WO2006001280A1 - 房水排出インプラント用のフィルター部および当該フィルター部を備える房水排出インプラント - Google Patents
房水排出インプラント用のフィルター部および当該フィルター部を備える房水排出インプラント Download PDFInfo
- Publication number
- WO2006001280A1 WO2006001280A1 PCT/JP2005/011374 JP2005011374W WO2006001280A1 WO 2006001280 A1 WO2006001280 A1 WO 2006001280A1 JP 2005011374 W JP2005011374 W JP 2005011374W WO 2006001280 A1 WO2006001280 A1 WO 2006001280A1
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- WIPO (PCT)
- Prior art keywords
- aqueous humor
- filter
- hollow fiber
- fiber membrane
- tube
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/0008—Introducing ophthalmic products into the ocular cavity or retaining products therein
- A61F9/0017—Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00781—Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
Definitions
- Part of filter for aqueous humor drainage implant and aqueous humor drainage implant comprising the filter part
- the present invention relates to a therapeutic device for effectively draining aqueous humor from the intraocular region to the outside of the conjunctiva, which is used for the purpose of lowering intraocular pressure in diseases such as glaucoma where the intraocular pressure increases.
- aqueous humor In normal eyes, aqueous humor (aqueous humor) is produced by the ciliary body, circulates through the anterior and posterior chambers, and then passes through Schlemm's canal and trabecular meshwork with a certain aqueous humor outflow resistance. It is discharged out of the eye. Normal intraocular pressure is 21 mmHg or less.
- aqueous humor outflow disorder of Schlemm's canal and trabecularis occurs secondary due to essential or inflammation, excessive aqueous humor accumulates in the eye and intraocular pressure It is thought to increase and cause glaucoma.
- Glaucoma is a disease characterized by increased intraocular pressure and optic nerve damage caused by it, and is a disease that can cause blindness if proper treatment is not performed due to visual field loss and visual impairment.
- the only treatment target for glaucoma is to adjust the intraocular pressure.
- the treatment goal is to reduce the intraocular pressure by treatment and stop the progression of optic nerve atrophy, and for that purpose, it is necessary to promote the outflow of aqueous humor that suppresses the production of aqueous humor.
- Treatment methods are classified into conservative treatment and open treatment.
- Conservative treatment uses eye drops or internal preparations to reduce intraocular pressure, but if conservative treatment alone does not provide sufficient intraocular pressure reduction, open treatment is selected. Open therapy is intended to promote outflow of aqueous humor.
- a trabeculectomy is a representative example of the open treatment. This is because the opening to the anterior chamber is artificially created in the cornea so that the aqueous humor is drained from the anterior chamber into the subconjunctival tissue and absorbed by the subconjunctival tissue. This is a method of forming a filtration follicle.
- aqueous humor drainage implants that can be implanted in a living body have been developed.
- Aqueous humor drainage implants currently used, like trabeculectomy, drain the aqueous humor under the conjunctiva and absorb it through the subconjunctival tissue. It consists of a tube connecting the cavities and a plate placed in the subconjunctival space. That is, the aqueous humor drainage device aims to prevent the blockage of the aqueous humor drainage channel by the tube, prevent adhesion between the conjunctival sclera by the plate, and secure a space for absorbing the aqueous humor.
- aqueous humor drainage implants for glaucoma treatment
- FIG. 12 (a) and FIG. There are two main categories. One is to discharge aqueous humor under the conjunctiva to reduce intraocular pressure, and the other is to discharge aqueous humor out of the conjunctiva to reduce intraocular pressure.
- the aqueous humor drainage implant shown in Fig. 12 (a) that drains aqueous humor under the conjunctiva is attached to the surrounding subconjunctival tissue due to wound healing, and the absorption of aqueous humor is absorbed. As a result, there is a problem that effective aqueous humor discharge cannot be performed.
- the aqueous humor drainage implant shown in Fig. 12 (b) that drains aqueous humor out of the eye from outside the conjunctiva can effectively drain aqueous humor out of the eye for a long time. There is a need to prevent retrograde infection of viruses and bacteria into the eye.
- FIGS. 11 (a) and 11 (b) The structure of the aqueous humor outflow device described in Patent Document 3 is shown in FIGS. 11 (a) and 11 (b).
- the hollow fiber membrane portion 111 of the aqueous humor outflow device described in Patent Document 3 is open at the end on the side located in the anterior chamber of the eyeball, while being located outside the eyeball.
- the end portion on the side to be closed is closed by the closing means 192.
- a part of the hollow fiber membrane portion 111 is fitted with a silicone tube 112 as a reinforcing means (see FIG. 11 (a)), and the entire hollow fiber membrane portion 111 is covered.
- Patent Document 3 The aqueous humor outflow device is configured such that aqueous humor from the inside of the eyeball to the outside of the eyeball is discharged from the inside of the hollow fiber membrane portion 111 to the outside of the tube as indicated by an arrow in the figure.
- the hollow fiber membrane 111 protrudes toward the outside and is in contact with the outside on its outer surface. There is a problem that it is easy to dry.
- the configuration in which the entire hollow fiber membrane part 111 is covered with the silicone tube 112 is the same in that the hollow fiber membrane part 111 is open to the outside. Therefore, there is a problem that the hollow fiber membrane portion 111 is easily dried.
- the hollow fiber membrane portion 111 which is a part of the filter of the aqueous humor outflow device, is dried, the possibility of contamination or breakage increases. For this reason, when the hollow fiber membrane portion 111 is dried, the aqueous humor filtration performance and the ability to prevent retrograde infection are deteriorated, resulting in a problem that the effective and safe aqueous humor discharge function is impaired.
- the aqueous humor outflow device disclosed in Patent Document 3 is impaired in the aqueous humor discharge function because the porous hollow fiber membrane 111 for preventing retrograde infection is easily dried. There is a problem that it is easy.
- the present invention has been made to solve the above problems, and its purpose is to discharge aqueous humor out of the conjunctiva while preventing retrograde infection, and to reduce its intraocular pressure lowering effect. It is an object of the present invention to provide a filter portion for an aqueous humor drainage implant that can be maintained over a long period of time and an aqueous humor drainage implant including the filter portion.
- the inventors of the present invention have made extensive studies to solve the above problems, and as a result, prevent retrograde infection from the outside of the eyeball into the eyeball through a route for discharging aqueous humor out of the eyeball conjunctiva. It is possible to prevent a part of the hollow filter from being dried by providing a part of the filter for this purpose to provide a part of the hollow filter for discharging the aqueous humor from the outside of the part of the hollow filter to the inside. I found it. As a result, a part of the filter for the aqueous humor drainage implant of the present invention that can prevent retrograde infection over a long period of time and an aqueous humor drainage implant comprising the filter part have been completed.
- a part of the filter of the present invention is used in an aqueous humor discharge implant in order to solve the above-described problem, and from outside the eyeball to the inside of the eyeball through a route for discharging aqueous humor out of the eyeball conjunctiva.
- This is intended to prevent retrograde infection of the outer tube, and the inside of the outer tube connected to the above path and the aqueous humor in the outer tube are filtered from the outside of a part of the hollow filter to the inside.
- the hollow filter is provided with a part, and is equipped with a ru.
- the aqueous humor drainage implant provided with a part of the filter of the present invention filters the aqueous humor in the outer cylinder part connected to the path for guiding the aqueous humor out of the eyeball from the outer part to the inner part of the hollow filter part. Since a part of the hollow filter is covered and discharged, it is covered with aqueous humor in the outer cylinder part. As a result, it becomes possible to greatly suppress the drying of a part of the hollow filter. Therefore, it is possible to realize an effective and safe aqueous humor drainage implant capable of preventing the aqueous humor filtration performance and the ability to prevent retrograde infection from being reduced by drying of the hollow filter part and maintaining the aqueous humor drainage function.
