JP2012010961A

JP2012010961A - Intraocular lens inserter

Info

Publication number: JP2012010961A
Application number: JP2010150299A
Authority: JP
Inventors: Shinji Nagasaka; 信司長坂
Original assignee: Nidek Co Ltd
Current assignee: Nidek Co Ltd
Priority date: 2010-06-30
Filing date: 2010-06-30
Publication date: 2012-01-19
Anticipated expiration: 2030-06-30
Also published as: JP5752901B2

Abstract

PROBLEM TO BE SOLVED: To improve usability by simplifying proper use according to the application of an intraocular lens inserter for which liquid such as a physiological salt solution is usable as a lubricant in inserting an intraocular lens.SOLUTION: The intraocular lens inserter includes: a cylindrical part body having, at the distal end, an insertion part inserted in an incision provided in an eyeball; a push-out means provided in a longitudinally movable manner inside the cylindrical part body and having a push-out rod for pushing the intraocular lens placed in the cylindrical part body, out of the distal end of the insertion part; and a connecting member provided at the cylindrical part body to make the cylinder distal end of a syringe, which is a separate case from the cylindrical part body and storing a predetermined liquid inside, attachable/detachable to/from the cylindrical part body.

Description

本発明は、眼内レンズを眼内に挿入するための眼内レンズ挿入器具に関する。 The present invention relates to an intraocular lens insertion device for inserting an intraocular lens into the eye.

従来、白内障の手術方法の一つとして水晶体を摘出した後、水晶体の代わりとして折り曲げ可能な軟性の光学部と，眼内にて光学部を固定保持させるための支持部とで構成される眼内レンズを挿入する手法が一般的に用いられている。折り曲げ可能な眼内レンズの挿入には、インジェクターと呼ばれる眼内レンズ挿入器具が用いられる。インジェクターは内部に置かれた眼内レンズをプランジャーと呼ばれる押出棒にて、挿入部の先端に向けて押し出し、先端から送出させる（例えば、特許文献１参照）。このような従来のインジェクターは、押し出される眼内レンズの滑りを良くするために、押し出し前に粘弾性物質が内部に注入され、眼内レンズの押し出しを好適に行うようにしている。また、粘弾性物質は水晶体が取り除かれた嚢を膨らませ、眼内レンズを嚢内に設置し易くするためにも用いられる。 Conventionally, as one of the surgical methods for cataracts, an intraocular structure composed of a soft optical part that can be bent instead of the crystalline lens and a support part for fixing and holding the optical part in the eye A method of inserting a lens is generally used. An intraocular lens insertion device called an injector is used to insert a foldable intraocular lens. The injector pushes the intraocular lens placed inside with an extrusion rod called a plunger toward the distal end of the insertion portion, and sends it out from the distal end (see, for example, Patent Document 1). In such a conventional injector, in order to improve the sliding of the intraocular lens to be pushed out, a viscoelastic substance is injected into the inside before pushing out, so that the intraocular lens is pushed out suitably. The viscoelastic material is also used to inflate the sac from which the crystalline lens has been removed and to facilitate the placement of the intraocular lens in the sac.

一方で、粘弾性物質の代わりに生理食塩水等の液体（眼灌流液）を用いることにより、安価に手間なく押し出し作業を行うことのできるインジェクターが提案されている。このようなインジェクターは、例えば、押出軸（プランジャー）の基端からインジェクター内部に液体を注入してインジェクター先端から液体を送り出す機構を備えるものや、インジェクター内部に液体を貯留するためのタンク部を備え、プランジャーの押し出しとともに液体を先端から送り出すものが知られている（特許文献２，特許文献３参照）。このような液体を用いたインジェクターは、水晶体が取り除かれた嚢を生理食塩水等の液体を用いて膨らませたり、インジェクター内における眼内レンズの滑りを良くすることが可能である。 On the other hand, there has been proposed an injector that can perform extrusion work at low cost without using a liquid (ocular perfusate) such as physiological saline instead of a viscoelastic substance. Such an injector includes, for example, a mechanism having a mechanism for injecting liquid from the proximal end of the extrusion shaft (plunger) into the injector and feeding the liquid from the distal end of the injector, or a tank part for storing the liquid inside the injector. It is known that a liquid is sent out from the tip together with pushing out a plunger (see Patent Document 2 and Patent Document 3). An injector using such a liquid can inflate the sac from which the lens has been removed using a liquid such as physiological saline, or improve the slipping of the intraocular lens in the injector.

特開２００６−３３３９８１号公報JP 2006-333981 A 特開２００８−３０７３９４号公報JP 2008-307394 A 特開２００９−２９１２５０号公報JP 2009-291250 A

しかしながら、特許文献２の挿入器具では、液を供給する装置をインジェクターに接続した状態で眼内レンズを挿入させる必要があり使い勝手が悪い。また、特許文献３の挿入器具においては、眼内レンズの押し出し動作に基づいて眼内への液の供給も行うため、眼内への液体の供給中に眼内レンズも押されてしまう可能性がある。 However, in the insertion instrument of Patent Document 2, it is necessary to insert an intraocular lens in a state where a device for supplying a liquid is connected to an injector, which is inconvenient. In addition, since the insertion device of Patent Document 3 also supplies the liquid into the eye based on the pushing operation of the intraocular lens, the intraocular lens may be pushed during the supply of the liquid into the eye. There is.

