JP2017185054A - Extrusion mechanism of intraocular lens insertion tool and intraocular lens insertion tool having the mechanism - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an extrusion mechanism of an intraocular lens insertion tool that improves intraocular lens extrusion control by the intraocular lens insertion tool.SOLUTION: An extrusion mechanism includes a first attaching part to which a tool having a first moving part that moves by being pressed by a fluid can be attached, a second moving part that moves when pressed by the first moving part, a third moving part for moving a plunger of an intraocular lens insertion tool, and a transmission part for transmitting pressing force accompanying the movement of the second moving part to the third moving part. The third moving part is an extrusion mechanism that moves the plunger based on the pressing force transmitted by the transmission part.SELECTED DRAWING: Figure 6

Description

  The present invention relates to an extrusion mechanism used for an intraocular lens insertion device and an intraocular lens insertion device using the mechanism.

  Intraocular lenses that are inserted as a substitute for the crystalline lens to replace the human turbid crystalline lens and correct refraction in cataract treatment are in practical use. In intraocular lens insertion surgery in the treatment of cataracts, for example, a few millimeters of incision wound (incision) is provided at the edge of the cornea, cornea, etc. After removal, the intraocular lens is inserted and fixed by an intraocular lens insertion device. In recent years, a technique for assisting insertion of an intraocular lens into the eye using an intraocular lens insertion device has been proposed (for example, Patent Document 1).

JP 2004-261263 A

  In the above intraocular lens insertion device, by pushing the plunger of the syringe, the pushing member of the intraocular lens is moved using the pressure by which fluid such as air or liquid in the syringe is pushed, and the intraocular lens is moved. It is ejected from the tip of the intraocular lens insertion device.

  However, when the push member of the intraocular lens is moved by operating the syringe, the push force and push speed of the intraocular lens change according to the push force of the plunger. In particular, when a highly viscous viscoelastic material is used, the resistance at the time of extrusion increases, so a large extrusion force is required, and the instability of the extrusion operation increases. Further, the pushing force and pushing speed depend on the characteristics of the fluid compressed by the plunger in the syringe. For this reason, there is a possibility that the surgeon cannot properly control the movement of the pushing member of the intraocular lens.

  The technology of the present disclosure has been made in view of the above circumstances, and an object thereof is to provide an intraocular lens insertion device push-out mechanism that improves the intraocular lens push-out control by the intraocular lens insertion device. It is to be.

  The push-out mechanism of the intraocular lens insertion device of the present disclosure includes a first attachment portion that attaches a device having a first moving portion that moves when pressed by a fluid, and is pressed by the first moving portion. A second moving unit that moves, a third moving unit that moves the plunger of the intraocular lens insertion instrument, and a transmission unit that transmits the pressing force associated with the movement of the second moving unit to the third moving unit. The third moving unit moves the plunger based on the pressing force transmitted by the transmitting unit. Thereby, the pushing force and pushing speed with respect to the pushing member of the intraocular lens insertion device can be stabilized.

Preferably, the transmission unit is a lever member that can contact the second moving unit and the third moving unit and rotates around a predetermined axis, and the lever member is used to move the second moving unit. You may comprise so that it may rotate with it and a 3rd moving part may move by rotation of a lever member. Further, the third moving unit may be configured to contact the lever member at a portion between the second moving unit and a predetermined axis. Alternatively, the transmission unit connects the first rack gear that moves with the movement of the second moving unit, the second rack gear that moves with the movement of the third moving unit, and the first rack gear and the second rack gear. It has a pinion gear. Furthermore, the instrument may be a syringe having a plunger as a first moving part, and the second moving part and the third moving part may be packing capable of sliding along a pipe line in the housing.

  Moreover, it is good also as a structure which has further the 2nd attaching part which attaches the pushing mechanism of said intraocular lens insertion instrument to which an intraocular lens insertion instrument is attached. Thereby, the conventional intraocular lens insertion instrument can be used by being connected to the auxiliary tool of the present invention. Furthermore, you may comprise the intraocular lens insertion device by which the housing | casing provided with the extrusion mechanism of said intraocular lens insertion device and the intraocular lens insertion device are provided integrally.

  According to the technology of the present disclosure, it is possible to provide an intraocular lens insertion device push-out mechanism that improves the intraocular lens push-out control by the intraocular lens insertion device.

