JP2006034917A - Intraocular lens - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intraocular lens, in which a stitch position can be chosen on a support part when carrying out a stitch of the intraocular lens for capsula lentis internal fixation to the piloid groove and whose adaptability to living body tissues is higher, and an intraocular lens for piloid groove stitches which does not have projections in the support part and is foldable. <P>SOLUTION: A portion W which is covered with the stitch threads of the loop-like support part H of the intraocular lens is thinned in a belt form. The support part H of this invention does not move when carrying out a stitch to the piloid groove, and even if the necessity for extraction of the intraocular lens arises, if the stitch threads are cut, drawing out of the lens from the piloid groove of support part H is easy and extraction of the intraocular lens can be operated easily. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

The present invention relates to an intraocular lens that is implanted into a patient's eye for vision correction after a cataract extraction operation of a cataract patient.

Human lenses become cloudy due to aging or trauma and become cataracts. In many cases, after obtaining intraocular transparency by cataract surgery, an intraocular lens is transplanted to the original lens for correcting vision. It is believed that the best result is that the intraocular lens (artificial lens) to be implanted is implanted in the lens capsule. However, if the lens capsule and the chin slats that support the capsule are damaged, the intraocular lens cannot be implanted into the lens capsule. At this time, the intraocular lens for ciliary groove sewing is implanted. At this time, when the range of damage to the chin strap is narrow, the intraocular lens for fixing the intracapsular lens is directly implanted into the ciliary groove. The ciliary groove is located behind the iris. When the degree of damage to the chin band is strong, or when the boundary membrane (vitreous membrane) with the lens is broken, an intraocular lens for ciliary groove stitching is implanted.

However, the intraocular lens for fixing the lens capsule may be transplanted as it is as an intraocular lens for ciliary groove sewing. At this time, the loop-shaped support part (haptic) of the intraocular lens is sewn to the ciliary groove from the external sclera.
Japanese Patent No. 2792588 discloses an intraocular lens for suturing the sclera and the like. A middle abdomen is provided in the middle of the loop-shaped support part, and a notch is provided in the center of the middle abdomen. A suture is applied to the notch and sutured to the sclera. In order to provide the notch, the middle part of the support part is thick.

First of all, the problem to be solved is that when the intraocular lens for fixing the intracapsular lens is sewn in the ciliary groove, it is difficult to determine the position to be put on the looped support part of the sewing thread. Since the eyeball is constantly moving, the support part is displaced from the sewing thread, causing the intraocular lens to be deviated and tilted, resulting in a decrease in patient vision.

Secondly, the support part has low flexibility in the conventional intraocular lens for ciliary groove sewing provided with a small loop loop in the loop-like support part or the intraocular lens disclosed in Japanese Patent No. 2792588. Thus, there is a possibility that the function of the support part that seeks the original flexibility is impaired and side effects are induced. In addition, when a suture is applied to a small annular loop or notch and a support is sewn to the ciliary groove, the eyeball is constantly moving, so that the eyeball is constantly moving and the ciliary tissue in the middle abdomen with the small annular loop or notch As the contact surface increases, the degree of inflammation at the site increases.
In addition, when these intraocular lenses have to be removed for some reason when adhering to a ciliary tissue that is in contact with the mid-abdomen with a small annular loop or notch, the small annular loop In addition, the middle abdomen with the cutouts cannot be separated from the ciliary tissue, and it becomes difficult to remove these intraocular lenses, making it difficult for the patient to recover their visual acuity.
In addition, the intraocular lens for ciliary groove sewing provided with a small annular loop and the intraocular lens disclosed in Japanese Patent No. 2792588 are each provided with one point on the support side and a notch in the annular loop. There is only one point on the support side, and the sewing position cannot be moved. Since the living eye has a different size for each patient, the sense of stability increases if the sewing position can be adjusted according to the eyeball size of the patient. The patient's axial length is about 20 to 30 mm, which is individually different.

Third, in the case of an operation in which the intraocular lens is inserted into the eye after being folded or rolled, the conventional intraocular lens for ciliary groove stitching cannot be folded or rounded due to its protrusions, and the incision can be cut. I had to take big. To develop an intraocular lens that can be folded or rolled into the eye and sewn into a ciliary groove. At present, there is no intraocular lens suitable for or developed for crevice stitching that can be folded or rolled.

