DEVICE TO TREAT VARIOUS FORMS OF ANGLE CLOSURE CROSS-REFERENCE

[0001] This application claims the benefit of U.S. Provisional Patent Application Number 62/550,415 filed August 25, 2017, the content of which is incorporated herein by reference.

BACKGROUND

[0002] Embodiments of the present invention encompass ophthalmic surgical implants for the treatment of a variety of anterior chamber angle closure conditions, including narrow or occluded angles, various forms of primary and secondary angle closure glaucomas, post-anterior segment surgery, congenital abnormalities of the anterior chamber angles, various forms of acquired or congenital peripheral anterior synechia, and post-surgical peripheral angle complications related to glaucoma drainage surgery, glaucoma tube and minimally invasive glaucoma surgery (MIGS) implants, post-corneal transplantation, post-cataract surgery, and the like.

[0003] Closure of the ocular anterior chamber (AC) angles occurs in a wide variety of congenital, acquired, and post-surgical conditions. Ocular morbidity results from physical closure of the AC angles which can cause a rise in intraocular pressure (IOP) and peripheral corneal endothelial cell damage. Various related conditions of Angle Closure Glaucoma (ACG) can involve conditions where anatomical or pathological obviation of the peripheral chamber angles by peripheral anterior synechia (PAS) leads to acute or chronic rises in IOP, leading to glaucomatous optic nerve damage. Other conditions where chamber angle closure is present may involve congenital states such as anterior segment dysgenesis, irido-corneal endothelial (ICE) syndrome, and acquired states such as corneal and anterior segment trauma, post- AC collapse, and surgically-induced or post-surgical angle complications such as PAS related to post-glaucoma filtration and tube surgery, and post-corneal transplantation surgery (post- penetrating keratoplasty (PK) or endothelial keratoplasty (EK). In post-keratoplasty situations, PAS causing adherence of the peripheral iris to the graft-host junction can be a major risk factor for allograft rejection and subsequent graft failure. [0004] Although there are currently available techniques for addressing closure of the anterior chamber angle in a patient, there still remains a need for improved approaches to treat patients presenting with such conditions. Embodiments of the present invention provide solutions to at least some of these outstanding needs. SUMMARY

[0005] As further discussed elsewhere herein, devices and methods according to embodiments of the present invention can be effective in achieving permanent physical separation of iris and peripheral cornea, in preventing or reducing the occurrence of narrowing or re-closure of the peripheral angles, and in preventing or reducing the occurrence of re-accumulation of PAS. [0006] One or more prop devices can be administered to a patient eye to prevent angle closure, or re-closure of anterior chamber angles or peripheral anterior synechia (PAS), and provide a permanent, physical separation of peripheral iris and peripheral cornea, across a range of clock hours of angle involvement, depending on the number of devices which may be inserted. In some cases, a prop device can be inserted into the anterior chamber angle of a patient eye, and can operate to prevent the cornea and the iris of the eye from sticking together.

[0007] Device and method embodiments can be used to treat all forms of angle closure and peripheral anterior synechiae, and in some embodiments, devices can attach to, or be inserted together with glaucoma implants (e.g. tubes, MIGS devices, Ahmed glaucoma valve, and the like). Surgical anterior chamber prop devices can be permanently inserted in the AC angle to provide a strut to physically separate peripheral cornea from peripheral iris, and thus prevent development or recurrence of PAS. Exemplary device configurations can include a base plate which is attached to the peripheral iris and tucked into the angle, by virtue of 1 or more barbed prongs which insert into the peripheral sclera or adjacent structures, and a prop which will strut the base plate against the peripheral cornea, thus maintaining the open angle. In some cases, the prop can be a relatively displaceable prop. For example, the prop can be displaceable relative to the base plate. In some cases, the prop can be an elevatable prop. For example, the prop can be elevated relative to the base plate. In some cases, the prop may not be elevatable. For example, the device may be constructed as a single unit (non-elevatable) or as a base plate with an attached extendable prop (elevatable). In some cases, the prop can be a vertical prop. For example, the prop can be disposed in a vertical orientation relative to a horizontally oriented base plate when the prop is in a displaced, elevated, or deployed configuration. In some cases, the prop can be a maneuverable prop. For example, the prop can be maneuverable relative to the base plate. In some instances, a device can stent approximately 2-3 clock hours of PAS.

Relatedly, in some instance, for a larger area of adhesion, several devices can be implanted along the extent of the PAS.

[0008] Device and method embodiments disclosed herein are well suited for treating patients who present with, or who are at risk of developing, a variety of ocular conditions, such as Primary Angle Closure Glaucoma (PACG) and related narrow and closed angle conditions, all forms of Secondary Angle Closure Glaucoma, post-glaucoma filtration surgery with narrow or closed angles, and for treating patients who undergo various ocular surgical procedures, such as post-glaucoma tube surgery or MIGS surgery with narrow or closed angles. Embodiments can be used in conjunction with post-glaucoma tube surgery to provide a tube guidance device to reduce proximity of the tube to the corneal endothelial surface. Embodiments can also be used during insertion or post-MIGS surgery to prevent angle narrowing, closure, and PAS.

Embodiments can be used post corneal transplant surgery to treat PAS, closed angles, and graft- host synechia. Embodiments can be administered during or post-anterior segment trauma with narrow or closed angles, or PAS. Embodiments can also be used for treating iridodialysis by stapling detached peripheral iris to the angles. Further, embodiments can be used to treat congenital angle closure or PAS conditions, including Iridocorneal Endothelial (ICE) syndrome, and various forms of anterior segment dysgenesis.

[0009] In one aspect, embodiments of the present invention encompass devices and methods for providing physical separation between a cornea and an iris in an eye of a patient. Exemplary methods include positioning a prop device at an anterior chamber angle of the eye of the patient while the prop device is in an undeployed configuration. The prop device can include an anterior engagement portion, a posterior engagement portion, and a peripheral engagement portion.

Methods can further include actuating the prop device from the undeployed configuration to a deployed configuration, and positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. In some cases, the structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye.

[0010] In some cases, the prop device, when positioned within the eye of the patient, maintains a predetermined distance between the posterior portion of the cornea and the anterior portion of the iris. In some cases, during the actuating step, the anterior engagement portion is sequentially and non-reversibly locked at multiple positions relative to the posterior engagement portion. In some cases, the anterior engagement portion moves relative to the posterior engagement portion during the actuating step. In some cases, the anterior engagement portion comprises a strut. According to some embodiments, the posterior engagement portion comprises a base. In some embodiments, the base includes a first portion and a second portion. In some embodiments, the patient presents with an ocular condition. In some embodiments, the ocular condition is peripheral angle closure, narrow or closed glaucoma, acute or chronic angle narrow or closed angle glaucoma, congenital abnormality of the anterior chamber angle, post-trauma peripheral angle complication, or post-surgical peripheral angle complication. According to some embodiments, the patient is at risk of developing an ocular condition. In some cases, the ocular condition is peripheral angle closure, narrow or closed glaucoma, acute or chronic angle narrow or closed angle glaucoma, congenital abnormality of the anterior chamber angle, post-trauma peripheral angle complication, or post-surgical peripheral angle complication. In some instances, methods may include administering a glaucoma implant to the eye of the patient. In some instances, the glaucoma implant is a glaucoma drainage tube implant or a minimally invasive glaucoma surgery (MIGS) device. In these instances, the device will help to orientate and stabilize the glaucoma drainage tube, or the MIGS tube, away from both the corneal surface, and the iris surface.

[0011] In another aspect, embodiments of the present invention encompass devices for administration to an anterior chamber angle of an eye of a patient, and methods for their use and manufacture. Exemplary prop devices can include a posterior engagement portion that engages an anterior portion of the iris, and a peripheral engagement portion that engages a structure of the eye. In some cases, the structure is a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. In some cases, prop devices can further include an anterior engagement portion that engages a posterior portion of a cornea of the eye. In some cases, the anterior engagement portion includes a strut. In some cases, the posterior engagement portion includes a base. In some cases, the base has one or more raised ridges. In some cases, the base includes a first base portion and a second base portion. In some cases, the peripheral engagement portion includes one or more barbs. In some cases, the base has inferior protrusions to attach to the anterior iris surface. In some cases, the prop device is configured for actuation from an undeployed configuration to a deployed configuration.

[0012] In still another aspect, embodiments of the present invention encompass devices and methods for providing physical separation between a first tissue and a second tissue at a treatment site of a patient. Exemplary methods can include administering a prop device to the treatment site while the prop device is in an undeployed configuration. The prop device can include an anterior engagement portion and a posterior engagement portion. Methods may also include actuating the prop device from the undeployed configuration to a deployed

configuration, and positioning the prop device at the treatment site so that anterior engagement portion engages the first tissue and the posterior engagement portion engages the second tissue, thereby providing physical separation between the first tissue and the second tissue.

