JP2009066249A - Device for inserting intraocular lens, and device for housing and inserting intraocular lens - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To allow the smooth insertion of a nozzle section to an incision of an eyeball by discharging liquid of low viscosity from the nozzle with a sufficient strength. <P>SOLUTION: An inserting device includes the nozzle section 12c which is inserted into an incision of the eyeball for discharging an intraocular lens 1 into the eyeball. The distal end 53 of the nozzle section is inclined with respect to the longitudinal direction of the inserting device and has a flat configuration compared to the proximal part of the nozzle section. The distal end of the nozzle section has such a configuration that its thickness t is identical or decreases from a center 12dc in the width direction toward both the ends 12de. <P>COPYRIGHT: (C)2009,JPO&amp;INPIT

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 the current cataract surgery, the central part of the anterior capsule of the eyeball is excised, the clouded lens is removed by an ultrasonic emulsification 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, the lens loaded in the instrument body is deformed to a small size while being moved in the instrument body by the push-out shaft, and the lens is inserted into the eye from the distal end opening of the insertion tube part (nozzle part) inserted into the incision. Many insertion tools are used to push out. 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.

  When inserting a lens into the eye using these insertion devices, a viscoelastic substance such as sodium hyaluronate is a lubricant in the insertion device so that the lens moves smoothly and deforms in the insertion device. As injected. The viscoelastic material also has a role of expanding (expanding) the space of the anterior chamber of the eye into which the lens is inserted.

  Conventionally, as disclosed in Patent Document 1, a syringe is used to inject a viscoelastic material from the opening of the tip of the nozzle portion, or an injection port provided in the insertion instrument body to inject a viscoelastic material. It is.

Further, Patent Document 2 discloses an insertion device in which the tip of the nozzle portion has a flat shape.
JP 2004-351196 A US Pat. No. 4,681,102

  When a lens is inserted into the eye during cataract surgery, it is necessary to insert the nozzle portion of the insertion device into an incision formed in the cornea of the eyeball. In general, a dedicated knife for forming an incision has a width of about 2.4 mm to 3.0 mm, and the incision formed in the cornea using this knife is linear, and the width is the width of the knife. Is almost the same. More recently, there is a tendency to make the incision smaller to reduce the burden on the patient.

  When inserting a nozzle part into such a small straight incision, the tip of the nozzle part may have a conventional cylindrical shape or a simple flat shape as disclosed in Patent Document 2. Then, it is difficult to smoothly insert into the incision.

  Recently, for the purpose of shortening the operation time and reducing the operation cost, there is a demand for using an inexpensive and low-viscosity liquid such as physiological saline instead of the viscoelastic substance. However, the intraocular pressure of the eyeball from which the lens has been removed is reduced, and the space in the anterior chamber is also narrowed. For this reason, in the case of using a liquid having low viscosity, the incision is difficult to open unless the liquid is allowed to flow out from the nozzle part to some extent, and it is difficult to smoothly insert the nozzle part into the incision. When the tip of the nozzle part has a cylindrical shape, or when a part is flat but the other part is not flat, it is difficult to increase the momentum of the liquid flowing out from the nozzle part.

  The present invention provides an insertion device for an intraocular lens that allows a low-viscosity liquid to flow out from a nozzle portion with sufficient momentum and enables smooth insertion of the nozzle portion into an incision (incision). To do.

  An insertion device according to one aspect of the present invention includes a nozzle portion that is inserted into an incision portion of an eyeball and feeds an intraocular lens into the eyeball. And the front-end | tip of a nozzle part has a flat shape rather than the base end side part of this nozzle part while it inclines with respect to the longitudinal direction of this insertion instrument. Furthermore, the tip of the nozzle part has a shape in which the thickness is the same or decreases from the center in the width direction to both ends of the tip.

  Note that an intraocular lens-incorporating insertion device including an intraocular lens arranged in a lens housing provided in the insertion device also constitutes another aspect of the present invention.

  Further, a method for manufacturing an intraocular lens-inserting type insertion device comprising the steps of preparing the insertion device and placing an intraocular lens in a lens housing provided in the insertion device is also provided. Configure other aspects.

  Furthermore, the method for manufacturing an insertion device according to another aspect of the present invention is applied to an insertion device for an intraocular insertion lens having a nozzle portion that is inserted into an incision portion of the eyeball and feeds the intraocular insertion lens into the eyeball. The The manufacturing method includes a step of cutting the tip side portion of the nozzle portion obliquely with respect to the longitudinal direction of the insertion instrument, and a pair of the tip portion of the nozzle portion that narrows each other in the insertion direction of the tip side portion. Inserting into a mold having an inclined surface and thermally deforming. In the thermal deformation step, the tip side portion of the nozzle portion is inserted obliquely with respect to the inclination direction of the inclined surface of the mold.