本発明は、上記従来技術の問題点に鑑み、生理食塩水等の液体を眼内レンズ挿入時の潤滑剤として使用可能な眼内レンズ挿入器具であって、用途に応じた使い分けを簡単に行う事が出来ると共に、使い勝手の良い眼内レンズ挿入器具を提供することを技術課題とする。 The present invention is an intraocular lens insertion device that can use a liquid such as physiological saline as a lubricant when inserting an intraocular lens in view of the above-described problems of the prior art, and easily performs proper use according to the application. It is a technical problem to provide an intraocular lens insertion device that can be used and is easy to use.

上記課題を解決するために、本発明は以下のような構成を備えることを特徴とする。 In order to solve the above problems, the present invention is characterized by having the following configuration.

（１）眼球に設けられた切開創に挿入する挿入部を先端に有する筒部本体と、該筒部本体内に前後方向に移動可能に設けられる押出手段であって，前記筒部本体内に置かれる眼内レンズを前記挿入部先端から押し出すための押出棒を有する押出手段と、を有する眼内レンズ挿入器具において、前記筒部本体とは別筐体であって内部に所定の液体が貯留されるシリンジの筒先を前記筒部本体に対して着脱可能とする接続部材が前記筒部本体に設けられていることを特徴とする。
（２）（１）の眼内レンズ挿入器具において、前記接続部材は前記シリンジの筒先と勘合するための開口を有する中空の筒部材であり、該中空を形成する前記接続部材の内部通路は前記筒部本体内を前後移動する前記押出棒の通路と繋がっていることを特徴とする。
（３）（２）の眼内レンズ挿入器具において、前記接続部材は前記筒部本体に対して着脱可能に設けられていることを特徴とする。
（４）（３）の眼内レンズ挿入器具において、前記接続部材はＬ字形状に形成されており、Ｌ字形状の折り曲げ位置を介して形成される腕部の前記開口に接続される側が、前記眼内レンズ挿入器具と前記シリンジとを術者が同時に片手で保持出来るような長さに形成されていることを特徴とする。
（５）（４）の眼内レンズ挿入器具において、前記接続部材の前記折り曲げ位置を介して形成される腕部の前記筒先に接続される側が前記筒先の長さよりも長く形成されていることを特徴とする。
（６）（５）の眼内レンズ挿入器具において、前記挿入部内壁には水溶性の高分子材料がコーティングされていることを特徴とする。
（７）（６）の眼内レンズ挿入器具において、前記接続部材は耐水性の材料で形成されていることを特徴とする。 (1) A cylinder main body having an insertion portion to be inserted into an incision provided in an eyeball at a distal end, and an extruding means provided in the cylinder main body so as to be movable in the front-rear direction. An intraocular lens insertion device having an extrusion rod for extruding an intraocular lens to be placed from the distal end of the insertion portion. The intraocular lens insertion device is a housing separate from the cylindrical body and stores a predetermined liquid therein. A connecting member is provided on the cylinder part main body so that the cylinder tip of the syringe can be attached to and detached from the cylinder main body.
(2) In the intraocular lens insertion device according to (1), the connecting member is a hollow cylindrical member having an opening for fitting with a cylindrical tip of the syringe, and an internal passage of the connecting member forming the hollow is the It is connected to the passage of the push rod that moves back and forth in the cylinder body.
(3) In the intraocular lens insertion device according to (2), the connection member is provided to be detachable from the cylindrical body.
(4) In the intraocular lens insertion device according to (3), the connecting member is formed in an L shape, and a side connected to the opening of the arm portion formed through an L-shaped bending position, The intraocular lens insertion device and the syringe are formed in such a length that an operator can simultaneously hold them with one hand.
(5) In the intraocular lens insertion device according to (4), the side of the arm portion formed through the bending position of the connection member is formed to be longer than the length of the tube tip. Features.
(6) In the intraocular lens insertion device according to (5), the inner wall of the insertion portion is coated with a water-soluble polymer material.
(7) In the intraocular lens insertion device according to (6), the connection member is formed of a water-resistant material.

本発明によれば、用途に応じた使い分けを簡単に行う事が出来ると共に、使い勝手の良い眼内レンズ挿入器具を提供できる。 ADVANTAGE OF THE INVENTION According to this invention, while being able to use properly according to a use, the intraocular lens insertion instrument with sufficient usability can be provided.

以下に本発明の実施の形態を図面に示しながら説明する。図１は眼内レンズの構成の説明図である。図１（ａ）は眼内レンズ１の正面図、図１（ｂ）は眼内レンズ１の側面図である。眼内レンズ１は所定の屈折力を有する光学部２と、光学部２を眼内で支持するための一対の支持部３とから構成される。光学部２は、ＨＥＭＡ（ヒドロキシエチルメタクリレート）等の単体、アクリル酸エステルとメタクリル酸エステルの複合材料等、従来、折り曲げ可能な軟性の眼内レンズに用いられている材料から形成されている。また、支持部３はＰＭＭＡ（ポリメチルメタクリレート）、ポリプロピレン等の従来眼内レンズの支持部として用いられる材料にて形成される。 Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is an explanatory diagram of a configuration of an intraocular lens. FIG. 1A is a front view of the intraocular lens 1, and FIG. 1B is a side view of the intraocular lens 1. The intraocular lens 1 includes an optical unit 2 having a predetermined refractive power and a pair of support units 3 for supporting the optical unit 2 in the eye. The optical unit 2 is formed of a material conventionally used for a flexible intraocular lens that can be bent, such as a simple substance such as HEMA (hydroxyethyl methacrylate) or a composite material of acrylic ester and methacrylic ester. Moreover, the support part 3 is formed with the material used as a support part of conventional intraocular lenses, such as PMMA (polymethylmethacrylate) and a polypropylene.

