JP2019042146A - Intraocular lens insertion instrument - Google Patents

Abstract

To provide an intraocular lens insertion instrument which can appropriately deform and project an intraocular lens.SOLUTION: An intraocular lens insertion instrument 10 inserts into a patient eye a bendable intraocular lens 1 having a disc-shaped optical portion and a support portion bendingly extending outwardly from the optical portion. The intraocular lens insertion instrument comprises: a push-out shaft P for pushing out the intraocular lens; a tubular insertion part 11 through of which tubular interior the push-out shaft extends for its insertion into an incision of the patient eye; a placement part 17 connected to the proximal end of the insertion part to place the intraocular lens thereon; a locking part 16 provided at the proximal end of the insertion part to lock the support portion of the intraocular lens placed on the placement part; and a deformation mechanism for bending the intraocular lens placed on the placement part.SELECTED DRAWING: Figure 2

Description

  The present disclosure relates to an intraocular lens insertion instrument for inserting an intraocular lens into a patient's eye.

  Intraocular lens insertion devices are known for inserting an intraocular lens into a patient's eye. For example, in the hingeless cartridge of Patent Document 1, the tacking of the front haptic and the bending of the optical part are performed in the process of placing the IOL picked by the forceps at the final position. Further, in the cartridge of Patent Document 2, tacking of the support portion and bending of the optical portion are performed in the process of closing the mounting table. In addition, the tacking of a support part (haptic) points out the method of arrange | positioning a support part inside an optical part.

JP-A-2015-533617 JP, 2010-158304, A

  However, in the case of the hingeless cartridge of Patent Document 1, the operator holds the soft IOL (intraocular lens) with forceps and moves the held IOL to perform haptic (support) tacking and optical section bending. It was easy to need skills. Further, in the case of the cartridge of Patent Document 2, since the restoration direction of the intraocular lens coincides with the direction of the support, the behavior of the support is likely to be large when the intraocular lens is restored in the eye.

  The present disclosure is intended to solve the above-described problems, and it is an object of the present disclosure to provide an intraocular lens insertion device capable of suitably deforming and injecting an intraocular lens.

In order to solve the above-mentioned subject, the present invention is characterized by having the following composition.
(1) An intraocular lens insertion device for inserting a foldable intraocular lens including a disc-shaped optical portion and a support portion curved and extending outward from the optical portion into an eye of a patient's eye And the cylindrical insertion portion which is inserted into the incisional wound of the patient's eye and which is connected to the proximal end of the insertion portion. A mounting portion on which the intraocular lens is mounted, and a locking portion provided at a proximal end of the insertion portion and locking the support portion of the intraocular lens mounted on the mounting portion And a deformation mechanism for bending the intraocular lens placed on the placement unit.

  According to the present disclosure, it is possible to provide an intraocular lens insertion device capable of suitably deforming and emitting an intraocular lens.

It is an external appearance perspective view of the intraocular lens insertion system of this embodiment. It is an external appearance perspective view of a cartridge. It is an AA sectional view of Drawing 2, and is a figure in the state where a mounting part was opened. FIG. 4 is a cross-sectional view at the same position as FIG. 3, in which the mounting portion is closed. It is the side view which looked at the intraocular lens insertion instrument of FIG. 2 from the left direction. It is a BB sectional view of FIG. It is a front view of an intraocular lens. It is a side view of an intraocular lens. It is explanatory drawing regarding the usage method of the intraocular lens insertion instrument of FIG. It is explanatory drawing which concerns on the usage method of the intraocular lens insertion system of FIG. It is explanatory drawing which concerns on the usage method of the intraocular lens insertion system of FIG. It is explanatory drawing which concerns on the usage method of the intraocular lens insertion system of FIG. It is explanatory drawing which concerns on the usage method of the intraocular lens insertion system of FIG. It is an external appearance perspective view of the cartridge of a modification example. It is sectional drawing of the cartridge of a modification example. It is explanatory drawing of the cartridge for comparison. It is explanatory drawing of the cartridge for comparison.

  Hereinafter, embodiments of the present invention will be described based on the drawings. FIG. 1 is an external perspective view of the intraocular lens insertion system 50 of the present embodiment. The intraocular lens insertion system 50 of the present embodiment is used to insert the intraocular lens 1 into the eye of a patient's eye.

<Intraocular lens insertion system>
The intraocular lens insertion system 50 of the present embodiment includes a hand piece 51 and a cartridge 10 (intraocular lens insertion device). The handpiece 51 is gripped by the operator. The tip portion of the cartridge 10 is inserted into the patient's eye. The cartridge 10 of the present embodiment is detachable from the hand piece 51. In the present embodiment, the hand piece 51 is formed of metal, and the cartridge 10 is formed of resin. For example, the hand piece 51 and the cartridge 10 may be formed of resin and integrally molded.

