the anterior chamber, and returns to the blood vessels through the trabecular meshwork at the anterior chamber angle, completing the “aqueous humor circulation. ” An obstruction in the aqueous humor circulation can lead to increased eye pressure. Clinically, most glaucoma cases are caused by increased resistance to aqueous humor outflow, such as narrowing or closure of the anterior chamber angle and trabecular sclerosis, while a few are caused by excessive aqueous humor secretion.
[0006] Lowering IOP is currently a common method of treating glaucoma. This may involve drug therapy, laser therapy, and / or surgical treatment. Drug therapy may require patient compliance, and long-term use may cause systemic and local complications. Laser surgery may only be suitable for some patients. Although traditional filtration surgery may be effective, it maybe unacceptable to some patients due to the complications and relatively large surgical trauma that may be caused by the surgery, especially for open-angle glaucoma. Thus, the common methods of treating glaucoma may not be satisfactory.
[0007] Minimally invasive glaucoma surgery (MIGS) is an emerging surgical techniquefor mild to moderate glaucoma. The use of implantable ophthalmic drainage devices for draining excess fluid from the eye, alone or in combination with cataract extraction, can effectively, minimally invasively, and conveniently lower IOP. Implantable ophthalmic drainage devicescan be divided into subconjunctival drainagedevices, Schlemm’s canal drainagedevices, and vein collateral membrane upper cavity drainage devices, depending on which anatomical way animplantable drainage device operates.
[0008] Suprachoroidal drainage devices may bepreferable because the suprachoroidal space is the physiological drainage route of aqueous humor and is larger in space, such thatimplantable ophthalmic drainage devices implanted in the suprachoroidal space may operate without forming a bleb. Currently, implantable ophthalmic drainage devices that drain fluid through the superior lumen can be classifiedas an inner-routedeviceor an external-routedevice, depending on the implantation method. Both categories of implantable ophthalmic drainage devices can reduce the IOP of glaucoma patients.
[0009] Implantation of an inner-route implantable drainage devicemaygenerally be combined with cataract extractionduring a simultaneous operation because the implantable drainage device may be at risk of shifting and / or falling off after subsequent operations, which can damage intraocular tissue. Implanting an external-route implantable drainage device may result in larger wounds and severe complications (e.g., explosive suprachoroidal hemorrhage and the like) during the perioperative period. Additionally, implanting an external-route implantable drainage device may result in fibrosis of the internal drainage area. These factors may limit the clinical application ofcurrent implantable ophthalmic drainagedevices that drain excess fluid using the superior lumen of the vein.
[0010] Further, current suprachoroidal implantable drainage devicescomprise mostly non-metallic (e.g., polyimide) tubes havingcavities. Due to the extrusion process used when manufacturing the tube, the tubemay haveconstant inner and outer diameter parameters and a fixed axial direction, which may cause the tube to slide in the suprachoroidal space after implantation, negatively impacting the drainage capability of the drainage implant device. Accordingly, to fix the tube in position, a structure (e.g., a ring with an increased outer diameter) may be provided. However, such fixing structuresmay bedifficult to manufacture and / or deploy due to the limitation of the smaller overall size of the tube (e.g., typically having an outer diameter of about0.40mm and an inner diameter of about 0.30 mm) .
[0011] In addition, existing technology may involve improper use of the drainage device, leading to unstable intraocular pressure and resulting in high side effects and risks. Also, the existing delivery process of current drainage devicesmay be hard to control, requiring an experienced operator. BRIEF SUMMARY
[0012] It is desirable to develop ophthalmic devices and delivery systems that can perform surgical treatment in a minimally invasive form and reduce postoperative complications. Such devices and systems would not only facilitate clinical operations and reduce postoperative complications, but also significantly relieve the patient’s pain and improve their quality of life.
[0013] To this end, the disclosed minimally invasive ophthalmic drainage implant delivery system overcomes the above-mentioned problems, such asdrainage devicedelivery process that cannot be effectively controlled, increasing the difficulty of delivering the drainage device and requiring an experienced operator.
[0014] To achieve these objectives, in some embodiments, the disclosed minimally invasive ophthalmic drainage implant delivery system comprises a switch for releasing animplantable ophthalmic drainage device from the delivery system. More specifically, in response to the switchbeing actuated, the delivery system is configured to release the implantable ophthalmic drainage device, thereby accurately deploying the implantable ophthalmic drainage deviceat a target location.
[0015] In some embodiments, the delivery system comprises a puncture needle, a buckle, a core base, and a core. When the implantable ophthalmic drainage device has reached the target location (e.g., via the puncture needle) , an operator can actuate the switch. Actuation of the switchcauses the buckle to open. The buckle opening causes a spring to push the core baseaway from the tip of the needle and release the core. Pushing the core base causes the implantable ophthalmic drainage device to be released from the core and delivery device, thereby accurately implanting the implantable ophthalmic drainage device in the target location.
[0016] In some embodiments, the delivery system comprises a rotating wheel, and rotation of the rotating wheel causes the implantable ophthalmic drainage device to move relative to the delivery device prior to implantation, allowing more accurate device positioning prior to release.
[0017] In some embodiments, the delivery system comprises a puncture needle, a needle base, a housing, an ejector pin, and a switch. The puncture needle can be fixedly connected to the needle base, and the puncture needle can move along an axis of the housing (e.g., slide back and forth within the housing) . The ejector pin can be fixed to a base of the housing and can be at least partially disposed in an inner cavity of the puncture needle in a sliding manner. When the implantable ophthalmic drainage device has reached the target position (e.g., via the puncture needle) , an operator can actuate the switch by depressing and pulling the switch towards the operator. The switch can be coupled to the needle base, such that pulling the switch backwards causes the needle base and the puncture needle to retract. Meanwhile, the position of the ejector pin can remain unchanged, such that the ejector pin pushes the implantable ophthalmic drainage device out of the puncture needle, thereby realizing in-situ release of the implantable ophthalmic drainage device.
[0018] Minimally invasive, implantable ophthalmic drainage devices are also disclosed. In some embodiments, the implantable ophthalmic drainage device comprises a plurality of retention rings and inner ring grooves. The plurality of retention rings can fix the position of the drainage device, preventing unintentional displacement or slippage of the drainage device when the drainage device is implanted. The arrangement of the inner ring grooves allows drainage speed control.
[0019] In some embodiments, the implantable ophthalmic drainage device comprises a flap valve to ensure drainage is in one direction. In some embodiments, the drainage device comprises microwells for releasing drugs into a targeted area after the drainage device is implanted. In some embodiments, the drainage device comprises a control unit, a pressure sensor, and a flow sensor for controlling flow, pressure, and drainage speed of fluids flowing in the device.
[0020] Further, the inventors have discovered that nickel-titanium shape memory alloys (e.g., having a nickel mass fraction between about 54.5%and about 57.0%) are shape memory alloys with good biocompatibility and excellent shape memory properties. Nickel-titanium shape memory alloys have not been used for implantable ophthalmic drainage devices, and particularly not in ophthalmic drainage devices used to fluidically connect an anterior chamber and a suprachoroidal space.
[0021] The disclosed ophthalmic drainage implantation devices can meet loading and implantation requirements and can be configuredrestore to a preset shape after being released from a delivery system. The preset shape can have a specific structure, which can be configured to prevent slippage of the ophthalmic drainage implantation device in the eye, thereby enhancing the fixation of the ophthalmic drainage implantation device while enabling drainage of excess fluid. Further, use of shape memory alloys such as nickel-titanium or nitinol can be advantageous over existing drainage devices that use polymer materials, because such shape memory alloys enable the use of heat treatments and / or other processing (e.g., adding slits or apertures, or other processing that can be done on alloys and not polymers) to improve reliability of the shape-memory alloy (e.g., the reliability of the shape memory alloy in restoring to a preset shape and / or dimensions) .
[0022] In some embodiments, the implantable ophthalmic drainage device can comprise a tube fitting with an inner cavity having a two-dimensional wave shape or a three-dimensional spiral shape. The two-dimensional wave shape or a three-dimensional spiral shape can include wave crests and wave troughs. The inner cavity can fluidically connect an anterior chamber of an eye with a suprachoroidal cavity of the eye. In some embodiments, the implantable ophthalmic drainage device can comprise one or more slits or apertures. The slits or apertures can allow drainage and may also reduce overall stiffness (e.g., due to the stiffness of the shape memory alloy) of the drainage device. By reducing the stiffness of the drainage device, the drainage device may be enabled to bend in specific configurations, such that the drainage device can be implanted to fluidically connect the anterior chamber and the suprachoroidal space.
[0023] In some embodiments, the ophthalmic implantable drainage device comprises a main body with a hollow cavity and an expansion anchor coupled with the main body. The expansion anchor can comprise a two-dimensional shape or a three-dimensional shape. A first end of the expansion anchor can be connected to a proximal segment of the main body and the second end can be connected to a distal segment of the main body. The proximal segment of the drainage body is configured to be proximal to a suprachoroidal space of an eye and the distal segment of the drainage body is configured to be proximal to an anterior chamber of the eye when the ophthalmic implantable drainage device is implanted in the eye.
[0024] The expansion anchor can be configured to expand. When implanted in an eye, the expansion of the expansion anchor in the upper ciliary cavity can cause the dissociation of the ciliary body to some extent, such that that the aqueous humor drained from the anterior chamber can enter the suprachoroidal space for transscleral or ciliary choroidal vascular absorption. Meanwhile, the dissociation of the ciliary body caused by the expansion anchor can inhibit thesecretion of aqueous humor by the pigment-free epithelial cells of the ciliary body, further reducing intraocular pressure.
[0025] In some embodiments, an ophthalmic drainage device delivery system comprises: ahousing; and a puncture needle disposed at an end of the housing. In some embodiments, a drainage device is configured to be disposed inside the puncture needle, andthe puncture needle is configured for puncturing a sclera of an eye and positioning the drainage device to a suprachoroidal space of the eye. In some embodiments, the delivery system further comprises an ejector tube disposed inside the puncture needle; and a rotating wheel and a rack. In some embodiments, gears of the rotating wheel couple to gears of the rack, androtation of the rotating wheel causes the ejector tube to move in a direction along an axis of the housing. The delivery system further comprises a core base; and a buckle. In some embodiments, in a closed position, the buckle is configured to couple to the core base; anda switch. In some embodiments, an actuation of the switch causes the buckle to change to an open position and to decouple the core base from the buckle, andthe decoupling of the core base from the buckle causes the ejector tube to release the drainage device from the puncture needle.
[0026] In some embodiments, the delivery system further comprises a core. In some embodiments, a first portion of the core passes through a cavity of the ejector tube, andwhen the drainage device is disposed inside the puncture needle, a second portion of the core passes through a cavity of the drainage device.
[0027] In some embodiments, the delivery system further comprises a button. In some embodiments, in a first position, the button is configured to lock the rotating wheel and the rack, and in a second position, the button is configured to allow the rotating wheel to rotate.
[0028] In some embodiments, the puncturing of the sclera of the eye comprises performing scleral penetration, the lining core passes through the drainage device, and the ejector tube is configured to support, fix, and guide the drainage device.
[0029] In some embodiments, the ejector tube is configured to abut with the drain device when the drainage device is disposed inside the puncture needle.
[0030] In some embodiments, the delivery system further comprises a first spring comprising two ends, the two ends respectively coupled to the switch and an ejector tube base.
[0031] In some embodiments, the delivery system further comprises a second spring coupled to the core base. In some embodiments, the decoupling of the core base buckle causes the second spring to push the core base and release the ejector tube.
[0032] In some embodiments, the switch comprises a first portion, the buckle comprises a second portion, andin the closed position, the second portion of the buckle is configured to couple to the first portion of the switch.
[0033] In some embodiments, the first portion has a conical structure, andthe second leg has an inverted cone structure.
[0034] In some embodiments, the delivery system further comprises a vibration sensor coupled to a light. In some embodiments, in response to detecting, via the vibration sensor, a vibration of the delivery system greater than a vibration threshold value, the light is configured to provide a warning.
[0035] In some embodiments, a delivery system for delivering a minimally invasive, implantable ophthalmic drainage device comprises: a puncture needle comprising a first inner cavity configured to receive the drainage device. In some embodiments, the drainage device is configured to compress in the puncture needle. In some embodiments, the delivery system further comprises a needle base fixedly connected to the puncture needle; a housing configured to receive the puncture needle and the needle base, such that the needle base and the puncture needle are movable along an axis of the housing; a switch coupled to the needle base and configured to move along the axis of the housing, causing the needle base and the puncture needle to move along the axis of the housing; and an ejector pin fixedly connected to a base of the housing. In some embodiments, at least a portion of the ejector pin is positioned inside the puncture needle and is configured to slidably engage with the puncture needle, and the ejector pin is configured to push the drainage device out of the puncture needle as the puncture needle moves along the axis of the housing.
[0036] In some embodiments, in a first switch state, the switch is positioned relative to the housing such that the housing prevents the switch from moving along the axis of the housing and in a second switch state, the switch is positioned relative to the housing such that the housing allows the switch to move along the axis of the housing. In some embodiments, depression of the switch causes the switch to enter the second switch state from the first switch state.
[0037] In some embodiments, the base of the housing comprises: a cavity configured to fixedly receive an end of the ejector pin; and a first locking structure configured to engage with a second locking structure of the housing such that the base is fixedly connected to the housing. In some embodiments, the first locking structure of the base is a threaded structure or a snap-fit structure.
[0038] In some embodiments, the puncture needle comprises stainless steel or nickel-titanium shape memory alloy, the needle base, housing, base, and switch comprise resin, and the ejector pin and the spring comprise stainless steel.
[0039] In some embodiments, the housing comprises: a housing inner cavity configured to slidably engage with an outer surface of the needle base; and a first housing inner cavity surface and a second housing inner cavity surface configured to slidably engage with an outer surface of the switch.
[0040] In some embodiments, the needle base comprises: a second inner cavity configured to slidingly engage with the ejector pin; a switch installation cavity configured to slidingly engage with the outer surface of the switch; and a cylinder fixedly engaged with an inner surface of a spring engaged with the switch. In some embodiments, the cylinder is arranged in the switch installation cavity.
[0041] In some embodiments, the puncture needle comprises a bevel needle tip.
[0042] In some embodiments, the puncture needle comprises a round blunt needle tip.
[0043] In some embodiments, an outer diameter of the puncture needle is between about 0.5 mm and about 0.7 mm, and an inner diameter of the puncture needle is between about 0.3 mm and about 0.5 mm.
[0044] In some embodiments, an outer diameter of the puncture needle is between about 0.4 mm and about 0.8 mm and an inner diameter of the puncture needle is between about 0.18 mm and about 0.61 mm.
[0045] In some embodiments, a minimally invasive, implantable ophthalmic drainage device comprises: a drainage body comprising a drainage cavity; a plurality of retention rings, each of the retention rings: having a respective center on a respective point on an axis of the drainage body, and protruding on an outer surface of the drainage body; and a plurality of inner ring grooves in the drainage cavity, each of the plurality of inner ring grooves concentric with a respective retention ring of the plurality of retention rings. In some embodiments, the plurality of inner ring grooves is configured for controlling a drainage speed. In some embodiments, the drainage device further comprises a flap valve coupled to the drainage cavity, the flap valve configured to: allow flow from a first side of the drainage cavity to a second side of the drainage cavity when a pressure of the first side is higher than a pressure of the second side, and disallow flow from the first side of the drainage cavity to the second side of the drainage cavity when the pressure of the first side is not higher than the pressure of the second side. In some embodiments, the drainage cavity is configured to fluidly connect an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye.
[0046] In some embodiments, the drainage device further comprises a plurality of microwells disposed along the outer surface of the drainage body, the plurality of microwells configured to store drugs for the eye.
[0047] In some embodiments, channels of the plurality of microwells have circular, square, or polygonal shapes.
[0048] In some embodiments, the plurality of microwells comprises one or more of ridges and slits.
[0049] In some embodiments, the plurality of microwells is configured to interact with the inner ring grooves, and the interaction between the plurality of microwells and the inner ring grooves controls the drainage speed and release rate of the drug.
[0050] In some embodiments, the drainage device further comprises a guiding and positioning end coupled to the first side of the drainage cavity, the guiding and positioning end comprising a positioning groove.
[0051] In some embodiments, the drainage device further comprises a discharge end couple to the second side of the drainage cavity.
[0052] In some embodiments, the discharge end is configured to have a curvature shaped according to a curvature of the eye when the drainage device is implanted in the eye.
[0053] In some embodiments, the discharge end comprises one or more of a thermoplastic material and rubber material.
[0054] In some embodiments, afirst diameter of the flap valve on the first side is greater than a second diameter of the flap valve on the second side.
[0055] In some embodiments, the drainage device further comprises: a guiding and positioning end; and an identification support ring on the guiding and positioning end. In some embodiments, the identification support ring comprises a ring or a woven mesh having a fluorescent material.
[0056] In some embodiments, the identification support ring furthercomprises one or more of nickel-titanium alloy, titanium alloy, and stainless steel.
[0057] In some embodiments, the drainage device further comprises a control unit, a pressure sensor, and a flow sensor. In some embodiments, the pressure sensor is configured to determine a pressure in the drainage device, the flow sensor is configured to determine a flow in the drainage device, and the control unit is configured to receive the pressure from the pressure sensor and the flow from the flow sensor.
[0058] In some embodiments, the control unit is configured to determine the drainage speed based on the pressure and flow.
[0059] In some embodiments, in accordance with one or more a determination that the pressure is higher than a threshold pressure and a determination that the flow is higher than a threshold flow, the drainage device is configured to change the drainage speed to a corrected drainage speed, and in accordance with a determination that the pressure is not higher than the threshold pressure and a determination that the flow is not higher than the threshold flow, the drainage device is configured to maintain the drainage speed.
[0060] In some embodiments, the corrected drainage speed is expressed as Q’ = Q x [1- (C-C1) / C ] , Q’represents the corrected drainage speed, Q represents the drainage speed, C represents the flow, and C1 represents a present flow.
[0061] In some embodiments, the plurality of inner ring grooves comprises five inner ring grooves, and spacings between adjacentinner ring grooves and depths of each inner ring grooves are adjustable to control the drainage speed.
[0062] In some embodiments, the spacings increase along one direction of the drainage body, and the depths increases along the one direction.
[0063] In some embodiments, acore of a delivery device is configured to pass through the drainage cavity.
[0064] In some embodiments, the drainage body comprises one or more of silicone rubber, block polyetherimide, polyurethane, polyethersulfone, polyimide, polyether ether ketone, and shape memory alloy.
[0065] In some embodiments, a minimally invasive, implantable ophthalmic drainage device comprises: a tube with an inner cavity, the tube comprising a two-dimensional wave shape or a three-dimensional spiral shape having a wave crest and a wave trough in a first state. In some embodiments, the tube comprises a shape memory alloy configured to restore the tube to the first state. In some embodiments, the inner cavity is configured to fluidly connect an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye, and the drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.
[0066] In some embodiments, the shape memory alloy comprises a nickel-titanium shape memory alloy.
[0067] In some embodiments, an outer diameter of the tube is between about 0.3 mm to about 0.6 mm and an inner diameter of the tube is between about 0.05 mm to about 0.3 mm.
[0068] In some embodiments, the tube comprises the two-dimensional wave shape having a period T between about 3.0 mm to about 6.0 mm, an amplitude A between about 0.6 mm to about 1.0 mm, and a length L between about 4 mm to about 6 mm.
[0069] In some embodiments, the tube comprises the two-dimensional wave shape, comprising a period T between about 3.0 mm to about 4.0 mm, an amplitude A between about 0.7 mm to about 0.8 mm, and a length L between about 4.5 mm to about 5 mm.
[0070] In some embodiments, the tube comprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 8.0 mm, a major diameter D between about 0.5 mm and about 1.5 mm, and a length L between about 4 mm and about 6 mm.
[0071] In some embodiments, the tube comprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 5.0 mm, a major diameter D between about 0.7 mm and about 1.0 mm, and a length L between about 4.5 mm and about 5.0 mm.
[0072] In some embodiments, the drainage device further comprises a plurality of apertures fluidically connecting the inner cavity to an outer surface of the tube. In some embodiments, the plurality of apertures comprises double-sided opposite apertures rotated at a preset angle along an axial direction of the tube or single-sided apertures rotated at a preset angle along the axial direction of the tube.
[0073] In some embodiments, the plurality of apertures is formed processed by laser cutting.
[0074] In some embodiments, the plurality of apertures comprises a circular shape, a rectangular shape, or an irregular shape.
[0075] In some embodiments, the drainage device further comprises one or more slits fluidically connecting the inner cavity to an outer surface of the tube. In some embodiments, the one or more slits are continuous spiral slits or intermittent slits evenly distributed axially or circumferentially along the tube.
[0076] In some embodiments, the drainage device further comprises a coating layer covering an outer surface of the tube. In some embodiments, the coating layer comprises Polytetrafluoroethylene (PTFE) , expanded polytetrafluoroethylene (ePTFE) , Fluorinated Ethylene Propylene (FEP) , Polyethylene (PE) , or silicone rubber.
