JP2008307297A - Incision knife for anterior lens capsule - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an incision knife for an anterior lens capsule, capable of more rapidly and safely incising the anterior lens capsule. <P>SOLUTION: The incision knife for an anterior lens capsule includes: a grip part; and a needle shape member which is extended from the grip part and bent at the distal end. The distal end of the needle shape member has a multi-fork shape having two forks or three or more forks. When the distal end of the needle shape member is made to have two or more forks, friction resistance with the anterior capsule is raised. Flatness in the needle and the anterior capsule is raised. Thus, operability is enhanced. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a cutting knife for incising an anterior lens capsule in ophthalmic surgery such as cataract treatment.

  Treatment of cataracts may involve replacing the patient's lens with an artificial lens. To remove the crystalline lens, a continuous circular incision (Continuous curvilinear capsulorrhexis; CCC) is formed by incising a portion of the capsular covering the front of the lens (also called the “anterior lens capsule”). The lens that has been crushed with ultrasonic waves or the like may be sucked and removed from the incisor.

  As a means for forming a continuous circular incision, a capsulotomy knife may be used. A conventional capsulotomy knife has, for example, a grasping portion, a probe extending from the grasping portion, and an incision portion disposed at the probe tip. Various proposals have been made to stably and safely incise the anterior lens capsule using such an incision instrument. For example, an incision device (see Patent Document 1) in which the cutting direction of the cutting portion disposed at the probe tip is opposite to the direction in which the probe extends, or an incision device in which the incision portion has a round shape (see Patent Document 2) ) Etc. have been proposed.

Furthermore, the tip of the injection needle of a syringe having an injection needle may be bent to form a capsulotomy knife. This capsulotomy knife is a relatively excellent means because it is inexpensive and has a strong incision edge.
Japanese Patent Laid-Open No. 8-47505 JP-A-8-275969

  When an attempt is made to form a continuous circular incision with a capsulotomy knife using the above-mentioned needle, the incision edge may be displaced outward from the desired incision line, but it is difficult to correct it. One of the causes was found to be “slip” due to low friction between the capsulotomy needle and the anterior capsule. Therefore, the present inventor increases the friction resistance with the anterior capsule by setting the tip of the needle of the capsulotomy knife to two or more crotch, and improves the operability by increasing the flatness between the needle and the anterior capsule. We examined improvement.

That is, the present invention relates to an anterior capsulotomy knife shown below.
[1] An anterior capsulotomy knife having a gripping portion and a needle-like member extending from the gripping portion and having a bent tip, and the tip of the needle-like member has two or more forks. An anterior lens capsule.
[2] The anterior capsulotomy knife according to [1], wherein a tip of the needle-like member is bent by 45 to 90 °.
[3] The anterior capsulotomy knife according to [1] or [2], wherein the needle-like member is a 27 gauge to 30 gauge needle.
[4] The anterior lens capsule incision according to any one of [1] to [3], wherein a distance between the crotch is equal to or less than a needle thickness of the needle-like member.
[5] The crystalline lens according to any one of [1] to [4], wherein the needle-like member is bent at a portion of 1 to 2 mm from the tip, and the bending angle is 30 to 60 °. Anterior capsulotomy knife.
[6] The anterior capsulotomy knife according to any one of [1] to [5], wherein the needle-shaped member is replaceable.

For example, the following effects can be obtained by the cutting instrument of the present invention.
1) Since the anterior capsule can be stably held (gripped) when the anterior capsule is incised, the operability of the incision is improved.
2) The edge that incises the anterior capsule is less likely to flow outward from the desired incision line. Even if it flows, it is easy to correct.
3) Shortening of operation time is expected.
4) The incised anterior capsule can be easily removed by being sandwiched between the crotch of the needle.

  The anterior capsulotomy knife of the present invention has a grip portion and a needle-like member extending from the grip portion. The grasping portion is a portion that is grasped by a practitioner using the incision instrument by hand. Therefore, the shape is not particularly limited as long as the shape is easy to grip. When using an injection needle as a needle-like member of an incision knife, a syringe can also be used as a holding part.

