JP2006333981A - Insertion implement for intraocular lens - Google Patents

Insertion implement for intraocular lens Download PDF

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Publication number
JP2006333981A
JP2006333981A JP2005159906A JP2005159906A JP2006333981A JP 2006333981 A JP2006333981 A JP 2006333981A JP 2005159906 A JP2005159906 A JP 2005159906A JP 2005159906 A JP2005159906 A JP 2005159906A JP 2006333981 A JP2006333981 A JP 2006333981A
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JP
Japan
Prior art keywords
lens
insertion
surface
loading
main body
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Pending
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JP2005159906A
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Japanese (ja)
Inventor
Kenichi Niizaki
賢一 新崎
Original Assignee
Canon Star Kk
キヤノンスター株式会社
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Priority to JP2005159906A priority Critical patent/JP2006333981A/en
Publication of JP2006333981A publication Critical patent/JP2006333981A/en
Application status is Pending legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1662Instruments for inserting intraocular lenses into the eye
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1662Instruments for inserting intraocular lenses into the eye
    • A61F2/1675Instruments for inserting intraocular lenses into the eye with a lubricated inner surface, e.g. the lubricant being coated on the inner surface or being injected through a port

Abstract

PROBLEM TO BE SOLVED: To provide an insertion device for an intraocular lens capable of injecting a viscoelastic material while easily checking the injection amount without damaging the tip of an insertion tube.
An insertion instrument (1) has a main body having a loading section (3) into which an intraocular lens (20) is loaded, and an extrusion shaft (5) that pushes the lens into the eye through an insertion port (4c) of the main body. The main body has a loading port 31a for loading the lens into the loading unit, and an injection port 4f for injecting a viscoelastic material into the main body. When the direction along the longitudinal direction of the extrusion shaft is the axial direction of the insertion instrument, the injection port has a direction different from the direction in which the first surface of the main body provided with the loading port faces in the axial direction. It is provided on the second surface 4b facing.
[Selection] Figure 4

Description

  The present invention relates to an insertion instrument for inserting an intraocular lens that is inserted in the eye for the purpose of correcting a refractive error or the like, after being inserted in place of the lens after removing the lens due to cataract It is about.

  In current cataract surgery, the central part of the anterior capsule of the eyeball is excised, the clouded lens is removed with an ultrasonic suction device, and then an artificial intraocular lens is placed there. When a lens is placed in the eye, the mainstream is a technique of using the flexibility of the lens and folding it into a small incision and inserting it into the eye through a small incision. This prevents postoperative astigmatism.

  In surgery, an insertion device that pushes the lens into the eye from the distal end opening of the insertion tube inserted into the incision is deformed to a small extent while moving the lens loaded in the device main body by the push shaft. Many are used. Such an insertion device is used not only in cataract surgery but also in insertion surgery of an intraocular lens for vision correction treatment or the like.

  The insertion device for the intraocular lens is stored separately from the lens, and the lens is loaded immediately before surgery, and the so-called preload type in which the lens is loaded at the time of factory shipment of the insertion device and stored together with the lens. (See Patent Document 1).

When inserting a lens into the eye using these insertion devices, a viscoelastic substance such as hyaluronic acid is injected into the insertion device so that the lens moves smoothly and deforms in the insertion device. . In particular, when the optical part is formed of a material containing a highly adhesive resin such as an acrylate ester or an elastomer, the dynamic friction resistance with the inner wall of the insertion device increases, so that the viscoelastic substance Otherwise, the lens may be twisted or clogged. For this reason, conventionally, using a syringe, a viscoelastic substance is injected from a lens outlet of an insertion tool, or from an injection hole formed on the same surface (for example, the upper surface) as a lens loading port provided in the insertion tool. A viscoelastic material is injected (see Patent Document 2).
JP 2001-104347 A JP 2004-351196 A

  However, when the viscoelastic material is injected from the lens insertion port, there is a risk that the vicinity of the insertion port may be damaged by the needle of the syringe.