<Handpiece>
The hand piece 51 of the present embodiment includes a main body 52 and a plunger 53. The plunger 53 is used to push the intraocular lens 1. The main body 52 of the present embodiment is cylindrical, and the rod-like plunger 53 can move along the extrusion axis P inside the main body 52. An opening 54 is formed in the side wall of the main body 52. The opening 54 is used to attach the cartridge 10 to the hand piece 51.

<Intraocular lens>
The intraocular lens 1 used by the intraocular lens insertion system 50 of this embodiment is demonstrated with reference to FIG. 7 and FIG. The intraocular lens 1 of the present embodiment includes an optical unit 2 and a pair of supporting units 3 (supporting units 3a and 3b). The optical unit 2 has a predetermined refractive power. The support 3 supports the optic 2 in the eye of the patient's eye. The optical unit 2 of the present embodiment is substantially disk-shaped, and includes an optical surface 4 a facing the corneal direction in the eye and an optical surface 4 b facing the retinal direction in the eye.

  In the present embodiment, the proximal ends 5 (proximal ends 5a and 5b) of the respective support portions 3 are disposed at symmetrical positions with respect to the optical axis. The support portion 3 of the present embodiment has an open loop shape, and extends from the optical portion 2 so as to curve outward. The intraocular lens 1 of the present embodiment is a one-piece intraocular lens, and the optical portion 2 and the support portion 3 are integrally formed by cutting, molding, or the like. The techniques of the present disclosure may be applied to the case of inserting an intraocular lens (e.g., a three-piece intraocular lens) in which a support is separately attached to the optical unit into the eye. In addition, the technology of the present disclosure may be applied to an intraocular lens having one or three or more open loop-shaped supports 3, an intraocular lens having a plate-like support, and the like.

  The intraocular lens 1 of the present embodiment is flexible and can be inserted into the eye in a bent state using the intraocular lens insertion system 50. 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 acid ester and methacrylic acid ester may be used as the material of the intraocular lens 1.

<Cartridge>
The cartridge 10 of the present embodiment will be described with reference to FIGS. In the cartridge 10 of the present embodiment, the movable portion 19 (part of the mounting portion 17) is rotated to open the mounting portion 17 in a first state (see FIG. 3) and the mounting portion 17. It can be transformed into the closed second state (see FIG. 4). FIG. 2 is an external perspective view of the cartridge 10 with the mounting portion 17 opened. FIG. 3 is a cross-sectional view taken along the line A-A of FIG. 2 and is a cross-sectional view of the cartridge 10 with the mounting portion 17 opened, as viewed from the proximal end side of the extrusion axis P. FIG. 4 is a cross-sectional view of the cartridge 10 with the placement unit 17 closed at the same cross-sectional position as in FIG. In FIG. 2, FIG. 3, and FIG. 4, the outline of the intraocular lens 1 placed on the placement unit 17 is indicated by a dotted line. 5 is a left side view of the cartridge 10 of FIG. 2, and FIG. 6 is a cross-sectional view of FIG.

  The insertion part 11 of this embodiment is cylindrical. Inside the insertion portion 11, a hollow portion 21 (see FIG. 6) communicating from the proximal end to the distal end is formed. In the state where the placement unit 17 is closed, the hollow portion 23 (see FIG. 4) is formed in the placement unit 17. In a state where the mounting portion 17 is closed, the hollow portion 21 of the insertion portion 11 and the hollow portion 23 of the mounting portion 17 communicate with each other, and the extrusion axis P penetrates the communicated hollow portion. The plunger 53 of the present embodiment is movable from the proximal side to the distal side along the extrusion axis P, and the intraocular lens 1 pushed by the plunger 53 is in the order of the hollow portion 23 and the hollow portion 21. Then, it is ejected from the injection hole 12. The cross section (the plane orthogonal to the extrusion axis P) of the hollow portion 21 of the present embodiment is substantially circular. An injection hole 12 is formed at the distal end of the insertion portion 11, and an edge portion 15 is formed at the proximal end of the insertion portion 11. That is, the edge portion 15 is an end portion of the cylindrical insertion portion 11. When the base end of the insertion portion 11 is viewed from the base end side of the extrusion axis P, the edge 15 is formed in a semi-arc shape centered on the extrusion axis P (see FIG. 3).

