JP2019042127A - Intraocular lens insertion device - Google Patents

Abstract

To provide an intraocular lens insertion device capable of appropriately inserting an intraocular lens into an eye.SOLUTION: A pushing member 310 includes an optical-unit contact part 314, a support-unit contact part 313, a first sunken part 321, and an upper-side rib 322. The optical-unit contact part 314 comes into contact with an optical unit of an intraocular lens to push the optical unit forward. The support-unit contact part 313 is formed on an upper side of the optical-unit contact part 314, and comes into contact with a rear support part of the intraocular lens to deformingly move the rear support part forward. The first sunken part 321 is formed rearward the optical-unit contact part 314 and support-unit contact part 313 out of a first side face 320 and sunken inward the first side face 320A of the optical-unit contact part 314 and support-unit contact part 313. The upper-side rib 322 projects laterally from an upper end of the first side face 320 and continuously extends from a front end of the support-unit contact part 313 to the first sunken part 321.SELECTED DRAWING: Figure 4

Description

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

  Heretofore, as one of cataract surgery methods, a method of inserting a foldable soft intraocular lens into the eye instead of the removed lens is used. In addition, in order to correct the refractive power of the eye, an intraocular lens may be inserted in front of the crystalline lens. For the insertion of the intraocular lens into the eye, an intraocular lens insertion instrument called an injector may be used.

  The intraocular lens insertion device may fold the intraocular lens in a state where the support portion of the intraocular lens is deformed and positioned on the optical unit (a state where so-called "tacking" is performed). By tacking, the possibility of breakage or the like of the support portion is reduced. In the intraocular lens insertion device described in Patent Document 1, a linear moving unit for moving the support unit in a direction approaching the optical unit, and an optical unit contact unit for pushing the optical unit forward are provided on the front end side of the rod-like extrusion member. It is done. By moving the pushing member forward, both movement of the intraocular lens and tacking are performed. An intraocular lens is inserted into the eye through a passage in the nozzle.

JP, 2016-19608, A

  When movement and tacking of the intraocular lens is performed by the rod-like push-out member, at least a part of the folded intraocular lens may be inserted between the push-out member and the inner wall of the nozzle. In the conventional intraocular lens insertion device, a large load is likely to be applied to the portion of the intraocular lens which has entered between the pushing member and the inner wall of the nozzle. When a large load is applied to the intraocular lens, breakage (for example, a crack) may occur.

  An exemplary object of the present disclosure is to provide an intraocular lens insertion device capable of appropriately inserting an intraocular lens into an eye.

  An intraocular lens insertion tool provided by an exemplary embodiment of the present disclosure comprises a deformable intraocular comprising an optic and one or more supports curved and extending outwardly from the optic. An intraocular lens insertion device for inserting a lens into an eye from an insertion opening at a front end through an internal passage, wherein the passage area is narrowed toward the front, and a nozzle having the insertion opening at the front end; And a rod-like push-out member for pushing the intraocular lens forward by moving forward in the passage along the axis of the passage, the push-out member being formed on the front end side of the push-out member, The optical part contact part pushing out the optical part in contact with the optical part, and the support part which is formed above the optical part contact part on the front end side of the pushing member and extends backward from the optical part In contact with the rear support The support contact portion for moving the rear support in a direction toward the optical portion, and the side on which the proximal end of the rear support of the intraocular lens is located among the left side surface and the right side surface of the pushing member When the side surface of the first side surface is a side surface of the first side surface, the first side surface is formed rearward of the optical portion contact portion and the support portion contact portion, and the first side surface is the first side surface. A first recessed portion which is recessed further inward than a side surface, and an upper side which protrudes laterally from an upper end portion of the first side surface and which extends continuously from a front end portion of the support portion contacting portion to the first recessed portion. And a rib.

  According to the intraocular lens insertion device in the present disclosure, the intraocular lens is properly inserted into the eye.

It is the perspective view which looked at the intraocular lens insertion instrument 10 from diagonally upper right. It is the perspective view which looked at the plunger 300 from diagonally upper right. They are (a) top view of intraocular lens 1, and (b) right side view. It is the perspective view which looked at the pushing member 310 from diagonally upper right. It is the perspective view which looked at the pushing member 310 from diagonally upward left. FIG. 10 is a right side view of the pushing member 310. FIG. 7 is a front view of a pushing member 310. It is a schematic explanatory drawing which shows the state of the movement at the time of extrusion of the intraocular lens 1, and a deformation | transformation. It is front sectional drawing in the front-back direction approximate center of the nozzle 180, when the intraocular lens 1 is passing. It is front sectional drawing of the insertion part 182 at the time of the intraocular lens 1 passing.