  In addition, when a viscoelastic material is injected from the injection port formed on the same surface as the lens loading port provided in the insertion tool, the loaded lens and the member covering the lens loading port are obstructed. It is difficult to confirm the amount of viscoelastic material. For this reason, there is a problem that it is necessary to repeat the injection and the confirmation of the injection amount many times, or the injection is excessive.

  It is an object of the present invention to provide an insertion device for an intraocular lens that can inject a viscoelastic material while easily checking the injection amount without damaging the tip of the insertion tube. To do.

  An insertion device for an intraocular lens according to the present invention as one aspect is an insertion device for inserting an intraocular lens into an eye, the main body having a loading portion into which the lens is loaded, And an extrusion shaft for extruding the lens into the eye through the insertion port of the main body. The main body has a loading port for loading the lens into the loading unit and an injection port for injecting a viscoelastic material into the main body. When the direction along the longitudinal direction of the extrusion shaft is the axial direction of the insertion instrument, the injection port is different from the direction in which the first surface of the main body provided with the loading port faces in the axial direction. It is provided in the 2nd surface which faces a direction, It is characterized by the above-mentioned.

  For example, the second surface may be a surface opposite to the first surface or a surface having an angle with respect to the first surface.

  The injection port may be formed in a size that prevents the injected viscoelastic substance from leaking out due to surface tension.

  According to the present invention, when the insertion tool is viewed in the axial direction, the injection port of the viscoelastic substance faces in a direction different from the surface of the main body on which the loading port is provided (for example, the loading port is on the upper surface of the main body. In some cases, the viscoelastic material can be injected while easily confirming the injection amount without obstructing the members provided around the loading port. In addition, it is possible to reliably prevent the periphery of the insertion port from being damaged as in the case of injection from the insertion port.

  Embodiments of the present invention will be described below with reference to the drawings.

  1A, 1B, 2 and 4 show an insertion device for an intraocular lens which is an embodiment of the present invention. 1A and 1B are views of the insertion instrument viewed from different directions. FIG. 2 is an enlarged view of the periphery of a lens loading section (to be described later) in the insertion instrument. Further, FIG. 4 shows a cross section taken along line IV-IV in FIG.

  As shown in FIGS. 1A and 1B, the insertion instrument 1 includes a cylindrical body 2, a lens loading mechanism 3 attached to the front end of the cylindrical body 2, and a bottom surface portion of the lens loading mechanism 3. It has a nozzle (insertion cylinder) 4 extending forward and an extrusion shaft 5 inserted into the cylinder 2 from the rear end opening of the cylinder 2. The cylindrical body 2, the lens loading mechanism 3 and the nozzle 4 constitute a main body as claimed. The extrusion shaft 5 is movable in the axial direction within the cylindrical body 2, the lens loading mechanism 3 and the nozzle 4.

  Here, in this embodiment, the axis L along the longitudinal direction of the cylindrical body 2, the nozzle 4 and the extrusion shaft 5 is the axis of the insertion instrument 1, the nozzle 4 side in the insertion instrument 1 is the front side, and the extrusion shaft 5 side is the axis. This will be described as the rear side. Moreover, let the surface shown by FIG. 1 (A) be the upper surface of this insertion instrument, and let the surface on the opposite side (surface of the paper back side of FIG. 1) be the lower surface or bottom face of this insertion instrument. In the top view of FIG. 1A, a direction orthogonal to the axis L is a left-right direction. The surface shown in FIG. 1B is referred to as a side surface of the insertion instrument. Furthermore, in the following description, the axial view means viewing from one of the directions of the axis L (axial direction). For example, FIG. 4 shows a cross section viewed in the axial direction.

  The lens loading unit 3 is loaded with an intraocular lens (IOL: hereinafter simply referred to as a lens) 20. The lens 20 is inserted into the eye for various purposes such as cataract treatment and vision correction. The lens 20 extends in a curved shape from an optical part 20a arranged in the eyeball instead of the crystalline lens of the human eye, and from two places in the circumferential direction (both radial directions) of the optical part 20a, and the optical part 20a in the eyeball. And a support portion 20b for supporting The curved shape includes all shapes extending from a base end portion fixed to the optical unit 20 so as to draw a curve and having a distal end separated from the optical unit 20, and the thickness, cross-sectional shape, and material thereof are not limited.