[0077] In some embodiments, a minimally invasive, implantable ophthalmic drainage device comprises: a drainage body comprising: an inner cavity; a proximal segment configured to be positioned proximal to a suprachoroidal space of an eye when the drainage device is implanted in the eye; and a distal segment configured to be positioned proximal to an anterior chamber of the eye when the drainage device is implanted in the eye; and an expansion anchor connected with the drainage body between the proximal and distal segment. In some embodiments, the expansion anchor comprises a two-dimensional shape or a three-dimensional shape in an expanded state. In some embodiments, the drainage body and expansion anchor comprise a shape memory alloy configured to restore the expansion anchor to the expanded state, and the drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.
[0078] In some embodiments, the proximal segment of the drainage body comprises a length of between about 0.2 mm and about 2.5 mm, and the distal segment of the drainage body comprises a length of about 0.5 mm to about 3.0 mm.
[0079] In some embodiments, the shape memory alloy comprises a nickel-titanium shape memory alloy.
[0080] In some embodiments, the drainage body and the expansion anchor are integrally formed.
[0081] In some embodiments, the drainage body comprises a drainage tube with an inner cavity, and a first end and a second end of the expansion anchor are threaded onto an outer wall of the drainage tube, such that one of the first end and the second end is fixedly connected with the outer wall of the drainage tube, and one of the first end and the second end is configured to slide freely along the outer wall of the drainage tube.
[0082] In some embodiments, an outer diameter of the drainage body is between about 0.15 mm and about 0.6 mm, an inner diameter of the drainage body is between about 0.05 mm and about 0.4 mm, and a total length of the minimally invasive, implantable ophthalmic drainage device is between about 2.5 mm and about 7.0 mm.
[0083] In some embodiments, the expansion anchor comprises: the two-dimensional shape; and two expansion ribs symmetrically arranged with respect to the drainage body. In some embodiments, the two-dimensional planar shape formed by the two expansion ribs comprises an expansion diameter between about 0.6 mm and about 2.0 mm.
[0084] In some embodiments, the expansion diameter is between about 0.8 mm and about 1.5 mm.
[0085] In some embodiments, the expansion anchor having the two-dimensional shape comprises a length between about 0.9 mm and about 2.2 mm.
[0086] In some embodiments, the expansion anchor having the two-dimensional shape comprises a length between about 1.0 mm and about 1.8 mm.
[0087] In some embodiments, the expansion anchor comprises: the three-dimensional shape; and n expansion ribs. In some embodiments, n is an integer greater than 2. In some embodiments, the n expansion ribs are uniformly distributed along a circumferential direction of the drainage body. In some embodiments, the n expansion ribs are arranged in parallel with an axial direction of the drainage body or in a spiral shape along the axial direction of the drainage body.
[0088] In some embodiments, n is 3 or 4.
[0089] In some embodiments, the expansion anchor comprises: three expansion ribs uniformly arranged along a circumferential direction of the drainage body; and a three-dimensional shape formed by the three expansion ribs. In some embodiments, the three-dimensional shape comprises an expansion diameter between about 0.4 mm and about 1.2 mm.
[0090] In some embodiments, the expansion diameter is between about 0.6 mm and about 0.8 mm.
[0091] In some embodiments, the expansion anchor having the three-dimensional shape comprises a length between about 0.8 mm and about 1.8 mm.
[0092] In some embodiments, the expansion anchor having the three-dimensional shape comprises a length between about 1.0 mm and about 1.5 mm.
[0093] In some embodiments, the expansion anchor is configured for ciliary body dissociation when the minimally invasive, implantable ophthalmic drainage device is implanted in the eye, such that aqueous humor drained from the anterior chamber can enter the suprachoroidal space for transscleral or ciliary choroidal vascular absorption.
[0094] In some embodiments, any of the above delivery systems is configured to receive and release any of the aboveminimally invasive, implantable ophthalmic drainage devices.
[0095] In some embodiments, any of the aboveminimally invasive, implantable ophthalmic drainage device can be loaded into any of the above delivery systems.
[0096] In some embodiments, a method of implanting any of the above minimally invasive, implantable ophthalmic drainage devices in an eye comprises: positioning, in a suprachoroidal space of the eye, a puncture needle of any of the above delivery systems, the drainage device loaded in the delivery device; while the drainage device is loaded in the delivery device, positioning, by the delivery system, the drainage device in the suprachoroidal space; and releasing, by the delivery system, the drainage device.
[0097] In some embodiments, the suprachoroidal space is expanded by injecting a viscoelastic agent.
[0098] Additional aspects and advantages of the embodiments will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the embodiments. DESCRIPTION OF THE FIGURES
[0099] FIG. 1 shows a schematic diagram of an exemplary ophthalmic drainage device delivery system, in accordance with some embodiments.
[0100] FIGS. 2-3show schematic diagrams of portions of exemplary delivery systems, in accordance with some embodiments.
[0101] FIGS. 4-7show schematic diagrams of components of exemplary delivery systems, in accordance with some embodiments.
[0102] FIG. 8 shows a perspective view of an exemplary puncture needle and needle base of an exemplary ophthalmic drainage device delivery system, in accordance with some embodiments.
[0103] FIG. 9 shows a perspective view of an exemplary housing of the delivery system, in accordance with some embodiments.
[0104] FIG. 10 shows a side view of an exemplary switch of the delivery system, in accordance with some embodiments.
[0105] FIG. 11 shows a perspective view of an exemplary spring of the delivery system, in accordance with some embodiments.
[0106] FIG. 12 shows a perspective view of the structure of an exemplary ejector pin and exemplary base, in accordance with some embodiments.
[0107] FIG. 13 shows an exploded view of an exemplary delivery system, in accordance with some embodiments.
[0108] FIG. 14 shows a perspective view of an exemplary implantable drainage device with an exemplary delivery system, in accordance with some embodiments.
[0109] FIG. 15A shows a cross-sectional view of an exemplary implantable drainage device in a mated relationship with components of an exemplary delivery system in an initial state, in accordance with some embodiments.
[0110] FIG. 15B shows a cross-sectional view of the exemplary implantable drainage device in a mated relationship with the exemplary delivery system in an activated state, in accordance with some embodiments.
[0111] FIG. 15C shows a cross-sectional view of the mating relationship between the exemplary implantable drainage device and the exemplary delivery system during a release process of the exemplary implantable drainage device, in accordance with some embodiments.
[0112] FIG. 15D shows a cross-sectional view of the exemplary implantable drainage device and the exemplary delivery system after the release process of the exemplary implantable drainage device, in accordance with some embodiments.
[0113] FIG. 16A shows a cross-sectional view of another exemplary implantable drainage device having an expansion anchor in a mated relationship with components of an exemplary delivery system in an initial state, in accordance with some embodiments.
[0114] FIG. 16B shows a cross-sectional view of the exemplary implantable drainage device having an expansion anchor in a mated relationship with the exemplary delivery system in an activated state, in accordance with some embodiments.
[0115] FIG. 16C shows a cross-sectional view of the mating relationship between the exemplary implantable drainage device having an expansion anchor and the exemplary delivery system during a release process of the exemplary implantable drainage device, in accordance with some embodiments.
[0116] FIG. 16D shows a perspective view of the exemplary implantable drainage device having an expansion anchor and the exemplary delivery system after the release process of the exemplary implantable drainage device, in accordance with some embodiments.
[0117] FIGS. 17-21 show schematic diagrams of exemplary implantable ophthalmic drainage devices, in accordance with some embodiments.
[0118] FIG. 22shows a perspective view of an exemplary two-dimensional wave-shapedimplantable ophthalmic drainage device, in accordance with some embodiments.
[0119] FIG. 23shows a perspective view of another exemplary two-dimensional wave-shaped implantable ophthalmic drainage device with circular apertures, in accordance with some embodiments.
[0120] FIG. 24shows a perspective view of another exemplary two-dimensional wave-shaped implantable ophthalmic drainage device with a continuous helical slit, in accordance with some embodiments.
[0121] FIG. 25shows a perspective view of another exemplary two-dimensional wave-shaped implantable ophthalmic drainage device with a coating layer and a continuous helical slit, in accordance with some embodiments.
[0122] FIG. 26shows a perspective view of another exemplary two-dimensional wave-shaped implantable ophthalmic drainage device, in accordance with some embodiments.
[0123] FIG. 27A shows a perspective view of an exemplary three-dimensional spiral-shapedimplantable ophthalmic drainage device, in accordance with some embodiments.
[0124] FIG. 27B shows a perspective view and a side view ofanother exemplary three-dimensional spiral-shaped implantable ophthalmic drainage device, in accordance with some embodiments.
[0125] FIG. 28A shows a perspective view of an exemplary implantable ophthalmic drainage device with a two-dimensional expansion anchor, in accordance with some embodiments.
[0126] FIG. 28B shows a perspective view of another exemplary implantable ophthalmic drainage device with a two-dimensional expansion anchor, in accordance with some embodiments.
[0127] FIG. 29shows a perspective view of an exemplary implantable ophthalmic drainage device with a three-dimensional expansion anchor, in accordance with some embodiments.
[0128] FIG. 30shows a perspective view of an exemplary implantable ophthalmic drainage device with a three-dimensional expansion anchor, in accordance with some embodiments.
[0129] FIG. 31A shows a cross-sectional view of suprachoroidal space injection of a viscoelastic, in accordance with some embodiments.
[0130] FIG. 31B shows a cross-sectional view of the position of the puncture needle during implantation of the implantable drainage device, in accordance with some embodiments.
[0131] FIG. 31C shows a cross-sectional view of animplantable drainage device in an eye after release is completed, in accordance with some embodiments.
[0132] Fig. 31D shows a cross-sectional view of the completion of implantation of animplantable drainagedevice in an eye, in accordance with some embodiments.
[0133] FIG. 32A shows a cross-sectional view of suprachoroidal space injection of a viscoelastic, in accordance with some embodiments.
[0134] FIG. 32B shows a cross-sectional view of the position of the puncture needle during implantation of the implantable drainage device, in accordance with some embodiments.
[0135] FIG. 32C shows a cross-sectional view of an implantable drainage device in an eye after release is completed, in accordance with some embodiments.
[0136] Fig. 32D shows a front view of the completion of implantation of an implantable drainage device in an eye, in accordance with some embodiments.
[0137] FIG. 33 shows an anterior segment optical coherence tomography (AS-OCT) image of an exemplary ophthalmic drainage device implanted in an eye after being implanted for one month, in accordance with some embodiments.DETAILED DESCRIPTION
[0138] The following description is presented to enable a person of ordinary skill in the art to make and use the various embodiments. Descriptions of specific devices, techniques, and applications are provided only as examples. Various modifications to the examples described herein will be readily apparent to those of ordinary skill in the art, and the general principles defined herein may be applied to other examples and applications without departing from the spirit and scope of the various embodiments. Thus, the various embodiments are not intended to be limited to the examples described herein and shown, but are to be accorded the scope consistent with the claims.
[0139] It should be appreciated that the figures and components described with respect to the figures are exemplary. The disclosed delivery systems may comprise fewer, more, and / or different components and features than described to achieve the benefits described herein. For example, the delivery system may comprise components from the systems described with respect to FIGS. 1-7, components from the systems described with respect to FIGS. 8-16D, and / or components from the systems described with respect to Examples 1-6. As another example, the drainage devices described with respect to FIGS. 17-30 and Examples 1-6may be delivered using any of the delivery systems described with respect to FIGS. 1-16D and Examples 1-6.
[0140] FIG. 1 illustrates a schematic diagram of an exemplaryophthalmic drainage device delivery system, in accordance with some embodiments. In some embodiments, the ophthalmic drainage device delivery systemcomprises a housing 1, a puncture needle 2, an ejector tube 4, core 5, ejector tube base 6, core base7, buckle 8, rotating wheel 9, rack 10, switch 11, first spring 12, second spring 13, and button 14.
[0141] In some embodiments, animplantable ophthalmic drainage device3 is placed inside the puncture needle 2, for example, prior to delivering the implantable ophthalmic drainage device 3 to a target area. Details regarding the implantable ophthalmic drainage deviceare described in more detail herein. The implantable ophthalmic drainage device 3 may be any of the implantable ophthalmic drainage devices described herein.
[0142] In some embodiments, the housing1comprises a shell with a hollow structure. As illustrated, the puncture needle 2 may be disposed at a distal end of the main housing 1 (e.g., the end of the system where the implantable ophthalmic drainage device3 is released) . In some embodiments, the distal end may be an end of the main housing proximal to the patient when the system is in use (e.g., during operation) , and the proximal end may be the end of the main housing 1 away from the patient when in the system is in use (e.g., during operation) . In some embodiments, the puncture needle comprises one or more of stainless steel and nickel titanium alloy.
[0143] As illustrated, an ejector tube 4 may be disposed inside the puncture needle 2 (e.g., a portion of the ejector tube 4 near the distal end is disposed inside the puncture needle 2) . Theimplantable ophthalmic drainage device 3 may be placed inside the puncture needle 2, for example, prior to delivery to a target area. In some embodiments, the puncture needle 2isconfigured to puncture the sclera, and the ejector tube 4is configured to position and release the implantable ophthalmic drainage device 3 for delivery at the suprachoroidal space. Additional details about these components will be described with respect to FIG. 2.
[0144] In some embodiments, the ejector tube base6 is disposed inside the housing 1 for holding the ejector tube 4 and fixing the position of the core 5. For example, as illustrated, the core 5 passes through an opening of the ejector tube base 6, and the opening keeps the core 5 parallel along an axis of the housing 1. In some embodiments, the core base7is disposed inside the ejector tube 6 for fixing one end of the core 5. For example, as illustrated, the ejector tube base 6 couples to the core base7 via an inner surface of the ejector tube base 6 and an exterior surface of the core base 7. The core 5 may be inserted into an opening of the core base7 as shown.
[0145] In some embodiments, the buckle 8 iscoupled to the ejector tube base 6 for fixing the core base 7, for example, while the delivery system is in a first configuration prior to delivery of the implantable ophthalmic drainage device 3. As illustrated, the buckle 8 may couple to the ejector tube base6 via an interior surface of the buckle 8 and an exterior surface of the ejector tube base 6. As described in more details herein, the buckle 8 is configured to cause the release and delivery of the implantable ophthalmic drainage device 3, for example, when the system is in a second configuration during the delivery of the implantable ophthalmic drainage device 3.
[0146] In some embodiments, the rack 10 is coupled to the rotating wheel 9 via gears of the rotating wheel 9 and gears of the rack 10. FIG. 7 shows additional details of the rotating wheel 9. The rack may be a bar with tooth-like parts along one edge that fits into a pinion, allowing changes between circular and straight-line movement, for example, as illustrated.
[0147] In some embodiments, the rack 10 is coupled to the ejector tube base 6. In some embodiments, the rotating wheel 9 is configured to control the movement of the rack 10 (e.g., along a length of the delivery system) via rotation of the rotating wheel 9. The rack 10 and rotating wheel 9 may operate as a rack and pinion. The rotation of the rotating wheel 9 causes its gears to rotate, actuating the gears of the rack 10, and causing the rack to move in a corresponding direction. The movement of the rack 10 causes the ejector tube base 6 to move in a corresponding direction. The movement of the ejector tube base6 causes the core 5, the ejector tube 4, and the implantable ophthalmic drainage device 3 (when it is loaded into the system before delivery) to move accordingly with respect to the delivery system. This arrangement may allow more precise control of drainage device placement by controlling an amount of drainage device length to exit the system prior to releasing the drainage device.
[0148] For example, turning the rotating wheel 9 in a counterclockwise directionin FIG. 1 would cause the core 5, and the ejector tube 4, and the implantable ophthalmic drainage device 3 to move towards the distal end of the system, allowing the drainage device 3 to advance towards a target location. As another example, turning the rotating wheel 9 in a clockwise directionin FIG. 1 would cause the core base 7, core 5, and the ejector tube 4 to move away from the distal end of the system.
[0149] The rotating wheel 9 may also be used to move the core 5 and cause the core 5 to exit the puncture needle 2 for loading the drainage device 3. After the drainage device 3 is loaded onto the core 5, the rotating wheel 9 may move the core 5 and the loaded drainage device 3 into the puncture needle.
[0150] In some embodiments, the switch11 is arranged on a side wall of the housing 1, the first spring 12 surrounds the ejector tube base 6, and the second spring 13 is arranged between the ejector tube base 6 and the core base 7. In some embodiments, the two ends of the first spring 12 are respectively coupled to the switch 11 and the ejector tube base 6. In some embodiments, one end of the second spring 13 is coupled to the ejector tube base 6, and the other end of the second spring 13 is coupled to the core base 7.
[0151] In some embodiments, the switch11 and the buckle 8 form a sliding buckling structure, and the states of the buckle 8 are controlled by changing the position of the switch 11.
[0152] For example, when the position of the switch 11 is closer to the distal end of the system (e.g., as shown in FIG. 1) , the springs cause the buckle 8, which is in a closed position, to keep the core base 7 fixed, for example, in a first configuration prior to the delivery of the implantable ophthalmic drainage device 3. As another example, when the position of the switch 11 is farther away from the distal end of the system (e.g., in response to an actuation of the switch 11 in this direction) , the switch causes the buckle 8 to release (e.g., first portion 15 of the switch causes second portion 16 of the buckle 8 to open, as described below, decoupling the core base 7 from the buckle 8) the core base 7, for example, in a second configuration during release of implantable ophthalmic drainage device 3. The opening of buckle 8 causes the second spring 13 to push the core base 7 away from the distal end direction, moving the core 5in the same direction. In response, the ejector tube 4 pushes out the implantable ophthalmic drainage device 3 and releases the drainage device from the core 5. This allows the implantable ophthalmic drainage device3to be accurately retained in a target location and minimizing force of the delivery device on the eye during release.
[0153] Additional details of these components are described herein. This arrangement simplifies implantable ophthalmic drainage device release, thereby reducing complexity and risk associated with the operation.
[0154] In some embodiments, the housing1 comprises one or more of stainless steel, aluminum alloy, and engineering plastic. In some embodiments, a surface of the housing comprises a pattern.
[0155] It should be appreciated that the shape of the housing1 can be designed according to use requirements and usage habits or preferences of operators. For example, the shape of the housing1has a cylindrical shape, but it is not limited to this shape.
[0156] In some embodiments, the button 14 is configured to lock the rack 10, preventing the rack 10 from sliding freely and allowing more precise control of the position of the rack 10. This allows the rotating wheel 9 to accurately control the movements of the ejector tube 4 and the core 5, and thus the movement of the implantable ophthalmic drainage device 3 prior to release. For example, when movement of the rack 10 is not desirable (e.g., when the drainage device 3 is ready for release) , pushing the button 14 into the main body 1 locks the rack 10, preventing accidental actuation of rotating wheel 9 and accidental movement of rack 10. As another example, when the button 14 is not pushed, the rotating wheel 9 and rack 10 may slide freely.
[0157] Compared to existingdelivery systems, in some embodiments, the discloses buckle keeps the core base and the ejector tube basefixed, the rotating wheel is coupled to the rack, the rack is connected to the ejector tube base, and the self-locking button is set to lock the rack, allowing control of rack movementand preventing the rack from sliding freely. Thus, the rotating wheel can accurately control the movements of the ejector and the core, to deliver the implantable ophthalmic drainage device to the appropriate position, avoiding the problem with current systems, which increase the difficulty of delivering the drainage device and require an experienced user to operate.
[0158] FIG. 2 illustrates a structural schematic diagram of a portion of an exemplary ophthalmic drainage device delivery system, in accordance with some embodiments. FIG. 2 shows additional details of the puncture needle 2, the implantable ophthalmic drainage device 3, the ejector tube 4, and the core 5.
[0159] As discussed, in some embodiments, the puncture needle 2 is used for scleral puncture. In some embodiments, the angle of the puncture needle 2is designed based on the patient’s eye reference index. The patient’s eye reference index may include the patient’s eyeball size, eyeball curvature, and implantation position.
[0160] Advantageously, the delivery system allowsmore flexibility with respect to an angle of the puncture needle2 during tube deployment, so that the puncture needle may be more accurately positioned for a particular operation, thereby improving the applicability of the puncture needle and further improving the use efficiency of the device.
[0161] In some examples, the puncture needle 2 is inserted about 4.0-6.0 mm into the suprachoroidal space, preferably about 4.5-5.0mm, through the sclera. The suprachoroidal space may be opened by injecting, via a suprachoroidal injector, a viscoelastic, allowing the needle to be precisely located. As described in more detail herein, the implantable ophthalmic drainage device 3 is then released out of the puncture needle 2, delivered into the suprachoroidal space, and pushed to the limbus.
[0162] As illustrated, a portion the core 5 passes through a cavity of the implantable ophthalmic drainage device 3, allowing the drainage device 3 to rest in the delivery device prior to release. Another portion of the core 5 passes through a cavity ofthe ejector tube 4. In some embodiments, the ejector tube 4 surrounds a portion of the core 5 and couples to the implantable ophthalmic drainage device 3 to support, fix, and guide the implantable ophthalmic drainage device 3. For example, as discussed above, actuation of therotating wheel 9 causes the core 5 and the ejector tube 4 to move, guiding the implantable ophthalmic drainage device 3 to move accordingly.