In an intraocular lens in which the optical part and the loop-shaped support part are integrated, the distance from the base of the optical part of the support part to the proximal end of the support part is made thin, and a step is provided to smooth the tip of the support part. The intraocular lens is characterized in that, depending on the size of the patient's eyeball, the sewing position of the support part to the ciliary groove can be selected at an arbitrary position of the thinned part of the support part. That is, the present invention is also characterized in that a step is provided in the support portion. Furthermore, the present invention provides an intraocular lens which does not have a noticeable shape change when wearing a ciliary groove on the support portion, that is, has no protrusion. As long as the sewing position selected arbitrarily is in the middle of the long axis of the intraocular lens in the middle of the support part, the band is narrower than before and after the support part, and the sewing position can be arbitrarily shifted on the thin support part. Provide the inner lens.
Furthermore, an intraocular lens having an arbitrarily selectable sewing position within a range of 0.5 to 2.0 mm is provided. To provide an intraocular lens in which the thickness of the thinned support portion is 20 to 50% thinner than the thickness of the support portion. This means of the present invention enables an intraocular lens that can be folded or rolled and inserted into the eye.

That is, the present invention solves the problem by narrowing the portion where the sewing thread is applied to the support portion into a strip shape and giving the width to shift the sewing position. The support portion of the present invention has a thickness of about 0.10 to 0.15 mm in diameter, for example, but the sewing site is made thin in a band shape by about 20 to 50% of this thickness. Alternatively, the thin part is about 0.10 to 0.15 mm in diameter, and the tip is about 20 to 50% thicker. That is, the tip is 0.12 to 0.225 mm. However, the present invention is not limited to the numerical values, and is characterized in that a thin portion and a thick portion are provided without providing a protrusion on the support portion. In addition, the position where the support part is made thin is provided at a position located at the tangent line of the ciliary groove that is annular in the eyeball. The length on the thinned support part and the band-like width on which the sewing thread is applied are preferably about 0.5 to 2.0 mm, but are not limited to these values. In general, there are many cow hitch knotting methods (a method of simply tying a rope to a cow's nose ring) to the thin portion of the support portion, and the support portion of the present invention is also supported.

This invention solves a subject by making the part which hangs a sewing thread | yarn to both when there are two loop-shaped support parts. The loop-shaped support portion of the present invention does not move when sewn in the ciliary groove, and even if it is necessary to remove the intraocular lens, if the sewing thread is cut, the support portion is removed from the ciliary groove. Is easy and can be easily removed.

The intraocular lens according to the present invention in which a portion where a sewing thread is applied to a loop-shaped support portion is thinned in a band shape is used as an intraocular lens for fixing a lens capsule, fixing a ciliary groove, and ciliary groove sewing, and is used by a user (surgery). There is no need to distinguish between them. This can avoid confusion in arranging various intraocular lenses for the surgeon or at the time of preparation for surgery.

In the intraocular lens according to the present invention in which the portion where the sewing thread is applied to the loop-shaped support portion is thinned in a band shape, when the sewing thread is tied to the support portion, it can be firmly fixed to any part thereof. It is hard to slip off and to come off. In other words, since the tip portion is thickened, the yarn is less likely to come off from the support portion due to the step between the thin support portion and the thick tip support portion. Then, the operator can select a sewing position on the support portion during the operation. That is, if the patient is a small eyeball, the major axis A of the intraocular lens is narrowed as described with reference to FIG. 1, and the sewing position is close to the major axis A if the eyeball is a large eyeball. Sewing place can be selected on the support portion tip E side.

In the present invention, when there are two loop-shaped support portions, the intraocular lens is often displaced up and down, left and right, and back and forth, which is often caused by applying sewing threads to both of them and sewing the ciliary groove. The inclination of is reduced. When the surgeon wants to sew the intraocular lens for fixing the lens capsule in the ciliary groove, check the thread (the position, the tensile strength of the thread, etc.) applied to the two support parts, and adjust the intraocular lens position, etc. However, the use of the intraocular lens of the present invention makes it easy to adjust the thread, and the deviation and inclination of the intraocular lens are improved. This greatly reduces the patient's postoperative visual acuity and intraoperative physician stress.

When the loop-shaped support portion is sewn in the ciliary groove by transplanting the intraocular lens of the present invention into a cataract patient, the lens does not deviate, and even if the necessity of removing the intraocular lens arises. If the sewing thread is cut, it is easy to remove the intraocular lens from the ciliary groove of the support portion, and it becomes easy to operate. This also greatly reduces the patient's postoperative visual acuity and intraoperative doctor's stress.

When the support portion is sewn in the ciliary groove by implantation of the intraocular lens of the present invention into a cataract patient, the conventional loop-shaped support portion of FIG. 4 is cut into a small annular loop or the mid-abdominal portion of FIG. Compared to the intraocular lens with a ciliary groove stitch that makes a prominent protrusion provided with a notch, the area and volume in contact with the living tissue are small and flexible, and post-operative inflammation at the sewn site can be reduced. If the support portion is flexible, it can be folded and the incision for intraocular lens implantation can be made smaller. This contributes to maintaining patient vision and reducing medication.