It is a figure which shows schematic structure of the intraocular lens in one Embodiment. It is a figure which shows schematic structure of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows schematic structure of the nozzle main body in one Embodiment. It is a figure which shows schematic structure of the positioning member in one Embodiment. It is a figure which shows schematic structure of the plunger in one Embodiment. It is a figure which shows schematic structure of the extrusion assistance tool of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows schematic structure of the insertion instrument fixing | fixed part of the pushing assistance tool of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows typically engagement with the pushing auxiliary | assistance tool and insertion instrument fixing | fixed part of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows schematic structure of the extrusion assistance tool of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows schematic structure of the extrusion assistance tool of the intraocular lens insertion instrument in one Embodiment. It is a figure which shows schematic structure of the extrusion assistance tool of the intraocular lens insertion instrument in one Embodiment. It is a table | surface which shows the pushing force and pushing speed of the plunger by the pushing assistance tool of the intraocular lens insertion device in the past, and the pushing force and pushing speed of the plunger by the pushing assistance tool of the intraocular lens insertion device in one Embodiment. It is a figure which shows schematic structure of the extrusion assistance tool of the conventional intraocular lens insertion instrument. It is a figure which shows schematic structure of the extrusion assistance tool of the intraocular lens insertion instrument in one modification. It is a figure which shows schematic structure of the intraocular lens insertion instrument in one modification.

  Embodiments in which the present invention is used in an intraocular lens insertion device will be described below with reference to the drawings.

FIG. 1 is a diagram showing a schematic configuration of an intraocular lens 2 inserted into a patient's eye by an intraocular lens insertion device according to the present embodiment. 1A is a plan view and FIG. 1B is a side view. Note that the orientation of the intraocular lens 2 does not correspond between FIGS. 1 (a) and 1 (b). The intraocular lens 2 is a so-called one-piece type, but a so-called three-piece type may be used. The intraocular lens 2 includes a lens body 2a having a predetermined refractive power, and two long flat plate-like support portions 2b connected to the lens body 2a for holding the lens body 2a in the eyeball. . The lens body 2a and the support portion 2b are made of a flexible resin material.

  In the present embodiment, in the intraocular lens insertion device 1 described later, one of the two support portions 2b is on the rear side of the lens body 2a, and the other support portion 2b is on the front side of the lens body 2a. The intraocular lens 2 is set on the stage unit 12 so as to be disposed. In addition, let the support part arrange | positioned at the front side of the lens main body 2a be a front support part, and let the support part arrange | positioned at the rear side of the lens main body 2a be a back support part.

  In the intraocular lens 2 in the present embodiment, the support portion 2b is subjected to a textured process. Thereby, when the intraocular lens 2 is pressed and moved by the plunger 30, the posture of the intraocular lens 2 can be stabilized. Specifically, for example, when the intraocular lens 2 is pressed and moved by the plunger 30, an appropriate frictional force is generated between the support portion 2 b and the inner wall surface of the nozzle body 10, whereby the intraocular lens 2 is moved to the nozzle. It can be prevented from rotating in the main body 10. In addition, since the support portion 2b is subjected to the embossing process, the support portion 2b can be prevented from sticking to the lens body 2a when the intraocular lens 2 is folded in the nozzle body 10. Furthermore, in the present embodiment, as shown in FIG. 1B, a flat portion 2c is provided in the peripheral portion of the lens body 2a of the intraocular lens 2, that is, the connecting portion between the lens body 2a and the support portion 2b, and the front optical By adopting a configuration in which the effective optical part diameter of the part is reduced, the center thickness of the lens is reduced, the sectional area of the lens is also reduced, and a thin lens shape is realized.

  FIG. 2 shows a schematic configuration of an intraocular lens insertion device 1 used for inserting the intraocular lens of the present embodiment into the eye. 2A is a plan view of the intraocular lens insertion device 1 when the stage lid 13 is opened, and FIG. 2B is a side view of the intraocular lens insertion device 1 when the stage lid 13 is closed. The figure is shown. The nozzle body 10 of the intraocular lens insertion device 1 is a cylindrical member having a substantially rectangular cross section, and a rear end portion 10b that is largely open at one end portion and an insertion tube that is narrowed to the other end portion. The nozzle part 15 as the part 100 and the front-end | tip part 10a are provided. As shown in FIG. 2 (b), the tip 10a is opened obliquely. The plunger 30 is inserted into the nozzle body 10 and can reciprocate. The plunger 30 corresponds to an example of an extrusion member.