[0013] In another aspect, embodiments of the present invention encompass devices and methods for providing physical separation between a cornea and an iris in an eye of a patient. Exemplary methods include positioning a prop device at an anterior chamber angle of the eye of the patient while the prop device is in a deployed configuration. The prop device can include an anterior engagement portion, a posterior engagement portion, and a peripheral engagement portion. Methods can also include positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure of the eye can be a trabecular meshwork of the eye, a sclera of the eye, and an adjacent structure of the eye. In some cases, the deployed configuration is a fully deployed rigid configuration. According to some embodiments, when the prop device is positioned within the eye of the patient, it operates to maintain a predetermined distance between the posterior portion of the cornea and the anterior portion of the iris. In some cases, the anterior engagement portion includes a strut. In some cases, the posterior engagement portion includes a base. In some cases, the peripheral engagement portion includes one or more barbed prongs. In some cases, the patient presents with an ocular condition. In some cases, the ocular condition is peripheral angle closure, narrow or closed glaucoma, acute or chronic angle narrow or closed angle glaucoma, a congenital abnormality of the anterior chamber angle, a post- trauma peripheral angle complication, or a post-surgical peripheral angle complication. [0014] In yet another aspect, embodiments of the present invention encompass devices and methods for providing physical separation between a cornea and an iris in an eye of a patient. Exemplary methods include positioning a prop device within an anterior chamber of the eye, where the prop device includes a bendable anterior engagement portion, a posterior engagement portion, and a peripheral engagement portion. Methods can also include bending the bendable anterior engagement portion away from the posterior engagement portion thereby actuating the prop device from an undeployed configuration to a deployed configuration. Methods can further include positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. In some cases, the deployed configuration is a fully deployed rigid configuration. In some cases, when the prop device is positioned within the eye of the patient, it operates to maintain a predetermined distance between the posterior portion of the cornea and the anterior portion of the iris. In some cases, the anterior engagement portion includes a strut. In some cases, the posterior engagement portion includes a base. In some cases, the peripheral engagement portion includes one or more barbed prongs. In some cases, the patient presents with an ocular condition. In some cases, the ocular condition is peripheral angle closure, narrow or closed glaucoma, acute or chronic angle narrow or closed angle glaucoma, a congenital abnormality of the anterior chamber angle, a post-trauma peripheral angle complication, or a post-surgical peripheral angle complication.

[0015] In yet another aspect, embodiments of the present invention encompass devices and methods for treating an eye of a patient presenting with iridodialysis. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes a posterior engagement portion and a peripheral engagement portion. Methods can also include positioning the prop device within the anterior chamber of the eye of the patient so that the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion skewers a detached edge of the iris and secures the detached edge of the iris relative to a scleral tissue of the eye. In some cases, the scleral tissue includes a scleral wall. [0016] In another aspect, embodiments of the present invention encompass devices and methods for securing an artificial iris within an eye of a patient. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes a posterior engagement portion and a peripheral engagement portion. Methods can also include positioning the prop device within the anterior chamber of the eye of the patient so that the posterior engagement portion engages an anterior portion of the artificial iris, and the peripheral engagement portion skewers an edge of the artificial iris and secures the edge of the artificial iris relative to a scleral tissue of the eye. In some cases, the scleral tissue includes a scleral wall.

[0017] In yet another aspect, embodiments of the present invention encompass devices and methods for anchoring an ophthalmic biosensor within an eye of a patient. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes an anterior engagement portion, a posterior engagement portion, a peripheral engagement portion, and the ophthalmic biosensor. Methods can also include positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adj acent structure of the eye. In some cases, the ophthalmic biosensor can be an intraocular pressure sensor, a glucose monitor, or a biomarker sensor. In some cases, the ophthalmic biosensor is attached with the anterior engagement portion. In some cases, the ophthalmic biosensor is attached with the posterior engagement portion. In some cases, the ophthalmic biosensor is attached with the peripheral engagement portion.

[0018] In a further aspect, embodiments of the present invention encompass devices and methods for anchoring an ophthalmic biosensor within an eye of a patient. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes a posterior engagement portion, a peripheral engagement portion, and the ophthalmic biosensor. Methods can also include positioning the prop device within the eye of the patient so that the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. In some cases, the ophthalmic biosensor can be an intraocular pressure sensor, a glucose monitor, or a biomarker sensor. In some cases, the ophthalmic biosensor is attached with the posterior engagement portion. In some cases, the ophthalmic biosensor is attached with the peripheral engagement portion. [0019] In yet another aspect, embodiments of the present invention encompass devices and methods for positioning a glaucoma adjunct device within an eye of a patient. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes an anterior engagement portion, a posterior engagement portion, and a peripheral engagement portion. Methods can also include positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. The glaucoma adjunct device can be engaged with the prop device, thereby positioning the glaucoma adjunct device within the eye of the patient. In some cases, the glaucoma adjunct device can be a glaucoma drainage implant (GDI) device, a glaucoma drainage device (GDD) device, or a minimally invasive glaucoma surgery (MIGS) device. In some cases, the anterior engagement portion includes a strut having an aperture, the glaucoma adjunct device includes a tube, and the tube of the glaucoma adjunct device is engaged with the aperture of the strut. [0020] In still another aspect, embodiments of the present invention encompass devices and methods for positioning a minimally invasive glaucoma surgery (MIGS) device within an eye of a patient presenting with closed angle glaucoma. Exemplary methods include inserting a prop device into an anterior chamber of the eye of the patient, where the prop device includes an anterior engagement portion, a posterior engagement portion, and a peripheral engagement portion. Methods can also include positioning the prop device within the eye of the patient so that anterior engagement portion engages a posterior portion of the cornea, the posterior engagement portion engages an anterior portion of the iris, and the peripheral engagement portion engages a structure of the eye. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. The MIGS device can be engaged with the prop device, thereby positioning the MIGS device within the eye of the patient.

[0021] In another aspect, embodiments of the present invention encompass devices and methods for providing physical separation between a first tissue and a second tissue at a treatment site of a patient. Exemplary methods include administering a prop device to the treatment site while the prop device is in a deployed configuration, where the prop device includes an anterior engagement portion and a posterior engagement portion. Methods can also include positioning the prop device at the treatment site so that anterior engagement portion engages the first tissue and the posterior engagement portion engages the second tissue, thereby providing physical separation between the first tissue and the second tissue.

[0022] In yet another aspect, embodiments of the present invention encompass devices for administration to an anterior chamber angle of an eye of a patient presenting iridodialysis.

Exemplary prop devices include a posterior engagement portion that engages an anterior portion of an iris of the eye, a peripheral engagement portion that skewers a detached edge of the iris and secures the detached edge of the iris relative to a scleral tissue of the eye. In some cases, the peripheral engagement portion comprises a barb. [0023] In another aspect, embodiments of the present invention encompass ophthalmic biosensor devices for implantation within an eye of a patient. Exemplary devices include an anterior engagement portion that engages a posterior portion of a cornea of the eye, a posterior engagement portion that engages an anterior portion of the iris, a peripheral engagement portion that engages a structure of the eye, and an ophthalmic biosensor. The structure can include a trabecular meshwork of the eye, a sclera of the eye, or an adjacent structure of the eye. In some cases, the ophthalmic biosensor can be an intraocular pressure sensor, a glucose monitor, or a biomarker sensor. In some cases, the ophthalmic biosensor is attached with the posterior engagement portion. In some cases, the ophthalmic biosensor is attached with the peripheral engagement portion. In some cases, the ophthalmic biosensor is attached with the anterior engagement portion. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] FIGS. 1A and IB depict aspects of a prop device and method of implantation according to embodiments of the present invention.

[0025] FIGS. 2A to 2 J depict aspects of a prop device and methods of actuation according to embodiments of the present invention.

[0026] FIGS. 3 A to 3H depict aspects of a prop device and methods of actuation according to embodiments of the present invention.

[0027] FIGS. 4A to 4 J depict aspects of a prop device and methods of actuation according to embodiments of the present invention.

[0028] FIGS. 5A, 5B(i), 5B(ii), and 5C depict aspects of a prop device according to embodiments of the present invention.

[0029] FIGS. 6A, 6B(i), 6B(ii), and 6C depict aspects of a prop device according to embodiments of the present invention.

[0030] FIG. 7 depicts aspects of prop devices according to embodiments of the present invention.

[0031] FIGS. 8 to 12 depict aspects of different peripheral engagement portion configurations according to embodiments of the present invention.

[0032] FIG. 13 depicts aspects of an mdodialysis staple device according to embodiments of the present invention.

[0033] FIG. 14 illustrates various shapes for a distal portion of a strut according to

embodiments of the present invention.

[0034] FIGS. 15A and 15B depict aspects of a prop device according to embodiments of the present invention.

[0035] FIG. 16 depicts aspects of a prop device according to embodiments of the present invention.

[0036] FIGS. 17A and 17B depict aspects of a prop device according to embodiments of the present invention. [0037] FIG. 18 depicts aspects of a prop device according to embodiments of the present invention.

[0038] FIGS. 19 and 19A depict aspects of a prop device according to embodiments of the present invention. [0039] FIG. 20 depicts aspects of a prop device according to embodiments of the present invention.

[0040] FIG. 21 depicts aspects of a prop device according to embodiments of the present invention.

[0041] FIG. 22 depicts aspects of a prop device according to embodiments of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

[0042] A healthy and normal eye provides an unobstructed aqueous humor flow pathway. Generally, aqueous humor is produced in the ciliary processes, and flows from the posterior chamber, through the pupil, and into the anterior chamber, and is then drained through the trabecular meshwork. When the anterior chamber angle is narrowed or closed, however, the outflow of aqueous humor from the anterior chamber or anterior chamber angle becomes impaired. This may occur because the peripheral portion of the iris becomes pushed anteriorly against the peripheral portion of the cornea. In this way, the flow pathway to the trabecular meshwork can become blocked, and the aqueous humor cannot drain from the anterior chamber. As the outflow of aqueous humor is impaired, either acutely or chronically, the intraocular pressure within the eye can increase, which in turn can lead to optic nerve damage or other undesirable physiological outcomes.

