JP2011050415A - Intraocular lens - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intraocular lens suppressing increase of the cross-sectional area of the intraocular lens in the extruding direction when support parts are integrally folded together with an optic part, and being appropriately fed out of an injector or appropriately disposed within a capsule. <P>SOLUTION: The foldable intraocular lens includes the optic part and a pair of support parts integrally formed with the optic part for supporting the optic part within an eye. The intraocular lens further includes a first constricted part formed at the proximal end of each support part coupled with the optic part as a base point for bending the whole support part, and a second constricted part formed between the first constricted part and the distal end of the support part as a base point for bending the support part by a prescribed length from the distal end of the support part. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an intraocular lens installed in the eye of a subject's eye.

  Conventionally, after removing the lens as one of the surgical methods for cataract, an intraocular unit having an optical part having refractive power instead of the crystalline lens and a loop-shaped support part with one end supporting the optical part in the eye open. A method of inserting a lens is generally used. Since such an intraocular lens is inserted into the eye through an incision provided in the patient's eye, it can be bent and restored to its original state so as to make the incision in the patient's eye as small as possible. There is known a one-piece type intraocular lens in which an optical part and a support part are integrally formed of a material having excellent elasticity (for example, see Patent Document 1). In addition, in such insertion of an intraocular lens, a technique is known in which an intraocular lens is folded (folded) using an intraocular lens insertion device called an injector (for example, a patent) Reference 2). The intraocular lens inserted into the eye in a bent state is restored to its original shape by opening in the eye, and is placed in a lens capsule or the like from which the lens has been removed.

JP-T-2005-507286 JP 2006-333924 A

  By the way, the one-piece type intraocular lens as described above is often folded together with the optical part while being positioned on the optical part in a state where the support part is folded by a bending operation by an injector. Then, the intraocular lens delivered from the injector is spread in the sac from which the crystalline lens has been removed, and is suitably placed in the eye by the support portion. By folding the support portion while being positioned on the optical portion in this way, twisting of the support portion that is likely to occur during folding is suppressed, and a release operation is suitably performed in the eye. However, when the intraocular lens is folded, the optical part and the support part are folded together, so that the cross-sectional area of the intraocular lens in the push-out direction when folded is increased, and the intraocular lens is difficult to be sent out. Such a problem can be solved by increasing the diameter of the delivery path on the injector side. However, since the outer diameter of the tip of the injector is increased, the incision in the eye of the subject is enlarged. A new problem arises.

  In view of the above-described problems of the prior art, the present invention can suppress an increase in the cross-sectional area of the intraocular lens in the push-out direction by folding the support portion together with the optical portion. It is an object of the present invention to provide an intraocular lens that can be suitably placed on the lens.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) In a foldable intraocular lens comprising an optical part and a pair of support parts that are integrally formed with the optical part and support the optical part in the eye, the support part is the optical part A first constricted portion formed at a base end of the support portion connected to the base portion and serving as a base point for bending the entire support portion; and a base point for bending a predetermined length from the tip of the support portion And a second constricted portion formed between the first constricted portion and the tip of the support portion.
(2) In the intraocular lens of (1), the support portion includes a front end portion extending from the front end to the second constricted portion and a rear end portion extending from the second constricted portion to the first constricted portion. The width of the front end is narrower than the width of the rear end.
(3) In the intraocular lens of (2), when the second constricted part is bent until the tip part is parallel to the pushing direction of the intraocular lens, the tip of the support part is the optical part. It is characterized by being formed on the support part so as not to reach the central part of the support.
(4) The intraocular lens of (3) is characterized in that a plurality of constricted portions are formed at the distal end portion.

  According to the present invention, it is possible to suppress an increase in the cross-sectional area of the intraocular lens in the push-out direction by folding the support portion together with the optical portion, and suitably performing delivery from the injector and placement in the sac. be able to.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram illustrating a configuration of an intraocular lens 100 according to an embodiment of the present invention. 1A is a front view, and FIG. 1B is a side view. The intraocular lens 100 includes an optical unit 110 having a predetermined refractive power and a pair of support units 120 for supporting the optical unit 110 in the eye. The support portion 120 has a loop shape with one end being a free end.