[0163] In some embodiments, the implantable ophthalmic drainage device 3 (e.g., the body of the drainage device) comprises one or more of silicone rubber, block polyetherimide, polyurethane, polyethersulfone, polyimide, polyether ether ketone, and shape memory alloy (e.g., nickel-titanium shape memory alloy) . In some embodiments, the ejector tube 4 comprises one or more of stainless steel and nickeltitanium alloy. In some embodiments, the core 5 comprises one or more of stainless steel and nickeltitanium alloy.
[0164] In some embodiments, the retraction of core5and the ejector tube 4’s detachment of the drainage device 3 enable the implantation process of the drainage device 3 to be more flexible. An operator can adjust the position of the drainage device 3according to the specific condition of the operation and ensure that the drainage device 3 accurately reaches the expected drainage area. Through the detachable design, the implantation depth and direction of the implantable ophthalmic drainage device can be controlled more accurately and the force of the delivery device during release is reduced, so that the risk of damaging surrounding tissues is reduced, and complications can be reduced.
[0165] As illustrated in FIG. 2, the end of the ejector tube 4is away from the proximal end of the system and abutted against the end of the implantable ophthalmic drainage device 3. Also as illustrated, the position of the ejector tube 4is further away from the distal end of the housing 1, relative to the position of the implantable ophthalmic drainage device 3.
[0166] FIG. 3 illustrates a structural schematic diagram of a portion of an exemplary ophthalmic drainage device delivery system, in accordance with some embodiments. FIG. 3 shows additional details of the ejector tube 22 and the core 23. In some embodiments, the ejector tube 22 is ejector tube 4, and the core 23 is the core 5. As shown in FIG. 3, a puncture needle, which may be the puncture needle 2, and an ejector tube 22 are disposed in the system, and the core 23 is disposed in the drainage cavity.
[0167] In some embodiments, as illustrated in FIG. 3, the implantable ophthalmic drainage device, which may be implantable ophthalmic drainage device3, is loaded in the puncture needle. The guiding and positioning end (e.g., guiding and positioning end 401, described below) may be at the distal end, the proximal end of the implantable ophthalmic drainage device is abutted by the ejector tube 22, and a lining core 23is arranged in the ejector tube 22to support and fix the position of the ejector tube 22 and the implantable ophthalmic drainage device.
[0168] In some embodiments, the implantable ophthalmic drainage device comprises an identification support ring (e.g., identification support ring 304, identification support ring 402, described below) , which may be located at the head of the implantable ophthalmic drainage device. The location of the implantable ophthalmic drainage device may be determined by observing whether the identification support ringat the head of the implantable ophthalmic drainage device enters the anterior chamber angle. Once the implantable ophthalmic drainage device is in place, the core 23is caused to release the implantable ophthalmic drainage device, the ejector tube 22 is fixed to ensure accurate positioning, as described herein. Then, the system is retracted to complete the drainage device implantation process.
[0169] In some embodiments, the mobility of ejector tube 22 and lining core 23 allows the implantable ophthalmic drainage deviceto be more agile in implantation process. An operator may more easily adjust the position of the implantable ophthalmic drainage device according to the specific conditions of the operation and ensure that the implantable ophthalmic drainage device accurately reaches the expected drainage area. Through this detachable design, the implantation depth and direction of the implantable ophthalmic drainage device can be controlled more accurately, reducing the risk of damaging surrounding tissues and complications.
[0170] Referring to FIGS. 4 to 6, the switch11comprises a first portion 15, and the buckle 8 comprises a second portion 16. In some embodiments, the first portion15has a conical structure, and the second portion 16 has inverted cone structure. In some embodiments, the first portion15 is configured to couple to the second portion 16 (e.g., while the buckle 8 is in a closed position, as described with respect to FIG. 1) .
[0171] As illustrated in FIG. 4, in some embodiments, the second portion16 of the buckle 8 comprises clamping protrusions perpendicular to the axis of the housing 1. In a first configuration (e.g., before the release of the implantable ophthalmic drainage device 3) , the clamping protrusions of the second portion16 of the buckle 8 apply a clamping force to the core base 7.
[0172] In some embodiments, when the implantable ophthalmic drainage device3 has reached a target location, the operator can actuate the switch 11, causing the first portion 15 of the switch 11 to push onto the second portion 16 of the buckle and the buckle 8 to open. This causes the second spring 13to push the core base 7away from the distal end of the system and moving the core 5 in the same direction, releasing the implantable ophthalmic drainage device 3 and causing the implantable ophthalmic drainage device 3 to withdraw from the system. This allows the implantable ophthalmic drainage device3to be accurately retained in a target location and minimizing force of the delivery device on the eye during release.
[0173] In some embodiments, the ophthalmic drainage device delivery systemcomprises a vibration sensor (not shown) . For example, the vibration sensor is disposed inside the proximal end of the main housing 1. In some embodiments, the vibration sensor is coupled to a light. In some embodiments, when the vibration sensor detects that a vibrationof the delivery device isgreater than a vibration threshold value, the light is configured to provide a warning (e.g., configured to flash) .
[0174] In some embodiments, the vibration threshold value can be set by an operatoraccording to the operation scenario. For instance, alower vibration threshold value (e.g., smaller vibrations may cause a warning to be provided) may be associated with a higher risk operation, thus, agreater demand for the operator’s accuracy and less vibration.
[0175] The vibration sensor may be used to record system vibration during operation. The operator may use the recorded values (e.g., the average vibration value) to determine operation requirements and set the vibration threshold value accordingly.
[0176] The ophthalmic drainage device delivery system may be used as follows. First, a viscoelastic agent may be injected into the patient’s suprachoroidal space through a suprachoroidal space syringe to expand the suprachoroidal space to a certain area or volume.
[0177] In some embodiment, after the suprachoroidal space is set, the housing1 is held, and the puncture needle 2 is inserted into the suprachoroidal space. After the insertion, the rotating wheel 9 is rotated to moveimplantable ophthalmic drainage device 3, which was loaded into the puncture needle 2. For example, the rotation of the rotating wheel 9 causes the implantable ophthalmic drainage device to advance towards the direction of the distal end of the system, as discussed above.
[0178] After observing that the retention ring on the implantable ophthalmic drainage device3 reaches the corneal margin, the rotation of rotating wheel 9 is stopped. The button 14 may be pushed to prevent accidental rotation of the rotating wheel 9 and further movement of the drainage device 3 prior to release. The switch 11 is actuated to release the implantable ophthalmic drainage device 3 into the suprachoroidal space. When the implantable ophthalmic drainage device3 is in place, the core 5 may be withdrawn first, and then the delivery system is withdrawn to complete the implantable ophthalmic drainage device 3 implantation process. After the implantable ophthalmic drainage device3 is released, the puncture needle 2 is withdrawn, and the example operation is completed.
[0179] In some embodiments, the implantable ophthalmic drainage device 3 may be released about 4.0-4.5mm away from the corneal margin. When the puncture needle 2 is inserted into the suprachoroidal space, the exposed length of the puncture needle 2 can be confirmed according to the puncture angle and the puncture distance, to avoid puncture failure caused by the length being too short or too long. By observing whether the identification support ring at the head of the implantable ophthalmic drainage device3 enters the anterior chamber angle, it can be determined whether the implantable ophthalmic drainage device 3 has reached the target location.
[0180] FIGS. 8-16D illustrate additional examplesof systems for delivering the implantable ophthalmic drainage devices. With reference to FIGS. 8-16D, the delivery system comprises a puncture needle 110, a needle base120, a housing 130, an ejector pin 140, a base150, a switch160, and a spring 170. The puncture needle 110 can be fixedly connected with the needle base120. The puncture needle 110 can comprise a first cylindrical cavity 111 for receiving an implantable ophthalmic drainage device. For example, an implantable ophthalmic drainage device can be elastically compressed and installed in the first cylindrical cavity 111 of the puncture needle. The housing 130 can be configured to receive the puncture needle 110 and the needle base120. For example, the puncture needle 110 may be arranged at the front end of the housing 130 (e.g., the end of the housing oriented towards the eye during an implantation procedure) , such that a part of the puncture needle 110 is inserted into the housing 130. The needle base120 may be arranged in the housing 130, such that the needle base120 can move forward and backward relative to the housing 130. The switch160 can be connected with the needle base120 and can correspond to an opening in the housing 130, such that sliding the switchalong an axis of the housing (e.g., sliding the switch back and forth within the opening) can push the needle basealong the axis of the housing (e.g., can push the needle baseback and forth relative to the housing) . Spring170 can be positioned between the switch160 and the needle base120. In some embodiments, the switch160 can be positioned a first switch state or a second switch state relative to the housing 130. In the first state, the switch160 can form a stop with the housing 130 to prevent movement of the needle base120 (e.g., the housing 130 can prevent movement of the switch 160 along the axis of the housing 130, thereby preventing movement of the needle base 120) . In the second state, the switch160 can be positioned to release the stop between the switch160 and the housing 130, such that the needle base120 and puncture needle 110can be moved within the housing 130 (e.g., the housing 130 can allow the switch 160 to move, thereby allowing the needle base 130 and puncture needle 110 to move) . The spring 170 can hold the switch160 in the first state and can be configured to compress when the switch160 is depressed, such that the switch160 can enter the second state from the first state when the switch160 is depressed. The ejector pin 140 can be fixedly connected with the base150. The outside diameter of the ejector pin 140 can correspond to the inside diameter of the puncture needle 110, such that the ejector pin can enter the first cylindrical inner cavity of the puncture needle 110 in a sliding manner. The ejector pin 140 can be used for supporting and releasing the minimally invasive drainage device. The base can be configured to fixedly connect with the housing 130.
[0181] In some examples, an implantable ophthalmic drainage device can be made of or a shape memory alloy (e.g., a nickel-titanium shape memory alloy or nitinol) such that it can be compressed (e.g., linearly compressed) and inserted into the rigid puncture needle 110. In some examples, where the implantable ophthalmic drainage device comprises a wave-shape or a spiral shape in a first state, the implantable ophthalmic drainage device can be compressed into a second state and inserted into the puncture needle. In some examples, where the implantable ophthalmic drainage device comprises an expansion anchor with a two-dimensional or three-dimensional shape in an expanded first state, the expansion anchor can be compressed into a second state and inserted into the rigid puncture needle, such that at least a portion of the distal segment of the drainage body of the implantable ophthalmic drainage device extends outside of the puncture needle. For example, a distal segment of the drainage body of the drainage device can extend out of the puncture needle 110 by between about 0.5 mm and about 3.0 mm. Prior to implantation of the implantable ophthalmic drainage device, the suprachoroidal space of the eye can be expanded by injecting a viscoelastic agent (e.g., via a different injection needle) .
[0182] Following injection of the viscoelastic, the disclosed delivery system can be used to implant the ophthalmic drainage device. For example, the needle 110 can be inserted into an eye such that it passes through the anterior chamber angle after entering the suprachoroidal space. For example, in the case of an ophthalmic drainage device having an expansion anchor, the needle 110 can be advanced into the suprachoroidal space until the distal end of the distal segment of the drainage body of the drainage device passes through the anterior chamber angle by about 0.3 mm to about 1.0 mm. The delivery system can then release the drainage device in situ after retraction of the needle 110 into the housing. Finally, the delivery system can be completely withdrawn from the eye.
[0183] Referring to FIG. 8, the puncture needle 110 can be fixedly connected with the needle base120. The puncture needle 110 can comprise first cylindrical cavity 111 for loading an implantable ophthalmic drainage device. In some embodiments, the outer diameter of the needle 110 may be between about 0.5 mm and about 0.7 mm and the inner diameter of the needle 110 may be between about 0.3 mm and about 0.5 mm. In some embodiments, the outer diameter of the needle 110 may be between about 0.4 mm and about 0.8 mm and the inner diameter of the needle 110 may be between about 0.18 mm and about 0.61 mm. The tip of the needle 110 may be a short bevel needle or a blunt needle. The needle base120 may comprise a second cylindrical inner cavity 121 axially identical to the puncture needle 110 (e.g., the second cylindrical inner cavity 121 can comprise an axis corresponding to an axis of the puncture needle) . The second cylindrical inner cavity 121 can be configured to slidably engage with the ejector pin 140 when the delivery system is assembled. The needle base120 may comprise a rectangular outer surface 122 configured to slidably engage with an inner cavity of housing 130 when the delivery system is assembled. The needle base120 can comprise a first needle base inner cavity surface 123 slidably engaged with the outer surface of the switch160 and a second needle base inner cavity surface 124. The first needle base inner cavity surface 123 and the second needle base inner cavity surface 124 can form a switch installation cavity to receive the switch160 and slidingly engage with the switch. The needle base120 can comprise a cylinder 125 located in the switchinstallation cavity, configured to fixedly engage with the inner surface of the spring 170 when the delivery system is assembled.
[0184] Referring to FIG. 10, switch160 includes a first switch outer surface 161 configured to slidably engage with first needle base inner cavity surface 123 and a second switch outer surface 162 configured to slidably engage with second needle base inner cavity surface 124 when the delivery device is assembled. The switch160 can further comprise a third switch outer surface 163 configured to slidably engage with first housing inner cavity surface 133 of housing 130 and a fourth switch outer surface 164 configured to slidably engage with a second housing inner cavity surface 134 of housing 130. The switch may also comprise a switch inner cavity surface 165 configured to fixedly engage with an outer surface of spring 170. Referring to FIG. 11, spring 170 can comprise a spring outer surface 171 configured to fixedly engage with switch inner cavity surface 165 and a spring inner surface 172 configured to fixedly engage with the outer surface of cylinder 125 of needle base120.
[0185] Referring backto FIG. 9, the housing 130 can comprise a third cylindrical inner cavity 131 configured to slidably engage with the puncture needle 110 when the delivery system is assembled. The housing 130 can further comprise a housing inner cavity 132 configured to slidably engage with the outer surface of the needle base120 when the needle base120 is housed within the housing 130. In some embodiments, the housing inner cavity 132 may be a rectangular cavity. The housing 130 can comprise a first housing inner cavity surface 133 and a second housing inner cavity surface 134. The first and second housing inner cavity surfaces can be configured to slidably engage with the outer surface of the switch160 when the delivery system is assembled. The width of the first housing interior cavity surface 133 can be greater than the width of the second housing inner cavity surface 134, and the diameters of the first switch outer surface 161, second switch outer surface 162, and third switch outer surface 163 can be greater than the width of the second housing inner cavity surface 134, such that the second housing inner cavity surface 134 restricts movement of the first, second, and third switch outer surfaces (e.g., forms the stop between the switch and the housing) when the switch is in the first state. The fourth switch outer surface 164 can have a smaller diameter than the first, second, and third switch outer surfaces and smaller than or equal to the width of the second housing inner cavity surface 134, such that the fourth switch outer surface 164 is slidable along the second housing inner cavity surface 134 when the switch is in the second state. The housing 130 can comprise a first locking structure 135, configured to engage with a second locking structure 152 of the base150. The first and second locking structures may be threaded structures or snap-fit structures, or other type of structures configured to fixedly connect the second locking structure 152 with the first locking structure 135.
[0186] Referring to FIG. 12, the base150 includes a cavity 151 configured to fixedly receive an end of the ejector pin. The base150 can further comprise a second locking structure 152 configured to engage or fixedly connect with the first locking structure 135 of the housing 130, such that the base150 is fixedly connected with the housing. The locking structure of the base can be threaded structure or a snap-fit structure.
[0187] In some embodiments, the puncture needle 110 can be made of stainless steel or nickel-titanium shape memory alloy. In some embodiments, the needle base120, the housing 130, the base150, and / or the switch160 may be made of resin. In some embodiments, the ejector pin 140 and / or the spring 170 may be made of stainless steel.
[0188] FIG. 13 illustrates an exploded view of the components of the delivery system and how the components can interface with each other. In the assembly process, after the needle base120 is inserted into the housing inner cavity 132, the spring inner surface 172 can be fixedly matched with the cylinder 125 of the needle base. The switch can be inserted into the housing such that the spring outer surface 171 can be fixedly matched with the switch inner cavity surface 165 and the second switch outer surface 162 of the switch160 passes through the first housing inner cavity surface 133 in the housing 130 to fit against the first needle base inner cavity surface 123. Meanwhile, due to the elasticity of the spring 170, the engagement of the first housing inner cavity surface 133 and the third switch outer surface 163 can be maintained. Because the width of the second housing inner cavity surface 134 is smaller than that of the first housing inner cavity surface 133 and the diameter of the third switch outer surface 163, the switch and needle basecan be prevented from moving along the axis of the housing (e.g., preventing from moving back and forth within the housing) (e.g., as shown in FIGS. 15A and 16A) .
[0189] Referring to FIG. 14, the implantable ophthalmic drainage device (e.g., device 3, 500, 600, 700, or 2000) can be inserted into the first cylindrical cavity 111 of the needle 110, such that the implantable ophthalmic drainage device is loaded into the delivery system.
[0190] FIGS. 15A-15D illustrate the process of implanting an implantable ophthalmic drainage device having a wave shape or a spiral shape using the delivery system. FIGS. 16A-16D illustrate the process of implanting an implantable ophthalmic drainage device having an expansion anchor using the delivery system. Referring to FIGS. 15A and 16A, switch 160 can be in an initial state (e.g., the first state as described above) with respect to the housing 130 and the needle base 120. That is, the switch 160 can be held in a position (e.g., due to spring 170) such that the switch 160 cannot slide, thereby preventing needle base100 from moving within housing 130. Referring to FIGS. 15B and 16B, the system can be brought into an activated state (e.g., the second state as described above) by depressing the switch 160 to disengage the first housing inner cavity surface 133 from the third switch outer surface 163, and engaging the first housing inner cavity surface 133 with the fourth switch outer surface 164. Referring to FIGS. 15C and 16C, the switch 160 can be slid backwards (e.g., retract) with respect to the housing, such that there is a sliding fit between the second housing inner cavity surface 134 of the housing and the fourth switch outer surface 164 of the switch 160. The retraction movement of the switch 160 can cause the retraction of the needle base 120 and the puncture needle 110. Meanwhile, the position of the ejector pin 140 can remain unchanged, such that that the ejector pin 140 pushes the implantable ophthalmic drainage device out of the puncture needle 110, thereby realizing in-situ release of the implantable ophthalmic drainage device. That is, the ejector pin 140 is configured to push the drainage device out of the puncture needle as the puncture needle moves back along the axis of the housing. Referring to FIGS. 15D and 16D, after removal of the depression force on switch 160, the delivery system may stay in the illustrated state when the implantable ophthalmic drainage device release is complete and may be removed by the operator. After the implantable ophthalmic drainage device is released by the delivery system, the implantable ophthalmic drainage device can restore from a compressed second state to the preset first shape (e.g., such that the implantable ophthalmic drainage device assumes a wave shape or a spiral shape, or such that an expansion anchor of the implantable ophthalmic drainage device expands) configured to fix the implantable ophthalmic drainage device in position.
[0191] FIGS. 17-30 illustrate exemplary implantable ophthalmic drainage devices, in accordance with some embodiments. These drainage devices may be delivered using any of the delivery systems described with respect to FIGS. 1-16D or any of the delivery systems described with respect to Examples 1-6. It should be appreciated that the illustrated drainage devices are exemplary. The disclosed drainage devices may include fewer, more, and / or different elements and features than described to achieve the benefits described herein. For example, a drainage device may comprise elements and features described in different figures and / or different examples of Examples 1-6.
[0192] The drainage devices may be minimally invasive, implantable ophthalmic drainage device for draining fluid using the suprachoroidal space and a delivery system (e.g., as described above) thereof. Prior to implantation of the drainage device in an eye, the suprachoroidal space of the eye may be opened by injecting, via a suprachoroidal injector, a viscoelastic, allowing the needle and device to be precisely located. The disclosed ophthalmic drainage devices are advantageous over existing drainage devices, which are limited due to poor fixation in the eye, difficult controls, and risks caused by existing implantation methods. In some embodiments, the ophthalmic drainage device comprises an expansion anchor to improve fixation of the device in the suprachoroidal space.
[0193] In some embodiments, the disclosed drainage devices solve the problems that existing aqueous humor drainage implant has difficulty simulating the natural flow of aqueous humor, leading to unstable eye pressure and side effects. The drainage systems are configured to regulate intraocular pressure and can be positioned accurately. The drainage devices allow simple and quick operations and reduction of risks and side effects.
[0194] FIG. 17 illustrates an exemplary implantable ophthalmic drainage device 300, in accordance with some embodiments. As illustrated, the drainage device 300 comprises a drainage body, andretention rings 302 on an outer surface of the drainage body. The drainage device 300 may further comprise identification support ring 304. In some embodiments, the drainage device 300 is configured to fluidly connect (e.g., via drainage cavity inside the drainage device 300) an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye.
[0195] In some embodiments, each of the retention rings 302 has a respective center on a point on an axis of the drainage body. For example, the axis of the drainage body is a horizonal axis (along left to right of the figure) in the center of the drainage cavity. Each of the retention rings 302, which may have annular shapes when looking in a direction into the drainage cavity, and the annual shapes may be each centered on different points on this axis.