  According to the present invention, by forming the tip of the nozzle portion obliquely, the nozzle portion can be inserted more smoothly into the linear incision than in the prior art. In addition, by reducing the thickness of the tip (tip opening) of the nozzle portion formed obliquely toward the both ends in the width direction, the thickness of the nozzle portion decreases toward the both ends in a uniform manner or closer to both ends. It can be drained with sufficient momentum. Thereby, the cornea around the incision can be swung to widen the incision, and the nozzle can be more easily inserted into the incision.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings.

  FIG. 1 shows an insertion system for an intraocular lens which is Embodiment 1 of the present invention. 1 is a top view, and the lower view is a side view.

  In the following description, the nozzle part side is referred to as the distal end side of the insertion instrument, and the side opposite to the nozzle part side is referred to as the rear end side or the base end side. In addition, the longitudinal direction of the insertion instrument extending to the front end side and the rear end side is referred to as an axial direction, and the direction orthogonal to the axial direction is the vertical direction (first direction) or the horizontal direction (first direction orthogonal to the first direction). 2 direction). Further, an axis that is parallel to the axial direction and passes through the inner space of the main body including the nozzle portion or the center of the intraocular insertion lens accommodated in the main body is indicated by a one-dot chain line in the drawing as the central axis of the insertion instrument.

  Reference numeral 10 denotes an insertion instrument for an intraocular lens (hereinafter simply referred to as a lens) according to the present embodiment, and reference numeral 15 denotes a liquid supply device that supplies a liquid 14 such as physiological saline to the insertion instrument 10.

  The insertion instrument 10 includes a main body 12 and an extrusion shaft 16. The main body 12 includes a cylindrical portion 12a, a lens holding portion (lens housing portion) 12b provided at the tip of the cylindrical portion 12a, a nozzle portion 12c provided at the tip of the lens holding portion 12b, and the cylindrical portion 12a. Is also formed as an integral part having a handle portion 12e provided on the rear side (opposite side of the nozzle portion 12c). The cylindrical portion 12a and the handle portion 12e have a hollow structure, and an extrusion shaft 16 is inserted therein.

  The lens holding portion 12b has a hollow flat plate shape, and the lens 1 is housed and held in a state where the optical portion (a portion replacing the crystalline lens in the eye) 1a is not substantially stressed. The state where substantially no stress is applied here refers to a state where stress or deformation that affects the optical function of the optical unit 1a does not occur even when stored for a long period of time.

  The lens 1 includes an optical unit 1a and a support unit 1b that is formed of a wire or the like and supports the optical unit 1a in the eye. In order to allow the lens 1 to be loaded into the lens holding part 12b, the lens holding part 12b has a structure that is divided into two parts in the vertical direction and a structure that opens and closes the lid. The lens holding portion 12b is not limited to this, and the lens is loaded from the rear end opening 20 of the main body 12. The lens holding portion 12b is not opened and closed, and is manufactured as an integrally molded part so as not to have an opening or a gap. It may be a thing.

  The form of the lens 1 is not limited to these, and the lens 1 may have an optical part and a flat support part.

  In this embodiment, the insertion instrument is a so-called preload insertion instrument in which the lens 1 is loaded (accommodated) in a lens holding portion 12b as a lens accommodating portion in advance before delivery to the hospital, such as when the insertion instrument is shipped from the factory. (Intraocular insertion lens insertion device) will be described. However, the present invention can be applied to other insertion devices. For example, the present invention can be applied to a type in which the insertion instrument and the lens are stored separately and the lens is loaded into the insertion instrument immediately before surgery.

  Furthermore, although a present Example demonstrates the case where it has the main body 12 which integrally molded from the handle part 12e-the nozzle part 12c, the insertion instrument of this invention is not restricted to this. For example, the nozzle may be used by being attached to a main body integrally formed from the handle portion to the lens holding portion. Further, a part having a nozzle part and a lens holding part may be used by being mounted on a main body having a cylinder part and a handle part. In any of these cases, after assembling (in use), since the handle portion to the nozzle portion are integrated and function as a main body, it is included in the insertion instrument of the present invention as in this embodiment.

  The push-out shaft 16 is provided at the first shaft portion 16a exposed from the main body 12 in a state before the lens 1 is inserted into the eye, and at the tip of the first shaft portion 16a. And a second shaft portion 16b extending in the direction. A lens contact portion 16c that contacts the lens 1 held by the lens holding portion 12b when the lens 1 is inserted into the eye and pushes it into the eye through the nozzle portion 12c is formed at the tip of the second shaft portion 16b. Has been.

  An injection portion 24 is formed at the rear end portion of the extrusion shaft 16 (first shaft portion 16a). A tube 13 extending from the liquid supply device 15 is connected to the injection part 24.

  An injection port 24 a for taking in physiological saline from the tube 13 is formed inside the injection unit 24. Furthermore, a flow path 16d extending in the distal direction (axial direction) from the injection port 24a is formed in the first shaft portion 16a. The tip of the flow path 16d is open to the space in the main body 12 at the tip of the first shaft portion 16a, in other words, the portion (intermediate portion) on the rear side of the lens contact portion 16c of the extrusion shaft 16. . This opening becomes the outflow port 16e into the main body 12 of the physiological saline.

