Patent Description:
Implantable devices can be used to provide a therapeutic agent to one or more locations of a patient. The implant may have a reservoir for holding therapeutic agent, and a structure to retain the implant at a desired location of the patient. The agent can be released from the implant into the patient to provide a therapeutic benefit. After an amount of time, the amount of fluid released can be less than ideal, and the fluid of the implant may be replaced, refilled, or exchanged to provide additional amounts of therapeutic agent to extend the therapy. A drug delivery device may be implanted into a patient's eye for the delivery of drug to the eye in treating eye disease. <CIT>, which is incorporated herein by reference, describes an example of an implantable drug delivery device for the eye. <CIT> describes insertion and removal methods and apparatus for therapeutic devices. <CIT> describes an intravitreal injection system for administering a pharmacological agent to an eye. <CIT> discloses ocular implant delivery assemblies which include a cannula for inserting the implant. <CIT> describes an intraocular injection apparatus for guiding a needle into the interior of an eye. <CIT> describes intracameral delivery devices having a sustained release material.

There remains a need for devices and methods for filling implants with drug and for holding the implantable device during insertion of the device into the patient.

The present invention is set out in the independent claims, with preferable features in the dependent claims. Implementations of the present disclosure provide methods, systems and devices for filling implants with drug and for holding the implantable device during insertion of the device into the patient. In many implementations, the methods, systems and devices provide for injection of a therapeutic agent into an implantable device prior to insertion. The implantable device can be manufactured and provided to a clinic without a therapeutic agent, such that the therapeutic agent can be placed in the implantable device in the clinic prior to insertion.

In one aspect, provided is an ocular implant system having an ocular implant having a retention structure and a reservoir sized and shaped to be inserted at least partially into an eye such that the implant can deliver a drug from the reservoir into the eye. The system has a carrier member with a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell; and a guide sleeve removably attached within at least a first region of the central channel of the shell, the guide sleeve defining a proximal port into the central channel that is accessible from the proximal end of the shell. The system includes an implant holder removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve. The implant holder has a pair of graspers adapted to releasably secure the implant at a distal end of the implant holder.

The system can further include a fill syringe sized and shaped to be inserted through the port into the central channel through the guide sleeve to fill the implant with one or more therapeutic agents. The guide sleeve can simultaneously detach from the shell and attach to the fill syringe when the fill syringe is inserted into the central channel. The guide sleeve can have at least one guide sleeve slot sized and shaped to receive a corresponding tab of the shell that projects into the at least one guide sleeve slot when the guide sleeve is positioned within the central channel. An edge of the guide sleeve slot can abut a distal end of the shell tab when in a locked first state. The fill syringe can have a needle assembly having an outer surface, and optionally the fill syringe can be pre-filled with the one or more therapeutic agents. Insertion of the fill syringe through the guide sleeve positioned within the central channel can cause contact between the outer surface of the needle assembly and an inner surface of the shell tab urging the shell tab to flex outward away from the guide sleeve slot into an unlocked second state wherein the edge of the guide sleeve slot no longer abuts the distal end of the shell tab.

A region of the guide sleeve can have a u-shaped slot forming a guide sleeve tab. The guide sleeve tab can have a free end that projects inwards towards a longitudinal axis of the guide sleeve positioned within the central channel. The fill syringe can have a first portion having a first outer diameter and a second portion having a second outer diameter. The first portion can be located distal to the second portion and the first outer diameter can be larger than the second outer diameter. Distal advancement of the fill syringe through the guide sleeve can cause the first portion of the fill syringe to abut against the free end of the guide sleeve tab and can urge the guide sleeve tab outward away from the longitudinal axis of the guide sleeve. Further distal advancement of the fill syringe through the guide sleeve can advance the first portion distal to the free end of the guide sleeve tab such that the free end flexes back inward toward the longitudinal axis and towards the smaller diameter second portion located proximal to the first portion. The free end of the guide sleeve tab can abut a proximal ledge of the first portion locking the guide sleeve to the fill syringe. The implant holder can have an interior configured to receive at least a portion of the needle assembly of the fill syringe.

The pair of graspers can extend substantially around the retention structure of the implant such that a fill port of the implant is available from within the interior of the implant holder. A first grasper of the pair of graspers can have a first protrusion and a second grasper of the pair of graspers can have a second protrusion. The first and second protrusions can be configured to be received within an indentation distal to the retention structure of the implant such that the retention structure is held within the interior of the implant holder and the reservoir extends distal to the implant holder.

The system can further include a handle member usable for inserting the implant into an eye. The implant holder can be configured to interchangeably couple with the carrier member and the handle member. The handle member can include an elongated proximal portion and a distal attachment portion. The distal attachment portion can releasably attach to the implant holder. The distal attachment portion of the handle member can be sized and shaped to be inserted through the central channel after the fill syringe and guide sleeve coupled to the fill syringe are removed from the shell. The distal attachment portion can include a first arm and a second arm. A proximal end region of the implant holder can have a pair of tabs formed by a pair of u-shaped slots. Each of the pair of tabs can have a projection on its inner surface. The first arm and the second arm can each have a recess on its outer surface. Each of the recesses can be configured to receive the projections when the first and second arms are inserted through the interior of the implant holder.

The handle member can further include an actuator configured to detach the implant from the implant holder. When the actuator is in a first state, the pair of graspers can be positioned adjacent one another and surround the implant. When the actuator is in a second state, the pair of graspers can be urged away from one another and release the implant. The actuator can include an actuator element, a spring-held slider member, and a pair of arms. The actuator element can have a projection extending from a lower surface and have a ramped surface. Movement of the actuator element towards the upper surface of the handle can cause the ramped surface to slide against a corresponding ramped surface of the slider member urging the slider member in a proximal direction relative to the pair of arms. The slider member can have a forked region interfaced with the pair of arms such that proximal movement of the slider member causes the pair of arms to open in a scissor-like movement. Opening the pair of arms can urge the pair of graspers away from one another releasing the implant held therebetween.

The central channel can terminate at a window extending through a distal end region of the shell. The pair of graspers can secure the implant within the window. The implant can have an elongate axis extending through a center of the implant from a proximal end to the distal end of the implant. The elongate axis of the implant can be concentric with an elongate axis of the central channel. A proximal end of the guide sleeve can be relatively flush with the proximal end of the shell. A proximal end of the guide sleeve can extend a distance beyond the proximal end of the shell. The proximal end of the guide sleeve can incorporate a gripping element. The gripping element can have an ergonomic size and shape that facilitates grasping by a user. The guide sleeve can have a generally cylindrical shape. The guide sleeve can have a c-shaped cross section such that a first side of the guide sleeve is cylindrical and a second side of the guide sleeve is discontinuous. The discontinuous second side of the guide sleeve can align with the first side of the shell and the central channel.

