JP2019170928A - Intraocular lens insertion instrument - Google Patents

Abstract

To provide an intraocular lens insertion instrument capable of inserting an intraocular lens in which a support part is subjected to tacking, into an eye of a patient, with a simple structure.SOLUTION: An intraocular lens 1 comprising an optical part 2 and support parts 3a, 3b extending outward from a peripheral edge of the optical part is mounted on a mount part 25, the intraocular lens is extruded by a plunger which is movable in a tip direction of an extrusion axis A to insert the intraocular lens into the eye of the patient. The mount part comprises: a mount surface on which the optical part is mounted; and engagement parts 51, 55 arranged above the optical part mounted on the mount surface, and engage to the support parts whose tip ends are deformed to be arranged inside the optical part. The engagement parts comprise a first support part for supporting the support parts from a lower side, and a second support part provided on a base end side of the extrusion axis relative to the first support part and supporting the support parts from the base end side.SELECTED DRAWING: Figure 5

Description

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

  Conventionally, as one of the surgical methods for cataracts, a method is generally used in which a lens is extracted and then a foldable soft intraocular lens is inserted instead of the lens. An intraocular lens insertion device (injector) is used for insertion of the intraocular lens. Patent Document 1 discloses an intraocular lens insertion instrument that fills an intraocular lens at a surgical site. In Patent Document 2, the support portion is deformed (so-called tacking) so that the tip of the support portion is arranged inside the optical portion, and the optical portion is bent so as to embrace (clamp) the deformed support portion. An intraocular lens insertion device for inserting a deformed intraocular lens into a patient's eye after being deformed is disclosed.

Japanese Patent Laying-Open No. 2015-157051 Japanese Patent Laid-Open No. 2006-19604

  In the intraocular lens insertion device of Patent Document 1, even if the support portion is pushed with a plunger, the support portion is difficult to be placed on the optical portion, and it is difficult to tack the support portion. Moreover, when trying to tackle the support portion as in Patent Document 2, the configuration of the intraocular lens insertion device tends to be complicated. Further, when the support portion is pushed by the plunger for tacking, unintentional deformation of the support portion is likely to occur while the support portion is being pushed by the plunger.

  Therefore, an object of the present disclosure is to provide an intraocular lens insertion device that can insert an intraocular lens having a support portion tacked into a patient's eye with a simple configuration.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) An intraocular lens having an optical part and a support part extending outward from the periphery of the optical part is placed on the placement part, and the intraocular lens is pushed out by a plunger that can move in the distal direction of the extrusion shaft. An intraocular lens insertion device for inserting the intraocular lens into a patient's eye, wherein the mounting unit includes a mounting surface on which the optical unit is mounted and the optical device mounted on the mounting surface. A locking part that locks the support part that is deformed so that the tip is located inside the optical part, and the locking part is located below the support part. A first support part that is supported from the first support part, and a second support part that is provided closer to the base end side of the extrusion shaft than the first support part and supports the support part from the base end side. To do.

  According to the intraocular lens insertion device of the present disclosure, it is possible to insert an intraocular lens with a support portion tacked into a patient's eye with a simple configuration.

It is an external appearance perspective view of the intraocular lens insertion instrument of this embodiment. It is an external appearance perspective view of a plunger. It is an external appearance perspective view of the front-end | tip of a plunger. It is the top view and side view of an intraocular lens. It is an external appearance perspective view of the intraocular lens insertion instrument which opened the cover member. It is a top view of the intraocular lens insertion instrument which opened the cover member. It is a left view of the intraocular lens insertion instrument which opened the cover member. FIG. 5 is a cross-sectional view (partial cross-sectional view) of FIG. 4. FIG. 5 is a β sectional view (partial sectional view) of FIG. 4. It is (gamma) sectional drawing (partial sectional drawing) of FIG. It is a figure explaining the utilization method of an intraocular lens insertion instrument. It is a figure explaining the utilization method of an intraocular lens insertion instrument. It is a figure explaining the utilization method of an intraocular lens insertion instrument. It is a figure explaining the utilization method of an intraocular lens insertion instrument. It is a figure explaining the utilization method of an intraocular lens insertion instrument.