<Overview>
The intraocular lens insertion instrument exemplified in the present disclosure inserts the intraocular lens into the eye from the insertion port at the front end through the internal passage. The intraocular lens comprises an optic and one or more supports curving outwardly from the optic. The intraocular lens insertion device comprises a nozzle and a pushing member. The nozzle has a passage area narrowed toward the front and has an insertion port at the front end. The pushing member is rod-like, and pushes the intraocular lens forward by moving forward in the passage along the axis of the passage. The pusher in the present disclosure comprises an optic contact, a support contact, a first recess and an upper rib. The optical portion contact portion is formed on the front end side of the push-out member, and contacts the optical portion to push the optical portion forward. The support portion contact portion is formed above the optical portion contact portion on the front end side of the push-out member, contacts the rear support portion which is a support portion extending rearward from the optical portion, and moves the rear support portion closer to the optical portion Move to Further, among the side surface on the left side and the side surface on the right side of the push-out member, the side surface on which the proximal end of the rear support portion of the intraocular lens is located is taken as a first side surface. The first recess is formed rearward of the optical portion contact portion and the support portion contact portion in the first side surface, and is recessed inward of the first side surface of the optical portion contact portion and the support portion contact portion. The upper rib protrudes laterally from the upper end of the first side surface and extends continuously from the front end of the support contact portion to the first recess.

  According to the intraocular lens insertion device exemplified in the present disclosure, even if a part of the intraocular lens gets in between the first side surface of the pushing member and the inner wall of the nozzle, the entering part can escape to the first depression. In addition, when a portion of the intraocular lens enters the gap between the upper surface of the push-out member and the inner wall of the nozzle (hereinafter referred to as the “upper gap”), a portion of the intraocular lens is caught in the upper gap The pushing member may be pushed out. In this case, a particularly heavy load is applied to the portion sandwiched by the upper gap. On the other hand, in the intraocular lens insertion device according to the present disclosure, the upper rib suppresses that a portion of the intraocular lens enters the gap in the upper portion from the first side surface side. Thus, the load on the intraocular lens is reduced, and the intraocular lens is appropriately inserted into the eye.

  In the present disclosure, the axial direction of the passage of the intraocular lens insertion device is taken as the front-rear direction of the intraocular lens insertion device. The direction in which the optical part contact part and the support part contact part are aligned when viewed from the front is taken as the vertical direction of the intraocular lens insertion device. The direction perpendicular to both the longitudinal direction and the vertical direction is the lateral direction of the intraocular lens insertion device. Here, the proximal end (that is, the portion connected to the optical unit) of the rear support in the intraocular lens is displaced to the left or right of the axis of the passage. In the present disclosure, of the left and right directions, the direction in which the proximal end of the rear support portion is located with respect to the axis of the passage is a first direction, and the other direction is a second direction. The first side surface of the pushing member is a surface facing the first direction.

  The front end face of the support contact portion may project further forward than the front end face of the optical contact portion. In this case, tacking is performed in a state in which the rear support portion is extended far to the front by the support portion contact portion that protrudes forward. Therefore, tacking is performed more appropriately. On the other hand, when the front end surface of the support portion contact portion protrudes forward relative to the front end surface of the optical portion contact portion, optics entering between the first side surface of the extrusion member and the inner wall of the nozzle as compared with the case where it does not protrude. Part volume increases. However, in the intraocular lens insertion device of the present disclosure, as described above, the influence of the intraocular lens getting in between the push-out member and the inner wall of the nozzle is suppressed by the first recess and the upper rib. Therefore, damage to the intraocular lens is also suppressed while tacking is properly performed.

  However, the front end surface of the support portion contact portion may be located at the same position as the front end surface of the optical portion contact portion or at the rear of the front end surface of the optical portion contact portion. Even in this case, the influence of the intraocular lens getting in between the first side surface of the pushing member and the inner wall of the nozzle is appropriately suppressed.