[0043] As further discussed elsewhere herein, an exemplary prop device can be inserted into the anterior chamber, so as to establish or preserve an open anterior chamber angle. For example, the prop device can operate to provide a permanent, physical separation between the peripheral iris and the peripheral cornea to prevent angle closure. In this way, the prop device can maintain or restore normal aqueous humor flow. In some cases, a base plate of the device can be engaged or coupled with the iris, a strut of the device can be engaged or coupled with the cornea, and an anchor mechanism can be engaged or coupled with, or embedded or inserted into, the trabecular meshwork. In some cases, the strut can be a relatively displaceable strut. For example, the strut can be displaceable relative to the base plate. In some cases, the strut can be an elevatable strut. For example, the strut can be elevated relative to the base plate. In some cases, the strut may not be elevatable. For example, the device may be constructed as a single unit (non-elevatable) or as a base plate with an attached extendable strut (elevatable). In some cases, the strut can be a vertical strut. For example, the strut can be disposed in a vertical orientation relative to a horizontally oriented base plate when the strut is in a displaced, elevated, or deployed configuration. In some cases, the strut can be a maneuverable strut. For example, the strut can be maneuverable relative to the base plate. Hence, an exemplary prop device can be used to prop open the anterior chamber angle (ACA), so that aqueous humor (AH) can flow out of the eye. When the ACA is closed, the AH can accumulate in the eye, causing a pressure build up that can damage eyesight.

[0044] Turning now to the drawings, FIG. 1 A provides a cross-section view of a patient eye 100. The eye 100 includes a cornea 110, an iris 120, and a trabecular meshwork 140. An anterior chamber angle 130 is defined by a space or distance between the cornea 110 and the iris 120. An anatomically narrow chamber angle, such as the angle 130 shown in FIG. 1A, can cause pupillary blockage of aqueous drainage, leading to further bowing forwards of the iris leading to peripheral angle closure, resulting in a sudden or chronic rise in intraocular pressure, which in turn can lead to glaucoma. As shown here, when the angle 130 is narrow or closed, fluid is prevented or inhibited from traveling from the angle 130 into the trabecular meshwork 140.

[0045] As depicted in FIG. IB, a prop device 150 can be inserted into the anterior chamber angle 130, so as to provide a strut that creates or maintains physical separation between the cornea (e.g. peripheral cornea) and the iris (e.g. peripheral iris). A prop device 150 can include an anterior engagement portion 152, a posterior engagement portion 154, and a peripheral engagement portion 156. When placed with the patient eye, the anterior engagement portion 152 can engage a posterior portion 112 of the cornea, the posterior engagement portion 154 can engage an anterior portion 122 of the iris, and the peripheral engagement portion 156 can engage the eye at another location, for example at or near the trabecular meshwork 140. The prop device 150 can operate to establish or maintain a distance D between the anterior portion 122 of the iris and the posterior portion 112 of the cornea. Distance D can be, for example, a predetermined distance. According to some embodiments, prior to, during, or following positioning of the prop device within the patient eye, the anterior engagement portion can be locked at multiple predetermined positions, wherein each predetermined position corresponds to a predetermined distance D (e.g. where the prop device 150 can operate to establish or maintain a distance D between the anterior portion 122 of the iris and the posterior portion 112 of the cornea). In some cases, during the actuating step, the anterior engagement portion is sequentially and non-reversibly locked at multiple positions relative to the posterior engagement portion. Hence, the anterior engagement portion can provide multiple predetermined distances as it is further actuated peripherally to the next locked positions. In some cases, retraction of the anterior engagement portion to the undeployed configuration is restricted.

[0046] In some instances, a prop device 150 can be permanently implanted within the patient eye. Once installed, the prop device 150 can help to prevent the development or recurrence of peripheral anterior synechiae (PAS) and other ophthalmological conditions associated with a narrow or closed anterior chamber angle. Narrow or closed angles can be caused by a variety of physiological conditions. In some cases, narrow or closed angles may be associated with certain ethnic groups, such as Asian populations. In some cases, multiple prop devices can be administered to the patient eye. For example, multiple prop devices can be implanted in a patient eye so as to treat, prevent, or inhibit the development of larger areas of PAS, or of a variety of corneal, glaucoma, or post-traumatic states of the eye. One or more prop devices can also be delivered to a patient eye so as to prevent glaucoma tube corneal touch, to prevent PAS and angle closure in minimally invasive glaucoma surgery (MIGS) procedures, or to treat iridodialysis.

[0047] In some instances, a patient may present with an eye that has been treated with corneal transplant procedures such as Descemet stripping and automated endothelial keratoplasty (DSAEK), Descemet' s membrane endothelial keratoplasty, and penetrating keratoplasty, and a glaucoma drainage device (e.g. Ahmed implant), where the eye has extensive PAS. Such patient eyes can have a high risk of glaucoma, allograft rejection, and endothelial cell loss.

Embodiments of the present invention encompass the delivery of one or more prop devices to the anterior chamber angle of such an eye of a patient. [0048] FIGS. 2A (anterior view) and 2B (posterior view) show aspects of a prop device 200 according to embodiments of the present invention. Prop device 200 includes an anterior engagement portion 202, a posterior engagement portion 204, and a peripheral engagement portion 206. As illustrated here, anterior engagement portion 202 is defined by a strut 220, posterior engagement portion 204 is defined by a base 240, and peripheral engagement portion 206 is defined by an anchor mechanism 260.

[0049] FIGS. 2C (anterior view) and 2D (posterior view) show two separate pieces of prop device 200, namely strut 220 and base 240. As depicted here, base 240 includes an aperture or opening 242 that is configured to slidingly receive strut 220. [0050] FIG. 2E depicts prop device 200 in an undeployed configuration. As shown here, the strut or angle prop 220 is retracted, so that prop device 220 is in a flat or low-profile

configuration suitable for placing or entering through a surgical wound in the patient eye. In some cases, one or more barbs can be implanted in the eye before a strut is advanced. In some cases, one or more barbs can be implanted in the eye after a strut is advanced. In some instances, the corneal wound can be a shelving wound. In some cases, the size of the wound can be on the order of 2 to 3 mm.

[0051] FIG. 2F depicts prop device 200 in a partially deployed configuration. As shown here, strut 220 advances peripherally through the aperture of base 240, in the direction indicated by arrow A. Deployment of strut 220 can either be in a curved motion (depicted by arrow A) or a straight linear motion at an angle from the base 240. FIG. 2G depicts prop device 200 in a further partially deployed configuration, where strut 220 is further advanced peripherally through the aperture of base 240 in the arrow indicated by arrow A. FIG. 2H depicts prop device 200 in a fully deployed configuration. Strut or angle prop 220 has been advanced peripherally, and thrust up to a locked and upright position. In some cases, the prop device 200 can be in a non- retractable configuration, whereby once the strut 220 is locked into position, it cannot later be retracted, such that the prop device is returned to the low profile or undeployed configuration of FIG. 2E. Hence, the strut pose can be clicked into place, in a non-reversible fashion. In some cases, strut 220 can be further advance peripherally to the next locked position, but retraction is restricted. [0052] According to some embodiments, when the strut 220 rotates and swings upward when deployed, it can be held in place, in the configuration depicted in FIG. 2H, by an internal locking mechanism 270 at the contact region (where strut 220 contacts base 240). In some instances, the internal locking mechanism 270 may include a ratchet system, where strut 220 slides along a linear rack in one direction and motion in the reverse is restricted. In some instances, the internal locking mechanism 270 may include a snap-fit mechanism, for example a ball snap-in or an annular snap joint where strut 220 clicks into place and position is retained. In some instances, the prop device 200 may be manufactured as a single immovable unit that includes strut 220, base 240, and anchor mechanism 260. In this embodiment, the prop device is fixed in a fully deployed configuration and requires no moving parts. The fixed prop can be maneuvered through a 2.5mm incision with appropriate angulations of the device as it enters through the wound at different stages. Relatedly, a prop device can be provided as a fixed device with no movable parts, and the device strut can be either locked in place (via a ratchet system or snap joint) or pre-fixed as a single unit with the base. [0053] FIG. 21 illustrates various shapes for a distal portion of a strut. As shown in panel (i), strut 220(i) can have a rounded tip at the distal portion of the strut. As shown in panel (ii), strut 220(ii) can have an enlarged rounded tip at the distal portion of the strut. As shown in panel (iii), strut 220(iii) can have a large contact tip at the distal portion of the strut. Advantageously, such shapes at a distal portion of the strut can operate to reduce or minimize potential damage that may otherwise occur to the cornea if the distal portion were too narrow or sharp.

[0054] As shown in FIG. 2J, in some cases a strut 220 can have an aperture 222 through which a glaucoma tube (not shown) can be inserted. The relative dimensions of strut 220 and 222 can vary.

[0055] FIG. 3A depicts aspects of a prop device 300 in a deployed configuration, according to embodiments of the present invention. Prop device includes a first portion 310, a second portion 320, and a strut 330. First portion 310 includes a base portion 312 and an anchor mechanism 314. Second portion 320 includes a base portion 322 and an anchor mechanism 324.

