Patent Grant
12239573
Aqueous humor is a fluid that fills the anterior chamber of the eye and contributes to the intraocular pressure or fluid pressure inside the eye. Ocular hypertension is a condition in the eye where the intraocular pressure or fluid pressure inside the eye is elevated. Untreated ocular hypertension can lead to disease, including glaucoma, which can result in a gradual and sometimes permanent loss of vision in the afflicted eye.
Many attempts have been made to treat ocular hypertension, and glaucoma in particular. Such attempts include surgical procedures that involve implantation of drainage devices designed to lower the intraocular pressure of the afflicted eye, as well as medicament administration. The goal of these treatments is to improve quality of life and to preserve visual function through a reduction of the intraocular pressure.
Though medicament administration is typically in the form of eyedrops that must be self-administered by the patient, implantable extended drug delivery devices can be employed in certain instances. Implantable extended drug delivery devices typically reside either on the exterior of the eye (e.g., extraocular approaches), or are alternatively implanted within the anterior chamber of the eye (intracameral approaches).
Extraocular approaches to medicament delivery present a variety of challenges. To be effective, the extraocular approach requires transporting, via the biological processes of the eye, a sufficient amount of the medicament through the conjunctival layer of the eye and into the anterior chamber of the eye. Obvious natural mechanisms such as the continual flushing mechanism of the human tear film, as well as the natural barrier to the interior of the eye formed by the conjunctiva, complicate the effectiveness of extraocular approaches, resulting in sub-optimal dose delivery over time. Extraocular approaches therefore sometimes include administration of an excessive amount of the medicament to extend a period of efficacy.
Intracameral approaches, on the other hand, are more invasive approaches requiring a puncture through the various tissue layers of the eye to gain access to, and placement of, the device within the anterior chamber of the eye. Intracameral approaches are additionally complicated where the medicament is administered in association with a device that is absorbable (bioabsorbable), as the degrading nature of the device may lead to the device dislodging and floating within the anterior chamber. Moreover, device removal and replacement again requires trauma to the tissues of the eye.
According to one example (“Example 1”), an implantable delivery device for dispensing a medicament includes a first microporous layer including a plurality of pores sized to permit tissue ingrowth, a second microporous layer including a plurality of pores sized to permit tissue ingrowth, a third microporous layer coupled to the first microporous layer including a plurality of pores sized to resist tissue ingrowth, and a reservoir for receiving the medicament, the reservoir being defined between the third microporous layer and the second microporous layer, wherein the third microporous layer is configured to meter a rate at which the medicament is eluted from the reservoir when the delivery device is implanted.
According to another example (“Example 2”), further to Example 1, the implantable delivery device further includes a fourth microporous layer coupled to the second microporous layer such that the reservoir is defined between the third microporous layer and the fourth microporous layer.
According to another example (“Example 3”), further to Example 2, the fourth microporous layer includes a plurality of pores sized to resist tissue ingrowth, and wherein the fourth microporous layer is permeable to the medicament.
According to another example (“Example 4”), further to Example 2, the fourth microporous layer is impermeable to the medicament.
According to another example (“Example 5”), further to Example 4, wherein the fourth layer includes an elastomer.
According to another example (“Example 6”), further to any of the preceding Examples, the first microporous layer includes an aperture configured to expose the third microporous layer.
According to another example (“Example 7”), further to any of the preceding Examples, the implantable delivery system includes one or more structural spacers disposed within the reservoir to maintain a separation between the second and third microporous layers.
According to another example (“Example 8”), further to any of the preceding Examples, the reservoir is configured to be refilled and emptied situ.
According to another example (“Example 9”), further to any of the preceding Examples, the reservoir is configured to inflate to accommodate medicament therein.
According to another example (“Example 10”), further to any of the preceding Examples, at least one of the first and second microporous layers include an expanded polytetrafluoroethylene (ePTFE) membrane.
According to another example (“Example 11”), further to any of the preceding Examples, a first portion of the third microporous layer is impermeable to the medicament, and wherein a second portion of the third microporous layer is permeable to the medicament.
According to another example (“Example 12”), further to any of the preceding Examples, the first portion of the third microporous layer includes an elastomer.
According to another example (“Example 13”), further to any of the preceding Examples, the delivery device is implantable within an eye.
According to another example (“Example 14”), further to Example 13, the medicament is an ocular medicament for treating glaucoma.
According to another example (“Example 15”), an implantable delivery device for dispensing a medicament includes a first microporous layer coupled to a second microporous layer to define a reservoir including a first interior surface and an opposing second interior surface, and a body having an exterior surface, wherein the first interior surface is separable from the second interior surface when the reservoir is filled with a medicament, wherein the first interior surface is configured to meter a dispensing of the medicament over a predetermined period of time, and wherein the first interior surface is configured to resist tissue ingrowth, and wherein the exterior surface of the body is configured to permit tissue ingrowth.
