Uveoscleral drainage device

• US 20060155238A1
• Filed: 03/13/2006
• Published: 07/13/2006
• Est. Priority Date: 07/19/2002
• Status: Active Grant

• Current Assignee: Yale University
• Original Assignee: Yale University
• Inventors: Shields, Milton B.
• Granted Patent: US 7,662,123 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002

Abstract

An ophthalmic shunt implantable in an eye having an elongate body and a conduit for conducting aqueous humor from an anterior chamber of the eye to the suprachoroidal space of the eye. The elongate body has a forward end and an insertion head that extends from the forward end. The insertion head defines a shearing edge suitable for cutting eye tissue engage thereby. The forward end and the insertion head of the body define a shoulder surface. The conduit has a first end defined on a portion of a top surface of the insertion head. The conduit also extends through the body from the forward end to a back end thereof. The first end of the conduit is spaced from the shearing edge and, in one example, from the shoulder of the body.

Claims

1. An ophthalmic shunt implantable in an eye, comprising:

an elongate body having a forward end, a spaced back end, and an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the body having a substantially fusiform cross-sectional shape, the forward end and the insertion head of said body further defining a shoulder surface; and

a conduit having a first end defined on a portion of the top surface of said insertion head and extending through said body from the forward end to the back end thereof, the first end being spaced from the shearing edge and the shoulder surface of said body.

2. The shunt of claim 1, wherein the elongate body has a lower surface, and wherein a portion of the insertion head is substantially co-planar to the lower surface thereof.

3. The shunt of claim 1, wherein the elongate body has an arcuate shape along at least a portion of its length that is adapted to extend along the curvature of the sclera.

4. The shunt of claim 1, wherein the elongate body has an upper surface and a spaced lower surface, and wherein at lease one planar surface constructed and arranged for grasping by a surgical tool is defined on at least a portion of at least one of the respective upper and lower surfaces of the elongate body.

5. The shunt of claim 1, wherein the elongate body has a longitudinal axis, and wherein a longitudinally extending groove constructed and arranged for grasping by a surgical tool is defined on at least a portion of an exterior surface of the elongate body.

6. The shunt of claim 5, wherein the elongate body has an upper surface and a spaced lower surface, and wherein the longitudinally extending groove is defined on at least a portion of the upper surface of the elongate body.

7. The shunt of claim 6, wherein a planar surface constructed and arranged for grasping by the surgical tool is defined on at least a portion of the lower surface of the elongate body.

8. The shunt of claim 6, wherein a second longitudinally extending groove constructed and arranged for grasping by the surgical tool is defined on at least a portion of the lower surface of the elongate body.

9. The shunt of claim 1, wherein the first end of the conduit is positioned at an acute angle with respect to the top surface of the insertion head.

10. The shunt of claim 1, wherein the elongate body is substantially rigid.

11. The shunt of claim 1, wherein the elongate body is comprised of biocompatible materials.

12. The shunt of claim 1, wherein an exterior surface of the elongate body is non-porous.

13. The shunt of claim 1, wherein the elongate body has a first elongate edge and a spaced second elongate edge, and wherein said body has at least a pair of spaced notches constructed and arranged for facilitating suturing the elongate body to eye tissue, one notch of the pair of spaced notches being defined in each respective elongate edge.

14. The shunt of claim 1, wherein the elongate body has an upper surface and a spaced lower surface, and wherein the body has at least a pair of spaced bores extending between the upper and lower surfaces of said body, the pair of spaced bores constructed and arranged for facilitating suturing the elongate body to eye tissue.

15. The shunt of claim 1, wherein the conduit comprises a wicking member constructed and arranged for regulating the flow of aqueous humor from an inlet end to an outlet end of the wicking member.

16. The shunt of claim 1, further comprising a wicking member constructed and arranged for regulating the flow of aqueous humor from an inlet end to an outlet end of the wicking member, the wicking member disposed within at least a portion of the conduit.

17. An ophthalmic shunt implantable in an eye, comprising:

a thin elongate body of a biocompatible material, the body having a forward end, a spaced back end, and a substantially fusiform cross-sectional shape, said body further comprising an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the shearing edge having a substantially arcuate shape, the forward end and the insertion head of said body further defining a shoulder surface; and

a conduit defined on a portion of the top surface of said insertion head and extending through said body from the forward end to the back end thereof, the conduit having a first end that is spaced from the shearing edge.

