Manually adjustable intraocular flow regulation
An implanted intraocular shunt can be manually manipulated, without surgical intervention, to modify the flow resistance of the shunt, thereby providing relief from high intraocular pressure while avoiding hypotony. For example, through application of pressure along a surface of the eye, a portion of the shunt can be displaced or separated relative to the shunt, thereby decreasing a flow resistance of the shunt.
1. A shunt for draining fluid from an interior chamber of an eye, the shunt comprising:
a main section having an inflow end portion, an outflow end portion, and wall defining a lumen,
a removable portion coupled to and extending distally beyond the outflow end portion to block flow through the lumen when present to provide a first nonzero flow rate, the removable portion providing a burstable seal across the outflow end portion and, upon application of compressive force against the shunt, being configured to (i) rupture and become separated from the shunt and displaced within the eye into an outflow area that has a lower pressure than the anterior chamber, (ii) act as a spacer and maintain patency of the outflow area, and (iii) facilitate fluid to flow through the lumen from the anterior chamber toward the outflow area at a second flow rate greater than the first nonzero flow rate.
2. The shunt of claim 1 , wherein the removable portion comprises a disk-shaped membrane coupled to the outflow end portion.
3. The shunt of claim 2 , wherein the wall of the main section comprises a first thickness and the membrane comprises a second thickness, the first thickness being greater than the second thickness.
4. The shunt of claim 2 , wherein the membrane is positioned within the lumen.
5. The shunt of claim 1 , wherein the removable portion has a bulbous shape and overlaps an outer surface of the shunt adjacent to the outflow end portion.
6. The shunt of claim 1 , wherein the removable portion comprises an outer cross-sectional profile greater than an outer diameter of the shunt.
7. A method of adjusting a flow rate of an intraocular shunt implanted in an eye, the method comprising:
determining a position of the intraocular shunt in the eye extending between an anterior chamber of the eye and a location of lower pressure of the eye; and
applying a force to an outer surface of the eye to separate the removable portion that extends distally beyond an outflow portion of the intraocular shunt and to reposition the removable portion to a location in an outflow area within the eye having a lower pressure than the anterior chamber and separated from the intraocular shunt to act as a spacer and maintaining patency of the outflow area, thereby permitting an increased flow rate through the intraocular shunt from a nonzero flow rate.
8. The method of claim 7 , wherein the removable portion comprises a first inner cross-sectional dimension and the intraocular shunt comprises a second inner cross-sectional dimension greater than the first inner cross-sectional dimension, and wherein the applying a force comprises compressing the second inner cross-sectional dimension to be smaller than the first inner cross-sectional dimension.
9. The method of claim 7 , wherein the applying a force comprises positioning the removable portion in a location spaced apart from an exit of the outflow portion after separating the removable portion from the intraocular shunt.
10. The method of claim 9 , further comprising extracting the removable portion from the eye after separating the removable portion from the outflow portion.
11. The method of claim 7 , wherein at least a portion of the removable portion is disposed internally within the intraocular shunt.
12. The method of claim 7 , wherein applying a force to the outer surface of the eye comprises applying a force via a finger.
13. A method of adjusting a flow rate of an intraocular shunt implanted in an eye, the method comprising:
determining a position of an outflow end of the intraocular shunt underlying a conjunctiva of the eye, the shunt being operative to permit flow of aqueous humor from an anterior chamber of the eye; and
massaging the outflow end of the shunt to dislodge a plug, extending distally beyond the outflow end, lumen of the shunt and to reposition the plug to a location separated from the shunt to an outflow area within the eye having lower pressure than the anterior chamber to act as a spacer and maintaining patency of the outflow area, thereby modifying a flow rate through the shunt from a nonzero flow rate.
14. The method of claim 13 , wherein the massaging the outflow end comprises positioning the plug in a location spaced apart from an exit of the outflow end after dislodging the plug from the lumen.
15. The method of claim 14 , further comprising extracting the plug from the eye after dislodging the plug from the outflow end.
16. The method of claim 13 , wherein the massaging the outflow end comprises massaging the conjunctiva of the eye to massage the outflow end of the intraocular shunt.
17. A shunt for treating glaucoma by draining fluid from an anterior chamber of an eye, the shunt comprising a main section and a blocking portion that is displaceably coupled to and extending distally beyond an outflow end portion of the main section, the blocking portion being configured to (1) block fluid flow therethrough in an occluding position at a nonzero flow rate and (2) to be repositioned at a flow position in which the blocking portion is separated from the main section upon application of compressive force against the shunt such that the blocking portion acts as a spacer within and maintains patency of an outflow area of the eye, thereby increasing flow through the shunt from the nonzero flow rate.
18. The shunt of claim 17 , wherein the removable portion comprises a material being any of a metal and a gelatin.
19. The shunt of claim 1 , wherein the removable portion comprises a material being any of a metal and a gelatin.