In an interrelated aspect, provided is an ocular implant handling system having a carrier member. The carrier member has a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell. The carrier member has a guide sleeve removably attached within at least a first region of the central channel of the shell. The guide sleeve defines a proximal port into the central channel that is accessible from the proximal end of the shell. The carrier member has an implant holder removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve. The implant holder has a pair of graspers adapted to releasably secure an implant at a distal end of the implant holder.

The handle member can be usable for inserting an implant into an eye. The system can further include an ocular implant having a retention structure and a reservoir sized and shaped to be inserted at least partially into an eye such that the implant can deliver a drug from the reservoir into the eye.

The system can further include a fill syringe sized and shaped to be inserted through the port into the central channel through the guide sleeve. The guide sleeve can simultaneously detach from the shell and attach to the fill syringe when the fill syringe is inserted into the central channel. The guide sleeve can have at least one guide sleeve slot sized and shaped to receive a corresponding tab of the shell that projects into the at least one guide sleeve slot when the guide sleeve is positioned within the central channel. An edge of the guide sleeve slot can abut a distal end of the shell tab when in a locked first state. The fill syringe can have a needle assembly having an outer surface. Insertion of the fill syringe through the guide sleeve positioned within the central channel can cause contact between the outer surface of the needle assembly and an inner surface of the shell tab urging the shell tab to flex outward away from the guide sleeve slot into an unlocked second state wherein the edge of the guide sleeve slot no longer abuts the distal end of the shell tab. A region of the guide sleeve can have a u-shaped slot forming a guide sleeve tab. The guide sleeve tab can have a free end that projects inwards towards a longitudinal axis of the guide sleeve positioned within the central channel.

The fill syringe can have a first portion having a first outer diameter and a second portion having a second outer diameter. The first portion can be located distal to the second portion and the first outer diameter can be larger than the second outer diameter. Distal advancement of the fill syringe through the guide sleeve can cause the first portion of the fill syringe to abut against the free end of the guide sleeve tab and urge the guide sleeve tab outward away from the longitudinal axis of the guide sleeve. Further distal advancement of the fill syringe through the guide sleeve can advance the first portion distal to the free end of the guide sleeve tab such that the free end flexes back inward toward the longitudinal axis and towards the smaller diameter second portion located proximal to the first portion. The free end of the guide sleeve tab can abut a proximal ledge of the first portion locking the guide sleeve to the fill syringe.

The implant holder can have an interior configured to receive at least a portion of the needle assembly of the fill syringe. The pair of graspers can extend substantially around the retention structure of the implant such that a fill port of the implant is available from within the interior of the implant holder. A first grasper of the pair of graspers can have a first protrusion and a second grasper of the pair of graspers can have a second protrusion. The first and second protrusions can be configured to be received within an indentation distal to the retention structure of the implant such that the retention structure is held within the interior of the implant holder and the reservoir extends distal to the implant holder.

The handle member can include an elongated proximal portion and a distal attachment portion. The distal attachment portion can releasably attach to the implant holder. The distal attachment portion of the handle member can be sized and shaped to be inserted through the central channel after the fill syringe and guide sleeve coupled to the fill syringe are removed from the shell. The distal attachment portion can include a first arm and a second arm. A proximal end region of the implant holder can have a pair of tabs formed by a pair of u-shaped slots. Each of the pair of tabs can have a projection on its inner surface. The first arm and the second arm can each have a recess on its outer surface. Each of the recesses can be configured to receive the projections when the first and second arms are inserted through the interior of the implant holder.

The handle member can further include an actuator configured to detach the implant from the implant holder. When the actuator is in a first state, the pair of graspers can be positioned adjacent one another and surround the implant. When the actuator is in a second state, the pair of graspers can be urged away from one another and release the implant. The actuator can include an actuator element, a spring-held slider member, and a pair of arms. The actuator element can have a projection extending from a lower surface and having a ramped surface. Movement of the actuator element towards the upper surface of the handle can cause the ramped surface to slide against a corresponding ramped surface of the slider member urging the slider member in a proximal direction relative to the pair of arms. The slider member can have a forked region interfaced with the pair of arms such that proximal movement of the slider member causes the pair of arms to open in a scissor-like movement. Opening the pair of arms can urge the pair of graspers away from one another releasing an implant held therebetween.

The central channel can terminate at a window extending through a distal end region of the shell. The pair of graspers can secure an implant within the window. An implant can have an elongate axis extending through a center of the implant from a proximal end to the distal end of the implant. The elongate axis of the implant can be concentric with an elongate axis of the central channel. A proximal end of the guide sleeve can be relatively flush with the proximal end of the shell. A proximal end of the guide sleeve can extend a distance beyond the proximal end of the shell. The proximal end of the guide sleeve can incorporate a gripping element. The gripping element can have an ergonomic size and shape that facilitates grasping by a user. The guide sleeve can have a generally cylindrical shape. The guide sleeve can have a c-shaped cross section such that a first side of the guide sleeve is cylindrical and a second side of the guide sleeve is discontinuous. The discontinuous second side of the guide sleeve can align with the first side of the shell and the central channel.

In an interrelated aspect, provided is an ocular implant handling and delivery system. The system includes a handle member usable for inserting an ocular implant into an eye having an elongated proximal portion and a distal attachment portion. The system includes a carrier member having a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell; and a guide sleeve removably attached within at least a first region of the central channel of the shell. The guide sleeve defines a proximal port into the central channel that is accessible from the proximal end of the shell. The system includes an implant holder removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve. The implant holder has a pair of graspers adapted to releasably secure the ocular implant at a distal end of the implant holder. The implant holder is configured to interchangeably couple with the carrier member and the handle member.

The system can further include the ocular implant. The ocular implant can include a retention structure and a reservoir sized and can be shaped to be inserted at least partially into an eye such that the ocular implant can deliver a drug from the reservoir into the eye.

In an interrelated aspect, provided is an ocular implant handling and filling system. The system includes a carrier member having a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell; and a guide sleeve removably attached within at least a first region of the central channel of the shell. The guide sleeve defines a proximal port into the central channel that is accessible from the proximal end of the shell. The system includes an implant holder removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve. The implant holder has a pair of graspers adapted to releasably secure an ocular implant at a distal end of the implant holder. The system includes a fill syringe sized and shaped to be inserted through the port into the central channel through the guide sleeve.

The system can further includes the ocular implant having a retention structure and a reservoir sized and shaped to be inserted at least partially into an eye such that the implant can deliver a drug from the reservoir into the eye. The system can further include a handle member usable for inserting an ocular implant into an eye. The handle member can include an elongated proximal portion and a distal attachment portion. The implant holder can be configured to interchangeably couple with the carrier member and the handle member.

