JP2018198748A - Intraocular lens insertion instrument - Google Patents

Abstract

To provide an intraocular lens insertion instrument in which the regurgitation of perfusate to the intraocular lens insertion instrument can be prevented in intraocular lens insertion surgery for forming an intraocular anterior chamber space by using the liquid having viscosity being lower than a viscoelastic substance as the perfusate.SOLUTION: An intraocular lens insertion instrument is configured by having: a substantially cylindrical insertion member for intraocular insertion; an intraocular lens pushing member 30 for pushing the intraocular lens and moving it in the insertion member, and pushing the intraocular lens in the eye from the insertion member; and a closing member 31d for closing the gap between the insertion member and the intraocular lens pushing member, when the intraocular lens is pushed in the eye by the intraocular lens pushing member.SELECTED DRAWING: Figure 5

Description

  The present invention relates to an intraocular lens insertion device capable of preventing a backflow of perfusate immediately after an intraocular lens is ejected by closing a distal end opening with an elastic member.

  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, an incision wound (incision) of several millimeters is created at the edge of the cornea, cornea, etc., and the lens is crushed by ultrasonic emulsification and the like and removed from the incision. After that, the intraocular lens is inserted and fixed by the intraocular lens insertion device.

  In addition, a technique for expanding the lens capsule using a balanced salt solution (BSS) or the like as a perfusate instead of a viscoelastic substance has been proposed. When the viscoelastic substance remains in the eye, there is a possibility that high intraocular pressure is caused after the operation. However, since BSS is lower in viscosity than the viscoelastic substance, such a phenomenon is unlikely to occur. Moreover, since BSS is cheaper than a viscoelastic substance, it can also be expected to reduce the operation cost. And the technique which assists the insertion of the intraocular lens in the eye by the intraocular lens insertion instrument using said perfusate is proposed.

International Publication No. 2008/149978 International Publication No. 2012/018006 Japanese National Patent Publication No. 11-514278

  In intraocular lens insertion surgery in which a liquid such as BSS having a lower viscosity than a viscoelastic substance is used as a perfusate to form an anterior chamber space in the eye, the intraocular lens is inserted immediately after the intraocular lens is inserted into the eye. Since the perfusate flows backward into the intraocular lens insertion device from the distal end opening of the insertion device, the backflowed perfusate may leak from holes or gaps provided in the intraocular lens insertion device, thereby contaminating the surgical field. In addition, as a result of the perfusion fluid flowing backward from the eye to the intraocular lens insertion device, it becomes difficult to reduce the intraocular lens inserted into the eye when the formation of the anterior chamber space becomes insufficient and the intraocular pressure decreases. there is a possibility.

  The technology of the present disclosure has been made in view of the above circumstances, and an object thereof is to form an anterior chamber space in an eye using a liquid having a lower viscosity than a viscoelastic substance as a perfusate. It is an object of the present invention to provide an intraocular lens insertion device capable of preventing the backflow of perfusate to the intraocular lens insertion device in an inner lens insertion operation.

  The intraocular lens insertion device of the present disclosure includes a substantially cylindrical insertion member that is inserted into the eye, an eye that presses the intraocular lens to move the insertion member, and pushes the intraocular lens into the eye from the insertion member. An inner lens pushing member and a closing member that closes a gap between the insertion member and the intraocular lens pushing member when the intraocular lens is pushed into the eye by the intraocular lens pushing member. Thus, when the surgeon operates the intraocular lens pushing member to insert the intraocular lens into the eye, the blocking member can suppress the possibility that a liquid such as BSS having a low viscosity will flow back into the insertion member. it can.

  Further, the occlusion member may be a substantially annular member that abuts on the outer peripheral surface of the intraocular lens pushing member. Further, the closing member may be provided in a groove formed on the outer peripheral surface of the intraocular lens pushing member. Moreover, the groove part may be formed so that the closing member can move in the groove part. Furthermore, a control member that controls the movement of the closing member when the intraocular lens is pushed into the eye by the intraocular lens pushing member and maintains the gap closed by the closing member may be provided in the groove portion.

