JP2012105736A - Intraocular lens insertion instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an intraocular lens insertion instrument suitably pushing out an intraocular lens into an eye with a simple configuration.SOLUTION: This intraocular lens insertion instrument includes: an insertion tubular part for inserting the intraocular lens placed on a placing part on which the intraocular lens is placed into the eye; and a plunger provided inside a cylinder of an insertion instrument body movably forward and backward in the axial direction so as to push the intraocular lens out of the insertion tubular part. At least a part of a contact area of the plunger with which a support part of the intraocular lens contacts is applied with a surface shape so as to generate a prescribed friction force between the plunger and the support part when pushing out the intraocular lens placed on the placing part.

Description

  The present invention relates to an intraocular lens insertion device for inserting an intraocular lens into the eye.

  Conventionally, it is composed of a soft optical part that can be bent as a substitute for the lens and a support part called a loop for fixing and holding the optical part in the eye after extracting the lens as one of the surgical methods for cataract A method of inserting an intraocular lens is generally used. An intraocular lens insertion device called an injector is used to insert a foldable intraocular lens. The injector has a tapered tip, and when the intraocular lens installed inside is pushed out toward the tip of the injector by a rod-shaped push-out member (plunger), the intraocular lens becomes smaller in accordance with the shape of the inner wall. It can be bent. In this way, since the intraocular lens is folded and delivered into the eye with a reduced diameter, the incision provided in the patient can be made as small as possible, reducing the burden on the patient and aftereffects such as postoperative astigmatism Can be suppressed.

  By the way, when the intraocular lens is pushed into the eye using an injector, the rear support portion may be extended rearward (backward with respect to the traveling direction of the intraocular lens) in the insertion portion. In this case, the rear support portion is left in the insertion portion while the optical portion pushed out by the plunger is positioned in the eye. Therefore, the surgeon had to push the back support portion into the eye by repeatedly performing the pushing operation by the injector. In view of this, an injector has been proposed that can push out the entire intraocular lens by providing a groove for pushing the rear support portion at the distal end side of the plunger (for example, Patent Document 1). reference).

JP 2009-18809 A

  However, the configuration of the prior art has a problem that the shape of the plunger tip is complicated.

  An object of the present invention is to provide an intraocular lens insertion device capable of suitably pushing an intraocular lens into the eye with a simple configuration in view of the above-described problems of the prior art.

  In order to solve the above problems, the present invention is characterized by having the following configuration.

(1) It has a mounting part for mounting an intraocular lens having an optical part and a pair of support parts for supporting the optical part in the eye, and the intraocular lens placed on the mounting part An intraocular lens comprising: an insertion tube part for insertion into the eye; and a plunger provided so as to be movable back and forth in the axial direction within the tube of the insertion instrument body in order to push the intraocular lens from the insertion tube part In the insertion device, when the intraocular lens placed on the placement portion is pushed out, the plunger and the support portion are in a contact region of at least a part of the plunger with which the support portion of the intraocular lens contacts. In order to generate a predetermined frictional force between the two, a surface shape is applied.
(2) In the intraocular lens insertion device according to (1), the predetermined frictional force refers to the forward movement of the plunger without sliding on the plunger in a state where the support portion is in contact with the contact area. The support portion is a frictional force that is movable.
(3) In the intraocular lens insertion device according to (2), the contact area has a surface shape subjected to roughening.
(4) In the intraocular lens insertion device according to (3), the roughening of the contact area is performed by at least one of shot blasting, filing, and cutting.

  According to the present invention, the intraocular lens can be suitably pushed into the eye with a simple configuration.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is an explanatory diagram of a configuration of a one-piece type 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 within the eye (the front side is a support unit 3a and the rear side with respect to the pushing direction of the intraocular lens). Support portion 3b). The intraocular lens 1 is integrally formed by cutting or molding of a soft material that can be bent, such as a simple substance such as HEMA (hydroxyethyl methacrylate), or a composite material of acrylic acid ester and methacrylic acid ester.

  FIG. 2 is a schematic view of the appearance of an intraocular lens insertion device (hereinafter referred to as an injector) 10, FIG. 2 (a) is a view seen from above, and FIG. 2 (b) is a view seen from the side. FIG. 3 is an explanatory diagram of the configuration of the pushing member (hereinafter referred to as a plunger) 40. FIG. 4 is a schematic cross-sectional view of the internal configuration of the injector 10. The injector 10 includes a hollow insertion tube portion (hereinafter referred to as an insertion portion) 20 for folding the intraocular lens 1 into a small size, a hollow tube portion main body (hereinafter referred to as a main body) 30 having the insertion portion 20 at the tip, and a main body. It is attached to 30 so as to be movable in the front-rear direction, and includes a plunger 40 for pushing out the intraocular lens 1.

