JP2005312835A - Lacrimal passage stent reinforced by thread - Google Patents

Lacrimal passage stent reinforced by thread Download PDF

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JP2005312835A
JP2005312835A JP2004136811A JP2004136811A JP2005312835A JP 2005312835 A JP2005312835 A JP 2005312835A JP 2004136811 A JP2004136811 A JP 2004136811A JP 2004136811 A JP2004136811 A JP 2004136811A JP 2005312835 A JP2005312835 A JP 2005312835A
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nst
brim
lacrimal
thread
tensile strength
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Katsuaki Kurihashi
克昭 栗橋
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M L C:Kk
有限会社エム・エル・シー
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<P>PROBLEM TO BE SOLVED: To solve the problem that a lacrimal passage stent for a lacrimal passage operation such as a nunchaku type silicone tube (NST) or a brim NST has a narrow section (40) which sometimes causes cutting. <P>SOLUTION: A thin thread (93) which is excellent in tensile strength, heat resistance, fatigue resistance and X-ray opacity is disposed in a body of the NST or the brim NST as a reinforcement member. Moreover, a cup type reinforcement member (94) connected to the thread (93) is disposed at a pointed head of the NST or the brim NST so that a penetration not easily occurs when the NST or the brim NST is pushed in by a metallic probe (61). <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

この発明は涙道閉塞やドライアイの治療に適した涙道ステントに関する。 This invention relates to a lacrimal stent suitable for the treatment of lacrimal duct obstruction and dry eye.

本発明者は涙道閉塞やドライアイの治療のために操作が簡単で患者に与える苦痛が少なく、しかも正確に素早く涙道内に挿入でき、従来のものに比較し効果的で、抜けにくく、装用感のよい涙道ステントを長年に渡り鋭意研究を続け、図2に示されるヌンチャク型シリコーンチューブ(以下NSTとする)や図3に示されるブリムNST、突起付き涙点プラグなどを発明した。 The present inventors have less pain operation has on the patient and easy to treat lacrimal duct obstruction and dry eye, yet exactly be inserted quickly lacrimal duct, a comparison with the conventional effective, more difficult to pull it out, wearing continued for many years over intensive study good lacrimal stent of sensitive (and less NST) Nunchuk silicone tube shown in FIG. 2 and brim NST shown in FIG. 3, was invented and with projections punctal plug. NSTやブリムNSTはすでにカネカメディックス社で製造販売されて多くの医師により使用されている。 NST and brim NST has already been used by many doctors are manufactured and sold by Kaneka Medix Corporation. 例えば、米国特許No.US6,383,192B1、栗橋克昭著「ダクリオロジー―臨床涙液学―」メディカル葵出版 1998年、栗橋克昭「涙道手術とドライアイ(ビデオ)」 製作:インターメディカ 企画:日本眼科医会、協賛:万有製薬株式会社、2003、特願2003−154328参照。 For example, US patent No.US6,383,192B1, Katsuaki Kurihashi al., "Dakurioroji - clinical tear Studies -" Medical Aoi published in 1998, Katsuaki Kurihashi "lacrimal surgery and dry eye (video)" Production: Inter Medica Planning: Japan ophthalmologists Association, sponsor: Banyu pharmaceutical Co., Ltd., 2003, refer to Japanese Patent Application No. 2003-154328.

図1に示すように、涙液は涙腺(14)から分泌され、角膜(15)や結膜(16)が存在する眼球表面(17)を潤した後に、涙道を通って下鼻道(18)に排出される。 As shown in FIG. 1, lacrimal fluid is secreted from the lacrimal gland (14), corneal (15) and the conjunctiva (16) after moistening the ocular surface (17) is present, the lower meatus through the lacrimal duct (18 ) it is discharged to. 涙道は、上涙点(1)、下涙点(2)、上涙小管垂直部(3)、下涙小管垂直部(4)、上涙小管垂直部と水平部の境界部(5)、下涙小管垂直部と水平部の境界部(6)、上涙小管水平部(7)、下涙小管水平部(8)、総涙小管(9)、内総涙点(10)、涙嚢(11)、鼻涙管(12)からなる。 Lacrimal tract, upper punctum (1), lower punctum (2), Uenamida small pipe vertical section (3), Shitanamida small pipe vertical section (4), the boundary portion of Uenamida tubule vertical portion and a horizontal portion (5) , Shitanamida boundary of tubule vertical portion and a horizontal portion (6), Uenamida canalicular horizontal section (7), Shitanamida canalicular horizontal section (8), the total canaliculus (9), the inner total punctum (10), tears sac (11), consisting of nasolacrimal duct (12). 鼻涙管(12)の下端(13)は下鼻道(18)に開いている。 The lower end of the nasolacrimal duct (12) (13) is open to Shitahanado (18). 涙小管水平部(7)、(8)の内腔の形態は紡錘形である。 Canalicular horizontal section (7), the form of the lumen (8) is spindle. 涙小管内腔に陰圧が発生することが知られている。 Negative pressure in the canalicular lumen has been known to occur. 例えば栗橋克昭著:ダクリオロジー―臨床涙液学―. For example Written by Katsuaki Kurihashi: Dakurioroji - Clinical tear Studies -. メディカル葵出版,東京,1998. Medical Aoi publication, Tokyo, 1998. 参照。 reference.
特開2000−70296号公報 JP 2000-70296 JP 米国特許No. United States Patent No. US 6,383,192B1 US 6,383,192B1 特願2003−154328 Japanese Patent Application No. 2003-154328 特願2003−198779 Japanese Patent Application No. 2003-198779 特表2002−529144 JP-T 2002-529144 特願2003−295664 Japanese Patent Application No. 2003-295664 特願2003−311886 Japanese Patent Application No. 2003-311886 特開平10−33584 JP-A-10-33584