  The support contact portion is disposed on the left or right side relative to the axis of the passage, on the side where the proximal end of the rear support of the intraocular lens is located (that is, the first direction described above). In this case, the support contact portion pushes the position of the rear support near the proximal end forward. Therefore, as compared with the case where the front end side of the rear support portion is pushed forward, the deformation movement of the rear support portion is stable, and the movement amount is easily secured. On the other hand, when the support portion contact portion is arranged to be biased in the first direction, the space between the first side surface of the push-out member and the inner wall of the nozzle is narrowed. However, in the intraocular lens insertion device of the present disclosure, as described above, the influence of the intraocular lens getting in between the push-out member and the inner wall of the nozzle is suppressed by the first recess and the upper rib. Therefore, damage to the intraocular lens is also suppressed while tacking is properly performed. However, even when the support contact portion is not arranged in the first direction, breakage of the intraocular lens is suppressed by providing the first recess and the upper rib.

  The push-out member may further include a lower rib that protrudes laterally from the lower end of the first recess in the first side surface. In this case, the lower rib reduces the possibility that at least a portion of the intraocular lens may enter from the first side in the gap formed by the bottom surface of the pushing member and the inner wall of the nozzle. Thus, the load on the intraocular lens is further reduced.

  The push-out member may further include an upper protrusion projecting forward from the upper end of the front end face of the support contact portion. In this case, the upper projection reduces the possibility of the rear support portion being displaced upward from the support contact portion.

  The push-out member may further include a lower protrusion projecting forward from the lower end of the front end face of the optical portion contact portion. In this case, the lower protrusion reduces the possibility of the optical part being displaced downward from the optical part contact part.

  When the side opposite to the first side among the side on the left side and the side on the right of the push-out member is the second side, a second sinking inward to the second side of the support portion contact portion The part may be formed. In this case, the space between the second side surface and the inner wall of the nozzle is increased. Therefore, even when a part of the intraocular lens gets in between the second side surface and the inner wall of the nozzle, it is difficult to increase the load on the intraocular lens.

  The push-out member may further include a second side rib extending laterally from the upper end of the second side and continuously extending from the front end of the support contacting portion toward the rear end. . In this case, it is suppressed by the second side rib that a part of the intraocular lens enters from the second side in the gap in the upper part generated between the upper surface of the pushing member and the inner wall of the nozzle. Therefore, the possibility that part of the intraocular lens gets caught in the gap in the upper part is further reduced. It goes without saying that the second side rib and the second depressed portion may be provided together. In this case, at least a portion of the second side rib extends laterally from the upper end of the second recess.

Embodiment
Hereinafter, typical embodiments of the present disclosure will be described with reference to the drawings. In the following description, the direction of the nozzle 180 side (lower left side in FIG. 1) of the main body 100 corresponds to the front of the intraocular lens insertion device 10 and the direction of the pressing portion 370 of the plunger 300 (upper right side in FIG. ) Is the back of the intraocular lens insertion device 10. Further, the upper side of the drawing of FIG. 1 is the upper side of the intraocular lens insertion device 10, the lower side of the drawing of FIG. 1 is the lower side of the intraocular lens insertion device 10, and the lower right side of FIG. The upper left side in the drawing of FIG. 1 is the left of the intraocular lens insertion device 10.

(overall structure)
The overall configuration of the intraocular lens insertion device 10 of the present embodiment will be described with reference to FIG. The intraocular lens insertion device 10 is used to insert the deformable intraocular lens 1 (see FIG. 3 and the like) into the eye. The intraocular lens insertion device 10 includes a main body 100 and a plunger 300. The main body 100 has a substantially cylindrical shape, and the plunger 300 for inserting the intraocular lens 1 into the eye through the passage inside the main body 100 is rod-like, and moves in the passage inside the main body 100 in the longitudinal direction be able to. The plunger 300 pushes the intraocular lens 1 filled in the inside of the main body 100 by moving forward along the pushing shaft (shaft of the passage) A.

  The main body 100 and the plunger 300 of the present embodiment are formed of a resin material. The intraocular lens insertion device 10 may be formed by molding, cutting by cutting out resin, or the like. When the intraocular lens insertion device 10 is formed of a resin material, the user can easily discard the used intraocular lens insertion device 10.

  In the present embodiment, in order to smoothly insert the adhesive soft intraocular lens 1 into the eye, the inner wall of the main body 100 is lubricated and coated. Further, the intraocular lens insertion device 10 of the present embodiment is formed to be colorless and transparent or colorless and translucent. Therefore, the user can easily visually recognize the deformed state of the intraocular lens 1 filled in the intraocular lens insertion device 10 from the outside of the intraocular lens insertion device 10.

(Body part)
The main body unit 100 will be described with reference to FIG. The main body portion 100 includes a main body cylindrical portion 110, an installation portion 130, and a nozzle (insertion portion) 180.