なお、図１では、光学部２と，先端が自由端とされ細いループ形状（Ｃ字状、Ｊ字状）からなる支持部３とを別々に作成しておき、その後、一体化させることで得られる３ピース型の眼内レンズが例に示されている。これ以外にも、眼内レンズ１０としては、前述した眼内レンズ材料を使用して、光学部２と支持部３とが、切削加工、モールディング加工等で一体的に形成される１ピース型の眼内レンズを用いることができる。 In FIG. 1, the optical unit 2 and the support unit 3 having a thin loop shape (C-shaped, J-shaped) with a free end at the tip are prepared separately and then integrated. The resulting three-piece intraocular lens is shown as an example. In addition to this, as the intraocular lens 10, using the intraocular lens material described above, the optical part 2 and the support part 3 are integrally formed by cutting, molding, or the like. An intraocular lens can be used.

図２は本実施形態で使用する眼内レンズ挿入器具１０の外観を示した概略外観図である。図２（ａ）は眼内レンズ挿入器具１０を上方から、図２（ｂ）は側方から見た状態を示している。また、図３に眼内レンズ挿入器具１０等の内部構成を示した断面の模式図を示す。
眼内レンズ挿入器具１０は、挿入部２０（カートリッジ）と、挿入部２０を先端に備える筒部本体３０と、筒部本体３０に対して前後方向に移動可能に取り付けられ眼内レンズ１を押し出すための押出部材４０から構成されている。挿入部２０には、先端に向かうに従いその内径が徐々に小さく（細く）なる領域を有したテーパ形状を有する挿入筒２１と、蓋部材２０ａとが設けられている。眼内レンズ１は蓋部材２０ａの内側の開口から眼内レンズ挿入器具１０の内部に載置される。眼内レンズ挿入器具１０内に置かれた眼内レンズ１は、挿入筒２１の内部を通ることにより小さく折り曲げられ、その先端２２から送出される。 FIG. 2 is a schematic external view showing the external appearance of the intraocular lens insertion device 10 used in the present embodiment. FIG. 2A shows the intraocular lens insertion device 10 as viewed from above, and FIG. 2B shows the state as viewed from the side. Moreover, the schematic diagram of the cross section which showed the internal structure of the intraocular lens insertion instrument 10 grade | etc., Is shown in FIG.
The intraocular lens insertion device 10 is attached to the insertion portion 20 (cartridge), a cylindrical body 30 provided with the insertion portion 20 at the tip, and movably in the front-rear direction with respect to the cylindrical body 30, and pushes out the intraocular lens 1. It is comprised from the extrusion member 40 for. The insertion portion 20 is provided with an insertion cylinder 21 having a tapered shape having a region where the inner diameter gradually decreases (thinner) toward the distal end, and a lid member 20a. The intraocular lens 1 is placed inside the intraocular lens insertion device 10 through the opening inside the lid member 20a. The intraocular lens 1 placed in the intraocular lens insertion instrument 10 is bent slightly by passing through the inside of the insertion tube 21 and is sent out from the distal end 22 thereof.

なお、挿入部２０の内壁には、親水性の高分子材料からなる潤滑剤がコーティングされている。このような親水性の高分子材料としては、例えば、ポリエチレングリコール、ポリアクリル酸、酸化ポリエチレン、酸化ポリプロピレン等が使用される。これ以外にも、周知の親水性の高分子材料を用いることができる。 Note that the inner wall of the insertion portion 20 is coated with a lubricant made of a hydrophilic polymer material. Examples of such a hydrophilic polymer material include polyethylene glycol, polyacrylic acid, polyethylene oxide, and polypropylene oxide. In addition to this, a known hydrophilic polymer material can be used.

筒部本体３０の側面には、外部から供給される生理食塩水等の液体（眼灌流液）を流入させるための開口部３１と、押出手段４０による眼内レンズ１の押出時に、術者の指で保持される鍔部（フランジ）３２とが形成されている。なお、本実施形態では、開口部３１は筒部本体３０の押出方向に対して上側（上面）に形成されているが、これ以外にも開口部３１は後述するシリンジ５０との接続方向を考慮して、筒部本体３０の側面、下面に形成することができる。 When the intraocular lens 1 is pushed out by the pushing means 40 and the opening 31 for allowing a liquid (ocular perfusate) such as physiological saline supplied from the outside to flow into the side surface of the cylindrical body 30, A flange (flange) 32 held by a finger is formed. In addition, in this embodiment, although the opening part 31 is formed in the upper side (upper surface) with respect to the extrusion direction of the cylinder part main body 30, the opening part 31 considers the connection direction with the syringe 50 mentioned later besides this. And it can form in the side surface of the cylinder part main body 30, and a lower surface.

また、図３に示すように、筒部本体３の内側には、押出部材４０の軸出しを行う軸出部２３が形成されており、これにより、押出手段４０の前後方向に移動に伴う軸ぶれが防止される。また、軸出部２３よりも挿入部２０側には、開口部３１を介して外部から供給された生理食塩水等の液体（眼灌流液）又は粘弾性物質が流入される空間ｓ１が形成されている。 Further, as shown in FIG. 3, a pivoting portion 23 that pivots the push-out member 40 is formed inside the cylindrical portion main body 3, whereby the shaft accompanying the movement of the push-out means 40 in the front-rear direction is formed. Shake is prevented. Further, a space s1 into which a liquid (ocular perfusate) or a viscoelastic substance such as physiological saline supplied from the outside through the opening 31 flows is formed on the insertion portion 20 side with respect to the pivot portion 23. ing.