発明しようとする問題点は図2に示されるNSTや図3に示されるブリムNSTの細い部分(40)が使用中に切れてしまうことがあるということである。 Trying invention to problem is that sometimes NST and narrow part (40) of the brim NST shown in FIG. 3 is shown in FIG. 2 would off during use.

本発明の解決手段は図4〜14に示されるようにNST、ブリムNSTの肉の中に引張り強度、耐熱性、耐疲労性、X線不透過性に優れた細い糸(93)を通すことである。 Solution of the present invention NST as shown in FIG. 4-14, the tensile strength in the meat brim NST, the heat resistance, fatigue resistance, passing a thin thread having excellent X-ray opaque (93) it is.

図4〜14に示されるように糸(93)を通すことにより、NSTやブリムNSTが切れにくくなる。 By threading (93) as shown in Figure 4-14, hardly expired NST and brim NST. 図9〜14に示されるブリムNSTは、さらに涙道内の安定性がよくなるように細い部分(40)の間に約2mmの長さのさらに細い部分(81)が存在する。 Brim NST shown in FIG. 9-14, further lengths further narrow part of about 2 mm (81) is present between the stability is good become so narrow part of the lacrimal duct (40). このさらに細い部分はツバ(23)より約1mmから始まる長さ2mmの部分で、その代表的例を図14に示す。 The more narrow portion in a portion of the length 2mm starting at about 1mm from the flange (23), shows the typical example in Figure 14. さらに細い部分(81)を設けることによりブリムNSTはしなやかになり涙小管垂直部(3、4)と涙小管水平部(7、8)の間のカーブに影響されにくくなり、涙道内の安定性がよくなる。 Further brim NST by providing a thin portion (81) is less likely to be affected by the curve between the canalicular vertical portion becomes supple (3,4) and canalicular horizontal section (7,8), the lacrimal duct stability There will be better.

本発明の実施形態においては、NSTやブリムNSTの肉の中に細い糸(93)を通すが、糸の太さはNSTやブリムNSTの肉厚に比較し十分に小さなものとなっており、糸(93)がNSTやブリムNSTに覆われている。 In an embodiment of the present invention is passed through a thin thread (93) into the meat of NST and brim NST, thickness of the yarn is made as small in comparison to the thickness of the NST or brim NST sufficient, thread (93) is covered with the NST and the brim NST. ブリムNSTやNSTの肉の最も薄い部分は0.15mm〜0.3mmであるので、糸(93)の太さは直径0.01〜0.1mmである。 Since the thinnest portion of the meat of the brim NST and NST is a 0.15mm~0.3mm, the thickness of the yarn (93) has a diameter of 0.01~0.1mm. 糸(93)は引張り強度、耐熱性、耐疲労性、X線不透過性に優れたステンレスや真鍮、ピアノ線などの金属やプラスチックその他が適当である。 Thread (93) is tensile strength, heat resistance, fatigue resistance, X-rays opaque excellent stainless steel or brass, metal or plastic, such as piano wire others are suitable.

図4に示される実施形態においてはNSTの全長にわたり肉の中に糸(93)を1本通したものである。 In the embodiment shown in FIG. 4 is a through one thread (93) into the meat over the entire length of the NST.

図5に示される実施形態においてはNSTの全長にわたり糸(93)を2本通したものであるが、3本以上でもよい。 But those through two thread (93) over the entire length of the NST in the embodiment shown in FIG. 5, may be three or more.