[0196] In some embodiments, the outer surface of the drainage body of the device 300 comprises a plurality of retention rings 302 with protruding structures. Aheight of a protrusion of a retention ring may be the samesurrounding the outer surface of the drainage device body. The retention rings 302 may be configured to prevent the drainage device 300 from shifting and to control the drainage speed. The retention rings 302 may also serve as distance markers and bumpers for controlling the release speed of the drainage device 300 from a delivery system.
[0197] The identification support ring 304 may be located on a part of the surface of the drainage device 300. The identification support ring 304 may be configured to support the tube mouth, as illustrated, and to display the delivery distance. The identification support ring 304 may comprise one or more of nickeltitanium alloy, titanium alloy, and stainless steel. The identification support ring allows an operator toobtain an accurate delivery distance during use. The parameters and position of the identification support ring 304 can be set according to the operation scenario and delivery distance, thereby improving the user’s usage efficiency.
[0198] As illustrated, the drainage device 300 may include a head 306, which may be used to cross the anterior chamber, the corneal limbus, and the suprachoroidal space to transport the aqueous humor from the anterior chamber to the suprachoroidal space. The head may be located near an end of the drainage device 300 opposing the identification support ring 304. The drainage device 300 may include a positioning groove, which may be used to locate the position of the head, and the positioning groove is attached at the corneal limbus.
[0199] The drainage device 300 may include a main body. When in use, the main body of the drainage device 300 is implanted in the suprachoroidal space to discharge the aqueous humor into the suprachoroidal space.
[0200] In some embodiments, the drainage device 300has a length ranging fromabout 4 to 6 mm, preferably about 4.5 mm, an outer diameter ranging from about 0.3 to 0.6 mm, preferably about 0.38 mm, and an inner diameter ranging fromabout 0.05 to 0.2 mm, preferably about 0.15 mm.
[0201] FIGS. 18-21 illustrate an exemplary implantable ophthalmic drainage device 400, in accordance with some embodiments. Referring to FIGS. 18 and 19, in some embodiments, the drainage device 400 comprises a guiding and positioning end 401, an identification support ring 402, a discharge end 403, a drainage cavity 404, and a control unit405. In some embodiments, the drainage device 400 is configured to fluidly connect (e.g., via drainage cavity 404) an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye.
[0202] In some embodiments, as illustrated, the guiding and positioning end 401 is provided with a positioning groove 411, a pressure sensor 412 for monitoring pressure, and a flow sensor 413 for monitoring flow. The positioning groove 411may be used for positioning the guiding and positioning end 401, for example, at a target location.
[0203] Advantageously, the positioning groove 411 of the guiding and positioning end 401 can ensure that the head of the drainage device 400 is accurately positioned at the limbus in the implantation process, avoiding displacement and dislocation. Thus, the accuracy and success rate of the operation can be improved.
[0204] The drainage device 400 may be implanted into the eye of a patient, and the discharge end 403 is positioned in the eye, and the guiding and positioning end 401 is in the direction out of the eye. Liquid in the eye may be discharged out of the eye through the guiding and positioning drainage end 401, realizing minimally invasive drainage. In some embodiments, the discharge end 403 is rigid.
[0205] Referring to FIG. 18, the drainage device 400 may have a cylindrical structure with a tube orifice at an end surface, the tube orifice is fluidly coupledwith a drainage cavity 404. The drainage device 400may be divided into a guiding and positioning end 401 and a discharge end 403. The diameter of the cylindrical structure of the discharge end 403 may be larger than that of the cylindrical structure of the drainage positioning end 401.
[0206] The outer surface of the guiding and positioning end 401 may be recessed inwards to form theannular positioning groove 411. The identification support ring 402 may surround the annular positioning groove 411. The identification support ring 402 may comprise a hard material. When the guiding and positioning end 401 is implanted and deformed (e.g., at a target location) , the identification support ring 402 may be kept annular and is not deformed, allowing the discharge end 403 to be supported. In this way, the tube orifice is not extruded and closed, and an operator can conveniently determine the position of the tube orifice during implantation.
[0207] In some embodiments, the discharge end 403 has a pre-shaped curvature, and the curvature may be pre-shaped according to the curvature of the eye (e.g., to match the eye curvature) . That is, when the drainage device is implanted in the eye, the discharge end 403 is configured to have a curvature shaped according to a curvature of the eye. The drainage device 400 may comprise a shape memory material, such that when the drainage device 400canbe loaded into a delivery system and returns to its intended shape when implanted.
[0208] For example, prior to operation, an ocular curvature measurement device (e.g., corneal topography) is used to measure the curvature of the eye. The pre-shaped curvature of the discharge end 403 may be designed according to the eye curvature measurement result. This would ensure that the curvature of the discharge end 403 matches the natural curvature of the eye.
[0209] In some embodiments, the material of the discharge end 403 is flexible, allowing the discharge end 403 to adapt to the curvature of the eye during implantation. The discharge end 403 may be manufactured according to the design, ensuring that the curvature of the discharge end 403 is matched with the curvature of the eye. In some embodiments, the discharge end 403 is manufactured using a thermoplastic material or a rubber material, and its curvature is bentusing heat treatment, or using an elastomeric material to allow the discharge end 403 to self-adjust the curvature during implantation. Advantageously, the discharge end 403 and eye curvature shape-matching would reduce the patient discomfortduring the implantation.
[0210] The identification support ring 402 may comprise a ring or woven mesh having a fluorescent color. The identification support ring 402 may comprise a material having fluorescent properties, such as a polymer containing a fluorescent dye. Such materials can emit light under light illumination of a specific wavelength, thereby providing a clear visual indication under a surgical microscope. The identification supporting ring 402 can have an annular structure, allowing the identification supporting ring 402 to fix at an appropriate position of the drainage device 400.
[0211] The diameter and thickness of the identification support ring 402 can be designed according to the size and shape of the drainage device 400 to ensure that the ring can be stably fixed to the drainage device. In some embodiments, instead of rings, the identification support ring 402 can be designed as a woven mesh. This design can allow a larger surface area, increase the distribution of the fluorescent material, and thus produce a more intense fluorescent effect under light irradiation.
[0212] Advantageously, fluorescent markers allow the operation to be more accurate, reducing the risk of the patient receiving a secondary procedure, as the drainage device 400 can be placed more accurately. The fluorescent markers allow the entrance of the drainage device 400 to be more easily identified and positioned during operation, simplifying operation and reducing operation time.
[0213] As illustrated, a plurality of retention rings 421may be arranged on the outer wall of the discharge end 403 at interval spacingand protruding outwards away from an axis of the drainage device 400 (e.g., a horizonal axis along left to right of the figure) . The retention rings 421may comprise rigid materials, so that the discharge end 403 can be fixed on the patient’s eye during the implantation process.
[0214] In some embodiments, each of the retention rings 421 has a respective center on a point on an axis of the drainage body. For example, the axis of the drainage body is a horizonal axis (along left to right of the figure) in the center of the drainage cavity 404. Each of the retention rings 421, which may have annular shapes when looking in a direction into the drainage cavity 404, and the annual shapes may be each centered on different points on this axis.
[0215] The control unit 405 may be arranged on the discharge end 403, and may be communicatively coupled (e.g., via a wired or wireless connection) to the pressure sensor 412 and the flow sensor 413. The control unit 405 can acquire and determine the real-time pressure via the pressure sensor 412 and the real-time flow via the flow sensor 413. The control unit 405 can cause the drainage speed to be maintained when it determines that the flow is smaller than or equal to a threshold flow (e.g., a desired maximum flow for drainage) and the pressure is smaller than or equal to a threshold pressure (e.g., a desired maximum pressure for drainage) . The control unit 405 can cause adjustments (e.g., reduce) to drainage speed to a desired drainage speed when determining that the real-time flow is greater than the threshold flow.
[0216] In some embodiments, the control unit 405 is configured to communicate with an external device for displaying the flow and pressure readings and for controlling the pressure and flow. In some embodiments, the control unit 405 provides an indication to an operator to adjust or maintain the drainage speed according to the detected pressure and / or flow. The drainage speed may be adjusted by adjusting drainage device parameters, such as parameters relating to inner grooves, adjusting the flap valve, and adjusting device dimensions, as explained herein.
[0217] Through the pressure sensor 412 and flow sensor 413, the pressure and flow in the drainage cavity 404 can be monitored in real-time via the control unit 405. In some embodiments, when the control unit 405 determines, via the pressure sensor 412, that the pressure is greater than at threshold pressure, the drainage cavity can be controlled (e.g., by reducing the pressure, as explained herein) to achieve a desired drainage speed. The pressure (e.g., at the guiding and positioning end 401) can be obtained repeatedly, and the control unit 405 may determine a difference between a desired pressure and the pressure. If the pressure is less than or equal to the desired pressure, the control unit 405 can be used for controlling the drainage cavity to maintain the drainage speed.
[0218] In some embodiments, the desired pressure value is set before operation according to patient conditions and operation requirements. The desired pressure may be determined according to factors such as the intraocular pressure, anterior chamber depth, and elasticity of the eyeball wall of the patient. The desired pressure may be 5 to 25 mbar, where 1 mbar is 100 pa. For example, the desired pressure is 15 mbar, for comparison with pressure reading from the pressure sensor 412.
[0219] During operation, the control unit 405 may monitor the pressure via the pressure sensor 412 at the guiding and positioning end 401. The control unit 405 may compare the monitored pressure with a desired pressure. If the pressure is greater than the desired pressure, there may be excessively fast drainage or excessive drainage. Because the pressure is greater than the desired pressure, the control unit 405 can cause the drainage device 400 to drain at a corrected drainage speed. The corrected drainage speed may be a value verified by calculation and experiments that can ensure safe and effective drainage under the condition of overlarge pressure.
[0220] The control unit 405 may continuously monitor the flow (via flow sensor 413) and the pressure (via pressure sensor 412) at the guiding and positioning end 401. After obtaining each set ofmeasurements, the control unit 405 can determine whether the pressure is less than or equal to the desired pressure. If the control unit 405 determines that the pressure is less than or equal to the desired pressure, the control unit 405 can cause the drainage device 400 to maintain the current drainage speed. If the pressure exceeds the desired value, thecontrol unit 405 can cause the drainage device 400 to drain at thecorrected drainage speed (e.g., 10 drops per minute) . The control unit 405 can continuously receive data from the pressure sensor 412 and the flow sensor 413 during the operation process and can cause adjustments in real time according to the data.
[0221] By monitoring and adjusting the drainage pressure in real time, efficient drainage process can be ensured, and excessive liquid accumulation or excessive liquid outflow can be avoided. A pressure too high may result in damage to the intraocular tissue, while a pressure too low may result in poor drainage. Adjustments can mitigate these risks and reduce the occurrence of complications. By maintaining a steady drainage rate, the intraocular pressure can be steadily maintained.
[0222] In some embodiments, the control unit 405 can calculate the drainage speed (e.g., at the drainage cavity 404) and cause adjustment of the drainage speed according to a corrected drainage speed, for example, when the control unit 405 determines that the flow is greater than a desired flow. The corrected drainage speed may be express as follows: Q’ = Q x [1- (C -C1) / C] , where Q’ is the corrected drainage speed, Q is the acquired drainage speed in the drainage cavity, C is the acquired flow from the flow sensor 413, and C1 represents the desired flow, which may be preset.
[0223] For example, a desired flow rate of 15 drops per minute may be set according to the patient condition and operation requirements. During the operation, the flow sensor 413 can monitor the flow of the drainage device 400 in real-time and send data to the control unit 405. After the control unit 405 receives the information from the flow sensor 413, the drainage speed is calculated, for example, to be 18 drops per minute.
[0224] The control unit 405 may compare the flow rate from the flow sensor 413 (for example, 20 drops per minute) to the desired flow (e.g., 15 drops per minute) . If the calculated flow is greater than the desired flow (e.g., the calculated flow is 20 drops per minute, greater than the set 15 drops per minute) , the adjustment mechanism is triggered. For instance, the control unit 405 causes adjustment of the drainage speed according to the calculated flow rate, and the corrected drainage speed is calculated by using the formula Q’ = Q x [1- (C -C1) / C] , where Q is the calculated drainage speed (18 drops per minute in this example) , C is the flow rate from the flow sensor 413 (20 drops per minute in this example) , and C1 is the desired flow rate (15 drops per min) .
[0225] In some embodiments, when the real-time flow exceeds the desired flow, the control unit 405 causes reduction of the drainage rate, preventing accumulation or overdriving of intraocular fluid, thereby reducing the risk of complications.
[0226] The control unit 405, pressure sensor 412, and flow sensor 413 allow accurate control according to desired flow and / or pressure setting, ensuring desired drainage effect. Accurate control of drainage speed would optimize operation outcome, reducing postoperative complications and improving a patient’s change of vision recovery. By improving surgical efficiency and reducing complications, medical costs may be reduced. The stable drainage speed can reduce patient discomfort.
[0227] The drainage cavity 404 may be horizontally arranged, relative to the page as shown, at a central position of the discharge end 403. The drainage cavity 404may also protrude outwards at the locations of the retention rings421 as shown, so that an inner ring groove (e.g., one of 423A-423E) matching (e.g., concentric) with a retention ring 421is formed. The design of the inner ring grooves423A-423E may beconfigured for regulating and controlling the back pressure by regulating and controlling the drainage speed ataninner ring groove.
[0228] In some embodiments, as illustrated, the inner ring grooves 423A-423E comprises a first inner ring groove 423A, second inner ring groove 423B, third inner ring groove 423C, fourth inner ring groove 423D, and fifth inner ring groove 423E. The spacing between adjacent inner ring grooves and the depth (e.g., an extent of protrusion of an inner ring groove in an outward direction) of each inner ring groove may be set to regulate and control drainage speed, thereby regulating and controlling pressure. It should be appreciated that the number of illustrated inner ring grooves is exemplary, and that the drainage device may include different numbers of inner ring grooves according to, for example, patient and operation requirements.
[0229] For example, the spacing between two pairs of adjacent inner ring grooves increases along one direction (e.g., from left to right of the page, from right to left of the page) , and the depth of each pair of inner ring grooveincreases along one direction (e.g., from left to right of the page, from right to left of the page) .
[0230] For example, the spacing between the first inner ring groove and the second inner ring groove is about 20 to 40 μm, the depth of the first inner ring groove is about 0 to 20 μm, the spacing between the second inner ring groove and the third inner ring groove is about 20 to 60 μm, the depth of the second inner ring groove is about 0 to 40 μm, the spacing between the third inner ring groove and the fourth inner ring groove is about 20 to 80 μm, the depth of the third inner ring groove is about 0 to 60 μm, the spacing between the fourth inner ring groove and the fifth inner ring groove is about 20 to 100 μm, the depth of the fourth inner ring groove is about 0 to 100 μm, and the depth of the fifth inner ring groove is about 0 to 120 μm. As discussed, these dimensions may be set according to desired flow, pressure, and drainage speed.
[0231] By coupling one end of the drainage cavity 404 with the guiding and positioning end 401, and through the arrangement of the inner ring grooves 423A-423E, accurate control of thepressure and drainage speed can be achieved. The arrangement from the first innerring groove to the fifth innerring groove (e.g., increasing spacing and depth along one direction) causes the pressure and drainage speed to be gradually reduced, allowing the drainage device 400 to adapt to different drainage requirements. The spacing between adjacent inner ring grooves and the depth of each inner ring groove may be adjustable, allowing greater flexibility.
[0232] Each of the first to fifthinner ring grooves can be set or adjusted according to operation needs. For example, the spacing and the groove depth can be adjusted according to the operation needs. For instance, an operator can adjust according to patient conditions and desired drainage effects to achieve optimal drainage benefits. By adjusting the spacing and the depth of theinner ring grooves, the drainage speed can be effectively controlled, and complications caused by excessively fast or excessively slow drainage, such as electrolyte imbalance caused by hypotension or excessive drainage, can be avoided. The design of the inner ring groove is beneficial for reducing friction and resistance of the drainage device, reducing the blockage risk of the drainage device, and prolonging the drainage device’s service life.
[0233] In some embodiments, the length of the drainage device400is about 4-6mm, preferably about 4.5mm, the outer diameter of the drainage device 400 is about 0.3-0.6mm, preferablyabout 0.35-0.4mm, and the inner diameter of the drainage device 400 is about 0.05-0.2mm, preferablyabout 0.10-0.16mm. These dimensions can be determined according to patient condition.
[0234] In some embodiments, the guide and positioning end 401 is about 1.0-1.5mm long, and the length of the guiding and positioning end 401extending out of the anterior chamber of a patient is about 0.4-0.6mm. In some embodiments, the length of a positioning groove 411 is about 0.5-0.8mm, and the depth of the positioning groove 411 is about 0.01-0.05mm. In some embodiments, the length of the discharge end 403 is about 3.0-3.5mm.
[0235] In some embodiments, the number of the retention rings 421 is three to six, and the spacing interval between adjacent rings is about 0.5-1.0mm. The innerring grooves 423A-423Ecan be arranged and matched with the retention rings 421. In some embodiments, the length of the identification supporting ring 402 is about 0.5-0.8mm, and the thickness of the identification supporting ring 402 is about 0.02-0.05mm.
[0236] The position of the drainage device400can be fixed by the retention rings421 of thedischarge end 403, preventing the drainage device400 from shifting or falling off when implanted and enhancing stability and the reliability of the device. The design of the innerring grooves423A-423Eallows the back pressure to be adjusted after implantation, according to patient needs and changes in the treatment process. Through the regulation and control via the inner ring grooves 423A-423E, drainage efficiency can be optimized, and low intraocular pressure during operation can be avoided, improving the treatment efficiency and benefits.
[0237] In some embodiments, the drainage device 400 comprisesa flap valve 414 in the guiding and positioning end 401 and coupled to the drainage cavity 404. For example, a cross or a straight opening is arranged on a first side of the flap valve 414, and a diameter of a second side (towards the right side of the page) of the flap valve 414 is larger than a diameter of the first side (towards the left side of the page) of the flap valve 414.
[0238] In some embodiments, as shown, the body of the flap valve 414 comprises a tapered configuration with a second diameter (of a side towards the right side of the page) that is larger than a first diameter (of a side towards the left side of the page) to increase resistance to aqueous flow. The first side of the flap valve 414 may comprise a cross or straight opening.
[0239] In some embodiments, the flap valve 414 is configured toallow flow from a first side of the drainage cavity to a second side of the drainage cavity when a pressure of the first side is higher than a pressure of the second side, anddisallow flow from the first side of the drainage cavity to the second side of the drainage cavity when the pressure of the first side is not higher than the pressure of the second side.
[0240] For example, when the aqueous humor pressure is higher (e.g., on the side of the guiding and positioning end 401) , the aqueous humor can flow out through the opening due to the conical structure (e.g., from the side of the guiding and positioning end 401 to the end of the drainage cavity 404) . When the aqueous humor pressure is lower, the opening can be closed to prevent the aqueous humor from flowing back. Advantageously, the flap valve 404 ensures flow in the drainage device 400 is in one direction.
[0241] Depending on the number and thickness of flaps, the flap valve 414 can be designed to regulate ocular pressure by configuring when to disallow aqueous humor flow, for example, to ensure flow is in one direction. The size of the opening can be adjusted by changing the number and thickness of the flaps, so that the resistance of the aqueous humor flow is changed, and the intraocular pressure is adjusted. The flap valve 414 may be manufacturedusing an integral injection molding process, to ensure the integrity and consistency of the valve. This method of manufacture also ensures the valve’s durability and biocompatibility.
[0242] The flap valve advantageously allows control of the drainage speed of aqueous humor, avoiding low intraocular pressure caused by fast drainage and high intraocular pressure caused by slow drainage during operation. Ocular hypertension caused by low ocular tension or inappropriate drainage speed can be avoided.
[0243] Compared to existing drainage devices, the positioning groove 411 of the guiding and positioning end 401 can ensure that the head of the drainage device is accurately positioned (e.g., at the limbus in the implantation process) , and displacement and dislocation of the drainage device can be avoided, thereby improving the accuracy and success rate of the operation. Using the pressure sensor 412 and flow sensor 413, the pressure and the flow in the drainage device can be monitored in real time via the control unit 405, allowing accurate control according to the predetermined flow setting for desired drainage effect. By maintaining a stable drainage rate and pressure, surgical outcome can be optimized, improving chances of vision recovery for the patient. The stable drainage speed reduces the patient discomfort. The position of the drainage device 400 can be fixed by the retention rings 421 of the discharge end 403, preventing the drainage device from shifting or falling off and improving the stability and the reliability of the device. The design of the inner ring grooves 423A-423E allows the pressure to be adjusted after implantation according to the specific needs of patients and the changes in the treatment process and adapting to the treatment needs of different patients. Through the regulation and control of the inner ring groove, drainage efficiency can be optimized, and unstable intraocular pressure can be avoided during operation, improving treatment efficiency and effect.
[0244] Referring to FIGS. 20 and 21, the outer wall of the discharging end 403 may comprise a plurality of microwells406. The microwells 406 may be configured for storing and releasing drugs into the eye. Achannel of the microwells 406 maybe one or more circular, square, and polygonal. The microwells 406 may comprise one or more of ridges, slits, and other aperture shapes. The geometry of the microwells 406 may be designed according to drug properties and drug release requirements. The microwells 406 may be configured to carry drugs.
