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.

1 . (canceled) 
     
     
         2 . A method of performing an ocular medical procedure, comprising the steps of:
 creating an incision into an anterior chamber of a living human eye;   removing lens tissue from the eye through the incision;   introducing an artificial intraocular lens into the eye through the incision;   introducing a flexible nitinol stent into the eye through the incision, the stent comprising a first portion comprising an elongate trough defining a channel that is open along a length of the first portion, and a second portion capable of fluid communication with the first portion, the second portion having an opening to facilitate inflow of aqueous humor; and   positioning the stent by advancing the first portion through a trabecular meshwork from within the anterior chamber until the elongate trough is located within and extends along a circumferential length of Schlemm's canal with the open channel in an orientation that facilitates flow of aqueous humor toward one or more collector channels in the eye and retaining the opening of the second portion within the anterior chamber to facilitate flow of aqueous humor from the anterior chamber through the second portion into the open channel of the elongate trough in Schlemm's canal.   
     
     
         3 . The method of  claim 2 , wherein the step of introducing the artificial intraocular lens is performed before the step of introducing the stent. 
     
     
         4 . The method of  claim 2 , wherein the step of introducing the stent is performed before the step of introducing the artificial intraocular lens. 
     
     
         5 . The method of  claim 2 , wherein the method is performed without impacting a sclera or conjunctiva of the eye. 
     
     
         6 . The method of  claim 2 , wherein the stent includes a protuberance to help stabilize the stent. 
     
     
         7 . The method of  claim 2 , wherein the stent is deployed from a cannula. 
     
     
         8 . The method of  claim 7 , wherein a sharpened end of the cannula is used to make an opening in the trabecular meshwork. 
     
     
         9 . The method of  claim 8 , wherein the stent is at least partially inserted through the opening in the trabecular meshwork. 
     
     
         10 . The method of  claim 2 , wherein the incision into the anterior chamber is self-sealing. 
     
     
         11 . The method of  claim 2 , wherein the incision into the anterior chamber is a corneal incision. 
     
     
         12 . A method of performing a medical procedure that combines a cataract operation with a surgical implantation to treat glaucoma, comprising the steps of:
 creating an incision into an anterior chamber of a living human eye;   removing lens tissue from the eye through the incision;   introducing an artificial intraocular lens into the eye through the incision;   introducing at least a portion of a cannula into the eye through the incision, wherein the cannula holds a flexible nitinol stent having a first portion defining a channel that is at least partially open along a length of the first portion, and a second portion capable of fluid communication with the first portion, the second portion having an opening to facilitate flow of aqueous humor into the second portion;   using a sharpened end of the cannula to create an opening in a trabecular meshwork of the eye;   advancing the stent through the opening in the trabecular meshwork; and   positioning the stent so that the first portion extends within and along a circumferential length of Schlemm's canal, and the opening of the second portion is retained in the anterior chamber, thereby allowing aqueous humor from the anterior chamber to bypass the trabecular meshwork through the stent.   
     
     
         13 . The method of  claim 12 , wherein the step of introducing the artificial intraocular lens is performed before the step of introducing at least the portion of the cannula. 
     
     
         14 . The method of  claim 12 , wherein the step of introducing at least the portion of the cannula is performed before the step of introducing the artificial intraocular lens. 
     
     
         15 . The method of  claim 12 , wherein the first portion of the flexible nitinol stent includes a plurality of openings along its length for the transmission of aqueous humor. 
     
     
         16 . The method of  claim 15 , wherein the plurality of openings consists of three openings. 
     
     
         17 . The method of  claim 12 , wherein the incision into the anterior chamber is self-sealing. 
     
     
         18 . A method of performing a medical procedure that combines a cataract operation with a surgical implantation to treat glaucoma through a single incision, comprising the steps of:
 creating an incision into an anterior chamber of a living human eye;   removing lens tissue from the eye through the incision;   introducing an artificial intraocular lens into the eye through the incision;   introducing at least a portion of a cannula into the eye through the incision, wherein the cannula holds a biocompatible metal stent comprising titanium;   creating an opening in a trabecular meshwork of the eye using an ab interno approach; and   positioning the stent through the opening so that it is located partially in the anterior chamber and partially within and along a circumferential length of Schlemm's canal, thereby allowing aqueous humor to bypass the trabecular meshwork through the stent,   wherein a first portion of the stent located within and along the circumferential length of Schlemm's canal comprises an elongate trough defining a channel that is open along a length of the first portion, and wherein a second portion of the stent located in the anterior chamber comprises an opening to facilitate inflow of aqueous humor.   
     
     
         19 . The method of  claim 18 , wherein the biocompatible metal stent comprises nitinol. 
     
     
         20 . The method of  claim 18 , wherein the incision into the anterior chamber is self-sealing. 
     
     
         21 . The method of  claim 18 , further comprising an actuating step to release the stent from the cannula. 
     
     
         22 . The method of  claim 18 , wherein the step of creating an opening in the trabecular meshwork occurs as a result of positioning the stent. 
     
     
         23 . The method of  claim 18 , wherein the biocompatible metal stent incorporates a slow-release pharmaceutical substance. 
     
     
         24 . A method of performing a medical procedure that combines a cataract operation with a surgical implantation to treat glaucoma, comprising the steps of:
 creating an incision into an anterior chamber of a living human eye through which the cataract operation is performed;   introducing a delivery applicator into the eye through the incision, wherein the delivery applicator holds a flexible nitinol stent comprising a first portion having an open, elongate shape and defining an open channel extending along an entire length of the first portion, and a second portion capable of fluid communication with the first portion, wherein the second portion comprises an opening to facilitate inflow of aqueous humor into the second portion;   using the delivery applicator to create an opening in a trabecular meshwork of the eye;   advancing the stent through the opening in the trabecular meshwork;   positioning the stent so that the first portion extends within and along a circumferential length of Schlemm's canal and the opening of the second portion remains in the anterior chamber, thereby allowing aqueous humor from the anterior chamber to bypass the trabecular meshwork through the stent.   
     
     
         25 . The method of  claim 24 , wherein the first portion of the stent includes a plurality of openings along its length for the transmission of aqueous humor. 
     
     
         26 . The method of  claim 24 , wherein the incision into the anterior chamber is self-sealing. 
     
     
         27 . The method of  claim 24 , wherein the flexible nitinol stent releases a pharmaceutical substance into the eye or ocular tissues. 
     
     
         28 . The method of  claim 24 , wherein the delivery applicator comprises a cannula. 
     
     
         29 . The method of  claim 24 , wherein the delivery applicator comprises a syringe.