図6に示される実施形態においてはNSTの細い部分に限局して糸(93)を1本通したものである。 In which through one thread (93) confined to a narrow portion of the NST in the embodiment shown in FIG.

図7に示される実施形態においてはNSTの細い部分に限局して糸(93)を2本通したものであるが、糸(93)は3本以上でもよい。 Although in the embodiment shown in FIG. 7 is obtained through two thread (93) confined to a narrow portion of the NST, the yarn (93) may be three or more.

図8に示される実施形態においてはNSTの先の部分を補強するために薄いステンレスなどでできたカップ状の部材が留置され、そのカップに1本又は2本以上の糸(93)が連結されている。 In the embodiment shown in FIG. 8 is placed cup-shaped member made of thin stainless like to reinforce the previous part of the NST, 1 or two or more yarns (93) is connected to the cup ing. 糸(93)は引張り強度、耐熱性、耐疲労性、X線不透過性に優れているので、NSTは十分に補強され、さらに、図8に示すように糸(93)に連結したカップ状の補強部材(94)を配置することによりNSTの挿入時に金属プローブで突き抜けることが少なくなる。 Thread (93) is tensile strength, heat resistance, fatigue resistance, so has excellent X-ray opacity, NST is sufficiently reinforced, further cup coupled to the thread (93) as shown in FIG. 8 It becomes less likely to penetrate a metal probe at the time of insertion of NST by arranging reinforcing members (94) of.

図9に示される実施形態においてはブリムNSTの全長にわたり肉の中に糸(93)を1本通したものである。 In which through one thread (93) into the meat over the entire length of the brim NST in the embodiment shown in FIG.

図10に示される実施形態においてはブリムNSTの全長にわたり肉の中に糸(93)を2本通したものであるが、3本以上でもよい。 But those through two thread (93) into the meat over the entire length of the brim NST in the embodiment shown in FIG. 10, may be three or more.

図11に示される実施形態においてはブリムNSTの細い部分に限局して糸(93)を1本通したものである。 In which through one thread (93) confined to a narrow part of brim NST in the embodiment shown in FIG. 11.

図12に示される実施形態においてはブリムNSTの細い部分に限局して糸(93)を2本通したものであるが、3本以上でもよい。 But those through two thread (93) confined to a narrow part of brim NST in the embodiment shown in FIG. 12, may be three or more.

図13に示される実施形態においてはブリムNSTの先の部分を補強するために、薄いステンレスなどでできたカップ状の部材(94)が留置され、そのカップに1本又は2本以上の糸(93)が連結されている。 To reinforce the previous part of the brim NST in the embodiment shown in FIG. 13, a thin cup-shaped member made of such as stainless (94) is placed, one or two or more yarns on its cup ( 93) are connected.

図8、13に示されるステンレスなどでできたカップ(94)についてはすでに本発明者が報告している。 Already present inventors have reported about a cup (94) made of such as stainless shown in Figure 8,13. 特開平10−33584参照。 See JP-A-10-33584.

図14は本発明のブリムNSTの最適な1例の寸法を示している。 Figure 14 shows the optimal example dimensions of the brim NST of the present invention.

図4〜8に示されるようにNSTに補強部材として糸(93)を取り付けたものは切れにくい。 The hard cut formed by attaching the thread (93) as a reinforcing member in the NST, as shown in Figure 4-8. 図15に示されるようにNSTの太い方のチューブ(42)に付けられた小さな切れ目(49)から金属プローブ(61)を挿入してNSTを涙道内に押し込む。 Pushed into the lacrimal duct to NST small cuts attached to the thicker tubes of NST (42) from (49) by inserting a metal probe (61) as shown in Figure 15.

図16はNSTの涙道内における留置状態を示しているが、従来のNSTと同じように涙道内の安定性はよい。 Figure 16 is shows an indwelling state of lacrimal duct of NST, the stability of the same as the lacrimal duct with the conventional NST good.

図9〜14に示されるようにブリムNSTに補強部材として糸(93)を取り付けたものは切れにくい。 The hard cut formed by attaching the thread (93) as a reinforcing member in the brim NST, as shown in Figure 9-14. 図17に示されるようにブリムNSTの太い方のチューブ(42)に付けられた小さな切れ目(49)から金属プローブ(61)を挿入してブリムNSTを涙道内に押し込む。 Pushed into the lacrimal duct with the brim NST from a small cut attached to the thicker tubes of brim NST (42) (49) by inserting a metal probe (61) as shown in Figure 17.