  In the following description, the direction from the rear end portion 10b of the nozzle body 10 to the front end portion 10a is the front direction, the opposite direction is the rear direction, the front side of the page in FIG. 2A is the upper direction, and the reverse direction is the lower direction. In FIG. 2B, the front side of the page is the left direction, and the opposite direction is the right direction. In this case, the upper side is the front side of the optical axis of the lens body 2a, which will be described later, the lower side is the rear side of the optical axis of the lens body 2a, the front side is the front side in the pressing direction by the plunger 30, and the rear side is pressed by the plunger 30 Corresponds to the rear side.

  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. A stage portion 12 for setting the intraocular lens 2 is provided on the rear side of the nozzle portion 15 in the nozzle body 10. The stage portion 12 opens to the upper side of the nozzle body 10 by opening the stage lid portion 13. Further, a positioning member 50 is attached to the stage portion 12 from the lower side of the nozzle body 10. With this positioning member 50, the intraocular lens 2 is stably positioned on the stage portion 12 even before use (during transportation).

  That is, in the intraocular lens insertion instrument 1, the intraocular lens 2 is placed on the stage unit 12 in front of the optical axis while the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12 at the time of manufacture. Set with the side up. Then, after the stage lid 13 is closed, it is shipped and sold. Furthermore, at the time of use, the user inserts the needle into the stage portion 12 through the needle hole 20a of the insertion portion 20 through the needle hole 20a of the insertion portion 20 and injects the lubricant. Then, the user removes the positioning member 50 with the stage lid portion 13 closed, and then pushes the plunger 30 into the distal end side of the nozzle body 10.

  As a result, the intraocular lens 2 is pressed by the plunger 30 and moved to the nozzle part 15, and then the intraocular lens 2 is released into the eyeball from the distal end part 10 a. In addition, the nozzle main body 10, the plunger 30, and the positioning member 50 in the intraocular lens insertion device 1 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.

  In addition, a confirmation window portion 17 is formed on a part of the stage lid portion 13 by forming a thin portion. Note that how thin the confirmation window 17 in the stage lid 13 should be determined as appropriate based on the material forming the stage lid 13 and the visibility of the intraocular lens from the confirmation window 17. Good. In addition, by forming the confirmation window portion 17, an effect of reducing sink marks when the stage lid portion 13 is molded can be expected.

  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 12. In this state, the intraocular lens 2 is pressed by the plunger 30 and is released from the distal end portion 10a. 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 released, the intraocular lens 2 is deformed according to 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 is discharged after being transformed into a shape.

  Moreover, the front-end | tip part 10a becomes what is called a bevel cut shape cut diagonally so that the area | region of the upper side of the nozzle part 15 may become a front side rather than the area | region of a lower side. In addition, although the detail of the front-end | tip of the nozzle part 15 which concerns on this embodiment is mentioned later, about the shape cut diagonally of this front-end | tip part 10a, it may be cut diagonally diagonally seeing from the left-right direction. However, it may be cut obliquely so as to have a bulge on the outside, that is, a curved shape.

  A stage groove 12 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 12. The dimension in the front-rear direction of the stage groove 12 a is set to be larger than the maximum width dimension including the support portions 2 b extending on both sides of the intraocular lens 2. Further, a set surface 12b, which is a mounting surface for the intraocular lens, is formed by the bottom surface of the stage groove 12a. The vertical position of the set surface 12b is set higher than the height position of the bottom surface of the through hole 10c of the nozzle body 10, and the set surface 12b and the bottom surface of the through hole 10c are connected by a bottom slope 10d. .

  The stage unit 12 and the stage lid unit 13 are formed integrally. The stage lid portion 13 has the same size in the front-rear direction as the stage portion 12. The stage lid portion 13 is connected by a thin plate-like connecting portion 14 formed by extending the side surface of the stage portion 12 to the stage lid portion 13 side. The connecting portion 14 is formed to be bendable at the center portion, and the stage lid portion 13 can be closed by overlapping the stage portion 12 from above by bending the connecting portion 14.

In the stage lid portion 13, ribs 13 a and 13 b for reinforcing the stage lid portion 13 and stabilizing the position of the intraocular lens 2 are provided on the surface facing the set surface 12 b when the lid is closed, and the upper side of the plunger 30. A guide protrusion 13c is provided as a guide. The stage lid portion 13 is provided with a needle hole 20a as an insertion hole for injecting hyaluronic acid into the stage portion 12 with a syringe before the operation of inserting the intraocular lens 2 into the eyeball. The needle hole 20 a is a hole that connects the outside of the stage unit 12 and the intraocular lens 2 housed in the stage unit 12 when the stage lid unit 13 is closed. The user inserts the needle of the syringe through the needle hole 20a before inserting the intraocular lens 2 and supplies hyaluronic acid, which is a viscoelastic substance, to a required position in the stage unit 12.

