JP2003325571A - Instrument for inserting deformable intraocular insertion lens - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an inserting instrument by which a lens advance speed is restricted in a stress-free state, so as to prevent the damage of the lens, and the lens is reliably inserted to an eye. <P>SOLUTION: An intraocular insertion lens 1 includes: a deformable optical part 2; and support parts 3(4) for supporting the optical part 2 in the eye. The intraocular insertion lens inserting instrument moves the lens 1 by a push-out mechanism comprising a push-out shaft through an insertion cylinder 21 with an opening at the distal end, and inserts the lens to the eye by mitigating stress in deforming the lens by a stress-free structure which is arranged in the insertion cylinder 21. A rough surface part 104 for increasing friction resistance is disposed on the inner surface of the insertion cylinder 21 near the stress-free structure. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a deformable intraocular lens that is inserted in place of the crystalline lens after the crystalline lens is removed due to a cataract, or a deformable lens that is inserted into the eye only for the purpose of correcting visual acuity. The present invention relates to an insertion tool for inserting a deformable intraocular insertion lens such as a vision correction lens into the eye.

[0002]

2. Description of the Related Art In 1949, Ridley transplanted an artificial lens, that is, an intraocular lens for the first time, into the human eye instead of the clouded lens during cataract surgery. Background of the Invention Implanting lenses for medical use has become widespread. This first intraocular lens is an intraocular lens that uses polymethylmethacrylate (PMMA) as the material for the optical part. Many ophthalmologists are concerned about complications associated with intraocular lens implantation after cataract surgery. Although intriguing and addressing many of these problems have been addressed, the innate problem of using a hard material in the optics has made the incision for implanting this intraocular lens an optical implant. The size of the incision to be made in the eyeball becomes large because a size somewhat larger than the diameter of the part is required, and the problem that the astigmatism after surgery is increased cannot be solved. In addition, a surgical method was also mentioned as one of the causes of the above-mentioned problems. That is, the original cataract lens extraction is an extracapsular cataract extraction (E) in which the lens is removed in its original form.
CCE), and this surgical method requires an incision of about 10 mm, which again has a problem of increasing astigmatism after surgery. In response to such a surgical method that causes astigmatism after surgery, ultrasonic phacoemulsification and aspiration (PEA) using an ultrasonic phacoemulsification device has recently appeared.
This is a method of extracting a crystalline lens by crushing the crystalline lens with ultrasonic waves and emulsifying and sucking the cloudy crystalline lens using a cylindrical ultrasonic tip. The size of the wound is only for inserting a cylindrical ultrasonic tip, and the incision can be about 3 mm to 4 mm for lens extraction.

Therefore, the operation for removing the clouded lens during cataract can be performed with a small incision to reduce astigmatism after the operation, but an intraocular lens that replaces the crystalline lens of the human eye is available. In the intraocular lens insertion procedure for implanting, the optic part of the intraocular lens is inserted due to the essential problem that the optical part of the intraocular lens is composed of a hard material. A slightly larger incision size, and a standard incision diameter of 6.0 mm requires an incision of 6.5 mm or more as an incision. Therefore, a lens that becomes cloudy from a small incision by ultrasonic phacoemulsification However, the small incision had to be expanded in order to insert the intraocular lens, and the problem of postoperative astigmatism caused by the large incision was not solved. For such a situation, in order to reduce astigmatism after surgery, an improved intraocular lens for reducing the size of the incision, that is, an elliptical optical part for inserting the minor axis in the direction of the incision. Intraocular insertion lens of, and the intraocular insertion lens of the small-diameter optical part with a reduced optical part diameter appeared, but until the essential problem that the optical part is rigid remained, incision in this case The size was reduced to about 5.5 mm and only about 1 mm.