  As the liquid supply device 15, it is possible to use a device that supplies the insertion instrument 10 using a pressure difference generated by putting the liquid 14 in a bottle and making the liquid level higher than the insertion instrument 10. In addition, an irrigation unit of an ultrasonic emulsification and suction device generally used in cataract surgery may be used as the liquid supply device 15.

  When the liquid 14 such as physiological saline is supplied from the liquid supply device 15 to the injection portion 24 (injection port 24a) of the insertion instrument 10, the liquid 14 passes through the flow path 16d in the extrusion shaft 16 and passes through the outlet 16e. It flows into the internal space of the handle portion 12e of the main body 12. Then, the liquid 14 flows through the internal space of the cylindrical portion 12a to the lens holding portion 12b and further to the nozzle portion 12c, and is discharged to the outside from the tip opening 12d of the nozzle portion 12c.

  FIG. 2 shows a flow path of the liquid 14 communicating from the liquid supply device 15 to the tip opening 12d of the nozzle portion 12c by hatching. By appropriately setting the flow rate of the liquid 14 from the liquid supply device 15, the liquid 14 can always flow in the main body 12 in the direction of the nozzle portion 12c and out of the tip opening 12d of the nozzle portion 12c.

  In the insertion instrument 10 shown in FIG. 1, an opening 20 is formed on the rear end side of the handle 12 e in the main body 12 as an opening in the internal space of the main body 12, in addition to the tip opening 12 d of the nozzle 12 c. . Specifically, a cylindrical member 22 having a screw portion for advancing the pushing shaft 16 in the pushing direction by a screw action at the time of lens insertion is inserted into the rear portion of the main body 12. 12 is formed as a gap or a groove-shaped passage. This is because the liquid 14 in the main body 12 leaks from the gap between the lens holding portion 12b and the handle portion 12e when the lens holding portion 12b has a vertically divided structure or a lid that can be opened and closed. This is particularly to prevent the portion held by the hand from getting wet. That is, by discharging excess liquid 14 from the opening 20 provided on the rear side of the handle portion 12e, the liquid 14 is prevented from leaking from the lens holding portion 12b, and the insertion instrument 10 is easily held. It is trying not to decline.

  It should be noted that the number, size, and location of the water drain openings are not limited as long as they do not directly affect the flow of the liquid 14 to be supplied to the nozzle portion 12c. Further, a water drainage passage having a small diameter that does not affect the flow in the flow path is connected to the flow path (hatched portion in FIG. 2) from the injection section 24 to the nozzle section 12c. Also good.

  A cylindrical intermediate member 25 extending from the rear portion of the main body 12 to the vicinity of the tip of the cylindrical portion 12a is press-fitted inside the cylindrical member 22 described above. An O-ring 23 for sealing is attached to a portion of the first shaft portion 16a on the inner surface of the intermediate member 25 slightly behind the outlet 16e. For this reason, the liquid 14 is prevented from leaking from the inside of the cylindrical member 22.

  As described above, when the outflow port 16e is disposed slightly on the nozzle portion 12c side from the seal portion formed by the O-ring 23, when the liquid flows into the main body 12 from the outflow port 16e, a part of the liquid is on the side opposite to the nozzle portion 12c side. Although it flows, the liquid 14 immediately flows toward the nozzle portion 12c because the back side thereof is sealed by the O-ring 23.

  Further, in this embodiment, as shown in FIG. 1, a cover 32 covering the vicinity of the end of the injection portion 24 and the tube 13 connected thereto is attached to the extrusion shaft 16. When the push shaft 16 is operated, the cover 32 is provided so that the operation can be easily performed without deforming the tube 13.

  There are various sizes of the diameter of the tube 13 connected to the injection part 24. For example, the size of the connector of the irrigation part of the ultrasonic emulsification and suction device varies depending on the manufacturer of the device, and the size of the tube 13 varies accordingly. Further, it is convenient if the flow rate of the liquid 14 can be adjusted by the size of the tube 13.

  For this reason, as shown in FIG. 3, you may provide the injection | pouring part 24 from which a size (size of the tube 13 which can be connected) differs in the rear part of the extrusion axis | shaft 16. FIG. In this case, the injection part 24 not connected to the tube 13 may be provided with a stopper or a lid.

  Further, in this system, since the liquid 14 such as physiological saline having a low viscosity is used, the operation of the extrusion shaft 16 becomes lighter than the case where a viscoelastic member is used, and the extrusion shaft 16 may be pushed strongly. Conceivable. Increasing the diameter of the O-ring 23 can avoid such an inappropriate operation to some extent, but it is not perfect.

  For this reason, in this embodiment, the spring 35 is disposed in the rear part of the main body 12 (the outer periphery of the extrusion shaft 16). Thereby, resistance is given to pushing operation of the pushing shaft 16, and it is surely avoided that pushing operation with improper momentum is performed.