According to another example (“Example 16”), further to Example 15, at least a portion the first interior surface is permeable to the medicament.
According to another example (“Example 17”), further to Examples 15 to 16, the second interior surface is impermeable to the medicament.
According to another example (“Example 18”), further to Example 17, the second interior surface includes an elastomer.
According to another example (“Example 19”), further to Examples 15 to 18, the reservoir is configured to be refilled and emptied in situ.
According to another example (“Example 20”), further to Examples 15 to 19, the reservoir is configured to inflate to accommodate medicament therein.
According to another example (“Example 21”), further to Examples 15 to 20, at least one of the first and second microporous layers include an expanded polytetrafluoroethylene (ePTFE) membrane.
According to another example (“Example 22”), further to Examples 15 to 21, a first portion of the first interior surface is impermeable to the medicament, and wherein a second portion of the first interior surface is permeable to the medicament.
According to another example (“Example 23”), further to Example 22, the first portion of the first interior layer includes an elastomer.
According to another example (“Example 24”), further to Examples 15 to 23, the delivery device is implantable within an eye.
According to another example (“Example 25”), further to Examples 15 to 24, the medicament is an ocular medicament for treating glaucoma.
According to another example (“Example 26”), a delivery device for dispensing a medicament includes a microporous body including a first microporous layer, a second microporous layer, and a third microporous layer, the first microporous layer being situated between the second and third microporous layers, the first microporous layer including a plurality of pores sized to resist tissue ingrowth, where the second and third microporous layers each include a plurality of pores sized to permit tissue ingrowth; and a medicament reservoir located between the first microporous layer and the third microporous layer.
According to another example (“Example 27”), further to Example 26, the first microporous layer includes a metering portion for dispensing a medicament over a period of time.
According to another example (“Example 28”), further to Examples 26 to 27, the second and third microporous layers define an exterior of the delivery device.
According to another example (“Example 29”), further to Examples 26 to 28, the first microporous layer is coupled to the second microporous layer.
According to another example (“Example 30”), further to Example 29, the second microporous layer includes an aperture configured to expose the first microporous layer.
According to another example (“Example 31”), further to Examples 26 to 30, the medicament reservoir is configured to be refilled and emptied in situ.
According to another example (“Example 32”), further to Examples 26 to 31, the medicament reservoir is configured to inflate to accommodate medicament therein.
According to another example (“Example 33”), further to Examples 26 to 32, at least one of the first, second, and third microporous layers include an expanded polytetrafluoroethylene (ePTFE) membrane.
According to another example (“Example 34”), further to Examples 26 to 33, wherein the first microporous layer includes a first portion that is permeable to the medicament and a second portion that is impermeable to the medicament, the second portion of the first microporous layer including an elastomer.
According to another example (“Example 35”), further to Examples 26 to 34, wherein the delivery device is implantable within an eye.
According to another example (“Example 36”), further to Examples 27 to 35, the medicament is an ocular medicament for treating glaucoma.
According to another example (“Example 37”), a medicament metering device having an exterior surrounding an interior that defines a medicament reservoir, the device includes a first stratum including a first microporous layer and a second microporous layer, the first microporous layer being configured to resist tissue ingrowth and the second microporous layer being configured to permit tissue ingrowth, the first microporous layer defining a portion of the interior and the second microporous layer defining a portion of the exterior; and a second stratum coupled to the first stratum such that the medicament reservoir is defined between the first and second strata, a portion of the first microporous layer of the first stratum being permeable to a medicament disposable within the medicament reservoir.
According to another example (“Example 38”), further to Example 37, the medicament reservoir is defined between portions of the first and second strata that are not coupled to one another such that the uncoupled portions of the first and second strata are free to deflect relative to one another.
According to another example (“Example 39”), further to Examples 37 to 38, the second stratum includes a third microporous layer and a fourth microporous layer, the third microporous layer of the second stratum being configured to resist tissue ingrowth and the fourth microporous layer of the second stratum being configured to permit tissue ingrowth, wherein the third microporous layer of the second stratum defines a portion of the interior and the fourth microporous layer defines a portion of the exterior.
According to another example (“Example 40”), further to Examples 37 to 39, the first and second microporous layers of the first stratum include expanded polytetrafluoroethylene (ePTFE).
According to another example (“Example 41”), further to Examples 37 to 40, the first microporous layer of the first stratum includes a plurality of pores that sized to resist tissue ingrowth, and wherein the second microporous layer of the first stratum includes a plurality of pores sized to permit tissue ingrowth.
According to another example (“Example 42”), further to Examples 39 to 41, the third microporous layer of the second stratum includes a plurality of pores that sized to resist tissue ingrowth, and wherein the fourth microporous layer of the second stratum includes a plurality of pores sized to permit tissue ingrowth.
According to another example (“Example 43”), further to Examples 39 to 42, the third microporous layer of the second stratum includes an elastomer such that the third microporous layer of the second stratum is impermeable to the medicament.