押出部材４０は、眼内レンズ１の押出時に術者により押圧される押圧部４１と、押圧部４１に接続され，押出部材４０を空間内で移動させるための軸基部４２と、軸基部４２の先端に接続され，軸基部４２よりも細い径で形成された押出棒４３と、押出棒４３の先端に形成され，眼内レンズ１の光学部の側面に当接される先端部４４とから構成される。なお、押出棒４３の長さは押出部材４０を空間内で押し込んだときに、押出棒４３の先端がカートリッジ２０の先端２２から十分に出るような長さとされる。 The push-out member 40 is connected to the press portion 41 pressed by the operator when the intraocular lens 1 is pushed out, the shaft base 42 for moving the push-out member 40 in the space, and the shaft base 42. A push rod 43 connected to the tip and formed with a diameter smaller than that of the shaft base 42 and a tip 44 formed at the tip of the push rod 43 and abutting against the side surface of the optical part of the intraocular lens 1 Is done. Note that the length of the push rod 43 is set such that the tip of the push rod 43 sufficiently protrudes from the tip 22 of the cartridge 20 when the push member 40 is pushed in the space.

なお、空間ｓ１と挿入部２０の切換位置は、押出手段４０の押出棒４３と後述するシリンジ５０から供給される液体が同時に通過できるような間隙に形成されている。これにより、押出手段４０による眼内レンズ１の押出のタイミングと、シリンジ５０による液体の供給のタイミングとを好適に切換えることができるようになる。 It should be noted that the switching position between the space s1 and the insertion portion 20 is formed in a gap that allows the liquid supplied from the push-out bar 43 of the push-out means 40 and a syringe 50 described later to pass through simultaneously. Thereby, the timing of pushing the intraocular lens 1 by the pushing means 40 and the timing of supplying the liquid by the syringe 50 can be suitably switched.

なお、液体を用いて眼内レンズの注入が行われる場合には、シリンジ（注射器）５０が眼内レンズ挿入器具１０内部に液体を供給するための注入器具として用いられる。ここで、図３にシリンジ５０を押出軸に対して水平な断面で見たときの断面図が示されている。シリンジ５０は、筒部本体５１と、シリンジ５０を術者の指で保持するための鍔部（フランジ）５５と、筒部本体５１内で液体（例えば、生理食塩水や眼灌流液）を貯留するための空間ｓ２と、空間ｓ２内を前後方向に移動可能に設けられた押出部材５３と、空間ｓ２から外部へと液体を流出させるための開口を有する筒先５４とから構成されている。なお、押出部材５３は液体の押出時に術者により押圧される押圧部５３ａと、押圧部５３ａに接続され空間ｓ２の容積を狭くすることで液体を押し出すための押出棒５３ｂとから構成される。 In addition, when injection | pouring of an intraocular lens is performed using a liquid, the syringe (injection device) 50 is used as an injection device for supplying a liquid into the intraocular lens insertion device 10 inside. Here, FIG. 3 shows a cross-sectional view of the syringe 50 viewed in a horizontal cross section with respect to the extrusion shaft. The syringe 50 stores a cylinder body 51, a flange (flange) 55 for holding the syringe 50 with an operator's finger, and a liquid (for example, physiological saline or ocular perfusate) in the cylinder body 51. For this purpose, a push-out member 53 provided to be movable in the front-rear direction in the space s2, and a tube tip 54 having an opening for allowing liquid to flow out from the space s2. The pushing member 53 includes a pressing portion 53a that is pressed by an operator when the liquid is pushed out, and a pushing bar 53b that is connected to the pressing portion 53a and pushes out the liquid by reducing the volume of the space s2.

なお、以上のような構成のシリンジ５０は、例えばＪＩＳ規格（ＪＩＳＴ３２１０：減菌済み注射筒、又はＩＳＯ５９４‐１：注射筒、注射針や他の医療用具も６％テーパーとの合致−パート１）にて、その筒先５４の形状（サイズ）が定められているものが使用される。これ以外にも、市販のシリンジ又は眼内レンズ挿入器具１０の仕様に合わせて設計されたシリンジを使用することができる。 The syringe 50 having the above-described configuration is, for example, JIS standard (JIST3210: sterilized syringe, or ISO594-1: syringe, injection needle, and other medical devices conform to 6% taper-part 1). The cylinder tip 54 having a predetermined shape (size) is used. In addition to this, a commercially available syringe or a syringe designed in accordance with the specifications of the intraocular lens insertion device 10 can be used.

また、眼内レンズ１の押出時に外部から液体（又は粘弾性物質）が供給される場合には、以上のような市販のシリンジ５０と眼内レンズ挿入器具１０とを接続するための接続部材６０が用いられる。図３に接続部材６０の断面図が示されている。本実施形態の接続部材６０は、開口部３１と嵌合する外形形状に形成された腕部６２と、内径がシリンジ５０の筒先５４の外径に略一致される形状に形成された腕部６３と、折り曲げ位置ＢとからなるＬ字型に形成されており、その内部は中空の筒型とされ、液体等が通過される貫通孔６１が形成されている。 Further, when a liquid (or viscoelastic substance) is supplied from the outside when the intraocular lens 1 is extruded, the connecting member 60 for connecting the commercially available syringe 50 and the intraocular lens insertion device 10 as described above. Is used. FIG. 3 shows a sectional view of the connecting member 60. The connection member 60 of the present embodiment includes an arm portion 62 formed in an outer shape that fits into the opening 31, and an arm portion 63 formed in a shape in which the inner diameter is substantially matched with the outer diameter of the tube tip 54 of the syringe 50. And a bent position B, the inside of which is a hollow cylinder, and a through-hole 61 through which liquid or the like passes is formed.