  Further, since it is not necessary for the liquid 14 to always flow during the operation, it is easy to use if the flow of the liquid 14 can be stopped if necessary. For this reason, in this embodiment, as shown in FIG. 1, a clip 38 is provided on the tube 13, and the clip 14 can be detached and flowed or stopped as necessary. Thereby, the usage-amount of the liquid 14 decreases and the operation room water-wetting by discharge | emission of the unnecessary liquid 14 is prevented. When the irrigation part of the ultrasonic emulsification and suction device is used as a liquid supply device, no clip is required, and the flow rate can be adjusted by operation (foot pedal) of the ultrasonic emulsification and suction device.

  In FIG. 4, the shape of the nozzle part 12c1 generally provided in the conventional insertion instrument is shown. FIG. 5 shows the shape of another nozzle portion 12c2 that is generally provided in a conventional insertion instrument. In these drawings, the upper drawing is a top view and the lower drawing is a side view.

  In the top view of FIG. 4, the tip of the nozzle portion 12c1 (tip opening 12d1) is a straight portion 56 that is orthogonal (not inclined) with respect to the axial direction, and a hypotenuse that is inclined with respect to the axial direction (central axis). Part 57.

  The nozzle portion 12c1 is originally formed so as to have a cylindrical shape, and then deformed so that the tip side portion has a tapered shape having an angle of about 40 ° to 80 °. The upper and lower inclined surfaces 58 formed by the deformation process are changed in the direction D1 orthogonal to the straight line portion 56, that is, in the axial direction so that the height with respect to the central axis changes (the contour line indicated by a two-dot chain line is in the direction D1. Formed in a direction perpendicular to each other). That is, the inclination direction of the inclined surface 58 is the same (parallel) direction D1 as the axial direction. In this way, the rear end of the slope 58 inclined so as to be separated from each other in the vertical direction toward the base end side portion (cylindrical portion) of the nozzle portion 12c1 is connected to the cylindrical portion of the nozzle portion 12c1. .

  When such a slope 58 is formed on the tip side portion of the nozzle portion 12c1, and then a part of the tip side portion of the nozzle portion 12c1 is cut to form the oblique side portion 57 shown in the top view, the tip of the nozzle portion 12c1 is obtained. The (tip opening 12d1) increases in thickness in the vertical direction (opening width) as it moves away from the central axis along the oblique side portion 57.

  On the other hand, in the top view of FIG. 5, the nozzle portion 12 d 2 has a simple cylindrical shape, and an oblique side portion 60 having an inclination with respect to the axial direction (center axis) is formed at the tip thereof. The slope 58 like the nozzle part 12c1 shown in FIG. 4 is not formed. Therefore, the tip (tip opening 12d2) of the nozzle portion 12c2 is not flat as shown in FIG.

  Note that the position and orientation of forming the oblique side portion 60 are not limited to the positions shown in FIG. 5, but as shown in the upper diagram of FIG. 6, the oblique side portion 60 may be formed in the opposite direction to FIG. As shown in the lower left and right figures, the hypotenuse 60 may be formed upward or downward.

  FIG. 7 shows a state where the conventional nozzle portion 12c1 shown in FIG. 4 is inserted into an incision formed in the eyeball. The upper figure is a top view, and the lower figure is a side sectional view.

  A straight incision 52 is formed in the eyeball 50 using a dedicated knife. The straight portion 56 formed at the tip of the nozzle portion 12c1 makes it difficult to insert the tip of the nozzle portion 12c1 into the incision 52. Further, after the straight portion 56 is inserted into the incision 52, as shown in the sectional view, the tip side portion of the nozzle portion 12c1 is crushed by receiving external force from the cornea in the thickness direction. Thereby, as shown in the top view, the protruding portion 57A appears at one end in the width direction (end on the base end side) of the oblique side portion 57. And this protrusion part 57A becomes resistance at the time of inserting the nozzle part 12c1 in the incision 52 further.

  FIG. 8 shows a state in which the conventional nozzle portion 12c2 shown in FIG. 5 is inserted into an incision formed in the eyeball. The upper figure is a top view, and the lower figure is a side sectional view. Also in this case, when the tip of the nozzle portion 12c2 is inserted into the linear incision 52 formed in the eyeball 50, as shown in the sectional view, the tip side portion of the nozzle portion 12c is crushed, as shown in the top view. In addition, a protruding portion 60 </ b> A appears at one end in the width direction of the oblique side portion 60 (an end on the base end side). And this protrusion part 60A becomes resistance at the time of inserting the nozzle part 12c2 in the incision 52. FIG.

  In FIG. 9, the shape of the nozzle part 12c in the insertion instrument of a present Example is shown. The upper figure is a top view and the lower figure is a side view.