  The optical unit 20a is formed of a material having flexibility and resilience, such as a silicone elastomer, a copolymer resin of acrylic acid ester and methacrylic acid ester, a collamer, and a water-soluble gel. The support portion 20b is formed of a material having flexibility and shape memory such as polyimide or acrylic resin.

  As shown in detail in FIG. 4, the lens loading mechanism 3 includes a base member 31 fixed to the front end portion of the cylindrical body 2, and a holding projection 31 b formed on the left and right in the opening 31 a of the base member 31. The holding frame 32 is attached to the portion, and the pressing member 33 is disposed in the opening 32a of the holding frame 32 so as to be movable in the vertical direction. The bottom surface portion 4b of the nozzle 4 shown in FIG. 1 (B) has a bottom surface side opening of the opening portion 31a of the base member 31 in a portion of the opening portion 31a of the base member 31 below the holding projection portion 31b. It is attached to cover. As shown in FIG. 4, the bottom surface portion 4b is formed in a substantially arc shape when viewed in the axial direction.

  As shown in FIG. 1B, a tapered hollow insertion tube portion 4a for injecting the lens 20 into the eye is formed at the front end portion of the bottom surface portion 4b of the nozzle 4. The insertion tube portion An insertion port 4c as a lens exit is formed at the tip of 4a.

  Here, in this embodiment, each member constituting the lens loading mechanism 3 is made of a material that is transparent, colored, or translucent (hereinafter collectively referred to as transparent). If it is not transparent, the injection amount of the viscoelastic material injected into the insertion instrument 1 cannot be confirmed from the outside as described later, and the behavior of the lens 20 in the insertion instrument can be confirmed. It is not possible. As the transparent material, plastic is preferable, and from the viewpoints of transparency, moldability, stability, and economy, olefin resins such as polypropylene and polyethylene, and polycarbonate resins are particularly preferable.

  The left and right holding protrusions 31b provided on the base member 31 constitute a first loading portion into which the lens 20 is loaded in the assembly process of the insertion instrument 1 at the factory. The holding protrusion 31b includes a support portion holding surface 31c and an optical portion holding surface 31d that is lowered by one step from the support portion holding surface 31c. Before the holding frame 32 is assembled to the base member 31 fixed to the cylindrical body 2, the lens 20 is loaded from above the opening (loading port) 31a of the base member 31, and the left and right optical unit holding surfaces 31d are loaded. The edge part of the optical part 20a is mounted. As shown in FIG. 2, each optical part holding surface 31 d is formed in a shape along the outer peripheral shape of the optical part 20 a in a top view. Thereby, the optical part 20a (namely, lens 20) is positioned. Moreover, the front-end | tip of each support part 20b is mounted in each support part holding surface 31c.

  When the holding frame 32 is inserted into the opening 31a of the base member 31 from above in this state, the tip of the support portion 20b is lightly sandwiched between the lower surface 32b of the holding frame 32 and the support portion holding surface 31c. The holding frame 32 is locked to the base member 31 by an engagement mechanism (not shown). Therefore, the lens 20 is loaded into the insertion instrument 1 in a state where no stress is applied to the optical unit 20a so as to deform it, and so as not to easily move from the loaded position. Thereby, it is possible to prevent the lens 20 from moving due to buoyancy when vibration is applied to the insertion instrument 1 or a viscoelastic material is injected into the insertion instrument 1 as will be described later.

  In this state, as shown by a two-dot chain line in FIG. 4, the extrusion shaft 5 is located at a position where the extension line to the front passes above the optical portion 20 a of the lens 20. Therefore, the lens 20 cannot be pushed out even if the extrusion shaft 5 is advanced.