  The insertion portion 20 includes an insertion cylinder 21 having a tip 21a and a lid member 20a. The intraocular lens 1 is placed on a mounting portion (mounting table) inside the insertion tube 21 through the opening of the lid member 20a. On the other hand, the insertion tube 21 is formed in a tapered shape having a region where the inner diameter gradually decreases (thinner) toward the distal end 21 a, and the intraocular lens 1 is bent slightly by passing through the inside of the insertion tube 21. It is delivered from the tip 21a.

  Next, the structure of the plunger 40 of this embodiment is demonstrated in detail. The plunger 40 is pressed against the optical part when the intraocular lens 1 is pushed out, a pressing part 41 pressed by the operator, a shaft base part 42 connected to the pressing part 41, a push rod 43 connected to the shaft base part 42. It is comprised from the front-end | tip 44 provided with the contact surface 44a contacted, and the axis | shaft 45 which connects the extrusion rod 43 and the front-end | tip 44. FIG. The contact surface 44a is formed in a plane perpendicular to the extrusion shaft, and is formed in a large area that can pass through the tip 21a together with the rear support portion 3b, so that it is suitable for the optical unit 2. It comes to contact | abut. The diameter of the shaft 45 is formed so as to be smaller than the diameter of the push rod 43 and the tip 44. As a result, when the intraocular lens 1 is pushed out, a clearance field is formed between the distal end 21a of the insertion portion 20 and the distal end 44 of the plunger 40 so that the support portion 3b on the rear side is positioned. Occurrence of problems such as being pinched and broken is avoided. With the configuration as described above, the plunger 40 is inserted through a passage connecting from the main body 30 to the distal end of the insertion portion 20 so as to advance and retreat in the axial direction. Further, a rough surface RF for increasing the friction with the rear support portion 3b is formed on a part of the surface of the plunger 40 (shaft 45) of the present embodiment.

  Here, an enlarged view of the vicinity of the tip 44 of the plunger 40 is shown in FIG. FIG. 5A is a view from the side, and FIG. 5B is a view from the top. In FIG. 5, when the intraocular lens 1 is pushed out, a part of the surface of the shaft 45 (the surface within a predetermined range from the connection position with the tip 44) in the range (contact region) where the rear support 3 b comes into contact. The circumference is formed on the rough surface RF. In this way, the rough surface RF for increasing the friction between the plunger 40 and the support portion 3b is formed, so that the support portion 3b is held by the friction of the rough surface RF when the intraocular lens 1 is pushed out. Thus, the entire intraocular lens 1 including the support portion 3b is pushed out to the tip 21a side at a time.

  The rough surface RF shown in the present embodiment indicates a state in which many irregularities or grooves exist on the surface, and the degree (surface roughness) is indicated by “JIS B 0601 1994”. It is defined by the maximum height Ry of the surface roughness. Here, the maximum height Ry of the surface roughness is extracted from the roughness curve obtained by measuring the unevenness of the surface state by the reference length of the average line, and the maximum value (mountain) of this extracted portion. Is measured in the direction of the vertical magnification of the roughness curve, and this value is expressed in micrometers.

In the present embodiment, the maximum roughness height Ry (JIS B 0601 1994) of the rough surface RF is assumed to be Ry = 6.3 μm or more. More preferably, Ry = 10 μm or more. When the rough surface RF is smaller than the maximum roughness height Ry = 6.3 μm, the rough surface RF and the support portion 3b are compared with the friction generated between the inner wall w of the insertion tube 21 and the support portion 3b. Therefore, it becomes difficult to hold the support portion 3b by the rough surface RF. Note that the maximum roughness height Ry is such that the support portion 3b is held on the rough surface RF and a frictional force is generated that allows the support portion 3b to move with the forward movement of the plunger 40. If it is.
In addition, the range of the maximum height Ry of the surface roughness shown here is an example, and the above condition is satisfied in consideration of the combination of the type of material of the intraocular lens 100 and the type of material constituting the injector 40. What is necessary is just to be determined.

  Here, the formation method of the plunger 40 provided with the above rough surfaces RF is demonstrated. First, the case where the plunger 40 is formed of a metal material such as iron or aluminum will be described. First, the outer shape of the plunger 40 is formed by cutting the metal bulk material formed in a predetermined shape by a known cutting process. Next, a rough surface RF is formed on a part of the surface of the shaft 45. As a method for forming the rough surface RF, mechanical processing used in normal metal processing such as well-known shot blasting, well-known cutting, and file processing with a file having a predetermined roughness is used. In addition to this, depending on the material of the plunger 40, after the plunger 40 is immersed in a specific chemical aqueous solution to form the entire surface rough, the surface other than the range where the rough surface RF is formed is smoothly formed by polishing. You may make it do.

  On the other hand, when the plunger 40 is formed of a resin such as plastic, a known molding process is used. In this case, an unevenness is formed in advance at a position where the rough surface RF is formed with a mold (metal) by a processing method such as shot blasting or etching. And the plunger 40 in which the rough surface RF was formed is obtained by pouring the resin material into the mold. Alternatively, after forming the outer shape of the plunger 40 with a metal mold, the rough surface RF is formed on a part of the surface of the plunger 40 by well-known shot blasting, cutting with a blade, or rapping. Anyway.

  In addition, although the case where the rough surface RF is formed on the entire circumference of a part of the shaft 45 where the support portion 3b is positioned is described here as an example, the present invention is not limited to this. Rough surface RF should just be formed so that the range which the support part 3b contacts the plunger 40 according to the internal shape of the insertion part 21, the shape of the front-end | tip part 44 of the plunger 40, etc. may be included.

  FIG. 6 shows the configuration of the plunger 40b of the second modification. 6A is a view from the top surface of the plunger 40b (tip 44 side), FIG. 6B is a view from the side surface, and FIG. 6C is a view from the bottom surface. As described above, the rough surface RF can be formed entirely on the surface of the plunger 40b so as to include a range where the support portion 3b contacts the plunger 40b. However, in this case, when the optical part 2 is pressed by the plunger 40b, the contact surface 44a that is in contact with the optical part 2 and a part of the optical part 2 is on the plunger 40b (tip 44). The rough surface RF is formed in a range excluding a range that may be ridden (for example, a range in which a gap is generated between the inner wall w of the insertion tube 21 and the side surface of the distal end 44 and the contact surface 44a side). So that In this way, the support portion 3b is held by the rough surface RF, and contact between the rough surface RF and the optical portion 2 can be avoided as much as possible, and the intraocular lens 1 is preferably pushed into the eye. Can be put out.

  Further, as shown in FIG. 6C, when the rough surface RF is formed on the bottom surface side of the distal end 44 at least at the position on the contact surface 44a side, the insertion tube 21 is pushed by the pushing operation of the intraocular lens 1. It is possible to prevent the optical unit 2 from going into a gap formed between the inner wall w of the lens and the distal end portion 44 of the plunger 40b. If it does in this way, it will come to be able to extrude the optical part 2 more suitably.

  Moreover, the structure of the plunger 40c of the modification 3 is shown in FIG. Here, FIG. 7A is a view seen from the top, FIG. 7B is a view seen from the side, and FIG. 7C is a view seen from the bottom. As described above, the rough surface RF for holding the support portion 3b may be formed only at least on the upper surface side of the plunger 40c with which the support portion 3b is contacted. Also in this case, as shown in FIG. 7C, the rough surface RF is formed at least on the abutting surface 44a side of the bottom surface of the tip 44, so that it is formed between the tip 44 of the plunger 40c. It is possible to prevent the optical unit 2 from going into the gap. In addition, according to the bending direction of the optical part 2, you may make it form rough surface RF in the bottom face side of the plunger with which the support part 3b is contacted.

  That is, in the case where the entire circumference of the plunger 40 is formed by an area that has been roughened and a surface area that has not been roughened, at least one of the upper surface, the lower surface, and the side surface of the plunger. However, it is only necessary to be formed in a region subjected to roughening.

Next, the extrusion operation of the intraocular lens 1 using the injector 10 (plunger 40) having the above configuration will be described. FIG. 8 is an explanatory diagram of the pushing operation of the intraocular lens 1.
First, the operator (user) places the intraocular lens 1 on the placement portion in the insertion portion 20 from the opening at the position of the lid member 20a using a lever or the like, and inserts the distal end 21a into the eye. When the pressing portion 41 is pushed in from this state, the support portion 3b comes into contact with the surface of the plunger 40. Then, as shown in FIG. 8A, when the support portion 3b comes into contact with the rough surface RF, the support portion 3b is held by the friction. On the other hand, when the plunger 40 is pushed toward the tip 21a, the contact surface 44a comes into contact with the optical unit 2. By pushing the plunger 40 from this state, the optical part 2 is bent along the inner wall w of the insertion part 20 (rounded down). At this time, as shown in FIG. 8B, the support portion 3 b held by the rough surface RF is also moved to the tip 21 a side with the pushing operation of the plunger 40.

  As described above, the optical unit 2 delivered from the distal end 21a is gradually opened in the sac. At this time, since the rear support portion 3b is held by the rough surface RF, the entire intraocular lens 1 can be prevented from being vigorously separated from the distal end 21a. It will be released. Moreover, since the optical part 2 is opened around the support part 3b held by the rough surface RF, the opening direction of the intraocular lens 1 is determined in one direction.

  When the plunger 40 is further pushed and the position of the rough surface RF holding the support portion 3b is pushed out from the tip 21a as shown in FIG. 8C, the support portion 3 is removed from the rough surface RF by the restoring force. Get away. And it comes to be arrange | positioned along the sac by the stress applied from within the eye. Thereby, the optical part 2 is suitably held in the eye by the support part 3.

  As described above, by forming the rough surface RF on the plunger 40, the rear support portion 3 is held by friction, and is moved toward the tip 21a along with the forward movement of the plunger. It becomes like this. Thereby, it becomes possible to easily push the intraocular lens 1 into the eye by a single pushing operation using the plunger 40 having a simple configuration.

  In the above, the friction between the plunger 40 and the support portion 3b is increased by making the surface of the plunger 40 the rough surface RF. However, the present invention is not limited to this. FIG. 9 shows the configuration of the plunger 40d of the fourth modification. Here, the figure seen from the upper surface is shown. In this case, the friction between the plunger 40d and the support portion 3b is increased by forming irregularities due to the grooves G on the surface of the plunger 40d in a range where the support portion 3b comes into contact. When the plunger 40d is formed of metal, the groove G is formed by well-known milling, lathe processing, or polishing processing. On the other hand, when the plunger 40 is formed of resin, as described above, an uneven shape may be formed in advance in a metal mold.

  Furthermore, as shown in the explanatory view of the configuration of the plunger 40e of the modified example 5 in FIG. 10, a contact surface D for pushing the rear support portion 3b is formed on the distal end side of the plunger 40e. May be. In addition, the contact surface D should just be formed in the position (position where a malfunction does not generate | occur | produce) where a part of support part 3b contacts suitably at the time of extrusion of the intraocular lens 1. FIG. In this way, as the intraocular lens 1 is pushed out by the tip 44a, the support portion 3b is further pushed out by the contact surface D, so that the intraocular lens 1 is pushed out into the eye more efficiently. become.

  In addition, although the example using the 1 piece type intraocular lens by which an optical part and a support part are integrally molded was demonstrated above, it is not restricted to this. Even in the case of a three-piece intraocular lens obtained by preparing the optical part and the support part separately and then integrating them, the support part is held by the plunger having the configuration of the present invention. Thus, the intraocular lens 1 can be easily pushed into the eye using an injector having a simple configuration.

It is explanatory drawing of a structure of the 1 piece type intraocular lens. It is the schematic of the external appearance of an injector. It is explanatory drawing of a structure of a plunger. It is a cross-sectional schematic diagram of the internal structure of an injector. It is an enlarged view near the front-end | tip of a plunger. It is the modification 2 of a structure of a plunger. It is the modification 3 of a structure of a plunger. It is explanatory drawing of the extrusion operation | movement of an intraocular lens. It is the modification 4 of a structure of a plunger. It is the modification 5 of a structure of a plunger.

DESCRIPTION OF SYMBOLS 1 Intraocular lens 2 Optical part 3 Support part 20 Insertion cylinder part 30 Tube part main body 40 Plunger RF Rough surface

Claims (4)

An intraocular lens having an optical part and a pair of support parts for supporting the optical part in the eye is placed, and the intraocular lens placed on the placement part is placed in the eye In an intraocular lens insertion device comprising an insertion tube portion for insertion and a plunger provided to be movable back and forth in the axial direction within the tube of the insertion device body in order to push out the intraocular lens from the insertion tube portion ,
In the contact area of at least a part of the plunger with which the support portion of the intraocular lens comes into contact, when the intraocular lens placed on the placement portion is pushed out, the plunger and the support portion are An intraocular lens insertion device having a surface shape for generating a predetermined frictional force. 2. The intraocular lens insertion device according to claim 1, wherein the predetermined frictional force is the forward movement of the plunger without sliding on the plunger in a state where the support portion is in contact with the contact area. An intraocular lens insertion device characterized by a frictional force of a size that can be moved. The intraocular lens insertion device according to claim 2, wherein the contact region has a roughened surface shape. 4. The intraocular lens insertion device according to claim 3, wherein the roughening of the contact area is performed by at least one of shot blasting, filing and cutting.

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