Patent Application
20140221908
The present disclosure relates generally to apparatus and method of treating glands of a patient and, in particular, of treating meibomian glands in eyelids of a patient.
The human body contains a number of glands including the lacrimal and meibomian glands of the eye, the sebaceous or pilo-sebaceous hair glands on the face and underarms, and the mammary glands in the breasts. These glands may malfunction due to age, irritation, environmental conditions, cellular debris, inflammation, hormonal imbalance and other causes. One common malfunction is the restriction or stoppage of the natural flow of secretions out of the gland.
While sometimes the description that follows is directed to the meibomian glands of the eye, it will be understood that description may also apply to other external glands of the body. With particular reference to the human eye, the tear film covering the ocular surfaces is composed of three layers. The innermost layer in contact with the ocular surface is the mucus layer. The middle layer comprising the bulk of the tear film is the aqueous layer, and the outermost layer is a thin (less than 250 nm) layer comprised of many lipids known as “meibum” or “sebum.” The sebum is secreted by the meibomian glands, enlarged specialized sebaceous-type glands located on both the upper and lower eyelids, with orifices designed to discharge the lipid secretions onto the lid margins, thus forming the lipid layer of the tear film. The typical upper lid has approximately 25 meibomian glands and the lower lid has approximately 20 meibomian glands, which are somewhat larger than those located in the upper lid. The meibomian gland comprises various sac-like acini which discharge the secretion into the duct of the gland. The secretion then passes into the orifices which are surrounded by smooth muscle tissue and the muscle of Riolan which are presumed to aid in the expression of sebum. The meibomian gland orifices open on the lid margin usually along the mucocutaneous junction also known as the gray line. The meibomian gland orifices are assumed to open with blinking and release minute amounts of sebum secretions onto the lid margin and then into the inferior tear meniscus. The lipid “sebum” in the tear meniscus is spread upward and over the tear film of the open eye by the upward blink action. If the lipid secretions are optimal, and adequate lipid layer is maintained at the air interface to minimize evaporation and prevent dry eye states. If the lipid secretions are inadequate the lipid layer is not adequate to minimize evaporation with resulting rapid evaporation leading to dry eye states. Thus, it will be seen that a defective lipid layer or an incorrect quantity or quality of such lipids can result in accelerated evaporation of the aqueous layer which, in turn, causes symptoms which may include symptoms such as dryness, scratching, irritation, burning, tearing, redness, and itchiness, which are collectively be referred to as “dry eye” symptoms.
Dry eye states have many etiologies. A common cause of common dry eye states is the condition known as “meibomian gland dysfunction”, a disorder where the glands are obstructed or occluded. As employed herein the terms “occluded” and “obstruction” as they relate to meibomian gland dysfunction are defined as partially or completely blocked or plugged meibomian glands. If completely obstructed the gland cannot secrete. If partially or intermittently occluded the gland may secrete either normal or decreased amounts of sebum. More usually the secretions are altered having semi-solid, thickened, congested secretions, frequently described as inspissated. The secretions may be clear or yellowish, the latter indicating possible infection. Meibomitis, an inflammation of the meibomian glands leading to their dysfunction, is usually accompanied by blepharitis (inflammation of the lids). Meibomian gland dysfunction may accompany meibomitis, or meibomian gland dysfunction may be present without obvious lid inflammation. Meibomian gland dysfunction is frequently the result of keratotic obstruction of the individual meibomian gland orifices and/or the central duct (canal) of the gland which compromises the secretory functions of the individual meibomian glands. More particularly, these keratotic obstructions include a combination of desquamated epithelial cells, keratin, sebaceous ground substance, and bacteria. While meibomitis is obvious by inspection of the external lids, meibomian gland dysfunction may not be obvious even when examined with the magnification of the slit-lamp biomicroscope, since there may not be external signs or the external signs may be so minimal that they are overlooked. The external signs of meibomian gland dysfunction may be limited to subtle alterations of the meibomian gland orifices, subtle or pronounced overgrowth of epithelium over the orifices, and pouting of the orifices of the glands with congealed material acting as the obstructive material under the epithelia overgrowth resulting in the pouting of the orifices.