- the hollow filter part of the filter part of the present invention includes a first closed part that closes an internal space of the hollow filter part and an outer space of the hollow filter part.
- a second occlusion portion is formed, and the second occlusion portion may be provided at a position on the outer side of the eyeball from the first occlusion portion in a state where the aqueous humor drainage implant is installed on the eyeball. preferable.
- the aqueous humor can pass through a part of the hollow filter between the first closed part and the second closed part.
- the aqueous humor discharge function of the aqueous humor discharge implant is controlled by changing the distance between the first closed part and the second closed part. It becomes possible.
- the gap between the hollow fiber membrane portion 111 on the anterior side of the eyeball and the silicone tube 112 is as follows. Filled with adhesive 191.
- the adhesive 191 is directly inserted into the eye. Accordingly, it is necessary to use an adhesive 191 that does not elute into the eye or that does not cause any problem even if it is eluted. Furthermore, the adhesive 191 may cause an allergic reaction by directly contacting the eye.
- the first occlusion portion is provided at a position where the aqueous humor drainage implant does not directly contact the eyeball in a state where the aqueous humor drainage implant is placed on the eyeball.
- the first occlusion portion is provided at a position where the aqueous humor drainage implant does not directly contact the eyeball in a state where the aqueous humor drainage implant is placed on the eyeball.
- the first blocking portion and the second blocking portion of a part of the filter of the present invention are formed at either end of the hollow filter portion.
- the aqueous humor can be filtered and discharged from the outside to the inside in the entire region of the hollow filter portion. That is, the aqueous humor can be filtered through substantially the entire part of the hollow filter.
- the second blocking portion may block between the outside of a part of the hollow filter and the end of the outer cylinder portion.
- a part of the filter of the present invention may include a plurality of the hollow filter parts. If a part of the hollow filter is increased, the aqueous humor drainage function is improved. Therefore, the desired aqueous humor drainage function can be imparted to the aqueous humor drainage implant by adjusting the number thereof.
- a part of the filter according to the present invention is inserted into the inside of the second hollow fiber membrane portion having an inner diameter larger than the outer diameter of the first hollow filter. It's okay. With this configuration, it is possible to increase the filtration area without increasing the outer diameter of a part of the hollow filter.
- the aqueous humor drainage implant is preferably used for glaucoma treatment.
- the present invention includes an aqueous humor drainage implant including a part of the filter described above.
- the aqueous humor drainage implant is preferably for glaucoma treatment, for example.
- the water guide tube portion constituting the path for discharging the aqueous humor of the aqueous humor drainage implant of the present invention out of the conjunctiva also includes an eyeball side water guide tube portion and an extraconjunctival water guide tube portion.
- the outer conjunctival water guide tube portion is formed by connecting the outer conjunctival eyeball side water guide tube portion and the outer conjunctival filter side water guide tube portion.
- the conjunctival outer eyeball side water guide tube portion has a bending elastic modulus at room temperature. The structure may be smaller than the bending elastic modulus at room temperature of the outer-conjunctival filter side conduit tube.
- the extraconjunctival water guiding tube portion that is particularly susceptible to eye movement absorbs the influence of the eye movement more reliably, and the invasion to the eyeball tissue accompanying the eye movement and the patient's pain In addition, it is possible to greatly prevent the deviation of the installation position of the aqueous humor drainage implant.
- the silicone tube 112 of the aqueous humor outflow device of Patent Document 3 is configured integrally as shown in FIGS. 11 (a) and 11 (b). For this reason, placing the aqueous humor outflow device in the conjunctival sac may cause conjunctival hemorrhage or a foreign object sensation during blinking.
- the bending elastic modulus of the extraconjunctival eyeball side conduit tube at room temperature is made smaller than the bending elastic modulus of the extraconjunctival filter side conduit tube at room temperature.
- the influence of the eye movement can be absorbed by the extraconjunctival eyeball side conduit tube, and can be more reliably prevented from affecting the extraconjunctival filter side conduit tube and part of the filter.
- the bending elastic modulus of a tube means a value measured and calculated at room temperature by a normal method (ASTM D790).
- the flexural modulus is small!
- the aqueous humor drainage implant of the present invention further includes a joint portion that removably connects the eyeball-side water guide tube portion and the extraconjunctival water guide tube portion. It may be a thing.
- the shape and installation method of the aqueous humor drainage implant can be adjusted to some extent with respect to individual differences between the eyeball and surrounding tissues. For example, by preparing in advance several types of the eyeball side water guide tube portion and the extraconjunctival water guide tube portion according to individual differences in the patient's eyeball and surrounding tissue, It can be a combination according to individual differences. This makes it easier to adjust the shape and installation method to some extent with respect to individual patient differences, compared to a case where the water guide tube is integrally formed.
- hollow filters are, for example, polyolefin-based, polybulal alcohol-based polymer, ethylene-butalcohol-based copolymer, polysulfone-based, polyacrylonitrile-based, cenorelose-based, cenorelose acetate-based, polymethylmethacrylate. It can be composed of hollow fiber membranes that have at least one kind of polymer or polyamide polymer material. Since such a hollow fiber membrane can be provided with a very small membrane pore diameter, retrograde infection to the virus level can be prevented by the hollow fiber membrane.
- the average membrane pore diameter of the hollow fiber membrane is preferably 0.3 ⁇ m or less, and the average membrane pore size of the hollow fiber membrane is more preferably 0.02 m or less.
- the “average membrane pore diameter” of the hollow fiber membrane is a value converted using a method used for a normal hollow fiber membrane for artificial kidney as shown in the following cited document. (Reference: Takeshi Sato et al .: Functions and indications of various blood purification methods Performance evaluation methods and functional classification of blood purifiers. “Dialysis Journal” published by the Japan Society for Dialysis Medicine, 29 (8), 1231-1245 1996).
- the hollow fiber membrane may be formed by chemically bonding a ionic group or a cationic group. This makes it possible to obtain the amount of aqueous humor required to reduce intraocular pressure while ensuring the prevention of retrograde infection up to the virus level.
- the hollow fiber membrane is electrically treated to prevent viruses.
- the ability to stop viruses can be improved compared to those that do not. That is, if the membrane pore diameter is the same, the virus-blocking ability of the hollow fiber membrane in which an anionic group or a cationic group is chemically bound by the electrical treatment is greater. For this reason, since the membrane pore diameter of the hollow fiber membrane can be increased while maintaining the desired virus prevention capability, it is possible to easily obtain the aqueous humor discharge amount necessary for reducing the intraocular pressure.
- FIG. 1 (a) is a cross-sectional view showing a schematic configuration of an aqueous humor drainage implant according to an embodiment of the present invention.
- FIG. 1 (b) is a cross-sectional view taken along the line AA ′ in FIG. 1 (a).
- FIG. 1 (c) is a cross-sectional view taken along the line BB ′ of FIG. 1 (a).
- FIG. 2 is a schematic view showing an installed state of the entire eyeball when an aqueous humor drainage implant according to an embodiment of the present invention is inserted up to the nasolacrimal duct.
- FIG. 3 is an overall view of the aqueous humor discharge implant of FIG. 2 in a state where the first half of the configuration and the second half of the configuration are divided.