  The main body cylindrical portion 110 is formed in a cylindrical shape extending in the front-rear direction, and is positioned on the base end side of the main body portion 100. A projecting portion 111 gripped by the user is formed on the outer periphery slightly forward of the rear end of the main body tubular portion 110.

  The installation portion 130 is connected to the tip end side of the main body cylindrical portion 110. The placement unit 130 is filled with the intraocular lens 1. In detail, the installation unit 130 includes the holding unit 160 and the setting unit 170. The holding unit 160 holds the intraocular lens 1 when the intraocular lens insertion device 10 is in the storage state. The set portion 170 is provided rotatably around the axis of the tip. When the setting unit 170 is rotated, the intraocular lens 1 held by the holding unit 160 is moved to a standby position where it can be pushed out by the plunger 300 and positioned.

  The nozzle 180 is connected to the tip side of the installation unit 130. The passage area in the nozzle 180 becomes narrower toward the front in order to deform the intraocular lens 1 smaller in the process of pushing the intraocular lens 1 forward. That is, the nozzle 180 is formed with a tapered internal space. At the tip of the nozzle 180, a cylindrical insertion portion 182 whose tip is obliquely cut is provided. The insertion portion 182 is inserted into the eye. An insertion port 183, which is an opening for discharging the intraocular lens 1 forward from an internal passage, is formed at the tip of the insertion portion 182. A passage inside the main body portion 100 penetrates from the rear end of the main body cylindrical portion 110 to the insertion port 183 at the tip of the nozzle 180.

(Plunger)
The schematic configuration of the plunger 300 will be described with reference to FIG. The plunger 300 of the present embodiment includes a pushing member 310, a pushing rod 330, a shaft base 350, and a pressing portion 370.

  The pressing portion 370 is formed at the proximal end of the plunger 300. The pressing portion 370 is a plate-like member extending in a direction orthogonal to the extrusion axis A. When the user pushes the plunger 300 forward, the finger of the user contacts the pressing portion 370.

  The shaft base 350 is a rod-like member extending forward from the tip end side of the pressing portion 370. In the present embodiment, the shaft base 350 is formed so that the shape of the cross section orthogonal to the extrusion axis A is substantially H-shaped. Rotation of the circumferential direction of extrusion axis A of plunger 300 to main part 100 is suppressed by inserting axis base 350 in main part cylinder part 110 whose shape of the section orthogonal to extrusion axis A is substantially rectangular. . When the plunger 300 moves forward and reaches a position where insertion of the intraocular lens 1 into the eye is completed, the inclined portion 353 formed at the lower end of the tip of the shaft base 350 is formed at a predetermined position of the main body 100 Contact the sloped surface. As a result, the tip end of the plunger 300 is prevented from protruding excessively from the insertion port 183 (see FIG. 1).

  The push rod 330 is a rod-like member, and extends forward from the tip of the shaft base 350 along the axial direction of the push axis A. The push rod 330 is formed so that the shape of the cross section orthogonal to the push axis A is substantially circular. Further, the thickness of the push rod 330 is such that it can pass through the insertion port 183 of the main body 100. The pushing member 310 is connected to the tip of the pushing rod 330. The pushing member 310 moves forward in the passage of the main body 100 along the pushing axis A, thereby tacking the intraocular lens 1 and discharging the intraocular lens 1 from the insertion port 183 into the eye. The detailed configuration of the pushing member 310 will be described later.

(Intraocular lens)
An example of the intraocular lens 1 inserted into the eye by the intraocular lens insertion device 10 will be described with reference to FIG. The intraocular lens 1 includes an optical unit 2 and a support unit 3. The intraocular lens 1 of the present embodiment is a so-called one-piece type intraocular lens in which the optical portion 2 and the support portion 3 are integrally molded. As the material of the intraocular lens 1, for example, various soft materials such as a simple substance such as BA (butyl acrylate) or HEMA (hydroxyethyl methacrylate) or a composite material of acrylic ester and methacrylic ester can be adopted.

  The optical unit 2 applies a predetermined refractive power to the patient's eye. The support unit 3 supports the optical unit 2 in the eye. As an example, the intraocular lens 1 of the present embodiment is provided with a pair of support portions 3. However, the number of support portions 3 is not limited to two. In the present embodiment, when the intraocular lens 1 is installed in the installation portion 130, the support portion 3 extending from the optical portion 2 toward the nozzle 180 (that is, forward) is referred to as a front support portion 3A. The support portion 3 extending toward the plunger 300 (that is, rearward) is referred to as a rear support portion 3B.