When the flow of secretions from the meibomian gland is restricted due to the existence of an obstruction, epithelial cells on the eyelid margin tend to grow over the gland orifice thus further restricting sebum flow and exacerbating the dry eye condition.
Blepharitis, or inflammation of eyelids, is a significant problem facing about ⅓ of the population over 50 years old. [1] The source of inflammation is blockage of the meibomian glands which line the eyelids due to debris including meibum, sebum, lipids and protein from the tears, and dead and devitalized epithelial cells (from the meibomian gland itself). The meibomian gland becomes blocked but continues to secrete meibum. The result in severe cases are styes (or internal hordeolae). [2] Bacteria which are normally found within the meibomian gland overpopulate due to the increased food supply. A lower grade, but much more prevalent problem associated with blocked meibomian glands is a persistent and nagging dry eye.
Typically blepharitis is treated and then managed and will ebb and flow according to exogenous and endogenous factors. The condition is currently treated by having patients apply hot compresses to the eyelids, lid massage, and application of surfactants to the eyelid. Patient compliance with this regimen is notoriously low.
Oral or topical antibiotics are given to reduce the bacterial load in the gland, but are associated with significant side effects, such as gastro-intestinal distress, inability to tolerate sunlight, and allergic reactions among other complications.
Topical anti-inflammatories are given to reduce eyelid inflammation, but do not penetrate deep into the gland.
A physician in Argentina is currently treating blepharitis by using a micro needle to push the debris cap over the meibomian gland into the gland itself. This questionably barbaric attempt to clear the gland opening is not optimal for obvious reasons.
The title of a recent article in the Harvard Woman's Health Watch sums up the efficacy of current treatment and practitioner frustration in managing the condition: “By the way, doctor. I suffer from blepharitis and have tried many medications, but the condition always returns. How can I cure it?”[3]
Therefore, a heretofore unaddressed need exists in the art to address the aforementioned deficiencies and inadequacies.
Certain aspects of the present disclosure are directed to a system for treating a gland of a patient. The system includes a handheld device including a probe, a tip of the probe being formed with a suction opening and a delivery opening; a backend apparatus including a fluid reservoir configured to contain a fluid, an agent reservoir configured to contain agent particles, and a suction force generator; a delivery channel in fluid communication with the delivery opening and the fluid reservoir and the agent reservoir, the delivery channel allowing a mixture of the fluid and the agent particles to travel through the delivery channel and exit at the delivery opening; and a suction channel in fluid communication with the suction opening and the suction force generator, the suction channel allowing a suction force being generated at the suction opening by the suction force generator.
In certain embodiments, the tip further includes a shoe adapted to be placed over a gland of a patient, a first side of the shoe having at least one suction area including the suction opening and at least one delivery area including the delivery opening, and the suction area surrounding the delivery area.
In certain embodiments, the delivering area has a plurality of discrete areas, and the suction area has a plurality of discrete areas.
In certain embodiments, the shoe has a plurality of protrusions placed adjacent to, and protruding away from, the suction area.
In certain embodiments, the handheld device further comprises an agitator at the tip of the probe and configured to generate an agitating force.
In certain embodiments, the backend apparatus has a delivery module in fluid communication with the fluid reservoir and the agent reservoir, and the delivery module is configured to utilize the fluid to deliver the agent particles to the delivery opening.
In certain embodiments, the gland is a meibomian gland in an eyelid of a patient, and the probe includes a heater at the tip and configured to heat the fluid exiting at the delivery opening to a predetermined temperature such that the heated fluid is sufficient to liquefy or soften an obstruction within or at the meibomian gland.
In certain embodiments, the backend apparatus has a heating source configured to heat the fluid in the fluid reservoir to generate a heated fluid. In certain embodiments, the agent particles include nanospheres each containing a medicine. In certain embodiments, a first portion of the nanospheres each include a first medicine, and a second portion of the nanospheres each include a second medicine. In certain embodiments, the nanospheres each include a drug cocktail containing at least one of antibiotic, anti-inflammatory, vasodilator or vasoconstrictor, anti-keritin, anti Veg-F, and salicylic acid.