  The optical unit 110 and the support unit 120 of the present embodiment can be bent such as a simple substance such as HEMA (hydroxyethyl methacrylate), a composite material of acrylic ester and methacrylic ester, and the intraocular lens 100 is fixed in the sac. Therefore, it is made of a material for a soft intraocular lens having a repulsive force required for the purpose. The intraocular lens 100 is a one-piece intraocular lens that uses the above-described intraocular lens material and integrally forms the optical unit 110 and the support unit 120 by cutting, molding, or the like.

  The optical unit 110 is a disk-shaped member, and includes a front surface 111 formed of a convex surface having a predetermined curvature, and a rear surface 112 formed of a convex surface having a predetermined curvature and having an edge portion 115 formed on the outer peripheral portion (peripheral portion). Prepare. The edge part 115 is formed at least on the rear side of the periphery of the optical part 110, and has a shape (angle) enough to contact or bite into the posterior capsule when the intraocular lens 100 is placed in the capsule of the patient's eye. When the edge portion 115 is in close contact with the posterior capsule, the secondary cataract is suppressed. Specifically, the edge portion 115 in contact with the sac suppresses cells migrating from the periphery of the optical unit 110 from entering the rear surface 112 side, and cell-derived white turbidity hardly occurs in the posterior sac behind the rear surface 112. I am doing so.

  One end of the support 120 for supporting the optical unit 110 in the sac is a free end, and the other end (base end) is connected to the optical unit 110. Further, the support part 120 is placed so as to face each other via the center (optical axis L) of the optical part 110, and is formed to extend radially by a predetermined length. Further, the support portion 120 extends while curving inward toward the tip in a state of being bent around the optical axis L by a predetermined angle. This makes it difficult for the support 120 to rotate when the intraocular lens 100 is opened in the sac during ejection of the intraocular lens described below.

  The length of the support portion 120 is such that a line segment connecting the intermediate point w1 of the width wa at the root R of the support portion 120 and the center (optical axis L) of the optical portion 110, the tip P of the support portion 120, and the optical portion 110. Is formed such that an angle θ formed by a line segment connecting with the center of the film becomes 50 ° or more and 90 ° or less. When the angle θ is less than 50 °, the contact between the crystalline lens capsule and the support portion 120 is not sufficient, and it is difficult to stably support the intraocular lens. In addition, when the angle θ exceeds 90 °, the support portion 120 becomes too long, and the support portion 120 is easily entangled in the use of an intraocular lens insertion device described later.

  Further, on the inner side of the support portion 120 (the side that does not come into contact with the sac when the intraocular lens 100 is placed in the eye), the constricted portion 125 is connected between the distal end P and the root R to the connection position with the optical portion 110. A constricted portion 126 is formed near the root R. The two constricted portions 125 and 126 are formed by constricting the inner side (inner periphery) so as to be narrower than the width of the front and rear support portions 120. In the present embodiment, the constricted portion 125 has a shape in which the inside is constricted so as to be narrower than the width of the front and rear support portions 120, but is not limited thereto. Any shape that can be bent (bent) from the middle of the support portion 120 when a predetermined stress is applied near the tip of the support portion 120 may be used. For example, as shown in FIG. 6, the width of the support portion 120 from the distal end to the proximal end is maintained at a predetermined length with the same width without being narrowed in the middle, and the width suddenly increases from there. It may be an inner peripheral shape portion formed so as to change. Such an inner peripheral shape portion is also included in the constricted portion in the present embodiment.

  In the support portion 120, the narrow portion 125 is formed so that the width at the position of the constricted portion 125 is narrower (thinner) than the width of the position of the constricted portion 126. Alternatively, when the support portion 120 is cut and viewed at the respective positions of the constricted portions 125 and 126, the cross-sectional area at the position of the constricted portion 125 is smaller than the cross-sectional area at the position of the constricted portion 126. Formed.