  Exemplary embodiments of the present disclosure will be described with reference to the drawings. As shown in FIG. 1, an intraocular lens insertion device 10 of this embodiment includes a hollow main body 30 and an eye that is inserted from the proximal end side of the main body 30 and is movable in the front-rear direction along the extrusion axis A. It comprises a plunger 40 for pushing out the inner lens 1.

<Main body>
An insertion portion 20 is formed at the tip of the main body 30. The insertion part 20 can fold the intraocular lens 1 small. The insertion part 20 has a substantially cylindrical insertion cylinder 21, and the insertion cylinder 21 has a tip 21a. The insertion tube 21 is formed in a tapered shape whose inner diameter gradually decreases (thinner) toward the tip 21a. The intraocular lens 1 that passes through the insertion tube 21 is gradually bent slightly along the inner wall. A mounting portion 25 on which the intraocular lens 1 before extrusion is placed is disposed at the tip of the main body 30.

<Plunger>
2 and 3 are used in combination. The plunger 40 of this embodiment includes a pressing portion 41 pressed by an operator, a shaft base portion 42 connected to the distal end side of the pressing portion 41, an extrusion rod 43 connected to the distal end of the shaft base portion 42, and the extrusion rod 43. A distal end portion 44 that is connected to the distal end and contacts the optical portion 2 when the intraocular lens 1 is pushed out is provided. A passage communicating from the base end to the distal end is formed in the main body 30, and the plunger 40 is inserted into this passage. The plunger 40 can advance and retreat in the axial direction of the extrusion shaft A. The plunger 40 can push (inject) the intraocular lens 1 from the hole formed in the front end 21 a by pushing the intraocular lens 1 placed on the placement surface 22.

<Locking part>
As shown in FIG. 3, a locking portion 45 (supporting portion locking portion) for locking the deformed rear support portion 3 b (see FIG. 13) is formed at the distal end portion 44 of the present embodiment. Yes. The locking portion 45 includes a first support portion 46 for supporting the rear support portion 3b in the deformed state from below, and a second support for supporting the rear support portion 3b in the deformed state from the base end side of the extrusion shaft A. The unit 47 is provided. In the distal end portion 44 of the present embodiment, a recessed portion 48 is formed between the distal end portion 44 and the placement surface 22 for allowing a part of the optical unit 2 (the proximal end side of the extrusion shaft A) to sink.

  The first support portion 46 of this embodiment is provided at the distal end of the plunger 40, and the second support portion 47 is formed on the proximal end side of the extrusion shaft A with respect to the first support portion 46. Further, the base end (extrusion surface 48 a) of the recessed portion 48 is formed on the base end side of the extrusion shaft A with respect to the second support portion 47. The first support portion 46 has a first support surface 46a that supports the rear support portion 3b from below, and the first support surface 46a faces upward. The second support portion 47 has a second support surface 47 a that supports the rear support portion 3 b from the base end side of the extrusion shaft A, and the second support surface 47 a faces the distal end direction of the extrusion shaft A. The depressed portion 48 has an extrusion surface 48 a that extrudes the optical unit 2 from the base end side of the extrusion shaft A, and the extrusion surface 48 a faces the distal end direction of the extrusion shaft A.

  The second support surface 47a is inclined leftward with respect to a surface orthogonal to the extrusion axis A. When the tip 44 is viewed from above, the second support surface 47a is inclined toward the base 4b of the rear support portion 3b of the intraocular lens 1 placed on the placement portion 25 (see FIG. 13). When the second support surface 47a is inclined toward the base 4b side of the rear support portion 3b, the deformed state of the rear support portion 3b is easily maintained when the intraocular lens 1 is pushed out. Thereby, for example, the unintended deformation of the rear support portion 3b during the extrusion of the intraocular lens 1 is suppressed.