Certain aspects of the present disclosure are directed to a method for treating a meibomian gland of a patient, The method including: placing a tip of a probe of a handheld device over a meibomian gland on an eyelid, the tip having a suction opening and a delivery opening; and operating a backend apparatus, the backend apparatus including a fluid reservoir having a fluid, an agent reservoir having agent particles, and a suction force generator, such that a delivery channel delivers a mixture of the fluid and the agent particles to exit at the delivery opening and to arrive at the meibomian gland, the delivery channel being in fluid communication with the delivery opening and the fluid reservoir and the agent reservoir; and such that a suction force is generated at the suction opening by the suction force generator and draws a material at the meibomian gland into a suction channel through the suction opening, the suction channel being in fluid communication with the suction opening and the suction force generator.
Certain embodiments of the present disclosure are directed to a handheld device for treating a target region of a patient. The handheld device includes: an elongate housing; a recess formed at a tip of the elongate housing; a head cartridge placed in the recess, including a delivery manifold having a plurality of delivery ports at a treatment side of the delivery manifold, the delivery manifold being in fluid communication with a fluid reservoir through a main port of, and at a backend side of, the delivery manifold, the delivery manifold allowing a fluid contained in the fluid reservoir to exit at the delivery ports; and a contact surface adjacent to the recess, the contact surface having a rugged texture surface.
These and other aspects of the present disclosure will become apparent from the following description of the preferred embodiment taken in conjunction with the following drawings and their captions, although variations and modifications therein may be affected without departing from the spirit and scope of the novel concepts of the disclosure.
The drawings described below are for illustration purposes only. The drawings are not intended to limit the scope of the present teachings in any way.
FIGS. 4(A)-(B) illustrate configurations of delivery tubes and suction tubes at the probe tip in accordance with certain embodiments of the present disclosure;
FIGS. 5(A)-(B) illustrate a manifold in accordance with certain embodiments of the present disclosure;
FIGS. 6(A)-(D) illustrate a handheld device in accordance with certain embodiments in use for treating a meibomian gland
FIGS. 9(A)-(C) illustrate a head cartridge in accordance with certain embodiments of the present disclosure.
The present disclosure is more particularly described in the following examples that are intended as illustrative only since numerous modifications and variations therein will be apparent to those skilled in the art. Various embodiments of the disclosure are now described in detail. Referring to the drawings,
The terms used in this specification generally have their ordinary meanings in the art, within the context of the disclosure, and in the specific context where each term is used. For convenience, certain terms may be highlighted, for example using italics and/or quotation marks. The use of highlighting has no influence on the scope and meaning of a term; the scope and meaning of a term is the same, in the same context, whether or not it is highlighted. It will be appreciated that same thing can be said in more than one way. Consequently, alternative language and synonyms may be used for any one or more of the terms discussed herein, nor is any special significance to be placed upon whether or not a term is elaborated or discussed herein. Synonyms for certain terms are provided. A recital of one or more synonyms does not exclude the use of other synonyms. The use of examples anywhere in this specification including examples of any terms discussed herein is illustrative only, and in no way limits the scope and meaning of the disclosure or of any exemplified term. Likewise, the disclosure is not limited to various embodiments given in this specification.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure pertains. In the case of conflict, the present document, including definitions will control.
As used herein, “around”, “about” or “approximately” shall generally mean within 20 percent, preferably within 10 percent, and more preferably within 5 percent of a given value or range. Numerical quantities given herein are approximate, meaning that the term “around”, “about” or “approximately” can be inferred if not expressly stated.
As used herein, “nanoscopic-scale,” “nanoscopic,” “nanometer-scale,” “nanoscale,” “nanocomposites,” “nanoparticles,” the “nano-” prefix, and the like generally refers to elements or articles having widths or diameters of less than about 1 μm, preferably less than about 100 nm in some cases. In all embodiments, specified widths can be smallest width (i.e. a width as specified where, at that location, the article can have a larger width in a different dimension), or largest width (i.e. where, at that location, the article's width is no wider than as specified, but can have a length that is greater).
As used herein, “plurality” means two or more.
As used herein, the terms “comprising,” “including,” “carrying,” “having,” “containing,” “involving,” and the like are to be understood to be open-ended, i.e., to mean including but not limited to.