However, with further improvement, a new intraocular lens for coping with the above-mentioned essential problems has recently been used. This is disclosed in JP-A-58-1
As disclosed in Japanese Patent No. 46346, a lens for insertion into an eye or at least an optical lens which is insertable from a small incision made in an eyeball and which uses a deformable elastic body having at least an optical portion having a predetermined memory characteristic. With the advent of a deformable intraocular lens having a support portion composed of a different member for supporting the optical portion in the eye, the use of an elastic body having a predetermined memory characteristic, and JP-A-58-146346, Kaihei 4-
212350, JP-A-5-103803, JP-A-5
As disclosed in JP-A-103808, JP-A-5-103809, and JP-A-7-23990, the optical portion of a deformable intraocular lens is compressed, rolled, or bent. This is the emergence of an insertion instrument that can be deformed by stretching or folding to change it from a large shape before deformation to a small shape and insert it from a small incision made in the eyeball. With these deformable intraocular lens and its insertion tool, intraocular lens insertion can be performed with a small incision, and cataract surgery with a small incision reduces postoperative astigmatism. It became possible to insert the lens for internal insertion.

That is, as shown in FIG. 7, as a deformable intraocular lens 1, a circular optical portion 2 formed of a deformable elastic body having a predetermined memory characteristic is provided on the outer peripheral portion of a different type from the optical portion 2. A base 3a of a pair of support parts 3 formed of a flexible material is embedded and fixed, a linear protrusion 3b of the support part 3 is curved, and two support parts 3 are arranged symmetrically. As shown in FIG. 8, the optical part 2 is made of a material having the same predetermined memory characteristics as in FIG.
In some cases, two front and rear supporting portions 4 having a thin plate-like shape for supporting the two are made to face each other and protrude.

A deformable intraocular lens 1 having a large shape, which is composed of an optical portion 2 and a supporting portion 3 or a supporting portion 4 and has at least a predetermined memory characteristic, has a large shape as shown in FIGS. In order to insert the intraocular insertion lens into the eye from an incision made in the eyeball by folding it into a small shape such as by folding it in two, and passing it through an insertion tube formed into a cylindrical shape, The insertion instrument shown in Kaihei 7-23990 is used.

In order to insert a deformable intraocular lens through the small incision using the above-mentioned insertion instrument, the opening / closing mechanism of the holding member of the insertion instrument is opened and the intraocular insertion lens is attached to the lens installation portion. By inserting and closing the opening / closing mechanism, the intraocular lens inserted in the lens installation part is transformed from the large shape before deformation to a small shape, and the locking member attached to the instrument body is moved to the lens installation part side. By locking the open / close mechanism in the closed state, the intraocular lens is installed in the installation section. After that, by operating the pushing mechanism of the insertion instrument, the pushing shaft is moved forward to push out the intraocular lens in the installation section, and through the insertion tube connected to the tip side of the installation section, the eye is inserted from the tip of the insertion tube inserted into the incision. An intraocular lens is inserted inside. The shape of the insertion tube is tapered,
The intraocular lens can be inserted through a smaller wound.

[0008]

However, as shown in the above-mentioned prior art, at least a deformable intraocular lens using a deformable elastic body or the like in which at least the optical portion has a predetermined memory characteristic, or at least A deformable elastic body having a predetermined memory characteristic is used for the optical unit, and a deformable intraocular lens made of a different member that supports the optical unit in the eye is deformed from a large shape before deformation to a small shape. Above, the above-mentioned insertion device for inserting a deformable intraocular insertion lens into the eye from a small incision made in the eyeball through a tapered tip part having a nozzle (cylindrical) shape has the following problems. There was a point. When inserting the intraocular lens into the eye by moving the inside of the insertion tube with the extrusion shaft, the insertion tube is made of the same material from the base end to the tip, so that the lens is not destroyed even if it moves inside the insertion tube. Since it is made of a strong material, when the frictional resistance between the lens and the insertion tube in the insertion tube is small, the stress generated during deformation is released at once when the lens comes out from the insertion tube tip into the eye. , There was a risk that the lens would jump out into the eye and damage the tissues in the eye. In order to improve it, the structure is known in which the stress of the lens is gradually released by the slit formed from the insertion tube tip toward the insertion tube base end direction, and the lens itself is inserted into the eye from the slit part. Has become. In addition, as another stress release structure, the insertion tube is cut off diagonally from the tip end to the base end to gradually release the stress, so that the stress is released all at once and the lens pops out into the eye. It was possible to avoid.

