Shunt and method treatment of glaucoma

Abstract

This invention provides a shunt for implantation between the anterior chamber of the eye and the epithelial-lined space through the frontal sinus bone of a patient for the treatment of glaucoma. The shunt includes a tube having a length sufficient to span the distance between the anterior chamber of the eye and the epithelial-lined space of the patient, the tube having an open anterior chamber end and a closed epithelial-lined space end, and a seal device associated with the tube between the anterior chamber and epithelial-lined space ends, for sealing a hole in the frontal sinus bone, and for anchoring the tube against movement from the frontal sinus bone. The shunt also includes a fluid pressure openable valve in the tube, located at or near the epithelial-lined space sinus end, allowing for controlled flow of aqueous humor through the tube when implanted. The invention also extends to a method of treating glaucoma in a patient by surgically implanting the shunt between the anterior chamber of the eye and the frontal sinus.

1 . A shunt for implantation between the anterior chamber of the eye and the epithelial-lined space through the frontal sinus bone of a patient for the treatment of glaucoma, comprising: 
 a tube having a length sufficient to span the distance between the anterior chamber of the eye and the epithelial-lined space of the patient, the tube having an open anterior chamber end and a closed epithelial-lined space end;    a seal device associated with the tube between the anterior chamber and epithelial-lined space ends, for sealing a hole in the frontal sinus bone, and for anchoring the tube against movement from the frontal sinus bone; and    a fluid pressure openable valve in the tube, located at or near the epithelial-lined space sinus end, allowing for controlled flow of aqueous humor through the tube when implanted.    
   
   
       2 . The shunt of  claim 1 , wherein the epithelial-lined space is the frontal sinus, and the closed end of the tube is thus the frontal sinus end.  
   
   
       3 . The shunt of  claim 2 , wherein the pressure openable valve is a longitudinal slit in the tube, and one or more ligature devices around the tube overlying or adjacent the slit such that adjustment of the one or more ligature devices adjusts fluid flow through the valve.  
   
   
       4 . The shunt of  claim 2 , wherein the shunt further comprises a reservoir located at the closed frontal sinus end of the tube, said reservoir having a side wall forming one or more apertures through which fluid can flow from the tube, and wherein the pressure openable valve is located in the reservoir.  
   
   
       5 . The shunt of  claim 4 , wherein the pressure openable valve comprises a pair of spaced apart discs connected together by a spring member, the disc facing the anterior chamber end being apertured to allow the valve to open with a predetermined fluid flow pressure from the anterior chamber end.  
   
   
       6 . The shunt of  claim 5 , wherein the pressure openable valve is a tapered nipple type valve.  
   
   
       7 . The shunt of  claim 5 , wherein the pressure openable valve is a butterfly type valve.  
   
   
       8 . The shunt of any preceding claim, wherein the seal device comprises a widened portion of the tube, or a pliable spool-shaped plug fixed to the tube and through which the tube is threaded, said plug having upper and lower pliable flanges which seal on either side of the hole in the frontal sinus bone and which prevent movement of the plug relative to the frontal sinus bone, the upper flange being anterior chamber facing and being sufficiently pliable to be slid through the hole in the frontal sinus bone.  
   
   
       9 . The shunt of any preceding claim, wherein the sealing device or plug bends the tube through an angle sufficient to prevent kinking of the tube as it is implanted between the anterior chamber and the frontal sinus.  
   
   
       10 . The shunt of  claim 8 , wherein the sealing device or plug bend the tube through an angle of between 80 and 100°.  
   
   
       11 . A method of treating glaucoma in a patient, comprising: 
 forming a hole from the exterior into the epithelial-lined space of the patient;    surgically implanting through the hole, between the anterior chamber and the epithelial-lined space, a shunt having a fluid pressure openable valve; and    draining aqueous humor from the anterior chamber through the shunt to the epithelial-lined space.    
   
   
       12 . The method of  claim 11 , wherein the epithelial-lined space is the frontal sinus, and the hole is formed in the frontal sinus bone.  
   
   
       13 . The method of  claim 12 , wherein the shunt includes a tube having an open anterior chamber end and a closed frontal sinus end, and wherein the valve is located at the frontal sinus end, allowing for controlled flow of aqueous humor through the tube when implanted.  
   
   
       14 . The method of  claim 13 , wherein the pressure openable valve is a longitudinal slit in the tube, and one or more ligature devices around the tube overlying or adjacent the slit such that adjustment of the one or more ligature devices adjusts fluid flow through the valve.  
   
   
       15 . The method of  claim 13 , wherein the shunt further comprises a reservoir located at the closed frontal sinus end of the tube, said reservoir having a side wall forming one or more apertures through which fluid can flow from the tube, and wherein the pressure openable valve is located in the reservoir.  
   
   
       16 . The method of  claim 15 , wherein the pressure openable valve comprises a pair of spaced apart discs connected together by a spring member, the disc facing the anterior chamber end being apertured to allow the valve to open with a predetermined fluid flow pressure associated with glaucoma from the anterior chamber end.  
   
   
       17 . The method of  claim 16 , wherein the pressure openable valve is a tapered nipple type valve.  
   
   
       18 . The method of  claim 16 , wherein the pressure openable valve is a butterfly type valve.  
   
   
       19 . The method of any preceding claim, wherein the shunt further comprises a seal device between the anterior chamber and frontal sinus ends of the tube, for sealing the hole in the frontal sinus bone, through which the tube is inserted, and for anchoring the tube against movement from the frontal sinus bone.  
   
   
       20 . The method of  claim 19 , wherein said seal device comprises a widened portion of the tube, or a pliable spool shaped plug fixed to the tube and through which the tube is threaded, said plug having upper and lower pliable flanges which seal on either side of the hole in the frontal sinus bone and which prevent movement of the plug relative to the frontal sinus bone, the upper flange being anterior chamber facing and being sufficiently pliable to be slid through the hole in the frontal sinus bone.  
   
   
       21 . The method of any preceding claim, wherein the sealing device or plug bends the tube through an angle sufficient to prevent kinking of the tube as it is implanted between the anterior chamber and the frontal sinus.  
   
   
       19 . The shunt of  claim 21 , wherein the sealing device or plug bend the tube through an angle of between 80 and 100°.