According to another example (“Example 44”), further to Examples 37 to 43, the first microporous layer of the first stratum includes a first portion that is permeable to the medicament and a second portion that is impermeable to the medicament, the second portion of the first microporous layer of the first stratum including an elastomer.
According to another example (“Example 45”), further to Examples 37 to 44, the delivery device is implantable within an eye.
According to another example (“Example 46”), further to Example 45, the medicament is an ocular medicament for treating glaucoma.
According to another example (“Example 47”), further to any of the preceding Examples, the medicament is included within a fluid suspension of particles.
According to another example (“Example 48”), further to Example 47, wherein the first microporous layer of the first stratum includes a plurality of pores sized to prevent passage of the particles through the first microporous layer.
The accompanying drawings are included to provide a further understanding of the embodiments of the disclosure and are incorporated in and constitute a part of this specification, illustrate examples, and together with the description serve to explain the principles of the disclosure.
Persons skilled in the art will readily appreciate that the various embodiments of the inventive concepts provided in the present disclosure can be realized by any number of methods and apparatuses configured to perform the intended functions. It should also be noted that the accompanying figures referred to herein are not necessarily drawn to scale, but may be exaggerated to illustrate various aspects of the present disclosure, and in that regard, the figures should not be construed as limiting.
The present disclosure relates to systems, devices, and methods for delivering a medicament to an eye of a patient. In various embodiments, the medicament is an ocular medicament that is configured to treat, for example, ocular hypertension and/or glaucoma, by causing the intraocular pressure to decrease from undesirably high levels that may lead to a gradual and sometimes permanent loss of vision in the afflicted eye. In various embodiments, medicament delivery systems according to the instant disclosure are configured to meter drug release rates for one or more different medicaments, and thus may be configured to provide multiple different release rates, including multiple different release rates for multiple medicaments. Some examples of suitable ocular medicaments include therapeutic agents, such as prostaglandin analogs (PGAs) (e.g., latanoprost), or therapeutic agents from other drug classes, including beta-blockers such as timolol, alpha-2-agonists such as brimonidine tartrate, or carbonic anhydrase inhibitors such as dorzolamide, compounds of carbonic anhydrase inhibitors and beta-blockers, and compounds of alpha-agonists and beta-blockers which may be administered in combination with PGAs.
In some embodiments, such medicament delivery systems are configured to be implanted and minimally invasively refillable one or more times in situ without requiring removal of the medicament delivery system from an implantation site. Given the size and subconjunctival target implantation locations, implantation procedures can be performed outside of the operating room, where needle puncture and small incisions are commonly performed. Additionally, some system examples include features for helping reduce micro-movement between the medicament delivery systems and the tissue into which they are implanted. Micro-movement sometimes leads to irritation of the surrounding tissue, which is known to lead to a foreign body tissue response that can cause excessive scar formation, eventual erosion of implanted devices, and/or site infection.
A medicament delivery system 1000 according to some embodiments is illustrated in
In some embodiments, the medicament delivery system 1000 may be further secured to the sclera 5004 or other surrounding tissue, such as by way of suturing, adhesives, or according to other known methods. Though the medicament delivery system 1000 may be permanently or semi-permanently secured at the time of implantation, the medicament delivery system 1000 may also initially be temporarily secured (or initially not secured at all), and subsequently secured to the sclera 5004 or other surrounding tissue by one or more portions of medicament delivery system 1000 configured to promote or permit cellular infiltration and tissue attachment.
With continued reference to
Moreover, the medicament delivery system 1000 may be minimally invasively refillable and/or emptiable in situ (e.g., without first requiring removal of the medicament delivery system 1000 from the implantation site). In some such embodiments, one or more of the first and second strata 1100 and 1200 are configured such that they may be repeatedly pierced with a cannula during medicament reservoir refilling or emptying operations without significantly jeopardizing the integrity of the first and/or second strata 1100 and 1200. In some embodiments, this integrity may be achieved by coating or imbibing the first and/or second strata 1100 and 1200 with an elastomeric material.
With reference now to
As depicted in
In some embodiments, the first and second strata 1100 and 1200 may be coupled together about a peripheral edge 1002 of the medicament delivery system 1000, as shown in
As shown in
One or more of the first and second strata 1100 and 1200 may be configured to elastically or plastically deform as the medicament reservoir 1300 is inflated. Moreover, in some embodiments, one the first and second strata 1100 and 1200 may be inelastic, which may help to control an expansion profile of the medicament delivery system 1000.
In various embodiments, one or both of the first and second strata 1100 and 1200 includes one or more regions configured to meter a release of medicament. These metering regions may be in the form of membranes, layers, or films, or coatings. In some embodiments, one or more of the first and second strata 1100 and 1200 includes one or more regions configured to permit or promote cellular infiltration or tissue ingrowth and attachment. Cellular infiltration and tissue attachment generally occurs where materials are of a sufficiently porous nature to permit fibroblastic infiltration. Accordingly, the medicament delivery system 1000 may include membranes, layers, films, and/or coatings that are configured to permit tissue ingrowth and attachment.