However, in order to further relax the stress and enhance safety, a long slit is formed in order to release the stress from a portion closer to the base end portion to the distal end, and a slanting angle is cut sharply. If the region to be cut off is lengthened, a slit or cut-off portion will be applied to the intraocular tissue at the incision wound portion, and there is a risk of contacting the intraocular tissue when the lens is pushed out and damaging the wound.

The present invention solves the above-mentioned problems,
The insertion tube that moves the insertion tube by the extrusion mechanism that advances the extrusion shaft and relieves the stress when the lens is deformed by the stress relief structure and inserts it into the eye. By providing a structure for increasing the frictional resistance between the lens and the insertion tube on the inner wall, the traveling speed of the lens at the time of stress release is limited by the increased frictional force to prevent the lens from being damaged, and the lens is more reliably The main object of the invention is to provide an insertion device capable of inserting the eye into the eye.

[0011]

According to a first aspect of the present invention, there is provided an intraocular lens having an deformable optical section and a support section for supporting the optical section in the eye, and an insertion tube having an opening at its tip. In the insertion instrument of the intraocular insertion lens that is moved by the inside and relaxes the stress at the time of lens deformation by the stress relief structure provided in the insertion tube and inserts it into the eye, the inner surface of the insertion tube corresponding to the stress release structure part By providing a structure that increases friction, it is possible to control the lens injection speed at the time of lens injection that could not be achieved by the conventional stress relief structure alone, so it is possible to safely insert the intraocular lens. To do.

According to a second aspect of the present invention, in the insertion device for the deformable intraocular lens according to the first aspect, the stress releasing structure is provided from the distal end of the insertion cylinder toward the proximal end.
The specific structure for relieving the stress when the lens is deformed is limited by the book or the plurality of slits.

The invention of claim 3 is the same as claim 1 or 2 above.
In the insertion instrument of the deformable intraocular lens described in (1), the specific structure for increasing frictional resistance is limited by roughening the inner surface of the insertion cylinder of the portion corresponding to the stress releasing structure over the entire circumference. It is a thing.

The invention of claim 4 is the same as claim 1 or 2 above.
In the insertion instrument of the deformable intraocular lens described in, the specific structure for increasing the frictional resistance by partially roughening the inner surface of the insertion cylinder of the portion corresponding to the stress releasing structure is limited. is there.

[0015]

DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 is a perspective view of a first embodiment of a deformable intraocular lens insertion tool according to the present invention.
A device main body 12 similar to the one disclosed in Japanese Patent Publication No. 91-91 except the insertion tube 21 is provided.
The male screw 12c is formed on the outer peripheral part of the a, and the male screw 12c is screw-fitted to the female screw 14a formed on the inner peripheral part of the operating cylinder 14 provided in the pushing mechanism part.

The extruding mechanism portion has a distal end portion of an extruding shaft 15 provided substantially coaxially with the operating cylinder 14 inserted in a rotatable manner with respect to each other. The extruding shaft 15 is operated by a rotation suppressing mechanism (not shown). It is possible to move in the longitudinal direction without rotating with respect to. The tip of the push shaft 15 (not shown) is formed in a known shape suitable for pushing the intraocular lens. The holding member 16 is coupled to the tip of the main body 12, and is a state in which the intraocular lens 1 (not shown) is set in an open state and closed by a known configuration so that the intraocular lens 1 is folded in two. I keep it as it is. A slide stopper 27 is movably fitted to the main body 12 without rotating in the axial direction, and the groove 27a fixes the holding member 16 in a closed state. The instrument main body 12, the operation cylinder 14, the pushing shaft 15, the wrapping member 16 and the insertion cylinder 21 formed integrally with the same are each formed of a synthetic resin as a molded product.