Collectively, first base portion 312 and second base portion 322 can constitute a base that can engage an anterior surface of an iris. As discussed further below, prop device 300 has a retractable width, and upon deployment, can span a greater width W. Accordingly, prop device 300 provides a small profile for administration to a patient eye through a minimal entry wound, and strut 330 can be erected by opening or separating the base portions 312 and 322 away from each other.

[0056] FIG. 3B provides a view of the anterior surfaces of first base portion 312 and second base portion 322. Base portion 312 includes a slot 314, a tab 316, and a strip 318, and base portion 322 includes a fin 324. As depicted by arrow A, fin 324 is configured to slidingly engage slot 314. Fin 324 includes levered protrusions 325 that engage apertures 315 of the first base portion.

[0057] FIG. 3C depicts another view of base portion 322. As shown here, base portion 322 includes fin 324, a slot 326 and a pin 328. Slot 326 of base portion 322 is configured to receive tab 316 of base portion 312. Tab 316 is not engaged with slot (not shown) of base portion 320. Fin 324 includes levered protrusions 325 that engage apertures of the first base portion 312.

[0058] FIG. 3D depicts partial engagement between first base portion 312 and second base portion 322, where prop device 300 is in an undeployed configuration. As shown here, fin 324 of base portion 322 is partially engaged with slot 314 of base portion 310. Strut 330 is engaged with pin (not shown) of base portion 322. As shown here and in FIG. 3E, strut 330 also includes a base 338 that cooperates with the strip 318 of the first base portion 312, so as to provide a locking mechanism.

[0059] FIG. 3E depicts partial engagement between first base portion 312 and second base portion 322 (and further engagement, when compared with FIG. 3D). As shown here, fin 324 of base portion 322 is partially engaged with slot 314 of base portion 310. Strut 330 has rotated toward a more anterior position, when compared to FIG. 3D, so as to represent a more deployed configuration. Hence, in this diagonal retractable design, the strut is erected by sliding the diagonal plates (first base portion 312 and second base portion 322) together. Sliding base portions 312 and 322 together can enforce a one-way motion, and when strut base 338 contacts strip 318, additional sliding causes the strut to rotate about the pin, until a flat contact surface of strut base 338 is parallel with a corresponding flat contact surface of strip 318. The strut is held firm by support from both the first and second base portions 312, 322 to enforce its structural stability at the area where the tab 316 engages with slot (not shown) of base portion 322. [0060] FIG. 3F depicts complete engagement between first base portion 312 and second base portion 322. As shown here, fin 324 of base portion 322 is fully engaged with slot 314 of base portion 310. Strut 330 has rotated toward an anterior and upright position. Prop device 300 is in a fully deployed configuration. [0061] FIG. 3G depicts a posterior view of prop device 300. In the configuration depicted here, there is complete engagement between first base portion 312 and second base portion 322. As shown here, fin 324 of base portion 322 is fully engaged with slot 314 of base portion 310. Strut 330 has rotated toward an anterior and upright position.

[0062] FIG. 3H provides an illustration of strut 330. As shown here, strut 330 includes an aperture 332 configured to receive the pin of the second base portion (not shown). Strut 330 can have a rounded tip 334 at a distal portion or stem 336 of the strut. Strut 330 also includes a base 338 that cooperates with the strip of the first base portion (not shown).

[0063] FIG. 4A depicts aspects of a prop device 400 according to embodiments of the present invention. Prop device includes a first portion 410, a second portion 420, and a strut 430. First portion 410 includes a base portion 412 and an anchor mechanism 414. Second portion 420 includes a base portion 422 and an anchor mechanism 424. Collectively, first base portion 412 and second base portion 422 can constitute a base that can engage an anterior surface of an iris. As discussed further below, prop device 400 has a retractable width, and upon deployment, can span a greater width W. Accordingly, prop device 400 provides a small profile for

administration to a patient eye through a minimal entry wound, and strut 430 can be erected by opening or separating the base portions 412 and 422 away from each other.

[0064] FIG. 4B provides a view of first base portion 412. As shown here, base portion 412 includes an interior arm 412a, a central arm 412b, a peripheral arm 412c, a first lateral arm 412d, and a second lateral arm 412e. Central arm 412b includes a platform 413b. [0065] FIG. 4C provides a view of second base portion 422. As shown here, base portion 422 includes an interior arm 422a having a pin 422b, a peripheral arm 422c, a first lateral arm 422d, and a second lateral arm 422e.

[0066] FIG. 4D depicts prop device 400 in an engaged and undeployed configuration. Strut 430 lies generally within a plane defined by first base portion 412 and second base portion 422. As discussed elsewhere herein, prop device 400 has a retractable width, and upon deployment, can span a greater width W. Accordingly, prop device 400 provides a small profile for administration to a patient eye through a minimal entry wound, and strut 430 is erected by opening or separating the base portions 412 and 422 away from each other. [0067] FIG. 4E depicts prop device 400 in an engaged and slightly further deployed configuration (as compared with FIG. 4D). And compared with FIG. 4C, first base portion 412 is moved further away from second base portion 422 as indicated by arrow A, and second base portion is moved further away from first base portion 412 as indicated by arrow B. Strut 430 lies generally within a plane defined by first base portion 412 and second base portion 422. [0068] FIG. 4F depicts prop device 400 in an engaged and still slightly further deployed configuration (as compared with FIG. 4E). And compared with FIG. 4E, first base portion 412 is moved further away from second base portion 422 as indicated by arrow A, and second base portion is moved further away from first base portion 412 as indicated by arrow B. Strut 430 is pivoted slightly further about pin (not shown) of second base portion 422. Rotational movement of the strut 430 is caused by engagement between strut base guide 439 and platform 413b. As discussed elsewhere herein, continued sliding or separation of first base portion 412 and second base portion 422 will further rotate the strut 430 toward the upright position, due to the interaction between strut base guide 439 and platform 413b, until the prop base 438 and the first base portion 412 engage one another at respective contact surfaces that fit flush, which provides structural stability to the prop device 400 in its deployed configuration.

[0069] FIG. 4G depicts prop device 400 in an engaged and still slightly further deployed configuration (as compared with FIG. 4F). And compared with FIG. 4F, first base portion 412 is moved further away from second base portion 422 as indicated by arrow A, and second base portion is moved further away from first base portion 412 as indicated by arrow B. Strut 430 is pivoted slightly further about pin (not shown) of second base portion 422.

[0070] FIG. 4H depicts prop device 400 in an engaged and fully deployed configuration. First base portion 412 and second base portion 422 are separated by their maximum distance. Strut 430 is now pivoted into a fully upright position. Prop device 400 also includes a peripheral locking mechanism 490 whereby first and second base portions 412, 422 are secured relative to one another when the prop device 400 is placed in the deployed configuration. [0071] FIG. 41 depicts aspects of strut 430 according to embodiments of the present invention. As shown here, strut 430 includes a rounded tip 434 at a distal portion or stem 436 of the strut. Strut 330 also includes a base 438 having an aperture 432 configured to receive the pin of the second base portion. Strut base 438 also includes a guide 439 that is configured to engage platform 413b of first base portion 412 as depicted in FIG. 4J.

[0072] As discussed elsewhere herein, occlusion, closure, or zipping of the anterior chamber angle can lead to impaired aqueous humor outflow, resulting in vision conditions such as angle closure glaucoma.

[0073] Device and method embodiments of the present invention can be used to treat, reduce, or prevent occlusion of the anterior chamber angle, thus providing improved aqueous humor outflow. Embodiments can also be used to prevent the complication of angle narrowing and inflammatory synechial closure of the angles after glaucoma surgery. Device and method embodiments of the present invention can be used to treat patients who present with, or who are at risk of developing, any of the vision conditions discussed herein. For example, angle closure glaucoma (ACG) and all its related narrow angle entities may result in appositional and inflammatory closure of the peripheral chamber angles, the primary anatomical/pathological stage in ACG. Patients presenting with such conditions can be treated with the devices and methods disclosed herein. Relatedly, Peripheral Anterior Synechia (PAS) formation can occur in various clinical scenarios, including corneal transplants (PK, EK), which have the attendant risk of PAS formation in the perioperative and/or postoperative periods, especially in glaucoma cases and post-glaucoma surgery, which can lead to higher graft rejection risks and IOP rise. PAS can also occur with post-surgical or post-traumatic PAS formation, especially after glaucoma surgery and in particular, with glaucoma drainage implants, and also in MIGS. Still further, PAS can occur in congenital forms of PAS, for example Irido-Corneal Endothelial syndrome (ICE) and mesodermal dysgenesis. Device and method embodiments disclosed herein are also suitable for treating patients who present with or are at risk of developing post-traumatic/post-surgical iridodialysis.

[0074] Device and method embodiments disclosed herein are particularly well suited for treating patients who present with, or who are at risk of developing, synechial closure of the peripheral chamber angles. In exemplary embodiments, administration of treatment devices or methods do not require bypassing the peripheral angle closure, making an opening in the peripheral iris, opening the trabecular meshwork, surgical separation of the PAS, individual suturing of dialysed iris tissue to the sclera.

[0075] In preventing or reducing the risk of formation or reformation of PAS or closed angles, embodiments of the present invention can reduce the risk of raised IOP and glaucoma, progressive inflammatory scarring and constriction of the chamber angles, progressive iris distortion, peripheral corneal endothelial damage and endothelial decompensation, and reduce of the risk of post-keratoplasty allograft rejection.