接続部材６０の腕部６２の先端が開口部３１に接続（嵌合）され、シリンジの筒先５４が腕部６３の先端に取り付けられることで、シリンジ５０の空間ｓ２と眼内レンズ挿入器具１０の空間ｓ１とが接続部材６０の中空（貫通孔６１）を介して繋がり、空間ｓ２内に貯留された液体が、貫通孔６１を介して、眼内レンズ挿入器具１０の空間ｓ１へと流入されるようになる。 The distal end of the arm portion 62 of the connecting member 60 is connected (fitted) to the opening 31 and the syringe barrel 54 is attached to the distal end of the arm portion 63, so that the space s 2 of the syringe 50 and the intraocular lens insertion instrument 10 The space s1 is connected through the hollow (through hole 61) of the connection member 60, and the liquid stored in the space s2 flows into the space s1 of the intraocular lens insertion device 10 through the through hole 61. It becomes like this.

なお、本実施形態のようなＬ字型の接続部材６０において、シリンジ５０に接続される腕部６３の長さｄ１は、筒先５４の長さｄ３よりも長く形成されることが好ましい。このようにすると、筒先５４全体が腕部６３に取り付けられることで接続状態を安定させることができるようになる。 In the L-shaped connection member 60 as in the present embodiment, the length d1 of the arm portion 63 connected to the syringe 50 is preferably formed longer than the length d3 of the tube tip 54. If it does in this way, it will come to be able to stabilize a connection state because the cylinder tip 54 whole is attached to the arm part 63. FIG.

また、折り曲げ位置Ｂは、腕部６２の一部が開口部３１に接続された状態で、腕部６３が押出部材４０の押出軸に対して略平行となるようにその折り曲げ角度が決定されることが好ましい。このようにすると、眼内レンズ挿入器具１０とシリンジ４０の押出方向とが一致されるので取扱いがし易くなる。 Further, the bending angle of the bending position B is determined so that the arm portion 63 is substantially parallel to the extrusion axis of the pushing member 40 in a state where a part of the arm portion 62 is connected to the opening 31. It is preferable. In this way, the intraocular lens insertion device 10 and the push-out direction of the syringe 40 are matched, so that handling becomes easy.

更に、開口部３１に接続される腕部６２の長さｄ２は、眼内レンズ挿入器具１０とシリンジ５０とを押出軸が平行となるように並べたときに、眼内レンズ挿入器具１０とシリンジ５０が干渉しない長さであると共に、接続部材６０で接続された眼内レンズ挿入器具１０とシリンジ５０とを術者が片手で保持できるような長さに設定されていることが好ましい。このようにすると、術者は指先の移動のみで押出部材４０による眼内レンズ１の押出動作と、押出部材５３による液体の供給動作と簡単に切換える事が出来るようになる。 Further, the length d2 of the arm portion 62 connected to the opening 31 is such that the intraocular lens insertion device 10 and the syringe 50 are aligned when the intraocular lens insertion device 10 and the syringe 50 are arranged so that the extrusion axes are parallel to each other. It is preferable that the length 50 does not interfere and is set to such a length that the surgeon can hold the intraocular lens insertion device 10 and the syringe 50 connected by the connection member 60 with one hand. In this way, the operator can easily switch between the pushing operation of the intraocular lens 1 by the pushing member 40 and the liquid supplying operation by the pushing member 53 only by moving the fingertip.

なお、上記ではＬ字形状の接続部材６０を例に挙げているが、これに限られるものではない。例えば、接続部材６０は直線形状であっても良い。これ以外にも、接続部材は内部に液体を通過させるための貫通孔が形成されており、眼内レンズ挿入器具１０の開口部３１とシリンジ５０の筒先５４とが貫通孔を介して接続されるような構成になっていれば良い。 In the above description, the L-shaped connection member 60 is taken as an example, but the present invention is not limited to this. For example, the connection member 60 may be linear. In addition to this, the connecting member has a through-hole for allowing liquid to pass through, and the opening 31 of the intraocular lens insertion device 10 and the tube tip 54 of the syringe 50 are connected via the through-hole. It suffices if the configuration is as follows.

なお、眼内レンズ挿入器具１０の開口部３１は、眼内レンズ挿入器具１０とシリンジ５０とを接続部材６０を介して接続した状態で、基端部側に引き出されたシリンジ５０の押圧部５３ａと、基端部側に引き出された押圧部４１の位置とが略等しくなる位置に形成されることが好ましい。これにより、術者はより押出部５３ａと押出部４１による押出動作の切換えを簡単に行うことができるようになる。 The opening 31 of the intraocular lens insertion device 10 is a pressing portion 53a of the syringe 50 drawn out to the proximal end side in a state where the intraocular lens insertion device 10 and the syringe 50 are connected via the connection member 60. And the position of the pressing portion 41 drawn out to the base end side is preferably formed at a position where it is substantially equal. As a result, the surgeon can more easily switch the extrusion operation by the push-out portion 53a and the push-out portion 41.

以上のような、接続部材６０はプラスチック、ポリカーボネイト、ＡＢＳ樹脂、ＰＶＣ（ポリ塩化ビニル）、アクリル、ＰＥＥＫ、シリコン等の樹脂又は合成樹脂によるモールド成形にて複数個が一度に作成される。また、これ以外にも接続部材６０は耐水性の材料にて形成することができる。また、接続部材６０がシリコン樹脂などの折り曲げ可能な材料で形成される場合には、接続部材６０を直線形状に形成して、術者は柔軟な接続部材６０を折り曲げることによって、眼内レンズ挿入器具１０に対してシリンジ５０を持ちやすい方向に位置させることができるようになる。 As described above, a plurality of connection members 60 are formed at a time by molding with a resin such as plastic, polycarbonate, ABS resin, PVC (polyvinyl chloride), acrylic, PEEK, silicon, or synthetic resin. In addition, the connection member 60 can be formed of a water resistant material. When the connecting member 60 is formed of a foldable material such as silicon resin, the intraocular lens can be inserted by forming the connecting member 60 in a linear shape and bending the flexible connecting member 60. It becomes possible to position the syringe 50 with respect to the instrument 10 in a direction in which it can be easily held.