  After loading the lens 20 in this way, the pressing member 33 is inserted into the opening 32a of the holding frame 32 from above. As shown in FIG. 4, arc-shaped protrusions 32 c extending in the vertical direction are formed on the inner surfaces of the left and right wall portions of the pressing member 33. On the other hand, recesses 33 a are formed in the lower portions of the left and right outer surfaces of the pressing member 33. In a state where the lens 20 is loaded on the holding projection 31b at the time of factory assembly, the pressing member 33 is pushed down to a position where the recess 33a engages with the projection 32c (hereinafter referred to as an upper position).

  At this time, the flange portion 33 c formed at the intermediate portion in the vertical direction of the pressing member 33 comes into contact with the inclined surface of the locking claw 32 d formed on the upper left and right inner walls of the holding frame 32. As a result, a pressing force is applied to the pressing member 33 to some extent, and the left and right wall portions of the holding frame 32 are elastically deformed by the cam action of the inclined surface, and the pressing member 33 is moved to the upper position as long as the interval between the wall portions does not increase. Can be held in. The pressing member 33 also functions as a cover for a loading port into which the lens 20 is loaded.

  A protrusion 33d is formed at the center of the lower surface of the pressing member 33, and protrusions 33e extending slightly below the protrusion 33d are formed on the left and right sides thereof. In a state in which the pressing member 33 is held at the upper position, the protrusions 33 d and 33 e are positioned above the optical unit 20 a of the lens 20. Therefore, as described above, the lens 20 is held in a state where no stress is applied to the optical unit 20a. A lens moving space S in which the bottom surface side is covered with the bottom surface portion 4b of the nozzle 4 is formed below the lens 20 loaded on the holding projection portion 31b which is the first loading portion.

  Then, the lens moving space S is divided into an upper region S1 and a lower region S2, and the left and right upper ends of the bottom surface portion 4b extend in the horizontal direction toward the inside of the lens moving space S (protrusion). Guide protrusions 4e and 4d are formed.

  As shown in FIG. 2, these guide projections 4e and 4d are in the axial direction of the insertion instrument 1, that is, the direction in which the lens 20 is moved by being pushed toward the insertion cylinder 4a by the push shaft 5 as will be described later. It extends continuously to the vicinity of the entrance (introduction region) to the insertion tube portion 4a.

  Thus, the insertion instrument 1 in which the lens 20 is loaded (preloaded) on the holding projection 31b in a state where no stress is applied to the optical unit 20a is shipped after being sterilized before factory shipment. The Since no stress is applied to the optical unit 20a, it can be stored for a long time in a hospital or the like.

  Then, during the operation of inserting the lens 20 into the eye (immediately before), as shown in FIG. 5, a pressing force is applied to the pressing member 33, and the holding frame 32 is moved by the cam action of the inclined surface of the locking claw 32d. The left and right walls are elastically deformed. Thereby, the space | interval between both wall parts spreads, and the engagement with respect to the latching claw 32d of the flange part 33c of the pressing member 33 is released. For this reason, the pressing member 33 can be moved downward from the upper position.

  When the pressing member 33 moves downward, the projections 33d and 33e abut against the upper surface of the optical unit 20a and deform it so as to be convex downward. Also, the tip of the support portion 20b sandwiched between the lower surface 32b of the holding frame 32 and the support portion holding surface 31c is pulled out from this position by the pressing force applied to the optical portion 20a. As a result, the optical unit 20a passes between the left and right holding projections 31b and between the left and right guide projections 4d and 4e, and moves into the region S2 below the guide projections 4d and 4e. Then, it is deformed so as to be along the inner surface of the bottom surface portion 4b (so as to have a convex shape toward the lower side).

  On the other hand, the tips of both support portions 20b that have come off between the lower surface 32b of the holding frame 32 and the support portion holding surface 31c move downward and rest on the upper surfaces 4e1 and 4d1 of the guide protrusions 4e and 4d. That is, the optical unit 20a is disposed in a region (optical unit moving region) S2 below the guide projections 4d and 4e in the lens movement space S, and the tips of both support units 20b are the upper surfaces of the guide projections 4e and 4d. 4e1 and 4d1 are arranged in a region (support portion moving region) S1 above. Hereinafter, the position where the lens 20 is located in this state is referred to as a second loading unit.