  Here, if the constricted part 125 to the front end P are the front end part 121a of the support part 120 and the constricted part 125 to the constricted part 126 are the rear end part 121b of the support part 120, the width of the constricted part 125 is the width of the front end part 121a. The width of the constricted portion 126 is slightly narrower than the width wc of the rear end portion 121b. The width wb of the tip 121a is preferably 0.1 mm to 0.6 mm, more preferably 0.2 mm to 0.5 mm. The width wc of the rear end portion 121b is wider than the width wb, preferably 0.6 mm to 1.5 mm, more preferably 0.7 mm to 1.1 mm. Further, the thickness of the front end part 121a and the rear end part 121b (the thickness of the support part in the optical axis direction of the optical part) may be similar, but the front end part 121a with respect to the thickness of the rear end part 121b. The thickness of can also be slightly reduced. The thickness of the tip 121a is preferably 0.2 mm to 0.5 mm, more preferably 0.3 mm to 0.4 mm. The rear end 121b has a thickness of 0.3 mm to 0.6 mm, preferably 0.4 mm to 0.5 mm.

  Due to such a configuration, when a predetermined stress is applied to the front end of the support part 120, the front end part 121a of the support part 120 is bent with the constricted part 125 as a base point, and the rear end part 121b from the front end part 121a of the support part 120 is bent. When a predetermined stress is uniformly applied to the vicinity, the entire support portion 120 is bent (bent) with the constricted portion 126 as a base point.

  The outermost diameter (maximum total length) of the intraocular lens 100 is set to such a size that a suitable stress is applied from the outer side to the inner side of the support part 120 when the intraocular lens 100 is placed in the sac, and preferably 9 mm or more. 15 mm or less. The diameter of the optical unit 110 is set based on the size of the pupil, and is preferably 4 mm or more and 8 mm or less. Along with the condition of the angle θ that defines the length of the support part 120 described above, the shape of the support part 120 is set so as to satisfy these conditions. If the diameter of the sac of the patient's eye is set to a predetermined value (for example, a diameter of 10 mm) in advance, the outermost diameter of the intraocular lens 100 is set to a diameter sufficiently longer than the predetermined value (for example, about 11 mm to 15 mm). At this time, the support part 120 has an outer periphery between the tip of the support part and the constricted part 125 and the constricted part 126 outside the circumference (set sac diameter) determined by a predetermined value from the center of the optical part 110. Designed to be located at. Note that it is not necessary that the entire outer periphery of the support portion 120 formed between the constricted portion 125 and the constricted portion 126 is positioned outside the set sac diameter, and is formed between the constricted portion 125 and the constricted portion 126. The design may be such that about half of the outer peripheral portion of the support portion 120 is positioned outside the set diameter of the sac when viewed from the distal end side.

  Next, an intraocular lens insertion device 1 (injector) for inserting the intraocular lens 100 into a patient's eye will be described. FIG. 2 is a schematic external view showing the external appearance of the intraocular lens insertion device 1 used in the present embodiment. FIG. 2A shows the intraocular lens insertion device 1 as viewed from above, and FIG. 2B shows the state as viewed from the side.

  The intraocular lens insertion device 1 includes an insertion unit that is inserted into an incision formed in the eyeball in order from the side of insertion into the eyeball, and a placement unit for installing the intraocular lens 100 (see FIG. 1) is provided. The lens holding unit 10 (hereinafter referred to as a cartridge), the cylindrical part 20 for mounting the cartridge 10 at the tip, the cartridge 10 and the inside of the cylindrical part 20 are inserted, and the eye from the tip of the cartridge 10 mounted on the cylindrical part 20 And an extrusion mechanism 30 for extruding the inner lens 100 to the outside.