- FIG. 4 is a schematic view showing an installation state of the entire eyeball when an aqueous humor drainage implant according to an embodiment of the present invention is installed on the conjunctiva.
- FIG. 5 (a) is a diagram illustrating a mechanism in which a conventional aqueous humor drainage implant hollow fiber membrane part dries due to deformation of the outer cylinder part.
- FIG. 5 (b) and FIG. 5 (a) are diagrams for explaining a mechanism in which the conventional aqueous humor drainage implant hollow fiber membrane part dries due to deformation of the outer cylinder part.
- FIG. 5 (c) are diagrams for explaining a mechanism in which the conventional aqueous humor drainage implant hollow fiber membrane part dries due to deformation of the outer cylinder part. .
- FIG. 6 (a) is a diagram for explaining that the hollow fiber membrane portion of the aqueous humor drainage implant according to the present embodiment is prevented from drying due to deformation of the outer tube portion.
- FIG. 6 (b) is a diagram for explaining that the hollow fiber membrane portion of the aqueous humor drainage implant of the present embodiment is prevented from drying due to deformation of the outer tube portion. .
- FIG. 6 (c) Together with FIG. 6 (a) and FIG. 6 (b), the hollow fiber membrane part of the aqueous humor drainage implant of this embodiment is suppressed from drying due to deformation of the outer cylinder part.
- FIG. FIG. 7 is a cross-sectional view showing a schematic configuration of a part of a filter in which two hollow fiber membrane portions are provided in an outer cylinder portion, which constitutes an aqueous humor drainage implant as another embodiment of the present invention.
- FIG. 8 is a cross-sectional view showing a schematic configuration of a part of a filter provided with a bundle of two hollow fiber membrane portions in an outer tube portion, which constitutes an aqueous humor drainage implant as another embodiment of the present invention. .
- a filter structure having a multiple structure by inserting a hollow fiber membrane portion having a small diameter, which constitutes an aqueous humor drainage implant according to another embodiment of the present invention, inside a hollow fiber membrane portion having a large diameter. It is sectional drawing which shows schematic structure of a part.
- a hollow fiber membrane part having a small diameter constituting an aqueous humor drainage implant according to another embodiment of the present invention is inserted into a hollow fiber membrane part having a large diameter, thereby forming a multiple structure.
- 2 is a cross-sectional view showing a schematic configuration of a part of the filter.
- FIG. 10 (b) is a cross-sectional view taken along the line CC ′ of FIG. 10 (a).
- ⁇ 11 (a)] is a cross-sectional view showing a schematic configuration of a conventional aqueous humor outflow tool.
- FIG. 11 (b) is a cross-sectional view showing a schematic configuration of another conventional aqueous humor outflow tool.
- ⁇ 12 (a)] is a schematic diagram showing a state in which a conventional aqueous humor drainage implant for glaucoma treatment is arranged in a different aqueous humor discharge route, and shows a case where aqueous humor is discharged under the conjunctiva.
- ⁇ 12 (b)] is a schematic diagram showing a state in which a conventional aqueous humor drainage implant for treating glaucoma is arranged in a different aqueous humor discharge route, and shows a case where aqueous humor is discharged out of the conjunctiva.
- Second tube (conducting tube, extraconjunctival conduit, extraconjunctival eye tube, tube)
- Blocking part (first blocking part, second blocking part)
- aqueous humor drainage implant of the present invention One embodiment of the aqueous humor drainage implant of the present invention will be described below with reference to FIGS. 1 (a) to 6 (c). A part of the filter according to the present invention is provided in the aqueous humor drainage implant. Therefore, it will be described together with the aqueous humor drainage implant.
- FIGS. 1 (a) to 1 (c) are cross-sectional views showing a schematic configuration of the filter unit 9 provided in the aqueous humor drainage implant of the present embodiment.
- a hollow fiber membrane part (hollow filter) 11 is provided in the outer cylinder part 12.
- the inside of the inner eye end of the hollow fiber membrane portion 11 is closed by a closing portion (first closing portion) 91.
- the outer eye end of the hollow fiber membrane part 11 is open, and the space between the outer side of the outer eye end and the inner side of the outer tube part 12 is closed by a closing part (second closing part) 92. Yes.
- the aqueous humor in which the outer force of the hollow fiber membrane portion 11 is also filtered inward can be guided to the outside of the eyeball and discharged. That is, as indicated by an arrow in FIG. 1 (a), filtration is performed inside the outer force of the hollow fiber membrane portion 11, and the aqueous humor in the outer tube portion 12 can be discharged out of the eyeball.
- Fig. 1 (b) is a cross-sectional view taken along the line AA 'in Fig. 1 (a). As shown in Fig. 1 (b), around the outer surface of the hollow fiber membrane portion 11, the inside of the outer tube portion 12 is shown. Since the aqueous humor is filled with the aqueous humor, the hollow fiber membrane portion 11 can be prevented from drying. Accordingly, it is possible to prevent the filtration function of the filter part 9 from being deteriorated or broken due to the drying of the hollow fiber membrane part 11.
- FIG. 1 (c) is a cross-sectional view taken along the line BB ′ of FIG. 1 (a), and shows a state where the filter part 9 is viewed from the side from which aqueous humor is discharged.
- the closing portion 91 in the figure is located on the far side of the drawing by the length of the hollow fiber membrane portion 11 and is closer to the drawing than the closing portion 92, and the hollow fiber membrane portion 11 between the closing portion 91 and the closing portion 92 is located.
- the aqueous humor from which the water is filtered is discharged from the open end of the hollow fiber membrane portion 11 where the closed portion 92 is formed on the outer side.
- the blocking portion 91 and the blocking portion 92 that block the hollow fiber membrane portion 11 may be any one that blocks the internal space of the hollow fiber membrane portion 11 and the outer space to stop the flow of aqueous humor in the space.
- it can be formed using known means.
- the closed portion 91 and the closed portion 92 can be formed by a closing method using a polyurethane adhesive or a closing method by heat welding. In this respect, the same applies to a blocking portion 93 (FIGS. 7, 8, 10A and 10B) described later.
- the overall configuration of the aqueous humor drainage implant including the filter part 9 will be described below with reference to Figs.
- FIG. 2 is a schematic diagram showing an installation state of the entire eyeball when the aqueous humor drainage implant according to one embodiment of the present invention is inserted up to the nasolacrimal duct.
- FIG. 3 is an overall view showing a state in which the first half and the second half of the configuration of the aqueous humor drainage implant of FIG. 2 are divided.
- the aqueous humor drainage implant 1 of the present embodiment is mainly composed of three parts, a first tube (water guide tube part 'eyeball side water guide tube part) 3, and a first It is composed of a joint (joint part) 5, a second joint (joint part) 6, and a rear half part 10 of the construction.
- first joint 5 and the second joint 6 will be collectively referred to as “joints 5 ⁇ 6” unless otherwise distinguished.
- the aqueous humor drainage implant 1 connects the anterior chamber of the eyeball and the outside of the conjunctiva 14 and is the first half of the configuration that is installed along the scleral wall under the conjunctiva 14.
- the joints 5 and 6 connecting the first tube 3 as the first half of the configuration and the second half 10 of the configuration.
- Fig. 2 shows the force when the latter half 10 is placed in either the lacrimal sac 24 or the nasolacrimal duct 25.
- the latter half 10 is placed on the conjunctiva 14. It is also possible to do.
- the conjunctiva 14 is used in the meaning including the eyeball conjunctiva, the conjunctival cap, and the eyelid conjunctiva.
