Therapeutic shunt device and method for treating glaucoma

Abstract

Surgical methods and related medical devices for treating glaucoma are disclosed. The method comprises trabecular bypass surgery, which involve bypassing diseased trabecular meshwork with the use of a seton implant. The seton implant is used to prevent a healing process known as filling in, which has a tendency to close surgically created openings in the trabecular meshwork. The surgical method and novel implant are addressed to the trabecular meshwork, which is a major site of resistance to outflow in glaucoma. In addition to bypassing the diseased trabecular meshwork at the level of the trabecular meshwork, existing outflow pathways are also used or restored. The seton implant is positioned through the trabecular meshwork so that an inlet end of the seton implant is exposed to the anterior chamber of the eye and an outlet end is positioned into fluid collection channels at about an exterior surface of the trabecular meshwork or up to the level of aqueous veins.

1 . A method of controlling the flow of aqueous humor in a living eye having an anterior chamber, a Schlemm's canal, and an episcleral venous system, the method comprising: 
 introducing into the living eye an indwelling tubular body which leads from the anterior chamber into Schlemm's canal to provide an aqueous humor directing channel out of the anterior chamber;    wherein the tubular body is at least partially coated with a therapeutic agent; and    stabilizing the tubular body to reduce expulsion thereof from at least one of Schlemm's canal or the anterior chamber; and    conducting aqueous humor through the tubular body to reduce intraocular pressure in the living eye.    
   
   
       2 . The method of  claim 1 , wherein the tubular body comprises a V-shape.  
   
   
       3 . The method of  claim 1 , wherein the step of stabilizing the tubular body comprises anchoring the tubular body.  
   
   
       4 . The method of  claim 1 , wherein the tubular body is dimensioned to allow non-linear fluid communication.  
   
   
       5 . The method of  claim 1 , wherein the tubular body comprises an inlet section and a distal section, wherein the distal section extends at an angle between about 30 degrees to about 150 degrees with reference to the inlet section.  
   
   
       6 . The method of  claim 1 , wherein the tubular body has an outer diameter of between approximately 0.03 mm and 0.5 mm.  
   
   
       7 . The method of  claim 1 , wherein the tubular body comprises first and second portions that meet at a junction, the first and second portions being oriented transverse to each other.  
   
   
       8 . The method of  claim 7 , wherein the first portion has a first length defined from the junction to a first open end and the second portion has a second length defined between second and third open ends, with the first length being different from the second length.  
   
   
       9 . A method of controlling the flow of aqueous humor in a living eye having an anterior chamber, a Schlemm's canal, and an episcleral venous system, the method comprising: 
 introducing into the living eye an indwelling tubular body which leads from the anterior chamber into Schlemm's canal to provide an aqueous humor directing channel out of the anterior chamber;    wherein the tubular body is at least partially coated with a therapeutic agent; and    conducting aqueous humor through the tubular body to reduce intraocular pressure in the living eye.    
   
   
       10 . An ocular device comprising: 
 a solid-walled tubular body for implantation into Schlemm's canal of a living eye wherein at least a portion of the tubular device comprises a non-linear aqueous humor directing channel;    wherein said tubular body is configured and dimensioned such that implantation of said tubular body in living tissue of said canal directs dynamic flow of aqueous humor from an anterior chamber of said living eye and through said non-linear aqueous humor directing channel toward episcleral veins; and    wherein the device is at least partially coated with a therapeutic agent.    
   
   
       11 . The device of  claim 10 , wherein the device comprises a V-shape.  
   
   
       12 . The device of  claim 10 , wherein the tubular body comprises first and second elongate lumens.  
   
   
       13 . The device of  claim 10 , wherein the device comprises an inlet section and a distal section, wherein the distal section extends at an angle between about 30 degrees to about 150 degrees with reference to the inlet section.  
   
   
       14 . The device of  claim 10 , wherein said tubular body further comprises a stabilizing portion for stabilizing the tubular body in Schlemm's canal.  
   
   
       15 . The device of  claim 10 , wherein said tubular body has an outer diameter of between 0.03 mm and 0.5 mm.