As used herein, terms such as “first”, “second”, “third”, and the like are used for distinguishing various elements, members, regions, layers, and areas from others. Therefore, the terms such as “first”, “second”, “third”, and the like do not limit the number of the elements, members, regions, layers, areas, or the like. Further, for example, the term “first” can be replaced with the term “second”, “third”, or the like.
As used herein, terms for describing spatial arrangement, such as “over”, “above”, “under”, “below”, “laterally”, “right”, “left”, “obliquely”, “behind”, “front”, “inside”, “outside”, and “in” are often used for briefly showing a relationship between an element and another element or between a feature and another feature with reference to a diagram. Note that embodiments of the present disclosure are not limited to this, and such terms for describing spatial arrangement can indicate not only the direction illustrated in a diagram but also another direction. For example, when it is explicitly described that “B is over A”, it does not necessarily mean that B is placed over A, and can include the case where B is placed under A because a device in a diagram can be inverted or rotated by 180°. Accordingly, “over” can refer to the direction described by “under” in addition to the direction described by “over”. Note that embodiments of the present disclosure are not limited to this, and “over” can refer to any of the other directions described by “laterally”, “right”, “left”, “obliquely”, “behind”, “front”, “inside”, “outside”, and “in” in addition to the directions described by “over” and “under” because the device in the diagram can be rotated in a variety of directions. That is, the terms for describing spatial arrangement can be construed adequately depending on the situation.
In certain embodiments, the probe body 116 has a chamber 120 that includes a delivery channel 124 and a suction channel 128. The delivery channel 124 can deliver fluids such as vapor, steam, warm mist humidified air, lipid emulsifier, medicine/drugs, gas, solution, liquid gas, surfactant, chemical/pharmacological agents, medicine/drugs, nanospheres containing medicines, etc. to the target, The suction channel 128 can transfer a suction force to the target, and thus can extract obstructions, cellular tissues, and materials that were supplied by the delivery channel 124 and that now have been used. The delivery channel 124 and the suction channel 128 are exposed at the probe tip 112 and define one or more delivery openings 132 and one or more suction openings 136 of the probe tip 112, respectively. In certain embodiments, the suction channel 128 surrounds the delivery channel 124. The probe tip 112 can have central delivery areas having the delivery openings 132 that supply fluid used to treat the target, as well as suction areas, having the suction openings 136 and around the delivery areas, that extract the obstructions, tissues, and other materials.
An agitator 140, such as a brush or a fluid jet device, is placed at the probe tip 112 and can be used to disrupt the target. The agitator 140 can apply agitating forces, such as vibratory type forces, including those generated mechanically or those using fluid type devices or mechanisms. For example, the agitator 140 can vibrate at a frequency in a predetermined range, for example, from about 1,000 Hz to about 20,000 Hz. The agitator 140 can vibrate at a varied frequency in accordance with a predetermined pattern or routine. For example, the agitator 140 can start at a low frequency and finish at a high frequency. In certain embodiments, the agitator 140, such as a fluid jet, can eject fluids at a pressure in a predetermined range in accordance with a predetermined pulse train.
In certain embodiments, the probe tip 112 can have a heater 144 placed adjacent to the delivery area. The heater 144 provides thermal energy, i.e., heats, to the fluids in the delivery channel 124 and can be used to control the temperature of the fluids exiting the delivery channel 124 at the delivery openings 132. The temperature can be controlled in a predetermined range. The probe tip 112 can also have a temperature sensor 148 adjacent to the delivery area that measures the temperature of the exiting fluids and to provide feedback to the heater 144 or a control module controlling the heater 144. The heater 144 can be turned on or off based on the feedback provided by the temperature sensor 148.
The handle 104 supports the probe 108. The delivery channel 124 and the suction channel 128 are placed through the handle 104. For example, the delivery channel 124 and the suction channel 128 can be implemented by tubes having diameters in a predetermined range. The handle 104 can also include an agitation module 152 that supplies the agitating force mechanically or through fluids to the agitator 140.