In at least one embodiment, the first and/or second strata 1100 and 1200 may be formed of a plurality of membrane layers. For example, as shown in
In some embodiments, one or more of the first and second membrane layers 1110 and 1120 may include a microporous microstructure. For example, one or more of the first and second membrane layers 1110 and 1120 may include biocompatible materials such as expanded polytetrafluoroethylene (ePTFE). Additionally, one or more of first and second membrane layers 1110 and 1120 of the first stratum 1100 may be formed of other biocompatible materials including biocompatible polymers, which may or may not be microporous, including, but not limited to, polyurethane, silicone, polysulfone, polyvinylidene fluorine (PVDF), polyhexafluoropropylene (PHFP), perfluoroalkoxy polymer (PFA), polyolefin, fluorinated ethylene propylene (FEP), acrylic copolymers and polytetrafluoroethylene (PTFE).
The first and/or second membrane layers may be in the form of one or more sheets or films, and they may include knitted, woven, and/or non-woven forms including individual or multi-fiber strands. In some embodiments, the first and/or second membrane layers 1110 and 1120 may be formed from a plurality of sheets or films of polymer material. In some embodiments, the sheets or films may be laminated or otherwise mechanically coupled together to form the first and/or second membrane layers 1110 and 1120 of the first stratum 1100. Coupling of the sheets or films may be accomplished by a variety of mechanisms, including heat treatment, high pressure compression, bonding agents such as one or more adhesives, lamination, or other suitable methods known to one of skill in the art.
In some embodiments, adjacently-situated membrane layers (e.g., first and second membrane layers 1110 and 1120) and/or the layers of material forming such membrane layers, may be partially or completely bonded via thermal methods where each of the polymers forming the materials are brought to or above their melting temperatures. In some embodiments, such thermal processes facilitate adhesive or cohesive bond formation between the materials or layers of material. In some embodiments, adjacently situated membrane layers and/or the layers of material forming such membrane layers, may be partially or completely bonded via thermal methods where at least one of the materials is brought to or above its melting temperature. Such thermal processes may facilitate adhesive or cohesive bond formation between the materials or layers of material. In some embodiments, one or more suitable adhesives are utilized and provide a sufficiently bonded interface. Adjacently situated membrane layers and/or the layers of material forming such membrane layers may be coupled together at one or more discrete locations to form stabilizing structures that extend through the resulting structure.
In some embodiments, the first stratum 1100, and/or the first and second membrane layers 1110 and 1120, and/or the sheets or films from which the first and second membrane layers 1110 and 1120 are formed may be subjected to one or more processes to modify a microstructure thereof. In some embodiments, such processes include, but are not limited to, material coating processes, surface pre-conditioning processes, and/or perforation processes. Material coating processes may be utilized to apply one or more drug or antimicrobial coatings to the polymer material (such as metallic salts (e.g. silver carbonate) and organic compounds (e.g. chlorhexidine diacetate). Hydrophilic coatings to enable wetout—including immediate wetout—of the polymer matrix can also be applied as polymer surfaces that are generally hydrophobic in nature. Surface coatings including antioxidant components can additionally or alternatively be applied to mitigate the body's inflammatory response that naturally occurs during wound healing after surgery. Material surfaces can additionally or alternatively be modified with anti-proliferative compounds (e.g., Mitomycin C, 5-fluoracil) to moderate the surrounding tissue response.
In some embodiments, one or more surface pre-conditioning processes may be utilized to form layers exhibiting an exemplary microstructure (e.g., wrinkles, folds, or other geometric out-of-plane structures), as explained in U.S. Pat. No. 9,849,629 to Zaggl. Such surface pre-conditioning could facilitate a bolder early inflammatory phase after surgery, providing an early stable interface between porous device and tissue. In some embodiments, a heparin coating may additionally or alternatively be applied to help minimize cell formation including fibrinogen buildup following a surgical implantation procedure.
In some embodiments, one or more perforation processes may be utilized to form a plurality of perforations or pores in one or more of the first and second membrane layers 1110 and 1120 of the first stratum 1100 to achieve a desired porosity. That is, one or more perforation processes may be utilized in addition to a reliance on any interstices, pores (voids between fibril and nodes making up the microstructure), and/or channels naturally occurring within the polymer material.
It will be appreciated that the first and second membrane layers 1110 and 1120 of the first stratum 1100 may be processed differently to achieve membrane layers having different material properties, such as different porosities and/or different cellular infiltration potential. In some embodiments, the first and second membrane layers 1110 and 1120 of the first stratum may not by subjected to any processing steps.