[0076] Embodiments of the present invention are particularly useful for reducing adjacent tissue damage. Exemplary embodiments confer the benefit of ease of insertion, for example by providing a small profile device to be inserted through a small (e.g. 2.5mm) corneal wound. In some cases, embodiments can provide ease of attachment, for example by employing two barbed prongs that are inserted into the peripheral cornea/sclera angle or trabecular meshwork for permanent positioning. In some cases, embodiments can provide ease of removal, by conferring the ability to pull out pronged attachments with minimal tissue damage. In some cases, embodiments confer the benefit of an adjustable vertical prong to strut the base plate away from the peripheral cornea, with minimal corneal touch. Exemplary device embodiments can be constructed from medically approved plastic material which is inert, and which is fully biocompatible, and can provide minimal inflammation or encapsulation. In some cases, a device can be constructed of titanium. In some cases, a device can include a material such as stainless steel, nylon, silicon, nitinol, polyether ether ketone (PEEK), polymethylmethacrylate (PMMA), hydrophobic/hydrophilic acrylate, or any combination of two or more of such materials. In some embodiments, by using a small profile device, it is possible to implant multiple devices to treat large clock hours of peripheral iris adhesion. In some cases, the size of a prop device may be on the order of 1 to 3 millimeters.

[0077] In some embodiments, a surgical anterior chamber prop device can be permanently inserted in the AC angle to provide a strut to physically separate peripheral cornea from peripheral iris, and thus prevent development or recurrence of PAS, in a wide variety of corneal, glaucoma and post-traumatic states, to prevent or reduce adhesion or apposition of the peripheral iris to structures in the angle of the anterior chamber, and also to prevent glaucoma tube corneal touch, to prevent angle closure in MIGS surgery, and to treat iridodialysis with related device variations.

[0078] As disclosed herein, a strut can have an aperture or circular opening, for example as depicted in FIG. 2J. In some cases, a strut device can provide an aperture or opening, for example as depicted in FIG. 6A(ii). Such configurations can be used in conjunction with a

Glaucoma Drainage Implant (GDI) or a MIGS device in which the internal tube of these devices can be threaded or inserted through the aperture or opening. In this way, the strut (e.g. when in the deployed configuration) can operate as a tube positioning guide, to ensure that the tube will also be placed parallel to the iris plane and held away from the peripheral cornea, thus reducing the likelihood of adjacent corneal endothelial damage due to intermittent tube corneal touch, or tube opening blockage with iris tissue if the tube is too close or adjacent to the iris. In some cases, the tube may not necessarily be parallel to the iris plane, and the strut will operate to hold or guide the tube away from the cornea.

[0079] According to some embodiments, devices as disclosed herein can be configured for attachment with a MIGS device, so as to provide a combined system to treat both open angle glaucoma, as well as closed or narrow angle glaucoma. These systems can also reduce the risk of PAS formation after MIGS surgery in the unlikely event of shallow ACs in the early postoperative period.

[0080] In some embodiments, devices and methods can be employed to reposition dialysed segments of iris which may be related to trauma or surgical complications. Exemplary iridodialysis devices can have prong or anchor structures as disclosed herein, but these prongs or anchors will not only be used to secure the device, but also to physically skewer the detached iris edge, and reattach it to the scleral wall. In some cases, a two prong or anchor device can operate like a staple. In some cases, a single prong or anchor device can operate as a rivet. Several such devices or rivets of staples may be inserted to treat differing widths of iridodialysis.

[0081] Although many of the embodiments disclosed herein pertain to devices and methods for establishing, maintaining, or increasing physical separation between the cornea and the iris, it is understood that in some cases, devices and methods can be used for establishing, maintaining, or increasing physical separation between tissues other than the cornea and iris. For example, prop devices as disclosed herein can be used for establishing, maintaining, or increasing physical separation between non-ocular tissues.

[0082] FIG. 5A depicts aspects of a prop device 500 according to embodiments of the present invention. This embodiment can provide a manual locking arrangement. As shown here, prop device 500 includes an anterior engagement portion 502, a posterior engagement portion 504, and a peripheral engagement portion 506. As illustrated here, anterior engagement portion 502 is defined by a strut 520, posterior engagement portion 504 is defined by a base 540, and peripheral engagement portion 506 is defined by an anchor mechanism 560. The left panel of FIG. 5A depicts the device in an assembled configuration., and the right panel provides a cross-section view. FIGS. 5B(i) and 5B(ii) (bottom view) depict aspects of a normal variant with inferior surface bristles. As shown here, prop device 500(i) includes an anterior engagement portion 502(i), a posterior engagement portion 504(i), and a peripheral engagement portion 506(i). As illustrated here, anterior engagement portion 502(i) is defined by a strut 520(i), posterior engagement portion 504(i) is defined by a base 540(i) with interior surface bristles 505(i) extending therefrom, and peripheral engagement portion 506(i) is defined by an anchor mechanism 560(i). The multiple inferior prongs or brushes 505(i) can operate to directly attach to the anterior iris surface. These multiple prongs, which may or may not be barbed, and can be used to firmly attach the base plate or posterior engagement portion 504(i) to the anterior iris surface by intermeshing with the anterior stromal fibres in an atraumatic manner when the plate or portion 504(i) is firmly pressed onto the iris surface. According to some embodiments, FIGS. 5B(i) and 5B(ii) depicts aspects of the base plate with inferior prongs or bristles 505(i) that, when embedded into the fibres and crypts of the anterior iris surface, can provide strong support and immobility of the device base 540(i). FIG. 5C depicts aspects of the connection between strut 520 and base 540. As shown in the left panel, the strut can be pushed up into the base, to lock in position. As shown in the right panel, the strut can be locked in two directions relative to the base (e.g. cannot be advanced further through the base, nor retracted from the base).

[0083] FIGS. 6A(i) and 6A(ii) depict aspects of a prop device 600 according to embodiments of the present invention. This embodiment can provide a manual locking arrangement. In some instances, an additional variant can be used in conjunction with any Glaucoma Drainage Implant (GDI) or MIGS device 601, with a silicon tube protruding into the AC. As shown here, prop device 600 includes an anterior engagement portion 602, a posterior engagement portion 604, and a peripheral engagement portion 606. As illustrated here, anterior engagement portion 602 is defined by a strut 620, posterior engagement portion 604 is defined by a base 640, and peripheral engagement portion 606 is defined by an anchor mechanism 660. As shown in FIG. 6A(ii), device 600 can include a tube 601 inserted through an opening of strut 620. Hence, this variant is well suited for use in conjunction with any Glaucoma Drainage Implant (GDI) or MIGS device 601, with a silicon tube protruding into the AC. As shown here, the strut can operate to hold in place the silicon tube of a GDI or MIGS device 601. According to some embodiments, the prop device 600 depicted in FIGS. 6A(i) and 6A(ii) can be referred to as a Glaucoma Variant. According to some embodiments, the prop device 600 depicted in FIGS. 6A(i) and 6A(ii) can be referred to as a Glaucoma Device Variant, as the entire device in all its main configurations can be used to treat glaucoma. FIGS. 6B(i) and 6B(ii) (bottom view) depict aspects of a glaucoma variant with inferior surface bristles. As shown here, prop device 600(i) includes an anterior engagement portion 602(i), a posterior engagement portion 604(i), and a peripheral engagement portion 606(i). As illustrated here, anterior engagement portion 602(i) is defined by a strut 620(i), posterior engagement portion 604(i) is defined by a base 640(i) with interior surface bristles 505(i) extending therefrom, and peripheral engagement portion 606(i) is defined by an anchor mechanism 660(i). The multiple inferior prongs or brushes 605(i) can operate to directly attach to the anterior iris surface. These multiple prongs, which may or may not be barbed, and can be used to firmly attach the base plate or posterior engagement portion 604(i) to the anterior iris surface by intermeshing with the anterior stromal fibres in an atraumatic manner when the plate or portion 604(i) is firmly pressed onto the iris surface. According to some embodiments, FIGS. 6B(i) and 6B(ii) depicts aspects of the base plate with inferior prongs or bristles 605(i) that, when embedded into the fibres and crypts of the anterior iris surface, can provide strong support and immobility of the device base 640(i). FIG. 6C depicts aspects of the connection between strut 620 and base 640. The strut 620 can include a base having an arched configuration which allows for the GDI or MIGS tube to be threaded through and guided within the semicircular opening of the arch, thus fixating the tube in the correct horizontal configuration with respect to the horizontal iris surface, so as to prevent inadvertent upwards pointing of the tube opening towards the cornea, and to also prevent downwards pointing of the tube onto the iris surface. As shown in the left panel of FIG. 6C, the strut can be engaged with the base by sliding the strut into the base. Thereafter, as shown in the right panel of FIG. 6C, the strut and the base can be locked together.

[0084] FIG. 7 depicts aspects of all-in-one prop devices 700 (e.g. normal variant) and 710 (e.g. glaucoma variant). In some embodiments, an injector can be used to lock the prop devices. In some cases, FIG. 7 can be interpreted as depicting aspects of a snap fit mechanism for prop devices 700 and 710, in which the device strut and base plate can be attached and secured (e.g. as compared with a linear ratchet system, such as that depicted in FIG. 5C). As depicted in the lower left panel, a locking mechanism can be used to couple a strut portion with a base portion. As shown in the cross-section view depicted in the lower right panel, where the strut portion (left) and the base portion (right) are locked, the locking mechanism can involve a snap fitting technique. The design for the snap fitting can be varied. For example, instead of a triangle configuration as depicted here, the snap fitting can involve a trapezium configuration, a square configuration, a rectangle configuration, or the like.