  According to the technique of the present disclosure, in the intraocular lens insertion operation in which an anterior chamber space in the eye is formed using a liquid having a viscosity lower than that of the viscoelastic substance as the perfusate, the perfusion liquid is reversely flowed to the intraocular lens insertion device. An intraocular lens insertion device that can be prevented can be provided.

Fig.1 (a) and FIG.1 (b) are figures which show an example of a structure of the intraocular lens insertion instrument in one Embodiment. FIG. 2A and FIG. 2B are diagrams illustrating an example of the configuration of an intraocular lens according to an embodiment. It is a figure which shows an example of a structure of the nozzle main body in one Embodiment. FIG. 4A and FIG. 4B are diagrams showing an example of the configuration of the positioning member in one embodiment. Fig.5 (a)-FIG.5 (d) are figures which show an example of a structure of the plunger in one Embodiment. Fig.6 (a)-FIG.6 (d) are figures which show an example of a structure of the plunger in a 1st modification. Fig.7 (a)-FIG.7 (d) are figures which show an example of a structure of the plunger in a 2nd modification. Fig.8 (a)-FIG.8 (d) are figures which show an example of a structure of the plunger in a 3rd modification.

  Embodiments of the present invention will be described below with reference to the drawings.

  FIG. 1 shows a schematic configuration of an intraocular lens insertion device 1 used for inserting the intraocular lens of the present embodiment into the eye. 1A is a plan view of the intraocular lens insertion instrument 1 when the stage lid 13 is opened, and FIG. 1B is a side view of the intraocular lens insertion instrument 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.1 (b), the front-end | tip part 10a is opening diagonally. The plunger 30 is inserted into the nozzle body 10 and can reciprocate. The nozzle body 10 is an example of an insertion member, and the plunger 30 is an example of an intraocular lens pushing member.

  In the following description, the direction from the rear end 10b of the nozzle body 10 to the front end 10a is the front direction, the opposite direction is the rear direction, the front side of the page in FIG. 1A is the upper direction, and the reverse direction is the lower direction. In FIG. 1B, 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.

In the vicinity of the rear end portion 10b of the nozzle body 10, there is integrally provided a holding portion 11 that protrudes like a plate and can be hooked by the operator when the plunger 30 is pushed into the distal end side of the nozzle body 10. It has been. 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 is configured such that the upper side of the nozzle body 10 is opened 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. By this positioning member 50, the intraocular lens 2 is stably held in 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. Then, the user wets the lens with a viscoelastic substance or a perfusate while the stage lid 13 is closed, and then removes the positioning member 50 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 portion 15, and then the intraocular lens 2 is released into the eye from the distal end portion 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, the intraocular lens insertion device 1 according to the present embodiment is a preset type in which the intraocular lens 2 is set in advance in the intraocular lens insertion device 1 before shipment. May be a so-called separate type that is set in the intraocular lens insertion device 1.

  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. 2 is a diagram illustrating a schematic configuration of the intraocular lens 2 according to the present embodiment. 2A is a plan view and FIG. 2B is a side view. Note that the orientation of the intraocular lens 2 does not correspond between FIGS. 2 (a) and 2 (b). The intraocular lens 2 is a so-called one-piece type in which the lens main body and the support portion are integrally formed of the same material, and the lens material is a flexible resin material. 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. . Further, the lens body 2a and the support portion 2b are connected to each other via a joint portion 2d. In addition, although the intraocular lens 2 in this embodiment is demonstrated as a one-piece type, the lens main body and the support part may be a three-piece type formed of a different material.

  In the present embodiment, in the intraocular lens insertion device 1, one support portion 2b of the two support portions 2b is disposed on the rear side of the lens body 2a, and the other support portion 2b is disposed on the front side of the lens body 2a. As described above, the intraocular lens 2 is set on the stage unit 12. 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 folded in the nozzle main body 10, it can also prevent that the support part 2b sticks to the lens main body 2a.