  A positioning member 50 is detachably provided below the set surface 12b of the stage unit 12. FIG. 4 shows a schematic configuration of the positioning member 50. FIG. 4A shows a plan view of the positioning member 50, and FIG. 4B shows a left side view of the positioning member 50. 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 projecting upward are formed inside the side wall portions 51 and 51. Further, first positioning portions 55 and 55 are formed to protrude from the outer peripheral side of the upper end surfaces of the first placement portions 54 and 54. The distance between the inner sides of the first positioning portions 55 and 55 is set slightly larger than the diameter of the lens body 2 a of the intraocular lens 2.

  In addition, a pair of second placement portions 56 and 56 protruding upward are formed inside the side wall portions 51 and 51. The heights of the upper surfaces of the second mounting parts 56 and 56 are equal to the heights of the upper surfaces of the first mounting parts 54 and 54. Furthermore, second positioning portions 57 and 57 that protrude further upward are formed on the outer portions of the upper surfaces of the second placement portions 56 and 56 over the entire left and right direction of the second placement portions 56 and 56. . The distance between the inner sides of the second positioning portions 57 and 57 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 2.

  Further, a third placement portion 58 on which a part of the front support portion of the support portion 2 b of the intraocular lens 2 is placed is formed inside the side wall portions 51, 51. Further, a third positioning portion 59 that protrudes further upward from the third placement portion 58 is formed. A part of the front support part comes into contact with the third positioning part 59. And the 4th mounting part 60 in which a part of back support part is mounted among the support parts 2b of the intraocular lens 2 is formed inside the side wall parts 51 and 51. As shown in FIG. Furthermore, the 4th positioning part 61 which protrudes further upwards from the 4th mounting part 60 is formed. A part of the rear support part comes into contact with the fourth positioning part 61. In addition, as shown in FIG.4 (b), the height of the upper surface of the 4th mounting part 60 and the 4th positioning part 61 is higher than the height of the upper surface of the 1st-3rd mounting part and the 1st-3rd positioning part. Is also provided to be low. On the other hand, on the outside of the side wall portions 51, 51, a rotation preventing wall portion 62 for preventing unnecessary rotation when the positioning member 50 is removed is provided.

  The positioning member 50 is assembled from below the set surface 12 b of the nozzle body 10. The set surface 12b of the nozzle body 10 is formed with a set surface through hole 12c that penetrates the set surface 12b in the thickness direction. The outer shape of the set surface through-hole 12c is substantially similar to the shape of the first to fourth placement portions and the first to fourth positioning portions of the positioning member 50 as viewed from above. When the positioning member 50 is attached to the nozzle body 10, the first to fourth placement portions and the first to fourth positioning portions are inserted into the set surface through hole 12c from the lower side of the set surface 12b, and the set surface It protrudes above 12b.

When the intraocular lens 2 is set on the setting surface 12b, 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 Also,
The position of the lens body 2a is restricted with respect to the horizontal direction (the direction horizontal to the set surface 12b) by the first positioning portions 55 and 55 and the second positioning portions 57 and 57. Furthermore, the two support portions 2b of the intraocular lens 2 are placed on the upper surfaces of the third placement portion 58 and the fourth placement portion 60, respectively. Further, the positions of the two support portions 2b are restricted with respect to the horizontal direction by the third positioning portion 59 and the fourth positioning portion 61, respectively.

  FIG. 5 shows a schematic configuration of the plunger 30. The plunger 30 has a slightly larger longitudinal length 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.

  A cutout portion 31 c is formed at the distal end portion of the action portion 31. As can be seen from FIG. 5B, the notch 31 c is formed in a groove shape that opens downward in the action portion 31 and penetrates in the left-right direction. Further, as can be seen from FIG. 5B, the groove wall on the distal end side of the cutout portion 31 c is formed with an inclined surface that goes downward as it goes to the distal end side of the action portion 31.