なお、上記では液体を使用して眼内レンズ１を眼内へ注入させる場合の構成を説明したが、粘弾性物質を用いる場合には、接続部材６０を用いずに、眼内レンズ挿入器具１０のみで眼内レンズ１の注入を行うことができる（なお、粘弾性物質の場合にも眼内レンズ挿入器具１０とシリンジ５０とを接続部材６０にて接続させた状態で、シリンジ５０から粘弾性物質を提供することもできる）。
以上のように、接続部材６０を用いることで、眼内レンズ挿入器具１０に対するシリンジ５０の接続の有無を切換えることができ、眼内レンズ挿入器具１０の術者の使い勝手を向上させることができるようになる。 In the above description, the configuration in the case where the intraocular lens 1 is injected into the eye using liquid is described. However, when a viscoelastic substance is used, the intraocular lens insertion device 10 is used without using the connection member 60. The intraocular lens 1 can be injected only with the viscoelasticity (in the case of a viscoelastic substance, the intraocular lens insertion device 10 and the syringe 50 are connected by the connecting member 60 and are viscoelastic). Substances can also be provided).
As described above, by using the connection member 60, it is possible to switch the presence / absence of the connection of the syringe 50 to the intraocular lens insertion device 10, and to improve the usability of the operator of the intraocular lens insertion device 10. become.

次に、以上のような構成を備える眼内レンズ挿入器具１０を用いた眼内レンズ１の押出時に、液体を用いる場合の動作を中心に説明する。図４に眼内レンズ挿入器具１０とシリンジ５０とを接続部材６０を介して一体で用いる場合の動作の説明図を示す。 Next, the operation in the case of using a liquid at the time of extrusion of the intraocular lens 1 using the intraocular lens insertion device 10 having the above configuration will be mainly described. FIG. 4 is an explanatory view of the operation when the intraocular lens insertion device 10 and the syringe 50 are used integrally through the connection member 60.

はじめに、術者（使用者）は、鑷子等を用いて眼内レンズ１を蓋部材２０ａの位置の開口から挿入部２０内の所定位置に置き、押出部材４０を筒部本体２０の基端側へと引き出しておく。次に、術者はシリンジ５０の空間ｓ２を生理食塩水等の液体で満たすため、予め押出部材５３を筒先５４側へと十分に押し込んだ状態で、シリンジ５０の筒先５４を液体に浸し、押出部材５３を基端側へと引き出す。これによって、空間ｓ２内に液体ｐｆを十分に貯留させる。 First, the operator (user) places the intraocular lens 1 at a predetermined position in the insertion portion 20 from the opening at the position of the lid member 20a by using a lever or the like, and places the pushing member 40 on the proximal end side of the cylindrical portion main body 20. Pull it out. Next, in order to fill the space s2 of the syringe 50 with a liquid such as physiological saline, the surgeon immerses the tube tip 54 of the syringe 50 in the liquid while the pusher 53 is sufficiently pushed in toward the tube tip 54 in advance. The member 53 is pulled out to the proximal end side. Thereby, the liquid pf is sufficiently stored in the space s2.

次に、術者は図４（ａ）に示すように、接続部材６０の腕部６２を眼内レンズ挿入器具１０の開口部３１へ取り付け、腕部６３をシリンジ５０の筒先５４に取り付ける。これにより眼内レンズ挿入器具１０とシリンジ５０とを一体化させて、眼内レンズ挿入器具１０とシリンジ５０の両方を（フランジ３２、５５の位置で）片手で保持する。 Next, as shown in FIG. 4A, the surgeon attaches the arm portion 62 of the connection member 60 to the opening 31 of the intraocular lens insertion device 10 and attaches the arm portion 63 to the tube tip 54 of the syringe 50. As a result, the intraocular lens insertion device 10 and the syringe 50 are integrated, and both the intraocular lens insertion device 10 and the syringe 50 are held with one hand (at the positions of the flanges 32 and 55).

以上のように眼内レンズ挿入器具１０の用意ができたら、術者は患者眼の眼内圧を所定の圧力に維持して球形状を確保し、水晶体が取り除かれた嚢を膨らませる（前房確保する）ようにする。患者眼に形成された切開創に挿入筒２１の先端２２を差し入れ、図４（ｂ）に示すように、シリンジ５０の押圧部５３ａを押すと、押出棒５３ｂによって空間ｓ２の容積が狭められて空間ｓ２内の液体ｐｆが筒先５４の開口から接続部材６０の貫通孔６１へと流出される。そして、貫通孔６１を通過した液体ｐｈは、眼内レンズ挿入器具１０の空間ｓ１内に流れ込んだ後、挿入部２０内へと流れ込むようになる。この時、液体ｐｈが挿入部２０内を通ることにより、挿入部２０内の内壁にコーティングされている潤滑剤が溶けて、眼内レンズ１が通過する通路の滑りが良くなる。そして、挿入部２０内を流れた液体ｐｈが眼内へと流入されるようになる。 When the intraocular lens insertion device 10 is prepared as described above, the surgeon maintains the intraocular pressure of the patient's eye at a predetermined pressure to ensure a spherical shape and inflates the sac from which the crystalline lens has been removed (anterior chamber). Ensure). When the distal end 22 of the insertion tube 21 is inserted into the incision formed in the patient's eye and the pressing portion 53a of the syringe 50 is pushed as shown in FIG. 4B, the volume of the space s2 is reduced by the push rod 53b. The liquid pf in the space s2 flows out from the opening of the tube tip 54 to the through hole 61 of the connecting member 60. Then, the liquid ph that has passed through the through hole 61 flows into the insertion portion 20 after flowing into the space s1 of the intraocular lens insertion device 10. At this time, the liquid ph passes through the insertion portion 20, so that the lubricant coated on the inner wall of the insertion portion 20 is melted and the passage of the passage through which the intraocular lens 1 passes is improved. Then, the liquid ph that has flowed through the insertion portion 20 flows into the eye.