  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 front end side through hole 10 c and a rear end side through hole 10 f whose cross-sectional shape changes in accordance with a change in the outer shape of the nozzle main body 10 are provided inside the nozzle main body 10. The through hole 10c is a hole that becomes a part of the movement path when the intraocular lens 2 is pressed and moved, and the through hole 10f is a hole through which the plunger 30 is inserted. When the intraocular lens 2 is released, the intraocular lens 2 is deformed and folded according to the change in the cross-sectional shape of the through hole 10c in the nozzle body 10, and is created on the patient's eyeball. It is released after being transformed into a shape that is easy to enter an incision.

  Further, the tip portion 10a of the nozzle body 10 has a shape cut obliquely so that the upper region of the nozzle portion 15 is in front of the lower region. Note that the shape of the tip portion 10a that is obliquely cut may be linearly obliquely cut when viewed from the left-right direction, or may have a bulge outward, that is, a curved shape. It may be cut into

  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 and 2 b extending on both sides of the intraocular lens 2. A set surface 12b 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 10f of the nozzle body 10, and the set surface 12b and the bottom surface of the through hole 10f 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 part 13, ribs 13 a and 13 b are provided on the surface facing the set surface 12 b when the lid is closed in order to reinforce the stage lid part 13 and stabilize the position of the intraocular lens 2. Further, a guide protrusion 13 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 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. A holding part 53 is formed at the lower end of the side wall part 51 so as to extend outward.

  And the 1st mounting part 54 and the 2nd mounting part 63 which protruded to the upper side are formed inside the side wall parts 51 and 51. As shown in FIG. Further, a first positioning portion 55 is formed on the outer peripheral side of the upper end surface of the first placement portion 54 so as to protrude. In addition, a pair of second positioning portions 64 for positioning the lens body 2 a and the support portion 2 b of the intraocular lens 2 are formed to protrude from the upper end surface of the second placement portion 63. The distance between the first positioning portion 55 and the second positioning portion 64 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2.

In addition, a pair of third placement portions 56 and 56 projecting upward are formed inside the side wall portions 51 and 51. The heights of the upper surfaces of the first placement portion 54, the second placement portion 63, and the third placement portions 56, 56 are equal to each other. Further, third positioning portions 57 and 57 that protrude further upward are formed on the outer portions of the upper surfaces of the third placement portions 56 and 56 over the entire left and right direction of the third placement portions 56 and 56. . The separation length between the insides of the third 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.

  Furthermore, the 4th mounting part 58 in which a part of front 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. Further, a fourth positioning portion 59 that protrudes further upward from the fourth placement portion 58 is formed. A part of the front support portion comes into contact with the fourth positioning portion 59. Further, a fifth placement portion 60 on which a part of the rear support portion of the support portion 2 b of the intraocular lens 2 is placed is formed inside the side wall portions 51 and 51. Furthermore, the 5th positioning part 61 which protrudes further upwards from the 5th mounting part 60 is formed. A part of the rear support part comes into contact with the fifth positioning part 61.

  In addition, as shown in FIG.4 (b), the height of the upper surface of the 5th mounting part 60 and the 5th positioning part 61 is higher than the height of the upper surface of the 1st-4th mounting part and the 1st-4th 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 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 fifth placement portions and the first to fifth 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 fifth placement portions and the first to fifth 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 set surface 12 b, the outer peripheral bottom surface of the lens body 2 a is the first mounting portion 54, the second mounting portion 63, and the third mounting portions 56, 56. Placed on top. Further, the position of the lens body 2a is restricted in the horizontal direction (the direction horizontal to the set surface 12b) by the first positioning portion 55, the second positioning portion 64, and the third positioning portions 57 and 57. Furthermore, the two support portions 2b of the intraocular lens 2 are placed on the upper surfaces of the fourth placement portion 58 and the fifth placement portion 60, respectively. Further, the positions of the two support portions 2b are restricted with respect to the horizontal direction by the fourth positioning portion 59 and the fifth positioning portion 61, respectively.