  The nozzle portion 12c is originally formed to have a cylindrical shape, and thereafter, a hypotenuse portion 53 having an inclination with respect to the central axis of the insertion instrument is formed at the tip of the nozzle portion 12c as shown in the top view. The Further, the tip side portion of the nozzle portion 12c is deformed so as to have a tapered shape having an angle of about 20 ° to 30 ° with the oblique side portion 53 as the tip. The upper and lower inclined surfaces 54 formed by the deformation process are changed so that the height with respect to the central axis changes in a direction D perpendicular to the hypotenuse 53, that is, in a direction different from the axial direction (contour lines indicated by two-dot chain lines). Are arranged in a direction perpendicular to the direction D). That is, the inclination direction of the inclined surface 54 is a direction D that is different (non-parallel) from the axial direction. In this way, the rear end of the slope 54 inclined so as to be separated from each other in the vertical direction from the oblique side portion 53 toward the proximal end portion (cylindrical portion) of the nozzle portion 12c is connected to the cylindrical portion of the nozzle portion 12c. .

  By forming the oblique side portion 53 at the tip of the nozzle portion 12c and forming the slope 53 as described above at the tip side portion of the nozzle portion 12c, as shown in FIG. 23, the oblique side portion 53 (that is, the nozzle portion 12c) is formed. The thickness t of the front end opening 12d) is the same or slightly decreased from the center (center axis) 12dc in the width direction of the oblique side portion 53 to both ends 12de. That is, the tip (the oblique side portion 53) of the nozzle portion 12c has a flat shape throughout. The term “flat shape” used herein means a shape that is flatter (having a higher flatness ratio) than the base end side portion of the nozzle portion 12c.

  FIG. 10 shows how the nozzle portion 12c of this embodiment is inserted into an incision formed in the eyeball. The upper figure is a top view, and the lower figure is a side sectional view.

  The eyeball 50 is formed with a linear incision 52 using a dedicated knife, as in the conventional case. Since the oblique side portion 53 of the nozzle portion 12c is formed obliquely with respect to the central axis, the tip of the nozzle portion 12c can be inserted into the incision 52 more easily than the nozzle portion 12c1 shown in FIG.

  When the tip of the nozzle portion 12c is inserted into the incision 52, the tip side portion of the nozzle portion 12c is crushed and deformed by the cornea as shown in the cross-sectional view, but the conventional nozzle portions 12c1, 12c2 and Compared to the amount of deformation. For this reason, the protruding amount of the protruding portion 53A that appears at one end in the width direction of the oblique side portion 53 is also small. Therefore, the protrusion 53A hardly causes resistance when the nozzle portion 12c is further inserted into the incision 52, and the nozzle portion 12c can be smoothly inserted into the incision 52.

  11 and 12 show a conventional procedure for forming the nozzle portion 12c1. The upper figure is a top view and the lower figure is a side view.

  A concave portion 63 having a pair of inclined surfaces 63A forming an inner angle of about 40 ° to 80 ° in the side view is formed in the mold 62 that thermally deforms the tip side portion of the nozzle portion 12c1. The pair of slopes 63A are formed so that the distance between them is reduced in the insertion direction of the nozzle portion 12c1. In the concave portion 63, the tip of the cylindrical nozzle portion 12c1 is perpendicular to the valley line B of the concave portion 63, that is, in the inclination direction (direction perpendicular to the line B) E of the inclined surface 63A of the concave portion 63. Insert it in parallel to. Thereby, the front end side part of the nozzle part 12c1 can be thermally deformed, and the inclined surface 58 can be formed in this front end side part.

  Thereafter, as shown in FIG. 12, the tip side portion of the nozzle portion 12c1 is cut with a cutter obliquely so as to form a predetermined angle with respect to the central axis (axial direction). Thereby, the hypotenuse part 57 is formed, and the tip shape of the nozzle part 12c1 as shown in FIG. 4 is completed. The order of the thermal deformation process for forming the slope 58 and the cutting process for forming the oblique side portion 57 may be reversed.

  The conventional nozzle portion 12c2 shown in FIG. 5 is formed by cutting the tip of the cylindrical nozzle portion 12c with a cutter so as to form a predetermined angle with respect to the central axis.

  13 and 14 show a molding procedure (manufacturing method) of the nozzle portion 12c of this embodiment. The upper figure is a top view and the lower figure is a side view.

  In FIG. 13, a concave portion 65 having a pair of inclined surfaces 65 </ b> A forming an inner angle of about 20 ° to 30 ° in the side view is formed in the mold 64 that thermally deforms the tip side portion of the nozzle portion 12 c. The pair of inclined surfaces 65A are formed so that the interval between them is reduced in the insertion direction of the nozzle portion 12c. In the recess 65, the tip side portion of the cylindrical nozzle portion 12 c is formed at a predetermined angle (an angle that is not perpendicular) with respect to the valley line B of the recess 65, that is, the slope 65 A of the recess 65. Is inclined with respect to the inclination direction (direction perpendicular to the line B) E. By this thermal deformation step, the tip side portion of the nozzle portion 12c1 can be thermally deformed, and the inclined surface 54 can be formed on the tip side portion.

