JP2013202088A - Implant - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an implant including a structure, wherein a carrier plate is stitched to a sclera and wherein the carrier plate and an anterior ocular chamber are connected by a discharge tube to discharge aqueous humor inside the anterior ocular chamber toward the carrier plate, implanted to an eye of a patient, and properly maintaining a discharge amount of the aqueous humor by fixing the distal end of the discharge tube inside the anterior ocular chamber in a proper attitude.SOLUTION: An implant 1 includes: a plate 2 stitched to a sclera; and a tube 3 having the distal end inserted into an anterior chamber, and discharging aqueous humor. The tube 3 includes a flange part 32, and the end face of an opening part 30 of the tube 3 is formed inclinedly to the axial direction of the tube. Thereby, the distal end of the tube 3 is certainly fixed inside the anterior chamber by the flange part 32, and the inclined opening part is hard to be closed, so that the aqueous humor can be certainly discharged.

Description

  The present invention relates to an implant.

  As is well known, glaucoma is one of the major diseases of the eye and can cause blindness, so proper treatment is essential. Glaucoma occurs when intraocular pressure continues to be abnormally high over a long period of time, and the increase in intraocular pressure is caused by impaired outflow of aqueous humor. Therefore, for glaucoma, treatment for appropriately flowing out aqueous humor is performed.

  As a method for treating glaucoma, there are drug prescriptions (eye drops and oral drugs), but there are also surgical procedures. Patent Document 1 listed below discloses an implant (graft, implant) that is transplanted into a patient's eye to drain aqueous humor from the anterior chamber (anterior chamber) to the outside of the eye.

Japanese Patent No. 3087746

  In the implant of Patent Document 1, an intraocular pressure is obtained by suturing a carrier plate to the sclera, connecting the carrier plate and the anterior chamber with a discharge tube, and discharging aqueous humor in the anterior chamber toward the carrier plate. Suppresses the abnormal rise. However, with this implant, there seems to be a problem at the tip of the drainage tube (the part inserted into the anterior chamber).

  First, the implant of Patent Document 1 does not have a structure for securely fixing the distal end portion of the discharge tube in the anterior chamber. Furthermore, it is not considered whether the distal end portion inserted into the anterior chamber is in an appropriate posture. For example, if the opening at the tip is blocked by an iris or the like, it is not desirable for proper drainage of aqueous humor.

  Moreover, in the implant of patent document 1, it considers suppressing the excessive discharge | emission of the aqueous humor which occurs in the initial stage after treatment. This is because if the aqueous humor is discharged excessively, the intraocular pressure may be abnormally reduced and damage the eyes. As a method for avoiding this problem, in Patent Document 1, the implant is transplanted in a state in which the discharge tube is closed with a suture so that the discharge cannot be performed in the initial stage after the operation.

  The suture is removed by a subsequent operation or dissolved at an appropriate time by a soluble material. However, according to the knowledge of the present inventor, it is desirable to maintain an appropriate discharge amount so that the discharge amount of the aqueous humor from the anterior chamber is not excessive, not only in the initial stage after the treatment.

  Therefore, in view of the above, the problem to be solved by the present invention is to sew a carrier plate to the sclera, connect the carrier plate and the anterior chamber with a discharge tube, and to remove aqueous humor in the anterior chamber from the carrier plate. To provide an implant that is implanted in a patient's eye with a structure for discharging to the patient's eye, the tip of the discharge tube being fixed in the anterior chamber in an appropriate posture, and maintaining the discharge of aqueous humor appropriately is there.