18. The shunt of claim 17, wherein the insertion head has a base portion having a first width, wherein the elongate body has a first elongate edge and a spaced second elongate edge, and wherein the first and second elongate edges are spaced a second width that is greater than said first width.

19. The shunt of claim 17, wherein the elongate body has a lower surface, and wherein a portion of the insertion head is substantially co-planar to the lower surface thereof.

20. The shunt of claim 17, wherein the elongate body has an arcuate shape along at least a portion of its length that is adapted to extend along the curvature of the sclera.

21. The shunt of claim 17, wherein the elongate body has an upper surface and a spaced lower surface, and wherein at least one planar surface constructed and arranged for grasping by a surgical tool is defined on at least a portion of at least one of the respective upper and lower surfaces of the elongate body.

22. The shunt of claim 17, wherein the elongate body has a longitudinal axis, and wherein a longitudinally extending groove constructed and arranged for grasping by a surgical tool is defined on at least a portion of an exterior surface of the elongate body.

23. The shunt of claim 22, wherein the elongate body has an upper surface and a spaced lower surface, and wherein the longitudinally extending groove is defined on at least a portion of the upper surface of the elongate body.

24. The shunt of claim 23, wherein a planar surface constructed and arranged for grasping by the surgical tool is defined on at least a portion of the lower surface of the elongate body.

25. The shunt of claim 23, wherein a second longitudinally extending groove is defined on at least a portion of the lower surface of the elongate body.

26. The shunt of claim 17, wherein an exterior surface of the elongate body is non-porous.

27. The shunt of claim 17, wherein the elongate body has a first elongate edge and a spaced second elongate edge, and wherein said body has at least a pair of spaced notches constructed and arranged for facilitating suturing the elongate body to eye tissue, one notch of the pair of spaced notches being defined in each respective elongate edge.

28. The shunt of claim 17, wherein the elongate body has an upper surface and a spaced lower surface, and wherein the body has at least a pair of spaced bores extending between the upper and lower surfaces of said body, the pair of spaced bores constructed and arranged for facilitating suturing the elongate body to eye tissue.

29. The shunt of claim 17, wherein the elongate body has a length of such extent to extend from proximate the anterior chamber of the eye to the suprachoroidal space.

30. The shunt of claim 17, wherein the conduit comprises a wicking member constructed and arranged for regulating the flow of aqueous humor from an inlet end to an outlet end of the wicking member.

31. The shunt of claim 17, further comprising a wicking member constructed and arranged for regulating the flow of aqueous humor from an inlet end to an outlet end of the wicking member, the wicking member disposed within at least a portion of the conduit.

32. An ophthalmic shunt implantable in an eye, comprising:

a thin elongate body of biocompatible material, the body having a longitudinal axis, a forward end, a spaced back end, and a substantially fusiform cross-sectional shape, the body further comprising an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the body defining a longitudinally extending bore, a proximal end of the bore defined in the forward end of the body, the proximal end positioned adjacent a portion of the top surface of the insertion head, the forward end and the insertion head of said body further defining a shoulder surface; and

a tube of biocompatible material, the tube having a first end and a spaced second end, at least a portion of the tube positioned within the bore of said body such that the second end of the tube is adjacent a distal end of the bore of said body and such that the first end of the tube extends through the proximal end of the bore and overlies a portion of the top surface of the insertion head, the first end of the tube being spaced from the shearing edge and the shoulder surface of said body.

33. The shunt of claim 32, wherein the shearing edge has a substantially arcuate shape.

34. An ophthalmic shunt implantable in an eye, comprising:

a thin elongate body of biocompatible material, the body having a longitudinal axis, an upper surface, a forward end, a spaced back end, and an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the upper surface of the body defining a longitudinally extending slit, the forward end and the insertion head of said body further defining a shoulder surface; and

a wicking member having an inlet end and an outlet end, the wicking member constructed and arranged for regulating the flow of aqueous humor from the inlet end to the outlet end and for positioning within at least a portion of the slit of said body and overlying a portion of the top surface of the insertion head, the inlet end of the wicking member being spaced from the shearing edge of said body.