[0085] FIG. 8 depicts aspects of a simple pyramidal barb design 800 (for an anchor mechanism or peripheral engagement portion) according to embodiments of the present invention. FIG. 9 depicts aspects of an arrow tip (3 blades) barb design 900 (for an anchor mechanism or peripheral engagement portion) according to embodiments of the present invention. FIG. 10 depicts aspects of an arrow tip (3 blades) barb design 1000 (for an anchor mechanism or peripheral engagement portion) according to embodiments of the present invention. FIG. 11 depicts aspects of an arrow tip (4 blades) barb design 1100 (for an anchor mechanism or peripheral engagement portion) according to embodiments of the present invention. FIG. 12 depicts aspects of an arrow tip (4 blades) barb design 1200 (for an anchor mechanism or peripheral engagement portion) according to embodiments of the present invention.

[0086] FIG. 13 depicts aspects of an mdodialysis staple variant design for a prop device 1300 according to embodiments of the present invention. One or more prop devices 1300 can be employed to reposition dialysed segments of iris which may be related to trauma or surgical complications. Exemplary mdodialysis devices can have prong or anchor structures as disclosed herein, but these prongs or anchors will not only be used to secure the device, but also to physically skewer the detached iris edge, and reattach it to the scleral wall. In some cases, a two prong or anchor device can operate like a staple. In some cases, a single prong or anchor device can operate as a rivet. Several such devices or rivets of staples may be inserted to treat differing widths of iridodialysis.

[0087] FIG. 14 illustrates various shapes for a distal portion of a strut. As shown in panel (i), strut 1420(i) can have a rounded tip at the distal portion of the strut. As shown in panel (ii), strut 1420(ii) can have an enlarged rounded tip at the distal portion of the strut. As shown in panel (iii), strut 1420(iii) can have a large contact tip at the distal portion of the strut. Advantageously, such shapes at a distal portion of the strut can operate to reduce or minimize potential damage that may otherwise occur to the cornea if the distal portion were too narrow or sharp.

Advantageously, such designs can achieve a suitable balance between minimal contact with the cornea and minimal tissue damage.

[0088] As disclosed elsewhere herein, a prop device can be constructed as a single unit. For example, a prop device can be manufactured as a single immovable unit that includes a strut, a base, and an anchor mechanism. Relatedly, a prop device can be provided as a fixed device with no movable parts, and the device strut can be either locked in place (e.g. via a ratchet system or snap joint) or pre-fixed as a single unit, with the strut, base, and anchor mechanism in fixed relationship with one another. Alternatively, prop devices can include a combination of actuated moving pieces. Prop device embodiments as disclosed herein are well suited for use as an adjunct to a variety of glaucoma treatments, including Glaucoma Drainage Implant (GDI) treatments, Glaucoma Drainage Device (GDD) treatments, Minimally Invasive Glaucoma Surgery (MIGS) treatments, and the like.

[0089] FIGS. 15A and 15B depict aspects of a prop device 1500 according to embodiments of the present invention. Prop device 1500 includes an anterior engagement portion 1502, a posterior engagement portion 1504, and a peripheral engagement portion 1506. As illustrated here, anterior engagement portion 1502 is defined by or includes a strut 1520, posterior engagement portion 1504 is defined by or includes a base 1540, and peripheral engagement portion 1506 is defined by or includes an anchor mechanism 1560. As shown here, anchor mechanism 1560 includes a first barbed prong 1562 and a second barbed prong 1564. According to some embodiments, harpoon barbs such as these can provide enhanced stability. In some cases, base 1540 can define an aperture 1542 therethrough. Prop device 1500 can be provided as a fixed rigid single piece device. [0090] In some cases, strut 1520 can include a bendable or malleable material, such as stainless steel, nylon, silicon, or nitinol. In some cases, strut 1520 can include a rigid material, such as polyether ether ketone (PEEK), polymethylmethacrylate (PMMA),

hydrophobic/hydrophilic acrylate, or stainless steel. In some cases, strut 1520 can include a shape memory material, such as Nitinol. When strut 1520 includes a shape memory material, the strut can be pushed or forced toward the base 1540, and in this compressed or pinched configuration the device 1500 can be inserted through a corneal incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position.

Similarly, strut 1520 may include a flexible material, such as stainless steel, nylon, silicon, or nitinol, whereby the strut can be pushed or forced toward the base 1540, and in this compressed or pinched configuration, or flattened profile, the device 1500 can be inserted through a corneal wound or incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position.

[0091] In some cases, elements of the anchor mechanism 1560, such as the first and second barbed prongs, can include a rigid material, such as steel, whereby the anchor mechanism retains its rigidity and does not collapse or bend when it is inserted into the trabecular meshwork or into other tissue of the eye. Rigidity in the barbed prongs 1562, 1564 can confer enhanced implantability and/or stability for the device 1500.

[0092] FIG. 16 depicts aspects of a prop device 1600 according to embodiments of the present invention. Prop device 1600 includes an anterior engagement portion 1602, a posterior engagement portion 1604, and a peripheral engagement portion 1606. As illustrated here, anterior engagement portion 1602 is defined by or includes a strut 1620, posterior engagement portion 1604 is defined by or includes a base 1640, and peripheral engagement portion 1606 is defined by or includes an anchor mechanism 1660. As shown here, anchor mechanism 1660 includes a first barbed prong 1662 and a second barbed prong 1664. According to some embodiments, harpoon barbs such as these can provide enhanced stability. In some cases, base 1640 can define an aperture 1642 therethrough. As shown here, base 1640 can include one or more inferior surface bristles 1645 (which may also be referred to as interior bristles, or prongs or brushes as described elsewhere herein). According to some embodiments, any of the prop devices disclosed herein can include one or more of such bristles. Inferior surface bristles, when embedded into the fibres and crypts of the anterior iris surface, can provide strong support and immobility of the device base 1640. Prop device 1600 can be provided as a fixed rigid single piece device. In some cases, strut 1620 can include a bendable or malleable material, such as stainless steel, nylon, silicon, or nitinol. In some cases, strut 1620 can include a rigid material, such as polyether ether ketone (PEEK), polymethylmethacrylate (PMMA),

hydrophobic/hydrophilic acrylate, or stainless steel. In some cases, strut 1620 can include a shape memory material, such as nitinol. When strut 1620 includes a shape memory material, the strut can be pushed or forced toward the base 1640, and in this compressed or pinched configuration the device 1600 can be inserted through a corneal incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position.

Similarly, strut 1620 may include a flexible material, such as stainless steel, nylon, silicon, or nitinol, whereby the strut can be pushed or forced toward the base 1640, and in this compressed or pinched configuration, or flattened profile, the device 1600 can be inserted through a corneal wound or incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. As shown here, the prop device base 1640 includes curved edges along a central (or anterior engagement) portion 1648 (e.g. disposed more toward the pupil when the prop device is implanted in the eye of a patient) of the base 1640. According to some embodiments, such curved edges can help facilitate smooth insertion of the device 1600 through a corneal wound of the patient and into the anterior chamber. In some cases, a corneal would can be a small incision, such as a 1.8 mm or a 2.0 mm incision.

[0093] FIGS. 17A and 17B depict aspects of a prop device 1700 according to embodiments of the present invention. Prop device 1700 includes an anterior engagement portion 1702, a posterior engagement portion 1704, and a peripheral engagement portion 1706. As illustrated here, anterior engagement portion 1702 is defined by or includes a strut 1720, posterior engagement portion 1704 is defined by or includes a base 1740, and peripheral engagement portion 1706 is defined by or includes an anchor mechanism 1760. As shown here, anchor mechanism 1760 includes a first barbed prong 1762 and a second barbed prong 1764. In some cases, base 1740 can define a first or peripheral aperture 1742 therethrough and a second or central aperture 1744 therethrough. Prop device 1700 can be provided as a fixed rigid single piece device. In some cases, strut 1720 can include a bendable or malleable material, such as stainless steel, nylon, silicon, or nitinol. In some cases, strut 1720 can include a rigid material, such as polyether ether ketone (PEEK), polymethylmethacrylate (PMMA),

hydrophobic/hydrophilic acrylate, or stainless steel. In some cases, strut 1720 can include a shape memory material, such as nitinol. When strut 1720 includes a shape memory material, the strut can be pushed or forced toward the base 1740, and in this compressed or pinched configuration the device 1700 can be inserted through a corneal incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position.

Similarly, strut 1720 may include a flexible material, such as stainless steel, nylon, silicon, or nitinol, whereby the strut can be pushed or forced toward the base 1740, and in this compressed or pinched configuration, or flattened profile, the device 1700 can be inserted through a corneal wound or incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. As shown here, the prop device base 1740 includes curved edges along a central (or anterior engagement) portion 1748 (e.g. disposed more toward the pupil when the prop device is implanted in the eye of a patient) of the base 1740. According to some embodiments, such curved edges can help facilitate smooth insertion of the device 1700 through a corneal wound of the patient and into the anterior chamber. In some cases, the "D" shaped portion of the central (or anterior engagement) portion of the base 1740 can facilitate gripping of the device 1700 by a pair of forceps or another type of grasping mechanism. As shown here, a plane defined the base 1740 and a plane defined by prongs of the anchor mechanism 1760 can provide a barb angle A. In some cases, the device is configured so that the angle facilitates ease of insertion of the anchor mechanism 1760 between the cornea and the iris of the patient. For example, barb angle A can have a value that is about 130 degrees. In some cases, barb angle A can have a value that is within a range from about 120 degrees to about 140 degrees.