  In order to solve the above-mentioned problems, an implant according to the present invention is a plate shape, which is disposed between the tenon sac and the sclera of the eye in such a posture that the front and back surfaces are along the tenon sac and the sclera. A flexible plate portion, a first opening portion is opened in a part of the plate portion, and a second opening portion is opened inside the anterior chamber of the eye, A tube that discharges the aqueous humor from the second opening to the first opening, and the tube inserts the second opening from the edge region of the eye into the anterior chamber In this state, the tube portion is formed so as to protrude outward in the radial direction so as to come into contact with the surface of the edge region, and the second opening portion is fixed in the anterior chamber. The front opening formed by inclining from the axial direction of the tube portion so that the second opening portion faces away from the iris with the two opening portions fixed in the anterior chamber. The end surface of the second opening, and further comprising a. As a result, the distal end of the pipe part for discharging aqueous humor is securely fixed by the fixing part, and the aqueous humor can be discharged reliably without closing the inclined opening.

  Moreover, the said fixing | fixed part is good also as including the collar part formed by the collar shape in the direction inclined from the axial direction toward radial direction outward from the outer peripheral surface of the said pipe part. Thereby, the front-end | tip of a pipe part can be reliably fixed in an anterior chamber by a buttocks.

  The fixing portion may include a protrusion that abuts on the anterior chamber surface of the edge region. Thereby, the front-end | tip of a pipe part can be reliably fixed in an anterior chamber by a projection part.

  Further, the inner diameter of the passage formed in the axial direction of the pipe portion and through which aqueous humor flows may be a numerical value within a range of 0.2 millimeters to 0.4 millimeters. Thereby, excessive discharge of aqueous humor can always be suppressed.

  Moreover, the whole including the said collar part in the said pipe part may be integrally formed with the same material. Thereby, the whole pipe part can be created by a simple process.

  Moreover, the said hook part and the front end side rather than the collar part in the said pipe part are good also as being formed separately from the part of the board part side rather than the said collar part, and joining. Thereby, the front-end | tip of a pipe part can be created appropriately.

  Moreover, the said pipe part may be provided with the side hole part which penetrates the channel | path which the aqueous humor distribute | circulates formed in the axial direction of a pipe part, and the outer peripheral surface of the said pipe part. Thereby, even if an opening part is closed, aqueous humor can be discharged | emitted from a side hole part.

The perspective view of the implant in one Example of this invention. FIG. 2 is a plan view of the implant of FIG. 1. FIG. 3 is a cross-sectional view of the implant of FIG. 2 along AA. BB sectional drawing of the implant of FIG. The figure which shows the front-end | tip of a tube. CC sectional drawing of FIG. The figure which shows the example of the state which transplanted the implant of FIG. 1 in the eye. The figure which shows the example of the intermediate stage of transplantation.

  Embodiments of the present invention will be described below with reference to the drawings. First, FIG. 1 is a perspective view of an embodiment of the implant 1 of the present invention used for glaucoma treatment. 2 is a plan view of the implant 1, FIG. 3 is a cross-sectional view taken along the line AA, and FIG. 4 is a cross-sectional view taken along the line BB. In the following description, unless otherwise specified, the side closer to the center in the eyeball structure is referred to as the lower side, the side far from the center is referred to as the upper side, the cornea side is referred to as the front, and the opposite side is referred to as the rear.

  The implant 1 includes a plate 2 (plate portion) and a tube 3 (tube portion). Plate 2 is provided to continuously form blebs (vesicles, vesicles, vesicles) between the Tenon's capsule and the sclera. Then, the aqueous humor is discharged from the anterior chamber through the tube 3 to the bleb formed by the plate 2. After the aqueous humor is discharged into the bleb, it penetrates into the tissue of the eye from the wall around the bleb and is further discharged from the capillaries. In this way, the aqueous humor is appropriately discharged, and an abnormal increase in intraocular pressure can be avoided. Formation and maintenance of the bleb by the plate 2 is suitable for stably maintaining a sufficient discharge amount of the aqueous humor.

  Specifically, the plate 2 is inserted under the Tenon's sac in the eye and sutured to the sclera. Thus, the presence of the plate 2 continuously forms a bleb under the Tenon's capsule. The planar shape of the plate 2 may be, for example, a disk shape, an elliptical disk shape, or a square shape with curved corners.