  The needle-like member of the anterior lens capsule incision of the present invention extends from the grasping portion. The material of the needle-like member is usually a metal (for example, stainless steel). It is preferable that the surface of the needle-shaped member (particularly, the surface of the tip of the needle-shaped member) hardly reflects visible light. This is to make it easier to visually recognize the incision when the anterior capsule is incised. In order to suppress the reflection of visible light, a surface treatment such as NG may be performed.

  The needle-like member is, for example, a 27 gauge to 30 gauge needle. A thin needle of the needle-like member is preferable because it facilitates the insertion of the needle tip between the cornea and the anterior capsule, but the strength is reduced, so that the incision operability may be lowered.

  The tip of the needle-like member of the anterior lens capsule cutting knife of the present invention is bent. For example, what is necessary is just to bend about 0.1-1 mm from a front-end | tip. More specifically, when the needle-shaped member is a 27 gauge needle (for example, a 27 gauge needle manufactured by Terumo Corporation), about 1/4 of the bevel portion may be bent, and a 30 gauge needle (for example, manufactured by Nipro Corporation, In the case of a 30 gauge needle), about 1/3 of the bevel portion may be bent.

  If the distance from the bent portion of the tip of the needle-like member to the tip is too short, the operability will be reduced because parts other than the tip of the needle-like member come into contact with the anterior capsule in the operation of anterior capsule incision. There is. Further, if the distance from the bent portion to the tip is too long, it may be difficult to insert the needle-like member between the cornea and the anterior capsule in the anterior capsulotomy operation.

  The bending angle of the tip of the needle-like member is preferably about 45 to 90 °. This is for improving the operability in the incision.

  The tip of the needle-like member is characterized by a multi-groove having two or three forks. FIG. 1 shows an example in which the tip of the needle-like member is bifurcated. The distance d between the crotch and the crotch is usually 1.5 times or less, preferably 1 or less, and may be narrower than the thickness of the needle of the acicular member. Since the anterior capsulotomy knife is used by being inserted between the cornea and the anterior capsule, it is necessary to facilitate the insertion thereof. This insertion may be difficult if the crotch distance d at the tip of the needle-like member is large.

  Also, when the number of crotch at the tip of the needle-like member is large, the operability of the incision is improved because it becomes easy to be caught on the anterior capsule as will be described later. However, as the number of crotch increases, the crotch distance tends to be longer, which may make it difficult to insert between the cornea and the anterior capsule.

  The crotch height h of the needle-like member may be the same between the crotches, or may be different depending on the crotch in consideration of operability. For example, the height of each crotch may be adjusted depending on whether the practitioner holds the incision knife with the right or left hand or cuts the anterior capsule clockwise or counterclockwise.

  Furthermore, as shown in FIG. 1, in order to improve the incision operation of the anterior capsule, it is preferable that the needle-like member is bent 1 to 2 mm (see distance L) from the distal end to the gripping portion side. The distance L from the tip of the bent portion is appropriately selected according to the size of the cornea, the position of the eyeball, etc., but is about 1.2 mm when used for human treatment. The angle θ2 to be bent is preferably about 30 to 60 °. Further, since the bending of the needle-shaped member is easier than the bending of the distal end portion, the practitioner himself may perform it appropriately according to the patient's condition.

  The needle-like member of the anterior lens capsule cutting knife of the present invention may be disposed in a replaceable manner in the grasping portion and made disposable. For example, the handle is used as a syringe, and the needle-like member is used as an injection needle.

FIG. 1 shows an example of a procedure for manufacturing the anterior lens capsulotomy knife of the present invention, but the procedure is not particularly limited.
In FIG. 1A, a conventional syringe is shown. The grasping part of the incision knife is a syringe 1. The injection needle 2 is a 27 gauge to 30 gauge injection needle. The tip portion 2-1 of the injection needle 2 is referred to as a bevel portion. FIG. 1B shows a state in which a part of the bevel portion 2-1 is cut into two to be bifurcated (2-2, 2-2 ′). FIG. 1C shows a state in which a part of the bevel portion (1/3 to 1/4 from the tip) is bent including the crotch portion. The bending angle θ1 may be 45 to 90 °. FIG. 1D shows a state where a portion of 1 to 2 mm (distance L in the drawing) is bent from the tip of the needle-like member 2. The bending angle θ2 may be 30 to 60 °.