  A mounting unit 17 is connected to the proximal end of the insertion unit 11. In detail, the mounting unit 17 of the present embodiment includes the fixed unit 18 and the movable unit 19. Each of the fixed portion 18 and the movable portion 19 is a plate-like member extending in parallel with the extrusion axis P, and is curved when viewed from the proximal end side of the extrusion axis P. The fixed portion 18 is connected to the proximal end of the insertion portion 11, and the movable portion 19 is connected to the side of the fixed portion 18 (see FIG. 2). The fixed portion 18 and the movable portion 19 are connected by a hinge, and the pivot axis Q of the hinge is parallel to the extrusion axis P. The movable portion 19 can pivot about the pivot axis Q by this hinge. The movable portion 19 of the present embodiment is connected to the left side of the fixed portion 18. When the mounting portion 17 is closed (see FIG. 4), the fixed mounting portion 18 and the movable portion 19 form a cylindrical mounting portion 17, and the hollow portion 23 is formed inside the cylindrical mounting portion 17. Is formed. On the other hand, in a state where the placement unit 17 is opened (FIGS. 2 and 3), the inner wall forming the hollow portion 23 is exposed, and the exposed inner wall is a placement surface 14 (see FIG. 2) for placing the intraocular lens 1 It becomes a mounting surface 14a and a mounting surface 14b).

  The edge 15 of the present embodiment includes the locking portion 16. The locking portion 16 of the present embodiment is used to lock the support portion 3 a of the intraocular lens 1 placed on the placement surface 14. More specifically, the locking portion 16 of the present embodiment is used to maintain the deformed state of the support portion 3a. When the intraocular lens 1 is placed on the placement unit 17 as in the case of the support unit 3a of the present embodiment, the support unit 3 disposed closer to the tip end of the extrusion axis P than the optical unit 2 is forward. Sometimes called support. As shown in FIGS. 5 and 6, the locking portion 16 of the present embodiment has a cutout shape in which a part of the edge 15 is cut away in the tip direction of the extrusion axis P (in other words, a part of the edge 15) Is depressed in the direction of the tip of the extrusion axis P).

  When the edge portion 15 is viewed from the base end side of the extrusion axis P, the locking portion 16 of the present embodiment is formed on the rotation axis Q side and is closer to the optical portion 2 placed on the placement portion 17. It is formed at the top (see FIG. 3). The angle D (FIG. 6) at which the locking portion 16 is formed is preferably in the range of 0 to 90 degrees, and is 35 degrees in the present embodiment. When the cartridge 10 of the present embodiment is viewed from above, the locking portion 16 is formed on the left side of the extrusion axis P, and the base end 5 a of the support portion 3 a of the intraocular lens 1 placed on the placement portion 17. Are disposed on the left side of the extrusion axis P, and the extrusion axis P passes through an intermediate position of the radius of the optical section 2. That is, in the cylindrical insertion portion 11, the locking portion 16 is formed on the side wall (left side) opposite to the side (right side) on which the proximal end 5a of the support portion 3a is disposed. The fixed portion 18 and the movable portion 19 of the present embodiment are provided with projecting portions 13 (13a, 13b) projecting in a direction away from the mounting surface 14 (see FIGS. 2 and 3). The protrusion 13a is provided at the right end of the placement surface 14a, and the protrusion 13b is provided at the left end of the placement surface 14b. The protrusion part 13 of this embodiment can suppress the problem in which the optical part 2 pops out from the mounting surface 14 when mounting the intraocular lens 1 on the mounting surface 14.

<How to use>
The usage method of the intraocular lens insertion system 50 of this embodiment is demonstrated using FIG. 9-FIG. 13 together. First, the user (operator or assistant) opens the mounting portion 17 of the cartridge 10 (see FIGS. 2 and 9). Next, the user mounts the intraocular lens 1 on the exposed mounting surface 14 (mounting surfaces 14a and 14b) (see FIGS. 2, 3 and 10). When the user places the intraocular lens 1 on the mounting surface 14, the user tacks the support portion 3 a to the inside of the optical portion 2 and locks the tacked support portion 3 a with the locking portion 16. That is, the intraocular lens 1 deformed (folded) such that the support portion 3 a extending in the tip direction of the extrusion axis P is tacked to the inside of the optical portion 2 is placed on the placement surface 14. In the present embodiment, a part of the support portion 3 a enters the hollow portion 21. In the present embodiment, the support portion 3 b (rear support portion) of the intraocular lens 1 placed on the placement surface 14 extends in the proximal direction of the extrusion axis P. The optical surface 4 a of the intraocular lens 1 placed on the placement surface 14 faces away from the placement surface 14.