- the latter half of the configuration 10 includes a second tube (water guide tube portion, extraconjunctival water guide tube portion, extraconjunctival eyeball side water guide tube portion) 7, and a third tube (water guide tube portion, extraconjunctival water guide tube).
- the first tube 3, the second tube 7, and the third tube 8 correspond to the water guide tube portion of the present invention
- the filter portion 9 corresponds to the filter portion of the present invention.
- the joints 5 and 6 correspond to the joint part of the present invention
- the second tube 7 and the third tube 8 correspond to the conjunctival outer conduit tube part.
- the second tube 7 and the third tube 8 correspond to an outer conjunctival eyeball side conduit tube portion and an outer conjunctival filter side conduit tube portion, respectively.
- the aqueous humor passes through the first tube 3 of the anterior chamber force of the eyeball and the joint 5 ⁇ 6 Led to. Then, at the joints 5 and 6, the aqueous humor comes out of the conjunctiva 14, and then consists of the upper lacrimal tubule 22 (or lower lacrimal tubule 23), lacrimal sac 24, and nasolacrimal duct 25 through the latter half 10. Will be discharged.
- the aqueous humor drained from the aqueous humor drainage implant 1 passes into the nasal cavity (not shown) connected to the nasolacrimal duct 25 and nasolacrimal duct 25 via the upper lacrimal canal 22 (or lower lacrimal tubule 23) and lacrimal sac 24. Absorbed.
- FIG. 2 shows a case where aqueous humor is absorbed in the nasal cavity via the latter half 10 of the configuration, but is discharged onto the conjunctiva 14 via the latter half 10 of the configuration as will be described later. It can also be configured. In this case, the discharged aqueous humor is absorbed by the conjunctival 14 tissue.
- the first tube 3 which is the first half of the configuration, has an inner diameter of 0.5 mm, an outer diameter of 1. Omm, and a length of 10 mm.
- One silicone tube force is also configured and connected to the joint 5 at the conjunctival outer stump 4.
- This first tube 3 is placed along the scleral wall under the conjunctiva 14 by surgery.
- the inner anterior chamber stump 2 of the first tube 3 is attached to the anterior chamber of the eyeball.
- the conjunctival outer stump 4 and the joint 5 are placed outside the conjunctiva 14 at the inner eye corner 26.
- the conjunctiva 14 and the subconjunctival tissue are incised in a valve shape to expose the sclera 16. At this time, stop bleeding if necessary. Then, the conjunctival outer stump 4 of the first tube 3 of the aqueous humor drainage implant 1 is sutured and fixed to the scleral wall of the inner eye corner 26. Next, the anterior chamber inner stump 2 of the first tube 3 of the aqueous humor discharge plant 1 is passed through the sclera 16 using a known method, and placed between the iris 17 and the cornea 15 into the anterior chamber.
- the first tube 3 is appropriately sewn and fixed to the scleral wall so that it can be installed in the shape shown in FIG. Then, the conjunctiva 14 is returned to its original position, and the incision is closed with sutures.
- the conjunctiva around the conjunctival outer stump 4 of the first tube 3 is exposed so that the first joint 5 connected to the conjunctival outer stump 4 of the first tube 3 is exposed outside the conjunctiva 14. 14 is closed using a known method such as a purse string suture or a bioadhesive.
- the aqueous humor can be guided out of the conjunctiva 14 from the anterior chamber via the first tube 3 and the joint 5. .
- the first tube 3 is placed in a living tissue such as the anterior chamber, the conjunctiva 14 and the sclera 16.
- the material of the first tube 3 has moderate flexibility and high biocompatibility, and any material can be used as long as it is a material.
- Specific examples of the first tube 3 include polyolefin resin, polyurethane resin, polybutadiene, polybutadiene such as silicone resin, polyethylene, polypropylene, polyisobutylene, ethylene acetate butyl copolymer, polynorbornene, etc.
- Various polymer materials such as synthetic rubbers such as isoprene, SBR (Styrene Butadiene Rubber) and SIR, and natural rubber can be mentioned. And from the point of use results and reliability, among the materials exemplified above, silicone-based resin and polyurethane-based resin are preferably used.
- the outer diameter of the first tube 3 is substantially the same as the outer diameter of the latter half 10 of the configuration to be subsequently connected.
- the outer diameter of the first tube 3 is generally about 0.5 to 1.5 mm, although there are individual differences. That is, the appropriate outer diameter of the first tube 3 differs depending on the patient to which the aqueous humor drainage implant 1 is to be installed, but is generally in the range of about 0.5 to 1.5 mm.
- the length of the first tube 3 is generally about 5 to 20 mm depending on the position at which the anterior chamber inner stump 2 is inserted into the anterior chamber.
- the first tube 3 is fixed along the scleral wall.
- a structure using any known technique may be installed in the first tube 3 as long as it achieves the purpose of facilitating the fixing operation.
- the structure using such a known technique there is a protrusion-like structure provided on the outer surface of the first tube 3.
- the conjunctival outer stump 4 of the first tube 3 is connected to the first joint 5, but the conjunctival outer stump 4 and the first joint 5 are fixed together in advance. It is desirable to leave. This further simplifies the surgical procedure and more reliably prevents infection of the connection force.
- the latter half 10 of the configuration of the aqueous humor drainage implant 1 of the present embodiment is composed of three partial caps. That is, the rear half 10 of the configuration includes three tubes, a second tube 7 connected to the second joint 6, a filter part 9, and a third tube 8 that connects the second tube 7 and the filter part 9. Partial force is also constructed. And this configuration By defining the shape and structure of the latter half 10 as described below, the latter half 10 is made minimally invasive on any of the upper lacrimal tubule 22, lower lacrimal tubule 23, lacrimal sac 24, nasolacrimal duct 25, and conjunctiva 14. If it can be installed, it is possible to achieve an effect that cannot be realized with a conventional aqueous humor drainage implant.
- FIG. 2 a case will be described in which the latter half 10 of the configuration is installed in one of the upper tear tubule 22, the lower tear tubule 23, the lacrimal sac 24, or the nasolacrimal duct 25.
- a small tube called a lacrimal passage through which tear fluid passes leads from the inner horn 26 to the nasal cavity (not shown).
- the lacrimal passage is a single tubular structure with a diameter of approximately lmm to l.5mm and a length of 10mm to 30mm.
- Upper punctum 20, lower punctum 21, upper lacrimal tubule 22, lower lacrimal tubule 23, lacrimal sac 24 The inner horn 26 and the nasal cavity are connected (communication).
- the aqueous humor drainage plant 1 of the present embodiment pays attention to the anatomical features of the lacrimal passage, and the latter half of the configuration 10 Can be installed in the lacrimal passage. That is, the aqueous humor drainage implant 1 of the present embodiment uses the inherent lacrimal tract while maintaining the natural structure, and discharges the aqueous humor from the anterior chamber into the nasal cavity. It is possible to realize a non-invasive installation that could not be achieved. In other words, the shape of the latter half 10 of the configuration can be inserted into the lacrimal passage in a minimally invasive manner by using a single tube shape that can be inserted into the lacrimal passage as will be described later.
- FIG. 4 is a schematic diagram showing the installation state of the entire eyeball when the aqueous humor drainage implant 1 of the present embodiment is installed on the conjunctiva. Note that members having the same functions as those in FIGS. 2 and 3 are denoted by the same reference numerals and description thereof is omitted.
- the aqueous humor drainage implant is not simply placed in the conjunctival sac and placed on the conjunctiva 14 along the curved surface of the eyeball wall. It is necessary to minimize the effects of exercise.