[0245] In some embodiments, the shape of the microwells 406 may depend on the manufacturing process and the drug requirements. For example, circular microwells may be easier to manufacture, while square or polygonal microwells may help the drug to be more evenly distributed.
[0246] The diameter or length of the microwells 406 may be smaller than the inner diameter of the drainage device400, to ensure that the drug can smoothly enter the drainage cavity 404. For example, the microwells 406 may have a diameter of about 20-50 μm. The microwells 406 can be uniformly distributed on the outer wall of the discharge end 403, to ensure that the drug can be uniformly released into the drainage cavity 404.
[0247] The number of microwells 406 can be determined according to the drug requirements and the desired therapeutic effect. For example, the drainage device may comprise 5-20 microwells 406. The depth of the microwells 406 may sufficiently to allow the drug to be stored therein, but not so deep to affect the structural stability of the discharge end 403 (e.g., the microwells 406 do not penetrate intothe drainage cavity 404) . The depth of the microwells 406 may be designed based on drug release requirements; a deeper depth may correspond with a longer drug release time. For example, the microwells 406 may have a depth of about 10-50 μm. Different drugs, such as antibiotics, anti-inflammatory drugs, and cytokines, may be loaded into the microwells 406 to meet different therapeutic needs. The drugs may be loaded into the microwells by solution dipping, spraying, or pressure filling.
[0248] The drug can be directly released into the drainage cavity 404 through respective microwells 406. Through this, local administration can be achieved, and undesired drug circulation and distribution can be reduced, thereby reducing side effects. The shape, size, and distribution of the microwells 406 can be designed according to a desired release rate and duration of the drug, so that the drug release is more stable and predictable. Through local administration, the drug can directly act on a lesion area, thereby improving the treatment efficiency and accelerating the recovery process. As discussed, the shape of the microwells 406 can be circular, square, or polygonal, providing more design options and flexibility to accommodate different drug and therapeutic needs.
[0249] The release rate of the drug may be based on the relationship between microwells 406 and inner ring grooves 423A-423E (e.g., distance between microwells and the inner ring grooves, spacing between microwells, depth and spacing between inner ring grooves) , for example, due to the inner ring grooves’ effect on the drainage rate, as explained herein. The drug release rate may be adjusted by changing this relationship. The microwells 406 may penetrate through the discharge end 403and configured for slowly releasing drugs loaded in the microwells 406, and the inner ring grooves423A-423E may be used for interacting with the microwells406 to adjust the release rate and the drainage speed of the drug.
[0250] For example, a drug is loaded into the microwells 406. The drainage speed is adjusted by changing one or morerelationships between the microwells406 and the innerring grooves. The drainage cavity 404 may comprise inner ring grooves made of a soft material (e.g., rubber material) capable of generating plastic deformation. The depth, width, or shape of the inner ring grooves can be adjusted by extrusion stretching, so as to be elongated or flattened, thereby changing the interaction between the drainage cavity 404 andmicrowells 406, and hence, how the drugs are released.
[0251] The drainage device 400 may be implanted into the eye of a patient, and the discharge end 403 is positioned in the eye, and the guiding and positioning end 401is in the direction out of the eye. After implantation, the drugs in the microwells406 may begin to be slowly released into eye through interactions with the innerring grooves, as described herein. Meanwhile, liquid in the eye may be discharged out of the eye through the guiding and positioning drainage end 401, realizing minimally invasive drainage. The drainage speed can be adjusted by changing the relationship between the microwells 406 and the inner ring grooves, to treat glaucoma or other eye diseases.
[0252] In some embodiments, the implantable ophthalmic drainage device can comprise a tube fitting having an internal cavity configured to provide a pathway for fluid (e.g., aqueous humor) to drain from an anterior chamber of an eye into the suprachoroidal space of the eye. In some embodiments, the implantable ophthalmic drainage device can comprise a nickel-titanium shape memory alloy (e.g., having a nickel mass fraction between about 54.5%and about 57.0%, or nitinol) configured to restore the drainage device to a preset first state. An implantable ophthalmic drainage device comprising a nickel-titanium shape memory alloy can be implanted in an eye such that the cavity of the implantable ophthalmic drainage device fluidically connects the anterior chamber to the suprachoroidal space of the eye, allowing drainage of fluid from the anterior chamber of the eye to the suprachoroidal space, thereby reducing intraocular pressure.
[0253] Usage of such a device between an anterior chamber and a suprachoroidal space of demonstrates improved drainage and fixation over existing drainage devices. Further, an implantable ophthalmic drainage device comprising a nickel-titanium shape memory alloy is biocompatible and can meet the requirements for implantation. An implantable ophthalmic drainage device comprising a nickel-titanium shape memory alloy can be compressed to a second state (e.g., linearly compressed) , such that it can be loaded in a needle of a delivery system. Importantly, an implantable ophthalmic drainage device comprising a nickel-titanium shape memory alloy can restore to the preset shape (e.g., the first state) from a compressed second state after being released from the delivery system. The preset shape (e.g., the first state) can have a specific structure (discussed in further detail below) configured to prevent slippage or displacement of the implantable ophthalmic drainage device once it is implanted, thereby enhancing fixation of the ophthalmic drainage device.
[0254] For example, the implantable ophthalmic drainage device can beshaped according to dimensions of the suprachoroidal space and the eye tissue, thereby enhancing the fixation and stability of the device in small dimensions of the eye. By reducing or eliminating the risk of slippage or displacement, the implantable ophthalmic drainage device can maintain effective drainage of excess fluid from the anterior chamber of the eye. Further, use of shape memory alloys such as nickel-titanium or nitinol can be advantageous over existing drainage devices that use polymer materials, because such shape memory alloys enable the use of heat treatments and / or other processing (e.g., adding slits or apertures, or other processing that can be done on alloys and not polymers) to improve reliability of the shape-memory alloy (e.g., the reliability of the shape memory alloy in restoring to a preset shape and / or dimensions) .
[0255] In some embodiments, the implantable ophthalmic drainage device can comprise one or more slits or apertures. The slits or apertures can allow drainage and may also reduce overall stiffness (e.g., due to the stiffness of the shape memory alloy) of the drainage device. By reducing the stiffness of the drainage device, the drainage device may be enabled to bend in specific configurations, such that the drainage device can be implanted to fluidically connect the anterior chamber and the suprachoroidal space.
[0256] In some embodiments, as shown in FIGS. 22-27B, an implantable ophthalmic drainage device (e.g., devices 500 and600) can comprise a tube fittinghaving an internalcavity (e.g., cavities510 and610) configured to provide a pathway for fluid (e.g., aqueous humor) to drain from an anterior chamber of an eye into the suprachoroidal space of the eye. The implantable ophthalmic drainage device can comprise a two-dimensional wave shape (e.g., as shown by device 500) or a three-dimensional spiral shape (e.g., as shown by device 600) in a first state. Thetwo-dimensional wave shape or three-dimensional spiral shape can include wave crests (e.g., crests 521, 621) and wave troughs (e.g., trough 522, 622) . The inner cavity (e.g., cavity510 or610) of an implantable ophthalmic drainage device can fluidically connectan anterior chamber of an eye with a suprachoroidal cavity when the implantable ophthalmic drainage device is implanted in the eye. In some embodiments, the outer diameter of the implantable ophthalmic drainage devicemay bebetween about 0.3 mm and about 0.6mm and the inner diameter (e.g., defining the internal cavity) of the implantable ophthalmic drainage device may be between about 0.05 and about 0.3mm. For example, the outer diameter of the implantable ophthalmic drainage device may be between about 0.3 mm and about 0.4 mm, and the inner diameter of the implantable ophthalmic drainage device may be about 0.10 mm and about 0.20 mm.
[0257] Referring to FIGS. 22-26, the implantable ophthalmic drainage device can comprise a two-dimensional wave shape (e.g., the two-dimensional wave implantable drainage device 500) in a first state. For example, the two-dimensional wave implantable ophthalmic drainage device 500 may have crests 521 and troughs 522. As shown in FIGS. 22 and 26, the two-dimensional wave shape can be defined by a wave period T, an amplitude A, and alength L. In some embodiments, the period T of the two-dimensional wave shape can be between about 3.0 and about 6.0mm. For example, the period Tmay be between about 3.0 and about 4.0mm. In some embodiments, T may be constant throughout the implantable ophthalmic drainage device. In some embodiments, period T may have a gradient value; in other words, the period T may gradually change throughout the length of the implantable ophthalmic drainage device. In some embodiments, the amplitude A of the two-dimensional wave shape may be between about 0.6 mm and about 1.0 mm. For example, the amplitude A may be between about 0.7 mm and about 0.8 mm. In some embodiments, amplitude A may have a gradient value; in other words, the amplitude A may gradually change throughout the length of the implantable ophthalmic drainage device. In some embodiments, the length L of the two-dimensional wave shape may be between about 4 mm and about 6 mm. For example, the length Lmay be between about 4.5 mm and about 5.0 mm. It should be understood that the previously listed values (e.g., for period T, amplitude A, and length L) are exemplary, and the device can be designed according to eye dimensions, drainage needs, etc.
[0258] As shown in FIGS. 22 and 26, the two-dimensional wave implantable drainage device 500mayhave different wave shape configurations, and the configuration may be designedaccording to eye dimensions, desired positioning, etc. In one example, as seen in FIG. 22, device 500 may have a wave shape such that neither end of device 500 terminates at a crest521 ortrough522. In another example, as shown in FIG. 26, device 500 may have a wave shape such that one end terminates at a crest521, and one end terminates at a trough522. While not shown, it should be understood that the two-dimensional wave implantable drainage device may have ends terminating at any point of the wave. Further, while FIGS. 22-26 show implantable drainage device 500 comprising about 1.5 wavelengths of a wave, it should be understood that the drainage devices can comprise other wavelengths and can be designed according to eye dimensions, drainage needs, etc.
[0259] Referring to FIGS. 27A and 27B, the implantable ophthalmic drainage device can comprise a three-dimensional spiral shape (e.g., the three-dimensional spiral implantable drainage device 600) in a first state. For example, the three-dimensional spiral implantable ophthalmic drainage device 600 may havecrests 621 and troughs 622. As shown in FIGS. 27A and 27B, the three-dimensional spiral shape can be defined by the inner and outer diameters of the tube fitting, the spiral pitch P, the spiral major diameter D (e.g., quantifying the diameter measured between crest to crest) , and the length L. In some embodiments, the pitch P of the spiral shape may be between about 3.0 mm and about 8.0mm. For example, the pitch P may be between about 3.0 and about 5.0mm. In some embodiments, pitch P may have a gradient value; in other words, the period P may gradually change throughout the length of the implantable ophthalmic drainage device. In some embodiments, the major diameter D value of the three-dimensional spiral may be between about 0.5 mm and about 1.5mm. For example, the major diameter D can be between about 0.7 mm and about 1.0mm. In some embodiments, major diameter D may have a gradient value; in other words, the majordiameter D may gradually change throughout the length of the implantable ophthalmic drainage device. In some embodiments, the length L of the three-dimensional spiral may be between about 4 mm and about 6mm. For example, the length L may be between about 4.5 mm and about 5.0mm. The spiral-shaped drainage device may be created using a mold and heat treatment, as described in more detail herein.
[0260] In some embodiments, as shown in FIGS. 23-25, the implantable ophthalmic drainage device may comprise one or more apertures (e.g., apertures 531, 532, 533, 534) or slits (e.g., slits 540) that fluidically connect the cavity with the outer surface of the implantable ophthalmic drainage device. In some embodiments, as shown in FIG. 23, the implantable ophthalmic drainage device may comprise a plurality of apertures (e.g., apertures 531, 532, 533, 534) . The apertures may allow aqueous humor to flow into the suprachoroidal space, which may enhance drainage. Further, the apertures may reduce the overall stiffness of the implantable ophthalmic drainage device, thereby enhancing its adaptability to ocular tissues. For example, by reducing stiffness using apertures, the implantable drainage devices may be able to bend in particular ways, enabling implantation in between the suprachoroidal space and the anterior cavity. In some embodiments, the plurality of apertures may be double-sided opposite apertures rotating along an axial direction of the tubefitting at a preset angle (e.g., about 90 degrees) or single-sided apertures rotating along the axial direction of the tube fitting at a preset angle (e.g., about 90 degrees. In some embodiments, the apertures can be created by laser cutting (forming e.g., distance between an aperture and device feature, aperture widths, distance between apertures) . Laser processing advantageously improves the manufacturability and dimensional consistency of the device. The apertures may comprise round or circular shapes, rectangular shapes, polygonal shapes, or any other special or irregular shapes (e.g., non-polygonal or non-circular shapes) . FIG. 23 shows an example of round apertures (e.g., apertures 531, 532, 533 and 534) that are single-side holes distributed at a left-hand angle and by 90 degrees. While FIG. 23 shows a two-dimensional wave shaped implantable drainage device having apertures, it should be understood that a three-dimensional spiral shaped implantable drainage device may also have apertures distributed as described above.
[0261] In some embodiments, as shown in FIGS. 24 and 25, an implantable ophthalmic drainage device can comprise a slit (e.g., slit 540) fluidically connecting the inner cavitywith the outer surface of the implantable ophthalmic drainage device. The slit may be positioned on the implantable drainage device at locations where the implantable drainage device will be implanted in the suprachoroidal space, such that the aqueous humor can be dispersed and flow into the suprachoroidal space, enhancing drainage. The slits may be formed using a mold and heat treatment.
[0262] Theslit may reduce the overall stiffness of the implantable ophthalmic drainage device, thereby enhancing its adaptability to ocular tissues. For example, by reducing stiffness using slits, the implantable drainage devices may be enabled to bend in particular ways, enabling implantation in between the suprachoroidal space and the anterior cavity. In some embodiments, the implantable ophthalmic drainage device may comprise a plurality of intermittent slits evenly distributed along the axial or circumferential direction of the drainage implant device. In some embodiments, as shown in FIGS. 24 and 25, the implantable ophthalmic drainage device may comprise a continuous spiral slit. While FIGS. 24 and 25 show a two-dimensional wave shaped implantable drainage device having a slit, it should be understood that a three-dimensional spiral shaped implantable drainage device may also have one or more slits distributed as described above.
[0263] In some embodiments, as shown in FIG. 25, the outer surface of the implantable ophthalmic drainage device may be partially or completely covered with a coating layer (e.g., coating layer 550) . In some embodiments, the coating layer can comprise Polytetrafluoroethylene (PTFE) , expanded polytetrafluoroethylene (ePTFE) , Fluorinated Ethylene Propylene (FEP) , Polyethylene (PE) , and / or silicone rubber. The coating layer, with independent voids or continuous gaps, may be configured to improve the structural integrity of the drainage implant device. While FIG. 25 shows a two-dimensional wave shaped implantable drainage device having a coating layer, it should be understood that a three-dimensional spiral shaped implantable drainage device may also have a coating layer distributed as described above.
[0264] In some embodiments, as shown in FIGS. 28A-30, an implantable ophthalmic drainage device (e.g., devices 700 and 800) can comprise a drainage body and an expansion anchor (e.g., expansion anchors 720 and 820) . The drainage body can include a cavity (e.g., cavities740 and 840) configured to provide a pathway for fluid (e.g., aqueous humor) to drain from an anterior chamber of an eye into the suprachoroidal space of the eye. The drainage body may comprise a proximal segment (e.g., proximal segments 730 and830) and a distal segment (e.g., distal segments 710 and810) separated from the proximal segment by an expansion anchor. For example, one end of the expansion anchor (e.g., expansion anchors 720 and 820) can be coupled to the proximal segment of the drainage body and the other end of the expansion anchor can be coupled to the distal segment of the drainage body. The distal segment (e.g., distal segment710 or 810) of the drainage body can be configured to be implanted in the anterior chamber of an eye and the proximal segment (e.g., proximal segment730 or 830) can be configured to be implanted in the suprachoroidal space of the eye. The expansion anchor (e.g., expansion anchor 720 and 820) can be configured to restore to a preset shape (e.g., an expanded first state) after insertion into the eye, thereby improving the fixation of the implantable ophthalmic drainage device in the eye. The expansion of the expansion anchor into the first state may also cause ciliary body dissociation, such that aqueous humor drained from the anterior chamber can enter the suprachoroidal space for transscleral or ciliary choroidal vascular absorption.
[0265] In some embodiments, as shown in FIGS. 28A, 29, and 30, the expansion anchor (e.g., expansion anchor 720 and 820) can beintegrated with the drainage body (e.g., the drainage body and the expansion anchor can be integrally formed of a single component) . In some embodiments, as shown in FIG. 28B, the expansion anchor (e.g., expansion anchor 720) can be a separate component configured to be combined with the drainage body. The expansion anchor can be coupled to the drainage body using welding or biocompatible glue. As shown in FIGS. 28A-30, the expansion anchor can have a first end connected to the proximal segment (e.g., proximal segment730 or 830) of the drainage body and a second end connected to the distal segment (e.g., distal segment710, 810) of the drainage body. The drainage body can tube fitting with an inner cavity, and a first end and a second end of the expansion anchor are threaded onto an outer wall of the tube fitting, such that one of the first end and the second end is fixedly connected with the outer wall of the tube fitting, and one of the first end and the second end is configured to slide freely along the outer wall of the tube fitting.
[0266] When expanded, the expansion anchor may comprise a two-dimensional (e.g., planar) shape (e.g., expansion anchor 720 of device 700 shown in FIGS. 28A and 28B) or a three-dimensional shape (e.g., expansion anchor 820 of device 800 shown in FIGS. 29 and 30) in an expanded first state. With reference to FIGS. 28A and 28B, the two-dimensional expansion anchor720 can comprise two expansion ribs (e.g., expansion ribs 721 and722, or expansion ribs 751 and752) . The two expansion ribs may be symmetrically distributed with respect to the drainage body and may be parallel to the axial direction of the drainage body. When expanded, the two expansion ribs may form a predetermined two-dimensional expansion plane having an expansion diameter between about 0.6 mm and about 2.0 mm. For example, the expansion plane may have an expansion diameter between about 0.8 mm and about 1.5 mm. An expansion diametermay refer to the diameters of the circumscribing circles formed by the expanded ribs in the direction perpendicular to the axial direction of the drainage body after theexpansion ribs are expanded.
[0267] The expansion anchor may be integrated with the drainage body (e.g., as shown in FIG. 28A) or may be combined with the drainage body (e.g., as shown in FIG. 28B) . In the case where the drainage body and the expansion anchor are separate components from each other, the drainage body and the expansion anchor may be assembled to form an assembly (e.g., assembly 750) . For example, the drainage body may be a drainage tube having an inner cavity (e.g., cavity740) and the first end and the second end of the expansion anchor can be fitted onto the outer wall of the drainage tube. Either the first end or the second end of the expansion anchor can be fixedly connected with the outer wall of the drainage tube. For example, a laser welding machine can be used to spot weld the connection between the drainage tube and the one end of the expansion anchor, leaving the other end to be free sliding, such that the other end can slide on the drainage tube, enabling expansion of the expansion anchor.
[0268] With reference to FIGS. 29 and 30, a three-dimensional expansion anchor 820 can comprise n expansion ribs (e.g., expansionribs 821, 822, and823, or ribs 824, 825, and 826) , where n is an integer greater than 2. For example, n may be 3 or 4. In some embodiments, the n expansion ribs can be uniformly distributed (e.g., at equal intervals) along the circumferential direction of the drainage body at intervals. The expansion anchor 820 can comprisen expansion ribs which are uniformly distributed along the circumferential direction of the drainage body at an angle of 360 / ndegrees. For example, if the expansion anchor 820 comprises three expansion ribs, the three expansion ribs may be uniformly distributed at 120 degree angular intervals. In some embodiments, with reference to FIG. 29, the expansion anchor 820 may comprise three expansion ribs (e.g., expansion ribs 821, 822, and 823) which are uniformly arranged along the axial direction parallel to the drainage body. In some embodiments, with reference to FIG. 30, the expansion anchor 820 may comprise three expansion ribs (e.g., expansion ribs 824, 825, and 826) which are spirally distributed along the axial direction of the drainage body.
[0269] When expanded, the three expansion ribs may form a predetermined three-dimensional expansion shape having an expansion diameter between about 0.4 mm and about 1.2 mm. For example, the expansion shape may have an expansion diameter between about 0.6 mm and about 0.8 mm. While FIGS. 29 and 30 show the implantable ophthalmic drainage device having an integrated expansion anchor 820 and drainage body, it should be understood that a three-dimensional expansion anchor 820 can be a separate component combined with a drainage body as discussed above with respect to the two-dimensional expansion anchor 720.