  The area of the main surface (the surface having the largest area) of the plate 2 may be, for example, 100 square millimeters or more and 600 square millimeters or less, and may be wider as the glaucoma symptoms are more severe. The main surface of the plate 2 may have a curved shape along the surface of the eyeball, and the radius of curvature may be, for example, not less than 12 millimeters and not more than 14 millimeters. The thickness of the plate 2 may be determined within a range of 0.5 mm or more and 2 mm or less, for example.

  The plate 2 may have the curved surface shape as described above before implantation into the eye, but more preferably, the plate 2 may be formed of a material having flexibility, flexibility, or elasticity. Specifically, it is preferable to use various elastomers such as silicon elastomer. In this case, it is preferable because the curved surface shape along the surface of the eyeball as described above is naturally obtained after transplantation into the eye.

  Further, the rear end portion of the plate 2 may be subjected to a process such as a curved surface shape, a tapered shape, or a smooth surface. Such processing facilitates insertion of the plate 2 described later into the eye.

  The plate 2 includes an extending portion 20, suture holes 21 and 22, a convex portion 23, and a plurality of hole portions 24. The extending portion 20 is formed in a plate shape that extends forward from the plate 2 at a position that is forward of the plate 2 during intraocular implantation. Then, a part (the base side) of the tube 3 is placed on and joined to the upper surface side of the extending portion 20. As a result, the tube 3 is stably integrated with the plate 2.

  The suture holes 21 and 22 are formed in the extending portion 20, and the suture holes 21 and 22 and the sclera are sutured by permanent (non-dissolvable) sutures. Thereby, since the plate 2 is securely fixed to the sclera at the front portion, problems such as an obstacle to the eye movement of the patient due to the plate 2 not being properly fixed in the eye after transplantation are effectively suppressed. The

  As shown in FIG. 1 and the like, the convex portion 23 projects in a band shape on the upper surface of the plate 2. The projection 23 is formed with a hole penetrating in the horizontal direction in the figure, and the tip (root side) of the tube 3 is inserted into and fixed to the through hole (for example, bonding with an adhesive). The tube 3 is stably fixed to the plate 2 by inserting and fixing the convex portion 23 into the through-hole portion, placing it on the extending portion 20, and joining.

  As shown in FIG. 4, a plurality of holes 24 are formed so as to penetrate from one main surface of the plate 2 to the back side thereof. In the example of FIG. 1, four are formed. When a certain period of time elapses after the plate 2 is placed in the eye, living tissue in the eye grows and connects the Tenon's capsule and the sclera through the hole 24. This further restricts movement of the plate 2 within the eye. Further, the outer inner wall and inner inner wall of the bleb (in the case of FIG. 7, the upper surface and the lower surface of the bleb) are pulled by the intraocular biological tissue that connects the tenon sac and the sclera through the hole 24. And the bleb is prevented from becoming excessively large. By these, it is suppressed effectively that the implant 1 causes the disorder | damage | failure of eye movement. The number and positions of the holes 24 are not limited to the example in FIG. 1 and the like, and may be any number and position.

  The tube 3 has a tube shape having two openings 30 and 31. The tube 3 may be formed of a material having flexibility, flexibility, or elasticity, such as rubber, various elastomer resins, or a resin material having elasticity. One opening 30 of the tube 3 is inserted into the anterior chamber from which aqueous humor is drained. The other opening 31 of the tube 3 is inserted and fixed in the through-hole portion of the convex portion 23 of the plate 2 as described above, and discharges aqueous humor to the vicinity (bleb) of the plate 2.

  As a main feature of the implant 1 of the present invention, the vicinity of the opening 30 of the tube 3 has a unique structure. FIG. 5 is a perspective view of the vicinity of the opening 30 (the tip of the tube 3), and FIG.