[0094] FIG. 18 depicts aspects of a prop device 1800 according to embodiments of the present invention. Prop device 1800 includes an anterior engagement portion 1802, a posterior engagement portion 1804, and a peripheral engagement portion 1806. As illustrated here, anterior engagement portion 1802 is defined by or includes a strut 1820, posterior engagement portion 1804 is defined by or includes a base 1840, and peripheral engagement portion 1806 is defined by or includes an anchor mechanism 1860. As shown here, anchor mechanism 1860 includes a first barbed prong 1862 and a second barbed prong 1864. In some cases, base 1840 can define a first or peripheral aperture 1842 therethrough and a second or central aperture 1844 therethrough. Prop device 1800 can be provided as a fixed rigid single piece device. In some cases, strut 1820 can include a bendable or malleable material, such as stainless steel, nylon, silicon, or nitinol. In some cases, strut 1820 can include a rigid material, such as polyether ether ketone (PEEK), polymethylmethacrylate (PMMA), hydrophobic/hydrophilic acrylate, or stainless steel. In some cases, strut 1820 can include a shape memory material, such as nitinol. When strut 1820 includes a shape memory material, the strut can be pushed or forced toward the base 1840, and in this compressed or pinched configuration the device 1800 can be inserted through a corneal incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. Similarly, strut 1820 may include a flexible material, such as stainless steel, nylon, silicon, or nitinol, whereby the strut can be pushed or forced toward the base 1840, and in this compressed or pinched configuration, or flattened profile, the device 1800 can be inserted through a corneal wound or incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. As shown here, the prop device base 1840 includes curved edges 1848 along a central (or anterior engagement) portion 1846 (e.g. disposed more toward the pupil when the prop device is implanted in the eye of a patient) of the base 1840. In this way, the curved edges contribute to a curved "D" shaped profile for the central (or anterior engagement) portion 1846. According to some embodiments, such curved edges can help facilitate smooth insertion of the device 1800 through a corneal wound of the patient and into the anterior chamber.

[0095] In some cases, a central (or anterior engagement) portion 1846 of the base 1840 can include one or more raised ridges 1845, which can facilitate stable gripping and/or manipulation of the device 1800 by a pair of forceps or another type of grasping mechanism. As shown here, ridges 1845 can be disposed on a superior side or surface 1847 of the base 1840. In some cases, an inferior (opposing) side of the base may include ridges. In some cases, ridges may be present on both a superior side and an inferior side of the base. In the embodiment depicted here, base 1840 defines multiple apertures 1842. The apertures can operate to allow ingrowth of iris tissue therein or therethrough when the device is implanted in the eye of a patient. Such ingrowth can inhibit or prevent iris creep of the device when implanted. In some cases, the base 1840 may have no apertures. It has been observed that following implantation into a living eye, the iris can grow into and/or through such apertures 1842. Such ingrowth can help to secure the device in place relative to the eye. However, if there are too many apertures or if the apertures are too large, excessive ingrowth of the iris into and through the device may lead to synechia, where the iris adheres to other tissue in the eye, such as the cornea or the trabecular meshwork.

[0096] FIG. 19 depicts aspects of a prop device 1900 (e.g. a glaucoma tube variant) according to embodiments of the present invention. Prop device 1900 includes an anterior engagement portion 1902, a posterior engagement portion 1904, and a peripheral engagement portion 1906. As illustrated here, anterior engagement portion 1902 is defined by or includes a strut 1920, posterior engagement portion 1904 is defined by or includes a base 1940, and peripheral engagement portion 1906 is defined by or includes an anchor mechanism 1960. As shown here, anchor mechanism 1960 includes a first barbed prong 1962 and a second barbed prong 1964. Prop device 1900 can be provided as a fixed rigid single piece device. In some cases, strut 1920 can include a bendable or malleable material, such as stainless steel, nylon, silicon, or nitinol. In some cases, strut 1920 can include a rigid material, such as polyether ether ketone (PEEK), polymethylmethacrylate (PMMA), hydrophobic/hydrophilic acrylate, or stainless steel. In some cases, strut 1920 can include a shape memory material, such as nitinol. When strut 1920 includes a shape memory material, the strut can be pushed or forced toward the base 1940, and in this compressed or pinched configuration the device 1900 can be inserted through a corneal incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. Similarly, strut 1920 may include a flexible material, such as stainless steel, nylon, silicon, or nitinol, whereby the strut can be pushed or forced toward the base 1940, and in this compressed or pinched configuration, or flattened profile, the device 1900 can be inserted through a corneal wound or incision. Once the device is disposed within the anterior chamber, the strut can resume its original deployed position. As shown here, the prop device base 1940 includes curved edges along a central (or anterior engagement) portion 1948 (e.g. disposed more toward the pupil when the prop device is implanted in the eye of a patient) of the base 1940. According to some embodiments, such curved edges can help facilitate smooth insertion of the device 1900 through a corneal wound of the patient and into the anterior chamber. In some cases, a central (or anterior engagement) portion 1946 of the base 1940 can include one or more raised ridges 1945, which can facilitate gripping and/or manipulation of the device 1900 by a pair of forceps or another type of grasping mechanism. As shown here, ridges 1945 can be disposed on a superior side 1947 of the base 1940. In some cases, an inferior

(opposing) side 1949 of the base may include ridges 1945. In some cases, ridges 1945 may be present on both a superior side 1947 and an inferior side (not shown) of the base 1940. In some instances, prop device 1900 can be used in conjunction with any Glaucoma Drainage Implant (GDI), Glaucoma Drainage Device (GDD), or MIGS device (not shown), an example of which is depicted in FIG. 6A(ii). For example, strut 1920 can define an opening 1922 into which a tube, a shunt, a valve, or another GDI, GDD, or MIGS device can be placed. In this way, the strut 1920 resembles a hoop shape. The size of the opening 1922 can vary, for example depending on the size of the adjunct device with which the prop is being used. Exemplary GDI, GDD, or MIGS devices that can be used on conjunction with prop device 1900 include the iStent device

(Glaukos, Laguna Hills, CA), the Cypass device (Alcon, Fort Worth, TX), the Xen device (Allergan, Dublin, Ireland), the Hydrus device (Ivantis, Irvine, CA), and the Ahmed Glaucoma Valve (New World Medical, Rancho Cucamonga, CA).

[0097] Prop device 1900 is well suited for use in conjunction with any Glaucoma Drainage Device (e.g. Ahmed implant) to provide a tube guidance device in which the internal tube of the GDD device can be threaded or inserted through the aperture or opening 1922. In this way, the strut 1920 (e.g. when in the deployed configuration) can operate as a tube positioning guide, to ensure that the tube will also be placed parallel to the iris plane and held away from the peripheral cornea, thus reducing the likelihood of adjacent corneal endothelial damage due to intermittent tube corneal touch, and also held away from the iris surface which result in tube blockage of iris erosion. For example, as depicted in FIG. 19 A, prop device 1900 can be used in conjunction with an adjunct device, such as a GDI, GDD, or MIGS device. As shown here, a tube 1901 of an adjunct device can be inserted through an opening of strut 1920. In some cases, strut 1920 can operate to hold in place a tube (for example a silicone tube) of an adjunct device, at a desired location (for example within the anterior chamber of the eye of the patient). An adjunct device can include other components that are not shown in FIG. 19A. In some cases, a proximal end 1902 of the tube can extend proximally, and into or through the tissue of the eye of the patient. For example, the tube can extend into or through the sclera, such as into or through a scleral tunnel, as part of a scleral tunneling technique. Prop device 1900 can be used in conjunction with a Glaucoma Drainage Device (e.g. Ahmed implant). Such devices can have a long tube that is extended into the anterior chamber of the eye which can be inserted into the arch or opening of the strut 1920. The angle prop device 1900 in such an instance can operate as a tube guidance device reducing the likelihood of adjacent corneal endothelial damage due to intermittent tube corneal touch, and also hold the tube away from the iris surface, thus preventing or reducing the likelihood of tube blockage or iris erosion.

[0098] FIG. 20 depicts aspects of a prop device 2000 (e.g. glaucoma MIGS variant) according to embodiments of the present invention. Prop device 2000 can include a combination of any of the features described elsewhere herein with regard to the other prop device embodiments. A base 2040 of the prop device 2000 includes a superior depression 2041 and an inferior extrusion 2043. As shown here, the depression and the extrusion are disposed toward a peripheral portion 2047 of the base (e.g. disposed more distant from pupil, and close to the trabecular meshwork, when the prop device is implanted in the eye of a patient). The depression can be, for example, a 150 μπι depression (e.g. relative to superior surface of the base). The extrusion 2043 can be, for example, a 50 μπι extrusion (e.g. relative to inferior surface of the base). In some cases, the depression may be more pronounced, or less pronounced. In some cases, the extrusion can be more pronounced, or less pronounced. In some cases, the depth of the depression 2041 (e.g. relative to the surface of base 2040) can have a value within a range from about 100 μπι to about 200 μπι. In some cases, the depth of the depression 2041 can have a value within a range from about 1 μηι to about 250 μπι. In some cases, the depression 2041 can be used to hold, support, or contact an adjunct device such as an iStent device, a Cypass device, a Xen device, a Hydrus device, or another type of MIGS device. Such adjunct devices may typically be intended for use in treating open angle glaucoma. Embodiments of the present invention contemplate use of such MIGS devices in treating closed angle glaucoma, when combined with prop devices and techniques disclosed herein. Typically, these adjunct MIGS devices include a small short protruding inlet (e.g. in contrast to an extended tube such as that depicted in FIG. 19A).