  The pair of support portions 3 extend outward from the peripheral portion of the optical portion 2. The support portion 3 has a loop shape curved in the circumferential direction, and the tip of the support portion 3 is a free end. The pair of support portions 3 has a symmetrical shape with respect to the center of the optical portion 2 and extends in the same circumferential direction. Therefore, a straight line connecting the base end portions 4 of the pair of support portions 3 passes through the center of the optical portion 2.

(Extruded member)
The configuration of the pushing member 310 in the plunger 300 of the present embodiment will be described in detail with reference to FIGS. 4 to 7. As shown in FIGS. 4 to 7, at the front end portion of the pushing member 310, a support contact portion 313, an optical contact portion 314, an upper protrusion 315, and a lower protrusion 316 are provided.

  The support portion contact portion 313 deforms and moves the rear support portion 3B in a direction approaching the optical portion 2 (that is, forward) by contacting the rear support portion 3B of the intraocular lens 1. That is, tacking of the rear support portion 3B is performed by the support portion contact portion 313. The support portion contact portion 313 is provided above the optical portion contact portion 314 in the front end portion of the push-out member 310. Therefore, although the details will be described later, when the rear support portion 3B is pushed forward by the support portion contact portion 313, the rear support portion 3B moves upward of the optical portion 2. The support portion contact portion 313 is formed in a curved shape that is convex toward the front. Therefore, the rear support portion 3B is not easily damaged.

  The optical portion contact portion 314 pushes the optical portion 2 forward by contacting the optical portion 2 of the intraocular lens 1. The optical portion contact portion 314 is provided below the support portion contact portion 313 in the front end portion of the push-out member 310. The optical portion contact portion 314 is formed in a curved shape that is convex toward the front, similarly to the support portion contact portion 313. Therefore, the optical part 2 is not easily damaged.

  As shown in FIG. 7, when the extrusion member 310 is viewed from the front along the extrusion axis A, the support portion contact portion 313 and the optical portion contact portion 314 both face forward. Therefore, only by pushing the plunger 300 forward, both the tacking of the rear support 3B and the push of the optical unit 2 forward can be performed.

  As shown in FIG. 6, in the present embodiment, the front end surface of the support portion contact portion 313 protrudes further forward than the front end surface of the optical portion contact portion 314. In this case, tacking is performed in a state in which the rear support portion 3B is extended far to the front by the support portion contact portion 313 which protrudes to the front than the optical portion contact portion 314. Thus, the accuracy of tacking is improved. Further, a connection surface 318 connecting the front end surface of the support portion contact portion 313 and the front end surface of the optical portion contact portion 314 is inclined to face obliquely forward. Therefore, the optical unit 2 in contact with the connection surface 318 is smoothly guided to the optical unit contact unit 314.

  As shown in FIG. 7, in the support portion contact portion 313, the base end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 is positioned in the left-right direction about the extrusion axis A (The right side in the present embodiment). This action will be described later.

  As shown in FIGS. 4 to 6, the upper protrusion 315 protrudes forward from the upper end of the front end surface of the support contact portion 313. The upper protrusion 315 suppresses the rear support 3 </ b> B from shifting upward from the support contact portion 313. As a result, since the malfunction which back support part 3B does not contact support part contact part 313 is controlled, it is easy to carry out tacking appropriately. The lower protrusion 316 protrudes forward from the lower end of the front end face of the optical portion contact portion 314. The lower protrusion portion 316 suppresses the optical portion 2 from being shifted downward from the optical portion contact portion 314. As a result, the problem in which the optical portion 2 is caught between the bottom surface of the pushing member 310 and the inner wall of the nozzle 180 is suppressed. Note that the phrase "the upper end of the front end surface of the support portion contact portion 313" does not limit that the upper protrusion 315 is strictly located at the upper end of the front end surface. That is, the upper projection 315 may be disposed in the vicinity of the upper end of the support contact portion 313. Similarly, the lower protrusion 316 may be disposed in the vicinity of the lower end of the optical portion contact portion 314.

  As shown in FIG. 7, the front end portion of the pushing member 310 is provided with many configurations (in the present embodiment, the support portion contact portion 313, the optical portion contact portion 314, the upper protrusion 315, and the lower protrusion 316). There is a need. Therefore, it is very difficult to secure a space between the pushing member 310 and the inner wall of the nozzle 180 by simplifying the configuration of the front end of the pushing member 310. When the space between the pushing member 310 and the inner wall of the nozzle 180 is narrow, the load on a part of the intraocular lens 1 entering the space is increased. However, the intraocular lens insertion device 10 of the present embodiment suppresses the increase in the load applied to the intraocular lens 1 by providing the configuration described below (for example, the first depression 321 and the upper rib 322 and the like). can do.