- the latter half 10 of the configuration is installed through the conjunctiva 14 as shown in FIG. Since it is integrated with the eyeball, it is possible to follow eye movements in all directions. In other words, it is only possible to install the latter half of the configuration 10 in the form of a single tube, so that it can be installed easily along the eyeball wall, and the obstacles to the conjunctiva 14 after installation and the feeling of foreign objects can be suppressed. In addition, an effect that it can be placed on the conjunctiva 14 in a minimally invasive manner is exhibited. In FIG. 4, the rear half 10 of the configuration is installed on the conjunctival circular lid 27 of the conjunctiva 14.
- the latter half 10 is composed of three parts, but the number of the plurality of parts constituting the latter half 10 is not limited to this.
- the shape of the rear half 10 is a single tube, and the rear half 10 is a plurality of parts, specifically the second tube 7, the third tube 8, and the filter unit. Only by dividing the three parts of the part 9 into the lower part 10 of the configuration should be placed on the upper lacrimal canal 22, the lower lacrimal canal 23, the lacrimal sac 24, the nasolacrimal duct 25, and the conjunctiva 14 in a minimally invasive manner Aqueous humor drainage implant 1 can be formed. The shape of one tube in the latter half 10 will be described in detail later.
- both the second tube 7 and the third tube 8 are silicone tubes having an inner diameter of 0.5 mm and an outer diameter of 1.0 mm.
- the rear half 10 of the configuration includes two silicone tubes.
- the length of the second tube 7 is 5 mm
- the length of the third tube 8 is 10 to 30 mm.
- the filter part 9 includes, for example, one polyethylene tube outer tube having an inner diameter of 0.8 mm, an outer diameter of 1. Omm, and a length of 10 mm, and an outer diameter of 0.7 mm and a length of 8 mm. And one hollow fiber membrane.
- the filter part 9 can be formed into a single tube shape similar to the second tube 7 and the third tube 8 by using a hollow fiber membrane as the filter.
- the shape and dimensions of the second tube 7, the third tube 8, and the filter part 9 of the latter half 10 of the configuration are the same as those of the latter half 10 of the upper tear tubule 22 and the lower tear tubule 23.
- the lacrimal sac 24 and the nasolacrimal duct 25 are designed on the basis of the anatomical basis of the lacrimal passage described above so that they can be installed with minimal invasiveness. It was devised based on the anatomical basis of the eyeball described above so that it can be placed on the conjunctiva 14 with minimal invasiveness.
- the latter half 10 of the structure is a surgical operation to either the upper lacrimal canal 22, the lower lacrimal canal 23, the lacrimal sac 24, the nasolacrimal duct 25, or the conjunctiva 14. It will be installed in such a place. As shown in FIG.
- the second tube 7 is used for the purpose of responding to eye movement as described later.
- the stump of the second tube 7 is connected to the first joint 5 by using the second joint 6. Also, as shown in FIG. 4, when the rear half 10 of the configuration is installed on the conjunctiva 14, the stump of the second tube 7 is connected to the first joint 5 using the second second joint 6. Connect and place the second half of the configuration 10 on the conjunctiva 14. 2 and 4, 18 indicates the upper eyelid 18, and 19 indicates the lower eyelid 19.
- the patient's situation is a situation in which there is nasolacrimal duct obstruction, discharged aqueous humor affects visual acuity, or a foreign body sensation due to the latter half 10 of the configuration is inevitably felt.
- a patient with nasolacrimal duct obstruction it is desirable to place the latter half 10 of the structure on the conjunctiva 14.
- the second half of the composition 10 is composed of the upper tear tubule 22, the lower tear tubule 23, and tears. It is desirable to install in either the sac 24 or the nasolacrimal duct 25.
- the second tube 7 to be subsequently installed is directly affected by the mechanical movement of the eyeball. .
- the expansion and contraction of the second tube 7 is insufficient with respect to the range of movement of the eyeball, the eye movement is restricted, which may lead to double vision, and the displacement of the placement position of the aqueous humor drainage implant 1 May occur.
- the second tube 7 is required to have particularly high stretchability, flexibility, and deformability that can sufficiently cope with eye movement. It is. That is, the material of the second tube 7 needs to be a material having high stretchability, flexibility, and deformability. Further, the second tube 7 may temporarily come into contact with the eyeball tissue mainly including the cornea depending on the movable range of the eyeball. At this time, it is important that the second tube 7 has sufficient stretchability, flexibility, and deformability in order to reliably prevent the eyeball tissue from being damaged. is there.
- the material used for the second tube 7 is required to have high flexibility and high biocompatibility that easily deforms in response to eye movement and reduces tissue invasion of the eye.
- the second tube 7 having such a condition as a part of the latter half 10 of the configuration, invasion of eyeball tissue due to eye movements, patient pain, displacement of the placement position of the aqueous humor drainage implant 1, etc. Can be greatly prevented.
- any material can be used as long as it is stretchable, flexible, deformable, highly biocompatible, and a material.
- silicone-based resin and polyurethane-based resin are preferably used.
- the outer diameter of the second tube 7 is substantially the same as that of the other first tube 3 and the third tube 8. Force due to the installation site Generally considering the expansion and contraction due to eye movement, it is 5mn! ⁇ 20mm or so. Further, it is more desirable that the second joint 6 and the second tube 7 are ones that are firmly fixed and integrally fixed. As a result, the surgical procedure can be simplified and infection of the connecting force between the two can be more reliably prevented.
- the third tube 8 should be placed in a living tissue such as the conjunctiva 14, the upper punctum 20, the lower punctum 21, the upper tubule 22, the lower tubule 23, and the lacrimal sac 24 Therefore, the material of the third tube 8 needs to be a material that has moderate flexibility and high biocompatibility. Any material can be used as the material of the third tube 8 as long as these conditions are satisfied.
- Typical examples include silicone resin, polyethylene, polypropylene, polyisobutylene, and ethylene acetate butyl.
- examples thereof include various polymer materials such as polyolefin resins such as copolymers, polyurethane resins, synthetic rubbers, and natural rubbers. Of the materials exemplified above, silicone-based resin and polyurethane-based resin are particularly preferably used.
- the outer diameter of the third tube 8 is that the tube 8 is placed in the upper lacrimal tubule 22, the lower lacrimal tubule 23, the lacrimal sac 24, and the nasolacrimal duct 25. 21 is required to be thinner than the inner diameter of the upper lacrimal tubule 22, the lower lacrimal tubule 23 and the lacrimal sac 24. These inner diameters have individual differences depending on each patient.
- the outer diameter of the third tube 8 is generally preferably about 0.5 mm to 1.5 mm.
- the length of the third tube 8 is generally 5mn, although it depends on the location of the latter half 10 of the configuration and the individual differences of patients. ⁇ About 20mm.
- Each of the second tube 7 and the third tube 8 has a bending elastic modulus at room temperature of 2000 Mpa or less, and the tissue invasion of the eyeball caused by the highly flexible eye movement and the patient's pain. The displacement of the aqueous humor drainage implant 1 can be prevented.
- the second tube 7 and the third tube 8 are composed of the same bending elastic modulus at room temperature, that is, the same flexibility. Tube of 8 More preferably, the flexural modulus at room temperature is smaller. As a result, the influence of the eye movement can be more reliably absorbed by the second tube 7.
- the installation position of the third tube 8 may be influenced by the elasticity of the second tube 7 and the behavior of the filter part 9 in the nasolacrimal duct 25.
- the latter half 10 of the structure is placed in any of the upper tear tubule 22, the lower tear tubule 23, the lacrimal sac 24, or the nasolacrimal duct 25, the situation where the upper punctum 20 or the lower punctum 21 exits.