In certain embodiments, the delivery channel 124 is further implemented by a delivery tubing 156 connecting the device with a backend apparatus 170; the suction channel 128 is further implements by a suction tubing 160 connecting the device 100 with the backend apparatus 170. The backend apparatus 170 includes a control module 174, a delivery module 178, a fluid module 182, an agent module 186, a suction module 190, and a power module 194. As will be discussed in more detail later, the fluid module 182 can release a fluid into the delivery module 178. The agent module 186 can release agent particles into the delivery module 178. The delivery module 178 can release the fluid, such as a vapor, and agent particles, such as nanospheres containing medications, through the delivery channel 124, 156 to the probe tip 112. The fluid module 182 can have a fluid reservoir having a fluid. The agent module 186 can have an agent reservoir having agent particles. The suction module 190 can have a suction force generator such as a suction pump that generates a vacuum, which through the suction channel 128 cause a suction force at the probe tip 112. The control module 174 allows a practitioner to control the release of the fluid and/or agent particles to exit at the probe tip 112 as well as to control the suction force generated at the probe tip 112. The power module 194 can receive power supply from a power source and energize the other modules in the backend apparatus 170. In certain embodiments, the power module 194 may include a power source which may be direct current (battery powered) or alternating current (wall socket) as desired.
In certain embodiments, the probe tip 112 has a shoe 200 that is to be placed over the target such as an external gland.
In certain embodiments, the standoff pegs 316 can also function as the agitator that provides mechanical forces. For example, the standoff pegs 316 can be vibrated by mechanism as known by one skilled in the art at a frequency in a predetermined range.
In certain embodiments, the delivery tubes 304 and the suction tubes 308, extending from the backside (backend side) of the shoe 200, are coupled with a backend manifold.
Similarly, the suction areas 508 can have one or more front suction openings 520 at the front side 504 of the manifold 500, which are defined by the suction passages crossing through the manifold 500. The suction tubes 308 pass through the front suction openings 520 and enter the suction passages in the manifold 500. The suction passages also define one or more back suction openings 528 at the backside of the manifold. In certain embodiments, the suction passage has multiple branches at the front end of the manifold 500. Each of the suction tubes 308 enters into a respective branch of the suction passage. The multiple branches converge into a single branch at the backend of the manifold. That single branch defines the back suction opening 528.
In certain embodiments, the back delivery opening 524 of a manifold is in fluid communication with the delivery module 178 of the backend apparatus 170 via a delivery tubing 572. In certain embodiments, the back suction opening 528 of a manifold is in fluid communication with the suction module 190 via a suction tubing 574.
Referring back to
In certain embodiments, the backend apparatus 170 can have an agent module 186 that provides agents such as chemical/pharmacological agents and drugs/medicines to the delivery module 178. The agents can be stored in an agent reservoir. In certain embodiments, the agents are in a particle form.
In certain embodiments, the agents are small particles or are encapsulated in small capsules, which can be moved by the momentum of the fluid. For example, nanospheres can be utilized to contain a drug cocktail having at least one of antibiotic, anti-inflammatory, vasodilator or vasoconstrictor, anti-keritin, anti Veg-F, salicylic acid, and other drugs. In certain embodiments, the small capsules such as the nanospheres are configured to time release the medicines after the nanospheres are delivered at the tissue of the target and infiltrate the tissue. In certain embodiments, a first portion of the nanospheres are configured to release the medicines contained after a first period of time from being delivered at the target, and a second portion of the nanospheres are configured to release the medicines contained after a second period of time from being delivered at the target. The nanospheres can include multiple different agents or medicines. For example, a first portion of the nanospheres each include a first medicine, a second portion of the nanospheres each include a second medicine.
The agent and fluid released into the delivery module 178 can be mixed in the delivery module 178. The flow of the fluid can force the agents to flow with the fluid through the delivery tubing/tubes 124, 156 and reach the delivery opening 132 at the probe tip 112. The delivery module 178 can deliver fluids containing at least one of vapor, steam, warm mist humidified air, lipid emulsifier, medicine/drug, gas, solution, liquid gas, etc. into the delivery tubing and tubes 124, 156. The delivery module 178 can employ necessary mechanism as known by one skilled in the art to expel or facilitate the fluid to travel through the delivery tubing and the tubes 124, 156 and exit at delivery opening 132 of the probe tip 112. The delivery module 178 can have a valve that allows the fluid to flow from the delivery module 178 into the delivery tubing 156 and disallow the fluid to flow from the delivery tubing 156 back to the delivery module 178. In certain embodiments, the fluid, and optionally the agent, travel through the delivery tubing/tubes 124, 156 as a result of its own physical characteristics, for example, the increased fluid pressure in the delivery module 178.