  Next, the configuration of the right side of the pushing member 310 will be described. As shown in FIG. 4, on the right side of the pushing member 310, a first recess 321, an upper rib 322, and a lower rib 323 are provided.

  The first depression 321 is formed rearward of the support contact portion 313 and the optical contact portion 314 in the first side surface (right side surface in the present embodiment) 320 of the push-out member 310. The first recessed portion 321 is a portion that is recessed inward (leftward in this embodiment) than the first side surface 320A of the support portion contact portion 313 and the optical portion contact portion 314. The first depression 321 is a part of the intraocular lens 1 that has entered between the first side surface 320 and the inner wall of the nozzle 180 (e.g., the vicinity of the proximal end 4B of the rear support 3B in a tacked state) Becomes a space to escape. Therefore, the load applied to the intraocular lens 1 is reduced by forming the first recessed portion 321, and the occurrence of breakage or the like of the intraocular lens 1 is suppressed.

  As shown in FIG. 4, between the first side surface 320A of the support contact portion 313 and the optical portion contact portion 314 and the side surface 321A of the innermost portion of the first depressed portion 321, it faces obliquely backward. It is smoothly connected by the inclined surface 321B. Therefore, there is no sharp level difference between the first side 320A of the support contacting portion 313 and the optical contacting portion 314 and the side 321A of the first recessed portion 321 which is the innermost part. Thus, when the part of the intraocular lens 1 that has fled into the first depression 321 returns to the front, it is possible to prevent the intraocular lens 1 from being damaged by the rapid step.

  The upper rib 322 is a rib-like member that protrudes laterally (in the present embodiment, to the right) from the upper end of the first side surface (in the present embodiment, the right surface) 320 of the pushing member 310. The upper rib 322 extends continuously from the front end of the support contact portion 313 to the first recess 321. Although the details will be described later, the upper rib 322 causes a portion of the intraocular lens 1 to enter from the first side surface 320 side into the gap 200 (see FIG. 9) between the upper surface of the pushing member 310 and the inner wall of the nozzle 180. Suppress. The upper rib 322 does not have to be formed strictly at the upper end of the first side surface 320. That is, the upper rib 322 may be disposed in the vicinity of the upper end portion of the first side surface 320.

  The lower rib 323 protrudes laterally (rightward in the present embodiment) from the lower end portion of the first recessed portion 321 in the first side surface (rightward surface in the present embodiment) 320 of the pushing member 310. The lower rib 323 suppresses that a part of the intraocular lens 1 enters the gap formed by the bottom surface of the pushing member 310 and the inner wall of the nozzle 180 from the first side surface 320 side. Similarly to the upper rib 322, the lower rib 323 does not have to be formed strictly at the lower end of the first side surface 320.

  Next, the configuration of the left side of the pushing member 310 will be described. As shown in FIG. 5, on the left side of the supporting portion contact portion 313 in the second side surface (left side surface in this embodiment) 325 of the pushing member 310, a second recessed portion 326 which is recessed inward is formed. . The second depression 326 is a space into which a part of the deformed intraocular lens 1 escapes. Therefore, the provision of the second recessed portion 326 makes it difficult for a load to be applied to a part of the intraocular lens 1 entering the left side of the pushing member 310.

(Movement and deformation of intraocular lens)
With reference to FIGS. 8 to 10, movement and deformation of intraocular lens 1 from placement unit 130 to nozzle 180 when intraocular lens 1 is inserted into the eye by intraocular lens insertion device 10 of the present embodiment. The state of will be described.

  First, the operator can push the intraocular lens 1 held by the holding portion 160 (see FIG. 1) of the installation portion 130 by the plunger 300 by rotating the setting portion 170 (see FIG. 1). Move to a standby position where Here, as shown in FIG. 8A, the base end 4B of the rear support 3B in the intraocular lens 1 held by the holder 160 is shifted in either the left or right direction with respect to the extrusion axis A. ing. As an example, in the present embodiment, the proximal end 4B of the rear support 3B is located on the right side (the lower side in FIG. 8) with respect to the extrusion axis A. Therefore, in the present embodiment, the right direction of the intraocular lens insertion device 10 is the first direction described above, and the left direction is the second direction described above. The direction in which the support portion 3 of the intraocular lens 1 extends may be the direction opposite to that of the present embodiment. In this case, the first direction described above is the left direction of the intraocular lens insertion device 10.

