Combined treatment for cataract and glaucoma treatment

Abstract

A method is provided for treatment of cataract in combination with a glaucoma procedure while maintaining the intraocular pressure by permitting aqueous to flow out of an anterior chamber of the eye through a surgically stented pathway. A trabecular stent is adapted for implantation within the trabecular meshwork of an eye such that intraocular liquid flows controllably from the anterior chamber of the eye to Schlemm's canal, bypassing the trabecular meshwork. Depending upon the specific treatment contemplated, pharmaceuticals may be utilized in conjunction with the trabecular stent enabling post-cataract healing processes.

What is claimed is: 
     
         1 . A method of performing surgery to lower intraocular pressure of an eye, comprising:
 providing an opening into an anterior chamber of the eye;   inserting a first instrument into the anterior chamber through said opening;   using said first instrument to perform a surgical procedure other than for lowering intraocular pressure;   removing said first instrument from the anterior chamber;   inserting a second instrument into the anterior chamber through said opening;   using said second instrument to perform a surgical procedure for lowering intraocular pressure or measuring intraocular pressure; and   removing said second instrument from the anterior chamber.   
     
     
         2 . The method of  claim 1 , wherein the surgical procedure other than for lowering intraocular pressure is performed prior to the surgical procedure for lowering intraocular pressure. 
     
     
         3 . The method of  claim 1 , wherein the surgical procedure for lowering intraocular pressure is performed prior to the surgical procedure other than for lowering intraocular pressure. 
     
     
         4 . The method of  claim 1 , wherein the surgical procedure other than for lowering intraocular pressure is a surgery to treat a cataract. 
     
     
         5 . The method of  claim 4 , wherein the surgery to treat a cataract comprises phacoemulsification of a lens of the eye. 
     
     
         6 . The method of  claim 1 , wherein the surgical procedure for lowering intraocular pressure is a surgery to treat glaucoma. 
     
     
         7 . The method of  claim 6 , wherein the surgery to treat glaucoma comprises making an incision in a trabecular meshwork of the eye to provide outflow of intraocular liquid. 
     
     
         8 . The method of  claim 1 , further comprising closing said opening after said first and second instruments have been removed from the anterior chamber. 
     
     
         9 . The method of  claim 1 , wherein said first instrument comprises an ultrasonic instrument. 
     
     
         10 . The method of  claim 1 , wherein said second instrument comprises an applicator. 
     
     
         11 . A method of performing surgery to lower intraocular pressure of an eye, comprising:
 providing an opening into an anterior chamber of the eye;   inserting a first instrument into the anterior chamber through said opening;   using said first instrument to perform a surgical procedure other than for lowering intraocular pressure;   removing said first instrument from the anterior chamber;   inserting a second instrument into the anterior chamber through said opening;   using said second instrument to implant a seton in a trabecular meshwork of the eye such that the seton conducts fluid from the anterior chamber to Schlemm's canal of the eye to lower intraocular pressure; and   removing said second instrument from the anterior chamber without removing said seton from the trabecular meshwork.   
     
     
         12 . The method of  claim 11 , wherein the surgical procedure other than for lowering intraocular pressure is performed prior to using said second instrument to implant said seton. 
     
     
         13 . The method of  claim 11 , wherein using said second instrument to implant said seton is performed prior to the surgical procedure other than for lowering intraocular pressure. 
     
     
         14 . The method of  claim 11 , wherein the surgical procedure other than for lowering intraocular pressure is a surgery to treat a cataract. 
     
     
         15 . The method of  claim 14 , wherein the surgery to treat a cataract comprises phacoemulsification of a lens of the eye. 
     
     
         16 . The method of  claim 11 , wherein the lowering of intraocular pressure is a treatment for glaucoma. 
     
     
         17 . The method of  claim 11 , further comprising making an incision in the trabecular meshwork for receiving said seton. 
     
     
         18 . The method of  claim 11 , further comprising closing said opening after said first and second instruments have been removed from the anterior chamber. 
     
     
         19 . The method of  claim 11 , wherein said seton comprises a tube. 
     
     
         20 . The method of  claim 11 , wherein said seton comprises a cutting tip for making an incision in the trabecular meshwork. 
     
     
         21 . The method of  claim 11 , wherein said seton has a first end disposed in Schlemm's canal. 
     
     
         22 . The method of  claim 21 , wherein said seton has a second end disposed in the anterior chamber. 
     
     
         23 . The method of  claim 11 , wherein said first instrument comprises an ultrasonic instrument. 
     
     
         24 . The method of  claim 11 , wherein said second instrument comprises an applicator. 
     
     
         25 . The method of  claim 24 , wherein said applicator comprises an actuator to release said seton from said applicator. 
     
     
         26 . The method of  claim 11 , wherein the intraocular pressure is maintained between about 10 mm Hg to about 21 mm Hg.