[0270] The ophthalmic drainage device may expand according to dimensions of the suprachoroidal space and the eye tissue, thereby enhancing the fixation and stability of the device in small dimensions of the eye. For example, the implantable ophthalmic device can be configured to have a preset shape comprising the expansion anchor in an expanded form. The implantable ophthalmic drainage device havinga preset two-dimensional plane-shaped or three-dimensional-shaped expansion anchor can be configured to be compressed into a second stateto fit into a puncture needle of a delivery system. Once the implantable ophthalmic drainage device is released from the delivery system (e.g., in an eye) , the implantable ophthalmic drainage device can restore to the preset shape (e.g., theexpansion anchor can restore to the expanded first state) . The restoring of the implantable ophthalmic drainage device to the preset shape (e.g., the expansion of the expansion anchor) can fix the implantable ophthalmic drainage device in position in the eye. Further, the restoring of the implantable ophthalmic drainage device to the preset shape (e.g., the first expanded state) in the upper ciliary cavity may cause the dissociation of ciliary body to some extent, such that the aqueous humor drained from the anterior chamber enters the supraciliary cavity of the ciliary body and is absorbed through the sclera or the choroidal blood vessel. Additionally, the dissociation of ciliary body caused by the expansion anchor may inhibit the secretion of aqueous humor by the pigment-free epithelial cells of the ciliary body, thereby further reducing intraocular pressure.
[0271] In some embodiments, the outer diameter of the drainage body of the implantable ophthalmic drainage devicemay be between about 0.15 mm and about 0.6mm. The inner diameter of the drainage body may be between about 0.05 mm and about 0.4mm. The total length of the implantable ophthalmic drainage device may be between about 2.5 mm and about 7.0mm. For example, the length of the distal segment of the drainage body may be between about 0.5 mm and about 3.0mm and the length of the proximal segment of the drainage body may be between about 0.2 mm and about 2.5mm. In some embodiments, a two-dimensional planar expansion anchor may have a length between about 0.9 mm and about 2.2 mm. For example, a two-dimensional (e.g., planar) expansion anchor may have a length between about 1.0 mm and about 1.8 mm. In some embodiments, a three-dimensional shape expansion anchor may have a length betweenabout 0.8 mm and about 1.8mm. For example, a three-dimensional shape expansion anchor may have a length between about 1.0 mm and about 1.5mm.
[0272] FIGS. 31A-31D illustrate an example process of implanting an implantable ophthalmic drainage device having a wave shape or a spiral shape in an eye. FIGS. 32A-32D illustrate an example process of implanting an implantable ophthalmic drainage device having an expansion anchor in an eye. Different from existing external methods, the disclosed implantation method of the drainage implantation device involves the protection of the suprachoroidal space usinga viscoelastic agent. For example, a viscoelastic agent can be injected into the eye to expand the suprachoroidal space to a certain area or volume prior to implantation of the drainage device. The implantation steps can include:
[0273] (1) The bulbar conjunctiva can be cutat a position about 4mm behind the corneoscleral limbus, the diameter of the incision being about 4mm;
[0274] (2) Referring to FIGS. 31A and 32A, a viscoelastic (about 70μl / eye) can be injected about 4mm behind the limbus using a syringe or other special instrument (e.g., suprachoroidal injector) ;
[0275] (3) Referring to FIGS. 31B and 32B, the puncture needle of the delivery system can be tilted (about 10 to about15 degrees tangential to the scleral surface) and inserted into the suprachoroidal space until the needle tip passes through about 0.5mm of the anterior chamber angle;
[0276] (4) Referring to FIGS. 31C and 32C, the switch of the delivery systemcan be depressed and retracted (e.g., after position of the drainage device is set prior to release) , releasing the implantable ophthalmic drainage device in situ;
[0277] (5) Referring to FIGS. 31D and 32D, the puncture needle can be withdrawn, completing implantation of the ophthalmic drainage device; and
[0278] (6) Pressure can be applied to the puncture to stopbleeding and allowing the puncture to self-close (if the puncture is not self-closing, a suture (e.g., a 10-0 size suture) can closethe incision) .
[0279] Specific examples of embodiments of this disclosure are provided below.
[0280] Examples 1-3 below can utilize a delivery system to perform in-situ intraocular release of exemplary implantable ophthalmic drainage devices. The puncture needle of the delivery system can have a puncture needle with a size of 23G (e.g., having an outer diameter of about 0.65 mm and an inner diameter of about 0.46 mm) . The needle tip can comprise a round blunt needle. In an initial state, the length of the puncture needle may extend beyondthe housing by a maximum of about 8mm and in a final state, the length of the puncture needle may extend beyond the housing by about 2mm. In other words, the maximum length that theswitchcan retract may be about 6mm. The outer diameter of the ejector pin in the delivery system may be about 0.40mm, and the length of the ejector pinmay extend beyond the housingby about 3mm. The total length of the delivery system may be about 100mm, and the maximum outer diameter of the delivery system may be about 22mm.
[0281] Example 1: Manufacturing and implanting a three-dimensional spiral shape implantable ophthalmic drainage device
[0282] In an exemplary procedure for manufacturing a three-dimensional spiral shape implantable ophthalmic drainage device, anickel-titanium shape memory alloy tube fitting with the outer diameter of about 0.3mm and the inner diameter of about 0.2mmcan be cut into short sections having a length of about 5.0mm. A stainless steel wire with an outer diameter of about 0.15mmcan be threaded through cavities of the short sections and can be pulled to fix the nickel-titanium shape memory alloy tube fittingin a mold or die havinga three-dimensional spiral groove. The die or mold may be internally provided with a metal wire support with an outer diameter of about 0.2 mm, wherein the width of the groove in the die or moldcan be about 0.4mm, and the pitch P can be about 4.5mm. The dimensions of the mold or die may determine the size parameters of the final implantable ophthalmic drainage device. For example, using the mold or die, the pitch P of the implantable ophthalmic drainage device can be controlled to be about 4.5mm, the large diameter D can be controlled to beabout 0.8mm, and the total number of turns can be controlled to be1turn.
[0283] Subsequent to fixation in the die or mold, the tube fitting can be subjected to heat treatment at 500 ℃ for 15min, then subjected to water cooling quenching to obtain a tube fittinghaving a three-dimensional spiral shape. The tube fittingcan then be subjected to acid washing in an acid washing solution (e.g., having hydrofluoric acid and nitric acid as main components) to remove any oxide skin formed during the heat treatment process. Subsequently, the tube fitting can be subjected to cleaning to obtain a three-dimensional spiral shaped implantable ophthalmic drainage device. The implantable ophthalmic drainage device can demonstrategood elasticity with a phase transition temperature of 28 ℃.
[0284] To assemble the implantable ophthalmic drainage device with a deliver system, the implantable ophthalmic drainage device can be threaded onto a stainless steel wire having an outer diameter of about 0.15mm. The stainless steel wire can then be inserted into the distal end of a puncture needle of the delivery system and drawn through the puncture needle such that the implantable ophthalmic drainage device is completely compressed and inserted into the distal end of the puncture needle of the delivery system using the stainless steel wire. The implantable ophthalmic drainage device can remain in the needle of the delivery system after the stainless steel wire is withdrawn. The drainage implantation device can be elastically compressed in the puncture needle, such that it can maintain a relative position within the puncture needle when the implantable ophthalmic drainage device is not acted upon by external force (e.g., by the ejector pin) .
[0285] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into the eye using the delivery system according to the operation steps discussed above. The delivery system can provide convenient operation and accurate positioning during the implantation process, such that the drainage implantation device can be successfully implanted into the expected position. After one month of implantation, the implantable ophthalmic drainage device can continue to demonstrate normal drainage function, no positional movement, and good tissue biocompatibility.
[0286] Example 2: Manufacturing and implanting a three-dimensional spiral shape implantable ophthalmic drainage device with a spiral slit
[0287] In an exemplary procedure for manufacturing a three-dimensional spiral shape implantable ophthalmic drainage device with a spiral slit, a continuous spiral slit can be made on a nickel-titanium shape memory alloy tube fittinghaving an outer diameter of about 0.3mm and an inner diameter of about 0.1mm using a laser cutting machine. Subsequently, the tube fitting can becut into short sections having a length of about 5.0 mm. The distance between the spiral slit and one end of the tubefitting (e.g., the end to be implanted in the anterior chamber) can be about 1.5mm and the distance between the spiral slit and the other end of the tube fitting (e.g., the end to be implanted in the suprachoroidal space) can be about 0.5mm. The pitch P of the spiral slit can be about 0.5mm, the total length can be about 3.0mm, having six turns around the circumference of the tube fitting, and the slit width (measured on the outer surface of the tube fitting) can beabout 0.06mm.
[0288] Subsequently, a short tubefitting with the spiral slit can be threaded onto a stainless-steel wire having an outer diameter of about 0.08mm and the stainless-steel wire can pulled to fix the tube fitting in a die or mold having a three-dimensional spiral groove. In some embodiments, the die or mold can be internally provided with a metal wire support having an outer diameter of about 0.2 mm. The width of the groove in the die or mold can be about 0.4mm, and the pitch P can be about 3.0mm. The dimensions of the mold or die can determine the size parameters of the implantable ophthalmic drainage device (e.g., in its implanted form) . For example, using the die or mold, the spiral pitch P of the implantable ophthalmic drainage device can be controlled to be about 3.0mm, the large diameter D can be controlled to beabout 0.8mm, and the total number of turns can be controlled to beabout 1.5 turns.
[0289] Subsequently to fixing the tube fitting in the die or mold, the tube fitting can be subjected to heat treatment at 520 ℃ for 20min andthen subjected to water cooling quenching to obtain a tube fitting having a three-dimensional spiral shape. The tube fitting canthen besubjected to acid washing in acid washing solution (e.g., with hydrofluoric acid and nitric acid as main components) to remove oxide skin formed during the heat treatment process. Subsequently, the tube fitting can be subjected to electrochemical polishing in polishing solution (e.g., with glacial acetic acid, ethanol, glycol and perchloric acid as main components) using an electrochemical workstation. Then, the tube fitting can be cleaned to obtain a three-dimensional spiral implantable ophthalmic drainage device with a spiral gap. The implantable ophthalmic drainage device can have good elasticity, a three-dimensional spiral shape, and a phase transition temperature of 30 ℃.
[0290] The implantable ophthalmic drainage device can be threaded onto a stainless-steel wire with the outer diameter of about 0.08mm. The stainless-steel wire can be inserted and drawn through the distal end of a puncture needle of the delivery system, such that the implantable ophthalmic drainage device can be completely compressed and inserted into the distal end of the puncture needle of the delivery system using the stainless steel wire. The drainage device canremain in the needle of the delivery system after the stainless-steel wire is withdrawn. The drainage implantation device canbeelastically compressed in the puncture needle, such that it can maintain arelative position within the puncture needle when the drainage implantation device is not acted upon by external force (e.g., by the ejector pin) .
[0291] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into an eye using the delivery system according to the operation steps detailed above. The delivery system can provide convenient operation and accurate positioning during the implantation process, such that the drainage implantation device can be successfully implanted in the expected position within the eye. The results after one month of implantation can demonstrate that the implantable ophthalmic drainage device can continue to havenormal drainage function, no positional movement, and good tissue biocompatibility.
[0292] Example 3: Manufacturing and implanting a two-dimensional wave shape implantable ophthalmic drainage device with a spiral slit
[0293] In an exemplary procedure for manufacturing a two-dimensional wave shape implantable ophthalmic drainage device with a spiral slit, a spiral slit can be cut into a nickel-titanium shape memory alloy tubefitting with an outer diameter of about 0.3mm and an inner diameter of about 0.2mm using a laser cutting machine. Subsequently, the tube fitting can be cut into short sections having a length of about 5.0 mm. The distance between the spiral slit and one end of the tube fitting (e.g., the end to be implanted in the anterior chamber) can be about 0.5 mm and the distance between the spiral slit and the other end of the tube fitting (e.g., the end to be implanted in the suprachoroidal space) can be about 0.5 mm. The pitch of the spiral slit can be about 0.5 mm, the total length can about 3.0 mm, having six rotations around the circumference of the tube fitting, and the gap width (measured on the outer surface of the tube fitting) can be about 0.2 mm.
[0294] A short section having a spiral slit can be loaded into a die or mold having a two-dimensional wave shaped groove. The dimensions of the die or mold can determine the size and shape parameters of the final implantable ophthalmic drainage device, including the wave period T and amplitude A. For example, using the die or mold, the period T can becontrolled to beabout 3.0mm in value, the amplitude A can be controlled to beabout 0.8mm in value, and the device can be formed to comprise 1.5 wavelengths.
[0295] Subsequently to fixing the tube fitting in the die or mold, the tube fitting can be subjected to heat treatment at 500 ℃ for 15min, then subjected to water cooling quenching to obtain a tube fitting having a two-dimensional wave shape. Subsequently, the tube fitting canbe subjected to acid washing in an acid washing solution (e.g., with hydrofluoric acid and nitric acid as main components) to remove oxides formed during the heat treatment process. Then, the tube fitting can besubjected to electrochemical polishing in a polishing solution (e.g., with glacial acetic acid, ethanol, glycol and perchloric acid as main components) by using an electrochemical workstation. In some examples, the tube fitting can be coated with a Polytetrafluoroethylene (PTFE) heat-shrinkable tube after cleaning to obtain a two-dimensional wave-shaped implantable ophthalmic drainage device having a spiral gap and a PTFE coating layer. The implantable ophthalmic drainage device can have good elasticity and a phase transition temperature of 28 ℃. The outer diameter of the tubefitting after the film coating isabout 0.4mm. The PTFE heat-shrinkable tube can be a Sub-Lite-WallTM ultrathin heat-shrinkable tube of the Zeus Company, having a part number of AWG34 (e.g., having an inner diameter ofabout 0.51mm and a recovery wall thickness of about 0.05 mm) , and the heat-shrinkable tube can be subjected to heat shrinkage at 350 ℃.
[0296] The implantable ophthalmic drainage device can thread onto a stainless-steel wire with an outer diameter of about 0.15 mm. The stainless-steel wire be inserted and drawn through the distal end of a puncture needle of the delivery system such that the implantable ophthalmic drainage device can be completely compressed and inserted into the distal end of the puncture needle of the delivery system using the stainless steel wire. The drainage implantation device can remainin the needle of the delivery system after the stainless steel wire is withdrawn. The implantable ophthalmic drainage device can be elastically compressed in the puncture needle, such that it could maintain a relative position within the puncture needle when the implantable ophthalmic drainage device is not acted upon by external force (e.g., by the ejector pin) .
[0297] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into an eye using the delivery system according to the operation steps detailed above. The delivery system can provide convenient operationand accurate positioning during the implantation process, such that the drainage implantation device can successfully implanted in the expected position. The results after one month of implantation can demonstrate that the implantable ophthalmic drainage device can have normal drainage function, no positional movement, and good tissue biocompatibility.
[0298] Example 4: Manufacturing and implanting an implantable ophthalmic drainage device with an integrated two-dimensional expansion anchor
[0299] In an exemplary procedure for manufacturing an implantable ophthalmic drainage device with an integrated two-dimensional (e.g., planar) expansion anchor, twohollowed structures can be engraved on a nickel-titanium shape memory alloy tubefitting having an outer diameter of about 0.2mm and an inner diameter of about 0.1mm using a laser, thereby formingtwoexpansion ribs. The circumferential width of the expansion ribs and the interval between the ribs can be one-fourth of the circumference of the tube fitting. The length of the expansion ribs can be about 2.0mm. The tubecan be cut at a length of about 0.5mm away from a first end of the expansion ribs (e.g., forming the proximal segment of the drainage body) and about 2.5mm away from the other end of the expansion ribs (e.g., forming the distal segment of the drainage body) , thereby forming a drainage device having a length of about 5.0mm. The manufacturing method can further comprise the steps of threadinga stainless steel wire with an outer diameter of about 1.1mm into a hollow structure, supporting and expanding the two ribs, subjecting the stainless steel wire and tubefitting toheat treatment for 15 min at the temperature of 500 ℃, and subjecting the stainless steel wire and tube fitting to water-cooling quenching, to obtain a two-dimensional expansion anchor drainage device. The method can further comprisewashing the drainage device in an acid wash solution (e.g., with hydrofluoric acid and nitric acid as main components) to remove oxide skin formed in the heat treatment process and carrying out electrochemical polishing in polishing solution (e.g., with glacial acetic acid, ethanol, ethylene glycol and perchloric acid as main components) by using an electrochemical workstation, and then cleaning to obtain an implantable drainage device with a two-dimensional expansion anchor, wherein the two-dimensional expansion anchor and the drainage main body are integrated components. The outer diameter of the drainage body of the implantable drainage device can be about 0.2mm and the inner diameter of the drainage body isabout 0.1mm. The total length of the implantable drainage device can be about 4.6mm, the length of the distal segmentisabout 2.5mm, the length of the proximal segmentcan be about 0.5mm, and the expansion diameter of the expansion anchor can be about 1.2mm. The drainage device can demonstrate good elasticity with a phase transition temperature of 28 ℃.
[0300] A delivery system can be used to perform in-situ intraocular release of the resulting implantable ophthalmic drainage device. The puncture needle of the delivery system can comprise 25G normal-wall needle tube (e.g., having an outer diameter of about 0.50 mm and an inner diameter of about 0.24 mm) with a round blunt needle tip. In an initial state, the length of the puncture needle can extend beyond the housing by about 6 mm and in a final state, the length of the puncture needle can extend beyond the housing by about 1 mm. In other words, the maximum length that the switchcan retract is about 5 mm. The outer diameter of the ejector pin in the delivery system can be about 0.2 mm, and the length of the ejector pincan extend beyond the housing by about 2 mm. The total length of the delivery system can about 100 mm, and the maximum outer diameter of the delivery system can be about 22 mm.
[0301] The drainage device can be pushed in a conical jig using a 25G normal wall needle cannula (e.g., having anabout 0.50 mm outside diameter and an about 0.24mm inside diameter) , thereby compressing the expansion anchor and loading it into the needle in the desired direction (e.g., such that at least part of the distal segment of the drainage device can be the first to exit the needle as shown FIGS. 16A and16D) . The distal segment of the drainage device canextend out of the puncture needle by about 1.0mm. The drainage device can maintain a relative position within the puncture needle when the drainage device is not actedupon by external force (e.g., by the ejector pin) .
[0302] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into an eyeusing the delivery system according to the operation steps detailed above. The delivery system can provide convenient operationand accurate positioning during the operation process, such that the drainage implantation device can be successfully implanted in the expected position. The results after one month of implantation can demonstrate that the implantable ophthalmic drainage device can continue to have normal drainage function and good tissue biocompatibility. As shown in FIG. 33, the AS-OCT image obtained at theone month of follow-up shows that the drainage device did not shift. Further, the image demonstrates that the expansion anchor dissociated the ciliary body.
[0303] Example 5: Manufacturing and implanting an implantable ophthalmic drainage device with a separate two-dimensional planar expansion anchor
[0304] In an exemplary procedure for manufacturing an implantable ophthalmic drainage device with a separate two-dimensional (e.g., planar) expansion anchor, twohollowed structures can be engraved on a nickel-titanium shape memory alloy tube fitting havingan outer diameter of about 0.3mm and an inner diameter of about 0.2mm using a laser, thereby formingtwoexpansion ribs. The circumferential width of the ribs and the interval between the ribs can be 1 / 4 of the circumference of the tube and the length of the ribs can beabout 2.0mm. The tube can be cut at a length of about 0.3 mm away from both ends of the expansion ribs, thereby formingan expansion anchor with a length of about 2.6mm. The manufacturing method can further comprisethreading a stainless steel wire with an outer diameter of about 1.1mm into a hollow structure, supporting and expanding the two expansion ribs, subjecting the stainless steel wire and the expansion anchor to heat treatment at a temperature of 500 ℃ for 15min, and then performing water cooling quenching to obtain a two-dimensional expansion anchorwith twoexpansion ribs, wherein the total length of the expansion anchorcan beabout 2.2mmand the expansion diameter can be about 1.2mm.
[0305] A nickel-titanium shape memory alloy tubefitting with an outer diameter of about 0.2mm and an inner diameter of about 0.1mm can be cut into a short section having a length of about 4.5mm to form a drainage main body of the implantable drainage device. The short section can be threaded into an inner cavity of the two-dimensional plane-shaped expansion anchor, such that the length of a distal segmentcan be adjusted to be about 2.0mm (e.g., the distance between the drainage body and the end part of the expansion anchorcan be about 1.7 mm) . Then, one end of the expansion anchor can be spot welded using a laser welding machine (e.g., the other end can be left in a free state such that the free end of anchor can freely slide on the drainage main body, allowing for expansion and compression of the anchor) , to obtain the assembly of the drainage body and the expansion anchor. The assembly can be subjected to an acid wash in an acid wash solution (e.g., with hydrofluoric acid and nitric acid as main components) to remove oxide skin formed during the heat treatment and welding processes, then subjected to electrochemical polishing in polishing solution (e.g., with glacial acetic acid, ethanol, ethylene glycol and perchloric acid as main components) by using an electrochemical workstation, and then cleaned to obtain a drainage device with the two-dimensional planar expansion anchor and the drainage body are assembled together. The outer diameter of the drainage body of the drainage device can be about 0.2mm and the inner diameter of the drainage body can be about 0.1mm. The total length of the drainage device can be about 4.5mm, the length of the distal segmentcan be about 2.0mm, the length of the proximal segmentcan be about 0.9 mm, and the expansion diameter of the expansion anchor can be about 1.2mm. The drainage device can demonstrate good elasticity, such that it can restore to a preset shape.