  FIG. 3 is a configuration diagram of the cartridge 10. 3A is a perspective view, and FIG. 3B is a state when the cartridge 10 is viewed from above. The cartridge 10 is integrally formed with an insertion portion 11 having a tapered shape whose diameter gradually decreases (thinner) toward the tip, and a placement portion 12 on which the intraocular lens 100 is installed. The cartridge 10 is entirely made of synthetic resin and is a disposable type that is discarded after one use.

  The insertion portion 11 has a hollow cylindrical shape, and the folded intraocular lens 100 is sent out through the hollow portion. The mounting portion 12 is formed of two halved members 12a and 12b. The lower edges of the halved members 12a and 12b are connected by a hinge portion 13 as shown in FIG. It is possible. Reference numerals 14 a and 14 b denote mounting tables provided on the half members 12 a and 12 b, respectively. is doing. In addition, on the placement unit 12 side of the insertion unit 11, a presser unit 19 is provided for contacting one of the support units 120 of the intraocular lens 100.

  When the half members 12a and 12b are closed, the wall surface shape (mounting surface shape) of the mounting table is deformed and substantially matches the proximal end opening shape (semicircular shape) of the insertion portion 11. In addition, the outer shape of the mounting portion 12 when the half members 12 a and 12 b are closed is substantially the same as the inner wall shape of the cylindrical portion 20. On the side surface of the half member 12a, a flat plate-like gripping portion 16 that is gripped when the user holds the cartridge 10 is provided. 15a and 15b are covers provided on each of the half members 12a and 12b so that when the half member 12a and the half member 12b are closed, the tops of the placement table 14a and the placement table 14b are covered. Is formed.

  In the cartridge 10 having such a configuration, the intraocular lens 100 is set on the mounting table 14a and the mounting table 14b when the mounting unit 12 is in the open state (the two halved members are separated). Thereafter, by attaching the cartridge 10 to the cylindrical portion 20, the split member 12a and the half member 12b are closed, and the intraocular lens 100 can be folded. As described above, an existing foldable intraocular lens can be used as the intraocular lens to be used.

  FIG. 4 is a perspective view showing an external configuration of the cylindrical portion 20. A mounting portion 21 for attaching and detaching the cartridge 10 is provided at the tip of the cylindrical portion 20. The mounting portion 21 has a shape in which the distal end of the cylindrical portion 20 is substantially halved, with a convex portion 22 at the distal end and a concave portion 23 at the proximal end symmetrical with respect to the push rod 31 that passes through the center of the cylindrical portion 20. Each is formed. Further, the convex portion 22 is located slightly above the central axis of the cylindrical portion 20, and the distance between the convex portions 22 provided on the left and right is slightly narrower (shorter) than the inner diameter of the cylindrical portion 20. . Such a shape of the convex portion 22 serves as a guide that restricts the halved members 12a and 12b that are opened when the cartridge 10 is mounted to the mounting portion 21 in a closing direction and limits the width thereof. The snap-in structure that locks the mounted cartridge 10 and prevents it from being easily detached from the cylindrical portion 20 is provided. Note that the left and right edges of the mounting portion 21 also serve as guides for restricting the halving member in the closing direction, like the convex portion 22.

  The operation of the intraocular lens insertion device having the above configuration will be described. The user (operator) sufficiently fills the insertion portion 11 and the mounting bases 14a and 14b of the cartridge 10 shown in FIG. 3 with a viscoelastic substance such as hyaluronic acid. The intraocular lens 100 is smoothly moved from the inside of the intraocular lens insertion device 1 into the sac by the viscoelastic substance.

  Next, the user places the intraocular lens 100 on the mounting tables 14a and 14b. At this time, as shown in FIG. 3B, the support part 120 on the front side of the intraocular lens 100 is arranged on the insertion part 11 side. While holding the gripping part 16 with one hand and holding the cartridge 10, the mounting part 12 (half member) is fitted into the concave part 23 provided in the mounting part 21 while the gripping part 16 (base end side) of the cartridge 10 is fitted. The bottom surfaces of 12a and 12b) are pressed against the convex portion 22 (or the left and right edges of the mounting portion 21). By pressing the bottom surface (lower part) of the mounting portion 12 against the convex portion 22 (or the left and right edge portions of the mounting portion 21), the convex portion 22 guides the half member 12a and the half member 12b to close together. It will be. When the mounting portion 12 is further pushed into the mounting portion 21, the cartridge 10 is mounted on the mounting portion 21 with the half member 12a and the half member 12b closed.