  Thereafter, as shown in FIG. 14, the tip of the nozzle portion 12 c is cut with a cutter so as to be inclined with respect to the central axis (axial direction) at the same angle as the insertion angle of the nozzle portion 12 c into the recess 65. By this cutting step, the oblique side portion 53 is formed, and the tip shape of the nozzle portion 12c as shown in FIG. 9 is completed. The order of the thermal deformation process for forming the slope 54 and the cutting process for forming the oblique side 53 may be reversed.

  However, since it is easier to insert into the incision 52 if the thickness of the tip of the nozzle portion 12c (the oblique side portion 53) is made as small as possible, a cutting process for forming the oblique side portion 53 is first performed as shown in FIG. After performing, it is preferable to perform the heat deformation process which forms the slope 54 using the type | mold 64. FIG.

  The tip opening 12d of the nozzle portion 12c formed as described above is flatter than the tip openings 12d1 and 12d2 of the conventional nozzle portions 12c1 and 12c2 over the entire width direction. Therefore, when a liquid such as physiological saline injected into the main body 12 flows out from the tip opening 12d, the flow velocity (momentum) is larger than when the liquid flows out from the tip openings 12d1 and 12d2 of the conventional nozzle portions 12c1 and 12c2. ) Can be increased.

  Then, as shown in FIG. 16, a liquid with a high flow rate flowing out from the tip opening 12d is applied to the periphery of the incision 52 of the eyeball 50 in which the intraocular pressure is reduced by extracting the crystalline lens. The incision 52 can be opened by waving the cornea. Therefore, the tip of the nozzle portion 12c can be easily inserted into the incision 52.

  In addition, the restoring force from the state by which the lens 1 was folded small within the nozzle part 12c changes with the materials. For this reason, when using the lens 1 with especially strong restoring force, it is good to form the slit extended in an axial direction in the front end side part of the nozzle part 12c. Thereby, when the lens 1 passes through the nozzle portion 12c, the tip side portion of the nozzle portion 12d expands, and the resistance to the lens 1 can be relaxed.

  FIG. 25 shows a manufacturing process (manufacturing method) of the intraocular lens-incorporating insertion device of the present embodiment having the above-described configuration.

  In step S1, the main body 12 and the extrusion shaft 16 (that is, the insertion tool) on which the nozzle portion 12c having the tip shape described above is formed are prepared.

  Next, in step S <b> 2, the lens 1 is disposed (accommodated) in the lens holding portion 12 b of the main body 12.

  In step S 3, the extrusion shaft 16 is assembled to the main body 12. In this way, the manufacture of the intraocular lens-incorporated insertion device is completed. The intraocular lens-incorporated insertion device is also referred to as a preload type or preset type insertion device.

  In FIG. 17, the tip shape of the nozzle part of the insertion instrument which is Example 2 of this invention is shown. The upper figure is a top view and the lower figure is a side view. The tip shape of the nozzle portion 12c ′ of the present embodiment is basically the same as that of the first embodiment, and has an oblique side portion 53 and an inclined surface 54.

  In the shape of the nozzle portion 12c of the first embodiment, when the tip is inserted into the incision 52, the protruding portion 53A appears at the end in the width direction of the oblique side portion 53, although the amount is small. For this reason, in the present embodiment, by forming the inner folding portion 68 that is folded inside the nozzle portion 12 c ′ at one end in the width direction (end on the base end side) of the oblique side portion 53, the appearance of the protruding portion 53 </ b> A is achieved. To avoid. The inward folding portion 68 can be formed by forming the oblique side portion 53 and the inclined surface 54 and then thermally deforming the heated tool against the end of the oblique side portion 53 in the width direction. FIG. 24 is a perspective view of the nozzle portion 12c ′ of the present embodiment.

  FIG. 18 shows a state where the nozzle portion 12 c ′ of this embodiment is inserted into an incision 52 ′ formed in the eyeball 50. When the nozzle portion 12c ′ is inserted into the incision 52, the nozzle portion 12c ′ receives an external force from the cornea in the thickness direction and is crushed. At this time, the inner folding portion 68 is deformed so as not to protrude outside the nozzle portion 12c ′. . For this reason, the protrusion part 53A like Example 1 does not appear. That is, the inward folding portion 68 is deformed so as to suppress the expansion of the width of the nozzle portion 12c ′ due to the crushing of the nozzle portion 12c ′.

  Therefore, even if the incision 52 'is smaller than the incision 52 for inserting the nozzle portion 12c of the first embodiment, the nozzle portion 12c' can be smoothly inserted.

  Further, in the present embodiment, the tip opening 12d ′ of the nozzle portion 12c ′ is narrower than the tip opening 12d of the nozzle portion 12c of the first embodiment by the inward folding portion 68. For this reason, when a liquid such as physiological saline injected into the main body 12 is caused to flow out from the tip opening 12d ′, the flow velocity (momentum) can be further increased as compared with the first embodiment. Therefore, the cornea around the incision 52 'can be further swollen more than when the nozzle portion 12c of the first embodiment is used, and the nozzle portion 12c' can be more easily inserted into the incision 52 '. be able to.