<Intraocular lens>
As shown in FIG. 4, the intraocular lens 1 of the present embodiment includes an optical unit 2 and a pair of support units 3 (a front support unit 3a and a rear support unit 3b). The optical unit 2 has a substantially disc shape, and includes an optical surface 2a, an optical surface 2b, and a side surface 2c that connects the pair of optical surfaces. The optical part 2 and the support part 3 are integrally molded. As the material of the intraocular lens 1, a material used for a flexible intraocular lens that can be bent conventionally, such as a simple substance such as HEMA (hydroxyethyl methacrylate), a composite material of acrylate ester and methacrylate ester, or the like is used. May be.

  The optical unit 2 gives a predetermined refractive power to the patient's eye. In order to support the optical unit 2 in the eye, the support unit 3 is connected to the peripheral portion (periphery) of the optical unit 2. In the present embodiment, when the intraocular lens 1 is placed on the placement portion 25, the support portion 3 disposed on the distal end side of the extrusion shaft A with respect to the optical portion 2 is referred to as a front support portion 3 a, and is more than the optical portion 2. The support portion 3 disposed on the base end side of the extrusion shaft A is referred to as a rear support portion 3b.

  A pair of support parts 3 (front support part 3a, rear support part 3b) extends outward from the peripheral part of the optical part 2. The support part 3 of this embodiment is a loop shape curved in the circumferential direction, and the tip of the support part 3 is a free end. That is, the support portion 3 has an open loop shape. The pair of support parts 3 are symmetrical with respect to the center of the optical part 2 and extend in the same circumferential direction.

<Placement part>
The placement unit 25 of the present embodiment will be described with reference to FIGS. 8 is an α-α sectional view of FIG. 6, FIG. 9 is a β-β sectional view of FIG. 6, and FIG. 10 is a γ-γ sectional view of FIG. 8-10, the outline of the optical part 2 mounted on the mounting part 25 and the outline of the rear support part 3b are indicated by dotted lines. 5-10, the plunger 40 is arrange | positioned in the initial position of the extrusion axis A direction.

  The placement unit 25 according to the present embodiment includes an opening 23, a base 24, and a lid member 27. The base 24 and the lid member 27 are connected by a hinge mechanism 28. The lid member 27 can open and close the opening 23. The hinge mechanism 28 has a hinge shaft extending in the left-right direction, and the lid member 27 can be rotated in the front-rear direction about the hinge shaft. The base portion 24 includes a bottom plate and side plates extending upward from left and right ends of the bottom plate. A placement surface 22 on which the intraocular lens 1 is placed is formed on the upper surface of the bottom plate.

<Locking part>
The mounting portion 25 of the present embodiment includes a locking portion for locking the rear support portion 3b that has been deformed so that the tip is disposed inside the optical portion 2 while maintaining the deformed state. The placement portion 25 of the present embodiment includes a plurality of locking portions. When the mounting portion 25 is viewed from above, a locking portion 51 (first locking portion) is formed on the right side of the extrusion shaft A, and a locking portion 55 (second locking portion) is formed on the left side of the extrusion shaft A. Has been. Each of the locking part 51 and the locking part 55 includes a first support part 52 (56) for supporting the rear support part 3b in the deformed state from below and a rear support part 3b in the deformed state from the base of the extrusion shaft A. A second support portion 53 (57) for supporting from the end side is provided.

  The locking portion 51, the locking portion 55, and the gap portion 29 of the present embodiment are formed on the proximal end side of the placement portion 25. The locking portion 51 (55) is disposed on the base end side of the mounting surface 22 and above the mounting surface 22, and a gap portion 29 is formed between the locking portion 51 and the mounting surface 22. The gap 29 is formed with a size that allows the proximal end of the optical unit 2 to sink. The locking portion 51 and the locking portion 55 are formed at the distal end of a plate member 34 (35) extending from the proximal end side of the extrusion shaft A to the distal end side, and the plate member 34 (35) is connected to the side plate of the base portion 24. Has been. In addition, since the latching | locking part is arrange | positioned at the both sides of the extrusion axis | shaft A, the latching | locking of the back support part 3b is stabilized and it becomes difficult to produce a tacking defect, for example. Tacking refers to a method for deforming an intraocular lens that deforms the support portion so that the tip of the support portion is disposed inside the optical portion. In other words, it refers to a method for deforming an intraocular lens in which the support portion is deformed until the tip of the support portion faces the optical surface. The locking portion 51 (55) of the present embodiment maintains the deformed state of the rear support portion 3b that has been deformed to the state where the tip of the rear support portion 3b faces the optical surface 2a above the optical surface 2a. To lock.