  Next, the worker injects a lubricant (viscoelastic substance) into the installation portion 130 using a syringe or the like to start forward movement of the plunger 300. As a result, as shown in FIG. 8A, the support contact portion 313 (see FIGS. 4 to 7) of the push-out member 310 contacts the rear support 3B of the intraocular lens 1.

  When the plunger 300 is further pushed forward, as shown in FIG. 8B, the rear support 3B moves (is bent) in the direction approaching the optical unit 2 by the pushing member 310. As described above, the support contact portion 313 is provided above the optical contact portion 314. Accordingly, the rear support portion 3B is deformed and moved to the upper side of the optical portion 2, and the tip of the rear support portion 3B faces the front. As a result, tacking of the rear support portion 3B is performed.

  In addition, as described above, in the support portion contact portion 313, the proximal end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 is positioned in the left-right direction about the extrusion axis A (The right side in the present embodiment). In this case, the support contact portion 313 pushes the position of the rear support 3B near the proximal end 4B forward. Therefore, as compared with the case where the distal end side of the rear support portion 3B is pushed, the deformation movement of the rear support portion 3B is stable, and the movement amount is easily secured.

  When the plunger 300 is further pushed forward, the optical portion contact portion 314 (see FIGS. 4 to 7) of the push-out member 310 contacts the optical portion 2, and the entire intraocular lens 1 moves forward. As shown in FIG. 8C, when the intraocular lens 1 reaches the nozzle 180, the front support 3A contacts the inner wall of the nozzle 180 which is tapered. As a result, the front support 3A deforms and moves upward of the optical unit 2, and the tip of the front support 3A faces rearward. That is, tacking of the front support 3A is performed.

  When the plunger 300 is further pushed forward, the optical part 2 of the intraocular lens 1 also contacts the inner wall of the nozzle 180 which is tapered. As a result, as shown in FIG. 8 (d), the intraocular lens 1 is slightly folded in a state in which the front support 3A and the rear support 3B are tacked.

  As shown in FIG. 8 (e), the intraocular lens 1 is folded so small that it can be pushed forward. The vicinity of the proximal end portion 4B of the rear support portion 3B and the vicinity of the rear end portion of the optical portion 2 enter between the first side surface 320 of the pushing member 310 and the inner wall of the nozzle 180. Since the passage area of the nozzle 180 becomes narrower toward the front, the space between the first side surface 320 and the inner wall of the nozzle 180 becomes gradually smaller. As a result, the load on the rear support portion 3B can be gradually increased. However, the first depressed portion 321 (see FIG. 4 etc.) is formed on the first side surface 320 of the pushing member 310 of the present embodiment. The rear support 3 </ b> B that has entered between the first side surface 320 and the inner wall of the nozzle 180 can escape to the first depression 321. Therefore, an increase in load applied to the rear support portion 3B is suppressed by the first recess 321.

  Further, as shown in FIG. 9, a gap 200 is formed between the upper surface of the pushing member 310 and the inner wall of the nozzle 180. When the passage area of the nozzle 180 is narrowed, a part of the intraocular lens 1 may be caught in the gap 200. When the pushing member 310 is pushed while the intraocular lens 1 is partially held in the gap 200, the intraocular lens 1 may be damaged. As the passage area of the nozzle 180 becomes smaller, a part of the intraocular lens 1 is pressed against the entrance of the gap 200 and is easily pinched.

  However, the upper rib 322 is formed on the pushing member 310 of the present embodiment. As shown in FIG. 9, the upper rib 322 functions to suppress entry of a portion of the intraocular lens 1 into the gap 200 from the first side surface 320 side. Therefore, a part of the intraocular lens 1 does not get caught in the gap 200, and turns around the upper rib 322. As a result, as shown in FIG. 10, the intraocular lens 1 smoothly moves forward without being caught in the gap 200 even in the insertion portion 182 where the passage area is the narrowest. Thus, the possibility of breakage or the like in the intraocular lens 1 is reduced.