  When the lens 20 is loaded in the second loading portion, the lower surface of the flange portion 33 c of the pressing member 33 comes into contact with the upper surface of the step portion 32 e formed inside the holding frame 32. For this reason, further downward movement of the pressing member 33 is prevented (hereinafter, the position of the pressing member 33 is referred to as a lower position). Further, in this state, arc-shaped protrusions 33 b formed on the left and right outer surfaces of the pressing member 33 and extending in the vertical direction engage with lower portions of the protrusions 32 c on the inner left and right sides of the holding frame 32. Thereby, the upward movement from the lower position of the pressing member 33 is prevented.

  As described above, the lens 20 loaded in the second loading unit in a state where the optical unit 20a and the support unit 20b (the tip thereof) are separated by the guide projections 4e and 4d is shown in FIG. As shown in FIG. 5, which is a cross-sectional view taken along line V, the vertical positions of the optical unit 20 a and the extrusion shaft 5 substantially coincide with each other, so that the front end of the optical unit 20 a is moved to the optical unit 20 a by advancing the extrusion shaft 5. Engage and the entire lens 20 moves forward.

  At this time, as shown in FIG. 3, the support portion 20b slides relative to the upper surfaces 4e1 and 4d1 of the guide protrusions 4e and 4d and is guided independently from the optical portion 20a. The optical unit 20a is also guided by sliding of its outer peripheral surface with respect to the lower surfaces 4e2 and 4d2 of the guide projections 4e and 4d. Accordingly, the lens 20 can be moved toward the insertion tube portion 4a without the support portion 20b being sandwiched between the optical portion 20a and the inner surface of the bottom surface portion 4b or the support portions 20b being entangled with each other.

  Note that two-dot chain lines 20a ′ and 20b ′ in FIG. 3 indicate the positions of the optical unit and the rear support unit that are being pushed out from the second loading unit toward the insertion tube unit 4a, respectively. . The support portion 20b 'is guided by the upper surface 4e1 of the guide protrusion 4e.

  As shown in FIG. 7, the insertion cylinder portion 4 a is abruptly smaller as the inner diameter goes forward. In order to deform (fold) the lens 20 into a small size as designed in the insertion cylinder portion 4 a. In the introduction region to the insertion tube portion 4a, it is necessary to move or hold the support portion 20b to an appropriate position with respect to the optical portion 20a. Accordingly, the support portion 20b (the tip thereof) from the second loading portion to the introduction region to the insertion cylinder portion 4a is different from the movement region S2 of the optical portion 20a (in other words, partitioned by the guide protrusions 4e and 4d). By guiding in the area S1, the lens 20 can be smoothly guided into the insertion tube portion 4a, and as a result, the lens 20 is folded into the insertion tube portion 4a into an appropriate small shape for insertion into the eye. be able to.

  Here, the guide protrusions 4e and 4d provided so as to partition the lens moving space S may be integrally formed with the nozzle 4, or the guide protrusions 4e and 4d made of the same material as the nozzle 4 are heated. You may make it attach to the nozzle 4 by melt | fusion and liquid welding.

  The axial length of the guide protrusions 4e and 4d is preferably the length from the second loading portion to the front of the insertion tube portion 4a of the nozzle 4 because of good stability. The thickness of the guide protrusions 4e and 4d can be arbitrarily selected. However, if the thickness is too thick, the support part 20b is difficult to ride on the upper guide protrusions 4e and 4d, and if it is too thin, the strength is weak and the support part 20b is lower. There is a possibility of moving to the region S2. For this reason, it is preferable that it is about 0.1-2 mm.