図18はNSTの涙道内における留置状態を示しているが、従来のブリムNSTと同じように涙道内の安定性はよい。 Figure 18 is shows an indwelling state of lacrimal duct of NST, the stability of the same as the lacrimal duct with the conventional brim NST good.

NSTやブリムNSTを補強するために糸(93)や糸付きカップ(94)などの補強部材を配置することにより、NSTやブリムNSTが破損しにくくなり、より安全に挿入することができる。 By to reinforce the NST or brim NST placing reinforcing member such as a yarn (93) and yarn with a cup (94) can NST and brim NST is hardly damaged, safer insertion.

涙道を示す概略図 Schematic diagram showing the lacrimal 従来のヌンチャク型シリコーンチューブ(NST)を示す概略図 Schematic diagram showing a conventional nunchaku silicone tubing (NST) 従来のブリムNSTを示す概略図 Schematic diagram illustrating a conventional brim NST 本発明による補強されたヌンチャク型シリコーンチューブ(NST)の断面を示す概略図 Schematic diagram showing a cross-section of reinforced nunchaku silicone tube according to the invention (NST) 本発明による補強されたヌンチャク型シリコーンチューブ(NST)の断面を示す概略図 Schematic diagram showing a cross-section of reinforced nunchaku silicone tube according to the invention (NST) 本発明による補強されたヌンチャク型シリコーンチューブ(NST)の断面を示す概略図 Schematic diagram showing a cross-section of reinforced nunchaku silicone tube according to the invention (NST) 本発明による補強されたヌンチャク型シリコーンチューブ(NST)の断面を示す概略図 Schematic diagram showing a cross-section of reinforced nunchaku silicone tube according to the invention (NST) 本発明による補強されたヌンチャク型シリコーンチューブ(NST)の断面を示す概略図 Schematic diagram showing a cross-section of reinforced nunchaku silicone tube according to the invention (NST) 本発明による補強されたブリムNSTの断面を示す概略図 Schematic diagram showing a cross-section of the brim NST reinforced according to the invention 本発明による補強されたブリムNSTの断面を示す概略図 Schematic diagram showing a cross-section of the brim NST reinforced according to the invention 本発明による補強されたブリムNSTの断面を示す概略図 Schematic diagram showing a cross-section of the brim NST reinforced according to the invention 本発明による補強されたブリムNSTの断面を示す概略図 Schematic diagram showing a cross-section of the brim NST reinforced according to the invention 本発明による補強されたブリムNSTの断面を示す概略図 Schematic diagram showing a cross-section of the brim NST reinforced according to the invention 本発明のブリムNSTの代表的な例の寸法を示す説明図 Explanatory view showing the dimensions of the typical examples of the brim NST of the present invention 本発明によるヌンチャク型シリコーンチューブ(NST)の実施例を示す説明図 Explanatory view showing an example of Nunchuk silicone tubing (NST) according to the invention 本発明によるヌンチャク型シリコーンチューブ(NST)の涙道内の状態を示す概略図 Schematic diagram illustrating the state of lacrimal duct Nunchuck silicone tube according to the invention (NST) 本発明によるブリムNSTの実施例を示す説明図 Diagram illustrating an embodiment of a brim NST according to the invention 本発明によるブリムNSTの涙道内の状態を示す概略図 Schematic diagram illustrating the state of lacrimal duct brim NST according to the invention

符号の説明 DESCRIPTION OF SYMBOLS

1 上涙点 2 下涙点 3 上涙小管垂直部 4 下涙小管垂直部 5 上涙小管垂直部と水平部の境界部 6 下涙小管垂直部と水平部の境界部 7 上涙小管水平部 8 下涙小管水平部 9 総涙小管 10 内総涙点 11 涙嚢 12 鼻涙管 13 鼻涙管の下端 14 涙腺 15 角膜 16 結膜 17 眼球表面 18 下鼻道 23 ツバ 25 腔 40 細いチューブ(またはロッド)、細い部分 42 太い方のチューブ 49 小さな切れ目 61 プローブ 81 さらに細い部分 93 糸 94 カップ状補強部材 1 upper punctum 2 lower punctum 3 Uenamida small pipe vertical portion 4 Shitanamida small pipe vertical portion 5 Uenamida tubule vertical portion and the boundary portion 6 Shitanamida small pipe vertical portion of the horizontal portion and the boundary portion 7 Uenamida small pipe horizontal portion of the horizontal portion 8 Shitanamida canalicular horizontal portion 9 total canaliculus 10 within the total punctum 11 lacrimal sac 12 nasolacrimal duct 13 nasolacrimal duct of the lower end 14 lacrimal gland 15 cornea 16 conjunctival 17 ocular surface 18 under meatus 23 flange 25 bore 40 thin tube (or rod), a thin part 42 the thicker tube 49 a small cut 61 probe 81 further narrow part 93 threads 94 cup reinforcing member