In an interrelated aspect, provided is a handling and filling system having a carrier member. The carrier member includes a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell. The carrier member includes a guide sleeve removably attached within at least a first region of the central channel of the shell. The guide sleeve defines a proximal port into the central channel that is accessible from the proximal end of the shell. The system includes an implant holder removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve. The implant holder has a pair of graspers adapted to releasably secure an implant at a distal end of the implant holder. The system includes a fill syringe sized and shaped to be inserted through the port into the central channel through the guide sleeve. The system includes a handle member usable for inserting the implant into an eye. The handle member includes an elongated proximal portion and a distal attachment portion. The implant holder is configured to interchangeably couple with the carrier member and the handle member.

The system can further include the ocular implant. The ocular implant can include a retention structure and a reservoir sized and shaped to be inserted at least partially into an eye such that the ocular implant can deliver a drug from the reservoir into the eye.

In an interrelated aspect, provided is a fill syringe sized and shaped to insert through a region of a carrier member holding an ocular implant. The fill syringe is configured to inject one or more therapeutic agents from the fill syringe into a reservoir of the ocular implant.

The carrier member can include a shell having a central channel extending at least partially through the shell from a proximal end towards a distal end of the shell. The carrier member can include a guide sleeve removably attached within at least a first region of the central channel of the shell. The guide sleeve can define a proximal port into the central channel that is accessible from the proximal end of the shell. A portion of the fill syringe can lock with a portion of the guide sleeve when the fill syringe is inserted through the central channel of the shell. Withdrawal of the fill syringe from the carrier member can remove the guide sleeve from the shell. The fill syringe can be pre-filled with the one or more therapeutic agents.

The above-noted aspects and features may be implemented in systems, apparatus, and/or methods, depending on the desired configuration. Features and advantages of the subject matter described herein will be apparent from the description and drawings, and from the claims.

Described herein are methods, devices and systems for easily, reproducibly, and safely filling an ocular implant with a material, such as a drug, and inserting the implant into a patient, such as a patient's eye. Although specific reference is made to placement of devices in the eye, systems described herein can be used with many devices used in locations other than the eye, such as in orthopedic, dental, intraluminal and transdermal locations. The systems and methods described herein are well suited for use with many drug delivery devices, such as refillable diffusion based devices, and can be exceptionally well suited for diffusion devices having a porous drug release structure configured for extended release in which the porous structure inhibits flow of fluid during exchange.

<FIG> shows an implementation of a system for holding, filling, and/or delivering an ocular implant. The system <NUM> can include an ocular implant handling system including an implant carrier member <NUM> and a handle member <NUM>. The system <NUM> can further include a fill syringe <NUM> (see <FIG>). The fill syringe <NUM> can contain a therapeutic agent, such as a pre-filled syringe. The carrier member <NUM> is sized and shaped to initially store an implant <NUM> prior to implantation of the implant <NUM> into the eye. The fill syringe <NUM> can interface with the carrier member <NUM> to fill the implant <NUM> with a flowable material, such as a liquid drug or therapeutic agent. The fill syringe <NUM> can interdigitate with the carrier member <NUM> holding the implant <NUM> and lock into a portion of the carrier member <NUM> (e.g. a guide sleeve), as will be described in more detail below. The therapeutic agent or agents suitable for use with the implant <NUM> can vary, for example, as described in <CIT>, entitled "Implantable Therapeutic Device," which is incorporated here in its entirety. The therapeutic agent can include one or more of a variety of active ingredients of the therapeutic agent, a formulation of the therapeutic agent, a commercially available formulation of the therapeutic agent, a physician prepared formulation of therapeutic agent, a pharmacist prepared formulation of the therapeutic agent, or a commercially available formulation of therapeutic agent having an excipient. The therapeutic agent may be referred to with generic name or a trade name.

A portion of the carrier member <NUM> can guide and properly align a cannula or needle <NUM> of the syringe <NUM> with the fill port of the implant <NUM>. The syringe <NUM> can interdigitate with this portion of the carrier member <NUM> and lock into it such that when the syringe <NUM> is removed, for example, after filling the implant <NUM> with the drug from the syringe <NUM>, the syringe <NUM> and this portion of the carrier member <NUM> locked onto the syringe can be withdrawn together. As will be described in more detail below, once the fill syringe <NUM> is removed (e.g. after the implant <NUM> is filled with drug), the handle member <NUM> can be inserted into the carrier member <NUM> and used to remove the implant <NUM> from the carrier member <NUM>. The handle member <NUM> and the carrier member <NUM> can interchangeably couple to the implant <NUM>. The handle member <NUM> can be coupled to the carrier member <NUM> in a manner that attaches the implant <NUM> to the handle member <NUM> and detaches the implant <NUM> from the carrier member <NUM>. The handle member <NUM> can then be used to position the implant <NUM> and insert the implant <NUM> into an eye. Each of these features will be described in more detail below. It should be appreciated that the implant <NUM> can be pre-filled and stored within the carrier member <NUM>. Alternatively, the implant <NUM> can be stored within the carrier member <NUM> while empty and filled prior to implantation in the eye, such as using a pre-filled syringe. It should also be appreciated that the implant <NUM> can be filled after implantation in the eye.

Generally, the implant <NUM> to be used with the system <NUM> described herein can include an internal reservoir. The reservoir can be a rigid-walled reservoir having a fixed volume. Alternatively, one or more of the reservoir walls can be configured to expand such that the reservoir volume changes depending on a fill status of the implant <NUM>. The implant <NUM> can include a proximal retention structure <NUM> and an indentation <NUM> or narrowed region that is sized smaller than the retention structure <NUM>. The indentation <NUM> can also be sized smaller than a shoulder region extending distal to the indentation <NUM>. The indentation <NUM> can be sized to fit in an elongate incision. The proximal retention structure <NUM> can include an access port having a penetrable region. For example, the proximal retention structure <NUM> can include or be covered by a penetrable barrier or septum structure such that the reservoir can be filled with a material. One or more outlets can be positioned in fluid communication with the reservoir of the implant <NUM> such that therapeutic agent in the reservoir can be delivered to the patient. The one or more outlets can incorporate a porous structure including one or more of many porous structures such as sintered material, openings in a non-permeable material, openings having a size and number to release therapeutic agent at an intended rate, a plurality of holes etched in a material, a semipermeable membrane, or nano-channels, for example. It should be appreciated that the configuration of implant <NUM> that can used with the system <NUM> described herein can vary. The systems described herein can be used with or incorporate features of devices described in <CIT>, entitled "Posterior Segment Drug Delivery"; <CIT>, entitled "Injector Apparatus and Method for Drug Delivery;" and <CIT>, entitled "Insertion and Removal Methods and Apparatus for Therapeutic Devices,".