  Further, as shown in FIG. 19, the inner folding portion 68 is pushed out of the nozzle portion 12c ′ by the lens 1 passing through the nozzle portion 12c ′. For this reason, the inner folding portion 68 does not hinder the smooth passage of the lens 1 in the nozzle portion 12c ′.

  Furthermore, also in the present embodiment, a slit extending in the axial direction may be formed in the tip side portion of the nozzle portion 12c ′. In this case, a slit may be formed in the valley fold portion of the inner folding portion 68. As a result, the strength of the inwardly folded portion 68 is reduced, so that when the lens 1 passes through the nozzle portion 12c ′, the inwardly folded portion 68 is deformed to the outside of the nozzle more easily than when there is no slit.

  In addition, although the present Example demonstrated the case where the inner folding part was provided in the width direction one end (end of the base end side) in the front end side part of the nozzle part 12c, it is the same as that of the width direction other end (end end side end). An inward fold may be provided.

  FIG. 20 shows an insertion device 10A that is a third embodiment of the present invention and has the nozzle portion 12c or 12c ′ described in the first or second embodiment. In addition, in a present Example, about the part which is common in the insertion instrument 10 demonstrated in Example 1, the same code | symbol as Example 1 is attached | subjected.

  In the insertion instrument 10 </ b> A, an injection part 24 ′ is formed in the cylindrical part 12 a of the main body 12. A liquid 14 such as physiological saline from the liquid supply device 15 is supplied to the injection unit 24 ′ via the tube 13. Thereby, the liquid 14 is injected into the main body 12. In the present embodiment, the flow path in the extrusion shaft 16 described in the first embodiment is not necessary.

  FIG. 21 shows an insertion instrument 10B that is a fourth embodiment of the present invention and has the nozzle portion 12c or 12c ′ described in the first or second embodiment. In addition, in a present Example, about the part which is common in the insertion instrument 10 demonstrated in Example 1, the same code | symbol as Example 1 is attached | subjected.

  In the insertion instrument 10B, an injection part 24 ″ is formed in the cylindrical part 12a of the main body 12. The needle of the syringe 40 can be inserted into the injection part 24 ″ and the liquid 14 can be injected into the main body 12 from the syringe 40. . Also in this embodiment, the flow path in the extrusion shaft 16 described in Embodiment 1 is not necessary.

  FIG. 22 shows an insertion device 10C that is the fifth embodiment of the present invention and has the nozzle portion 12c or 12c ′ described in the first or second embodiment.

  This insertion instrument 10C has a main body 212 having a cylindrical portion 212a, a lens holding portion 212b, and a handle portion 212e, and a nozzle portion 212c attached to the tip of the lens holding portion 212b.

  The lens holding portion 212b holds the lens 1 so that the optical portion is not substantially stressed at the upper position inside thereof.

  A lens deformation mechanism 218 is provided in the lens holding portion 212b. When the lens deformation mechanism 218 is pushed into the lens holding portion 212b, the lens 1 is pushed down to the lower position while being slightly deformed from the upper position in the lens holding portion 212b. In this lower position, the lens 1 can be pushed into the eye by the pushing shaft 216.

  Similarly to the insertion instrument 10 of the first embodiment, an injection portion 224 and a flow path 216d are also formed on the extrusion shaft 216. In addition, an outlet (not shown) is formed at an intermediate position in the axial direction of the extrusion shaft 216.

  In the insertion device 10C of the present embodiment, an injection portion may be provided in the cylindrical portion 212a, and the liquid may be injected into the main body 12 by connecting the tube 13 or inserting the needle of the syringe 40 therein.

  In each of the above-described embodiments, the insertion tool having an injection part for injecting liquid into the extrusion shaft and the main body has been described. However, the nozzle part having the shape shown in FIG. 9 and FIG. It is also applicable to an insertion device that does not have a.

  For example, it can also be applied to an insertion device that introduces liquid into the main body by immersing the tip opening of the nozzle in a liquid in a container such as a beaker and pulling the extrusion shaft to the side opposite to the lens insertion direction. Can do.

  In each of the above-described embodiments, the insertion device using a low-viscosity liquid such as physiological saline has been described. However, the nozzle portion having the shape shown in FIG. 9 or FIG. The present invention can also be applied to an insertion device using the In this case, the injection part and the flow path provided in the extrusion shaft and the main body in the above embodiment may be omitted.

  As described above, according to each of the above embodiments, the tip of the nozzle portion is formed obliquely, and the liquid can flow out from the tip opening with a sufficient momentum. However, the nozzle part can be inserted more easily.

  In addition, by providing an inner fold at the width direction end at the tip of the nozzle part, the width of the tip of the nozzle part hardly expands even when the nozzle part is crushed. The nozzle portion can be inserted more smoothly.

  Further, by forming a slit in the inwardly folded portion, the lens can pass through the nozzle portion more smoothly.

  Each embodiment described above is only a representative example, and various modifications and changes can be made to each embodiment in carrying out the present invention.