The advantages of transplanting the intraocular lens of the present invention into a cataract patient can be summarized as follows: improvement and maintenance of visual acuity of the patient, reduction of intraoperative stress of the surgeon, reduction of medication, reduction of various intraocular lens reserve stocks, eyes of surgical personnel The internal lens can be used and handled easily.

In the present invention, as shown in FIG. 1, a part W of an intraocular lens having a loop-shaped support portion called a support portion H is thinned in a band shape, and the intraocular lens is inserted into a ciliary groove in a patient's eyeball. Sews the lens. As shown in FIG. 2, a sewing thread K is used to sew the support portion to the narrowed portion W, and the support portion H is sewn into the ciliary groove. Although the present invention has been described with a cowchitch knot that is normally operated as shown in FIG. 2, other knotting methods may be used. The knot can be selected anywhere in the thin portion W depending on the size of the patient's eyeball.

In the present invention, if the posterior chamber intraocular lens has a support part that has been generally implanted conventionally, a part of the support part is made thin as shown by W in FIG. 1, and polymethylmethacrylate, acrylic resin, and silicone are used. The present invention can be implemented regardless of the material such as resin. In addition, if there are a plurality of support portions H, better stability can be obtained by sewing the intraocular lens of the present invention in which a plurality of the support portions H are partially narrowed in a band shape.

A portion W of the support portion H of the present invention shown in FIG. However, since the size of the eyeball varies depending on the patient, the length of the portion W for thinning a part of the support portion H of the present invention is preferably about 0.5 to 2.0 mm, and the thin portion W of the support portion H is shaped like a belt The thread sewn in the position cannot escape to the lens L side or the tip end E side of the support portion H outside the length range. The width of the portion W for thinning a part of the support portion H of the present invention is such that the position of the ciliary groove is patient-specific and varies depending on the patient. It becomes possible to cope with.

1 and 2, a portion W where the sewing thread is applied to the loop-shaped support portion H is thinned in a band shape. For example, the support portion H is usually about 0.1 to 0.15 mm in diameter, but the portion W is made thinner by about 20 to 50% of the thickness. As shown in FIG. 2, once the sewing thread is tightened at an arbitrary position selected by the portion W, the thread is unlikely to come off to the left and right due to the step D. Regardless of the position of FIG. 1 and FIG. 2, the portion W has a diameter of about 0.1 to 0.15 mm in diameter from the loop-shaped support portion H as shown in FIG. About 20-50% thicker. The present invention is not limited to these numerical values. Once the sewing thread is tightened at an arbitrary position selected by the portion W, the thread has a step D, so that it is difficult to come off from the front end E of the support section.

4 and 5 show an intraocular lens for ciliary groove sewing that has already been disclosed. 4 is an upper half view of an intraocular lens in which a small annular loop is provided on the support H of the optical part L, and FIG. 5 is provided with a notch on the middle part of the support H of the optical part L. FIG. These two support portions H are less flexible than the conventional intraocular lens without protrusions or the intraocular lens of the present invention. When flexibility becomes poor, there is a risk that the degree of inflammation will increase without adapting to living tissue. Moreover, in FIG.4 and FIG.5, the area of the projection part of the ring-shaped loop R of the support part H and the middle abdominal notch part C increases, the contact area with a biological tissue increases, and an inflammation degree increases. Further, when the living tissue adheres to the protrusions R and C, when the intraocular lens has to be removed for some reason, the protrusions R and C cannot be separated from the living tissue. It may be difficult to remove the inner lens, and it may be difficult for the patient to recover vision. Further, since the threaded portion is threaded through the looped loop R and threaded at the notch portion, the sewing thread cannot be removed from the loop tip E, but is fixed at a predetermined position and the patient's eyeball is different. Does not correspond to size.

An intraocular lens as shown in FIG. 1 was prepared, and a thread was tied as shown in FIG. The intraocular lens was prepared with a major axis of 12.5 mm, an optical part diameter of 6 mm, a loop-shaped support part thickness of 0.13 mm, and an overall polymethyl methacrylate. The thin part W of the support part H was 0.09 mm thick, and the strip length was 2.0 mm. Steps were provided by 0.2 mm in width on both sides of the 2.0 mm, the tip E and the support base, and the thickness was returned from 0.09 mm to 0.13 mm. The distance from the tip E to the center of the thin part W was 2.0 mm. As shown in FIG. 2, a 9-0 polypropylene suture (thickness: about 0.035 mm) was used for the support portion W.

