JP2006068440A - Intraocular lens insertion apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intraocular lens insertion apparatus capable of controlling the movement of an intraocular lens in a cartridge and, after attaching the cartridge, executing the insertion of the intraocular lens without any trouble. <P>SOLUTION: This intraocular lens insertion apparatus is provided with an insertion tube part to be inserted in an incision provided in an eyeball, a lens retainer part having a mounting stand provided at the end of the insertion tube part for mounting the intraocular lens, having a mounting face extending along the direction of bending the intraocular lens, and capable of deforming the shape of the mount face; an insertion apparatus body detachably attaching the lens retainer part at the end and having a guide means guiding the deformation of the mounting stand in the direction of bending the intraocular lens in mounting, and a push-out means axially extractably/retractably provided in the tube of the insertion apparatus body for pushing out the intraocular lens from the insertion tube part. The lens retainer part is provided with a regulation member regulating the movement of the intraocular lens laid on the mount before mounting the insertion apparatus body. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an intraocular lens insertion device for inserting an intraocular lens into the eye.

2. Description of the Related Art Conventionally, a technique of inserting an intraocular lens instead of a crystalline lens after removing the crystalline lens is generally used as one of the surgical methods for cataract. In order to insert an intraocular lens, first, an incision for inserting the intraocular lens is provided in the eyeball, and the cloudy crystalline lens inside the incision is crushed with an ultrasonic cataract surgical device or the like and sucked. Then, an intraocular lens is inserted through the incision at the place where the lens was.
Thus, when inserting an intraocular lens, the method of using the intraocular lens insertion instrument called an injector is common. As such an injector, a holder (cartridge) for placing an intraocular lens is used as a lens package (lens case) and is removable from the injector body. In such a cartridge, the intraocular lens is placed without being fixed, or the intraocular lens is fixed so as not to move within the cartridge, and the cartridge is attached to the injector body. After that, a device having a mechanism for releasing the fixed state is known (see Patent Document 1).
JP 2001-104363 A

However, when the cartridge is handled as a lens package without fixing the position of the intraocular lens, the intraocular lens may move in the cartridge during transportation or storage and jump out of the cartridge. Further, when a cartridge for fixing the position of the intraocular lens is used, it is troublesome to release the fixed state after being attached to the injector body.
In view of the above-described problems of the prior art, the present invention can suppress the movement of the intraocular lens even when the cartridge is used as a lens case, and can be used without any labor after attaching the cartridge to the injector. It is an object of the present invention to provide an intraocular lens insertion device that can perform the insertion operation.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) In an intraocular lens insertion device for inserting a deformable intraocular lens into the eye, the insertion tube for placing an insertion tube portion to be inserted into an incision provided in the eyeball and the intraocular lens. A lens holding unit having a mounting table provided on the base end side of the unit and having a mounting surface along a direction in which the intraocular lens is bent, the mounting table being deformable, and the lens An insertion instrument main body having guide means for guiding the deformation of the mounting table in the direction in which the intraocular lens is bent when the holding part can be attached and detached at the distal end part, and the intraocular lens from the insertion cylinder part Pushing means provided to be able to move back and forth in the axial direction within the cylinder of the insertion instrument body, and the lens holding part is placed on the mounting table before being attached to the insertion instrument body. Movement of the intraocular lens It has a restricting member for restricting the flow.
(2) In the intraocular lens insertion device of (1), the intraocular lens is placed at a movable position from the movement restriction position by the restriction member in accordance with the operation of bending the intraocular lens placed on the mounting table. It is characterized by.
(3) In the intraocular lens insertion device according to (1), the restricting member is a protrusion that extends from the upper part of the lens holding part toward the placing table and restricts the movement of the placed lens in the front-rear direction. It is characterized by.
(4) In the intraocular lens insertion device according to (3), a pair of the protrusions are provided so as to restrict the movement in the front-rear direction with the intraocular lens placed on the mounting table interposed therebetween. Features.
(5) In the intraocular lens insertion device according to (4), when the mounting table constituting the lens holding portion is formed of two halved members that can be opened and closed and have hinge portions that connect the lower edges, and is closed Bending restriction that has an inner wall shape that substantially matches the opening shape on the proximal end side of the insertion tube portion, and further that the lens holding portion restricts the bending direction along the inner wall surface when the intraocular lens is bent. It has a member.
(6) In the intraocular lens insertion device according to (5), the insertion device body has mounting means for detachably mounting the lens holding portion, and the mounting means snaps to lock the lens holding portion. It is an in-structure.