  Here, when the lens 20 is pushed out from the second loading portion into the eye, a viscoelastic substance is injected into the lens moving space S in order to improve the sliding of the lens 20 in the insertion device 1. There is a need. For this reason, in the insertion instrument 1 of the present embodiment, as shown in FIG. 4, a viscoelastic material injection port 4 f is formed in the bottom surface portion 4 b of the nozzle 4. As the viscoelastic substance, a hydrophilic polymer is generally used, and hyaluronic acid (sodium) aqueous solution is often used particularly in the ophthalmic field. For this reason, hyaluronic acid (sodium) aqueous solution is also used in this example.

  The amount of the viscoelastic substance injected is not particularly limited as long as the lens is covered with the viscoelastic substance, but generally 0.1 ml (milliliter) to 0.3 ml is preferable.

  Note that the position (axial position) of the injection port 4f shown in FIG. 4 is the position of the IV-IV line as the cross-sectional position shown in FIG. As can be seen from the chain line L ′), the insertion cylinder portion 4a is located below the first loading portion, that is, ahead of the second loading portion provided in the direction orthogonal to the axial direction, In the rear region. However, in the present invention, the axial position of the inlet 4f is not limited to this, and the number of inlets 4f is not limited to one.

  Moreover, although the present Example demonstrated the case where the injection port 4f was provided in the bottom face (bottom part 4b of the nozzle 4) of the insertion instrument 1, the direction in which the surface provided with the loading port was turned even if it is other than that. Any surface that faces in a different direction may be used. For example, as shown by a two-dot chain line in FIG. 4, it may be provided on the side surface of the insertion instrument 1, or may be provided on both the bottom surface and the side surface.

  FIG. 6 shows a typical axial view shape of this type of insertion instrument. Reference numeral 60 denotes a main body of the insertion instrument, and reference numeral 70 denotes a nozzle (insertion cylinder) provided at the front of the main body. When the shape of the main body 60 viewed in the axial direction is a polygon on the left side of the alternate long and short dash line in the figure, the right side shows a case where the arc shape is partially included as in this embodiment. In this figure, when the loading port 62 is provided in the surface 61 facing upward U, the surfaces facing in a direction different from the direction U in which the surface 61 faces indicate all of the surfaces 63 to 69. Although not shown in the drawings, when the shape of the main body viewed in the axial direction is formed of only one surface such as a cylindrical surface, in other words, it is a portion facing in a direction different from the direction in which the portion provided with the loading port faces. Good.

  As described above, the injection port 4f is provided on the bottom surface of the insertion instrument 1 (nozzle 4), so that the injection amount of the viscoelastic substance is confirmed as compared with the case where it is provided on the upper surface of the insertion instrument 1 in the same manner as the loading port. It becomes easy. That is, since a plurality of thick members constituting the lens loading mechanism 3 are combined and arranged on the upper surface side of the insertion instrument 1, it is extremely difficult to confirm the injection amount of the viscoelastic substance 8 in a top view. It is. For this reason, quick work is hindered, for example, it is necessary to repeat the injection and the confirmation of the injection amount, that is, the upside down of the insertion instrument 1.

  On the other hand, in the present embodiment, as shown in FIG. 7, on the bottom surface side of the portion from the lens loading mechanism 3 to the insertion port 4c in the insertion instrument 1, the bottom surface of the transparent nozzle 4 (the bottom surface portion 4b and the insertion tube). Only part 4a). For this reason, the viscoelastic substance 8 injected from the injection port 4f can be clearly seen. Furthermore, the injection of the viscoelastic material from the injection port 4f is performed by holding the insertion instrument 1 with the bottom face up and inserting a syringe needle (not shown) containing the viscoelastic material into the injection port 4f. It is common. Therefore, according to the present embodiment, the injection operation can be performed while checking the injection amount of the viscoelastic substance 8, and the injection operation can be performed quickly.

  Further, the diameter of the injection port 4f needs to be a size that prevents the injected viscoelastic substance 8 from leaking out due to its surface tension. For example, the size of a needle for injecting a viscoelastic substance is preferable. Specifically, about 0.1 mm to 2.0 mm is preferable. If it is less than 0.1 mm, it becomes smaller than the thickness of a general injection needle, and if it is more than 2.0 mm, the viscoelastic substance may leak out from the injection port 4f.