As best shown in <FIG> and also <FIG>, <FIG>, and <FIG>, the carrier member <NUM> includes a shell <NUM> and a guide sleeve <NUM>. The guide sleeve <NUM> is removably attached to the shell <NUM>. The system <NUM> also includes an implant holder <NUM> configured to releaseably hold an ocular implant <NUM> within the shell <NUM>. The implant holder <NUM> can be reversibly coupled to the shell <NUM> of the carrier member <NUM>. As such that implant holder <NUM> can be an interchangeable element that can be coupled to the carrier member <NUM>, for example prior to filling with a syringe <NUM>, and can be released from the carrier member <NUM>, for example after filling with a syringe <NUM> and prior to implantation in a patient using a delivery tool. Thus, the implant holder <NUM> can be interchangeably coupled with the carrier member and the delivery tool.

The shell <NUM> of the carrier member <NUM> includes a central channel <NUM> extending at least partially through an upper surface of a first side, such as its front side <NUM>, from a proximal end <NUM> of the carrier member <NUM> towards a distal end region <NUM> of the carrier member <NUM> along a longitudinal axis. The central channel <NUM> can terminate at an opening or window <NUM> extending through a distal end region <NUM> of the shell <NUM>. The implant <NUM> can be positioned by the implant holder <NUM> within the window <NUM>. The shell <NUM> of the carrier member <NUM> can be generally ergonomically shaped such that a user can hold the carrier member <NUM> in one hand positioned around the underside of the carrier member <NUM>. The central channel <NUM> can be available and readily visible on the front side <NUM> of the carrier member <NUM>. The shell <NUM> of the carrier member <NUM> can include one or more textured regions <NUM> or indentations on its external surface to improve a user's grip on the carrier member <NUM> during use.

It should be appreciated that reference herein to terms such as "upper," "lower," "upwards," "downwards," "front," "back," "proximal," "distal" are used herein for orientation from one point of view of a user operating the systems described herein and are not intended to be limiting.

The implant <NUM> can have an elongate axis extending through a center of the implant <NUM> from the proximal-most end to the distal-most end of the implant <NUM>. The system <NUM> (and/or each of the components of the system) can also have an elongate axis that is concentric with the elongate axis of the implant <NUM> forming a longitudinal axis A with which each of the components of the system <NUM> are substantially aligned. When the implant <NUM> is held by the implant holder <NUM> within the carrier member <NUM>, the elongate axis of the implant <NUM> can be aligned substantially with the longitudinal axis A of the system and the syringe <NUM> can be inserted substantially along the longitudinal axis A such that the needle <NUM> penetrates an upper surface of the implant <NUM>. It should be appreciated that the syringe <NUM> can interdigitate within the central channel <NUM> along the longitudinal axis A or, in other implementations, can be inserted at an angle to the longitudinal axis A.

As mentioned, the carrier member <NUM> can include the guide sleeve <NUM> that can be removably attached within at least a region of the slot of the shell <NUM>. The guide sleeve <NUM> can define a proximal port <NUM> into the central channel <NUM> of the shell <NUM> that allows for access to the slot from a proximal end of the shell <NUM>. The guide sleeve <NUM> can help to ensure proper alignment between the syringe <NUM> and the implant <NUM> such that a needle <NUM> of the syringe <NUM> inserts through a septum or fill port of the implant <NUM>. The guide sleeve <NUM> can provide guiding alignment during insertion of the syringe <NUM> through the port <NUM> into the central channel <NUM> towards the implant <NUM> mounted within the implant holder <NUM> of the carrier member <NUM>.

The configuration of the guide sleeve <NUM> can vary. The guide sleeve <NUM> can have a length such that it extends a distance between the proximal end <NUM> of the shell <NUM> or central channel <NUM> and a distal region of the central channel <NUM>. The guide sleeve <NUM> can be relatively flush with a proximal end <NUM> of the shell <NUM> (see <FIG>) or the guide sleeve <NUM> can extend a distance beyond the proximal end <NUM> of the shell <NUM>, for example, as shown in <FIG>. In this implementation, the guide sleeve <NUM> can incorporate a gripping element <NUM>. The gripping element <NUM> of the guide sleeve <NUM> may have an ergonomic size and shape that facilitates it being grasped by a user, such as between the fingers of a user's hand as will be described in more detail below.

In some implementations, the guide sleeve <NUM> can have a generally cylindrical shape. The guide sleeve <NUM> can be a generally cylindrical element having an overall c-shaped cross section such that the underside or back side of the guide sleeve <NUM> is cylindrical and the front side of the guide sleeve <NUM> is slotted or discontinuous (see <FIG> and also <FIG>). In this implementation when the guide sleeve <NUM> is reversibly coupled with the shell <NUM> in the central channel <NUM>, the cylindrical lower surface of the guide sleeve <NUM> can abut a lower portion <NUM> of the shell <NUM> and the discontinuous portion of the guide sleeve <NUM> can align with the upper surface of the front side <NUM> of the shell <NUM>.

As mentioned above and as best shown in <FIG> and also in <FIG>, the syringe <NUM> can have a body sized and shaped to be inserted into the central channel <NUM> of the shell <NUM> of the carrier member <NUM> via the port <NUM> such that a needle <NUM> of a needle assembly <NUM> of the syringe <NUM> can be inserted into the implant <NUM> mounted via the implant holder <NUM> on the carrier member <NUM>. The syringe <NUM> can fill the implant <NUM> with a liquid drug or any other liquid prior to inserting the implant <NUM> into the eye. The syringe <NUM> can have any of a variety of configurations as known in the art. In some implementations, the syringe <NUM> can include a reservoir <NUM> that may be pre-filled with a fluid drug or any other fluid. The reservoir <NUM> can include a proximal opening configured to receive a mechanism for expelling the fluid from the reservoir <NUM> through a distal opening of the reservoir <NUM>. The mechanism for expelling the fluid from the reservoir <NUM> can be a plunger <NUM> including a piston rod <NUM> terminating at a piston head <NUM>. The piston head <NUM> can be configured to contact the liquid to be injected from the reservoir <NUM> and maintain a seal as the plunger <NUM> is displaced distally within the reservoir <NUM>. A stop element can be incorporated that prevents withdrawal of the piston rod <NUM> or piston head <NUM> through the proximal opening. A proximal end of the syringe <NUM> can include a flange <NUM> that can aid in the advancement of the plunger <NUM> within the reservoir <NUM> as is known in the art. As the syringe <NUM> is used to inject material into the implant <NUM> using the plunger <NUM>, a user can apply a force against an upper surface of the flange <NUM> (e.g. with the user's thumb) and apply a force against a lower surface of portion <NUM> (e.g. with a user's finger) therein applying a squeezing pressure to the syringe <NUM> engaged with the carrier member <NUM>.