According to some embodiments, by virtue of the depression 2041 and/or extrusion 2043, it is possible to wedge the prop device 2000 below (or posterior to) an inlet snorkel of a MIGS device, such that the prop device 2000 operates to separate or maintain separation of the cornea from the iris, and therefore facilitate clear access to the inlet lumen (e.g. to promote the flow of aqueous humor from the anterior chamber and into the inlet of the MIGS device). In such a way, a MIGS device can be used, in combination with a prop device, to treat a patient presenting with closed angle glaucoma. [0099] Prop device 2000 is well suited to prevent PAS and angle closure in patients who have received a minimally invasive glaucoma surgery (MIGS) device (e.g. iStent, XEN Gel Stent, CyPass, Hydrus, MicroShunt, and the like). According to some embodiments, one or more surgical anterior chamber prop devices can be permanently inserted in the anterior chamber angle (e.g. at the iridocorneal angle) to provide a strut to physically separate peripheral cornea from peripheral iris.

[0100] The configurations depicted in FIGS. 6A(ii), 19, 19A, and 20 can be used in

conjunction with MIGS devices (and/or GDI devices, GDD devices, and the like) to provide a combined system to treat both open angle glaucoma, as well as closed or narrow angle glaucoma. These systems can also reduce the risk of PAS formation after MIGS surgery which could otherwise block the MIGS device (and/or GDI devices, GDD devices, and the like) in the early or late postoperative period.

[0101] As shown in FIG. 20, the posterior of the base 2040 can be slightly depressed in the middle (e.g. to form depression 2041) thereby allowing the base 2040 to fit below a

nozzle/snorkel of a MIGS devices while firmly pressing onto the iris surface, thus allowing clear access to the inlet orifices of the devices or implants.

[0102] FIG. 21 depicts aspects of an mdodialysis staple variant design for a prop device 2200 according to embodiments of the present invention. One or more prop devices 2200 can be implanted in an eye of a patient to reposition dialysed segments of the iris which may be related to trauma or surgical complications, and/or to attach an artificial iris, such as the HumanOptics Artificial Iris. Exemplary mdodialysis devices can have prong or anchor structures as disclosed herein. In some cases, the prongs or anchors can be used to secure the device (e.g. to the trabecular meshwork), and also to physically skewer the detached iris edge, and/or reattach it to the scleral wall. In some cases, a two prong or anchor device can operate like a staple. In some cases, a single prong or anchor device can operate as a rivet. Several such devices or rivets of staples may be inserted to treat differing widths of mdodialysis. As shown here, prop device 2200 includes a base 2240 and an anchor mechanism 2260. The anchor mechanism 2260 includes a first barbed prong 2262 and a second barbed prong 2264. According to some embodiments, a barbed prong may have two lateral barbs 2262a, 2262b. As shown here, a barbed prong may be devoid of an anterior barb and a posterior barb, such that the anterior- facing surface 2262c of the prong and the opposing posterior- facing surface (not shown) are generally smooth or flat. Any of the prop device embodiments disclosed herein can include such a barbed prong design. In some cases, such as design can facilitation sliding of the prongs between layers of tissue, such as the layers of the trabecular meshwork. [0103] As shown here, prop device 2200 can include one or more raised ridges 2245 on the superior surface of the base plate 2240. The raised ridges allow the device 2200 to be grasped firmly without rotating, for example by ridged teeth of a forceps device. In some cases, an inferior surface (not shown) opposing the superior surface of the base plate may also include one or more raised ridges. According to some embodiments, the base plate 2240 may have a smaller width, for example a width smaller than the horizontal width of the prop device. As discussed elsewhere herein, an iridodialysis staple variant design such as prop device 2200 can be used to re-attach an iridodialysed iris. According to some embodiments, an iridodialysis staple variant design such as prop device 2200 (FIG. 21) or 1300 (FIG. 13) can be used to attach an artificial iris such as the CustomFlex Artificial Iris (HumanOptics AG, St. Augustin, Germany). [0104] FIG. 22 depicts aspects of a prop device 2300 according to embodiments of the present invention. Prop device 2300 can include a combination of any of the features described elsewhere herein with regard to the other prop device embodiments. As shown here, prop device 2300 includes a biosensor 2395, for example coupled with a base 2340 of the prop device. In some cases, the prop device 2300 can operate as an attachment point to secure one or more biosensors (e.g. intraocular pressure sensors, glucose monitors, biomarker sensors, and the like) implanted within the eye. In some cases, a biosensor can be either attached at the posterior of the base plate or on anterior engagement portion. In some cases, a biosensor can be attached with a superior surface 2347 of the base 2340, or with an inferior surface (not shown). In some cases, one or more biosensors can be secured with the eye using one or more iridodialysis variant prop devices, such as prop devices 2200 (FIG. 21) or 1300 (FIG. 13).

[0105] According to some embodiments, prop devices as disclosed herein can operate as an anchor mechanism to anchor any of a variety of diagnostic or therapeutic mechanisms at the anterior chamber angle, and to maintain such mechanisms in a stable position within the eye.

[0106] One or more of the prop device embodiments disclosed herein can be used to treat a patient presenting with post-anterior segment trauma with narrow or closed angles, or Peripheral Anterior Synechia (PAS), including post-surgical closed angles or PAS. In some cases, one or more of the prop device embodiments disclosed herein can be used to treat patients presenting with Primary Angle Closure Glaucoma (PACG) and other related narrow and closed angle conditions. [0107] In some cases, one or more of the prop device embodiments disclosed herein can be used in conjunction with glaucoma tube surgery to provide a tube guidance device to reduce proximity of the tube to the corneal endothelial surface. In some cases, one or more of the prop device embodiments disclosed herein can be used in conjunction with minimally invasive glaucoma surgery (MIGS), for example to treat or prevent angle narrowing, closure, and PAS. [0108] In some cases, one or more of the prop device embodiments disclosed herein can be used to treat patients presenting with iridodialysis. For example, a single prong or multi-prong anchor device can operate to stabilize or secure the separated or detached iris portion. In some cases, this can involve using one or more devices to staple a detached peripheral iris to the sclera. In some cases, one or more pronged devices can be implanted to attach a detached iris to a scleral wall or scleral spur and ciliary body junction. In some cases, one or more single prong or multi-prong anchor devices can be used to attach an artificial iris to the scleral wall.

[0109] In some instances, one or more of the prop device embodiments disclosed herein can be used to treat a patient presenting with any form of Secondary Angle Closure Glaucoma. In some instances, one or more of the prop device embodiments disclosed herein can be used to treat a patient presenting with any of a variety of congenital angle closure or PAS conditions, including ICE syndrome, and various forms of anterior segment dysgenesis.

[0110] In some cases, one or more of the prop device embodiments disclosed herein can be used to provide an anchoring platform for ophthalmic biosensor implants or any other anterior chamber device. [0111] Normal variant designs, which can be used to treat patients who present with or who are at risk of developing primary angle glaucoma or PAS, include devices 200, 300, 400, 500, 500(i), 700, 1500, 1600, 1700, and 1800. Glaucoma tube variant designs, which can operate to facilitate placement of a tube relative to the anterior chamber angle, include devices 600, 600(i), 710, and 1900, as well as other devices that are modified to include a strut aperture 222 such as that depicted in FIG. 2J. Glaucoma MIGS variant designs, which can operate to facilitate placement of a MIGS device relative to the eye of the patient, include device 2000. Biosensor variant designs, which can operate to secure placement of a biosensor device relative to the eye of a patient, include device 2300. Iridodialysis variant designs, which can operate to secure dialysed segments of the iris and perform other functions described elsewhere herein, include devices 1300 and 2200.

[0112] All features of the described systems and devices are applicable to the described methods mutatis mutandis, and vice versa. Embodiments of the present invention encompass kits having prop devices as disclosed herein. In some embodiments, the kit includes one or more prop devices, along with an inserter and instructions for using the device or devices according to any of the methods disclosed herein. In some embodiments, the kits are used for treating a patient who has an ocular condition, or who may be at risk of developing an ocular condition. In some embodiments, a kit includes one or more prop devices as described herein packaged in a container for storage and/or shipment. In some embodiments, the kit further comprises instructions for administering the prop devices to a patient.

[0113] Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, one of skill in the art will appreciate that certain changes, modifications, alternate constructions, and/or equivalents may be practiced or employed as desired, and within the scope of the appended claims. In addition, each reference provided herein in incorporated by reference in its entirety to the same extent as if each reference was individually incorporated by reference. Relatedly, all publications, patents, patent applications, journal articles, books, technical references, and the like mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, patent application, journal article, book, technical reference, or the like was specifically and individually indicated to be incorporated by reference.