Under the microscope, we saw the displacement of the suture on the support, but the thread was firmly fixed. With the naked eye, it seemed that there was almost no processing on the support part, regardless of whether or not there was a thread. However, of course, the difference in the thickness of the support portion was found under the microscope. Four circular plastic cases with size diameters 10.0, 10.5, 11.0, and 11.5 mm, and a thin band-like part of the support part of the intraocular lens having a major axis A of 12.5 mm prepared as shown in FIG. As a result of testing whether the portion touches the outer circumference circle, for example, in the case of 11.5 mm, the portion close to the tip E of the support portion touches, and in any case, the strip-like thin portion of 2.0 mm touches the outer circumference circle well. It was. The support part was very flexible, and it seemed to fit well in both the lens capsule and the ciliary groove. The area in contact with the ciliary groove is clearly smaller than the conventional one, or smaller than the small annular loop shown in the reference diagram, FIG. 4 or FIG. The support part of the smooth shape was exhibited without this protrusion. This suggests that the intraocular lens of the present invention can be folded.

Claw hitch knotting with 9-0 polypropylene thread was carried out to the thin part W of the two support parts H of the intraocular lens manufactured in Example 1, and the suture thread knot of the lens was tested. The cowchitched thread shown in FIG. 2 did not move to the left and right once tightened, and there was no concern about squeezing from the tip E of the support. The knots of the yarn cowchitch were smooth without any protrusions without exceeding the support thickness of 0.13 mm. When the outside of the knot between the two sutures was cut, and the knot was gently pressed with a scissors, the loop was pulled out smoothly with few catches.

An intraocular lens as shown in FIG. 3 was prepared. The intraocular lens has a major axis of 12.5 mm, an optical part diameter of 6 mm, a loop-like support part thickness of 0.13 mm, and the whole is made of hydroxyethyl methacrylate (HEMA). The thin part W of the support part H was 0.13 mm thicker than the base part of the support part optical part. The thickness of the tip E was 0.2 mm. The tip E was 1.30 mm in length, provided with a step D, and made the portion W thinner.

For comparative study, an intraocular lens for ciliary groove stitching, (model NR81K (Nidek Corporation) and model CZ70BD (ALCON, USA)), intraocular lens for intracapsular fixation, (model VA60BB, HOYA Corporation), Then, the intraocular lens produced in Example 3 was used as a bilateral intraocular lens, and a sewing test was performed with a simulated eye having an inner diameter of 11.06 mm (which is said to be the average diameter of a human ciliary groove), and the fixation state was observed. did. With the bilateral intraocular lens, the step was not visible to the naked eye, and there was no concern about the suture thread coming off, and it was easy to select the ciliary groove fixing position. In addition, the stability after suturing was observed to be the best for the bilateral intraocular lens. The inventor made an academic report on the details of the intraocular lens shown in FIG. 3 at the 19th Japan Intraocular Lens Refraction Surgery Society on June 26, 2004.

Industrial applicability

The intraocular lens of the present invention can also be applied to mammals, particularly animals such as dogs and cats.

These are the front views of the intraocular lens Example which narrowed the part which applies a sewing thread | yarn to the support part of this invention. FIG. 3 is an enlarged view of a portion where a sewing thread is applied to the support portion shown in FIG. 1, and is a front view in which the sewing thread is tied to a cow hitch. These are the front views of the Example of the intraocular lens which thinned from the optical part base of the support part of this invention to the front-end | tip part proximal. This is a reference figure with a small loop loop on the support, only the upper half of the intraocular lens, and the ciliary groove sewing that has been used for the purpose of applying a sewing thread to the loop loop of the support. It is a reference drawing of an intraocular lens. Is a diagram of the lower half of the intraocular lens disclosed in Japanese Patent No. 2792588, and is a reference diagram for explaining the intraocular lens for ciliary groove stitching having a notch in the middle of the loop-shaped support part. is there.

Explanation of symbols

A. . . . . Long diameter of intraocular lens C.I. . . . . B. Notch in the middle abdomen for threading the support . . . . Step E. . . . . Support part tip part H.R. . . . . Support (Lens support loop, haptic)
L. . . . . Optical part (lens) of intraocular lens
R. . . . . Small annular loop for threading the support W. . . . . A part that is thinned in a band to put a suture on the support

Claims (3)

In an intraocular lens in which the optical part and the loop-shaped support part are integrated, the distance from the base of the optical part of the support part to the proximal end of the support part is made thin, and a step is provided to smooth the tip of the support part. The intraocular lens is characterized in that, depending on the size of the patient's eyeball, the sewing position of the support part to the ciliary groove can be selected at an arbitrary position of the thinned part of the support part. The thickness from the base of the optical part to the proximal end of the support part is set to a diameter of 0.10 to 0.15 mm, and the distal part is made 20 to 50% thicker than the thickness to the proximal part of the tip part. The intraocular lens according to Item 1. 2. The intraocular lens according to claim 1, wherein the intraocular lens can be used for intracapsular fixation, ciliary groove fixation, or ciliary groove sewing.

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