  Next, the schematic structure of the plunger 30 in this embodiment is shown to Fig.5 (a)-FIG.5 (d). 5A is a plan view of the plunger 30, FIG. 5B is a side view of the plunger 30, and FIG. 5C is a portion of the plunger 30 where the O-ring 31 d is provided. FIG. 5D is a diagram showing the nozzle body 10 and the plunger 30 when the intraocular lens 2 is injected into the eye from the distal end portion 10 a of the nozzle body 10 by the plunger 30. is there.

  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 shown in FIGS. 5A and 5B, the notch 31c is formed in a groove shape that opens downward in the action portion 31 and penetrates in the left-right direction. Further, as shown in 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. On the other hand, 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 f 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 above.

  Further, in the cylindrical portion 31a, a substantially annular O-ring 31d is provided on the proximal end side of the plunger 30 relative to the notch portion 31c, that is, on the pressing plate portion 33 side. The O-ring 31d is an example of a closing member, and closes the gap between the insertion member and the intraocular lens pushing member when the intraocular lens is pushed into the eye by the intraocular lens pushing member. As shown in FIG. 5C, the O-ring 31d is provided so as to come into contact with the outer peripheral surface of the plunger 30, more specifically, the outer peripheral surface of the cylindrical portion 31a. Note that the pressing force applied to the cylindrical portion 31a by the O-ring 31d can be appropriately set by changing the wire diameter or inner diameter of the O-ring 31d.

  Next, the function of the O-ring 31d when the intraocular lens 2 is injected into the eye from the distal end portion 10a of the nozzle body 10 by the plunger 30 will be described. Before the intraocular lens 2 is housed in the intraocular lens insertion device 1, the plunger 30 is inserted into the nozzle body 10 and placed at the initial position. Further, as described above, the positioning member 50 is attached to the nozzle body 10 from below the set surface 12b. Thereby, the 1st mounting part 54 of the positioning member 50, the 2nd mounting part 63, and the 3rd mounting parts 56 and 56 are hold | maintained in the state protruded to the set surface 12b.

  And the upper surface of the 1st mounting part 54, the 2nd mounting part 63, and the 3rd mounting parts 56 and 56 in the state where the lens main body 2a of the intraocular lens 2 orient | assigned the support part 2b to the front-back direction of the nozzle main body 10. Placed and positioned. In this state, a part of the support part 2b on the rear side of the intraocular lens 2 is sandwiched and supported by the notch part 31c of the plunger 30.

  After the intraocular lens 2 is set on the stage unit 12, the tip 10a of the nozzle body 10 is inserted into the incision created in the eye tissue. Here, since the front-end | tip part 10a has a diagonal opening shape, insertion to an incision can be performed easily. Then, after the nozzle portion 15 is inserted into the incision, the pressing plate portion 33 of the plunger 30 is pushed into the distal end side of the nozzle body 10. As a result, the distal end portion of the action portion 31 of the plunger 30 contacts the outer periphery of the lens body 2a of the intraocular lens 2 set on the set surface 12b, and the intraocular lens 2 is guided toward the distal end portion 10a by the plunger 30. Is done.

As shown in FIG. 5D, when the intraocular lens 2 is injected into the eye from the distal end portion 10 a of the nozzle body 10 by the plunger 30, the O-ring 31 d is inserted into the through hole 10 c of the nozzle body 10. Abutting on the inner peripheral surface, the gap between the cylindrical portion 31a of the plunger 30 and the inner peripheral surface of the through hole 10c of the nozzle body 10 is closed by the O-ring 31d. As a result, in the through hole 10c of the nozzle body 10, the flow path of the intraocular BSS from the distal end portion 10a to the proximal end portion 10b is blocked by the cylindrical portion 31a and the O-ring 31d. Thus, when the surgeon operates the plunger 30 to eject the intraocular lens 2 into the eye, the intraocular BSS used as the perfusate flows out of the nozzle body 10 through the nozzle body 10. Thus, it is possible to suppress the possibility of the surgical site being fouled by the BSS.