  In addition, slits 31d and 31f are formed in the middle of the front and rear direction of the left and right flat portions 31b and in the vicinity of the base end. The slits 31d and 31f are formed to have a substantially L shape including a cut extending in the left-right direction and a cut extending in the front-rear direction. Moreover, movable pieces 31e and 31g are formed in the flat part 31b by forming slits 31d and 31f. The movable pieces 31e and 31g perform a so-called axis deviation prevention function so that the cylindrical portion 31a is positioned at the center in the left-right direction of the nozzle body 10 when the plunger 30 moves in the nozzle body 10. In the present embodiment, two pairs of movable pieces 31e and 31g are formed, but only one pair or three or more pairs may be formed.

  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 a portion of the insertion portion 32 that is ahead of the center in the front-rear direction. When the plunger 30 is inserted into the nozzle body 10, the locking hole 10e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32a are engaged. The relative position between the nozzle body 10 and the plunger 30 in the initial state is determined. It should be noted that the claw portion 32a and the locking hole 10e are formed at the positions where the distal end of the action portion 31 is located on the rear side of the lens body 2a of the intraocular lens 2 set on the stage portion 12 in the engaged state. The support portion 2b on the rear side of the main body 2a is set so that the cutout portion 31c can be supported from below. Also in the insertion part 32, a substantially L-shaped slit composed of a notch extending in the left-right direction and a notch extending in the front-rear direction may be formed, similarly to the slits 31d and 31f. The slit formed in the insertion portion 32 in this way also functions to prevent the axis deviation of the plunger 30.

  6 to 11 illustrate a schematic configuration of the push-out assisting tool 70 of the intraocular lens insertion device 1 according to this embodiment. The push-out assisting tool 70 corresponds to an example of a push-out mechanism. The extrusion assisting tool 70 has a housing 79 formed of a resin material such as polypropylene. The push-out assisting tool 70 has an opening 71 that communicates with the opening 210 on the rear end side of the syringe 200 of the syringe barrel, and an opening 72 through which the intraocular lens insertion device 1 is inserted. The syringe 200 is provided with a packing 220 slidably on the inner wall of the syringe 200. A plunger 230 is connected to the packing 220. The plunger 230 corresponds to an example of a first moving unit. The syringe 200 corresponds to an example of a moving member having a first moving unit that is moved by the pressure of the fluid.

  Further, the extrusion assisting tool 70 is provided with a pipe portion 73 which is a through passage having an opening 71 at one end. The pipe portion 73 is provided so as to penetrate the extrusion assisting tool 70, and has an opening 74 at the other end of the opening 71. Moreover, the cross-sectional area of the cross section by the plane perpendicular | vertical to the extending | stretching direction (paper surface up-down direction) is substantially constant. In this embodiment, although the cross-sectional shape of the pipe part 73 assumes a circle, the cross-sectional shape is not limited to this.

Furthermore, slits 75 and 76 extending in the extending direction are formed on the inner wall of the tube portion 73.
As will be described later, the slits 75 and 76 are provided so that the lever member 77 can pass therethrough. The lever member 77 corresponds to an example of a transmission unit. The lever member 77 can rotate in the direction of the arrow 77b in the push-out assisting tool 70 about the central axis 77a. Further, the pipe portion 73 is provided with a moving member 78 between the opening 71 and the lever member 77 at the initial position. FIG. 6 shows a schematic configuration of the moving member 78. The moving member 78 is slidably in contact with the inner wall of the pipe portion 73. The moving member 78 has a conical portion 78a, and a projection 78b is provided at the apex of the conical portion 78a. The protrusion 78b is configured to make substantially point contact with the lever member 77. The moving member 78 corresponds to an example of a second moving unit.

  Further, the extrusion assisting tool 70 is provided with a pipe portion 81 having an opening 72 at one end. The opening 72 is provided with an engaging portion 72a that engages with a claw portion 85d of an insertion instrument fixing portion 85 described below. The engaging portion 72a corresponds to an example of a first attachment portion. The engaging portion 72a is a slit into which the claw portion 85d can be fitted. Unlike the pipe part 78, the other end of the opening 72 of the pipe part 81 is closed by the wall part 82 of the push-out assisting tool 70. Further, the cross-sectional area of the cross section by a plane perpendicular to the extending direction of the pipe portion 81 (up and down direction on the paper surface) is substantially constant. In this embodiment, the cross-sectional shape of the pipe part 81 assumes a circle, but the cross-sectional shape is not limited to this.

Furthermore, slits 83 and 84 extending in the extending direction are formed on the inner wall of the tube portion 81.
As will be described later, the slits 83 and 84 are provided so that the lever member 77 can pass therethrough. Further, a moving member 86 is provided between the opening 72 and the lever member 77 at the initial position in the pipe portion 81. The moving member 86 is slidably in contact with the inner wall of the pipe portion 81. The moving member 86 has a conical portion 86a, and a protrusion 86b is provided at the apex of the conical portion 86a. The protrusion 86b is configured to make substantially point contact with the lever member 87. The moving member 86 corresponds to an example of a third moving unit.