The distal opening of the reservoir <NUM> can be in fluid communication with a needle assembly <NUM> coupled to the syringe by a luer <NUM> (see <FIG> and <FIG>). The needle assembly <NUM> can include a needle <NUM> and optionally a needle limiter <NUM> positioned around the needle <NUM>. The needle limiter <NUM> can have a length such that a distal-most tip of the needle <NUM> extends only a short distance beyond the needle limiter <NUM> to prevent penetration of the needle <NUM> within the implant <NUM> beyond that short distance so as not to damage the implant <NUM> during filling. As the distal-most tip of the needle <NUM> penetrates the septum or fill port of the implant <NUM>, the needle limiter <NUM> can abut an internal region of the implant holder <NUM> or an upper surface of the implant <NUM> preventing the needle <NUM> from penetrating the implant <NUM> beyond a desired depth. The syringe <NUM> can include a needle cap configured to cover the needle <NUM> and needle limiter <NUM>. The needle assembly <NUM> may be integrally formed with the syringe <NUM> or the needle assembly <NUM> may be detachable from the syringe <NUM>.

As mentioned above, the guide sleeve <NUM> can be removably attached from within the central channel <NUM> of the shell <NUM>. The shell <NUM> and/or the guide sleeve <NUM> can include a locking mechanism that reversibly secures the guide sleeve <NUM> to the shell <NUM>. The locking mechanism can be released, for example, upon insertion of the syringe <NUM> as will be described in more detail below. After the syringe <NUM> has been inserted into the guide sleeve <NUM> positioned within the central channel <NUM> of the shell <NUM> such as to inject drug into the implant <NUM>, the locking mechanism between the guide sleeve <NUM> and the shell <NUM> can unlock. The guide sleeve <NUM> can release from the shell <NUM> and lock onto the syringe <NUM> such that both the guide sleeve <NUM> and the syringe <NUM> can be removed from the shell <NUM> upon withdrawal of the syringe <NUM> from the implant <NUM>. The locking mechanism can simultaneously release the guide sleeve <NUM> from the shell <NUM> and lock the guide sleeve <NUM> onto a region of the syringe <NUM>. When the syringe <NUM> is inserted into the guide sleeve <NUM>, which can be in locked engagement with the shell <NUM> of the carrier member <NUM>, the locking mechanism holding the guide sleeve <NUM> onto the syringe <NUM> can be activated or locked and the locking mechanism locking the guide sleeve <NUM> to the shell <NUM> can be deactivated or unlocked. The respective locking mechanisms can activate/deactivate in a simultaneous or step-wise manner. Once the switch in engagement occurs (i.e. locked engagement between the guide sleeve <NUM> and the shell <NUM> to an unlocked state and unlocked engagement of the syringe <NUM> and the guide sleeve <NUM> to a locked state), the syringe <NUM> can then be removed from the carrier member <NUM> with the guide sleeve <NUM> secured to the syringe <NUM>. <FIG> shows an implementation of the system <NUM> with the syringe <NUM> inserted into the carrier <NUM>. <FIG> shows an implementation of the system <NUM> after the syringe <NUM> has been used to fill the implant <NUM> and the syringe <NUM> has been decoupled from the carrier member <NUM>. The guide sleeve <NUM> is shown detached from the carrier member <NUM> and is now attached to the syringe <NUM>. It should be appreciated that unlocking or detaching the guide sleeve <NUM> from the carrier member <NUM> is not dependent upon filling the implant <NUM>.

The locking mechanism between the shell <NUM> and the guide sleeve <NUM> can include one or more corresponding slots and tabs providing a fixed, but reversible coupling between the shell <NUM> and the guide sleeve <NUM>. In one implementation and as best shown in <FIG>, <FIG>, and <FIG>, the guide sleeve <NUM> can include one or more slots <NUM> having a size and shape configured to accept tabs <NUM> of the shell <NUM> such that the tabs <NUM> reversibly insert through the slots <NUM> when the guide sleeve <NUM> is positioned within the central channel <NUM> of the shell <NUM>. The slots <NUM> can be located on opposing sides of the guide sleeve <NUM>. The guide sleeve <NUM> can also include one or more tabs <NUM> formed by a u-shaped slot <NUM> through a thickness of the guide sleeve <NUM>. It should be appreciated that tabs <NUM> as well as tabs <NUM> can have a degree of flexibility such that they can move slightly with respect to the longitudinal axis A of the system to provide for reversible attachment between the guide sleeve <NUM> and the shell <NUM> as well as between the guide sleeve <NUM> and the syringe <NUM>, which will be described in more detail below.

<FIG>, <FIG> and also <FIG> show an implementation of a locking mechanism that initially locks the guide sleeve <NUM> to the shell <NUM> of the carrier member <NUM>. The shell <NUM> can include one or more tabs <NUM> configured to insert through one or more corresponding slots <NUM> in the guide sleeve <NUM>. In <FIG>, the tabs <NUM> are shown in a first state that locks the guide sleeve <NUM> to the shell <NUM> of the carrier member <NUM>. The flexible tabs <NUM> can extend through the corresponding slots <NUM> in the guide sleeve <NUM> preventing withdrawal of the guide sleeve <NUM> in a proximal direction along arrow P. In the locked first state, an edge of the slot <NUM> can abut a distal edge of the tab <NUM>. <FIG> shows a syringe <NUM> inserted distally into the guide sleeve <NUM> such that an outer surface of the needle assembly <NUM> of the syringe <NUM> presses against an inner surface of the flexible tabs <NUM> urging them in outward direction. The proximal end of the tabs <NUM> can be ramped such that the outer surface of the needle assembly <NUM> can smoothly press against and slide along the inner surface of the tabs <NUM> as the syringe <NUM> is urged in a distal direction along arrow D. The tabs <NUM> can be urged back out the slots <NUM> in the guide sleeve <NUM> releasing the locking engagement between the slots <NUM> of the guide sleeve <NUM> and the tabs <NUM> of the shell <NUM>. In the unlocked second state, the edge <NUM> of the slot <NUM> may no longer abut the distal edge <NUM> of the tab <NUM>.

This same act of inserting the syringe <NUM> distally through the guide sleeve <NUM> releasing the locked engagement between the guide sleeve <NUM> and the shell <NUM> can also cause the guide sleeve <NUM> to lock onto a portion of the syringe <NUM>. In some implementations, the one or more tabs <NUM> formed by the u-shaped slot <NUM> through a thickness of the guide sleeve <NUM>, for example, in the cylindrical underside of the guide sleeve <NUM> (see <FIG> and also <FIG>). Similar to the tabs <NUM> of the shell <NUM>, the tab <NUM> on the guide sleeve <NUM> can flex inward and outward relative to a longitudinal axis A of the guide sleeve <NUM> to capture a corresponding portion of the syringe <NUM>. A free end <NUM> of the tab <NUM> can be angled or curved such that it projects inward towards the longitudinal axis of the guide sleeve <NUM>, or have a feature that encroaches within the interior of the sleeve <NUM>. When the syringe <NUM> is inserted distally through the guide sleeve <NUM> releasing the tabs <NUM> of the shell <NUM> from the slots <NUM> in the guide sleeve <NUM>, the flexible tab <NUM> of the guide sleeve <NUM> can capture the corresponding portion of the syringe <NUM> preventing the syringe <NUM> from being detached from the carrier member <NUM> without the guide sleeve <NUM> being coupled to the syringe <NUM>.