患者眼に液体ｐｆが充填されて眼球（嚢）が十分に膨らんだ状態で、眼内レンズ１を眼内へと挿入させる。図４（ｃ）に示すように、空間ｓ１内で押出部材４０が押されることで、先端部４４が光学部２の側面に当接される。この状態から、更に押出部材４０が押し込まれていくと、眼内レンズ１が挿入筒２１の内壁に沿って、折り曲げられていく（丸め込まれていく）。 The intraocular lens 1 is inserted into the eye while the patient's eye is filled with the liquid pf and the eyeball (sac) is sufficiently swollen. As shown in FIG. 4C, when the pushing member 40 is pushed in the space s <b> 1, the distal end portion 44 comes into contact with the side surface of the optical unit 2. When the push-out member 40 is further pushed in from this state, the intraocular lens 1 is bent along the inner wall of the insertion tube 21 (rounded up).

ところで、術者は眼内レンズ１を押し出しながら、眼内レンズ１の取り付け位置をより正確に決定させるために、切開創から入れられた挿入筒２１の位置を調節することがあり、これにより、眼内の液体の一部が外部に出てしまうことがある。この場合、本実施形態では、術者が再び押出部材５３を押すことによって、液体ｐｈをシリンジ５０から眼内レンズ挿入器具０１の空間ｓ１を介して、眼内に注入させることで、再び眼内の形状（内圧）を適切に保つことができるようになる。この時、押出部材４０の先端４４が押し出し途中の眼内レンズ１に当接されているが、押出部材４０と液体を押し出すための押出部材５３とは各々独立しているため、術者は眼内レンズ１の押し出しの状態を変えることなく、液体ｐｆのみを押し出すことができる。 By the way, the operator may adjust the position of the insertion tube 21 inserted from the incision in order to determine the attachment position of the intraocular lens 1 more accurately while pushing out the intraocular lens 1. Some of the liquid in the eye may come out. In this case, in this embodiment, when the surgeon pushes the pushing member 53 again, the liquid ph is injected into the eye from the syringe 50 through the space s1 of the intraocular lens insertion device 01, so that the intraocular again. The shape (internal pressure) can be maintained appropriately. At this time, the distal end 44 of the push-out member 40 is in contact with the intraocular lens 1 being pushed out, but since the push-out member 40 and the push-out member 53 for pushing out the liquid are independent of each other, Only the liquid pf can be pushed out without changing the pushing state of the inner lens 1.

前房確保された状態で、眼内での眼内レンズ１の取り付け位置が定まったら、術者は押出部材４０によって眼内レンズ１を眼内へと押し出す。これにより、先端２２から眼内レンズ１が眼内へと押し出され、光学部２が眼内で開放されると共に、支持部３が眼内から加えられる応力によって嚢に沿って配置され、眼内レンズ１が眼内で好適に保持されるようになる。
以上のように液体を用いる場合に、接続部材６０を介して市販のシリンジ５０と眼内レンズ挿入器具１０とを接続させるだけで、簡単に眼内レンズの押出と液体の押出とを独立して使い分けることができるようになる。 When the attachment position of the intraocular lens 1 is determined in the eye while the anterior chamber is secured, the operator pushes the intraocular lens 1 into the eye by the pushing member 40. As a result, the intraocular lens 1 is pushed out from the distal end 22 into the eye, the optical part 2 is opened in the eye, and the support part 3 is arranged along the sac by the stress applied from inside the eye. The lens 1 is suitably held in the eye.
In the case of using a liquid as described above, the intraocular lens and the liquid can be easily and independently extruded simply by connecting the commercially available syringe 50 and the intraocular lens insertion device 10 via the connecting member 60. It becomes possible to use properly.

なお、以上の説明では手術に液体を用いる場合を例に挙げて説明したが、術者によっては液体よりも粘弾性物質の使用を好む場合がある。また、被検者眼の状態によっても液体よりも粘弾性物質を用いる方が好ましい場合があると考えられる。 In the above description, the case where a liquid is used for surgery has been described as an example. However, some surgeons may prefer to use a viscoelastic substance rather than a liquid. Further, it may be preferable to use a viscoelastic substance rather than a liquid depending on the condition of the subject's eye.

粘弾性物質を用いて眼内レンズの注入を行う場合には、術者は接続部材６０及びシリンジ５０を用いずに、眼内レンズ挿入器具１０のみを使用する。なお、この場合には、図示を略す注射器にて眼内に粘弾性物質を供給して前房確保がされた状態で、挿入部２０及び挿入筒２１の内側に予め粘弾性物質が塗布された眼内レンズ挿入器具１０の先端２２が眼内に差し入れられる。そして、押出手段４０の操作で眼内レンズ１の押出動作が行われる。
つまり、粘弾性物質が使用される場合には、眼内レンズ１の押出に不要な接続部材６０（シリンジ５０）が取り除かれて、より簡単な構成で眼内レンズ１の注入動作を行うことができるようになる。 When an intraocular lens is injected using a viscoelastic substance, the operator uses only the intraocular lens insertion device 10 without using the connection member 60 and the syringe 50. In this case, the viscoelastic material is applied in advance to the inside of the insertion portion 20 and the insertion tube 21 in a state where the vestula is supplied into the eye with a syringe (not shown) and the anterior chamber is secured. The tip 22 of the intraocular lens insertion device 10 is inserted into the eye. Then, the push-out means 40 pushes out the intraocular lens 1.
That is, when a viscoelastic substance is used, the connection member 60 (syringe 50) unnecessary for the extrusion of the intraocular lens 1 is removed, and the injection operation of the intraocular lens 1 can be performed with a simpler configuration. become able to.