  In the present embodiment, the inner surface (for example, the surface of the first loading portion, the bottom surface portion 4b (second loading portion) of the nozzle 4 and the insertion tube in the region where the lens 20 contacts or moves in the insertion instrument 1. A hydrophilic polymer film (layer) is formed on the inner surface of the tip of the portion 4a, and on the upper and lower surfaces 4e1, 4e2, 4e2, 4d2) of the guide protrusions 4e, 4d. Specifically, a film containing at least one of a hyaluronic acid aqueous solution and a sodium hyaluronate aqueous solution is formed. Thereby, the lubricity in the insertion instrument 1 of the lens 20 improves, and the lens 20 can be sent out more smoothly into the eye. In particular, by forming a film with a hyaluronic acid (sodium) aqueous solution or a hyaluronic acid (sodium) aqueous solution, which is the same component as the viscoelastic substance injected into the insertion device 1, the film can be easily released, and the lens can be further improved. The slipperiness of 20 can be improved.

  Other examples of hydrophilic (water-soluble) polymers used include synthetic polymers such as polyethylene glycol (PEG), polypropylene glycol (PPG), sodium polyacrylate (PAA), polyacrylamide (PAAm), and polystyrene. Examples include sodium sulfonate (PSSNa), polyvinylpyrrolidone (PVP), polyvinyl alcohol (PVA), polyethyleneimine (PEI), carboxymethylcellulose (CMC), sodium dextran sulfate, hydroxyethylated starch (HEPES), and polyphosphoric acid.

  In addition, it is a natural polymer, and polysaccharides include hyaluronic acid and / or sodium hyaluronate (HA), sodium alginate, dextran, dextrin, heparin, chitosan, sodium chondroitin sulfate, and polysaccharides. Can be mentioned.

  Of these, it is preferable to use polysaccharides from the viewpoints of biocompatibility and diversity of molecular weights obtained.

  Also, as a method for forming a coating film, any method such as contact between a bulk solution such as dipping into an aqueous solution and the surface of the cartridge, spraying of an aqueous solution, and application by brushing of an aqueous solution or gel can be used. In the water-soluble polymer used as a solvent, a concentration of 0.1% to 60% by weight is preferable for dipping or spray coating, but 50% by weight when the gel is applied by brushing or the like. The following are preferably used.

The aqueous solution used for dipping and spraying is preferably an aqueous solution in which a water-soluble polymer is simply dissolved. However, for adjusting the pH, salts such as sodium hydroxide, sodium carbonate, phosphate buffer solution, drying acceleration and crystallization are preferred. In order to control the degree, an organic solvent such as ethanol may be added.
The molecular weight of the water-soluble polymer is arbitrary, but from the viewpoint of convenience during film formation, it is preferable to adjust the molecular weight according to the solution concentration so that the solution viscosity is at most 10,000 mPs. Above that, the viscosity is too high and the film formation operation becomes complicated.

  The lens loaded in the insertion instrument of the present invention may have any configuration, and even in a three-piece type lens in which the optical part and the support part are made of different materials, the optical part and the support part are the same. A one-piece type lens made of a material may be used.

  In the above-described embodiment, the insertion instrument using the tapered nozzle 4 has been described. However, the lens may be slightly deformed in the lens loading mechanism and sent out into the eye by a straight nozzle.

  Further, in the above-described embodiment, the insertion device of the type in which the lens is preloaded in the first loading portion, the lens is loaded (moved and deformed) in the second loading portion, and then pushed into the eye is described. The invention is not limited to this type but can be applied to various types of insertion instruments. For example, an insertion device of a type that pushes out a lens loaded in one loading portion as it is (in this case, there is no lens loading mechanism, and a cover that covers the loading portion is provided instead), or an insertion device immediately before surgery It may be of a type in which a lens or lens package stored separately is loaded into the insertion instrument.