As mentioned previously, the guide sleeve <NUM> can include an inner diameter configured to receive the outer diameter of the syringe <NUM> such that the syringe <NUM> can be inserted through the guide sleeve <NUM> to inject drug into the implant <NUM> mounted within the implant holder <NUM> located distal to the guide sleeve <NUM> (see <FIG>). The free end <NUM> of the flexible tab <NUM> of the guide sleeve <NUM> projecting inward towards the central longitudinal axis A of the system <NUM>. The syringe <NUM> can urge the flexible tab <NUM> outward away from the central longitudinal axis A as the syringe <NUM> is inserted through the guide sleeve <NUM>. Thus, the syringe <NUM> can be freely inserted in a distal direction along arrow D through the guide sleeve <NUM>. However, the tab <NUM> can prevent the syringe <NUM> from being withdrawn in a proximal direction along arrow P away from the guide sleeve <NUM>. As best shown in <FIG>, a distal region of the syringe <NUM> can include a first portion <NUM> having a first outer diameter and a second portion <NUM> having a second outer diameter. The first portion <NUM> can be located distally to the second portion <NUM> and the first outer diameter can be larger than the second outer diameter. As the syringe <NUM> is inserted through the guide sleeve <NUM>, the outer diameter of the first portion <NUM> can abut the free end <NUM> of the tab <NUM> urging the tab <NUM> outward. Once the first portion <NUM> is advanced distal to the tab <NUM>, the free end <NUM> can flex back inward towards the longitudinal axis A and towards the smaller diameter second portion <NUM> located proximal to the first portion <NUM>. The first portion <NUM> can have a proximal ledge <NUM> such that if the syringe <NUM> is withdrawn in a proximal direction, the free end <NUM> of the tab <NUM> can abut the proximal ledge <NUM> and cause the now-released guide sleeve <NUM> to withdraw along with the syringe <NUM>.

As mentioned above, an implant holder <NUM> is removably attached within at least a region of the central channel <NUM> of the shell <NUM>. The implant holder <NUM> can be positioned such that an interior <NUM> of the implant holder <NUM> is coaxial with the central channel <NUM> of the carrier member <NUM> and the guide sleeve <NUM> (see <FIG>). A proximal end <NUM> of the implant holder <NUM> can lie adjacent to the distal end of the guide sleeve <NUM> and a distal end <NUM> of the implant holder <NUM> can extend beyond the central channel <NUM> into the window <NUM>. The interior <NUM> of the implant holder <NUM> can be configured to receive at least a portion of the needle assembly <NUM> of the syringe <NUM> (see <FIG>), as will be described in more detail below.

Now with respect to <FIG>, the implant holder <NUM> includes a pair of moveable mating graspers 905a, 905b configured to releasably secure the implant <NUM> to the carrier member <NUM>. As best shown in <FIG>, the implant <NUM> can include a proximal retention structure <NUM> that can include an indentation <NUM> dimensioned to receive first protrusion 907a of a first grasper 905a and a second protrusion 907b of a second grasper 905b to hold the implant <NUM> therebetween. The protrusions 907a, 907b can be shaped in a variety of ways to engage the implant <NUM>, including lentoid, oval, elliptical, or circular structures. The protrusions 907a, 907b can include a structure similar to the shape profile or outer contour or corresponding geometry of the indentation of the implant <NUM>.

Still with respect to <FIG>, first protrusion 907a on the first grasper 905a can include a proximal surface 910a to engage a region of the distal surface 306a of the retention structure <NUM>, and the second protrusion 907b on the second grasper 905b can include a proximal surface 910b to engage another region of the distal surface 306b of the retention structure <NUM>. The first grasper 905a can be urged toward the second grasper 905b to slide the first protrusion 907a and the second protrusion 907b into the indentation <NUM> of the retention structure <NUM> such that the proximal surfaces 910a, 910b engage the distal surfaces 306a, 306b. The graspers 905a, 905b can extend substantially around a portion of the retention structure <NUM> of the implant <NUM> to hold the implant <NUM>. The septum or fill port of the implant <NUM> can be available within the interior <NUM> of the implant holder <NUM> and the body of the implant <NUM> can extend beyond the implant holder <NUM>. The implant <NUM> can be held by the implant holder <NUM> such that a longitudinal axis of the implant <NUM> is aligned substantially concentric or coaxial with the longitudinal axis A of the system <NUM>.

The syringe needle <NUM> can be inserted coaxially along the axis A of the implant <NUM> such that the needle <NUM> of the syringe <NUM> is advanced along the axis A toward the proximal end of the implant <NUM>. The needle <NUM> of the syringe <NUM> can penetrate the fill port until a needle stop <NUM> contacts the proximal surface <NUM> of the graspers <NUM> or a proximal end of the implant <NUM> preventing further penetration of the needle <NUM>. The interior <NUM> of the implant holder <NUM> as well as the guide sleeve <NUM> can further aid in aligning the syringe <NUM> and the needle <NUM> with the implant <NUM> and with the longitudinal axis A. The implant holder <NUM> can additionally incorporate an opening into the interior <NUM> such that a needle can be inserted at an angle to the longitudinal axis A.

The implant holder <NUM> can be an interchangeable element that can lock in an alternating fashion with different portions of the system <NUM>, such as the shell <NUM> of the carrier <NUM> and a portion of the handle member <NUM>. The proximal end <NUM> of the implant holder <NUM> can be reversibly coupled to a region of the shell <NUM> such as within the central channel <NUM> by a locking mechanism. The locking mechanism can be configured to unlock the implant holder <NUM> from the shell <NUM> and then lock the implant holder <NUM> onto the handle member <NUM> once the handle member <NUM> is inserted into the carrier member <NUM>, which is described in more detail below. The implant holder <NUM> can be attached to the region of the shell <NUM> and then attached to the handle member <NUM> upon release from the shell <NUM>. The locking mechanism can include an indentation <NUM> near a proximal end <NUM> of the implant holder <NUM> configured to receive a correspondingly shaped element <NUM> of the shell <NUM> (see <FIG> and also <FIG>). The indentation <NUM> can have smooth edges such that the implant holder <NUM> can be removed from the element <NUM>, as will be described in more detail below. The locking mechanism can also include a tab <NUM> formed by a u-shaped slot <NUM> located adjacent the indentation <NUM>, such as just distal to the indentation <NUM>. The tab <NUM> can include a projection <NUM> on its inner surface (see <FIG>) configured to engage with a correspondingly shaped recess <NUM> within a region of the handle member <NUM> when the handle member <NUM> is inserted through the interior <NUM> of the implant holder <NUM> as will be described in more detail below.