The suction module 190 has necessary mechanism including a suction force generator such as a suction pump, as known by one skilled in the art to generate a vacuum in the suction module 190. The vacuum in the suction module 190 generates a suction force, which is transferred through the suction tubing/tubes 128, 160 to the suction opening 136 of the probe tip 112. When the probe tip 112 is placed over the target such as a gland, the suction force can draw the surrounding matters of a predetermined size, such as the obstruction at or within the gland or the agents supplied by the delivery tubes 124, 156 and that are used, into the suction opening 136. The suction force in the suction tubes/tubing 128, 160 will continue to draw the matters into the suction module 190. The suction module 190 can have necessary mechanisms, such as a waste reservoir, that are used to dispose the matters.
The backend apparatus 170 can have a power module 194 that provides power to the delivery, fluid, agent, suction, and control modules.
The control module 174 controls the suction module 190, the delivery module 178, the agent module 186, and the fluid module 182. For example, the control module 174 can instruct the fluid module 182 to release a fluid to the delivery module 178, the agent module 186 to release agents into the delivery module 178, and the delivery module 178 to deliver the mixture of the fluid and agent to delivery opening 132 of the probe tip 112 through the delivery tubing/tubes 124, 156. The control module 174 can also instruct the suction module 190 to operate the vacuum pump and generate a suction force at the suction opening 136 through the suction tubes/tubing 128, 160 of the probe tip 112.
As an example, the above described system can be used to treat belpharitis in the human eye by removing the debris cap and evacuating the meibomian gland. A surfactant along with a warm steam, provided by the handheld device 100, creates substantially high and often about 100% humidity on the surface of the meibomian gland and will dissolve the cap. Additionally, the agitator 140 such as a brush that is incorporated in the device 100 would remove the cap. The slurry can be aspirated using suction.
The above described system can be utilized and applied by an optometrist or ophthalmologist in the office at the slit-lamp (present in all offices). There are around 40,000 optometrists and 8,000 ophthalmologists practicing in the US alone. This can potentially benefit around ⅓ of the human population over 50 years of age.
As briefly mentioned herein above, obstruction composition will vary with the etiology which produced it. However, the obstruction will, in most cases, consist of a combination of, dead cells, keratin, bacteria, desquamated cells, sebaceous ground substance, milky fluid, inspissated or creamy secretions, or any combination of the foregoing in solid, semi-solid and thickened forms. The obstruction may be in the gland channel, at the gland orifice, atop the gland orifice or a combination of the foregoing. As employed herein, obstruction refers to any of the foregoing.
Thus, it is self-evident that any obstruction of the channel will restrict or prevent secretions from exiting the gland and further, that in order to clear such obstructions or “occlusions”, the obstruction may be loosened from the gland wall, and/or broken up, fractured, softened, or liquefied so that it will fit through the gland orifice without causing excessive pain. Lastly, the obstruction remnants must be removed from the gland.
In particular, in
For example, when treating a meibomian gland of a patient, optionally a warmed eye mask is positioned over the patient's eyelids to help liquefy or soften the meibomian gland obstructions. Alternative heating mechanism may include conduction, convection and radiation supplied by one or more of the following: thermal conduction, thermal convection, ultrasonic energy, laser energy, RF energy, direct and/or indirect transfer from heat source ad microwave energy which may be applied for a preselected period of time. By varying the amplitude, intensity and length of application, some of the foregoing mechanism may also be employed to fracture or break up the obstruction. In certain embodiments, a closed loop feedback control module, well known to those skilled in the art may be employed during heating to measure temperature proximate the eyelid to ensure that the obstruction does, in fact, reach a temperature sufficient to turn the obstructive material into a flowable, liquid or semi-liquid state. A plate can be then placed behind the eyelid, and a roller tool is gently rolled over the eyelid and eyelid margin to express and unblock the gland.