- the third tube 8 may be pulled into the nasolacrimal duct 25 side.
- the latter half of the configuration 10 may be fixed at an appropriate position.
- the method of fixing the latter half 10 of the configuration is not particularly limited, and a conventionally known configuration can be adopted.
- the latter half 10 can be composed of the upper tear tubule 22, the lower tear tubule 23, and the lacrimal sac.
- the third tube 8 may be omitted as necessary, and the second tube 7 and the filter part 9 may be short-circuited. Is possible.
- the rear half 10 of the configuration is placed on the conjunctiva 14 as the eye moves. There is a possibility that the installation position will become unstable due to deviation from the above. Such a situation can be prevented by fixing the latter half 10 of the configuration to an appropriate position on the conjunctiva 14.
- the method for fixing the latter half of the structure 10 on the conjunctiva 14 can use a conventionally known technique and is not particularly limited. For example, a method of fixing the latter half of the structure 10 to the conjunctiva 14 can be mentioned.
- the outer diameter of the filter part 9 is placed in the upper lacrimal canal 22, the lower lacrimal canal 23, the lacrimal sac 24, and the nasolacrimal duct 25, these upper punctum 20, lower punctum 21, It is required to be thinner than the inner diameter of the upper tear tubule 22, the lower tear tubule 23, and the lacrimal sac 24.
- the inner diameter of the filter part 9 is also 0.5 mm because it is about 0.5 mm to 1.5 mm. It is desirable to be about ⁇ 1.5 mm.
- the length of the force filter part 9 with individual differences among patients is generally about 5mm to 20mm.
- the outer diameter of the filter part 9 is the outer diameter of the hollow fiber membrane part 11, and the outer cylinder part 12 In this case, the outer diameter of the filter part 9 is the outer diameter of the outer cylinder part 12.
- the hollow fiber membrane part 11 of the filter part 9 discharges aqueous humor to reduce intraocular pressure, and at the same time, viruses, bacteria, fungi, etc. existing outside the conjunctiva 14 are the first. This also prevents intrusion into the tube 3 and the rear half 10 of the structure. As a result, the intraocular pressure is reduced, and the external force of the conjunctiva 14 can be prevented from causing retrograde infection.
- the condition of the hollow fiber membrane part 11 required from the viewpoint of aqueous humor discharge is that the production rate of aqueous humor is 2.
- the range is 0 ⁇ lZmin to 3.0 ⁇ lZmin, and the target intraocular pressure is about 10.0 mmHg to 20.0 mmHg.
- This force is that the aqueous humor discharge flow rate of 2.0 / ⁇ ⁇ to 3.0 lZmin or more can be obtained in the hollow fiber membrane part 11 at a water pressure of about 10.0 mmHg to 20.0 mmHg. is there.
- the amount of aqueous humor flowing out under a constant water pressure was measured.
- the pipe installed vertically is filled with BSS Plus (Santen Pharmaceutical Co., Ltd.), a commercially available simulated aqueous humor, with a pipe lower end force of about 13 cm, and a 10 mm long hollow fiber membrane section at the lower end of the pipe. 11 was connected, and the weight of BSS plus that flowed out per unit time was measured.
- the volume of spilled BSS plus was calculated from the weight of spilled BSS plus and the specific gravity of BSS plus.
- the prototype EVAL layer is 15 weight ethylene content 32 mole 0/0, Echire down vinyl alcohol copolymer having a saponification degree 99 mol 0/0 (manufactured by Kuraray Co., EVAL EC- F100A (trade name)) Parts, dimethyl sulfoxide 73 parts by weight, water 10 parts by weight and lithium chloride 2 parts by weight were heated and dissolved at 90 ° C. with stirring to prepare a membrane forming stock solution.
- the LST (Lower Solution Temperature) of the film-forming stock solution obtained as described above was 28 ° C.
- the film-forming stock solution is a transparent homogeneous solution at a high temperature, but phase separation occurs when the temperature is lowered, and the solution becomes cloudy. When left for a long time, it separates into two layers.
- the temperature at which this phase separation begins to occur is referred to as LST in this embodiment.
- the film-forming stock solution at 40 ° C was extruded while water was fed from the center as an internal injecting agent, passed through an air layer at 15 ° C, and then introduced into a water bath. And solidified. Thereafter, the hollow fiber membrane E1, which is the above-mentioned trial eval membrane, was produced by a method of washing with water, wet heat treatment, drying and heat treatment to obtain a dry hollow fiber membrane according to a conventional method.
- the LST of the membrane-forming stock solution used to produce this hollow fiber membrane E2 was 30 ° C.
- Table 1 shows the results of the evaluation experiment of the average membrane pore diameter and outer diameter of the hollow fiber membranes El and E2 performed as described above. The amount of runoff satisfying the condition of simulated aqueous humor outflow according to the production rate of the aqueous humor was observed. As a result, it was found that the aqueous humor drainage implant 1 of the present invention is effective in draining aqueous humor so that the intraocular pressure can be kept within the normal range.
- a pressure open / close type check valve or pressure regulating valve is appropriately installed in accordance with the performance of the hollow fiber membrane section 11 to be used. It may be incorporated into the joint 6 of the 2 or the latter half 10 of the configuration.
- the pressure open / close check valve opens and closes in order to maintain the intraocular pressure within the normal intraocular pressure range of about 7 mmHg to 20 mmHg.
- Any known technology may be used for the pressure open / close check valve as long as it achieves this purpose.
- a slit check valve used for Krupin-Denver eye shunt
- check valves used in Ahmed glaucoma implants US Pat. No. 5,071,408, US Pat. No. 6,261,256
- the pressure check valve is a check valve, it prevents backflow of aqueous humor in situations where the nasolacrimal duct pressure suddenly rises, such as when the nose is bitten or sneezed. I can do it.
- the condition of the hollow fiber membrane of the hollow fiber membrane part 11 that is required for prevention of retrograde infection and viewpoint power is that the diameter of the virus particles is about 0.02 ⁇ m to 0.3 ⁇ m.
- the average diameter of the hollow fiber membrane is not more than 3 ⁇ m, preferably within the range of 0.0001 ⁇ m to 0.02 ⁇ m, more preferably 0.0001 ⁇ m. m to 0.01 ⁇ m. If the average membrane pore size of the hollow fiber membrane is larger than the above range, it is likely to be difficult to prevent virus particles.
- the condition of the average membrane pore diameter of the hollow fiber membrane is a condition that can be flexibly adjusted within the range in which the prevention of retrograde infection at the virus level, which is the purpose of the hollow fiber membrane portion 11, can be achieved. is there. That is, as described later, when a function of electrically blocking viruses is added to the hollow fiber membrane part 11, virus trapping is performed by reducing the average membrane pore diameter of the hollow fiber membrane, and electrical trapping. Will be performed. For this reason, the hollow fiber membrane used for the hollow fiber membrane portion 11 exhibits a function of preventing retrograde infection at the virus level even if the average membrane pore diameter is larger than the above range. If there is something that can be done, there is no problem.
- the hollow fiber membrane material used for the hollow fiber membrane portion 11 can be any material that has moderate water filtration performance and can prevent retrograde infection to the virus level.
- Polymer materials such as polyolefins, polybutyl alcohol polymers, ethylene butyl alcohol copolymers, polysulfones, polyacrylonitriles, celluloses, cellulose acetates, polymethylmethacrylates, polyamides, etc. Is mentioned.