As mentioned above, the system <NUM> can also include the handle member <NUM>. After the syringe <NUM> is removed from the carrier <NUM> and the guide sleeve <NUM> has transferred attachment from the shell <NUM> of the carrier <NUM> to the syringe <NUM> as shown in <FIG>, the handle member <NUM> can be attached to the implant holder <NUM> holding the implant <NUM> (see <FIG> and <FIG>). The implant holder <NUM> can be interchangeably attached to the shell <NUM> of the carrier <NUM> and the handle member <NUM>. Insertion of the handle member <NUM> into the carrier member <NUM> can release the attachment of the implant holder <NUM> with the shell <NUM> and cause the attachment between the implant holder <NUM> and the handle member <NUM> such that the implant holder <NUM> can be removed from the carrier <NUM> and the handle member <NUM> can be used to insert the implant being held by the implant holder <NUM> into a patient.

The handle member <NUM> can include an elongated proximal portion <NUM> that can be grasped by a user and the distal attachment portion <NUM> that can releaseably attached to the implant <NUM> via the implant holder <NUM>. The proximal portion <NUM> of the handle member <NUM> can be sized and shaped to be grasped by a user and can have an ergonomic shape that facilitates quick and easy positioning of the implant <NUM> and release of the implant <NUM> into the patient. The distal attachment portion <NUM> of the handle member <NUM> can be inserted into the central channel <NUM> of the carrier member <NUM> after removal of the guide sleeve <NUM> from the central channel <NUM>. In this regard, the attachment portion <NUM> can removably attach, engage or otherwise mate with the implant holder <NUM> of the carrier member <NUM>, which holds the implant <NUM> (see <FIG>). Once attached to the implant holder <NUM>, the handle member <NUM> can be removed from the carrier member <NUM> such that it takes the implant holder <NUM> (and attached implant <NUM>) out of the carrier member <NUM> along with it. The handle member <NUM> can then be used to manipulate the implant <NUM> held by the implant holder <NUM> such that the implant <NUM> can be inserted into an eye. <FIG> shows handle member <NUM> after it has been removed from the carrier member <NUM> with the removable implant holder <NUM> now attached to the handle member <NUM>.

As described above and with respect to <FIG>, the proximal end <NUM> of the implant holder <NUM> can be reversibly coupled to a region of the shell <NUM> by a locking mechanism configured to unlock the implant holder <NUM> from the shell <NUM> and lock the implant holder <NUM> onto the handle member <NUM> once the handle member <NUM> is inserted into the carrier member <NUM>. The locking mechanism can include the indentation <NUM> located near a proximal end <NUM> of each grasper <NUM> and the tab <NUM> adjacent the indentation <NUM> having the projection <NUM> on its inner surface. The projection <NUM> can have a ramped proximal end and a flat lower surface <NUM>. When the implant holder <NUM> is locked to the shell <NUM>, the correspondingly-shaped element <NUM> of the shell <NUM> can rest within the indentation <NUM>. When the attachment portion <NUM> of the handle <NUM> is inserted through the implant holder <NUM>, the projection <NUM> on the inner surface of the tab <NUM> can insert within the recess <NUM> near the distal end of the attachment portion <NUM>. Distal movement of the attachment portion <NUM> along arrow D through the interior <NUM> of the implant holder <NUM> can cause the tab <NUM> to flex slightly outward as the outer surface of the distal end of the attachment portion <NUM> slides past the ramped surface of the projection <NUM> on the inner surface of the tab <NUM>. Once the projection <NUM> aligns with the recess <NUM>, the tab <NUM> can flex back inward such that the projection <NUM> snaps into the recess <NUM>. The recess <NUM> and the projection <NUM> can have corresponding shapes such that the projection <NUM> can be received at least in part within the recess <NUM>. Further distal movement of the handle <NUM> through the interior <NUM> of the implant holder <NUM> can be prevented due to contact between the distal-most end of the attachment portion <NUM> and a surface <NUM> of the interior <NUM> of the implant holder <NUM>. Thus, a region of the attachment portion <NUM> between the recess <NUM> and the distal-most end of the attachment portion <NUM> can be captured between the projection <NUM> and this surface <NUM> (see <FIG>). Proximal withdrawal of the handle <NUM> along arrow P from the central channel <NUM> of the shell <NUM> can cause a lower surface <NUM> of the projection <NUM> to abut a distal wall <NUM> of the recess <NUM> causing the implant holder <NUM> to be withdrawn with the handle <NUM> in a proximal direction along arrow P out from the central channel <NUM>.

Now with regard to <FIG>, the handle member <NUM> can have at least one deployment mechanism including an actuator <NUM>, such as a button, knob, slider, etc., that can be actuated to detach the implant <NUM> from the implant holder <NUM> and handle member <NUM>. The actuation of the actuator <NUM> can simply release the implant <NUM> or it can push or otherwise expel the implant <NUM> from the handle member <NUM>. <FIG> shows an implementation of a deployment mechanism that releases the implant <NUM> from the handle member <NUM> upon actuation of the actuator <NUM>. As described above, the implant holder <NUM> can include a pair of movable tips or graspers <NUM> that grasp the implant <NUM> such that when the handle member <NUM> is inserted within the interior <NUM> of the implant holder <NUM> the graspers <NUM> secure the implant <NUM> to the handle member <NUM>. In the initial state shown in <FIG>, the graspers <NUM> can be positioned such that they hold the implant <NUM> in a secured position relative to the handle member <NUM>. Once the actuator <NUM> is depressed, the graspers <NUM> can separate and release the implant <NUM> as shown in <FIG>. <FIG> show cross-sectional views of an implementation of the deployment mechanism. The actuator <NUM> can be pressed (or slide) so as to exert a force onto a spring held slider member <NUM>. The force of the actuator <NUM> can slide the slide member <NUM> to a position that causes the graspers <NUM> to open. The amount of force required to slide the slider member <NUM> forward and open the graspers <NUM> can be variable. The slider member <NUM> and the actuator interface at ramped connection can have different ramp angles resulting in a smoothing of the force required for the user to open the handle tips.