  The present invention can suppress the movement of the intraocular lens in the cartridge even if the cartridge is used as a lens case, and can perform the insertion operation of the intraocular lens without attaching trouble after the cartridge is attached to the injector. It can be carried out.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a schematic external view showing the external appearance of an intraocular lens insertion device 1 used in the present embodiment. FIG. 1A shows the intraocular lens insertion device 1 as viewed from above, and FIG. 1B shows the state as viewed from the side.

  The intraocular lens insertion device 1 includes an insertion unit for insertion into an incision formed in the eyeball in order from the side of insertion into the eyeball, and a placement unit for installing the intraocular lens 40 (see FIG. 2) is provided. The lens holding unit 10 (hereinafter referred to as a cartridge), a cylindrical part 20 serving as an insertion instrument body for mounting the cartridge 10 at the tip, and the cartridge 10 and the cylindrical part 20 are inserted into the cylindrical part 20. The push-out mechanism 30 is configured to push the intraocular lens 40 outward from the tip of the cartridge 10.

  FIG. 2 is a diagram showing the configuration of the intraocular lens 40. The intraocular lens 40 includes an optical unit 41 having a predetermined refractive power and a support unit 42 for supporting the optical unit 41 in the eye. The optical part 41 of the intraocular lens 40 used in the present embodiment is used for a conventional foldable soft intraocular lens made of a simple substance such as HEMA (hydroxyethyl methacrylate) or a composite material of acrylic ester and methacrylic ester. It is formed from the material which is made. The support portion 42 is also formed of a material conventionally used as a support portion for an intraocular lens, such as PMMA (polymethyl methacrylate).

FIG. 3 is a diagram illustrating the configuration of the cartridge 10. 3 (a) is a perspective view of the cartridge 10, FIG. 3 (b) is a view when the intraocular lens 40 is placed on the cartridge 10, and FIG. 3 (c) It is the sectional view on the AA line of FIG.3 (b). In addition, in FIG.3 (c), the support part 42 of the intraocular lens 40 is not shown in figure.
As shown in the figure, the cartridge 10 is integrally formed with an insertion portion 11 having a tapered shape whose diameter gradually decreases (thinner) toward the tip and a placement portion 12 on which the intraocular lens 40 is installed. Is formed. The cartridge 10 is entirely made of synthetic resin and is a disposable type that is discarded after one use. Further, the cartridge 10 itself is used as a lens case for storing the intraocular lens 40.

  The insertion portion 11 has a hollow cylindrical shape, and the folded intraocular lens 40 is sent out through the hollow portion. The mounting portion 12 is formed of two halved members 12a and 12b. The lower edges of the halved members 12a and 12b are connected by a hinge portion 13 as shown in FIG. It is possible. 14a and 14b are mounting tables (surfaces) provided on the half members 12a and 12b, respectively, and the shape (wall surface shape) of the mounting surface on which the intraocular lens 40 is placed is along the direction in which the intraocular lens 40 is bent. It has a curved surface. The half members 12a and 12b connected by the hinge part 13 are opened halfway so as to maintain a state in which the intraocular lens 40 is sandwiched from both sides without being attached to the cylinder part 20. It is the composition which is. With such a configuration, even when the intraocular lens 40 is placed on the placement unit 12, the intraocular lens 40 is sandwiched from both sides without applying stress sufficient to bend the intraocular lens 40. The left-right movement of the intraocular lens 40 is restricted.

