Ocular Delivery Systems for Ab-Interno Schlemm’s Canal Access
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Solution Overview
Problem
Current glaucoma treatments, such as viscocanalostomy and canaloplasty, are invasive and challenging due to the difficulty in accessing Schlemm's canal from the outside, leading to prolonged procedures and increased risk of complications.
Innovation Solution
Development of minimally invasive systems and methods for accessing Schlemm's canal from the inside (ab-interno) to deliver ocular devices, tools, and fluid compositions that maintain patency and enhance aqueous humor drainage, using a cannula with a distal curved portion and a universal handle for easy manipulation, enabling single-handed, single-operator control.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If ab-externo approach (accessing Schlemm's canal from outside) is used, then ocular devices can be delivered to maintain canal patency, but the procedure becomes invasive and challenging with prolonged operation time
Solution Approach 1:
The patent inverts the traditional ab-externo approach by implementing an ab-interno approach, where the cannula accesses Schlemm's canal from the inside of the eye through the anterior chamber. This reversal of the access direction eliminates the need for complex external dissection and significantly reduces procedure time while maintaining reliable canal patency.
2Reliability
If ab-externo approach is used, then ocular devices can be delivered, but tissue disruption is increased and surgical complexity increases
Solution Approach 1:
By reversing the access route from external to internal, the cannula enters through the anterior chamber and penetrates the trabecular meshwork to reach Schlemm's canal. This approach minimizes disruption to external ocular structures and reduces surgical complexity while ensuring reliable device delivery to the target location.
3Reliability
If traditional surgical procedures are used, then intraocular pressure can be reduced, but the risk of complications increases
Solution Approach 1:
The inverted ab-interno approach reduces the risk of complications by avoiding extensive external dissection and creating a more controlled access path. The cannula enters through the anterior chamber, allowing for precise control and minimized trauma to ocular tissues, thereby reducing complications while effectively reducing intraocular pressure.
4Loss of time
If minimally invasive ab-interno approach is used, then procedure time is reduced and tissue disruption is minimized, but access to Schlemm's canal becomes more challenging
Solution Approach 1:
The cannula incorporates a curved distal portion that facilitates navigation through the anterior chamber and penetration of the trabecular meshwork to reach Schlemm's canal. This curvature is optimized to follow the natural anatomical path, making the minimally invasive approach easier to perform while maintaining reduced procedure time and tissue disruption.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Facilitates safe and efficient delivery of ocular devices and fluid compositions to reduce intraocular pressure, minimizing tissue disruption and procedure time, while allowing for simultaneous cataract and glaucoma surgery through a single incision.
Implementation Method 1
A cannula is coupled to and extends from the housing distal end. The cannula may include a proximal end and a distal curved portion, the distal curved portion having a proximal end and a distal end and a radius of curvature defined between the ends; a body; a distal tip having a bevel; and a lumen extending from the proximal end through the distal tip. The bevel may directly engage the distal end of the curved portion of the cannula
Data Source
AI summary
Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device, tool, or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Some systems described here may be configured to cut or tear the trabecular meshwork with the body of an elongate member located within Schlemm's canal. Other tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.