In an implementation, the actuator <NUM> can include an actuator element <NUM> configured to pivot around a pivot pin <NUM> when the actuator <NUM> is depressed towards an upper surface <NUM> of the handle member <NUM>. The actuator element <NUM> can also include a projection <NUM> extending from its lower surface <NUM> such that as the element <NUM> pivots around the pivot pin <NUM> the projection <NUM> is moved downwards such that the ramped surface <NUM> of the projection <NUM> slides along a ramped surface <NUM> of the slider member <NUM>. This contact between the ramped surface <NUM> of the projection <NUM> against the ramped surface <NUM> of the slider member <NUM> can cause the slider member <NUM> to move in a proximal direction against the force of the spring <NUM> compressing the spring <NUM>. The slider member <NUM> can have a forked region <NUM> near its distal end. The attachment portion <NUM> of the handle member <NUM> can interface with the forked region <NUM>. The attachment portion <NUM> can include a first arm <NUM> rotatably coupled to a second arm <NUM> around a pivot point <NUM>. The first arm <NUM> and second arm <NUM> can be biased such as by a spring or other element such that their distal ends <NUM> are urged towards one another. As described above, the distal region <NUM> of the arms <NUM>, <NUM> can extend within the interior <NUM> of the implant holder <NUM> such that the projections <NUM> of the implant holder <NUM> mate with the recesses <NUM> on the arms <NUM>, <NUM>. A region <NUM> of the arms <NUM>, <NUM> proximal of the pivot point <NUM> can interface with the forked region <NUM> of the slider member <NUM>. A first prong 1020a of the forked region <NUM> can rest against a first region <NUM> of the arm <NUM> and a second prong 1020b of the forked region <NUM> can rest against a second region <NUM> of the arm <NUM> (see <FIG>). When the slider member <NUM> is moved in a proximal direction along arrow P, the first and second prongs 1020a, 1020b can slide relative to the arms <NUM>, <NUM> such that they abut a ramped proximal end <NUM> of each respective arm <NUM>, <NUM> and cause the arms <NUM>, <NUM> to open or pivot relative to one another around pivot point <NUM>. The distal region <NUM> of the arms <NUM>, <NUM> can move away from one another in a scissor-like movement. This, in turn, can cause the distal region <NUM> of the arms <NUM>, <NUM> engaged with the projections <NUM> of the implant holder <NUM> to press against the inner surface of the implant holder <NUM> and can cause the graspers <NUM> to likewise move away from one another releasing the implant <NUM> held therebetween (see <FIG>).

The actuator element <NUM> can be arranged relative to the arms <NUM>, <NUM> of the handle member <NUM> such that as the actuator element <NUM> is pressed downwards towards the upper surface of the handle member <NUM>, the arms <NUM>, <NUM> can each move outward at an angle away from the longitudinal axis A of the system <NUM> and from one another. The arms <NUM>, <NUM> can be configured to move away from one another such that one arm moves to a first side and the opposing arm moves to a second opposite side away from the longitudinal axis A of the system <NUM>. The arms <NUM>, <NUM> also can be configured to move away from one another such that one arm moves upwards and one arm moves downwards away from the longitudinal axis A of the system <NUM>. As mentioned previously, reference herein to terms such as "upper," "lower," "upwards," "downwards," "front," "back," "proximal," "distal" etc. are used herein for orientation from one point of view of a user operating the systems described herein and are not intended to be limiting. For example, the actuator element <NUM> can be positioned on an upper surface of the handle member <NUM> from the point of view of the user such that the actuator element <NUM> is pressed using a thumb and the actuator element <NUM> moved towards the upper surface of the handle member <NUM>. The actuator element <NUM> also can be positioned on a lower surface of the handle member <NUM> from the point of view of the user such that the actuator element <NUM> is pressed using a finger and the actuator element <NUM> moved towards the lower surface of the handle member <NUM>.

One or more components of the system <NUM> can be provided as a kit. The kit can include sterile packaging within which one or more components of the system <NUM> can be contained including the carrier member <NUM> having a guide sleeve <NUM> and implant holder <NUM> attached. An implant <NUM> can be held within the implant holder <NUM> or the implant <NUM> can be contained within sterile packaging separated from the system <NUM> such that the implant <NUM> is engaged with the implant holder <NUM> after the sterile kit has been opened. The kit can further include a handle member <NUM>. The kit can further include needle assembly <NUM> configured to couple to a pre-filled syringe. Alternatively, the kit can include the syringe. The kit can further include a removal tool. In some implementations, the kit can include a carrier member <NUM> having a guide sleeve <NUM> and having an implant holder <NUM> coupled to the shell <NUM> of the carrier member <NUM>. The implant holder <NUM> can be reversibly coupled to an implant <NUM>. The implant <NUM> can be empty. In an interrelated implementation, the kit can further include a handle member <NUM> configured to engage with the implant holder <NUM> holding the implant <NUM> after the implant <NUM> has been filed with a drug. In an interrelated implementation, a syringe <NUM> can be provided that is configured to interdigitate with a portion of a carrier member <NUM> such that a needle of the syringe <NUM> can insert through a proximal portion of the implant <NUM> being held by the carrier member <NUM> to fill the implant <NUM> with a drug. The syringe <NUM> can be pre-filled with one or more therapeutic agents. The carrier member <NUM> can include a guide sleeve <NUM> configured to lock onto a portion of the syringe <NUM> upon insertion of the syringe <NUM> into the guide sleeve <NUM> of the carrier member <NUM>. The implant <NUM> can be held by an implant holder <NUM> locked onto the carrier member <NUM>, such as within the central channel <NUM>. The implant holder <NUM> holding the implant <NUM> can attach to a portion of a handle member <NUM> after removal of the syringe <NUM> from the carrier member <NUM> upon filling of the implant <NUM>. The handle member <NUM> having the implant holder <NUM> now attached to it can be used to deliver the implant <NUM> held within the implant holder <NUM> into a target location of the patient. In an interrelated implementation, the kit can include a carrier member <NUM> having a shell <NUM> and a guide sleeve <NUM>, and an implant holder <NUM> holding an implant <NUM>. The carrier member <NUM> can have a central channel <NUM> that facilitates access to the implant <NUM> being held by the implant holder <NUM>, such as for filling with a syringe <NUM>. The syringe <NUM> can be part of the kit or a separate component. The syringe <NUM> can be pre-filled with one or more therapeutic agents or can be empty. The handle member <NUM> can also be part of the kit or a separate component. The implant <NUM> can be part of the kit or a separate component. In an interrelated aspect, all of the components can be provided as a single kit or can be provided as separate components.

While this specification contains many specifics, these should not be construed as limitations on the scope of what is claimed or of what may be claimed, but rather as descriptions of features specific to particular embodiments. Only a few examples and implementations are disclosed. Variations, modifications and enhancements to the described examples and implementations and other implementations may be made based on what is disclosed.

In the descriptions above and in the claims, phrases such as "at least one of" or "one or more of' may occur followed by a conjunctive list of elements or features.

Claim 1:
An ocular implant handling and filling system (<NUM>) comprising:
a carrier member (<NUM>) comprising:
a shell (<NUM>) having a central channel (<NUM>) extending at least partially through the shell from a proximal end (<NUM>) towards a distal end (<NUM>) of the shell; and
a guide sleeve (<NUM>) removably attached within at least a first region of the central channel of the shell, the guide sleeve defining a proximal port (<NUM>) into the central channel that is accessible from the proximal end of the shell;
an implant holder (<NUM>) removably attached within at least a second region of the central channel of the shell adjacent to a distal end of the guide sleeve, the implant holder having a pair of graspers (905a, 905b) adapted to releasably secure an ocular implant (<NUM>) at a distal end (<NUM>) of the implant holder; and
a fill syringe (<NUM>) sized and shaped to be inserted through the port (<NUM>) into the central channel (<NUM>) through the guide sleeve (<NUM>).