  In the present embodiment, the plunger 30 of the intraocular lens insertion device 1 is inserted through the opening 72, and the pressing plate portion 33 at the rear end of the plunger 30 is received by the plunger receiving portion 86 c of the moving member 86. Plunger receiving portion 86c has a recess into which pressing plate portion 33 of plunger 30 is fitted. Further, an insertion instrument fixing portion 85 for fixing the intraocular lens insertion instrument 1 to the push-out assisting tool 70 is attached to the opening 72.

  As shown in FIG. 7, the insertion instrument fixing portion 85 has a partial cylindrical portion 85a having a substantially C-shaped cross section in a plane perpendicular to the longitudinal direction. The partial cylindrical portion 85 a is formed so as to be insertable into the tube portion 81. Moreover, the hollow part 85b which can accommodate the nozzle main body 10 and the plunger 30 of the intraocular lens insertion instrument 1 is formed in the partial cylindrical part 85a. The partial cylindrical portion 85a is formed with a slit 85c through which the hold portion 11 of the intraocular lens insertion device 1 is inserted. Furthermore, a claw portion 85d that protrudes toward the outside of the side surface is formed on a part of the side surface of the partial cylindrical portion 85a.

FIG. 8 is a partial cross-sectional view of the extrusion assisting tool 70, the insertion instrument fixing portion 85, the plunger 30 of the intraocular lens insertion instrument, and the nozzle body 10. FIG. 8 schematically shows a state in which the insertion instrument fixing portion 85 is fixed to the push-out auxiliary tool 70. When the partial cylindrical portion 85 a is inserted into the tube portion 81, the claw portion 85 d comes into contact with the housing 79. Further, when the partial cylindrical portion 85a is pushed into the tube portion 81, the claw portion 85d pushes up a part of the housing 79 in contact with the claw portion 85d in the direction indicated by the arrow 79a, and the claw portion 85d is engaged with the engaging portion 72a. Engage with the slit. Thereby, the insertion instrument fixing | fixed part 85 is fixed with respect to the extrusion assistance tool 70. FIG. In the present embodiment, the insertion instrument fixing portion 85 is cylindrical, but the shape may be determined appropriately in terms of design in relation to the shape of the intraocular lens insertion instrument used. For example, the hollow instrument 85b It is also conceivable that the portion has a rectangular shape instead of a cylinder.

  In the present embodiment, as shown in FIG. 9, the syringe 200 is fixed to the extrusion assisting tool 70 by the syringe fixing unit 80. The syringe fixing unit 80 corresponds to an example of a second attachment unit. The syringe fixing unit 80 corresponds to an example of an attachment unit that attaches the moving member to the housing. The syringe fixing portion 80 has a flange engaging portion 80 a that engages with a part of the rear end side of the syringe 200, for example, the flange 230. When the flange 230 is engaged with the flange engaging portion 80 a and the syringe fixing portion 80 is attached to the extrusion assisting tool 70, the syringe 200 is fixed to the extrusion assisting tool 70. When the syringe 200 is fixed to the push-out auxiliary tool 70 by the syringe fixing unit 80, the opening 210 and the opening 71 on the rear end side of the syringe 200 communicate with each other.

  Next, the operation of each part of the extrusion assisting tool 70 will be described with reference to FIGS. In the present embodiment, as shown in FIG. 9, the syringe 200 is fixed to the extrusion assisting tool 70 by the syringe fixing unit 80. Further, the holding unit 11 of the intraocular lens insertion device 1 is inserted through the slit 85 c of the insertion device fixing unit 85, and the insertion device fixing unit 85 is attached to the intraocular lens insertion device 1. Then, the insertion instrument fixing portion 85 is inserted into the pipe line 81 from the opening 72 of the extrusion assisting tool 70, and the insertion instrument fixing section 85 becomes the extrusion assisting tool 70 by the engaging portion 72a of the claw portion 85d and the opening 72. It is fixed against. Further, the pressing plate portion 33 of the plunger 30 of the intraocular lens insertion device 1 is fitted into the plunger receiving portion 86 c of the moving member 86.