  As shown in these figures, a flange 32, a protrusion 33, and a side hole 34 are provided in the vicinity of the opening 30. The flange portion 32 is formed on the outer peripheral surface of the tube 3 as a flange shape inclined in an oblique direction. As will be described later, the inclination direction and the inclination angle of the collar portion 32 are determined in accordance with the angle of the edge region with respect to the iris or the like. As a result, the axis (long axis) direction of the tube 3 is maintained substantially parallel to the iris with the opening 30 inserted into the anterior chamber.

  The protrusion 33 is formed in a shape that protrudes in one direction from the outer peripheral surface of the tube 3. The projecting portion 33 is formed at a position where the collar portion 32 abuts on the eye inner side (anterior chamber side) surface of the edge region in a state where the collar portion 32 abuts on the eye outer surface of the edge region. The protrusion 33 is formed so as to have flexibility. When the opening 30 is inserted into the anterior chamber, the protrusion 33 is folded, and after the insertion, the protrusion 33 may be opened outward. Thereby, an edge area | region becomes a form clamped by the collar part 32 and the projection part 33, and the position of the tube 3 is fixed reliably.

  The protrusion 33 may be formed of, for example, a shape memory alloy. In that case, when the tip of the tube 3 is inserted, it is inserted as a shape along the axial direction of the tube 3, and when the protrusion 33 is inserted into the anterior chamber, it is opened outward by the temperature in the eye. And after forming the projection part 33 separately, for example with a shape memory alloy etc., it may insert in the recessed part formed in the side surface of the tube 3, and should just adhere | attach with some adhesives, for example. A plurality of protrusions 33 may be formed. In that case, the protrusions 33 may be formed at intervals in the circumferential direction on the outer peripheral surface of the tube 3.

  The side hole 34 is formed on the side of the tube 3 and penetrates through the outside of the tube 3 and a drainage passage 35 that is a passage through which aqueous humor flows. The side hole 34 is formed to discharge aqueous humor even when the opening 30 is closed. The number and position of the side holes 34 are not limited to the example in FIG. 5 and the like, and may be any number or position.

  As shown in FIG. 5 and the like, the end surface of the opening 30 may be formed so as to be inclined with respect to the axial direction of the tube 3 (that is, neither parallel nor orthogonal to the axial direction). The inclination direction may be an inclination direction in which the opening 30 faces the opposite side to the iris in a state where the position of the tube 3 is fixed by the flange portion 32 and the projection portion 33.

  Therefore, the inclination direction of the opening 30 is opposite to the inclination direction of the flange 32 (that is, in FIG. 6, the end surface of the opening 30 is inclined rightward in the figure with respect to the axis perpendicular to the axis, and the flange 32 is leftward in the figure). Incline). Thereby, since the possibility that the iris blocks the opening 30 is reduced, it is suitable for the drainage of the aqueous humor.

  For example, the flange portion 32 and the protrusion portion 33 may be integrally formed of the same material as the tube 3 (that is, the entire tube 3 including the flange portion 32 and the protrusion portion 33 may be integrally formed of the same material. ). In that case, what is necessary is just to design appropriately, such as making the collar part 32 and the projection part 33 thicker than the thickness of the tube 3 main body so that it may have required intensity | strength.

  Alternatively, the portion of the tube 3 that is on the tip side of the flange portion 32 (including the flange portion 32) is formed of another member (for example, a material having a higher hardness than other portions of the tube 3, such as metal or a harder resin). May be. Then, the tube 3 is prepared separately, and the tube 3 may be inserted (inserted) into the distal end portion (for example, with an adhesive or the like) and bonded. In this case, the portion other than the distal end portion of the tube 3 is flexible so that it is suitable for implantation into the eye, and since the distal end portion is hard (not flexible), it is securely fixed in the anterior chamber.

  The shape of the tip of the opening 30 of the tube 3 is a sharp shape, and when inserting into the anterior chamber, the tip of the tube 3 is inserted into the edge region without first inserting a hole with another instrument and inserting it. You can do it. This simplifies the surgical process.