Further, as show in
While, or before or after, applying the fluid to the eyelid, the practitioner can use the agitator to apply an external regulated force to the eyelid and/or directly over the obstructed gland to loosen the obstruction within the gland or at the orifice. As discussed above, in certain embodiments, the agitator, such as the standoff pegs, can vibrate at different frequencies. The practitioner can determine the optimum frequency and other parameters such that the agitating force is transmitted through the eyelid tissue to the obstruction. For example, the standoff pegs (or other types of agitators) of the probe tip are in contact with the gland orifice or the tissues surround the orifice. Movement of the standoff pegs can cause the obstruction at or in the gland to be loosened or separated from the gland. The agitation in combination with the application of the fluid, in particular a heated medium, and the surfactant can sufficiently loosen the obstruction in or at the gland as well as dilate the orifice of the gland such that the obstruction can be extracted from the gland without causing much discomfort to the patient.
The control module allows the practitioner to turn on the suction module at any preferred time. The suction module generates a vacuum, which generates a suction force at the suction opening of the probe tip. When the probe tip is placed in close proximity to the gland, the suction force can draw the obstruction at or in the gland into the suction tubes. When the delivery module is operating or has been operated, the suction force can as well evacuate the used fluids, chemical/pharmacological agents, or cellular materials from the gland margin.
In certain embodiments, the agent module can release small agent particles or small capsules containing medication into the delivery module. For example, sticky nanospheres containing a drug cocktail having at least one of antibiotic, anti-inflammatory, vasodilator or vasoconstrictor, anti-keritin, anti Veg-F, salicylic acid or other drugs can be released to the delivery module. The agent module can release a fluid such as warm vapor into the delivery module. In this example, the delivery module delivers the mixture of warm vapor and the drug nanospheres to the probe tip. In certain circumstances, the nanospheres can be considered as being carried by the vapor. The mixture exits the delivery opening of the probe tip and infiltrates the gland. In certain circumstances, the nanospheres can attach to the walls of the gland channel and time release the drug cocktail encapsulated at predetermined time or time intervals. The suction module can be used to aspirate the mixture of the vapor and the drug nanospheres, so that the mixtures does not contact the ocular surface.
In operation, the probe tip will be run along the upper and lower eyelids introducing humidity and other medications such as lipid emulsifiers (Cocamidopropyl Hydroxysultaine, etc), antibiotics (tetracycline, doxycycline, etc), or anything else (anti-inflammatory agents, etc). The suction module will at the same time evacuate the material introduced to the eyelid as well as remove the cap from the meibomian gland and evacuate the contents of the meibomian gland.
The practitioner thus can utilize embodiments of the present disclosure for drug delivery. For example, after cleaning out the meibomian glands, the system can be used to get doxycycline or some other anitibiotic or anti-inflammatory directly into the site.
The foregoing description of the exemplary embodiments of the disclosure has been presented only for the purposes of illustration and description and is not intended to be exhaustive or to limit the disclosure to the precise forms disclosed. Many modifications and variations are possible in light of the above teaching.
The embodiments were chosen and described in order to explain the principles of the disclosure and their practical application so as to enable others skilled in the art to utilize the disclosure and various embodiments and with various modifications as are suited to the particular use contemplated. Alternative embodiments will become apparent to those skilled in the art to which the present disclosure pertains without departing from its spirit and scope.
In certain embodiments, the tip of the handheld device can contain a agitator, such as a brush or scrubber, at, or adjacent to, the contact surface or the cartridge recess. As described above, the agitator can apply an agitating force, such as a vibrating force, to the target or tissues surrounding the target. The agitator force can serve to soften or loosen the target, the surrounding tissues, or the obstruction in a gland.
The head cartridge can be placed in the recess in the removable manner. For example, the head cartridge can be snapped on and off in the recess. Once being properly placed in the recess, the head cartridge is coupled with the delivery tubes and the suction tubes placed in the housing of the handheld device. In certain embodiments, the recess may hold the head cartridge entirely within the recess, such that when the recess is placed over a target region, a space still exist between the target region and the treatment side of the head cartridge.
As will be described in more detail below, the head cartridge can have an encasement that defines delivery, suction, irrigation ports or openings. Those functional ports can vary in size, shape, location and/or configuration. The encasement can be made of soft polymer or other suitable materials as known to one skilled in the art. The encasement can be shaped to match the contour of the eyelid, as well as can apply varying pressure across its width or height.