  As described above, in the intraocular lens insertion device 10, a part of the intraocular lens 1 enters the space between the pushing member 310 and the inner wall of the nozzle 180. In particular, as shown in FIG. 9, in addition to a part of the optical part 2, a part of the rear support part 3B also intrudes into the space between the first side face 320 of the pushing member 310 and the inner wall of the nozzle 180. Further, in the present embodiment, as described above, the support portion contact portion 313 of the pushing member 310 is disposed to be biased to the first side surface 320 side (right side in FIG. 9). Therefore, the space on the first side 320 side is narrow. Furthermore, in the present embodiment, the front end surface of the support portion contact portion 313 protrudes more forward than the front end surface of the optical portion contact portion 314. Therefore, the volume of the optical unit 2 entering between the first side surface 320 and the inner wall of the nozzle 180 is increased as compared with the case where the front end surface of the support unit contact unit 313 does not project forward from the front end surface of the optical unit contact unit 314 Do. Therefore, a large load is likely to be applied to a part of the intraocular lens 1 which has entered between the first side surface 320 and the inner wall of the nozzle 180. However, the intraocular lens insertion device 10 of the present embodiment can suppress an increase in load applied to the intraocular lens 1 by including the first depression 321 and the upper rib 322 and the like.

  The techniques disclosed in the above embodiments are merely examples. Therefore, it is also possible to change the technique illustrated in the above embodiment. For example, the intraocular lens insertion device 10 of the above embodiment has a plurality of configurations in order to suppress an increase in load applied to the intraocular lens 1. However, the increase in the load applied to the intraocular lens 1 is suppressed even if only one of the configurations is adopted without adopting all of these configurations. For example, the pushing member 310 may include the upper rib 322 without the first recess 321. In addition, the pushing member 310 may be provided with the first depression 321 without the upper rib 322.

  Further, in the above embodiment, although the upper side rib 322 is provided on the first side surface 320, no rib is provided on the upper end portion of the second side surface 325. However, the upper end portion of the second side surface 325 may be provided with a rib (second side rib). In this case, the second side rib extends laterally (in the present embodiment, to the left) from the upper end of the second side 325 and is continuous from the front end of the support contact portion 313 to the rear end. It may extend. In this case, it is suppressed by the second side rib that a part of the intraocular lens 1 enters the gap 200 between the upper surface of the pushing member 310 and the inner wall 185 of the nozzle 180 from the second side 325 side.

  Moreover, in the intraocular lens insertion device 10 of the said embodiment, as shown in FIG. 9, the upper rib 322 provided in the extrusion member 310 suppresses that a part of intraocular lens 1 entraps in the clearance gap 200 of upper part. Do. However, it is also possible to change this configuration. For example, instead of the upper rib 322 of the pushing member 310, a rib may be provided which protrudes inward from the inner wall of the nozzle 180. Even in this case, the possibility that part of the intraocular lens 1 is caught in the gap 200 is reduced.

DESCRIPTION OF SYMBOLS 1 intraocular lens 2 optical part 3 support part 3B back support part 4 proximal end 10 intraocular lens insertion instrument 180 nozzle 183 insertion port 300 plunger 310 extrusion member 313 support part contact part 314 optical part contact part 315 upper projection part 316 Lower side projection 320 first side 321 first recess 322 upper rib 323 lower rib A pushing shaft

Claims (3)

Inserting a deformable intraocular lens with an optic and one or more supports curved and extending outward from the optic into the eye through the inner passage from the insertion opening at the front end An intraocular lens insertion device,
The passage area becomes narrower toward the front, and a nozzle having the insertion port at the front end,
A rod-shaped push-out member that pushes the intraocular lens forward by moving forward in the passage along the axis of the passage;
Equipped with
The extrusion member is
An optical portion contact portion which is formed on the front end side of the push-out member and pushes the optical portion forward in contact with the optical portion;
The front end side of the push-out member is formed above the optical part contact part and contacts the rear support part, which is the support part extending backward from the optical part, so that the rear support part approaches the optical part A support contact portion to be moved to
The optical portion of the first side surface when the side surface on the side where the proximal end of the rear support portion of the intraocular lens is located among the side surface on the left side and the side surface on the right side of the pushing member is the first side surface A first recess which is formed rearward of the contact portion and the support portion contact portion and which is recessed inward of the first side surface of the optical portion contact portion and the support portion contact portion;
An upper rib projecting laterally from an upper end of the first side surface and continuously extending from a front end of the support contact portion to the first recess;
An intraocular lens insertion device characterized by comprising. An intraocular lens insertion device according to claim 1, wherein
The intraocular lens insertion device according to claim 1, wherein a front end surface of the support portion contact portion protrudes further forward than a front end surface of the optical portion contact portion. An intraocular lens insertion device according to claim 1 or 2, wherein
The intraocular lens insertion device according to claim 1, wherein the support contact portion is biased to a side of the left side and the right side of the shaft where the proximal end of the rear support portion of the intraocular lens is located.

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