  The locking part 51 (55) of this embodiment will be described in more detail. In the present embodiment, the first support portion 52 (56) is provided at the distal end of the plate member 34, and the second support portion 53 (57) is provided closer to the proximal end side of the extrusion shaft A than the first support portion 52 (56). It has been. The first support portion 52 (56) has a first support surface 52a (56a) that supports the rear support portion 3b from below, and the first support surface 52a (56a) faces upward. The second support portion 53 (57) has a second support surface 53a (57a) that supports the rear support portion 3b from the base end side of the extrusion shaft A, and the second support surface 53a (57a) is the tip of the extrusion shaft A. Turn to the direction.

  The second support surface 53a (57a) suppresses restoration (movement in the proximal direction) of the rear support portion 3b in the deformed state. The second support surface 53a (57a) serves as a guide mechanism for deforming the rear support portion 3b into a predetermined shape. By deforming the rear support portion 3b into a predetermined shape, unintentional deformation of the rear support portion 3b when the intraocular lens 1 is pushed by the plunger 40 can be suppressed. Since the intraocular lens insertion device 10 of the present embodiment includes a plurality of second support surfaces (53a, 57a), the rear support portion 3b is easily deformed into a more suitable shape. Thereby, the tacking of the rear support portion is more stable. In this embodiment, the plunger 40 also has the second support surface 47a, and the tacking of the rear support portion is more stable.

  The second support surface 53a (57a) is inclined leftward with respect to the surface orthogonal to the extrusion axis A. When the mounting portion 25 is viewed from above, the second support surface 53a (57a) is inclined toward the root 4b of the rear support portion 3b of the intraocular lens 1 mounted on the mounting portion 25 (see FIG. 13). ). The closed lid member 27 is disposed above the placement surface 22 and the locking portion 51 (55). In the intraocular lens insertion device 10 of the present embodiment, when the lid member 27 is opened, the placement surface 22 and the locking portion 51 (55) appear, so that the placement of the intraocular lens 1 on the placement portion 25 is easy. is there.

  In addition, as shown in FIG. 8, the distance from the mounting surface 22 to the first support surface 56a is defined as a distance Ha, and the distance from the mounting surface 22 to the first support surface 46a is defined as a distance Hb. When the distance from the surface 22 to the first support surface 52a is defined as the distance Hc, in this embodiment, the relationship is Distance Ha = Distance Hb = Distance Hc. However, the relationship of distance Ha> distance Hb> distance Hc may be used. However, when the initial position of the plunger 40 is set to the base end side of the extrusion shaft A from the present embodiment, the relationship of distance Ha (distance Hc)> distance Hb is preferable. That is, the rear support part 3b locked by the locking part 51 and the locking part 55 may be arranged at a position higher than the first support surface 46a. Thereby, when the plunger 40 advances, it becomes easy to latch the back support part 3b with the latching | locking part 45. FIG.

  In a state where the plunger 40 is disposed at the initial position, the first support surface 52a, the first support surface 46a, and the first support surface 56a smoothly move from the left end of the first support surface 52a to the right end of the first support surface 56a. A plane (in the present embodiment, a plane) that is continuous with each other is formed. Further, the second support surface 53a, the second support surface 47a, and the second support surface 57a provide a smoothly continuous surface (curved surface in the present embodiment) from the left end of the second support surface 53a to the right end of the second support surface 57a. Is formed. Thereby, it is easy to change the back support part 3b into a more suitable shape, and the tacking of the back support part is more stable. The intraocular lens insertion device 10 of the present embodiment includes a plurality of locking portions (45, 51, 55). For example, the intraocular lens insertion device 10 includes only the locking portions 51 and the locking portions 55. Also good. Further, for example, an intraocular lens insertion device including only the locking portion 51 may be used.