  Next, the user closes the placement unit 17 (see FIG. 11). As the mounting unit 17 is closed, the entire optical unit 2 is bent so that the optical surface 4a is valley-folded. The valley-folded optical surface 4a encloses the support 3a. That is, the optical part 2 is bent while the support part 3a is tacked. Next, the user completely closes the placement unit 17 (see FIG. 12). When the placement portion 17 is completely closed, the hollow portion 23 is formed inside the placement portion 17, and the intraocular lens 1 in which the support portion 3a is surrounded by the optical portion 2 is disposed in the formed hollow portion 23 . The optical part 2 of the present embodiment is deformed into a substantially cylindrical shape along the inner wall forming the hollow part 23, and the support part 3a is disposed inside the optical part 2 deformed into a substantially cylindrical shape (see FIG. 4) .

  Next, the user mounts the cartridge 10 on the hand piece 51 as shown in FIG. 1, and then inserts the distal end portion of the insertion portion 11 into an incision formed in the cornea of the patient's eye. Next, the user pushes the proximal end of the plunger 53 with a finger to advance the plunger 53 in the distal direction of the pushing axis P. As shown in FIG. 13, the intraocular lens 1 pushed by the plunger 53 moves in the distal direction while the support portion 3 a is covered with the optical portion 2. When the tip of the plunger 53 reaches the vicinity of the injection hole 12, the intraocular lens 1 is ejected (ejected) from the injection hole 12. The ejected intraocular lens 1 is restored in the eye of the patient. The user places the intraocular lens 1 in the lens capsule. The intraocular lens 1 of the present embodiment is different from the direction in which the deformed intraocular lens 1 is restored (left and right direction in FIG. 1) and the direction in which the support portion 3 faces (front and rear direction in FIG. 1). The behavior of the support portion 3 when the inner lens 1 is restored is suppressed. As described above, the intraocular lens 1 is inserted into the patient's eye using the intraocular lens insertion system 50 of the present embodiment.

<Effect of locking part>
The effects of the locking portion 16 of the present embodiment will be described using FIG. 16 and FIG. 17 in combination. 16 and 17 show a cartridge 60 for comparison. The cartridge 60 for comparison and the cartridge 10 of the present embodiment are different in whether or not the locking portion 16 is provided. Since the cartridge 60 for comparison does not have the locking portion 16, for example, the direction in which the leading end portion of the tacked support portion 3a faces tends to be unstable (see FIG. 16). As a reason that the deformed state of the support portion 3a is likely to be unstable, for example, the restoring force acts on the deformed support portion 3a, the inner wall of the cartridge 10 has high lubricity, the inside of the insertion portion 11 and the mounting surface 14 It is conceivable that a lubricant (viscoelastic substance etc.) is applied to the above. As shown in FIG. 16, if the optical unit 2 is bent while the tacking of the support portion 3a is unstable, for example, there is a risk that the tacking of the support portion 3a may be released while the intraocular lens 1 is being pushed by the plunger 53. There is. If tacking of the support portion 3a is released, installation of the intraocular lens 1 in the capsule is facilitated, and the support portion 3a is easily damaged during the extrusion of the intraocular lens 1.

  Further, since the cartridge 60 for comparison is not provided with the locking portion 16, for example, the support portion 3a is easily inserted between the optical portion 2 and the mounting surface 14 (FIG. 17). That is, the support portion 3a is easily back-tucked (the support portion 3a is disposed outside the bent optical portion 2). In the back tacking state, placement of the intraocular lens 1 in the capsule is easy and time-consuming, and the support portion 3a is easily broken during the extrusion of the intraocular lens 1. The cartridge 10 of the present embodiment is provided with the locking portion 16 for locking the support portion 3a, so that tacking of the support portion 3a is unlikely to be unstable. Also, the user can use the locking portion 16 as a guide for deforming the support portion 3a into a predetermined shape. Therefore, even a user who is unfamiliar with the handling of the intraocular lens insertion system 50 can easily deform the support portion 3a into a suitable shape using the locking portion 16 (guide means).

<Modification example>
FIG. 14 shows a cartridge 20 of the modification. The cartridge 20 of the modified example includes a lid 22 for fitting with the locking portion 16. The lid 22 is provided on the movable portion 19. The shape of the lid 22 corresponds to the notch shape of the locking portion 16. When the mounting portion 17 is closed, the lid 22 and the locking portion 16 are fitted, and the lid 22 fills the cutout area of the locking portion 16. As a result, for example, when the mounting portion 17 is closed, the risk of part of the support portion 3 jumping out of the locking portion 16 is suppressed. FIG. 15 shows a cartridge 30 of the modified example. The locking portion 31 provided in the cartridge 30 of the modified example is formed in a shape in which a part of the cylindrical insertion portion 11 is expanded outward. The shape of the locking portion 31 is not limited to the present disclosure, as long as the deformed supporting portion 3 a can be locked by the locking portion 31.