In some embodiments, the first membrane layer 1110 (also referred to herein as a medicament metering membrane layer) is configured to meter a rate at which a medicament passes through the first membrane layer 1110 and thus a rate at which a medicament is released by the medicament delivery system 1000. In various embodiments, the first membrane layer 1110 is also configured to resist cellular infiltration and attachment. In some embodiments, the first membrane layer 1110 includes interstices, perforations, pores, channels, or combinations thereof that are sized and shaped to resist, impede, or otherwise minimize cellular infiltration while remaining permeable to one or more medicaments. The interstices, perforations, pores, or channels of the first membrane layer 1110 of the first stratum 1100 may be less than (or have an average size of less than) about one (1) to about two (2) microns, for example, although a variety of dimensions may be selected based upon application. By being resistant to cellular ingrowth and attachment, the first membrane layer 1110 of the first stratum 1100 operates to maintain a separation between the medicament disposed within the medicament reservoir 1300 and the tissue surrounding the medicament delivery system 1000. This separation operates to maintain a controlled and stable rate at which medicament is released by the medicament delivery system 1000.
The second membrane layer 1120 (also referred to herein as an ingrowth membrane layer) is configured to promote or permit cellular infiltration and attachment. The second membrane layer 1120 thus generally includes interstices, perforations, pores, channels, or combinations thereof that are sized and shaped to promote or permit cellular infiltration. Thus, the second membrane layer 1120 generally includes interstices, perforations, pores, channels or combinations thereof having an average size that exceeds an average size of the interstices, perforations, pores, or channels of the first membrane layer 1110 of the first stratum 1100. In some embodiments, the second membrane layer 1120 may include interstices, perforations, pores, or channels that range in size (or average size) from between twenty (20) microns and one hundred (100) microns, although a variety of dimensions are contemplated. For example, the size (or average size) of the interstices, perforations, pores, or channels may exceed one hundred fifty (150) microns in other embodiments. Thus, while the first membrane layer 1110 operates to meter and maintain a controlled and stable rate at which medicament is released by the medicament delivery system 1000, the second membrane layer 1120 helps facilitate biointegration of the medicament delivery system 1000 by permitting cellular ingrowth and tissue attachment. Cellular ingrowth and tissue attachment helps minimize micro-movement.
In some embodiments, the interface between the first and second membrane layers 1110 and 1120 of the first stratum 1100 operates as a boundary to cellular infiltration into the first membrane layer 1110. That is, in some embodiments, the first stratum 1100 is configured such that cellular infiltration and proliferation is limited to within the second membrane layer 1120, and not into the first membrane layer 1110. Thus, in various embodiments, cellular infiltration and proliferation within the second membrane layer 1120 can generally propagate up to the boundary between the first and second membrane layers 1110 and 1120. In some embodiments, the first stratum 1100 may be configured to prevent or otherwise minimize a potential for cellular infiltration and proliferation across the boundary between the first and second membrane layers 1110 and 1120 of the first stratum 1100.
It should also be appreciated that while the first stratum 1100 (and the corresponding first and second membrane layers 1110 and 1120 of the first stratum 1100) of the medicament delivery system 1000 shown in the accompanying figures are ovularly shaped, the first and second membrane layers 1110 and 1120 and thus the first stratum 1100 may be formed of other shapes and/or sizes provided that the medicament delivery system 1000 effectively fulfills its intended purpose of being implantable within a tissue, such as a subconjunctival pocket, and operable to cause a release of a medicament disposed within the medicament reservoir 1300 of the medicament delivery system 1000 to one or more regions of the tissue surrounding the medicament delivery system 1000. For instance, the first and second membrane layers 1110 and 1120 and thus the first stratum 1100 may be square, rectangular, trapezoidal, or any other polygonal or non-polygonal shape (e.g., bean-shaped) as desired, provided the shape does not prohibit implantation or render the medicament reservoir 1300 incapable of dispensing medicament.
As shown in
The second membrane layer 1220 the second stratum 1200 is similar to the second membrane layer 1120 of the first stratum 1100 in that the second membrane layer 1220 of the second stratum 1200 is configured to promote or permit cellular infiltration and attachment. The second membrane layer 1220 thus generally includes interstices, perforations, pores, channels, or combinations thereof consistent with those discussed above for the second membrane layer 1120 of the first stratum 1100. Thus, in various embodiments, the medicament delivery system 1000 includes a second stratum 1200 that is formed of a first membrane layer 1210 and a second membrane layer 1220 where the first membrane layer 1210 is permeable to a medicament and configured to resist cellular infiltration and tissue attachment and where the second membrane layer 1220 is permeable to the medicament and configured to promote or permit cellular infiltration and tissue attachment.