  Further, even after the O-ring 31d comes into contact with the inner peripheral surface of the through hole 10c of the nozzle body 10, the surgeon pushes the plunger 30 toward the distal end portion 10a of the nozzle body 10 so that the plunger 30 is moved to the nozzle body. 10, the surgeon shuts off the BSS flow path in the nozzle body 10 by the O-ring 31 d and prevents the back flow of the BSS to the nozzle body 10 while preventing the plunger 30. Can be operated.

  The above is the description of the present embodiment, but the configuration of the plunger and the like is not limited to the above-described embodiment, and various modifications can be made within the scope that does not lose the same technical idea as the present invention. Is possible. Below, the modification of said embodiment is demonstrated, referring a figure. In the following description, the same components as those in the above embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

  The plunger 310 in a 1st modification is shown to Fig.6 (a)-6 (d). 6A to 6D are diagrams corresponding to FIGS. 5A to 5D showing the plunger 30. FIG.

  As shown in FIGS. 6 (a) to 6 (d), in this modification, the outer circumferential surface of the cylindrical portion 310a of the plunger 310 circulates in a direction substantially perpendicular to the front-rear direction (axial direction) of the cylindrical portion 310a. A groove portion 31f is provided. An O-ring 31e is fitted in the groove 31f. In addition, the structure of the other part of the cylindrical part 310a is the same as said cylindrical part 31a. Moreover, as an example, the position of the groove 31f in the cylindrical part 310a is a position corresponding to the position of the O-ring 31d in the cylindrical part 31a of the above-described embodiment. However, the position of the groove part 31f in the cylindrical part 310a is not limited to this. Further, the depth and width of the groove 31f and the wire diameter and inner diameter of the O-ring 31e can be appropriately changed.

  As shown in FIG. 6D, when the intraocular lens 2 is injected into the eye from the distal end portion 10 a of the nozzle body 10 by the plunger 310, the O-ring 31 e becomes the inner periphery of the through hole 10 c of the nozzle body 10. The O-ring 31e closes the gap between the cylindrical portion 310a of the plunger 310 and the inner peripheral surface of the through hole 10c of the nozzle body 10. As a result, in the through hole 10c of the nozzle body 10, the flow path of the intraocular BSS from the distal end portion 10a to the proximal end portion 10b is blocked by the cylindrical portion 310a and the O-ring 31e.

  Further, even after the O-ring 31e comes into contact with the inner peripheral surface of the through hole 10c of the nozzle body 10, the operator pushes the plunger 310 toward the distal end portion 10a of the nozzle body 10 so that the plunger 310 is moved to the nozzle body. 10, the operator can block the BSS flow path in the nozzle body 10 by the O-ring 31 e and prevent the back flow of the BSS to the nozzle body 10 while preventing the plunger 310. Can be operated.

  Further, since the O-ring 31e is fitted in the groove 31f, when the O-ring 31e contacts the inner peripheral surface of the through hole 10c of the nozzle body 10, the O-ring 31e causes the BSS nozzle body 10 as described above. It is possible to expect the effect that the backflow into the inside is prevented and the plunger 310 is prevented from moving toward the tip portion 10a of the nozzle body 10. Therefore, after the surgeon operates the plunger 310 to inject the intraocular lens 2 from the distal end portion 10a of the nozzle body 10 into the eye, the O-ring 31e accidentally pushes the plunger 310 further forward. Can also be prevented.

The plunger 320 in a 2nd modification is shown to Fig.7 (a)-7 (d). Note that FIG.
(A) -7 (d) is a figure corresponding to Drawing 5 (a)-5 (d) which shows plunger 30 like Drawing 6 (a)-6 (d).

  As shown in FIGS. 7 (a) to 7 (d), in this modification, the outer circumferential surface of the cylindrical portion 320a of the plunger 320 circulates in a direction substantially perpendicular to the front-rear direction (axial direction) of the cylindrical portion 320a. A groove portion 31h is provided. An O-ring 31g is fitted in the groove 31h. The groove portion 31h is formed so that the length of the cylindrical portion 320a in the front-rear direction is longer than the wire diameter of the O-ring 31g, and the groove portion 31f is slidable in the groove portion 31h. And different. Moreover, the structure of the other part of the cylindrical part 320a is the same as said cylindrical part 31a. As an example, the initial position of the O-ring 31g fitted in the groove 31h in the cylindrical portion 320a, that is, the position of the O-ring 31g before the O-ring 31g contacts the inner peripheral surface of the through-hole 10c, This is a position corresponding to the position of the O-ring 31d in the cylindrical portion 31a of the embodiment. However, the initial position of the O-ring 31g in the groove 31h is not limited to this. Further, the depth and width of the groove 31h and the wire diameter and inner diameter of the O-ring 31g can be appropriately changed.