FIG. 9(A)-(C) illustrates a head cartridge in accordance with certain embodiments of the present disclosure. The head cartridge has a suitable shape such that it can be securely placed in the recess of the handheld device. In this specific example shown in
As a specific example,
The top and bottom layers of the branches of the suction fluid network can be placed in or can be received by the top and bottom rows of openings/ports of the encasement, respectively. The middle layer of the branches of the suction network can be placed in or can be received by the openings/ports at the both ends of the middle row of the openings/ports of the encasement. The layer of the branches of the delivery fluid network can be placed in or can be received by the middle row of openings/ports, other than the end openings/ports, of the encasement.
The head cartridge with the above configuration can be placed in the recess of the handheld device housing. The handheld device alone or in conjunction with the backend apparatus, as described above, can administer liquid medicine through the delivery openings/ports of head cartridge to a target region (such as a gland) of the patient. The suction openings/ports surrounding the delivery openings/ports can remove the administered liquid medicine as it migrates outward from the target region.
In certain embodiments, the functional modules, such as the control, suction, delivery, fluid, agent, and power modules, contained in the backend apparatus shown in
The delivery module, regardless where it is located, can have a flow motivation mechanism derived from a diaphragm pump, peristaltic pump, or other type of pump or mechanical means to expel or move the fluid, such as liquid medicine, received from the fluid module, to exit at the head cartridge through the delivery tubing and the delivery manifold.
In certain embodiments, the suction and delivery motivation may be derived from the same pumps/means. In other words, the same motivation mechanism used in the delivery module can as well be used by the suction module to provide a suction force.
Although FIGS. 9(A)-(C) illustrate fluid networks having separate delivery manifold and suction manifold, in certain embodiments a single manifold can implement both the delivery and the suction functions. For example, such a bifunctional manifold can have a single set of branches at the treatment side as well as a delivery main port and a suction main port at the backend side. In use, the bifunctional manifold can be switched to be in fluid communication with the delivery module or the suction module. For example, initially the bifunctional manifold can be in communication with the delivery module but not with the suction module, and the bifunctional manifold is used to administrate a medicine to the target region of the patient. After, the bifunctional manifold is switched to be in fluid communication with the suction module but not with the delivery module, and the suction module can generate a suction force through the bifunctional module and can remove materials at the target region, e.g., the administered medicine.
Further, the waste reservoir may include a rigid container under suction force generator, e.g., a pump or a vacuum. The drug reservoir can include a rigid or flexible container under pressure. The fluid reservoir can contain a medicine or a agent in fluid form. The fluid reservoir can be pressurized by heat/steam generation. The fluid reservoir can be pressurized by mechanical means. A heater can be used to heat the fluid, such as liquid drugs, contained in the fluid reservoir. Parts or all of the functional modules can be disposable. Further, in certain embodiments, the activation of the handheld device may be achieved by button on the device or by a foot pedal connected with the handheld device or the backend apparatus.
This PCT application claims the benefit of U.S. Provisional Application No. 61/504,092, filed on Jul. 1, 2011 and entitled “Surfactant Ported Device For Treatment of Blepharitis and Applications of Same.” The disclosure of the above application is incorporated herein by reference in its entirety. Some references, which may include patents, patent applications and various publications, are cited in a reference list and discussed in the description of this disclosure. The citation and/or discussion of such references is provided merely to clarify the description of the present disclosure and is not an admission that any such reference is “prior art” to the disclosure described herein. All references listed, cited and/or discussed in this specification are incorporated herein by reference in their entireties and to the same extent as if each reference was individually incorporated by reference. In terms of notation, hereinafter, bracketed “n” represents the nth reference cited in the reference list. For example, [1] represents the 1st reference cited in the reference list, namely, Lemp M A, Nichols K K. Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment. Ocul Surf. 2009 April; 7(2 Suppl):S1-S14.
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/US2012/045298 | 7/2/2012 | WO | 00 | 4/7/2014 |
| Number | Date | Country | |
|---|---|---|---|
| 61504092 | Jul 2011 | US |