Claims (5)

  1. ヌンチャク型シリコーンチューブ(NST)が切れにくく、X線で映るように、NSTの肉の中に引張り強度、耐熱性、耐疲労性、X線不透過性に優れた細い糸を通していることを特徴とする涙道ステント。 Hardly broken Nunchuk silicone tubing (NST) is, as reflected by X-ray, and characterized in that through the tensile strength in the meat NST, the heat resistance, fatigue resistance, a thin thread having excellent X-ray opaque lacrimal duct stent.
  2. ブリムNSTが切れにくく、X線で映るように、ブリムNSTの肉の中に引張り強度、耐熱性、耐疲労性、X線不透過性に優れた細い糸を通していることを特徴とする涙道ステント。 Brim NST is hardly broken, as reflected by X-ray, the tensile strength in the meat brim NST, the heat resistance, fatigue resistance, lacrimal stents, characterized in that through a thin thread having excellent X-ray opaque .
  3. ブリムNSTの細い部分でツバから1mmの点から始まり2mmにわたり、さらに細くなっていることを特徴とする請求項2に記載の涙道ステント。 Brim NST of over terms from collar 1mm by thin portions at the beginning 2 mm, lacrimal stent of claim 2, characterized in that is even thinner.
  4. 細い糸に連結した引張り強度、耐熱性、耐疲労性、X線不透過性に優れたカップ状の補強部材を先端部に配置していることを特徴とする請求項1に記載の涙道ステント。 Tensile strength and ligated into thin threads, heat resistance, fatigue resistance, lacrimal stent of claim 1, characterized in that it is arranged an X-ray opaque excellent cup-shaped reinforcing member to the tip portion .
  5. 細い糸に連結した引張り強度、耐熱性、耐疲労性、X線不透過性に優れたカップ状の補強部材を先端部に配置していることを特徴とする請求項2又は3に記載の涙道ステント。 Tensile strength and ligated into thin threads, tear according to claim 2 or 3, characterized in that it heat resistance, fatigue resistance, the X-ray opacity to the excellent cup-like reinforcing member disposed at the distal end road stent.
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WO2011049198A1 (en) * 2009-10-22 2011-04-28 株式会社カネカ Tube device for insertion into lacrimal passage
US8691265B2 (en) 2006-03-31 2014-04-08 Mati Therapeutics, Inc. Drug delivery methods, structures, and compositions for nasolacrimal system
US9132088B2 (en) 2008-04-30 2015-09-15 Mati Therapeutics Inc. Composite lacrimal insert and related methods
US9180045B2 (en) 2004-07-02 2015-11-10 Mati Therapeutics Inc. Treatment medium delivery device and methods for delivery of such treatment mediums to the eye using such a delivery device
US9216108B2 (en) 2008-02-18 2015-12-22 Mati Therapeutics Inc. Lacrimal implants and related methods
US9445944B2 (en) 2007-09-07 2016-09-20 Mati Therapeutics Inc. Lacrimal implants and related methods
US9463114B2 (en) 2004-04-15 2016-10-11 Mati Therapeutics Inc. Punctal plug with active agent
US9610271B2 (en) 2011-08-29 2017-04-04 Mati Therapeutics Inc. Sustained release delivery of active agents to treat glaucoma and ocular hypertension
US9949942B2 (en) 2008-05-09 2018-04-24 Mati Therapeutics Inc. Sustained release delivery of active agents to treat glaucoma and ocular hypertension
US9974685B2 (en) 2011-08-29 2018-05-22 Mati Therapeutics Drug delivery system and methods of treating open angle glaucoma and ocular hypertension
CN108742960A (en) * 2018-07-06 2018-11-06 董南 Lacrimal passage recovery support and its manufacturing method
US10238535B2 (en) 2009-02-23 2019-03-26 Mati Therapeutics Inc. Lacrimal implants and related methods

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US9463114B2 (en) 2004-04-15 2016-10-11 Mati Therapeutics Inc. Punctal plug with active agent
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US9949942B2 (en) 2008-05-09 2018-04-24 Mati Therapeutics Inc. Sustained release delivery of active agents to treat glaucoma and ocular hypertension
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US9610271B2 (en) 2011-08-29 2017-04-04 Mati Therapeutics Inc. Sustained release delivery of active agents to treat glaucoma and ocular hypertension
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