  Further, when the half members 12a and 12b are closed, the wall surface shape (mounting surface shape) of the mounting table is deformed and substantially coincides with the proximal end side opening shape (semicircular shape) of the insertion portion 11. (See FIG. 7). Reference numerals 15a and 15b denote covers provided on the upper portions of the half members 12a and 12b. When the half member 12a and the half member 12b are closed, the upper portions of the mount table 14a and the mount table 14b are provided. It is formed to cover. A pair of protrusions 16a and 16b formed to extend from above the mounting table 14a toward the mounting table 14a are provided at the end of the cover 15a. A predetermined interval is provided between the protrusion 16a and the protrusion 16b. This interval has an interval at which the intraocular lens 40 placed on the placement unit 12 can be sandwiched from the front and rear direction, and the intraocular lens 40 in a state before the cartridge 10 is mounted on the cylinder unit 20. It plays the role which regulates the movement to the front-back direction (refer FIG.3 (c)). The lengths of the protrusions 16a and 16b are long enough to restrict the back and forth movement of the intraocular lens 40 when the intraocular lens 40 is not bent. When the half members 12a and 12b are closed and the intraocular lens 40 is bent, the intraocular lens 40 is positioned further below the tips of the protrusions 16a and 16b, and the intraocular lens 40 is sent out. It does not get in the way.

  Moreover, the convex part 17 formed so that it might extend toward the mounting base from the upper direction of a mounting base along the longitudinal direction of the cover 15b is provided in the edge part of the cover 15b. When the intraocular lens 40 set in the cartridge 10 is bent, the convex portion 17 plays a role of restricting the bending along the inner wall surface (mounting surface) of the mounting table.

  Reference numeral 18 denotes a flat plate-shaped grip portion provided on the side surface of the half member 12a and used when the user holds the cartridge 10 in his / her hand. The gripping part 18 also serves to fix the cartridge 10 to the cylinder part 20. Reference numeral 19 denotes a wing provided on the opposite side of the grip portion 18 via the placement portion 12. The wing 19 also serves to fix the cartridge 10 to the cylindrical portion 20 in the same manner as the grip portion 18.

  FIG. 4 is a diagram illustrating an example of a state in which the cartridge 10 is used as a lens package. Reference numeral 100 denotes a base used for fixing the cartridge 10. Protrusions 100 a to 100 d for fixing the cartridge 10 are formed on the base 10. The protrusions 100a to 100d are formed on the base 100 at intervals that are the same as or slightly shorter than the width of the front, rear, left, and right of the cartridge 10, and the cartridge 10 is placed in and sandwiched as shown in the figure. To fix. The protrusions 100b and 100d are in the above-described half-opened state (the state in which the mounting portion 12 of the cartridge 10 is not attached to the cylindrical portion 20 and has an interval enough to sandwich the intraocular lens 40 from both sides). It is formed on the base 100 at intervals that can be maintained, and the cartridge 10 is sandwiched from both sides. Reference numeral 101 denotes a bag covering the base 100. The base 100 with the cartridge 10 attached is sealed in a state of being put in the bag 101, sterilized, and transported or stored.

FIG. 5 is a perspective view showing the external configuration of the cylindrical portion 20, and FIG. 6 is a cross-sectional view showing the internal configuration of the cylindrical portion 20.
As shown in the figure, a mounting portion 21 for attaching and detaching the cartridge 10 is provided at the tip of the cylindrical portion 20. The mounting portion 21 has a shape in which the tip of the cylindrical portion 20 is substantially halved. A convex portion 22 is formed at the tip of the cylindrical portion 20 symmetrically with respect to the push rod 31 that passes through the center of the cylindrical portion 20. In addition, fixing portions 23 for sandwiching and fixing the cartridge 10 from both sides are formed at the base end of the mounting portion 21 symmetrically with respect to the push rod 31 (see FIG. 1).

  The convex portion 22 is located slightly above the central axis of the cylindrical portion 20, and the distance between the convex portions 22 provided on the left and right is slightly narrower (shorter) than the inner diameter of the cylindrical portion 20. Further, the distal end of the convex portion 22 is bent toward the proximal end side of the cylindrical portion 20, and forms a concave portion 22 a into which the grip portion 18 provided on the cartridge 10 and the front side portion of the wing 19 can be inserted. The fixing portion 23 is located slightly above the central axis of the cylindrical portion 20, and the distance between the fixing portions 23 provided on the left and right sides is slightly narrower (shorter) than the inner diameter of the cylindrical portion 20. Further, the width between the concave portion 22a and the fixed portion 23 is substantially equal to the width in the front-rear direction of the grip portion 18 and the wing 19 of the cartridge 10, and the front side of the grip portion 18 and the wing 19 is inserted into the concave portion 22a. In the meantime, the holding part 18 and the wing 19 can be accommodated.