  Thus, in the state where the half member 12a and the half member 12b are closed, the width (interval) between the mounting table 14a and the mounting table 14b is narrow, so the intraocular lens 100 is formed on the wall surface of the mounting table. Will be pushed from the left-right direction. As a result, stress is applied to the intraocular lens 100, and the intraocular lens 100 is slightly bent along the wall surfaces (mounting surfaces) of the mounting tables 14a and 14b.

  After the cartridge 10 is mounted on the mounting portion 21, the intraocular lens insertion device 1 is operated to insert the intraocular lens 100. The push rod 31 of the push mechanism 30 is moved toward the tip inside the cylindrical portion 20. At this time, by pushing the vicinity of the tip of the rear support portion 120 with the push rod 31, the rear support portion 120 is bent with the constricted portion 125 as a base point.

  By the way, when the optical unit 110 is slightly bent along the wall surfaces (mounting surfaces) of the mounting tables 14a and 14b, the support unit 120 may be curved along the wall surfaces of the mounting tables 14a and 14b. In this state, when the rear support portion 120 is pushed by the push rod 31, a part of the tip 121a is sandwiched between the push rod 31 and the edge portion 115 of the optical portion 110 (FIG. 5). (See (a)). On the other hand, when the support part 120 does not follow the wall surface, when the push bar 31 is brought into contact with the edge part 115 of the optical part 110, the support part 120 is detached from the push bar 31 so that a part of the tip part 121a is obtained. Is placed on the optical unit 110.

  Thereby, the whole intraocular lens 100 is pushed by the insertion part 11 ahead. At this time, by applying a pressure in the pushing direction (front-rear direction) of the intraocular lens 100 by the viscoelastic substance, the front support portion 120 is bent with the constricted portion 125 as a base point, and the distal end portion 121a gradually becomes the optical portion 110. It comes to be put on the peripheral part.

  FIG. 5A shows a state in which the tip P of the support part 120 is placed on the optical part 110. FIG. 5B shows a cross-sectional view of the intraocular lens 100 viewed along a cross-section B perpendicular to the extrusion direction through the optical axis L. When the intraocular lens 100 is viewed in a cross section perpendicular to the extrusion direction, the cross-sectional area S1 at the position (center position) of the optical axis L of the optical unit 110 becomes the maximum value. Therefore, when the support part 120 is placed in the vicinity of the optical axis L1, the maximum value of the cross-sectional area during extrusion of the intraocular lens 100 increases by the thickness of the support part 120, so the intraocular lens 100 is emitted. It becomes difficult.

  Therefore, in the present embodiment, by providing the constricted portion 125 in the middle of the support portion 120, the tip portion 121a formed by a predetermined length from the tip of the front support portion 120 is first bent during the extrusion process. By bending (bending), the front end P of the support part 120 is prevented from being bent to the vicinity of the center of the optical part 110. In addition, since the rear support 120 is also bent at the front end 121 a first by the constricted portion 125, even if the support 120 is placed on the optical unit 110, only a part of the front end 121 a is part of the optical unit 110. It is avoided that the front end P is positioned up to the center of the optical unit 110 without stopping on the periphery.

  Accordingly, even when the support unit 120 is folded on the optical unit 110 in an integrated manner, the maximum value of the cross-sectional area when the intraocular lens 100 is emitted is hardly increased. That is, the constricted part 125 acts so that the tip P of the support part 120 is disposed at a position avoiding the vicinity of the center of the optical part 110 when the tip 121a is bent at the maximum.