The top view and side view which show the insertion instrument of the lens for intraocular insertion which is Example 1 of this invention. The top view which showed the flow path of the liquid in the insertion instrument of Example 1 by hatching. The figure which shows the modification of the insertion instrument of Example 1. FIG. The top view and side view which show the shape of the nozzle part in the conventional insertion instrument. The top view and side view which show the shape of the nozzle part in another conventional insertion instrument. Furthermore, the upper side figure and side view which show the shape of the nozzle part in the other conventional insertion instrument. The top view and sectional drawing which show a mode that the nozzle part of the conventional insertion instrument was inserted in the incision. The top view and sectional drawing which show a mode that the nozzle part of the other conventional insertion instrument was inserted in the incision. The top view and side view which show the shape of the nozzle part in the insertion instrument of Example 1. FIG.

The top view and sectional drawing which show a mode that the nozzle part of the insertion instrument of Example 1 was inserted in the incision. The top view and sectional drawing which show the thermal deformation process of the nozzle part in the conventional insertion instrument. The top view and side view which show the cutting process of the nozzle part in the conventional insertion instrument. The top view and sectional drawing which show the thermal deformation process of the nozzle part in the insertion instrument of Example 1. FIG. The top view and side view which show the cutting process of the nozzle part in the insertion instrument of Example 1. FIG. The top view and sectional drawing which show the other thermal deformation process of the nozzle part in the insertion instrument of Example 1. FIG. Sectional drawing which shows a mode that a liquid flows out toward the incision from the nozzle part of the insertion instrument of Example 1. FIG. The top view and side view which show the front-end | tip shape of the nozzle part in the insertion instrument which is Example 2 of this invention. The top view and sectional drawing which show a mode that the nozzle part in the insertion instrument of Example 2 was inserted in the incision. FIG. 6 is a top view showing a state in which a lens passes through a nozzle portion in the insertion instrument of Example 2. The top view and side view of the insertion instrument which are Example 3 of this invention. The top view and side view of the insertion instrument which are Example 4 of this invention. The side view of the insertion instrument which is Example 5 of this invention. The perspective view which shows the front-end | tip shape of the nozzle part in the insertion instrument of Example 1. FIG. The perspective view which shows the front-end | tip shape of the nozzle part in the insertion instrument of Example 2. FIG. The flowchart which shows the manufacturing process of the insertion instrument (lens interior type insertion instrument for intraocular insertion) of Example 1. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Intraocular lens 1a Optical part 1b Support part 10, 10A, 10B, 10C Insertion instrument 12,212 Main body 12a, 212a Tube part 12b, 212b Lens holding part 12c, 12c1,12c2,12c3,212c Nozzle part 12d, 12d1 , 12d2, 212d Tip opening 12e, 212e Handle part 13 Tube 14 Liquid 15 Liquid supply device 16, 216 Extrusion shaft 16d, 216d Flow path 24, 24 ', 24 ", 224 Injection part 50 Eyeball 52 Incision wound

Claims (8)

An insertion device for an intraocular lens having a nozzle part that is inserted into an incision part of the eyeball and sends out the intraocular lens into the eyeball,
The tip of the nozzle portion has an inclination with respect to the longitudinal direction of the insertion instrument, and has a flatter shape than the proximal end portion of the nozzle portion,
The insertion instrument, wherein the tip has a shape whose thickness is the same or decreases from the center in the width direction to both ends of the tip. Between the base end side portion of the nozzle part and the tip, it has a slope inclined with respect to the longitudinal direction,
The insertion instrument according to claim 1, wherein an inclination direction of the slope is different from the longitudinal direction.   The insertion device according to claim 1, further comprising an injection part for injecting a liquid into the main body separately from the nozzle part. At least one end in the width direction of the tip side portion of the nozzle part has an inwardly folded part folded inside the nozzle part,
The inner fold portion is deformed so as to suppress an increase in width of the distal end side portion when the distal end side portion receives an external force in a thickness direction thereof. The insertion device according to one.   The insertion instrument according to claim 4, wherein a slit extending in the longitudinal direction is formed in the inner folding portion. An insertion instrument according to any one of claims 1 to 5,
An intraocular lens-incorporating insertion instrument, comprising an intraocular lens disposed in a lens housing provided in the insertion instrument. Preparing an insertion instrument according to any one of claims 1 to 5;
And a step of arranging an intraocular lens in a lens housing portion provided in the insertion instrument. A method of manufacturing an insertion device for an intraocular lens having a nozzle part that is inserted into an incision in an eyeball and feeds the intraocular lens into the eyeball,
Cutting the tip side portion of the nozzle portion obliquely with respect to the longitudinal direction of the insertion instrument;
Inserting the tip side portion of the nozzle portion into a mold having a pair of inclined surfaces whose distance from each other is reduced in the insertion direction of the tip side portion;
In the thermal deformation step, the distal end portion of the nozzle portion is inserted obliquely with respect to the inclined direction of the inclined surface.