  In addition, the shape of the fixing portion 23 serves as a guide that restricts the half members 12a and 12b that are opened when the cartridge 10 is attached to the attachment portion 21 in a closing direction and restricts the width thereof. It has a snap-in structure that locks the mounted cartridge 10 so that it does not easily come off the cylindrical portion 20. Note that the left and right edge portions of the mounting portion 21 also serve as guides for regulating the halved members 12a and 12b in the closing direction, like the fixing portion 23.

  As shown in FIG. 6, the inside of the cylindrical portion 20 is hollow, and an extrusion mechanism portion 30 is inserted through the cylindrical portion 20 so as to advance and retract in the axial direction of the cylindrical portion 20. The extrusion mechanism unit 30 includes an extrusion rod 31, a shaft portion 32, and an extrusion portion 33. The push rod 31 is attached to the tip of the shaft portion 32. When the shaft portion 32 moves forward, the intraocular lens 40 is pushed forward from the cartridge 10 attached to the tip of the tube portion 20, and from the tube tip to the outside. Play the role of sending out.

In the intraocular lens insertion device having the above-described configuration, the mounting operation of the cartridge 10 described above will be described.
As shown in FIG. 7 (a), before being mounted on the cylinder portion 20, the intraocular lens 40 is not bent and tilted while the edge (edge) is brought into contact with the mounting tables 14a and 14b. In this state, it is placed in the mounting portion 12. More specifically, as shown in FIG. 3 (c), the intraocular lens 40 is positioned between the protrusion 16a and the protrusion 16b, and the side that contacts the mounting table 14a is faced up. It is placed in an inclined state with the abutting side down, and the edge is brought into contact with the mounting tables 14a and 14b. By placing the intraocular lens 40 in such a state (position), the left and right movements of the intraocular lens are restricted by the mounting tables 14a and 14b, and the forward and backward movements are restricted by the protrusions 16a and 16b. .

  When the cartridge 10 is mounted on the cylindrical portion 20, the push rod 31 is pulled out to the proximal end side of the cylindrical portion 20, and the grip portion 18 (front side) of the cartridge 10 is fitted into the recess 22 a provided in the mounting portion 21. The bottom surface of the mounting portion 12 (half member 12a, 12b) is pressed against the fixing portion 23 while being combined. By pressing the bottom surface (lower part) of the mounting portion 12 against the fixing portion 23, the fixing portion 23 guides the half member 12 a and the half member 12 b so as to be closed. When the mounting portion 12 is further pushed into the mounting portion 21, as shown in FIG. 1, the half member 12a and the half member 12b are mounted on the mounting portion 21 in a closed state.

  When the half member 12a and the half member 12b are thus closed, the cartridge 10 is in a state as shown in FIG. 7B. At this time, since the width (interval) between the mounting table 14a and the mounting table 14b is narrow, the intraocular lens 40 is pushed from the left and right directions on the wall surface of the mounting table. As a result, stress is applied to the intraocular lens 40, and the intraocular lens 40 is bent along the wall surfaces (mounting surfaces) of the mounting tables 14a and 14b. When the intraocular lens 40 is bent to the opposite side, the upper surface of the intraocular lens hits the convex portion 17 and the bending in that direction is restricted, so that the mounting tables 14a and 14b are finally provided. It will be bent along the wall surface. As shown in FIG. 7B, the intraocular lens 40 is bent along the wall surfaces of the mounting tables 14a and 14b, so that the movement between the protrusions 16a and 16b is controlled in the front-rear direction. It will be placed (moved) in a position that is not subject to movement restrictions.