In some embodiments, the interface between the first and second membrane layers 1210 and 1220 of the second stratum 1200 operates as a boundary to cellular infiltration into the first membrane layer 1210. That is, in some embodiments, the second stratum 1200 is configured such that cellular infiltration and proliferation is limited to the second membrane layer 1220, and not into the first membrane layer 1210. Thus, in various embodiments, cellular infiltration and proliferation within the second membrane layer 1220 can generally propagate up to, but not through, the boundary between the first and second membrane layers 1210 and 1220. In some embodiments, the second stratum 1200 may be configured to prevent or otherwise minimize a potential for cellular infiltration and proliferation across the boundary between the first and second membrane layers 1210 and 1220 of the second stratum 1200. It should be appreciated that the second stratum 1200 may include membrane layers in addition to the first and second membrane layers 1210 and 1220.
Similar to the first stratum 1100 mentioned above, the second stratum 1200 may be formed of shapes and/or sizes other than those depicted in the accompanying figures (e.g., square, rectangular, trapezoidal, bean-shaped, or any other polygonal or non-polygonal shape) provided that the medicament delivery system 1000 effectively fulfills its intended purpose of being implantable within a tissue and operable to cause a release of a medicament disposed within the medicament reservoir 1300 to one or more regions of the tissue surrounding the medicament delivery system 1000.
As shown in
Similarly, as shown in
In various embodiments, the first and second strata 1100 and 1200 (including the various membrane layers thereof) may be connected or coupled to one another according to known methods, such as by way of heat treatment, high pressure compression, bonding agents such as one or more adhesives, combinations thereof, or other techniques known to those of skill in the art.
In some embodiments, the first faces 1102 and 1202 of the first and second strata 1100 and 1200, respectively, are coupled along the peripheral edge 1002 of the medicament delivery system 1000 such that one or more portions of the first faces 1102 and 1202 of the first and second strata 1100 and 1200 remain uncoupled to one another. In some embodiments, such uncoupled regions remain free to slide, translate, actuate, separate, or otherwise move relative to one another. This relative motion between the uncoupled or unbonded portions of the first and second strata 1100 and 1200 provides that a volume of the medicament reservoir 1300 may vary with an amount of medicament present in the medicament reservoir 1300. For example, the medicament delivery system 1000 may be transitionable between states or configurations, including a first configuration where the medicament reservoir 1300 has a first volume and a second configuration where the medicament reservoir 1300 has a second volume greater than the first volume.
As the medicament delivery system 1000 is configured to deliver medicament, and because the medicament delivery system 1000 can be refilled or emptied in situ, it will be appreciated that the medicament delivery system 1000 is transitionable between the first and second configurations in situ.
Moreover, the medicament reservoir 1300 may be accessed in situ by way of a cannula, needle or other suitable instrument or method, to add or remove medicament from the medicament reservoir 1300.
The medicament delivery system 1000 shown in
However, in other embodiments, the medicament delivery system may be configured such that medicament is metered and dispensed from the medicament delivery system through one or the other of the first and second strata, but not both. That is, in some embodiments, the medicament delivery system may be configured such that a first one of the first and second strata is permeable to a medicament, while the other of the first and second strata is impermeable to the medicament. For example, turning now to
The second stratum 2200 of the medicament delivery system 2000 shown in
With continued reference to
In some embodiments, the various membrane layers are formed of expanded polytetrafluoroethylene (ePTFE), although other biocompatible polymers suitable for use in forming medicament impermeable membrane layers including, but not limited to, urethanes, silicones (organopolysiloxanes), copolymers of silicon-urethane, styrene/isobutylene copolymers, polyisobutylene, polyethylene-co-poly(vinyl acetate), polyester copolymers, nylon copolymers, fluorinated hydrocarbon polymers and copolymers or mixtures of any of the foregoing may be used.
In various embodiments, the elastomer or elastomeric material may include perfluoromethyl vinyl ether and tetrafluoroethylene, (per)fluoroalkylvinylethers (PAVE), a copolymer of tetrafluoroethylene and perfluoromethyl vinyl ether, silicone, a fluoroelastomer, a urethane, or a TFE/PMVE copolymer.
With continued reference to the medicament delivery system 2000 shown in
In some embodiments, one or more of the first and second strata may be configured to include one or more medicament permeable portions and one or more medicament impermeable portions. Turning now to
In various embodiments, the first portion 3112 of the first membrane layer 3110 generally includes interstices, perforations, pores, channels, or other release features that are sized and shaped to allow medicament disposed within the medicament reservoir 3300 to be released through the first portion 3112. In some embodiments, metering the release of the medicament disposed within the medicament reservoir 3300 by the first stratum 3100 may be tuned or otherwise controlled by increasing (or alternatively decreasing) a surface area of the metering first portion 3112 of the first membrane layer 3110. In some embodiments, increasing a surface area of the metering first portion 3112 from a first surface area to a second larger surface area is associated with an increase of an amount of medicament released by the medicament delivery system 3000 per unit of time. Similarly, decreasing a surface area of the metering first portion 3112 from a first surface area to a second smaller surface area is associated with a decrease of an amount of medicament released by the medicament delivery system 3000 per unit of time.