The intraocular lens 1 as shown in FIG. 7 is inserted into the eye using the insertion tool. The intraocular lens 1 is the optical unit 2
And the support portion 3. The support portion 3 is made of a material different from that of the optical portion 2, and is fixed in the eye by its spring property. The method of inserting the folded and wrapped intraocular lens 1 into the eye is as follows. The insertion tube 21 is inserted into the eye from which the crystalline lens is removed, and the operation tube 14 is rotated to rotate the pushing shaft 15
Is used to push out from the distal end portion of the insertion tube 21 and insert the intraocular lens 1 into the eye. The intraocular lens 1 that has moved in the space inside the insertion tube 21 by the pushing shaft 15 is restored to the shape before being folded in two when it comes out of the insertion tube 21 due to the elastic restoring force of the optical portion 2.

2, FIG. 3, and FIG. 4 are a left side view, a plan view of the same, and a right side view of the insertion cylinder 21 of the first embodiment of the present invention, which is a front side from the center of the insertion cylinder. . In the upper plan view of FIG. 3 and the like, a cutout portion 100 for inserting the intraocular lens 1 from a smaller wound and a slit 103 which is a stress releasing structure are provided. The notch 100 is shown in FIG.
And flat portion 102 for improving the insertability into the wound
a and 102b are formed. The flat portion 102 is shown in FIG.
a, 102b and a slit 103 formed from the tip of the insertion cylinder 21 which is a stress releasing means toward the base end.

The slit 103 extends from the tip of the insertion cylinder to the base end side in the center of the width direction of FIG. 4, and as shown in FIGS. 2 and 3, the slit 103 is provided with a space from the base end of the insertion cylinder 21. It is formed on the portion opposite to 103 in the direction perpendicular to the direction. Further, the distal end portion of the insertion tube 21 is formed by the flat portions 102a and 102b so as to be tapered, and further, the distal end portion of the slit 103 is curved to the right and slightly projected as shown in FIG.

When the intraocular lens 1 is moved to the base end portion of the first slit 103 when the intraocular lens 1 is inserted, the first slit 103 is opened by the restoring stress of the intraocular lens 1 and the restoring stress is released. The peripheral portion of the lens 1 is pushed out from the first slit 103 to the side portion of the insertion cylinder. When the stress of the intraocular lens 1 is released by the slit 103, if the friction between the intraocular lens and the insertion tube 21 is small, the intraocular lens itself restores to its original shape at a high speed when the stress is released. In order to avoid this, the rough surface portion 104 provided over the entire circumference of the inner surface of the insertion tube near the slit 103 increases the frictional resistance between the intraocular lens 1 and the inner surface of the insertion tube 21 to restore the intraocular lens at a high speed. To prevent it.

In FIG. 5, the restoring force of the folded intraocular lens 1 causes the first slit 103 to open from the tip of the insertion tube 21, and the edge of the lens 1 extends from the opening to the side of the insertion tube 21. The state of being extruded is shown. The force that the first slit 103 tries to return to the original state after the marginal portion of the lens 1 is pushed out from the opening of the first slit 103 and the restoring stress of the lens 1 is gently and sufficiently released by the rough surface portion 104. The intraocular lens 1 is fixed by sandwiching it. After this,
By further pushing out the pushing shaft 15, the entire intraocular lens 1 is inserted into the eye.

FIG. 6 shows a structure in which a rough surface is provided only on a part of the inner circumference of the insertion party, and FIGS.
It is possible to control the ejection speed of the lens in the same manner as.

In the above embodiment, the flat portion 102 is provided at the tip of the insertion tube 21 in order to facilitate insertion into the wound.
a and 102b are provided, and the internal volume of the tip portion of the insertion tube 21 is small. Therefore, if the rough surface portion 104 provided to increase the frictional resistance is not formed,
When the vicinity of the center of the lens having the largest volume in the folded state passes near the base of the first slit 103, the restoring force of the lens is released all at once, so that the intraocular lens 1 is vigorously pushed out from the slit 103. there is a possibility.
As a result, there is a risk of damaging intraocular tissue by the support portion 3 of the intraocular lens 1 shown in FIG.

In the above-described embodiment, the structure in which the inner surface of the insertion cylinder near the slit 103, which is the stress releasing structure, is roughened to increase the frictional resistance with the lens, but the method of increasing the frictional resistance is not limited to this. Alternatively, the same effect can be obtained by, for example, coating the inner surface of the insertion cylinder with a substance having a strong adhesive property at a portion corresponding to the rough surface.