  Next, when fluid is supplied to the syringe 200 from the fluid supply unit 250 provided at the tip of the syringe 200, the packing 220 slides toward the opening 210 at the rear end of the syringe 200 by the fluid. As the packing 220 moves, the plunger 230 moves into the pipe 73 of the push-out assisting tool 70, and the pressing plate portion 240 contacts the moving member 78.

  Further, when the fluid is supplied to the syringe 200, the plunger 230 moves the moving member 78 toward the opening 74. Then, as shown in FIG. 9, the protrusion 78 b of the moving member 78 comes into substantially point contact with the lever member 77. Furthermore, with the movement of the moving member 78, the lever member 77 rotates in the direction of the arrow 77b about the rotation shaft 77a.

  When the lever member 77 rotates, the moving member 86 is moved toward the opening 72 by the lever member 77 as shown in FIG. As the moving member 86 moves, the plunger 30 is moved to the distal end side of the intraocular lens insertion device 1, and the intraocular lens housed in the intraocular lens insertion device 1 by the plunger 30 is moved into the intraocular lens insertion device. 1 is moved to the tip side. Further, when the fluid is supplied to the syringe 200, the plunger 30 is further moved to the distal end side of the intraocular lens insertion device 1, the intraocular lens is moved to the distal end side of the intraocular lens insertion device 1, and the intraocular lens. It is injected from the tip of the insertion instrument 1.

FIG. 12 is a table showing the relationship between the pushing force (N) and the pushing speed when the plunger 500 of the intraocular lens insertion device 300 is moved using the conventional pushing aid 400 illustrated in FIG. It is.

  As shown in FIG. 13, in the conventional example, the pushing assisting tool 400 is attached to the holding part 320 of the intraocular lens insertion device 300 by the engaging part 410. The syringe 420 of the push-out assisting tool 400 is provided with a packing 430 that can slide on the inner wall of the syringe 420, and the packing 430 is moved to the plunger 500 side by the fluid supplied from the outside via the fluid supply unit 440. Moving. As a result, the packing 430 comes into contact with the plunger 500, and the plunger 500 is moved to the distal end side of the intraocular lens insertion device 300 as the packing 430 moves.

  As shown in FIG. 12, when the plunger 420 is pushed out with the capacity of the syringe 420 set to M and the supply air pressure (Pa) set to P, in the conventional example, the supplied fluid is supplied to the plunger 500 via the packing 430. Assume that the pushing force applied is F, and the pushing speed of the plunger 500 is V. On the other hand, when the above-described M and P perform the extrusion operation in the embodiment of the present application, the extrusion force becomes 2F and the extrusion speed becomes 0.5 V, and the extrusion force and the extrusion speed can be changed. In the conventional example, it is generally difficult to set both the pushing force and the pushing speed of the plunger 500 to preferable values even if the capacity of the syringe and the supply air pressure are adjusted.

  However, by using the extrusion assisting tool 70 of this embodiment, even if the capacity M of the syringe 420 and the supply air pressure (Pa) P are fixed, the pushing force or pushing speed of the plunger 30 is set to a preferable value. Therefore, it can be expected that the insertion of the intraocular lens into the patient's eye using the intraocular lens insertion device 1 can be performed more smoothly than in the past.

  Although the above description is related to the present embodiment, the push-out mechanism of the present invention is not only a fluid-controlled intraocular lens insertion device, but also a manually controlled intraocular lens insertion device and a viscoelastic material used when inserting an intraocular lens. It can also be used as a syringe for injecting the blood. Especially when using a highly viscous viscoelastic substance, the operation of the syringe becomes heavy. Therefore, it is effective to attach an auxiliary device such as the present invention to a syringe for injecting a viscoelastic substance so that it can be used with a light operational feeling. Is.

  Note that the configuration of the push-out assisting tool and the like is not limited to the above-described embodiment, and various modifications can be made within a range that does not lose the same technical idea as the present invention. For example, in the above-described embodiment, the push-out assisting tool 70 is configured to move the plunger 30 of the intraocular lens insertion device 1 using the movements of the moving members 78 and 86 and the lever member 77. As in the modification shown in FIG. 14, the plunger 30 may be moved as a mechanism for decelerating using a configuration in which a rack gear and pinion gears having different sizes are combined. 14 corresponds to the state of the push assist tool 70 shown in FIG. Moreover, in this modification, the same code | symbol is attached | subjected about the structure corresponding to said embodiment, and detailed description is abbreviate | omitted.