<How to use>
The usage method of the intraocular lens insertion device 10 of this embodiment is demonstrated using FIGS. 11-15. First, the operator picks up the intraocular lens insertion device 10 and opens the lid member 27. As shown in FIG. 11, when the lid member 27 is opened, the placement surface 22 and the locking portions (45, 51, 55) appear through the opening 23. In FIG. 11, the plunger 40 is disposed at the initial position.

  Next, after applying a viscoelastic material to the placement surface 22 and the like, the surgeon picks the intraocular lens 60 with an insulator or the like and places (fills) the intraocular lens 60 on the placement portion 25 as shown in FIG. )Begin to. At this time, the rear support part 62b is arranged on the first support surface (52a, 46a, 56a) of the locking part (51, 45, 55), and the base end side of the optical part 2 is a gap (gap part 29, depressed). The intraocular lens 60 is placed on the placement portion 25 so as to be embedded in the portion 48). FIG. 13 shows the intraocular lens 60 placed on the placement unit 25.

  The intraocular lens 1 placed on the placement part 25 is deformed so that the tip of the rear support part 3 b is disposed inside the optical part 2. That is, the intraocular lens 1 on which the rear support portion 3b is tacked is placed on the placement portion 25. Here, the deformation state of the rear support portion 3b is maintained by the second support surfaces (53a, 47a, 57a). The front support part 3a and the optical part 2 are arranged (placed) on the placement surface 22, and the front end side of the rear support part 3b is engaged above the optical part 2 by the locking parts (51, 45, 55). It has been stopped.

  Returning to the description with reference to FIGS. When the placement of the intraocular lens 60 on the placement unit 25 is completed, the operator closes the lid member 27. Next, the operator inserts the distal end 21a into an incision formed in the cornea or sclera of the patient's eye. Next, the surgeon advances the plunger 40 as shown in FIG. 14 and pushes the entire intraocular lens 1 in the direction of the distal end of the extrusion axis A. In the intraocular lens insertion device 10 of this embodiment, when the intraocular lens 1 is placed on the placement portion 25, the rear support portion 3b is tacked, and the plunger 40 is intraocularly tacked to the rear support portion 3b. It only pushes out the entire lens 1. Therefore, after the placement on the placement portion 25, the rear support portion 3b is hardly deformed (the tip end of the rear support portion 3b is largely moved), and the rear support portion 3b is not easily deformed unintentionally.

  As shown in FIG. 14, when the surgeon further pushes the plunger 40, the intraocular lens 1 is folded small by the insertion tube 21, and the intraocular lens 1 folded slightly from the distal end of the insertion tube 21 is the eye of the patient's eye. It is injected (discharged) inside. The intraocular lens 1 is emitted in a state where the front support portion 3a and the rear support portion 3b are tacked. Although details are omitted, the front support portion 3a is tucked while the plunger 40 is pushed out by using the tapered shape of the insertion tube 21.

<Summary>
As described above, the intraocular lens insertion device 10 of the present embodiment mounts the intraocular lens 1 having the optical part 2 and the support part (for example, the rear support part 3b) extending outward from the periphery of the optical part 2. This is an intraocular lens insertion device 10 that is placed on the placement unit 25 and pushes out the intraocular lens 1 with a plunger 40 that can move in the distal direction of the push-out axis A to insert the intraocular lens 1 into a patient's eye. The mounting unit 25 is disposed above the mounting surface 22 on which the optical unit 2 is mounted, the optical unit 2 mounted on the mounting surface 22, and the tip is disposed inside the optical unit 2. Thus, a locking portion for locking the deformed support portion is provided. The locking part includes a first support part that supports the support part from below, and a second support part that is provided closer to the base end side of the extrusion shaft A than the first support part and supports the support part from the base end side. I have. Thereby, for example, it is easy to push out the intraocular lens 1 while maintaining the tacked state. Therefore, it is difficult to cause an event that the tacking state is released while the intraocular lens 1 is pushed out.

