Drug delivery methods, structures, and compositions for nasolacrimal system

An implant for insertion into a patient, the patient having a path for tear fluid associated with an eye, the implant comprising:

• a body comprising a therapeutic agent and a support structure, the body configured to, when implanted at a target location along the tear fluid path, release a quantity of the therapeutic agent into the tear fluid each day for a sustained release period of days, the quantity being significantly less than 10% of a recommended daily drop-administered quantity of the therapeutic agent.

A method of delivering a therapeutic agent to an eye having associated tear fluid, the method comprising:

• placing a drug core in a canaliculus of the eye, the drug core comprising a matrix and inclusions of the therapeutic agent within the matrix, wherein a portion of the drug core is exposed to the tear;
• releasing the therapeutic agent to the tear of the eye, wherein the therapeutic agent dissolves into the matrix such that the matrix remains substantially saturated with the therapeutic agent while the therapeutic agent is released through the exposed portion at therapeutic levels over a sustained period.

A punctal plug to treat glaucoma, the plug comprising:

• a body no more than about 2.0 mm across, when inserted in the punctum for days delivers at least a therapeutic quantity of therapeutic agent each day of the 35 days.

A method of treating glaucoma with a punctal plug, the method comprising:

• eluting at least 10 ng per day of a therapeutic agent from the punctal plug for at least 90 days.

A punctal plug to treat glaucoma, the plug comprising:

• a plug body, the body comprising a therapeutic agent, wherein the body is adapted to release the therapeutic agent at therapeutic levels in response to a surfactant of the eye.

A punctal plug to treat glaucoma, the plug comprising:

• a plug body, the body comprising a therapeutic agent, wherein the body is adapted to release from about 80 to 120 ng of the therapeutic agent into a tear of the eye for at least about 20 days.

A punctal plug to treat glaucoma, the punctal plug comprising:

• a body comprising therapeutic agent stored within a volume no more than about 0.02 cm3, wherein the body is adapted to deliver therapeutic levels of the therapeutic agent for at least about 1 month.

A composition of matter to treat glaucoma of an eye having an associated tear, the composition comprising:

• inclusions comprising a concentrated form of a therapeutic agent, wherein the therapeutic agent comprises a solubility in water no more than about 0.03% by weight;
• and
• a silicon matrix encapsulating the inclusions, wherein the therapeutic agent is soluble in the silicone matrix to release the therapeutic agent from the silicone matrix into the tear at therapeutic levels.