  The extrusion assisting tool 700 has a configuration in which rack gears 710 and 740 and pinion gears 720 and 730 are combined instead of the lever member 77 of the extrusion assisting tool 70 in the above-described embodiment. A configuration in which the rack gears 710 and 740 and the pinion gears 720 and 730 are combined corresponds to an example of the transmission unit. The moving member 78 and the rack gear 710 are integrally joined, and the pinion gear 730 uses a larger one than the pinion gear 720 to form a speed reduction mechanism, and the joint 750 between the moving member 78 and the rack gear 710 is used. Is formed so as to pass through the slit 76. Further, the moving member 86 and the rack gear 740 are integrally joined, and a joint portion 760 between the moving member 86 and the rack gear 740 is formed so as to pass through the slit 84.

  Therefore, when the fluid is supplied to the syringe 200 and the moving member 78 moves to the opening 74 side by the plunger 230, the rack gear 710 moves with the movement of the moving member 78, and the pinion gear 720 that meshes with the rack gear 710 rotates. Further, as the pinion gear 720 rotates, the pinion gear 730 that meshes with the pinion gear 720 rotates, and the rack gear 740 that meshes with the pinion gear 730 moves to the opening 72 side. As the rack gear 730 moves, the moving member 86 also moves toward the opening 72, and the plunger 30 moves toward the distal end side of the intraocular lens insertion device 1.

  Further, by appropriately changing the number of teeth and dimensions of the rack gears 710 and 740 and the pinion gears 720 and 730, the pushing force and pushing speed with respect to the plunger 30 can be set as shown in FIG. Further, the number of rack gears and pinion gears is not limited to the example shown in FIG. Therefore, both the push-out force and push-out speed of the plunger 30 can be set to preferable values by the push-out assisting tool 700 of the present modification, and the intraocular lens using the intraocular lens insertion device 1 can be set in the patient's eye. It can be expected that the insertion into can be performed more smoothly than in the past.

  Further, in the above example, the example in which the push-out assisting tool is connected to a conventional intraocular lens insertion device has been described. However, as schematically shown in FIG. 15, the push-out assisting tool 70 and the intraocular lens are used. The insertion device 1 </ b> A may be provided integrally, and the above-described mechanism of the push-out assisting tool and the intraocular lens insertion device may be configured integrally. Furthermore, it may be a so-called preload type product in which an intraocular lens is loaded in advance on an intraocular lens insertion device and sold.

DESCRIPTION OF SYMBOLS 1 Intraocular lens insertion instrument 2 Intraocular lens 30 Plunger 70, 700 Extrusion auxiliary tool 78, 86 Moving member 77 Lever member 200 Syringe 710, 740 Rack gear 720, 730 Pinion gear

Claims (8)

A first attachment portion for attaching an instrument having a first moving portion that moves when pressed by a fluid;
A second moving part that moves by being pressed by the first moving part;
A third moving unit for moving the plunger of the intraocular lens insertion device;
A transmission unit for transmitting a pressing force accompanying the movement of the second moving unit to the third moving unit;
Have
The third moving unit moves the plunger based on the pressing force transmitted by the transmitting unit, and the pushing mechanism of the intraocular lens insertion device. The transmission unit is a lever member that can contact the second moving unit and the third moving unit and rotates around a predetermined axis;
2. The intraocular lens according to claim 1, wherein the lever member is rotated in accordance with the movement of the second moving unit, and the third moving unit is moved by the rotation of the lever member. Extrusion mechanism for the insertion tool.   3. The push-out of the intraocular lens insertion device according to claim 2, wherein the third moving unit abuts on the lever member at a portion between the second moving unit and the predetermined axis. mechanism.   The transmission unit includes a first rack gear that moves with the movement of the second moving unit, a second rack gear that moves with the movement of the third moving unit, the first rack gear, and the second rack gear. The push-out mechanism of the intraocular lens insertion device according to claim 1, further comprising a pinion gear that connects the two to each other.   5. The push-out mechanism for an intraocular lens insertion device according to claim 1, wherein the mechanism is a syringe having a plunger as the first moving part. 6.   6. The intraocular lens according to claim 1, wherein the second moving unit and the third moving unit are packings capable of sliding along a pipe line in the housing. Extrusion mechanism for the insertion tool.   The push-out mechanism for an intraocular lens insertion device according to any one of claims 1 to 6, further comprising a second mounting portion for mounting the intraocular lens insertion device.   An intraocular lens comprising: a housing including the push-out mechanism for the intraocular lens insertion device according to any one of claims 1 to 6; and the intraocular lens insertion device. Insertion instrument.

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