  As shown in FIG. 7D, when the intraocular lens 2 is injected into the eye from the distal end portion 10a of the nozzle body 10 by the plunger 320, the O-ring 31g becomes the inner periphery of the through hole 10c of the nozzle body 10. The gap between the cylindrical portion 320a of the plunger 320 and the inner peripheral surface of the through hole 10c of the nozzle body 10 is closed by the O-ring 31g. As a result, in the through hole 10c of the nozzle body 10, the flow path of the intraocular BSS from the distal end portion 10a to the proximal end portion 10b is blocked by the cylindrical portion 320a and the O-ring 31g.

  Furthermore, in this modification, the O-ring 31g can move in the front-rear direction of the cylindrical portion 320a in the groove portion 31h. Therefore, even after the O-ring 31g comes into contact with the inner peripheral surface of the through hole 10c of the nozzle body 10, the operator pushes the plunger 320 toward the distal end portion 10a of the nozzle body 10 so that the O-ring 31g becomes the groove 31h. Since the plunger 320 can be moved in the forward direction with respect to the nozzle body 10 as long as the inside moves, the operator blocks the BSS flow path in the nozzle body 10 with the O-ring 31g, and the BSS nozzle The plunger 320 can be operated while preventing backflow to the main body 10.

  The plunger 330 in a 3rd modification is shown to Fig.8 (a) -8 (d). 8 (a) to 8 (d) are similar to FIGS. 6 (a) to 6 (d) and FIGS. 7 (a) to 7 (d), and FIG. It is a figure corresponding to (d).

  As shown in FIGS. 8A to 8D, in this modification, the outer circumferential surface of the cylindrical portion 330 a of the plunger 330 circulates in a direction substantially perpendicular to the front-rear direction (axial direction) of the cylindrical portion 320 a. A groove portion 31k (FIG. 8C) is provided. Further, an O-ring 31i is fitted in the groove 31k. In addition, the groove part 31k is formed so that the length of the cylindrical part 330a in the front-rear direction is longer than the wire diameter of the O-ring 31i, like the groove part 31h. Moreover, the structure of the other part of the cylindrical part 330a is the same as said cylindrical part 31a. Further, the groove 31k is provided with a biasing member 31j that biases the O-ring 31i toward the front of the cylindrical portion 330a in the groove 31k. The urging member 31j is an example of a control member that controls the movement of the closing member to maintain the gap closed by the closing member.

The biasing member 31j includes washers 31p and 31q and a spring 31r sandwiched between the washers 31p and 31q. The washers 31p and 31q and the spring 31r are formed of a biocompatible material, and the spring 31r is a coil spring as an example. A cylindrical portion 31a is inserted through the washers 31p and 31q and the spring 31r. In the groove portion 31k, the washer 31p is brought into contact with the O-ring 31i by the elastic force of the spring 31r, so that the O-ring 31i is brought into contact with the cylindrical portion 330.
Press in the forward direction of a. Thereby, in the groove part 31k, the O-ring 31i is positioned as shown in FIGS. 8A to 8D by the biasing member 31j and the groove part 31k.

  Further, as an example, the initial position of the O-ring 31i fitted in the groove 31k in the cylindrical portion 330a, that is, the position of the O-ring 31i before the O-ring 31i contacts the inner peripheral surface of the through hole 10c is as described above. It is a position corresponding to the position of the O-ring 31d in the cylindrical portion 31a in the embodiment. However, the initial position of the O-ring 31i in the groove 31k is not limited to this. Further, the depth and width of the groove 31k, the wire diameter and inner diameter of the O-ring 31i, the spring constant of the spring 31r, and the like can be changed as appropriate.