  As a main feature of the tube 3 of the present invention, the cross-sectional area of the drainage passage 35 is a suitable cross-sectional area for an appropriate amount of aqueous humor discharge. Specifically, the cross section of the drainage passage 35 has a diameter of, for example, 0.3 mm (or within a predetermined range thereof, for example, 0.25 mm to 0.35 mm, or 0.2 mm to 0.4 mm). ). In this case, the cross section of the tube 3 has, for example, a circle having a diameter of 0.5 millimeters (or within a plus or minus range thereof, for example, 0.45 millimeters to 0.55 millimeters, or 0.4 millimeters to 0.6 millimeters). The shape may be used.

  By designing the drainage passage 35 to have a small cross-sectional area in this way, aqueous humor is discharged through the drainage passage 35 only when the intraocular pressure (pressure in the anterior chamber) exceeds a predetermined value (for example, 5 mmHg). The Therefore, excessive discharge of aqueous humor can be suppressed at all times, and an appropriate discharge amount can be maintained. This effect, combined with the effect of bleb formation by the plate 2, always ensures a sufficient amount of aqueous humor to avoid an abnormal increase in intraocular pressure, and can always avoid excessive discharge. This produces a remarkable effect that has never been seen before.

  As described above, the inner diameter of the drainage passage 35 may be designed only near the tip of the tube 3 (near the opening 30 and on the tip side of the flange 32). In that case, what is necessary is just to make the other part (opening 31 side) of the tube 3 a larger internal diameter. Alternatively, the drainage passage of the entire tube 3 may have a small inner diameter as described above.

  As described above, when the tip part (including the collar part 32) is formed as a separate member rather than the collar part 32, the drainage passage at the tip part rather than the collar part 32 has an inner diameter (0.3 mm) as described above. Alternatively, the tube 3 is formed to have a larger inner diameter within a predetermined range, for example, 0.25 mm to 0.35 mm, or 0.2 mm to 0.4 mm. What is necessary is just to join. That is, the inner diameter of the drainage passage on the distal end side of the flange and the flange is 0.25 mm or more and 0.35 mm or less (or 0.2 mm or more and 0.4 mm or less), and the plate is more than the flange. The inner diameter of the drainage passage on the part side may be larger than the inner diameter of the drainage passage on the tip side.

  Alternatively, the drainage passage at the tip of the flange 32 and the drainage passage of another tube 3 have the same inner diameter (the inner diameter of 0.3 mm, or its plus or minus predetermined range, for example, 0.25 mm or more 0 .35 millimeters or less, or 0.2 millimeters or more and 0.4 millimeters or less). That is, the inner diameter of the entire drainage passage of the pipe part may be 0.25 mm or more and 0.35 mm or less (or 0.2 mm or more and 0.4 mm or less).

  An example of a state in which the implant 1 is implanted in the eye is shown in FIG. FIG. 7 is a cross-sectional view parallel to the visual axis direction. In the example of FIG. 7, the plate 2 of the implant 1 is inserted between the sclera 107 and the tenon sac 108. Since the plate 2 has flexibility (flexibility, elasticity), the shape of the plate 2 is flexibly deformed so that the surface of the plate 2 is in surface contact with the curved surface shape of the sclera 107.

  Due to the presence of the plate 2, a bleb 111 (bleb) is formed around the plate 2 as a reaction of the human body. As the plate 2 continues to exist, the bleb 111 continues to be formed. As a result, the plate 2 is floated in the bleb 111. However, the plate 2 is sutured to the sclera 107 with sutures using the suture holes 21 and 22. Thereby, since the plate 2 is fixed to the sclera 107 by the front part (extension part 20), problems such as obstruction of the patient's eye movement due to the plate 2 not being fixed are avoided.

  After the tube 3 of the implant 1 penetrates the tenon sac 108, for example, the distal end (opening 30) is inserted into the anterior chamber 110 from the edge region 109 (limbus) that is adjacent to the cornea 106 in the sclera 107. The The tube 3 may be inserted up to a position where the collar portion 32 is in contact with the outer surface of the edge region 109.