The top view (A) and side view (B) of the insertion instrument which is an Example of this invention. The enlarged top view of the lens loading part of the insertion instrument of an Example (lens loading state). The enlarged top view of the lens loading part of the insertion instrument of an Example (lens extrusion state). Sectional drawing in the IV-IV line in FIG. 1 (B) of the insertion instrument of an Example. Sectional drawing in the VV line | wire in FIG. 1 (B) of the insertion instrument of an Example. The bottom view of the nozzle part of the insertion instrument of an Example. Explanatory drawing of the surface of a main body.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Loading device 2 Cylinder 3 Lens loading mechanism 4 Nozzle 4a Insertion cylinder part 4b Bottom part 4c Insertion port 4d, 4e Guide protrusion part 4f Injection port 5 Extrusion shaft 20 Intraocular lens 20a Optical part 20b Support part 31 Base member 31a Opening (loading port)

Claims (4)

  1. An insertion device for inserting an intraocular lens into the eye,
    A main body having a loading portion into which the lens is loaded;
    An extrusion shaft for extruding the lens through the insertion port of the main body into the eye,
    The main body has a loading port for loading the lens into the loading unit, and an injection port for injecting a viscoelastic substance into the main body.
    When the direction along the longitudinal direction of the extrusion shaft is the axial direction of the insertion instrument,
    When viewed in the axial direction, the injection port is provided on a second surface of the main body that faces a direction different from a direction of the first surface on which the loading port is provided. Insertion device for insertion lens.
  2.   The insertion device according to claim 1, wherein the second surface is a surface opposite to the first surface when viewed in the axial direction.
  3.   The insertion device according to claim 1, wherein the second surface is a surface having an angle with respect to the first surface when viewed in the axial direction.
  4.   The insertion device for an intraocular lens according to any one of claims 1 to 3, wherein the injection port has a size such that the injected viscoelastic substance does not leak due to surface tension.
JP2005159906A 2005-05-31 2005-05-31 Insertion implement for intraocular lens Pending JP2006333981A (en)

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WO2009008441A1 (en) * 2007-07-11 2009-01-15 Hoya Corporation Intraocular lens inserting tool, and intraocular lens movement control method
US8382769B2 (en) 2008-06-17 2013-02-26 Hoya Corporation Intraocular lens insertion device
US8460311B2 (en) 2004-12-27 2013-06-11 Hoya Corporation Intraocular lens implanting device
US8470032B2 (en) 2008-09-04 2013-06-25 Hoya Corporation Intraocular lens insertion device
US8475528B2 (en) 2007-05-30 2013-07-02 Hoya Corporation Intraocular lens insertion device
US8523877B2 (en) 2005-02-24 2013-09-03 Hoya Corporation Intraocular lens inserting instrument
US8523941B2 (en) 2005-12-08 2013-09-03 Hoya Corporation Instrument for inserting intraocular lens
US8545512B2 (en) 2005-01-26 2013-10-01 Hoya Corporation Intraocular lens insertion device
US8574239B2 (en) 2005-09-28 2013-11-05 Hoya Corporation Intraocular lens insertion device
US8603103B2 (en) 2009-01-07 2013-12-10 Hoya Corporation Intraocular lens insertion device
US8647382B2 (en) 2010-06-10 2014-02-11 Hoya Corporation Ocular implant insertion apparatus and methods
JP2014505521A (en) * 2010-12-20 2014-03-06 ノバルティス アーゲー Intraocular lens transfer case
US8702795B2 (en) 2008-08-21 2014-04-22 Hoya Corporation Intraocular lens inserting device
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JPH09506285A (en) * 1994-08-05 1997-06-24 カイロン ビジョン コーポレイション Device for inserting a flexible intraocular lens
JP2005028161A (en) * 1996-09-26 2005-02-03 Bausch & Lomb Inc Method and apparatus for inserting flexible membrane into eye
JP2003325568A (en) * 2002-05-08 2003-11-18 Canon Star Kk System for inserting intraocular insertion lens
JP2006517837A (en) * 2003-02-14 2006-08-03 イアン・エイトン Method and device for compressing an intraocular lens

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