For example, if a medicament delivery system includes a medicament reservoir having a first size (e.g., volume) and a first medicament metering membrane layer having a first surface area and including a first material having a first release rate per unit area, then the medicament delivery system is associated with a first medicament release rate per unit time and with metering a release of the medicament for a first period of time. If the size of the medicament reservoir is increased from the first size to a second, larger size while maintaining the first surface area and the first material of the metering membrane layer, then it should be appreciated that the medicament delivery system is operable to meter a release of medicament for a second period of time longer than the first period of time. On the other hand, if the first surface area of the metering membrane layer is decreased to a second, decreased surface area while the first material of the metering membrane layer and the first size of the medicament reservoir are maintained, then it should be appreciated that the medicament delivery system is operable to meter a release of medicament for a third period of time longer than the first period of time. Additionally, if the first material of the metering membrane layer is changed to a second material which has a second, decreased release rate per unit area, while the first size of the medicament reservoir and the first surface area of the metering membrane layer are maintained, then it should be appreciated that the medicament delivery system is operable to meter a release of medicament for a fourth period of time longer than the first period of time. Combinations of the above concepts may be utilized to maintain a medicament release period while increasing an amount of medicament released per unit of time. For example, if the size of the medicament reservoir is increased from the first size to a second, larger size in combination with an increase in the surface area of the metering membrane layer from the first surface area to a second, increased surface area while maintaining the first material of the metering membrane layer, then it should be appreciated that the medicament delivery system is operable to increase an amount of medicament released during the first period of time.
It is to also be appreciated that different materials may possess different flow rates per unit area, based for example of differing microstructures (e.g., increased quantity and/or size of interstices, perforations, pores, channels or other release features present in the microstructure). Thus, different materials may be additionally or alternatively selected to tune or otherwise control the degree or amount by which the release of the medicament disposed within the medicament reservoir is metered.
The various medicament delivery systems discussed herein thus provide for configurations including a relatively large medicament reservoir without also inherently possessing a high release rate of medicament due to an associated large medicament metering surface area, or alternatively, a relatively small medicament reservoir without also inherently possessing a low release rate of medicament due to an associated low medicament metering surface area. A relatively large medicament reservoir in combination with a low release rate provides fora medicament delivery system 1000 that can be implanted for long periods of time (e.g., weeks, months, a year, or more) without requiring interventions to refill medicament. Conversely, a relatively small medicament reservoir in combination with a high release rate provides for a medicament delivery system that can be implanted and dispense medicament at a fast rate without being oversized and interfering with normal eye operation (e.g., blinking and eye movements).
In addition, it should be appreciated that medicaments having coarser molecular structures generally require that the medicament delivery system include a microstructure having interstices, pores, channels and/or other release features that correspond in size such that the medicament can pass through the material of the medicament metering membrane layer. Thus, it will be appreciated that different medicament delivery systems may be selected for use in administering different medicaments.
With continued reference to the medicament delivery system 3000 shown in
While the medicament delivery system 3000 shown in
It should also be appreciated that while the medicament delivery system 3000 shown in
In various embodiments, a medicament delivery system may be configured such that one or more of the medicament metering membrane layers discussed herein may be exposed to a tissue surface of the patient's anatomy. For example, turning now to
The first stratum 4100 shown in
Direct exposure of the first membrane layer 4110 of the first stratum 4100 helps enable more effective and efficient drug delivery to tissue. Maintaining a separation between the first membrane layer 4110 and a tissue surface helps minimize micro-movement between the first membrane layer 4110 and the tissue. As discussed above, minimizing micro-movement helps minimize micro-irritations.
Thus, in various embodiments, the medicament delivery system 4000 includes a medicament permeable first stratum 4100 and a medicament impermeable second stratum 4200, where the first stratum 4100 includes a first membrane layer 4110 and a second membrane layer 4120 and where the first membrane layer 4110 is permeable to a medicament and configured to resist cellular infiltration and tissue attachment and where the second membrane layer 4120 is permeable to the medicament and configured to promote or permit cellular infiltration and tissue attachment and where the second membrane layer 4120 is configured such that one or more portions of the first membrane layer 4110 are exposed to tissue when implanted while the second membrane layer 4120 is positioned between the tissue and one or more other portions of the first membrane layer 4110 while implanted.
In some embodiments, the various medicament delivery systems discussed herein are shaped as thin, puck-shaped members. The medicament delivery systems may include thicknesses between exterior opposing surfaces of the (e.g., a distance measured between the second face 1104 of the first stratum 1100 and the second face 1204 of the second stratum 1200) of less than or equal to half of a millimeter (0.5 mm), such as between one-tenth of a millimeter (0.1 mm) and half of a millimeter (0.5 mm), for example although a variety of dimensions are contemplated. For example, given differing anatomies of the human body, the medicament delivery systems may exceed half of a millimeter (0.5 mm) without departing from the spirit or scope of the present disclosure provided that the thickness does not substantially interfere with normal eye functioning (e.g., pivoting and blinking).