  Moreover, the intraocular lens insertion device 10 of this embodiment has the latching | locking part arrange | positioned at the right and left of the extrusion axis | shaft A. As shown in FIG. Thereby, for example, the support of the rear support portion 3b in the deformed state is more stable. Therefore, it is easy to push out the intraocular lens 1 while maintaining the tacked state. Further, the intraocular lens insertion device 10 of the present embodiment has a guide mechanism for deforming the support portion into a predetermined shape by continuously arranging a plurality of locking portions. Thereby, the back support part 3b can be tacked in a more suitable shape.

  In addition, the locking portion of the present embodiment is formed on the proximal end side of the mounting portion 25 and can be opened and closed for mounting the intraocular lens on the mounting portion 25 above the mounting surface 22 and the locking portion. A lid member 27 is disposed. Thereby, for example, it is easy to fill the intraocular lens 1 into the intraocular lens insertion device 10 at a surgical site. Further, in the intraocular lens insertion device 10 of the present embodiment, a locking portion that locks the supporting portion that is deformed so that the tip is disposed inside the optical unit 2 is formed at the tip of the plunger 40. Thereby, for example, even if the plunger 40 is advanced, the rear support portion 3b is not easily detached. Moreover, as for the intraocular lens insertion device 10 of this embodiment, the latching | locking part with which the plunger 40 is provided has an inclined surface inclined with respect to the surface orthogonal to the extrusion axis | shaft A, and the latching | locking part latches an inclined surface. It is inclined to the base side of the supporting part. Thereby, the unintentional deformation | transformation of the back support part 3b when the plunger 40 is advanced is suppressed. The aspect of the intraocular lens insertion device 10 is not limited to the present embodiment, and for example, the insertion part 20 and the placement part 25 may be in a cartridge form. In this case, it is sufficient that the cartridge includes a latch.

  It should be thought that embodiment disclosed this time is an illustration and restrictive at no points. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

DESCRIPTION OF SYMBOLS 1 Intraocular lens 2 Optical part 3b Back support part 10 Intraocular lens insertion instrument 22 Mounting surface 25 Mounting part 40 Plunger 51 Locking part 52 1st support part 53 2nd support part A Extrusion shaft

Claims (6)

An intraocular lens having an optical part and a support part extending outward from the periphery of the optical part is placed on the placement part, and the intraocular lens is pushed out by a plunger that can move in the distal direction of the push-out shaft. An intraocular lens insertion device for inserting the intraocular lens into
The placement section is
A mounting surface on which the optical unit is mounted;
A locking part that locks the supporting part that is arranged above the optical part placed on the placement surface and is deformed so that the tip is placed inside the optical part;
With
The locking portion is provided at a base end side of the extrusion shaft from the first support portion to support the support portion from below and the first support portion, and supports the support portion from the base end side. 2 support portions,
An intraocular lens insertion device.   2. The intraocular lens insertion device according to claim 1, wherein the locking portions are arranged on the left and right sides of the push-out shaft.   The intraocular lens insertion device according to claim 2, wherein a guide mechanism for deforming the support portion into a predetermined shape is formed by continuously arranging the plurality of locking portions. An intraocular lens insertion device.   It is an intraocular lens insertion instrument of any one of Claims 1-3, Comprising: The said latching | locking part is formed in the base end side of the said mounting part, Above the said mounting surface and the said latching | locking part. Further, an openable and closable lid member for placing the intraocular lens is disposed on the placement part.   It is an intraocular lens insertion instrument of any one of Claims 1-4, Comprising: The support part latching | locking part which latches the said support part deform | transformed so that a front-end | tip may be arrange | positioned inside the said optical part Is formed at the tip of the plunger. 6. The intraocular lens insertion device according to claim 5, wherein the support portion locking portion has an inclined surface that is inclined with respect to a plane orthogonal to the extrusion shaft, and the inclined surface is the support portion locking portion. An intraocular lens insertion device, wherein the device is inclined toward the base side of the support portion to be locked.

Images