35. The shunt of claim 34, wherein the shearing edge has a substantially arcuate shape.

36. The shunt of claim 34, wherein the body has a substantially fusiform cross-sectional shape.

37. The shunt of claim 34, wherein the elongate body has a lower surface, and wherein at least one planar surface constructed and arranged for grasping by a surgical tool is defined on at least a portion of at least one of the respective upper and lower surfaces of the elongate body.

38. The shunt of claim 37, wherein one planar surface is defined in a portion of the slit of said body.

39. The shunt of claim 34, wherein the elongate body has a longitudinal axis, and wherein a longitudinally extending groove constructed and arranged for grasping by a surgical tool is defined on at least a portion of an exterior surface of the elongate body.

40. The shunt of claim 34, wherein an exterior surface of the elongate body is non-porous.

41. The shunt of claim 34, wherein the elongate body has a first elongate edge and a spaced second elongate edge, and wherein said body has at least a pair of spaced notches constructed and arranged for facilitating suturing the elongate body to eye tissue, one notch of the pair of spaced notches being defined in each respective elongate edge.

42. The shunt of claim 34, wherein the elongate body has a lower surface, and wherein the body has at least a pair of spaced bores extending between the upper and lower surfaces of said body, the pair of spaced bores constructed and arranged for facilitating suturing the elongate body to eye tissue.

43. The shunt of claim 34, wherein the elongate body has a length of such extent to extend from proximate the anterior chamber of the eye to the suprachoroidal space.

44. A method for lowering eye pressure in an eye, comprising:

a. making a first incision in and through the conjunctiva and the sclera at a position posterior to the limbus;

b. providing a biocompatible ophthalmic shunt comprising;

i. an elongate body having a forward end, a spaced back end, and an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the forward end and the insertion head of said body defining a shoulder surface; and

ii. a conduit having a first end defined on a portion of the top surface of said insertion head and extending through said body from the forward end to the back end thereof, the first end being spaced from the shearing edge and the shoulder surface of said body,

c. grasping a portion of the elongate body of the shunt;

d. disposing the insertion head of the shunt in and through the first incision and into the supracilliary space of the eye;

e. inserting at least a portion of the shearing edge of the insertion head of the shunt into and through the anterior chamber angle and into the anterior chamber of the eye so that the first end of the conduit is in fluid communication with the anterior chamber; and

f. suturing the first incision closed.

45. The method of claim 44, further comprising suturing the implant to a portion of the sclera.

46. The method of claim 44, further comprising, prior to suturing the first incision closed, forcing the insertion head anteriorally to seat the shoulder surface of the implant adjacent an interior surface of the supraciliary space of the eye.

47. A method for treating glaucoma in an eye, comprising:

a. providing a biocompatible ophthalmic shunt comprising;

i. a thin elongate body of a biocompatible material, the body having a forward end, a spaced back end, and a substantially fusiform cross-sectional shape, said body further comprising an insertion head extending from the forward end of the elongate body, the insertion head having a top surface and defining a shearing edge constructed and arranged for cutting eye tissue engaged thereby, the shearing edge having a substantially arcuate shape, the forward end and the insertion head of said body defining a shoulder surface; and

ii. a conduit defined on a portion of the top surface of said insertion head and extending through said body from the forward end to the back end thereof, the conduit having a first end that is spaced from the shearing edge and the shoulder surface of said body,

b. inserting at least a portion of the shearing edge of the insertion head of the shunt into and through the anterior chamber angle and into the anterior chamber of the eye;

c. disposing the first end of the conduit into fluid communication with the anterior chamber of the eye;

d. disposing the back end of the elongate body of the shunt into the suprachoroidal space of the eye so that a second end of the conduit is in fluid communication with the suprachoroidal space; and

d. securing the shunt to the eye by suturing a portion of the elongate body to the eye.

48. The method of claim 47, wherein the shunt is sutured to a portion of the sclera.

49. The method of claim 47, further comprising introducing the insertion head anteriorally to seat the shoulder surface of the implant adjacent an interior surface of the supraciliary space of the eye.

50. The method of claim 47, further comprising, prior to the insertion of the insertion head into the anterior chamber making a first incision in and through the conjunctiva and the sclera at a position posterior to the limbus.