In some embodiments, the various medicament delivery systems disclosed herein may have diameters (or widths across a major axis) in the range of five (5) millimeters to fifteen (15) millimeters. In a particular embodiment, the medicament delivery system disclosed herein may have a diameter (or width across a major axis) of ten (10) millimeters. In those embodiments where the medicament delivery systems are ovularly shaped, the medicament delivery systems may include a major dimension (e.g., of the oval) of up to about thirty (30) millimeters and corresponding minor dimension of up to about ten (10) millimeters. Though, as discussed above, given differing anatomies of the human body, the medicament delivery systems may exceed such dimensions (e.g., fifteen (15), and ten (10) and thirty (30) millimeters) without departing from the spirit or scope of the present disclosure provided that the size does not substantially interfere with normal eye functioning (e.g., pivoting and blinking). Likewise, the medicament delivery systems disclosed herein may include diameters (or widths across a major axis) of less than five (5) millimeters without departing from the spirit or scope of the present disclosure provided that the medicament delivery systems are operable to elute a sufficient degree of medicament for absorption by the surrounding tissue. The shapes and sizes discussed herein should not be viewed as limiting.
Additionally, while medicament delivery systems discussed above are described as including a single medicament reservoir, it is to be appreciated that any of the above-discussed medicament delivery systems may include multiple reservoirs. These reservoirs may be fluidly coupled or isolated from one another. In some embodiments, each reservoir may be configured to house a same or different medicament. Accordingly, in some embodiments, the medicament delivery systems discussed herein may be configured to deliver multiple different medicaments, either from the same reservoir, or from a plurality of different reservoirs.
Additionally, in various embodiments, it is to be appreciated that the medicament may be loaded onto or otherwise incorporated into bioabsorbable particles which help aid in metering the medicament. In some embodiments, the particles may be of a size where they can be made into a dispersion and injected or otherwise delivered to within a medicament reservoir in situ (e.g., while the medicament delivery system is implanted within the patient's eye). That is, in some examples, the medicament may be included in a fluid suspension of particles. In various embodiments, a filled or partially filled medicament microporous reservoir may be accessed in situ (e.g., via syringe or other suitable means) and the contents of the reservoir (e.g., particles) removed and/or reloaded with fresh particles to maintain a constant delivery of medication over time. In various embodiments, placement of the fluid suspension of particles within the medicament reservoir may be accomplished via a syringe or other suitable means of delivery.
In some embodiments, the medicament delivery systems discussed herein are configured such that the medicament microporous reservoir retains the particles in the medicament reservoir and permits the dispersion carrier fluid (e.g., water) to exit the reservoir through one or more strata of the medicament delivery system. For instance, in some embodiments, the material defining the medicament reservoir (e.g., one or more of the first, second, third, or fourth microporous layers) may include a microstructure that is configured to prevent the particles of the fluid suspension from passing through the material. For example, the first microporous layer may be configured to resist tissue ingrowth, and may include interstices, perforations, pores, channels, or combinations thereof that prevent the particles of the fluid suspension from passing through the material. In some embodiments, the particles are configured to break down or degrade over time such that the medicament (alone or in a solution with the fluid) can percolate, diffuse, or otherwise pass through one or more of the strata of the microporous reservoir from an interior of the medicament reservoir to an exterior of the medicament delivery system for absorption by the body. In some embodiments, a concentration of the solution of dispersion carrier fluid and particles may change or be changed over time. For example, particles may be added to the dispersion carrier fluid (e.g., in situ) to increase a concentration of particles within the reservoir. Additionally or alternatively, dispersion carrier fluid may be added to reduce a concentration of particles within the reservoir.
In some embodiments, the various medicament delivery systems disclosed herein may additionally or alternatively include one or more structural spacers, such as one or more stents, struts, and/or reinforcing element. The one or more structural spacers may be incorporated into, integrated into, coupled to, or otherwise disposed within the reservoir to maintain a separation between those microporous layers forming the reservoir. Such structural spacers may be formed of any suitable biocompatible material (e.g., natural materials, or synthetic materials such as metals and polymers) discussed herein.
The inventive scope of this application has been described above both generically and with regard to specific embodiments and examples. It will be apparent to those skilled in the art that various modifications and variations can be made in the embodiments and examples without departing from the scope of the disclosure. Likewise, the various components discussed in the embodiments and examples discussed herein are combinable. Thus, it is intended that the embodiments and examples cover the modifications and variations of the inventive scope.
This application is a national phase application of PCT Application No. PCT/US2019/048759, internationally filed on Aug. 29, 2019, which claims the benefit of Provisional Application No. 62/724,425, filed Aug. 29, 2018, which are incorporated herein by reference in their entireties for all purposes.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2019/048759 | 8/29/2019 | WO |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2020/047221 | 3/5/2020 | WO | A |
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