Further, in the above-mentioned embodiment, the stress releasing structure is shown as the slit provided from the tip of the insertion cylinder to the root portion, but the present invention is not limited to this, and as described above, cut off diagonally from the tip end of the insertion cylinder to the root portion. The same effect can be obtained by adopting a different shape and providing a structure for increasing frictional resistance on the inner surface of the insertion cylinder in the vicinity thereof.

The intraocular lens 1 used in the embodiment is
Although the optical part 2 and the supporting part 3 as shown in FIG. 7 are made of different materials, the supporting part 4 made of the same kind of material as the optical part 2 shown in FIG. It can be used even if it is fixed in the eye, and is not limited to the intraocular lens 1 shown in FIG. 7, and the intraocular lens 1 shown in FIG.
Can also be used.

[0027]

As described above, claim 1 of the present invention
In the insertion device of the deformable intraocular lens, the deformable optical part, the intraocular lens consisting of the support part for supporting the optical part in the eye, through the insertion tube having an opening at the tip, In an instrument for inserting an intraocular lens, which is moved by an extruding mechanism including an extruding shaft and relaxes the stress at the time of lens deformation by the stress releasing structure provided in the inserting cylinder to insert into the eye, in the vicinity of the stress releasing structure part By providing a structure to increase the frictional resistance on the inner surface of the insertion tube, it is possible to slowly push the lens into the eye even with an insertion tube having a smaller cross-sectional area than the conventional insertion tool composed only of the stress relief structure. It is possible to safely insert the intraocular lens.

According to a second aspect of the present invention, in the apparatus for inserting a deformable intraocular lens, the stress relief structure described in the first aspect is limited to a specific structure. In 3 and 4, the structure that increases the frictional resistance,
It is specifically limited and has the same effects as the above.

[0029]

[Brief description of drawings]

FIG. 1 is a perspective view of an entire insertion tool showing a first embodiment of a deformable intraocular lens insertion device of the present invention.

FIG. 2 is a left side view of a main part showing the insertion cylinder of FIG.

FIG. 3 is an upper plan view of a main part showing the insertion tube of FIG.

FIG. 4 is a right side view of a main portion showing the insertion cylinder of FIG.

5 is a plan view of the main part showing the usage state of the insertion tube of FIG. 1. FIG.

FIG. 6 is a top plan view of a main portion showing another embodiment of a structure for increasing frictional resistance.

FIG. 7 is a plan view of a conventional deformable intraocular lens.

FIG. 8 is a plan view showing another example of a conventional deformable intraocular lens.

[Explanation of symbols]

1 intraocular lens 2 Optics 3 Supports of different types of flexible materials 4 Support part made of the same material as the optical part 12 Instrument body 14 Control tube 15 Extrusion shaft 16 Holding member 21 insertion tube 27 Slide stopper 100 Notch provided at the tip of the insertion tube 102a flat part 102b flat part 103 slit 104 Rough surface provided to increase frictional resistance

Claims (4)

[Claims] 1. A lens for intraocular insertion, which comprises a deformable optical part and a support part for supporting the optical part in the eye, is moved by an extruding mechanism including an extruding shaft through an insertion tube having an opening at the tip. In an instrument for inserting an intraocular lens that relieves stress at the time of lens deformation by the stress relief structure provided in the insertion tube and inserts the lens into the eye, friction resistance increases on the inner surface of the insertion tube near the stress release structure portion. A device for inserting a deformable intraocular lens, which is characterized in that a structure is provided. 2. The deformable intraocular insert according to claim 1, wherein the stress releasing structure is one or a plurality of slits provided from the distal end of the insertion tube toward the proximal end. Lens insertion tool. 3. The structure for increasing the frictional resistance is characterized in that the inner surface of the insertion cylinder is roughened over the entire circumference.
Alternatively, the deformable intraocular lens insertion tool according to claim 2. 4. The insertion device for a deformable intraocular lens according to claim 1 or 2, wherein the structure for increasing the frictional resistance is such that the inner surface of the insertion tube is partially roughened. .