- hollow fiber membranes are used in a wide range of forces. In the medical field, they are mainly used for artificial kidneys. Generally, the average membrane pore diameter of the hollow fiber membrane for artificial kidney is about 0.005 / ⁇ ⁇ to 0.008 / zm, and the hollow fiber of the hollow fiber membrane portion 11 constituting the aqueous humor drainage implant 1 of the present invention. It can be said that the above-mentioned conditions required for the film are satisfied. Therefore, it can be appropriately selected from the industrially produced hollow fiber membranes for artificial kidneys and used as the hollow fiber membranes constituting the present invention.
- hollow fiber membranes for artificial kidney include APS-150, AM-FP-130, AM-GP-13, AM-UP-13 (above, manufactured by Asahi Medical Co., Ltd.), Meltraxl40, Meltraxl60 (above, manufactured by Izumi Medical Co., Ltd.), FB—130U (manufactured by Nipro Co., Ltd.), BS-1.6 (manufactured by Toray Industries, Inc.), PS—1.6N (manufactured by Kawasumi Chemical Industry Co., Ltd.) (See Sesuke Takashima, “Characteristics Required for Membrane Materials”, Tari-Cal Engineering, 1997, No. 8, No. 6, p479-492). .
- the virus In addition to trapping the virus by the pore size of the hollow fiber membrane, the virus is electrically blocked in order to more reliably prevent the retrograde infection to the virus level while maintaining the above aqueous humor discharge flow rate. It is also possible to add the performance to the hollow fiber membrane part 11.
- the hollow fiber membrane portion 11 is When the ionic group is chemically bound (introduced) and negatively charged, the virus particles are electrically repelled by the negative ions present in the hollow fiber membrane and blocked from passing through the membrane.
- a cationic group is chemically bonded to the hollow fiber membrane part 11 and positively charged, the virus particles are electrically attracted and adsorbed with the positive ions present in the hollow fiber membrane. As a result, passage through the membrane is prevented.
- a protein that is one of the constituent components of a virus is an ampholyte and has a cationic group.
- electrically blocking viruses is to block the passage of virus particles through the hollow fiber membrane using the above-described electrical force.
- an electrical performance is added, and a larger membrane pore diameter (average) than that of an uncharged membrane. Even if the pore size can be blocked, the virus can be prevented!
- any method can be used as long as it can introduce an ionic group into the hollow fiber membrane of the hollow fiber membrane portion 11.
- a method of introducing an ionic group into the hollow fiber membrane part by known acid treatment, alkali treatment, oxidation treatment, light irradiation, addition reaction, graft reaction and the like.
- an ionic group such as a sulfate group, a carboxyl group, or an amino group can be easily formed by utilizing a reaction such as esterification, etherification, or micle addition.
- a reaction such as esterification, etherification, or micle addition.
- the hollow fiber membrane part 11 in order to easily install the hollow fiber membrane part 11 outside the conjunctiva 14 and increase the durability of the filter part 9, the hollow fiber membrane part 11 has an outer cylinder.
- Part 12 is established. Any material can be used as the material of the outer tube portion 12 as long as it has an appropriate hardness and high biocompatibility. Examples thereof include silicone-based resin, polyethylene resin, and the like.
- High-grade resins such as polyethylene-based resins, polypropylene-based resins, polybulal alcohol-based resins, ethylene-vinyl alcohol copolymers, polyurethane-based resins, synthetic rubbers, natural rubbers, trans-polyisoprene-based resins, polycarbonate-based resins
- Low-grade resins such as polyethylene-based resins, polypropylene-based resins, polybulal alcohol-based resins, ethylene-vinyl alcohol copolymers, polyurethane-based resins, synthetic rubbers, natural rubbers, trans-polyisoprene-based resins, polycarbonate-based resins
- molecular materials Of the materials exemplified above, silicone-based resin, polyurethane-based resin, and transpolyisoprene-based resin are particularly preferably used.
- the latter part 10 can be subjected to a hydrophilic treatment.
- Any known method may be used for the hydrophilization treatment, and examples thereof include surface grafting, oxidation treatment, acid treatment, alkali treatment, micle addition reaction, and the like.
- the rear half 10 of the configuration can be exchanged as necessary.
- the hollow fiber membrane part 11 used for the filter part 9 in the latter half 10 of the structure it is anticipated that the pores of the hollow fiber membrane will be clogged with proteins contained in the aqueous humor over time and the filter function will deteriorate.
- the latter half 10 of the configuration including the filter part 9 can be removed at the joints 5 and 6 and easily replaced with the new rear half 10 of the configuration.
- any material can be used for the joints 5 and 6, but examples thereof include polyacetal-based resin, silicone-based resin, polyethylene-based resin, polypropylene-based resin, Polymer materials such as ethylene vinyl alcohol copolymer, polyurethane resin, ABS (Acrylonitrile-Butadiene-Styrene) resin, polycarbonate resin, ceramics such as alumina and titanium, stainless steel, etc. Metals etc. are mentioned.
- the joints 5 and 6 may be of any known structure as long as the purpose of connecting the first tube 3 and the second tube 7 of the rear half 10 of the structure is achieved while preventing foreign matter from entering from the outside.
- Technology may be used, but examples include tapered connectors, screw connectors, ball joints, couplers (manufactured by Nitto Koki Co., Ltd.), tube filters (manufactured by Nitto Koki Co., Ltd.), etc. Can be mentioned.
- the joints 5 and 6 are structured so that they can be easily attached and detached and the confirmation of the attachment / detachment operation can be easily performed by sound and touch. Couplers of such a structure (Nitto Kohki Co., Ltd.) ), Tube filter (Nitto Kohki Co., Ltd.) and the like are preferably used.
- the size and shape of the joints 5 and 6 may be any size and shape as long as the invasion to the conjunctiva 14 and the upper eyelid 18 and the lower eyelid 19 due to eye movement can be suppressed.
- the size is about 1 to 5 cubic millimeters, and the shape can be a shape composed of curved surfaces as shown in Fig. 3.
- the hollow fiber membrane portion 11 of the filter part 9 reduces intraocular pressure and prevents retrograde infection from outside the conjunctiva 14 from occurring. And in order for the hollow fiber membrane part 11 to maintain such a function, it is necessary to prevent the hollow fiber membrane part 11 from drying.
- the aqueous humor drainage implant 1 of the present embodiment is structurally configured so that the aqueous humor in the outer cylindrical portion 12 is filtered and discharged to the inside of the outer force of the hollow fiber membrane portion 11 so that the hollow fiber membrane portion 1 is structurally discharged.
- the drying of the hollow fiber membrane portion 11 due to the deformation of the outer cylinder portion 12 can also be effectively prevented. This will be described below with reference to FIGS. 5 (a) to 5 (c) and FIGS. 6 (a) to 6 (c).
- FIG. 5 (a) shows a state in which aqueous humor is discharged to the outside of the inner force of the hollow fiber membrane portion 111 and the silicone tube 112 of the conventional aqueous humor discharge implant is filled with the internal force of the aqueous humor. Yes. As shown in the figure, drying of aqueous humor from which the inner force of hollow fiber membrane part 111 is also discharged to the outside is prevented by aqueous humor in silicone tube 112 to prevent drying of hollow fiber membrane part 111. Can do. However, since the outer cylinder portion 12 is installed in the living body, it is necessary to configure the outer cylinder portion 12 so as not to damage the living body!
- the silicone tube 112 has the hollow fiber membrane portion 111 and the outer cylinder so that water is pushed out from the dropper when it is deformed by an external force such as eye movement.