[0306] A delivery system can be used to perform in-situ intraocular release of the resulting implantable ophthalmic drainage device. The puncture needle of the delivery system can comprise a 23G thin-wall needle tube (e.g., having an outer diameter of about 0.60 mm and an inner diameter of about 0.37 mm) with a round blunt needle tip. In an initial state, the length of the puncture needle can extend beyond the housing by about 5 mm and in a final state, the length of the puncture needle can extend beyond the housing by about 1 mm. In other words, the maximum length that the switchcan retract is about 4 mm. The outer diameter of the ejector pin in the delivery system can be about 0.3 mm, and the length of the ejector pincan extend beyond the housing by about 2 mm. The total length of the delivery system can be about 100 mm, and the maximum outer diameter of the delivery system can be about 22 mm.
[0307] The drainage device can be pushed in a conical jig using a 25G normal wall needle cannula (e.g., having a about 0.50 mm outside diameter and a about 0.24 mm inside diameter) , thereby compressing the expansion anchor and loading it into the needle in the desired direction (e.g., such that at least part of the distal segment of the drainage device can be the first to exit the needle as shown FIGS. 16A and 16D) . The distal segmentof the drainage device can extendout of the puncture needle by about 1.5 mm. The drainage device can maintain its relative position within the puncture needle when the drainage device is not acted upon by external force (e.g., by the ejector pin) .
[0308] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into the eye using the delivery system according to the operation steps detailed above. The delivery system can provide convenient operationand accurate positioning during the operation process, such that the drainage implantation device can be successfully implanted in the expected position. The results after one month of implantation demonstrate that the implantable ophthalmic drainage device has normal drainage function, no positional movement, and good tissue biocompatibility.
[0309] Example 6: Manufacturing and implanting an implantable ophthalmic drainage device with an integratedthree-dimensional expansion anchor
[0310] In an exemplary procedure for manufacturing an implantable ophthalmic drainage device with an integrated three-dimensional expansion anchor, threehollow structures can be engravedina nickel-titanium shape memory alloy tube fitting with an outer diameter of about 0.2mm and an inner diameter of about 0.1mm using a laser, thereby forming threeexpansion ribs. The circumferential width of the expansion ribs and the interval between the expansion ribs can be1 / 6 of the circumference of the tube. The length of the ribs can be about 1.7mm. The tube can be cut at a length of about 1 mm away from a first end of the expansion ribs (e.g., forming the proximal segment of the drainage body) and about 2 mm away from the other end of the expansion ribs (e.g., forming the distal segment of the drainage body) , thereby forming a drainage device having a length of about 4.7 mm.
[0311] The method canfurther comprise the steps of placing thetube into a die or mold, axially compressing the tube byabout 0.2mm, thereby expanding the threeexpansion ribs. Then, the tube can be subjected to heat treatment at 500 ℃ for 15min, subjecting to water cooling quenching, and removed from the die to obtain an implantable drainage device with threeexpansion ribs forming a three-dimensional expansion anchor. The method can further comprisecarrying out acid washing on the device in an acid washing solution (e.g., with hydrofluoric acid and nitric acid as main components) to remove oxide skin formed in the heat treatment process, carrying out electrochemical polishing in polishing liquid (e.g., with glacial acetic acid, ethanol, ethylene glycol and perchloric acid as main components) by using an electrochemical workstation, and then washing to obtain a finalimplantable drainage devicehaving a three-dimensional expansion anchor. The drainage device has good elasticity and a phase transition temperature of 28 ℃.
[0312] A delivery system can be used to perform in-situ intraocular release of the resulting implantable ophthalmic drainage device. The puncture needle of the delivery system can comprise a 25G thin-wall needle tube (e.g., having an outer diameter of about 0.50 mm and an inner diameter of about 0.24 mm) with a round blunt needle tip. In an initial state, the length of the puncture needle can extend beyond the housing by about 6 mm and in a final state, the length of the puncture needle can extend beyond the housing by about 1 mm. In other words, the maximum length that the switchcan retract is about 5 mm. The outer diameter of the ejector pin in the delivery system can be about 0.2 mm, and the length of the ejector pincan exceed the housing by about 2 mm. The total length of the delivery system can be about 100 mm, and the maximum outer diameter of the delivery system can be about 22 mm.
[0313] The drainage device can be pushed in a conical jig using a 25G normal wall needle cannula (e.g., having anabout 0.50 mm outside diameter and anabout 0.24 mm inside diameter) , thereby compressing the expansion anchor and loading it into the needle in the desired direction (e.g., such that at least part of the distal segment of the drainage device can be the first to exit the needle as shown FIGS. 16A and 16D) . The distal segment of the drainage device can extend out of the puncture needle by about 1.0 mm. The drainage device can maintain a relative position within the puncture needle when the drainage device is not acted upon by external force (e.g., by the ejector pin) .
[0314] After cleaning and sterilization, the implantable ophthalmic drainage device can be implanted into an eye using the delivery system according to the operation steps as detailed above. The delivery system can provide convenient operationand accurate positioning during the operation process, such that the drainage implantation device can be successfully implanted in the expected position. The results after one month of implantation showthat the implantable ophthalmic drainage device had normal drainage function, no positional movement, and good tissue biocompatibility.
[0315] EXEMPLARY EMBODIMENTS
[0316] This disclosure provides the following exemplary embodiments:
[0317] 1. An ophthalmic drainage device delivery system, comprising: ahousing; apuncture needle disposed at an end of the housing, wherein: adrainage device is configured to be disposed inside the puncture needle, andthe puncture needle is configured for puncturing a sclera of an eye and positioning the drainage device to a suprachoroidal space of the eye; an ejector tube disposed inside the puncture needle; arotating wheel and a rack, wherein: gears of the rotating wheel couple to gears of the rack, androtation of the rotating wheel causes the ejector tube to move in a direction along an axis of the housing; acore base; a buckle, wherein, in a closed position, the buckle is configured to couple to the core base; anda switch, wherein: an actuation of the switch causes the buckle to change to an open position and to decouple the core base from the buckle, andthe decoupling of the core base from the buckle causes the ejector tube to release the drainage device from the puncture needle.
[0318] 2. The delivery system of embodiment1, further comprising a core, wherein: afirst portion of the core passes through a cavity of the ejector tube, andwhen the drainage device is disposed inside the puncture needle, a second portion of the core passes through a cavity of the drainage device.
[0319] 3. The delivery system of embodiment1 or 2, further comprising a button, wherein: in a first position, the button is configured to lock the rotating wheel and the rack, and in a second position, the button is configured to allow the rotating wheel to rotate.
[0320] 4. The delivery system of any of embodiments1-3, wherein: the puncturing of the sclera of the eye comprises performing scleral penetration, the lining core passes through the drainage device, and the ejector tube is configured to support, fix, and guide the drainage device.
[0321] 5. The delivery system of any of embodiments1-4, wherein the ejector tube is configured to abut with the drain device when the drainage device is disposed inside the puncture needle.
[0322] 6. The delivery system of any of embodiments1-5, further comprising a first spring comprising two ends, the two ends respectively coupled to the switch and an ejector tube base.
[0323] 7. The delivery system of any of embodiments1-6, further comprising a second spring coupled to the core base, wherein the decoupling of the core base buckle causes the second spring to push the core base and release the ejector tube.
[0324] 8. The delivery system of any of embodiments1-7, wherein: the switch comprises a first portion, the buckle comprises a second portion, andin the closed position, the second portion of the buckle is configured to couple to the first portion of the switch.
[0325] 9. The delivery system of embodiment8, wherein: the first portion has a conical structure, andthe second leg has an inverted cone structure.
[0326] 10. The delivery system of any of embodiments1-9, further comprising a vibration sensor coupled to a light, wherein in response to detecting, via the vibration sensor, a vibration of the delivery system greater than a vibration threshold value, the light is configured to provide a warning.
[0327] 11. A delivery system for delivering a minimally invasive, implantable ophthalmic drainage device, comprising: apuncture needle comprising a first inner cavity configured to receive the drainage device, wherein the drainage device is configured to compress in the puncture needle; aneedle base fixedly connected to the puncture needle; ahousing configured to receive the puncture needle and the needle base, such that the needle base and the puncture needle are movable along an axis of the housing; aswitch coupled to the needle base and configured to move along the axis of the housing, causing the needle base and the puncture needle to move along the axis of the housing; an ejector pin fixedly connected to a base of the housing, wherein at least a portion of the ejector pin is positioned inside the puncture needle and is configured to slidably engage with the puncture needle, and wherein the ejector pin is configured to push the drainage device out of the puncture needle as the puncture needle moves along the axis of the housing.
[0328] 12. The delivery system of embodiment 11, wherein in a first switch state, the switch is positioned relative to the housing such that the housing prevents the switch from moving along the axis of the housing and in a second switch state, the switch is positioned relative to the housing such that the housing allows the switch to move along the axis of the housing, wherein depression of the switch causes the switch to enter the second switch state from the first switch state.
[0329] 13. The delivery system of embodiment12, wherein the base of the housing comprises: acavity configured to fixedly receive an end of the ejector pin; anda first locking structure configured to engage with a second locking structure of the housing such that the base is fixedly connected to the housing, wherein the first locking structure of the base is a threaded structure or a snap-fit structure.
[0330] 14. The delivery system of embodiment13, wherein: the puncture needle comprises stainless steel or nickel-titanium shape memory alloy, the needle base, housing, base, and switch comprise resin, and the ejector pin and the spring comprise stainless steel.
[0331] 15. The delivery system of embodiment14, wherein the housing comprises: ahousing inner cavity configured to slidably engage with an outer surface of the needle base; anda first housing inner cavity surface and a second housing inner cavity surface configured to slidably engage with an outer surface of the switch.
[0332] 16. The delivery system of embodiment15, wherein the needle base comprises: asecond inner cavity configured to slidingly engage with the ejector pin; aswitch installation cavity configured to slidingly engage with the outer surface of the switch; anda cylinder fixedly engaged with an inner surface of a spring engaged with the switch, wherein the cylinder is arranged in the switch installation cavity.
[0333] 17. The delivery system of any of embodiments 11-16, wherein the puncture needle comprises a bevel needle tip.
[0334] 18. The delivery system of any of embodiments 11-16, wherein the puncture needle comprises a round blunt needle tip.
[0335] 19. The delivery system of any of embodiments 11-18, wherein an outer diameter of the puncture needle is between about 0.5 mm and about 0.7 mm, and an inner diameter of the puncture needle is between about 0.3 mm and about 0.5 mm.
[0336] 20. The delivery system of any of embodiments 11-18, wherein an outer diameter of the puncture needle is between about 0.4 mm and about 0.8 mm and an inner diameter of the puncture needle is between about 0.18 mm and about 0.61 mm.
[0337] 21. A minimally invasive, implantable ophthalmic drainage device comprising: a drainage body comprising a drainage cavity; aplurality of retention rings, each of the retention rings: having a respective center on a respective point on an axis of the drainage body, andprotruding on an outer surface of the drainage body; aplurality of inner ring grooves in the drainage cavity, each of the plurality of inner ring grooves concentric with a respective retention ring of the plurality of retention rings, wherein the plurality of inner ring grooves is configured for controlling a drainage speed; anda flap valve coupled to the drainage cavity, the flap valve configured to: allow flow from a first side of the drainage cavity to a second side of the drainage cavity when a pressure of the first side is higher than a pressure of the second side, anddisallow flow from the first side of the drainage cavity to the second side of the drainage cavity when the pressure of the first side is not higher than the pressure of the second side, wherein: the drainage cavity is configured to fluidly connect an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye.
[0338] 22. The drainage device of embodiment21, further comprising a plurality of microwells disposed along the outer surface of the drainage body, the plurality of microwells configured to store drugs for the eye.
[0339] 23. The drainage device of embodiment 22, wherein channels of the plurality of microwells have circular, square, or polygonal shapes.
[0340] 24. The drainage device of embodiment 22 or 23, wherein the plurality of microwells comprises one or more of ridges and slits.
[0341] 25. The drainage device of any of embodiments22-24, wherein: the plurality of microwells is configured to interact with the inner ring grooves, and the interaction between the plurality of microwells and the inner ring grooves controls the drainage speed and release rate of the drug.
[0342] 26. The drainage device of any of embodiments 21-25, further comprising a guiding and positioning end coupled to the first side of the drainage cavity, the guiding and positioning end comprising a positioning groove.
[0343] 27. The drainage device of any of embodiments 21-26, further comprising a discharge end couple to the second side of the drainage cavity.
[0344] 28. The drainage device of embodiment 27, wherein the discharge end is configured to have a curvature shaped according to a curvature of the eye when the drainage device is implanted in the eye.
[0345] 29. The drainage device of embodiment 27 or 28, wherein the discharge end comprises one or more of a thermoplastic material and rubber material.
[0346] 30. The drainage device of any of embodiments21-29, wherein a first diameter of the flap valve on the first side is greater than a second diameter of the flap valve on the second side.
[0347] 31. The drainage device of any of embodiments 21-30, further comprising: aguiding and positioning end; andan identification support ring on the guiding and positioning end, wherein the identification support ring comprises a ring or a woven mesh having a fluorescent material.
[0348] 32. The drainage device of embodiment 31, wherein the identification support ring furthercomprises one or more of nickel-titanium alloy, titanium alloy, and stainless steel.
[0349] 33. The drainage device of any of embodiments 21-32, further comprising a control unit, a pressure sensor, and a flow sensor, wherein: the pressure sensor is configured to determine a pressure in the drainage device, the flow sensor is configured to determine a flow in the drainage device, andthe control unit is configured to receive the pressure from the pressure sensor and the flow from the flow sensor.
[0350] 34. The drainage device of embodiment 33, wherein the control unit is configured to determine the drainage speed based on the pressure and flow.
[0351] 35. The drainage device of embodiment 34, wherein: in accordance with one or more a determination that the pressure is higher than a threshold pressure and a determination that the flow is higher than a threshold flow, the drainage device is configured to change the drainage speed to a corrected drainage speed, andin accordance with a determination that the pressure is not higher than the threshold pressure and a determination that the flow is not higher than the threshold flow, the drainage device is configured to maintain the drainage speed.
[0352] 36. The drainage device of embodiment 35, wherein the corrected drainage speedis expressed as Q’ = Q x [1- (C-C1) / C ] , Q’ represents the corrected drainage speed, Q represents the drainage speed, C represents the flow, and C1 represents a present flow.
[0353] 37. The drainage device of any of embodiments21-36, wherein the plurality of inner ring grooves comprises five inner ring grooves, andspacings between adjacentinner ring grooves and depths of each inner ring grooves are adjustable to control the drainage speed.
[0354] 38. The drainage device of embodiment37, wherein the spacings increase along one direction of the drainage body, and the depths increases along the one direction.
[0355] 39. The drainage device of any of embodiments21-38, wherein a core of a delivery device is configured to pass through the drainage cavity.
[0356] 40. The drainage device of any of embodiments 21-39, wherein the drainage body comprises one or more of silicone rubber, block polyetherimide, polyurethane, polyethersulfone, polyimide, polyether ether ketone, and shape memory alloy.
[0357] 41. A minimally invasive, implantable ophthalmic drainage device comprising: atube with an inner cavity, the tube comprising a two-dimensional wave shape or a three-dimensional spiral shape having a wave crest and a wave trough in a first state, wherein the tube comprises a shape memory alloy configured to restore the tube to the first state; andwherein: the inner cavity is configured to fluidly connect an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye, andthe drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.
[0358] 42. The drainage device of embodiment 41, wherein the shape memory alloy comprises a nickel-titanium shape memory alloy.
[0359] 43. The drainage device of embodiment 41 or 42, wherein an outer diameter of the tube is between about 0.3 mm to about 0.6 mm and an inner diameter of the tube is between about 0.05 mm to about 0.3 mm.
[0360] 44. The drainage device of any of embodiments 41-43, wherein the tube comprises the two-dimensional wave shape having a period T between about 3.0 mm to about 6.0 mm, an amplitude A between about 0.6 mm to about 1.0 mm, and a length L between about 4 mm to about 6 mm.
[0361] 45. The drainage device of any of embodiments 41-44, wherein the tube comprises the two-dimensional wave shape, comprising a period T between about 3.0 mm to about 4.0 mm, an amplitude A between about 0.7 mm to about 0.8 mm, and a length L between about 4.5 mm to about 5 mm.
[0362] 46. The drainage device of any of embodiments 41-43, wherein the tube comprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 8.0 mm, a major diameter D between about 0.5 mm and about 1.5 mm, and a length L between about 4 mm and about 6 mm.
[0363] 47. The drainage device of any of embodiments 41-43, wherein the tube comprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 5.0 mm, a major diameter D between about 0.7 mm and about 1.0 mm, and a length L between about 4.5 mm and about 5.0 mm.
[0364] 48. The drainage device of any of embodiments 41-47, further comprising a plurality of apertures fluidically connecting the inner cavity to an outer surface of the tube, wherein the plurality of apertures comprises double-sided opposite apertures rotated at a preset angle along an axial direction of the tube or single-sided apertures rotated at a preset angle along the axial direction of the tube.
[0365] 49. The drainage device of embodiment 48, wherein the plurality of apertures is formed processed by laser cutting.
[0366] 50. The drainage device of embodiment 48 or 49, wherein the plurality of apertures comprises a circular shape, a rectangular shape, or an irregular shape.
[0367] 51. The drainage device of any of embodiments 41-47, further comprising one or more slits fluidically connecting the inner cavity to an outer surface of the tube, wherein the one or more slits are continuous spiral slits or intermittent slits evenly distributed axially or circumferentially along the tube.
[0368] 52. The drainage device of any of embodiments 41-51, further comprising a coating layer covering an outer surface of the tube, wherein the coating layer comprises Polytetrafluoroethylene (PTFE) , expanded polytetrafluoroethylene (ePTFE) , Fluorinated Ethylene Propylene (FEP) , Polyethylene (PE) , or silicone rubber.
[0369] 53. A minimally invasive, implantable ophthalmic drainage device comprising: adrainage body comprising: an inner cavity; aproximal segment configured to be positioned proximal to a suprachoroidal space of an eye when the drainage device is implanted in the eye; anda distal segment configured to be positioned proximal to an anterior chamber of the eye when the drainage device is implanted in the eye; andan expansion anchor connected with the drainage body between the proximal and distal segment, wherein the expansion anchor comprises a two-dimensional shape or a three-dimensional shape in an expanded state, wherein the drainage body and expansion anchor comprise a shape memory alloy configured to restore the expansion anchor to the expanded state, and the drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.
[0370] 54. The drainage device of embodiment53, wherein the proximal segment of the drainage body comprises a length of between about 0.2 mm and about 2.5 mm, and the distal segment of the drainage body comprises a length of about 0.5 mm to about 3.0 mm.
[0371] 55. The drainage device of embodiment 53 or 54, wherein the shape memory alloy comprises a nickel-titanium shape memory alloy.
[0372] 56. The drainage device of any of embodiments 53-55, wherein the drainage body and the expansion anchor are integrally formed.
[0373] 57. The drainage device of any of embodiments 53-56, wherein: the drainage body comprises a drainage tube with an inner cavity, and a first end and a second end of the expansion anchor are threaded onto an outer wall of the drainage tube, such that one of the first end and the second end is fixedly connected with the outer wall of the drainage tube, and one of the first end and the second end is configured to slide freely along the outer wall of the drainage tube.
[0374] 58. The drainage device of any of embodiments 53-57, wherein an outer diameter of the drainage body is between about 0.15 mm and about 0.6 mm, an inner diameter of the drainage body is between about 0.05 mm and about 0.4 mm, and a total length of the minimally invasive, implantable ophthalmic drainage device is between about 2.5 mm and about 7.0 mm.
[0375] 59. The drainage device of any of embodiments 53-58, wherein the expansion anchor comprises: the two-dimensional shape; andtwo expansion ribs symmetrically arranged with respect to the drainage body, wherein the two-dimensional planar shape formed by the two expansion ribs comprises an expansion diameter between about 0.6 mm and about 2.0 mm.
[0376] 60. The drainage device of embodiment 59, wherein the expansion diameter is between about 0.8 mm and about 1.5 mm.
[0377] 61. The drainage device of embodiment 59 or 60, wherein the expansion anchor having the two-dimensional shape comprises a length between about 0.9 mm and about 2.2 mm.
[0378] 62. The drainage device of any of embodiments 59-61, wherein the expansion anchor having the two-dimensional shape comprises a length between about 1.0 mm and about 1.8 mm.
[0379] 63. The drainage device of any of embodiments 53-58, wherein the expansion anchor comprises: the three-dimensional shape; and n expansion ribs, wherein n is an integer greater than 2, wherein the n expansion ribs are uniformly distributed along a circumferential direction of the drainage body, and wherein the n expansion ribs are arranged in parallel with an axial direction of the drainage body or in a spiral shape along the axial direction of the drainage body.
[0380] 64. The drainage device of embodiment 63, wherein n is 3 or 4.
[0381] 65. The drainage device of embodiment 63 or 64, wherein the expansion anchor comprises: three expansion ribs uniformly arranged along a circumferential direction of the drainage body; and a three-dimensional shape formed by the three expansion ribs, wherein the three-dimensional shape comprises an expansion diameter between about 0.4 mm and about 1.2 mm.