  After the cartridge 10 is mounted on the mounting portion 21, the pushing portion 33 is pushed, and the push rod 31 is moved forward. The push rod 31 moves in the cylinder toward the tip, and pushes the intraocular lens 40 toward the insertion portion 11 in the front. When the intraocular lens 40 enters the insertion portion 11 and the opening diameter of the insertion portion 11 becomes narrower, the intraocular lens 40 is bent along the wall surface inside the insertion portion 11 (rounded). As a result, the intraocular lens 40 bent slightly from the distal end of the insertion portion 11 is pushed out into the eye.

  According to such a configuration, by mounting the cartridge 10 on the mounting portion 21 by the snap-in method, the intraocular lens can be easily set while being bent, and the forward / backward movement restriction can be released. Further, when the cartridge 10 is mounted on the mounting portion 21, the grip portion 18 is positioned in the horizontal direction with respect to the intraocular lens insertion instrument 1, so that it can be easily handled sensuously in the snap-in method.

  In the above embodiment, the cartridge 10 is snapped in from above the mounting portion 21. However, the present invention is not limited to this, and the intraocular lens is bent without being stressed before the cartridge is mounted on the cylindrical portion. When the cartridge is installed in the cylinder, stress is applied to the intraocular lens, and the intraocular lens is bent and set to release the restriction of movement. Any configuration is possible.

It is the figure which showed the structure of the intraocular lens insertion instrument in this embodiment. It is the figure which showed the structure of the intraocular lens used by this embodiment. It is a figure showing the composition of the cartridge in this embodiment. It is the figure which showed the state which used the cartridge as a lens package. It is the perspective view which showed the external appearance of the cylinder part in this embodiment. It is sectional drawing which showed the internal structure of the cylinder part. It is the figure which showed the state of the intraocular lens before cartridge mounting and after mounting.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Cartridge 12 Mounting part 16a, 16b Protrusion part 17 Convex part 20 Cylinder part 21 Mounting part 22 Convex part 23 Fixing part 40 Intraocular lens

Claims (6)

In an intraocular lens insertion device for inserting a deformable intraocular lens into an eye, an insertion tube portion to be inserted into an incision provided in an eyeball and a base of the insertion tube portion for placing the intraocular lens A lens holder having a mounting surface provided on the end side and having a mounting surface along a direction in which the intraocular lens is bent, the mounting table being capable of deforming the shape of the mounting surface; and In order to push out the intraocular lens from the insertion tube part, the insertion instrument body having guide means for guiding the deformation of the mounting table in the direction in which the intraocular lens is bent when being attached and detachable at the distal end part And an extruding means provided so as to be able to move forward and backward in the axial direction within the cylinder of the insertion instrument body, and the lens holding part is placed in the intraocular region before being mounted on the insertion instrument body Regulation of lens movement Intraocular lens insertion device, characterized in that it comprises a regulating member for. The intraocular lens insertion device according to claim 1, wherein the intraocular lens is placed at a movable position from a movement restriction position by the restriction member in accordance with an operation of bending the intraocular lens placed on the mounting table. Intraocular lens insertion device. 2. The intraocular lens insertion device according to claim 1, wherein the restriction member is a protrusion that extends from the upper part of the lens holding part toward the placement table and restricts the movement of the placed lens in the front-rear direction. Intraocular lens insertion device. 4. The intraocular lens insertion device according to claim 3, wherein the protrusion is provided in a pair so as to restrict the movement in the front-rear direction with the intraocular lens placed on a mounting table interposed therebetween. Intraocular lens insertion device. 5. The intraocular lens insertion device according to claim 4, wherein the mounting table constituting the lens holding portion is composed of two openable and closable half members having hinge portions connecting the lower edges and is closed when the insertion tube is closed. An inner wall shape substantially corresponding to the opening shape of the proximal end side of the portion, and the lens holding portion has a bending restricting member for restricting the bending direction along the inner wall surface when the intraocular lens is bent. An intraocular lens insertion device. 6. The intraocular lens insertion device according to claim 5, wherein the insertion device main body has mounting means for detachably mounting the lens holding portion, and the mounting means has a snap-in structure for locking the lens holding portion. An intraocular lens insertion device characterized in that: