JP2013244186A - Intraocular lens insertion instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a technology capable of turning a positional relationship between a support part of an intraocular lens and a distal end of a plunger after inserting the intraocular lens from an incised wound into an eyeball to such a positional relationship that it is easy to stably perform fine adjustment of an intraocular lens position, and improving work efficiency of the fine adjustment of the intraocular lens position inside the eyeball.SOLUTION: When a support part 2b of an intraocular lens 2 is in such a curve shape that a position is changed in a circumferential direction as separating from the center of a lens body 2a, at a stage part 12, the intraocular lens 2 is held so that the distal end of the support part 2b and a pressurization part which is a part to pressurize the lens body 2a by a plunger 30 are on the opposite side of a connection part of the support part 2b and the lens body 2a.

Description

  The present invention relates to an intraocular lens insertion device for inserting an intraocular lens into a patient's eyeball.

  Conventionally, in surgery such as cataracts, an incision is made in the eye tissue such as the cornea (capsular membrane) and anterior lens capsule in the eyeball, and the lens in the capsule is removed and removed through this incision, An intraocular lens that replaces the crystalline lens is inserted into the eye through the incision and placed in the sac.

  Particularly in recent years, when an intraocular lens is inserted into an eyeball from an incision, an insertion instrument as described below is often used. That is, the distal end opening of the insertion tube portion provided at the distal end portion of the instrument body is inserted into the eyeball through the incision, and the intraocular lens is slightly deformed in the instrument body from the distal end opening of the insertion tube portion to a rod shape. The intraocular lens is inserted into the eyeball by pushing it out with a plunger (see, for example, Patent Documents 1 to 4). By using such an insertion device, the intraocular lens can be easily inserted into the eyeball using the incision formed for the removal of the crystalline lens. Astigmatism and infection can be suppressed.

  By the way, an intraocular lens often comprises a lens body that functions as a lens and a beard-like or belt-like support part that supports the lens body at a predetermined position. In many cases, the support portion is connected to the lens body at a plurality of locations on the outer peripheral portion of the lens body, and is provided so as to draw a curve whose position changes in the circumferential direction as the distance from the center of the lens body increases. In this case, the intraocular lens is in a state in which the lens body easily rotates in one direction within the eyeball and is difficult to rotate in the opposite direction according to the direction in which the support portion extends. Further, in the above intraocular lens insertion work, after inserting the intraocular lens into the eyeball from the incision, the outer periphery of the lens body is further pressed with the tip of the plunger that pushed the intraocular lens from the insertion instrument. The position of the intraocular lens in the eyeball may be finely adjusted by slightly rotating it.

  In this fine adjustment of the position of the intraocular lens, when the intraocular lens is inserted into the eyeball through the incision, the tip of the plunger is supported by the connection part between the support part and the lens body on the outer periphery of the lens body. When the front end of the lens is pressed, the lens body tends to rotate in a direction that is difficult to rotate in relation to the shape of the support, and it is difficult to finely adjust the position of the intraocular lens. is there.

  On the other hand, when the intraocular lens is inserted into the eyeball through the incision, the distal end of the plunger presses the opposite side of the distal end of the support portion from the connection portion between the support portion and the lens body on the outer periphery of the lens body In this case, the lens body tends to rotate in a direction that is easy to rotate in relation to the shape of the support portion, and fine adjustment of the position of the intraocular lens can be performed smoothly.

  As described above, the work efficiency of fine adjustment of the position of the intraocular lens thereafter is affected by the positional relationship between the support portion and the tip of the plunger after the intraocular lens is inserted into the eyeball through the incision. On the other hand, after the intraocular lens is inserted into the eyeball from the incision, the positional relationship between the support portion and the plunger tip is stable, and the positional relationship that facilitates subsequent fine adjustment of the intraocular lens position is set. Thus, there has been a demand for improving the work efficiency of fine adjustment of the position of the intraocular lens.

JP 2009-160153 A JP 2009-183367 A JP 2009-160151 A JP 2010-158304 A

  The object of the present invention is to stably finely adjust the position of the intraocular lens in a stable manner with respect to the positional relationship between the support part of the intraocular lens and the tip of the plunger after the intraocular lens is inserted into the eyeball from the incision. It is an object of the present invention to provide a technique capable of improving the working efficiency of fine adjustment of the intraocular lens position in the eyeball with easy positional relationship.

The present invention for solving the above problems includes a curve in which a plurality of support portions of an intraocular lens are connected to the lens body at the outer periphery, and the positions change in the circumferential direction as the distance from the center of the lens body increases. Has a shape,
In the intraocular lens insertion device, of the plurality of support portions, the support portion closest to the portion where the connection portion is pressed by the plunger (the press portion), the pressing portion and the support portion tip end with respect to the connection portion. The greatest feature is that the intraocular lens is held in the storage portion so as to be on the opposite side.

More specifically, an instrument body having an insertion cylinder portion to be inserted into an incision formed in eyeball tissue and formed in a substantially cylindrical shape,
A storage unit that is provided integrally or separately with the instrument body, and that can accommodate the intraocular lens by accommodating the intraocular lens; and
The intraocular lens is deformed along the shape of the inner wall of the instrument body and pressed by pressing the pressing part on the outer periphery of the intraocular lens housed in the instrument body with the tip. A plunger that pushes into the eyeball from the tube portion,
An intraocular lens insertion device for inserting an intraocular lens into the eyeball by pushing the intraocular lens into the eyeball from the distal end of the insertion tube portion inserted into the eyeball from the incision,
The intraocular lens includes a lens body and a plurality of support portions that support the lens body.
The plurality of support portions have a connection portion with the lens body on the outer periphery of the lens body, and a shape including a curve whose position changes in the circumferential direction as the distance from the center of the lens body increases.
Of the plurality of support portions, the connection portion is the closest to the pressing portion on the outer periphery of the lens body, and the tip of the support portion and the pressing portion are connected on the outer periphery of the lens body. The intraocular lens is held in the storage portion so as to be located on the opposite side to the portion.

  Here, when the intraocular lens housed in the housing portion is pressed with the plunger and pushed out from the distal end of the insertion instrument, the plunger is opposite to the distal end of the support portion with respect to the connection portion between the support portion and the lens body. When the intraocular lens is pushed out into the eyeball, the positional relationship between the connecting portion and the pushing portion in the storage portion is maintained, and the distal end side of the supporting portion with respect to the plunger shaft The tendency to be pushed out in a closed state has become clear.

  This is because when the plunger is pressed against the connecting part between the nearest support part and the lens body, the resistance to the movement of the intraocular lens is generally caused by the presence of the support part. This is because a moment that moves the intraocular lens toward the distal end side of the support portion due to the pressing force by the plunger acts.

  By using this tendency, if the plunger is pressed against the connecting part between the nearest support part and the lens body, the side opposite to the tip of the support part is used, and when the intraocular lens is inserted into the eyeball. Thus, the distal end of the plunger can be more reliably positioned on the side opposite to the distal end of the support portion with respect to the connection portion with respect to the nearest support portion. Then, in the subsequent fine adjustment of the position of the intraocular lens, the doctor who is the user directly presses the outer periphery of the intraocular lens with the plunger as it is, thereby rotating the intraocular lens more smoothly and making the eye more efficient. It is possible to finely adjust the position of the inner lens.

Further, in the present invention, the plurality of support portions have a shape including a curve whose position changes counterclockwise when viewed from the front side of the optical axis as it is away from the center of the intraocular lens,
Among the plurality of support portions, the connection portion is the closest to the pressing portion on the outer periphery of the lens body, and the pressing portion is on the downstream side in the clockwise direction when viewed from the optical axis front side with respect to the connection portion. The intraocular lens may be held in the storage portion so as to be positioned.

  Currently, the shape of the support portion of the intraocular lens is mainly a curved shape in which the position changes counterclockwise as viewed from the front side of the optical axis as the distance from the center of the intraocular lens increases. Therefore, in the storage unit, the intraocular lens is held so that the pressing unit that is closest to the pressing unit among the plurality of supporting units is positioned on the downstream side in the clockwise direction when viewed from the optical axis front side with respect to the connection unit. By doing so, it becomes possible to rotate the intraocular lens more smoothly and finely adjust the position of the intraocular lens more efficiently for the intraocular lens of the type that is most commonly seen at present.

In the present invention, the intraocular lens includes a lens body and two support portions,
The connecting portion between the two support portions and the lens body is opposed to each other across the center of the lens body,
In the storage portion, a straight line connecting the connecting portions between the two support portions and the lens body, and the axis of the plunger intersect the straight line at a predetermined angle with respect to the straight line at the center of the lens body. You may make it do.

  According to this, while the pressing part pressed by the plunger is positioned on the opposite side to the tip of the support part on the outer periphery of the lens body with respect to the connection part between the support part and the lens body, It is possible to press the lens body so that the axis passes through the center of the lens body. According to this, the movement of the intraocular lens can be further stabilized, and the intraocular lens can be more reliably moved to the distal end of the insertion instrument by pressing the intraocular lens with the plunger.

  If it does so, it will become possible to perform smoothly the insertion operation | work which inserts an intraocular lens in an eyeball with the fine adjustment operation | work of the position of the intraocular lens in an eyeball. As a result, it is possible to improve the work efficiency of both the insertion work of the intraocular lens and the fine adjustment work of the position after the insertion.

  In the present invention, the predetermined angle may be not less than 30 degrees and not more than 60 degrees. Here, when the predetermined angle is too small, the moment acting on the intraocular lens is reduced, so that the tip position of the plunger and the connection of the nearest support part at the time when the intraocular lens is inserted into the eyeball. The stability of the positional relationship with the part may be reduced. On the other hand, if the predetermined angle is too large, the size in the left-right direction of the storage portion necessary for storing the lens body and the support portion in the storage portion becomes large, and the insertion instrument becomes large.

In the present invention, by setting the predetermined angle to 30 degrees or more and 60 degrees or less, the above two factors can be appropriately balanced, and the tip position of the plunger at the time when the intraocular lens is inserted into the eyeball, Both the stability of the positional relationship with the connection portion of the nearest support portion and the suppression of the horizontal dimension of the storage portion can be realized.

  The intraocular lens insertion device according to the present invention is a preset type in which the intraocular lens is stored in the storage unit in the manufacturing process, and is distributed and used in a state where the intraocular lens is stored in the storage unit. It is good.

  Then, at the time of inserting the intraocular lens, the tip position of the plunger is more reliably determined when the intraocular lens is inserted into the eyeball simply by pushing the plunger into the instrument body. The nearest support portion can be positioned on the opposite side of the support portion from the tip of the support portion. Then, in subsequent fine adjustment of the position of the intraocular lens, the intraocular lens can be rotated more smoothly by pressing the intraocular lens as it is with the plunger, and the fine adjustment of the position of the intraocular lens can be performed more efficiently. It becomes possible to do.

  The means for solving the above-described problems of the present invention can be used in combination as much as possible.

  According to the present invention, after the intraocular lens is inserted into the eyeball from the incision, the positional relationship between the support portion of the intraocular lens and the plunger tip is stably finely adjusted in the intraocular lens position in the eyeball. Therefore, the work efficiency of fine adjustment of the position of the intraocular lens can be improved.

It is a figure which shows schematic structure of the insertion instrument of the conventional intraocular lens. It is a figure which shows schematic structure of the conventional intraocular lens. It is a figure which shows schematic structure of the conventional nozzle body. It is a figure which shows schematic structure of the conventional positioning member. It is a figure which shows schematic structure of the conventional plunger. It is a figure for demonstrating the relationship between the positional relationship of the connection part of a support part, a lens main body, and a plunger after inserting an intraocular lens in an eye, and the behavior of the intraocular lens when it presses with a plunger. In the stage part, it is a figure for demonstrating the relationship between the positional relationship of the connection part of a support part and a lens main body, and the press part pressed with a plunger, and the behavior of the intraocular lens at the time of pushing out an intraocular lens with a plunger. is there. It is a figure for demonstrating the holding posture of the intraocular lens in the Example of this invention. It is a figure which shows schematic structure of the insertion instrument in the Example of this invention.

Embodiments of the present invention will be described below with reference to the drawings.
<Example 1>

FIG. 1 shows a schematic configuration of a conventional intraocular lens insertion instrument 101 (hereinafter also simply referred to as an insertion instrument 101). 1A is a plan view, and FIG. 1B is a side view. The insertion instrument 101 is formed in a cylindrical shape having a substantially rectangular cross section, and has a large opening on one side (hereinafter, the side having the large opening is referred to as a rear end portion 10b), and an insertion tube that is narrowed down on the other side end. The nozzle main body 10 as an instrument main body provided with the nozzle part 15 as a part and the front-end | tip part 10a opened diagonally, and the plunger 30 which is inserted in the nozzle main body 10 and can reciprocate are provided. In the following, the direction from the front end 10a to the rear end 10b of the nozzle body 10 or the opposite direction is the front-rear direction, the vertical direction to the paper surface in FIG. 1A is the vertical direction, and the paper surface in FIG. The vertical direction is the left-right direction.

  Near the rear end portion 10 b of the nozzle body 10, there is integrally provided a holding portion 11 that protrudes in a plate shape and hooks a finger when the user pushes the plunger 30 toward the distal end side of the nozzle body 10. Further, a stage portion 112 as a storage portion for setting the intraocular lens 2 is provided on the rear end side of the nozzle portion 15 in the nozzle body 10. The stage portion 112 is configured such that the upper side of the nozzle body 10 (the vertical front side in FIG. 1A) is opened by opening the stage lid portion 113. Further, the positioning member 50 is attached to the stage portion 112 from the lower side of the nozzle body 10 (the back side perpendicular to the paper surface in FIG. 1A). By this positioning member 50, the intraocular lens 2 is stably held in the stage portion 112 before use (during transportation).

  That is, in the insertion instrument 101, the intraocular lens 2 is set on the stage unit 112 with the stage lid unit 113 opened and the positioning member 50 attached to the stage unit 112 at the time of manufacture. Then, after the stage lid 113 is closed, it is shipped and sold. Further, during use, the user removes the positioning member 50 while keeping the stage lid 113 closed, and then pushes the plunger 30 into the distal end side of the nozzle body 10. Thus, the intraocular lens 2 is pressed by the plunger 30, and the intraocular lens 2 is pushed out from the distal end portion 10a. In addition, the nozzle body 10, the plunger 30, and the positioning member 50 in the insertion instrument 101 are formed of a resin material such as polypropylene. Polypropylene is a material with a proven track record in medical equipment and high reliability such as chemical resistance.

  FIG. 2 is a diagram showing a schematic configuration of the intraocular lens 2. 2A is a plan view and FIG. 2B is a side view. The intraocular lens 2 is formed of a lens body 2a having a predetermined refractive power and two support portions 2b and 2b that are provided on the lens body 2a and hold the lens body 2a in the eyeball. The support portions 2b and 2b are band-like portions extending in the horizontal direction from portions that are 180 degrees apart from each other on the outer periphery of the lens body 2a. A curve whose position changes around is formed. The lens body 2a is formed of a flexible resin material, and the support portions 2b and 2b are formed integrally with the lens body 2a and are formed of the same member.

  FIG. 3 shows a plan view of the nozzle body 10. As described above, in the nozzle body 10, the intraocular lens 2 is set on the stage unit 112. In this state, the intraocular lens 2 is pushed out from the distal end portion 10a by being pressed by the plunger 30. In addition, a through hole 10 c whose cross-sectional shape changes according to a change in the outer shape of the nozzle body 10 is provided in the nozzle body 10. When the intraocular lens 2 is pushed out, the intraocular lens 2 is deformed in accordance with a change in the cross-sectional shape of the through hole 10c in the nozzle body 10 and easily enters an incision formed in the patient's eyeball. It will be extruded after being transformed into.

  A stage groove 112 a having a width slightly larger than the diameter of the lens body 2 a of the intraocular lens 2 is formed in the stage portion 112. The dimension in the front-rear direction of the stage groove 112 a is set to be larger than the maximum width dimension including the support portions 2 b and 2 b extending on both sides of the intraocular lens 2. A set surface 112b is formed by the bottom surface of the stage groove 112a. The vertical position of the set surface 112b (position perpendicular to the paper surface of FIG. 3) is set above the height position of the bottom surface of the through hole 10c of the nozzle body 10 (front side perpendicular to the paper surface of FIG. 3). The set surface 112b and the bottom surface of the through hole 10c are connected by a bottom slope 10d.

The stage part 112 and the stage cover part 113 are integrally formed. The stage lid portion 113 has the same longitudinal dimension as the stage portion 112. The stage lid portion 113 is a thin plate-like connecting portion 11 formed by extending the side surface of the stage portion 112 toward the stage lid portion 113 side.
4 are connected. The connecting portion 114 is formed to be bendable at the center, and the stage lid portion 113 can be closed by overlapping the stage portion 112 from above by bending the connecting portion 114.

  In the stage lid portion 113, ribs 113a and 113b are provided on the surface facing the set surface 112b when the lid is closed to reinforce the stage lid portion 113 and stabilize the position of the intraocular lens 2. A guide protrusion 113 c is provided as a guide on the upper side of the plunger 30.

  A positioning member 50 is detachably provided below the set surface 112b of the stage portion 112. FIG. 4 shows a schematic configuration of the positioning member 50. 4A shows a plan view, and FIG. 4B shows a side view. The positioning member 50 is configured as a separate body from the nozzle main body 10, and has a structure in which a pair of side wall portions 51, 51 are connected by a connecting portion 52. At the lower ends of the respective side wall portions 51, holding portions 53, 53 extending outward and extending are formed.

  A pair of first mounting portions 54 and 54 are formed on the upper end portions of the side wall portions 51 and 51, respectively. Further, first positioning portions 55, 55 are formed to protrude from the outer peripheral side of the upper end surface of the first placement portion 54. The distance between the inner diameters of the first positioning portion 55 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 1.

  In addition, a pair of second mounting portions 56 and 56 are formed at both ends of the connecting portion 52 in the front-rear direction and have a rectangular shape when viewed from above and project upward. The height of the upper surface of the second placement unit 56 is equal to the height of the upper surface of the first placement unit 54. Furthermore, second positioning portions 57 and 57 are formed on the outer surface of the second placement portions 56 and 56 so as to further protrude upward over the entire left and right direction of the second placement portion 56. . The separation between the insides of the second positioning portions 57 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2. In addition, locking claws 58 and 58 that slightly protrude in the front-rear direction are formed on the upper end portion of the second placement portion 56 over the entire left-right direction.

  In the present embodiment, the positioning member 50 is assembled from below the set surface 112b of the nozzle body 10. A set surface through hole 112c that penetrates the set surface 112b in the thickness direction is formed in the set surface 112b of the nozzle body 10. The outer shape of the set surface through hole 112c is substantially similar to the shape of the first mounting portion 54 and the second mounting portion 56 of the positioning member 50 as viewed from above. When the positioning member 50 is attached to the nozzle body 10, the first placement portions 54 and 54 and the second placement portions 56 and 56 are inserted into the set surface through hole 112c from the lower side of the set surface 112b. , And protrudes above the set surface 112b.

  At that time, the locking claws 58, 58 provided in the second positioning portions 57, 57 project to the set surface 112b through the set surface through hole 112c and are locked to the upper surface of the set surface 112b. As a result, the positioning member 50 is assembled from the lower side of the nozzle body 10, and the first placement portions 54 and 54 and the second placement portions 56 and 56 are fixed in a state of protruding from the set surface 112b. When the intraocular lens 2 is set on the setting surface 112b, the bottom surface of the outer peripheral portion of the lens body 2a is placed on the upper surfaces of the first placement portions 54 and 54 and the second placement portions 56 and 56. The Further, the position of the lens body 2 a is restricted with respect to the horizontal direction by the first positioning portions 55 and 55 and the second positioning portions 57 and 57.

FIG. 5 shows a schematic configuration of the plunger 30. The plunger 30 has a length in the front-rear direction that is slightly larger than the nozzle body 10. And it forms from the action part 31 of the front end side based on a column shape, and the insertion part 32 of the rear end side based on a rectangular rod shape. And the action part 31 is comprised including the cylindrical part 31a made into the column shape, and the thin plate-shaped flat part 31b extended in the left-right direction of the cylindrical part 31a.

  Further, the insertion portion 32 has a substantially H-shaped cross section as a whole, and the horizontal and vertical dimensions thereof are set slightly smaller than the through hole 10 c of the nozzle body 10. In addition, a disc-shaped pressing plate portion 33 is formed at the rear end of the insertion portion 32 so as to spread in the vertical and horizontal directions.

  A claw portion 32 a that protrudes toward the upper side of the insertion portion 32 and can be moved up and down by the elasticity of the material of the plunger 30 is formed at the tip side of the insertion portion 32 from the center in the front-rear direction. When the plunger 30 is inserted into the nozzle body 10, the locking hole 10 e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32 a engage with each other. The relative position between the nozzle body 10 and the plunger 30 in the state is determined. It should be noted that the claw portion 32a and the locking hole 10e are formed at the positions where the tip of the cylindrical portion 31a of the plunger 30 is located behind the lens body 2a of the intraocular lens 2 set on the stage portion 112 in the engaged state. It is set as follows.

  Prior to use of the insertion instrument 1 configured as described above, the plunger 30 is inserted into the nozzle body 10 and disposed at the initial position. Further, as described above, the positioning member 50 is attached to the nozzle body 10 from below the set surface 112b. Thereby, the 1st mounting part 54 and the 2nd mounting part 56 of the positioning member 50 are hold | maintained in the state protruded to the set surface 112b.

  Next, the lens body 2a of the intraocular lens 2 is placed and positioned on the upper surfaces of the first placement part 54 and the second placement part 56 in a state where the support parts 2b and 2b are oriented in the front-rear direction of the nozzle body 10. The In this state, since the outer peripheral portion of the lens body 2a is in contact with the first placement portion 54 and the second placement portion 56, the central portion of the intraocular lens 2 is supported in an unloaded state. Thereafter, the insertion instrument 101 is distributed and used in a state where the stage lid 113 is closed.

  When inserting the intraocular lens 2 into the eyeball using the insertion instrument 101, first, the positioning member 50 is removed from the nozzle body 10. As a result, the first placement portion 54 and the second placement portion 56 that supported the lens body 2a of the intraocular lens 2 are retracted from the set surface 112b, and the intraocular lens 2 is movable on the set surface 112b. Placed.

  Subsequently, the distal end portion 10a of the nozzle portion 15 of the nozzle body 10 is inserted into the incision provided in the eye tissue. Here, since the distal end portion 10a has an oblique opening shape, it can be easily inserted into the incision. And after inserting the nozzle part 15 in an incision, the press board part 33 of the plunger 30 is pushed in the front end side of the nozzle main body 10 in the state. Thereby, the front-end | tip of the cylindrical part 31a of the plunger 30 contact | abuts to the outer periphery of the lens main body 2a of the intraocular lens 2 set to the set surface 12a, and the intraocular lens 2 is guided toward the front-end | tip part 10a by the plunger 30.

  The intraocular lens 2 is deformed in accordance with the change in the cross-sectional shape of the through hole 10c in the nozzle body 10 during the movement to the distal end portion 10a, and is deformed so as to easily enter the incision formed in the patient's eyeball. Extruded above.

Here, in the actual insertion operation of the intraocular lens 2, the intraocular lens 2 is pushed into the eyeball from the incision opened in the patient's eyeball using the insertion instrument 101, and then the operator of the insertion instrument 101 is operated. The doctor rotates the outer circumference of the intraocular lens 2 with the tip of the cylindrical portion 31a of the plunger 30 (hereinafter, also referred to as the tip of the plunger 30 for simplicity) by appropriately pressing the outer periphery of the intraocular lens 2 through the incision. Fine adjustment of the position of the intraocular lens 2 may be performed.

  In this case, the influence of the positional relationship between the distal end of the plunger 30 and the support portion 2b when the intraocular lens 2 is pushed into the eyeball from the incision, on the subsequent fine adjustment work of the position of the intraocular lens 2. Will be described with reference to FIG. When the intraocular lens 2 is pushed out of the incision into the eyeball, as shown in FIG. 6A, the tip of the plunger 30 is located between the support portion 2b and the lens body 2a in the circumferential direction of the outer periphery of the lens body 2a. When located on the counterclockwise downstream side (the front end side of the support portion 2b) when viewed from the front side of the lens optical axis (the front side perpendicular to the paper surface in FIG. 6) from the connection portion 2c, When the outer periphery of the lens 2 is pressed, the intraocular lens 2 is rotated counterclockwise, and the support portions 2b and 2b are caught by the tissue in the eyeball and are difficult to rotate. Further, the support portion 2b closest to the plunger 30 and the plunger 30 cross each other, which may make it difficult to rotate the intraocular lens 2.

  On the other hand, when the intraocular lens 2 is inserted into the eyeball through the incision, the tip of the plunger 30 is positioned between the lens body 2a and the support portion 2b in the circumferential direction of the outer periphery of the lens body 2a as shown in FIG. When located on the downstream side of the lens optical axis front side (the front side perpendicular to the paper surface in FIG. 6) from the connection part 2c (on the opposite side to the front end of the support part 2b), the lens is left at the front end of the plunger 30 as it is. When the outer periphery of the main body 2a is pressed, the lens main body 2a is rotated clockwise, and the intraocular lens 2 can be easily rotated without the support portions 2b and 2b being caught by the tissue in the eyeball. As a result, the work efficiency of fine adjustment of the position of the intraocular lens 2 is increased.

  In consideration of such a tendency, in this embodiment, when the intraocular lens 2 is held on the stage unit, the pressing portion 2d which is a portion that presses the intraocular lens 2 with the plunger 30 is the lens of the intraocular lens 2. The connecting portion 2c between the main body 2a and the support portion 2b is held so as to be positioned downstream in the clockwise direction when viewed from the front side of the optical axis. Hereinafter, the reason will be described with reference to FIG.

  First, when the intraocular lens 2 is held on the stage portion, as shown in FIG. 7A, the pressing portion 2d that is a portion pressed by the plunger 30 in the stage portion is formed between the lens body 2a and the support portion 2b. Consider a case where the connecting portion 2c is located on the downstream side in the counterclockwise direction when viewed from the front side of the optical axis. In this case, when the lens body 2 a is pressed by the plunger 30, the lens is affected by the friction between the support portion 2 b and the inner wall of the stage portion, the phenomenon of being caught between the plunger 30 and the inner wall of the stage portion, or being entangled with the plunger 30. It has been found that a counterclockwise moment is generated in the main body 2a and the lens main body 2a tends to move to the left side as viewed from the plunger 30 side. In this case, the tip of the support part 2b closest to the pressing part 2d and the pressing part 2d are located on the same side of the outer periphery of the lens body 2a with respect to the connection part 2c.

  Next, as shown in FIG. 7B, when the intraocular lens 2 is held on the stage portion, the pressing portion 2 d that is a portion pressed by the plunger 30 supports the lens body 2 a of the intraocular lens 2. Consider a case where the connecting portion 2c with the portion 2b is located on the downstream side in the clockwise direction when viewed from the front side of the optical axis. In this case, when the lens body 2a is pressed by the plunger 30, a clockwise moment is generated in the lens body 2a due to friction between the support portion 2b and the inner wall of the stage portion, and the lens body 2a is moved from the plunger 30 side. It turns out that there is a tendency to approach the right side. In this case, the tip of the support portion 2b closest to the pressing portion 2d and the pressing portion 2d are located on the opposite side of the connection portion 2c on the outer periphery of the lens body 2a.

  In the present embodiment, the pressing portion 2d that is a portion pressed by the plunger 30 is utilized with respect to the connection portion 2c between the lens body 2a and the support portion 2b of the intraocular lens 2 in the present embodiment. The stage portion is held so as to be positioned downstream in the clockwise direction when viewed from the front side of the optical axis. More specifically, as shown in FIG. 8, the intraocular lens 2 is moved with the straight line connecting the two connecting portions 2 c in the intraocular lens 2 tilted 45 degrees counterclockwise with respect to the axis of the plunger 30. I decided to keep it. In this embodiment, the straight line connecting the two connecting portions 2c in the intraocular lens 2 and the axis of the plunger 30 are set to intersect at the center of the lens body 2a.

  FIG. 9 shows an intraocular lens insertion device 1 according to the present embodiment. Compared with the conventional insertion instrument 101 shown in FIG. 1, the stage unit 12 is different, and the other configurations are the same. In FIG. 9, about the structure equivalent to the conventional insertion instrument 101, while using the same code | symbol, description is abbreviate | omitted.

  The stage portion 12 in the insertion instrument 1 is set so that the straight line connecting the connecting portions 2c of the two support portions 2b is inclined 45 degrees counterclockwise with respect to the axis of the plunger 30. It is configured. Specifically, the outer shape is wider than the stage portion 112 in the conventional insertion instrument 101. And even if it sets so that the intraocular lens 2 may incline 45 degree | times, it can be accommodated including the support parts 2b and 2b.

  In the stage portion 12, the intraocular lens 2 is held on the right side (upper side in FIG. 8) when viewed from the plunger 30, and the intraocular lens 2 is guided when the intraocular lens 2 is inserted into the eyeball. Two walls, a right front stage wall portion 12a and a right rear stage wall portion 12b, are formed. The right front stage wall portion 12a and the right rear stage wall portion 12b regulate the position of the lens body 2a of the intraocular lens 2 on the right side when viewed from the plunger 30. And between the right front stage wall part 12a and the right rear stage wall part 12b, the right accommodating part 12f which is a space which can accommodate the support part 2b located in the diagonally rear side of the lens main body 2a is formed. In the right storage portion 12f, the position of the support portion 2b is regulated by the right front stage wall portion 12a and the right rear stage wall portion 12b, and thereby the above-described 45 degree angle is maintained.

  Similarly, on the left side of the stage portion 12 as viewed from the plunger 30 (lower side in FIG. 8), two walls, a left front stage wall portion 12c and a left rear stage wall portion 12d, are formed. The left front stage wall portion 12c and the left rear stage wall portion 12d regulate the position of the lens body 2a of the intraocular lens 2 on the left side when viewed from the plunger 30. And between the left front stage wall part 12c and the left rear stage wall part 12d, the left accommodating part 12g which is the space which can accommodate the support part 2b located in the diagonally front side of the lens main body 2a is formed. Also in the left storage portion 12g, the position of the support portion 2b is regulated by the left front stage wall portion 12c and the left rear stage wall portion 12d so as to maintain the above 45 degree angle.

  In the present embodiment, a groove having a width slightly larger than the diameter of the lens body 2a of the intraocular lens 2 is formed by the right front stage wall portion 12a, the right rear stage wall portion 12b, the left front stage wall portion 12c, and the left rear stage wall portion 12d. Is formed. Also in the present embodiment, a set surface 12b is formed in the same manner as the set surface 112b of the conventional insertion instrument 101. The vertical position of the set surface 12b (the position perpendicular to the paper surface of FIG. 9A) is higher than the height position of the bottom surface of the through hole 10c of the nozzle body 10 (the direction perpendicular to the paper surface of FIG. 9A). The set surface 12b and the bottom surface of the through hole 10c are connected by a bottom slope 10d.

Similarly to the conventional insertion instrument 101, the stage 12 is configured such that the upper side of the nozzle body 10 (the front side perpendicular to the paper surface in FIG. 9A) is opened by opening the stage lid 13. In addition, a positioning member 50 is attached to the stage portion 12 from the lower side (the vertical back side in FIG. 9A), and the intraocular lens 2 is attached by the positioning member 50 before use (during transportation). The holding point is the same as that of the conventional insertion instrument 101.

  The stage lid portion 13 of this embodiment is also coupled to the stage portion 12 by the coupling portion 14, and ribs 13a and 13b are provided on the surface of the stage lid portion 13 that faces the set surface 12b when the lid is closed. Yes. In addition, a guide protrusion 13 c that guides the upper side of the plunger 30 is provided.

  When the intraocular lens 2 is inserted into the patient's eyeball using the insertion instrument 1 of the present embodiment, the positioning member 50 is first removed as in the conventional insertion instrument 101. Then, at the tip of the plunger 30, the intraocular lens 2 set on the stage unit 12 is pressed forward and moved. At that time, the lens body 2a moves along a groove formed by the right front stage wall 12a and the right rear stage wall 12b, the left front stage wall 12c and the left rear stage wall 12d, and the set surface 12b. Further, the two support portions 2b and 2b are moved forward while being deformed or folded along with the movement of the lens body 2a by the slope formed by the right front stage wall portion 12a and the left front stage wall portion 12c and housed in the groove. Moving.

  In the process, the support portion 2b disposed on the obliquely rear side contacts the set surface 12b, the right front stage wall portion 12a and the wall surface of the through hole 10c, or in some cases, the plunger 30 and the set surface 12b or the right front stage wall portion 12a, A resistance force against the movement of the intraocular lens 2 is generated by being sandwiched between the wall surface of the through-hole 10c or being entangled with the plunger 30.

  As a result, a clockwise moment in FIG. 9A acts on the intraocular lens 2, and it tends to move to the right side when viewed from the plunger 30. Then, when the intraocular lens 2 is pushed into the eyeball from the distal end portion 10a, the tendency to be pushed rightward with respect to the axis of the plunger 30 becomes strong.

  Then, as shown in FIG. 6B, the plunger 30 in the eyeball and the positional relationship between the support portion 2 b disposed on the oblique rear side of the intraocular lens 2 and the connection portion between the lens body 2 a are shown. It is possible to stably control so that the tip of is located on the downstream side of the connecting portion 2c in the clockwise direction when viewed from the front side of the lens optical axis (the side opposite to the tip of the support portion 2b). As a result, the doctor who is the user can finely adjust the position of the intraocular lens 2 in the eyeball more efficiently by continuously operating the outer periphery of the lens body 2a with the plunger 30 as it is. .

  As described above, according to the insertion instrument 1 in the present embodiment, when the intraocular lens 2 is pushed out into the eyeball, it is possible to stably perform fine adjustment of the position of the intraocular lens 2 thereafter. And the efficiency of the fine adjustment work of the position of the intraocular lens 2 can be improved.

  In the above-described embodiments, the description has been made on the assumption of a so-called preset system (including a preset insertion instrument) in which an intraocular lens is loaded in advance on an intraocular lens insertion instrument. However, the present invention is not limited to this, so that the intraocular lens insertion device and the intraocular lens are stored separately, and the so-called intraocular lens is loaded immediately before insertion into the eyeball. It can also be applied to a separate inserter. In the above-described embodiment, the example in which the support portions 2b and 2b of the intraocular lens 2 are formed integrally with the lens body 2a has been described. However, in the present invention, the support portion is separate from the lens body 2a. The present invention is also applicable to intraocular lenses that are formed and connected by being inserted into the lens body 2a. In that case, the hole for inserting the support portion in the lens body 2a corresponds to the connection portion.