<Summary>
As described above, the intraocular lens insertion device according to the present embodiment includes the foldable intraocular lens 1 including the disk-shaped optical unit 2 and the support unit 3 that is curved and extended outward from the optical unit 2. An intraocular lens insertion device for inserting the intraocular lens into the eye of a patient's eye, wherein the pushing axis P for pushing out the intraocular lens 1 and the pushing axis P penetrate the inside of the tube and are inserted into the incision of the patient's eye Provided at the proximal end of the insertion portion 11 which is connected to the proximal end of the insertion portion 11 and on which the intraocular lens 1 is placed, and at the proximal end of the insertion portion 11 It comprises a locking portion 16 for locking the support portion 3 of the intraocular lens 1 placed, and a deformation mechanism for bending the intraocular lens 1 placed on the placement portion 17. Thus, for example, even if the intraocular lens 1 placed on the placement unit 17 is deformed, unintended deformation of the support unit 3 is less likely to occur. Therefore, breakage of the support portion 3 during ejection of the intraocular lens 1 can be suppressed, and intracapsular placement of the intraocular lens 1 is facilitated.

  Further, the locking portion 16 of the present embodiment locks the support portion 3 bent to face the optical portion 2. Thereby, for example, the intraocular lens 1 can be ejected in the state where the support portion 3 is tacked. Therefore, breakage of the support portion 3 during ejection of the intraocular lens 1 can be suppressed, and intracapsular placement of the intraocular lens 1 is facilitated. Further, the deformation mechanism of the present embodiment deforms the intraocular lens 1 placed on the placement unit 17 into a curved shape as viewed from the proximal direction of the extrusion axis P. Thereby, for example, it is easy to make small incisions formed in a patient's eye smaller. Moreover, the latching | locking part 16 of this embodiment is formed in the cut | notch shape which cut in the cylindrical edge in the front-end direction. Thereby, for example, the locking portion 16 can be easily formed, and it is difficult to prevent the pushing of the intraocular lens 1.

  The locking portion 16 of the present embodiment locks the support portion 3a (front support portion) disposed closer to the tip end side of the extrusion axis P than the optical portion 2. However, the cartridge 10 or the hand piece 51 may be provided with a locking portion that locks the support portion 3 b (rear support portion) disposed closer to the proximal side than the optical portion 2. In this case, for example, the locking portion may be provided on the proximal end side of the cartridge. The aspect which locks only the support part 3b may be sufficient. In this embodiment, the intraocular lens 1 placed on the placement unit 17 is folded using a hinge, but the deformation mechanism of the intraocular lens 1 is not limited to this. However, it is preferable that the intraocular lens 1 be bent in a cylindrical shape along the extrusion axis P.

  The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is shown not by the above description but by the scope of claims, and is intended to include all modifications within the scope of claims and equivalents thereof.

1: Intraocular lens 2: Optical part 3: Support part 10: Cartridge 11: Insertion part 16: Locking part 17: Mounting part 18: Fixed part 19: Movable part P: Pushing shaft

Claims (4)

An intraocular lens insertion device for inserting a foldable intraocular lens including a disc-shaped optical portion and a support portion curved and extending outward from the optical portion into an eye of a patient's eye,
An extrusion shaft for pushing out the intraocular lens;
The cylindrical insertion portion through which the pushing shaft penetrates a cylindrical inside and which is inserted into an incisional wound of the patient's eye;
A mounting portion connected to the proximal end of the insertion portion on which the intraocular lens is mounted;
A locking portion which is provided at a proximal end of the insertion portion and which locks the support portion of the intraocular lens placed on the placement portion;
A deformation mechanism that bends the intraocular lens placed on the placement unit;
An intraocular lens insertion device comprising: An intraocular lens insertion device according to claim 1, wherein
The locking portion locks the support portion bent to face the optical portion.
Intraocular lens insertion device characterized by the above. An intraocular lens insertion device according to claim 1 or 2, wherein
The deformation mechanism deforms the intraocular lens placed on the placement unit into a curved shape as viewed from the proximal direction of the extrusion shaft.
Intraocular lens insertion device characterized by the above. The intraocular lens insertion device according to any one of claims 1 to 3, wherein
The intraocular lens insertion device, wherein the locking portion is formed in a cut shape in which the cylindrical edge is cut in a distal direction.

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