[0382] 66. The drainage device of embodiment 65, wherein the expansion diameter is between about 0.6 mm and about 0.8 mm.
[0383] 67. The drainage device of any of embodiments 63-66, wherein the expansion anchor having the three-dimensional shape comprises a length between about 0.8 mm and about 1.8 mm.
[0384] 68. The drainage device of any of embodiments 63-67 wherein the expansion anchor having the three-dimensional shape comprises a length between about 1.0 mm and about 1.5 mm.
[0385] 69. The drainage device of any of embodiments 53-68, wherein the expansion anchor is configured for ciliary body dissociation when the minimally invasive, implantable ophthalmic drainage device is implanted in the eye, such that aqueous humor drained from the anterior chamber can enter the suprachoroidal space for transscleral or ciliary choroidal vascular absorption.
[0386] 70. The delivery system of any of embodiments 1-20, wherein the delivery system is configured to receive and release the minimally invasive, implantable ophthalmic drainage device of any of embodiments 21-69.
[0387] 71. The minimally invasive, implantable ophthalmic drainage device of any of embodiments 21-69, wherein the drainage device is configured to be loaded into the delivery system of any of embodiments 1-20.
[0388] 72. A method of implanting a minimally invasive, implantable ophthalmic drainage device of any of embodiments 21-69 in an eye, the method comprising: positioning, in a suprachoroidal space of the eye, a puncture needle of the delivery system of any of embodiments 1-20, the drainage device loaded in the delivery device; while the drainage device is loaded in the delivery device, positioning, by the delivery system, the drainage device in the suprachoroidal space; andreleasing, by the delivery system, the drainage device.
[0389] 73. The method of embodiment 72, wherein the suprachoroidal space is expanded by injecting a viscoelastic agent.
[0390] In the disclosure, it should be understood that the terms “center, ” “longitudinal, ” “lateral, ” “length, ” “width, ” “thickness, ” “upper, ” “lower, ” “front, ” “rear, ” “left, ” “right, ” “vertical, ” “h orizontal, ” “top, ” “bottom, ” “inner, ” “outer, ” “clockwise, ” “counterclockwise, ” “axial, ” “radial, ” “circ umferential, ” “distal, ” “proximal, ” etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings are merely for convenience in describing the embodimentsand simplifying the disclosure, and do not indicate or imply that the device or element being referred to must have a specific orientation, be configured and operated in a specific orientation, and therefore should not be construed as limiting the embodiments.
[0391] Furthermore, the terms “first, ” “second, ” and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining “afirst” or “asecond” may explicitly or implicitly include at least one such feature. In the disclosure, the meaning of “plurality” means at least two, for example, two, three, etc., unless specifically defined otherwise.
[0392] In the disclosure, unless explicitly specified and limited otherwise, the terms “mounted, ” “connected, ” “secured, ” “coupled, ” “attached, ” “abut, ” and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally formed, mechanically connected, electrically connected, or communicable with each other, directly connected, indirectly connected through an intervening medium, or in communication between two elements or in an interactive relationship between two elements, unless otherwise explicitly specified. The specific meaning of the above terms in the disclosure can be understood by those of ordinary skill in the art according to the specific circumstances.
[0393] In the disclosure, unless expressly stated or limited otherwise, a first feature “up” or “down, ” a second feature may be the first and second features in direct contact, or the first and second features in indirect contact via an intervening medium. Moreover, a first feature being “above, ” “over, ” and “on” a second feature may be a first feature being directly above or obliquely above the second feature, or simply indicating that the first feature is level higher than the second feature. The first feature being “under, ” “below, ” and “beneath” the second feature may be the first feature being directly under or obliquely below the second feature, or simply indicating that the first feature is less level than the second feature.
[0394] For purposes of this disclosure, the terms “one embodiment, ” “some embodiments, ” “example, ” “aparticular example, ” or “some examples, ” etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the disclosure. In this specification, schematic representations of the above terms are not necessarily directed to the same embodiment or the same. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, the different embodiments or examples described in this specification and the features of the different embodiments or examples may be combined and combined by those skilled in the art without contradiction.
[0395] While embodiments of the disclose have been shown and described, it should be understood that the above embodiments are illustrative and not to be construed as limiting the disclosure, and that variations, modifications, alternatives, and variations may be made to the above embodiments by those skilled in the art within the scope and spirit of the disclosure, and any such modifications, equivalents, improvements, etc. are intended to be included within the scope of the disclosure.
Claims
1.An ophthalmic drainage device delivery system, comprising:a housing;a puncture needle disposed at an end of the housing, wherein:a drainage device is configured to be disposed inside the puncture needle, andthe puncture needle is configured for puncturing a sclera of an eye and positioning the drainage device to a suprachoroidal space of the eye;an ejector tube disposed inside the puncture needle;a rotating wheel and a rack, wherein:gears of the rotating wheel couple to gears of the rack, androtation of the rotating wheel causes the ejector tube to move in a direction along an axis of the housing;a core base;a buckle, wherein, in a closed position, the buckle is configured to couple to the core base; anda switch, wherein:an actuation of the switch causes the buckle to change to an open position and to decouple the core base from the buckle, andthe decoupling of the core base from the buckle causes the ejector tube to release the drainage device from the puncture needle.2.The delivery system of claim 1, further comprising a core, wherein:a first portion of the core passes through a cavity of the ejector tube, andwhen the drainage device is disposed inside the puncture needle, a second portion of the core passes through a cavity of the drainage device.3.The delivery system of claim 1 or 2, further comprising a button, wherein:in a first position, the button is configured to lock the rotating wheel and the rack, andin a second position, the button is configured to allow the rotating wheel to rotate.4.The delivery system of any of claims 1-3, wherein:the puncturing of the sclera of the eye comprises performing scleral penetration,the lining core passes through the drainage device, andthe ejector tube is configured to support, fix, and guide the drainage device.5.The delivery system of any of claims 1-4, wherein the ejector tube is configured to abut with the drain device when the drainage device is disposed inside the puncture needle.6.The delivery system of any of claims 1-5, further comprising a first spring comprising two ends, the two ends respectively coupled to the switch and an ejector tube base.7.The delivery system of any of claims 1-6, further comprising a second spring coupled to the core base, wherein the decoupling of the core base buckle causes the second spring to push the core base and release the ejector tube.8.The delivery system of any of claims 1-7, wherein:the switch comprises a first portion,the buckle comprises a second portion, andin the closed position, the second portion of the buckle is configured to couple to the first portion of the switch.9.The delivery system of claim 8, wherein:the first portion has a conical structure, andthe second leg has an inverted cone structure.10.The delivery system of any of claims 1-9, further comprising a vibration sensor coupled to a light, wherein in response to detecting, via the vibration sensor, a vibration of the delivery system greater than a vibration threshold value, the light is configured to provide a warning.11.A delivery system for delivering a minimally invasive, implantable ophthalmic drainage device, comprising:a puncture needle comprising a first inner cavity configured to receive the drainage device, wherein the drainage device is configured to compress in the puncture needle;a needle base fixedly connected to the puncture needle;a housing configured to receive the puncture needle and the needle base, such that the needle base and the puncture needle are movable along an axis of the housing;a switch coupled to the needle base and configured to move along the axis of the housing, causing the needle base and the puncture needle to move along the axis of the housing;an ejector pin fixedly connected to a base of the housing, wherein at least a portion of the ejector pin is positioned inside the puncture needle and is configured to slidably engage with the puncture needle, and wherein the ejector pin is configured to push the drainage device out of the puncture needle as the puncture needle moves along the axis of the housing.12.The delivery system of claim 11, wherein in a first switch state, the switch is positioned relative to the housing such that the housing prevents the switch from moving along the axis of the housing and in a second switch state, the switch is positioned relative to the housing such that the housing allows the switch to move along the axis of the housing, wherein depression of the switch causes the switch to enter the second switch state from the first switch state.13.The delivery system of claim 12, wherein the base of the housing comprises:a cavity configured to fixedly receive an end of the ejector pin; anda first locking structure configured to engage with a second locking structure of the housing such that the base is fixedly connected to the housing, wherein the first locking structure of the base is a threaded structure or a snap-fit structure.14.The delivery system of claim 13, wherein:the puncture needle comprises stainless steel or nickel-titanium shape memory alloy,the needle base, housing, base, and switch comprise resin, andthe ejector pin and the spring comprise stainless steel.15.The delivery system of claim 14, wherein the housing comprises:a housing inner cavity configured to slidably engage with an outer surface of the needle base; anda first housing inner cavity surface and a second housing inner cavity surface configured to slidably engage with an outer surface of the switch.16.The delivery system of claim 15, wherein the needle base comprises:a second inner cavity configured to slidingly engage with the ejector pin;a switch installation cavity configured to slidingly engage with the outer surface of the switch; anda cylinder fixedly engaged with an inner surface of a spring engaged with the switch, wherein the cylinder is arranged in the switch installation cavity.17.The delivery system of any of claims 11-16, wherein the puncture needle comprises a bevel needle tip.18.The delivery system of any of claims 11-16, wherein the puncture needle comprises a round blunt needle tip.19.The delivery system of any of claims 11-18, wherein an outer diameter of the puncture needle is between about 0.5 mm and about 0.7 mm, and an inner diameter of the puncture needle is between about 0.3 mm and about 0.5 mm.20.The delivery system of any of claims 11-18, wherein an outer diameter of the puncture needle is between about 0.4 mm and about 0.8 mm and an inner diameter of the puncture needle is between about 0.18 mm and about 0.61 mm.21.A minimally invasive, implantable ophthalmic drainage device comprising:a drainage body comprising a drainage cavity;a plurality of retention rings, each of the retention rings:having a respective center on a respective point on an axis of the drainage body, andprotruding on an outer surface of the drainage body;a plurality of inner ring grooves in the drainage cavity, each of the plurality of inner ring grooves concentric with a respective retention ring of the plurality of retention rings, wherein the plurality of inner ring grooves is configured for controlling a drainage speed; anda flap valve coupled to the drainage cavity, the flap valve configured to:allow flow from a first side of the drainage cavity to a second side of the drainage cavity when a pressure of the first side is higher than a pressure of the second side, anddisallow flow from the first side of the drainage cavity to the second side of the drainage cavity when the pressure of the first side is not higher than the pressure of the second side, wherein:the drainage cavity is configured to fluidly connect an anterior chamber of an eye with a suprachoroidal space of the eye when the drainage device is implanted in the eye.22.The drainage device of claim 21, further comprising a plurality of microwells disposed along the outer surface of the drainage body, the plurality of microwells configured to store drugs for the eye.23.The drainage device of claim 22, wherein channels of the plurality of microwells have circular, square, or polygonal shapes.24.The drainage device of claim 22 or 23, wherein the plurality of microwells comprises one or more of ridges and slits.25.The drainage device of any of claims22-24, wherein:the plurality of microwells is configured to interact with the inner ring grooves, andthe interaction between the plurality of microwells and the inner ring grooves controls the drainage speed and release rate of the drug.26.The drainage device of any of claims21-25, further comprising a guiding and positioning end coupled to the first side of the drainage cavity, the guiding and positioning end comprising a positioning groove.27.The drainage device of any of claims21-26, further comprising a discharge end couple to the second side of the drainage cavity.28.The drainage device of claim 27, wherein the discharge end is configured to have a curvature shaped according to a curvature of the eye when the drainage device is implanted in the eye.29.The drainage device of claim 27 or 28, wherein the discharge end comprises one or more of a thermoplastic material and rubber material.30.The drainage device of any of claims21-29, wherein a first diameter of the flap valve on the first side is greater than a second diameter of the flap valve on the second side.31.The drainage device of any of claims21-30, further comprising:a guiding and positioning end; andan identification support ring on the guiding and positioning end, wherein the identification support ring comprises a ring or a woven mesh having a fluorescent material.32.The drainage device of claim 31, wherein the identification support ring furthercomprises one or more of nickel-titanium alloy, titanium alloy, and stainless steel.33.The drainage device of any of claims21-32, further comprising a control unit, a pressure sensor, and a flow sensor, wherein:the pressure sensor is configured to determine a pressure in the drainage device,the flow sensor is configured to determine a flow in the drainage device, andthe control unit is configured to receive the pressure from the pressure sensor and the flow from the flow sensor.34.The drainage device of claim 33, wherein the control unit is configured to determine the drainage speed based on the pressure and flow.35.The drainage device of claim 34, wherein:in accordance with one or more a determination that the pressure is higher than a threshold pressure and a determination that the flow is higher than a threshold flow, the drainage device is configured to change the drainage speed to a corrected drainage speed, andin accordance with a determination that the pressure is not higher than the threshold pressure and a determination that the flow is not higher than the threshold flow, the drainage device is configured to maintain the drainage speed.36.The drainage device of claim 35, wherein the corrected drainage speedis expressed as Q’ = Q x [1- (C-C1) / C] , Q’ represents the corrected drainage speed, Q represents the drainage speed, C represents the flow, and C1 represents a present flow.37.The drainage device of any of claims21-36, whereinthe plurality of inner ring grooves comprises five inner ring grooves, andspacings between adjacentinner ring grooves and depths of each inner ring grooves are adjustable to control the drainage speed.38.The drainage device of claim 37, wherein the spacings increase along one direction of the drainage body, and the depths increases along the one direction.39.The drainage device of any of claims21-38, wherein a core of a delivery device is configured to pass through the drainage cavity.40.The drainage device of any of claims21-39, wherein the drainage body comprises one or more of silicone rubber, block polyetherimide, polyurethane, polyethersulfone, polyimide, polyether ether ketone, and shape memory alloy.41.A minimally invasive, implantable ophthalmic drainage devicecomprising:a tube with an inner cavity, the tube comprising a two-dimensional wave shape or a three-dimensional spiral shape havinga wave crestand a wave trough in a first state, wherein the tube comprises a shape memory alloy configured to restore the tube to the first state; andwherein:the inner cavityis configuredto fluidly connect an anterior chamber of an eye witha suprachoroidal space of the eye when the drainage device is implanted in the eye, andthe drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.42.The drainage device of claim 41, wherein the shape memory alloy comprises a nickel-titanium shape memory alloy.43.The drainage device of claim 41 or 42, wherein an outer diameter of the tube is between about 0.3 mm to about 0.6 mmand an inner diameter of the tube is between about 0.05 mm to about 0.3 mm.44.The drainage device ofany of claims 41-43, wherein the tubecomprises the two-dimensional wave shape having a period T between about 3.0 mm to about 6.0mm, an amplitude A between about 0.6 mm to about 1.0mm, and a length Lbetween about 4 mm to about 6mm.45.The drainage device of any of claims 41-44, wherein the tube comprises the two-dimensional wave shape, comprisinga period T between about 3.0 mm to about 4.0 mm, an amplitude A between about 0.7 mm to about 0.8 mm, and alength L between about 4.5 mm to about 5mm.46.The drainage device ofany of claims41-43, wherein the tubecomprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 8.0 mm, a major diameter D between about 0.5 mm and about 1.5 mm, and alength Lbetween about 4 mm and about 6 mm.47.The drainage device of any of claims 41-43, wherein the tube comprises the three-dimensional spiral shape, having a pitch P between about 3.0 mm and about 5.0 mm, a major diameter D between about 0.7 mm and about 1.0 mm, and a length L between about 4.5 mm and about 5.0 mm.48.The drainage device ofany of claims 41-47, further comprising a plurality of apertures fluidically connecting the inner cavityto an outer surface of the tube, wherein the plurality of aperturescomprises double-sided oppositeapertures rotated at a preset angle along an axial direction of the tube or single-sided apertures rotated at a preset angle along the axial direction of the tube.49.The drainage device of claim 48, wherein the plurality of apertures is formed processed by laser cutting.50.The drainage device of claim 48 or 49, wherein the plurality of apertures comprises a circular shape, a rectangular shape, or an irregular shape.51.The drainage device of any of claims 41-47, further comprising one or more slits fluidically connecting the inner cavity to an outer surface of the tube, wherein the one or more slits are continuous spiral slits or intermittent slits evenly distributed axially or circumferentially along the tube.52.The drainage device ofany of claims 41-51, further comprising a coating layer covering an outer surface of the tube, wherein the coating layer comprises Polytetrafluoroethylene (PTFE) , expanded polytetrafluoroethylene (ePTFE) , Fluorinated Ethylene Propylene (FEP) , Polyethylene (PE) , or silicone rubber.53.A minimally invasive, implantable ophthalmic drainage device comprising:a drainage body comprising:aninner cavity;a proximal segment configured to be positioned proximal to a suprachoroidal space of an eye when the drainage device is implanted in the eye; anda distal segment configured to be positioned proximal to an anterior chamber of the eye when the drainage device is implanted in the eye; andan expansion anchor connected with the drainage bodybetween the proximal and distal segment, wherein the expansion anchor comprisesa two-dimensional shape or a three-dimensional shapein an expanded state,wherein the drainage body and expansion anchor comprise a shape memory alloy configured to restore the expansion anchor to the expanded state, and the drainage device is configured to be compressed into a second state for insertion into a puncture needle of a delivery device.54.The drainage device of claim 53, wherein the proximal segment of the drainage body comprises a length of between about 0.2 mm and about 2.5mm, and the distal segment of the drainage body comprises a length of about 0.5 mm to about 3.0mm.55.The drainage device of claim 53 or 54, wherein the shape memory alloy comprises a nickel-titanium shape memory alloy.56.The drainage device of any of claims 53-55, wherein the drainage body and the expansion anchor are integrally formed.57.The drainage device of any of claims 53-56, wherein:the drainage body comprises a drainage tube with an inner cavity, anda first end and a second end of the expansion anchor are threaded onto an outer wall of the drainage tube, such that one of the first end and the second end is fixedly connected with the outer wall of the drainage tube, and one of the first end and the second end is configured to slide freely along the outer wall of the drainage tube.58.The drainage device of any of claims 53-57, wherein anouterdiameter of the drainage body is between about 0.15 mm and about 0.6mm, aninnerdiameter of the drainage body is between about 0.05 mm and about 0.4mm, and a total length of the minimally invasive, implantable ophthalmic drainage device is between about 2.5 mm and about 7.0mm.59.The drainage device of any of claims 53-58, wherein the expansion anchor comprises:the two-dimensional shape; andtwo expansion ribs symmetrically arranged with respect to the drainage body, wherein the two-dimensional planar shape formed by the two expansion ribs comprises an expansion diameter between about 0.6 mm and about 2.0mm.60.The drainage device of claim 59, wherein the expansion diameter is between about 0.8 mm and about 1.5mm.61.The drainage device of claim 59 or 60, wherein the expansion anchor having the two-dimensional shapecomprises a length between about 0.9 mm and about 2.2 mm.62.The drainage device of any of claims 59-61, wherein the expansion anchor having the two-dimensional shapecomprises a length between about 1.0 mm and about 1.8 mm.63.The drainage device of any of claims 53-58, wherein the expansion anchor comprises:the three-dimensional shape; andn expansion ribs, wherein n is an integer greater than 2, wherein the n expansion ribs are uniformly distributed along a circumferential direction of the drainage body, and wherein the n expansion ribs are arranged in parallel with an axial direction of the drainage body or in a spiral shape along the axial direction of the drainage body.64.The drainage device of claim 63, wherein n is 3 or 4.65.The drainage device of claim 63 or 64, wherein the expansion anchor comprises:three expansion ribs uniformly arranged along a circumferential direction of the drainage body; anda three-dimensional shape formed by the three expansion ribs, wherein the three-dimensional shapecomprises an expansion diameter between about 0.4 mm and about 1.2mm.66.The drainage device of claim 65, wherein the expansion diameter is between about 0.6 mm and about 0.8mm.67.The drainage device of any of claims 63-66, wherein the expansion anchor having the three-dimensional shape comprises a length between about 0.8 mm and about 1.8 mm.68.The drainage device of any of claims 63-67 wherein the expansion anchor having the three-dimensional shapecomprises a length between about 1.0 mm and about 1.5 mm.69.The drainage device of any of claims 53-68, wherein the expansion anchoris configured for ciliary body dissociation when the minimally invasive, implantable ophthalmic drainage device is implanted in the eye, such that aqueous humor drained from the anterior chamber can enter the suprachoroidal space for transscleral or ciliary choroidal vascular absorption.70.The delivery system of any of claims 1-20, wherein the delivery system is configured to receive and release the minimally invasive, implantable ophthalmic drainage device of any of claims 21-69.71.The minimally invasive, implantable ophthalmic drainage device of any of claims 21-69, wherein the drainage device is configured to be loaded into the delivery system of any of claims 1-20.72.A method of implanting a minimally invasive, implantable ophthalmic drainage device of any of claims 21-69 in an eye, the method comprising:positioning, in a suprachoroidal space of the eye, a puncture needle of the delivery system of any of claims 1-20, the drainage device loaded in the delivery device;while the drainage device is loaded in the delivery device, positioning, by the delivery system, the drainage device in the suprachoroidal space; andreleasing, by the delivery system, the drainage device.73.The method of claim 72, wherein the suprachoroidal space is expanded by injecting a viscoelastic agent.
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