  The intraocular lens 100 is inserted into the insertion portion 11 and further bent along the wall surface inside the insertion portion 11 (rounded). Then, the intraocular lens 100 bent slightly from the distal end of the insertion portion 11 is pushed into the eye. At this time, a part of the support part 120 is placed on the optical part 110, but since the amount of increase in the maximum value of the cross-sectional area of the intraocular lens 100 is limited, the subject who prescribes the intraocular lens 100 It is not necessary to enlarge the eye incision.

  In addition, when force in the front-rear direction is further applied to the intraocular lens 100 in a state where the distal end portion 121a is bent most, the force is applied to the constricted portion 126 and the whole support portion 120 starts to be bent. However, since most of the pressure applied in the front-rear direction has already been applied to the constricted portion 125, the amount of bending of the entire support portion 120 via the constricted portion 126 can be small.

When the intraocular lens 100 starts to come out from the distal end of the insertion part, the optical part 110 and the support part 120 are gradually opened. When the intraocular lens 100 is opened in the sac, the outside (outer periphery) of the support part 120 is substantially aligned with the sac, and the intraocular lens 100 is held via the support part 120 by the repulsive force generated by the constricted part 126. Is done. In addition, since the support part 110 has a sufficient length, the center part of the optical part 110 is brought into contact with the concentric compression applied from the periphery so as to be naturally bent along the sac. It becomes difficult to shift and the entire intraocular lens 100 is suitably held.
In addition, the extent of the extension of the support part 120 at the position of the constricted part 126 is determined so that the length formed by the tips of the opposite roots R is equal to or less than the diameter of the sac of the patient's eye.

  As described above, by providing the constricted portion 125 in the support portion 120, even when the support portion 120 is formed with a length necessary for realizing good intracapsular fixation, the maximum during injection of the intraocular lens 100 is obtained. It is difficult to increase the cross-sectional area. Accordingly, the intraocular fixing of the intraocular lens can be suitably performed by the support portion 120, and the incision formed in the eye of the subject can be reduced.

  In the above example, the case where the two constricted portions 125 and 126 are formed has been described. However, the constricted portion formed in the support portion 120 may be three or more. For example, it is assumed that a third constricted portion 127 is formed in the middle of the distal end portion 121a. When the intraocular lens 100 is placed in the sac, a concentric force is applied. At this time, the constricted portions 125 and 127 are bent with respect to the concentric force to generate a repulsive force. It comes to contact suitably.

It is a figure explaining the structure of an intraocular lens. It is the schematic explanatory drawing which showed the external appearance of the intraocular lens insertion instrument. It is a block diagram of a cartridge. It is the perspective view which showed the external appearance structure of the cylinder part. The state in which the tip of the support part is placed on the optical part when the intraocular lens is inserted is shown. It is a figure explaining the example of a change of a structure of an intraocular lens.

110 Optical part 120 Support part 121a Front end part 121b Rear end part 125, 126 Constriction part

Claims (4)

In a foldable intraocular lens comprising an optical part and a pair of support parts formed integrally with the optical part for supporting the optical part in the eye,
The support part is
A first constricted portion formed at a base end of the support portion connected to the optical portion and serving as a base point for bending the entire support portion;
A second constricted portion formed between the first constricted portion and the distal end of the support portion to serve as a base point for bending a predetermined length from the distal end of the support portion;
An intraocular lens comprising: The intraocular lens of claim 1,
The support portion includes a tip portion extending from the tip to the second constricted portion;
A rear end portion from the second constricted portion to the first constricted portion,
An intraocular lens, wherein the width of the front end is narrower than the width of the rear end. The intraocular lens of claim 2,
The second constricted part has a length so that the tip of the support part does not reach the central part of the optical part when the tip part is bent until the tip part is parallel to the pushing direction of the intraocular lens. The intraocular lens is formed on the support portion. The intraocular lens of claim 3,
An intraocular lens, wherein a plurality of constricted portions are formed at the distal end portion.

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