  Further, in the above embodiment, when the support portions 2b and 2b of the intraocular lens 2 have a curved shape in which the circumferential position changes counterclockwise as viewed from the front side of the optical axis as the distance from the lens center increases. However, the present invention is not limited to the shape of the support portion as shown in the above embodiment. For example, the present invention can also be applied to a case where the support portions 2b and 2b of the intraocular lens 2 have a curved shape in which the circumferential position changes clockwise as viewed from the front side of the optical axis as the distance from the lens center increases. In this case, in the stage portion, the intraocular lens 2 is held so that the pressing portion is located on the downstream side in the counterclockwise direction when viewed from the optical axis front side with respect to the connection portion 2c. Further, the support portions 2b and 2b may be composed only of the curved shape as described above, or may include the curved shape as described above in part. For example, in addition to the curved shape as described above, a part of the shape of the support portion may include a linear shape or another curved shape.

  That is, in the present invention, in the stage portion, the intraocular lens is always positioned so that the pressing portion is located on the side opposite to the tip of the support portion with respect to the connection portion between the closest support portion and the lens body. Be placed. The present invention can be applied to any shape and number of support portions as long as the purpose is met.

  In the above embodiment, the intraocular lens 2 is held in a state where the straight line connecting the two connecting portions 2 c in the intraocular lens 2 is inclined 45 degrees counterclockwise with respect to the axis of the plunger 30. did. However, the angle between the straight line and the axis is not limited to 45 degrees. If it is in the range of 30 degrees or more and 60 degrees or less, the stability of the positional relationship between the distal end position of the plunger 30 and the connection part 2c of the nearest support part 2b when the intraocular lens 2 is inserted into the eyeball is improved. While being able to maintain, it can suppress that the width | variety of an insertion instrument becomes large too much.

DESCRIPTION OF SYMBOLS 1 ... Insertion instrument 2 ... Intraocular lens 2a ... Lens main body 2b ... Support part 2c ... Connection part 2d ... Pressing part 10 ... Nozzle main body 10a ... Tip part 10b ... Rear end 12 ... Stage 12a ... Right front stage wall 12b ... Right rear stage wall 12c ... Left front stage wall 12d ... Right rear stage wall 12e ... Set surface 12f ... Right storage part 12g ... Left storage part 13 ... Stage lid part 13a ... Rib 13b ... Rib 13c ... Guide protrusion 15 ... Insertion tube part 30 ... Plunger 50 ... Positioning member

Claims (5)

An instrument body having an insertion tube portion to be inserted into an incision formed in the eyeball tissue and formed in a substantially cylindrical shape;
A storage unit that is provided integrally or separately with the instrument body, and that can accommodate the intraocular lens by accommodating the intraocular lens; and
The intraocular lens is deformed along the shape of the inner wall of the instrument body and pressed by pressing the pressing part on the outer periphery of the intraocular lens housed in the instrument body with the tip. A plunger that pushes into the eyeball from the tube portion,
An intraocular lens insertion device for inserting an intraocular lens into the eyeball by pushing the intraocular lens into the eyeball from the distal end of the insertion tube portion inserted into the eyeball from the incision,
The intraocular lens includes a lens body and a plurality of support portions that support the lens body.
The plurality of support portions have a connection portion with the lens body on the outer periphery of the lens body, and a shape including a curve whose position changes in the circumferential direction as the distance from the center of the lens body increases.
Of the plurality of support portions, the connection portion is the closest to the pressing portion on the outer periphery of the lens body, and the tip of the support portion and the pressing portion are connected on the outer periphery of the lens body. The intraocular lens insertion device, wherein the intraocular lens is held in the storage portion so as to be located on the opposite side to the portion. The plurality of support portions have a shape including a curve whose position changes counterclockwise as viewed from the front side of the optical axis as it is away from the center of the intraocular lens,
Among the plurality of support portions, the connection portion is the closest to the pressing portion on the outer periphery of the lens body, and the pressing portion is on the downstream side in the clockwise direction when viewed from the optical axis front side with respect to the connection portion. The intraocular lens insertion device according to claim 1, wherein the intraocular lens is held in the storage portion so as to be positioned. The intraocular lens consists of a lens body and two support parts,
The connecting portion between the two support portions and the lens body is opposed to each other across the center of the lens body,
In the storage portion, a straight line connecting the connecting portions between the two support portions and the lens body, and the axis of the plunger intersect the straight line at a predetermined angle with respect to the straight line at the center of the lens body. The intraocular lens insertion device according to claim 1 or 2.   The intraocular lens insertion device according to claim 3, wherein the predetermined angle is an angle of not less than 30 degrees and not more than 60 degrees.   The intraocular lens is stored in the storage unit in a manufacturing process, and is a preset type that is distributed and used in a state in which the intraocular lens is stored in the storage unit. The intraocular lens insertion device according to any one of the above.

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