  The distance d between the tip of the needle-like member and the crotch is usually 1.5 times or less, preferably 1 or less, the thickness of the injection needle 2. When the distance d is too large, the pressure may be reduced by applying pressure. The height h of the bent portion at the tip may be about 0.1 to 1 mm.

  FIG. 2 shows a state in which the anterior lens capsule is incised using the anterior lens capsule cutting knife of the present invention. FIG. 2A is a view of the eyeball from the front; FIG. 2B is a view of the cross section of the eyeball. FIG. 2B shows a state where the needle-like member 2 is inserted between the anterior capsule 3 and the cornea 6.

  FIG. 2A shows a state in which the anterior capsule is cut in the direction of the arrow along the dotted line in the drawing using the anterior lens capsule cutting knife. Since the anterior capsule is covered with the cornea, it is first necessary to insert a cutting knife between the cornea and the anterior capsule. In order to facilitate the insertion, it is preferable to make the needle-like member of the incising knife, particularly the tip thereof thin. Therefore, the tip of the needle-like member of the cutting knife of the present invention has a crotch (two forks in the figure), but the distance between the crotch is made as short as possible.

  As shown in FIG. 2A, the front capsule 3 is hooked at the tip of the incising needle 2 to make a crack, and then the anterior capsule 3 is beaten with the needle 2 so that a circular cutting line (dotted line in the figure). The anterior capsule is cut along. Then, the cut anterior capsule (anterior capsule flap) 3-1 is folded. A continuous circular notch is formed while repeating this cutting and folding. It is necessary to prevent the cutting line from shifting toward the iris 5 (outward). The crystalline lens 4 is exposed by cutting the anterior capsule 3, the exposed crystalline lens 4 is pulverized with ultrasonic waves, and the pulverized crystalline lens 4 can be sucked and removed.

  Therefore, it is important that the tip of the cutting blade needle 2 is easily caught on the anterior capsule. Conventionally, since the tip of the needle-shaped member of the incising knife is hooked on the anterior capsule at one point, it is difficult to be caught on the anterior capsule and “slip” is likely to occur.

  On the other hand, as shown in FIG. 2B, the anterior capsulotomy knife of the present invention has a crotch (the bifurcation 2-2 and 2-2 'in FIG. 2) as the tip of the needle-like member 2 of the knife. The anterior capsule 3 can be supported at multiple points. Therefore, the tip of the needle-like member 2 is easily caught on the anterior capsule and the operation is stabilized. Therefore, even if the anterior capsulotomy edge flows outward, it can be easily corrected and cut into a circle. Further, the anterior capsule 3 cut into a circular shape can be easily taken out by sandwiching it between the crotch at the tip of the needle-like member.

  The incision instrument of the present invention is used in an operation for incising the anterior lens capsule, such as an operation for extracting a lens, and enables a safer and quicker operation.

It is a figure which shows the example of the procedure which manufactures the anterior lens capsule cutting knife of this invention. It is a figure which shows a mode that the front capsule is cut | disconnected using the lens front capsule cutting blade of this invention, and a continuous circular incision is formed.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Gripping part 2 Needle-like member 2-1 Tip part of needle-like member 2-2 Crotch of tip part of needle-like member 3 Anterior capsule 3-1 Anterior capsule flap 4 Lens 5 Iris 6 Cornea

Claims (6)

A pre-capsular capsulotomy knife having a grasping part, and a needle-like member extending from the grasping part and having a bent tip,
An anterior capsulotomy knife in which the tip of the needle-like member is a bifurcated or multi-grown crotch or more.   The anterior capsulotomy knife according to claim 1, wherein a tip of the needle-like member is bent by 45 to 90 °.   The anterior capsulotomy knife according to claim 1 or 2, wherein the needle-like member is a 27 gauge to 30 gauge needle.   4. The anterior capsulotomy knife according to claim 1, wherein a distance between the crotch is equal to or less than a thickness of a needle of the acicular member. 5.   The anterior capsulotomy knife according to any one of claims 1 to 4, wherein the needle-like member is bent at a portion of 1 to 2 mm from the tip, and the bending angle is 30 to 60 °.   The anterior capsulotomy knife according to claim 1, wherein the needle-shaped member is replaceable.

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