これ以外にも、上述したように接続部材６０を介して、眼内レンズ挿入器具１０とシリンジ５０とが接続された状態で、シリンジ５０内の空間ｓ２に粘弾性物質を貯留させることにより、押出手段４０と押出手段５３とによって、粘弾性物質と眼内レンズ１の押出動作とが独立して行われる用にしても良い。このようにすると、被検者眼への器具の取り付け回数が少なくなることで、より患者の負担を減らすことができるようになる。
以上のように、接続部材６０の着脱のみで、同一種類の眼内レンズ挿入器具１０を用いた眼内レンズの注入動作を用途に応じてより簡単な構成で行うことができるようになる。 In addition to this, as described above, the intraocular lens insertion instrument 10 and the syringe 50 are connected via the connecting member 60, and the viscoelastic substance is stored in the space s2 in the syringe 50, thereby allowing the extrusion. The viscoelastic substance and the pushing operation of the intraocular lens 1 may be performed independently by the means 40 and the pushing means 53. If it does in this way, a patient's burden can be reduced more because the frequency | count of attachment of the instrument to a subject's eye decreases.
As described above, the injection operation of the intraocular lens using the same type of intraocular lens insertion device 10 can be performed with a simpler configuration according to the application by simply attaching and detaching the connection member 60.

なお、上記では眼内レンズ挿入器具１０と接続部材６０とが別部材にて形成されている場合が示されているが、これに限られるものでは無い。例えば、眼内レンズ挿入器具１０の開口部３１の位置に、上述したような接続部材６０が一体で形成されていても良い。この場合、眼内レンズ挿入器具１０と接続部材６０とはモールド型によるモールド成形にて一体成形される。この場合にも、接続部材６０へのシリンジ５０の取り付けの有無を切換えるだけで、より簡単な構成での液体又は粘弾性物質による眼内レンズ１の押出を行うことができるようになる。 In addition, although the case where the intraocular lens insertion instrument 10 and the connection member 60 are formed as separate members is shown above, the present invention is not limited to this. For example, the connection member 60 as described above may be integrally formed at the position of the opening 31 of the intraocular lens insertion device 10. In this case, the intraocular lens insertion device 10 and the connection member 60 are integrally formed by molding with a mold. Also in this case, the intraocular lens 1 can be extruded with a liquid or a viscoelastic substance with a simpler configuration by simply switching whether or not the syringe 50 is attached to the connecting member 60.

眼内レンズの構成の説明図である。It is explanatory drawing of a structure of an intraocular lens. 眼内レンズ挿入器具の概略外観図である。It is a schematic external view of an intraocular lens insertion instrument. 眼内レンズ挿入器具等の内部構成を示した断面模式図である。It is the cross-sectional schematic diagram which showed internal structures, such as an intraocular lens insertion instrument. 眼内レンズ挿入器具とシリンジとを用いた動作の説明図を示す。Explanatory drawing of operation | movement using an intraocular lens insertion instrument and a syringe is shown.

１０眼内レンズ挿入器具
３０筒部本体
３１開口部
４０押出部材
４３押出棒
５０シリンジ
５４筒先
６０接続部材 DESCRIPTION OF SYMBOLS 10 Intraocular lens insertion instrument 30 Cylinder part main body 31 Opening part 40 Extrusion member 43 Extrusion stick 50 Syringe 54 Tube tip 60 Connection member

Claims

A cylindrical body having an insertion portion at the tip for insertion into an incision provided in the eyeball;
Push means provided in the cylinder main body so as to be movable in the front-rear direction, and having a push rod for pushing an intraocular lens placed in the cylinder main body from the distal end of the insertion section. In the intraocular lens insertion device,
A connecting member that is a separate housing from the cylindrical main body and that allows a cylindrical tip of a syringe in which a predetermined liquid is stored to be removable from the cylindrical main body is provided in the cylindrical main body. A characteristic intraocular lens insertion device.

2. The intraocular lens insertion device according to claim 1, wherein the connection member is a hollow cylinder member having an opening for fitting with a cylinder tip of the syringe, and an internal passage of the connection member forming the hollow is the cylinder body. An intraocular lens insertion device connected to a passage of the push rod that moves back and forth inside.

The intraocular lens insertion device of claim 2,
The intraocular lens insertion device, wherein the connecting member is detachably attached to the cylindrical body.

The intraocular lens insertion device of claim 3,
The connecting member is formed in an L shape, and an operator connects the intraocular lens insertion instrument and the syringe on the side connected to the opening of an arm portion formed through an L-shaped bending position. An intraocular lens insertion device having a length that can be held with one hand at the same time.

The intraocular lens insertion device of claim 4,
The intraocular lens insertion device, wherein a side of the connecting member connected to the tube tip of the arm portion formed through the bending position is formed longer than the length of the tube tip.

The intraocular lens insertion device of claim 5,
The inner wall of the insertion portion is coated with a water-soluble polymer material.

The intraocular lens insertion device of claim 6,
The intraocular lens insertion device, wherein the connecting member is formed of a water-resistant material.