  At this time, the entire collar portion 32 may be in surface contact with the edge region 109. Due to the inclination of the buttocks 32 from the axial direction of the tube 3, the insertion direction of the tube 3 into the anterior chamber 110 is substantially parallel to the iris 103. The inclination angle of the collar portion 32 is designed to satisfy this condition.

  The protrusion 33 is in a folded state (along the axial direction of the tube 3) at the time of insertion, and opens outward after being inserted into the anterior chamber 110. As a result, the tip of the projection 33 abuts against the anterior chamber side surface of the edge region 109. In this way, the flange portion 32 and the projection portion 33 sandwich the edge region 109 from both sides, and the position of the tube 3 is securely fixed. Due to the inclination of the opening 30 from the axial direction of the tube 3, the end surface of the opening 30 faces in the opposite direction to the iris 103.

  As is well known, aqueous humor is generated by the ciliary body 102 and circulates through the pupil to the anterior chamber 110 of the eye in front of the lens 101 to provide nutrition. In a normal eye, aqueous humor is discharged out of the eyeball through the trabecular meshwork 104 and Schlemm's canal 105. However, in glaucoma patients, for example, clogging of the trabecular meshwork 104 prevents proper drainage of the aqueous humor and increases intraocular pressure beyond the normal range. When the intraocular pressure rises abnormally, for example, the optic nerve is damaged by the pressure, and the visual field and visual acuity are impaired.

  When the implant 1 of the present invention is implanted, the bleb 111 is formed at the latest several months after the implantation. The aqueous humor in the anterior chamber 110 is discharged from the opening 30 in the anterior chamber 110 toward the other opening 31. The aqueous humor penetrates into the living tissue from the periphery of the bleb 111 after being discharged from the opening 31 into the bleb 111. In this way, aqueous humor is discharged from the anterior chamber out of the eye, and an abnormal increase in intraocular pressure is suppressed.

  The implantation procedure of the implant 1 is, for example, as follows. FIG. 8 shows an example of an intermediate stage of transplantation surgery. In the implantation procedure of the implant 1, for example, an incision 150 is made in the Tenon sac 108 near the edge region 109. The plate 2 is inserted through the incision 150 toward the back of the eye from the incision 150. The insertion position may be between the tenon sac 108 and the sclera 107.

  In this insertion, the plate 2 can be inserted between the tenon sac 108 and the sclera 107 smoothly because the shape of the tip (back side in the eye) of the plate 2 is a curved shape, a tapered shape, or a smooth process. . Thereafter, the tube 3 is inserted into the anterior chamber 110 from the edge region 109 as described above, for example. The tube 3 exposed between the tenon sac 108 and the cornea 106 may be covered with the sclera graft 10 and sutured to the sclera 107, for example. The suturing step with the scleral graft 10 may be omitted.

  Immediately after the implantation of the implant 1, if an excessive amount of aqueous humor is discharged through the tube 3 before the bleb 111 is formed around the plate 2, an abnormal drop in intraocular pressure is caused. May cause eye damage. In the implant 1 according to the invention, such a possibility is appropriately avoided by the structure of the tube 3.

  That is, since the cross-sectional area (or inner diameter) of the drainage passage 35 of the tube 3 is designed to suppress drainage of a predetermined amount or more as described above, excessive drainage is suppressed even immediately after transplantation. Thereafter, after the bleb 111 is formed, the aqueous humor is stably discharged within a predetermined amount of drainage. In the implant 1 of the present invention, the flow direction of the aqueous humor is not limited to one direction from the anterior chamber to the bleb. Distribution in both directions from the anterior chamber to the bleb and from the bleb to the anterior chamber is allowed. Thus, even if the flow from the bleb to the anterior chamber is forced for some reason (such as pressure on the bleb side), the implant 1 appropriately copes with it.