  As shown in FIG. 8D, when the intraocular lens 2 is injected into the eye from the distal end portion 10 a of the nozzle body 10 by the plunger 330, the O-ring 31 i is in the inner periphery of the through hole 10 c of the nozzle body 10. Abutting on the surface, the gap between the cylindrical portion 330a of the plunger 330 and the inner peripheral surface of the through hole 10c of the nozzle body 10 is closed by the O-ring 31i. As a result, in the through hole 10c of the nozzle body 10, the flow path of the intraocular BSS from the distal end portion 10a to the proximal end portion 10b is blocked by the cylindrical portion 330a and the O-ring 31i.

  Furthermore, in this modification, the urging member 31j that positions the O-ring 31i in the groove 31k expands and contracts in the front-rear direction of the cylindrical portion 330a by the spring 31r. Therefore, when the O-ring 31 i comes into contact with the inner peripheral surface of the through hole 10 c of the nozzle body 10, the operator pushes the plunger 330 toward the distal end portion 10 a side of the nozzle body 10, thereby pressing the plunger 330. The spring 31r is added via the cylindrical portion 330a and the washer 31q. At this time, the O-ring 31i is in contact with the inner peripheral surface of the through hole 10c of the nozzle body 10 while being maintained by the spring 31r.

  For this reason, the spring 31r contracts in the front-rear direction of the cylindrical portion 330a by a force pushing the plunger 330 applied from the washer 31q. Further, when the spring 31r contracts, the O-ring 31i moves in the groove portion 31k in the rearward direction of the cylindrical portion 330a relative to the cylindrical portion 330a in a state where the O-ring 31i is in contact with the inner peripheral surface of the through hole 10c. . As a result, the cylindrical portion 330a moves toward the tip portion 10a of the nozzle body 10 by a distance corresponding to the length by which the spring 31r contracts. As described above, in this modification, when the plunger 330 is moved in the forward direction with respect to the nozzle body 10, the O-ring 31i moves in the groove 31k according to the contraction of the spring 31r of the biasing member 31j. The surgeon can operate the plunger 330 while blocking the flow path of the BSS in the nozzle body 10 by the O-ring 31i and preventing the back flow of the BSS to the nozzle body 10.

  In the above description, the urging member 31j is a member having washers 31p, 31q and a spring 31r. However, if the O-ring 31i can be positioned and moved as described above, the urging member 31j can be used instead of the urging member 31j. Various elastic bodies such as a cylindrical silicone rubber and an air spring may be used.

  In this embodiment, the plunger 30 is provided with an O-ring, but an O-ring may be provided on the inner peripheral surface of the through hole 10c of the nozzle body 10.

DESCRIPTION OF SYMBOLS 1 Intraocular lens insertion instrument 2 Intraocular lens 10 Nozzle main body 30,310,320,330 Plunger 31d, 31e, 31g, 31i O-ring 31f, 31h, 31k Groove part 31j Energizing member

Claims (5)

A substantially cylindrical insertion member inserted into the eye;
An intraocular lens pushing member that pushes the intraocular lens to move in the insertion member and pushes the intraocular lens from the insertion member into the eye;
An intraocular lens comprising: a closing member that closes a gap between the insertion member and the intraocular lens pushing member when the intraocular lens is pushed into the eye by the intraocular lens pushing member. Insertion instrument.   The intraocular lens insertion device according to claim 1, wherein the closing member is a substantially annular member that abuts on an outer peripheral surface of the intraocular lens pushing member.   The intraocular lens insertion device according to claim 1, wherein the closing member is provided in a groove formed in the outer peripheral surface of the intraocular lens pushing member.   The intraocular lens insertion device according to claim 3, wherein the groove portion is formed so that the closing member is movable in the groove portion.   The groove is provided with a control member for controlling the movement of the closing member and maintaining the closing of the gap by the closing member when the intraocular lens is pushed into the eye by the intraocular lens pushing member. The intraocular lens insertion device according to claim 4, wherein:

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