- the aqueous humor between parts 1 and 2 is pushed out. Since the aqueous humor in the space between the silicone tube 112 and the hollow fiber membrane part 111 is directly affected by the deformation of the outer cylinder part 12, a large amount of aqueous humor is filled outside the outer cylinder part 12. Discharged into
- FIG. 5 (c) shows a state in which the silicone tube 112 returns to its original shape after being deformed as shown in FIG. 5 (b).
- the portion occupied by the aqueous humor becomes a space.
- the outer surface of the hollow fiber membrane part 111 comes into direct contact with the outside air in many areas, and as a result, drying of the hollow fiber membrane part 111 is promoted.
- the aqueous humor drainage implant 1 of the present embodiment has a structure that can effectively suppress drying of the hollow fiber membrane portion 11 due to deformation of the outer tube portion 12.
- Figure 6
- FIG. 6 (a) shows a state in which the entire inside of the outer cylindrical portion 12 is filled with aqueous humor in the aqueous humor drainage implant 1 of the present embodiment.
- the aqueous humor inside the hollow fiber membrane part 11 can prevent the inner fiber of the hollow fiber membrane part 11 from being dried. This is the same as the above-mentioned conventionally known one.
- the filter part 9 of the present embodiment adopts a configuration in which aqueous humor is filtered and discharged from the outside to the inside of the hollow fiber membrane part 11 inside the outer cylinder part 12. And then. For this reason, the aqueous humor drainage implant 1 provided with the filter part 9 of this embodiment is shown in FIG.
- the aqueous humor drainage implant of the present embodiment includes two or more hollow fiber membrane portions 11 in the outer tube portion 12.
- FIG. 7 shows a schematic configuration of a part of the filter in which two hollow fiber membrane portions 11 are provided in the outer cylindrical portion 12.
- the aqueous humor drainage implant according to the present embodiment filters aqueous humor by means of two hollow fiber membrane parts 11, so that the gap between the two hollow fiber membrane parts 11 is It is necessary to form a blocking portion 93 that closes.
- the blocking portion 93 functions as a second blocking portion.
- FIG. 8 in the case where the hollow fiber membrane portion is bundled and provided in the outer tube portion 12, the aqueous humor is not discharged from between the hollow fiber membrane portions 11, It is not necessary to form the blocking portion 93.
- the aqueous humor drainage implant according to the present embodiment has two hollow fiber membrane portions 11 provided in the outer cylindrical portion 12, compared to the one using the same hollow fiber membrane portion 11, Filtration performance and the like can be improved.
- the number of the hollow fiber membrane portions 11 is not limited to two, and the filtration performance of the filter part 9 can be adjusted by changing the number of the hollow fiber membrane portions 11.
- FIG. 9 Still another embodiment of the aqueous humor drainage implant of the present invention will be described below with reference to FIG. 9, FIG. 10 (a), and FIG. 10 (b). Note that the same members as those in the above-described embodiment are denoted by the same reference numerals and description thereof is omitted.
- the aqueous humor drainage implant of the present embodiment is different from the above-described embodiment in that two hollow fiber membrane parts I IA 'I IB having different diameters are provided in the outer cylinder part 12. Yes. Other configurations are the same as those of the aqueous humor drainage implant 1 described in the first embodiment.
- FIG. 9 and FIG. 10 (a) and FIG. 10 (b) show a multiple structure by inserting the hollow fiber membrane portion 11A having a small diameter inside the hollow fiber membrane portion 11B having a large diameter.
- FIG. 5 is a cross-sectional view showing a schematic configuration of a part of a filter.
- FIG. 9 and 10 (a) and 10 (b) indicate the flow of aqueous humor from the inside of the eyeball to the outside of the eyeball.
- the aqueous humor in the outer tubular portion 12 is filtered by filtering from the outside to the inside of the hollow fiber membrane portion 11A and by filtering the inner force of the hollow fiber membrane portion 11B to the outside. Is discharged outside the eyeball.
- the blocking portion 93 functions as a second blocking portion.
- FIG. 10 (a) is a cross-sectional view of a configuration in which a part of the filter shown in FIG. 9 is inverted with respect to the direction of aqueous humor flow.
- a closed portion 92 for closing the outside and the outer cylindrical portion 12 is provided at the downstream end of the aqueous humor of the hollow fiber membrane portion 11B
- the hollow fiber membrane portion 11A and the hollow fiber membrane are provided.
- a closed portion 93 that closes the space between the portions 11B is formed at the upstream end of the aqueous humor
- a closed portion 91 that closes the inside of the hollow fiber membrane portion 11A is formed at the downstream end thereof.
- FIG. 10 (b) is a cross-sectional view taken along the line CC ′ of the filter part 9 in FIG. 10 (a).
- the outer cylinder part 12 and the hollow fiber membrane part 11B During this time, the aqueous humor in the hollow fiber membrane portion 11A is filtered out through the hollow fiber membrane portions 11 and 11 and discharged to the outside.
- the aqueous humor in the outer cylindrical portion 12 is filtered by filtering from the inside to the outside of the hollow fiber membrane portion 11A and by filtering from the outside to the inside of the hollow fiber membrane portion 11B. Is discharged outside the eyeball The
- the blocking portion 93 functions as a first blocking portion.
- a part of the filter according to the present invention is configured to filter the outer cylinder part, the inside of which is connected to the path, and the aqueous humor in the outer cylinder part from the outside to the inside of the part of the hollow filter. And a part of the hollow filter to be discharged.
- the present invention can be used as a therapeutic device for discharging aqueous humor out of the intraconjunctival conjunctiva used for the purpose of lowering the intraocular pressure of a glaucoma or other observer.
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Abstract
Description
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CN103834674A (zh) * | 2014-03-21 | 2014-06-04 | 华中农业大学 | 一种分离的5-烯醇丙酮莽草酸-3-磷酸合酶基因 |
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US4886488A (en) * | 1987-08-06 | 1989-12-12 | White Thomas C | Glaucoma drainage the lacrimal system and method |
US5346464A (en) * | 1992-03-10 | 1994-09-13 | Camras Carl B | Method and apparatus for reducing intraocular pressure |
JPH08117267A (ja) * | 1994-10-28 | 1996-05-14 | Tomey Technol Corp | 房水流出具 |
US20040073156A1 (en) * | 2001-01-09 | 2004-04-15 | Brown J. David | Glaucoma treatment device and method |
JP2004208898A (ja) * | 2002-12-27 | 2004-07-29 | Japan Science & Technology Agency | 緑内障治療用房水排出インプラント |
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2005
- 2005-06-21 WO PCT/JP2005/011374 patent/WO2006001280A1/ja active Application Filing
- 2005-06-21 JP JP2006528545A patent/JPWO2006001280A1/ja active Pending
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US4886488A (en) * | 1987-08-06 | 1989-12-12 | White Thomas C | Glaucoma drainage the lacrimal system and method |
US5346464A (en) * | 1992-03-10 | 1994-09-13 | Camras Carl B | Method and apparatus for reducing intraocular pressure |
JPH08117267A (ja) * | 1994-10-28 | 1996-05-14 | Tomey Technol Corp | 房水流出具 |
US20040073156A1 (en) * | 2001-01-09 | 2004-04-15 | Brown J. David | Glaucoma treatment device and method |
JP2004208898A (ja) * | 2002-12-27 | 2004-07-29 | Japan Science & Technology Agency | 緑内障治療用房水排出インプラント |
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CN103834674A (zh) * | 2014-03-21 | 2014-06-04 | 华中农业大学 | 一种分离的5-烯醇丙酮莽草酸-3-磷酸合酶基因 |
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