  Furthermore, additional means may be employed to maintain the drainage immediately after transplantation. As an example of a specific method, a soluble plug member may be packed in the drainage passage 35 of the tube 3 at the time of transplantation. The soluble plug member may be formed of a material that is soluble in aqueous humor or other in-vivo moisture. The plug member functions as a plug immediately after the operation and suppresses the discharge of aqueous humor, but the function of the plug decreases by gradually dissolving after the operation, and the discharge of aqueous humor increases. . Thereby, the excessive amount of drainage immediately after transplanting is appropriately suppressed.

  The above embodiment is merely an example, and may be arbitrarily changed within the scope of the gist of the claims. For example, the form which abbreviate | omits one of the collar part 32 and the projection part 33 may be sufficient. In this case, the structure can be simplified. Further, the shape of the flange portion 32 is not limited to the shape formed over the entire circumference, and may be formed only in a part in the circumferential direction.

1 Implant 2 Plate (plate part)
3 Tube (pipe part)
32 buttock (fixed part)
33 Protruding part (fixing part)

In order to solve the above-mentioned problems, an implant according to the present invention is a plate shape, which is disposed between the tenon sac and the sclera of the eye in such a posture that the front and back surfaces are along the tenon sac and the sclera. A flexible plate portion, a first opening portion is opened in a part of the plate portion, and a second opening portion is opened inside the anterior chamber of the eye, A tube that discharges the aqueous humor from the second opening to the first opening, and the tube inserts the second opening from the edge region of the eye into the anterior chamber In this state, the tube portion is formed so as to protrude outward in the radial direction so as to come into contact with the surface of the edge region, and the second opening portion is fixed in the anterior chamber. The front opening formed by inclining from the axial direction of the tube portion so that the second opening portion faces away from the iris with the two opening portions fixed in the anterior chamber. The end surface of the second opening, wherein the fixing part comprises a flange portion formed in a direction inclined from the axial direction in a flange shape toward the outer circumferential surface outward in the radial direction of the pipe section Features. As a result, the distal end of the pipe part for discharging aqueous humor is securely fixed by the fixing part, and the aqueous humor can be discharged reliably without closing the inclined opening.

Claims (7)

Between the tenon sac and the sclera of the eye, a plate part that is flexible and has a plate shape that is arranged in such a posture that the front and back surfaces are along the tenon sac and the sclera,
The first opening is opened in a part of the plate portion, and the second opening is arranged in the interior of the anterior chamber of the eye so that the aqueous humor in the anterior chamber can be passed through the second opening. And a pipe part that discharges from the first opening to the first opening,
The pipe part is
The second opening is formed so as to protrude radially outward of the tube portion so as to contact the surface of the edge region when the second opening is inserted into the anterior chamber from the edge region of the eye. A fixing part for fixing the part in the anterior chamber;
The second portion is formed by inclining from the axial direction of the tube portion so that the second opening portion faces away from the iris in a state where the fixing portion fixes the second opening portion in the anterior chamber. The end face of the opening,
An implant comprising:   The implant according to claim 1, wherein the fixing portion includes a heel portion formed in a heel shape in a direction inclined from the axial direction toward a radially outward direction from an outer peripheral surface of the tube portion.   The implant according to claim 1, wherein the fixing portion includes a protrusion that abuts on the anterior chamber side surface of the edge region.   The implant according to any one of claims 1 to 3, wherein an inner diameter of a passage formed in the axial direction of the tube portion and through which aqueous humor flows is a numerical value within a range of 0.2 millimeters to 0.4 millimeters.   The implant according to any one of claims 1 to 4, wherein the entire tube portion including the collar portion is integrally formed of the same material.   The said pipe | tube part and the front end side rather than the collar part in the said pipe part are formed separately from the part of the board part side rather than the said collar part, and were joined to any one of Claims 1 thru | or 4. Implants.   The said pipe part is provided with the side hole part formed in the axial direction of a pipe part and penetrating the channel | path through which aqueous humor distribute | circulates, and the outer peripheral surface of the said pipe part. Implants.

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