JP2020137894A - Intraocular lens insertion instrument - Google Patents

Abstract

To provide an intraocular lens insertion instrument enabling appropriate insertion of an intraocular lens into an eye.SOLUTION: The intraocular lens insertion instrument comprises a nozzle and an extrusion member 310. The nozzle has passage area that becomes smaller as it goes forward and has an insertion port at the nozzle's front end. The extrusion member 310 moves forward in a passage of the nozzle along the passage's axis to extrude an intraocular lens forward. The extrusion member 310 pushes the intraocular lens forward in the passage of the nozzle to fold an optical part in a roll shape in a state in which the intraocular lens's support part is folded and locate the support part inside the folded optical part. The intraocular lens insertion instrument comprises a pressing part 327. The pressing part 327 presses a rear support part to the optical part side in a state in which the rear support part is folded on the optical part side.SELECTED DRAWING: Figure 4

Description

The present disclosure relates to an intraocular lens insertion device that inserts an intraocular lens into the eye.

Conventionally, as one of the surgical methods for cataract, a method of inserting a bendable soft intraocular lens into the eye instead of the removed crystalline lens has been used. In addition, an intraocular lens may be inserted in front of the crystalline lens in order to correct the refractive power of the eye. An intraocular lens insertion device called an injector may be used to insert the intraocular lens into the eye.

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 portion (so-called "tacking" is performed). By tacking, the possibility of damage to the support portion is reduced. For example, in the intraocular lens insertion device described in Patent Document 1, when the operator pushes out the extrusion member, the rear support portion of the intraocular lens is bent inside the outer peripheral portion of the optical portion by the extrusion member. When the extruded member is further extruded and the intraocular lens moves toward the tip of the nozzle, the front support portion of the intraocular lens comes into contact with the inner wall surface of the nozzle, and the front support portion is also bent inside the outer peripheral portion of the optical portion. .. Further, when the intraocular lens is pushed toward the tip side, the optical portion is folded with the front support portion and the rear support portion mounted on the ceiling surface side of the optical portion. The intraocular lens is then inserted into the eye through a passage in the nozzle.

Japanese Unexamined Patent Publication No. 2016-190023

In the process of folding the optical portion, if the support portion is not bent at an appropriate position on the optical portion, various defects can occur.

For example, the position of the bent support portion with respect to the upper surface (the surface on the ceiling side) of the optical portion may be higher than the appropriate position. In this case, the upper space of the space in the passage of the nozzle is narrowed by the support portion above the appropriate position. The edge of the optical portion and the like slide toward the inner wall of the nozzle and are folded toward the ceiling side. Therefore, if the space on the ceiling side in the nozzle is narrow, the edge of the optical portion sliding on the inner wall of the nozzle easily enters the gap between the inner wall on the ceiling side of the nozzle and the extrusion member.

Further, if the support portion is above an appropriate position, the support portion may be sandwiched between both edges of the optical portion that is folded toward the ceiling side. In addition, the support portion may not be properly arranged inside the optical portion that is folded into a roll shape. In these cases, problems such as damage to the support portion are likely to occur. Further, if the optical portion is folded while the support portion is positioned above an appropriate position, the amount of bending of the optical portion may be inappropriate. If the optics are not bent in the proper amount, the load on the nozzle and the load required for pushing the intraocular lens forward in the nozzle may increase.

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

The intraocular lens insertion device provided by a typical embodiment in the present disclosure includes a deformable intraocular lens having a disk-shaped optical portion and one or more support portions extending outward from the optical portion. , An intraocular lens insertion device that is inserted into the eye through an insertion port at the front end through an internal passage, and the passage area becomes narrower toward the front, and a nozzle having the insertion port at the front end and the passage. It comprises a rod-shaped extrusion member that pushes the intraocular lens forward by moving forward in the passage along an axis, the extrusion member pushing the intraocular lens forward in the passage of the nozzle. In a state where the support portion is bent on the optical portion, the optical portion is folded into a roll shape, the support portion is positioned inside the folded optical portion, and the intraocular lens is inserted. The instrument is a pressing portion that presses the rear support portion downward, which is the optical portion side, in a state where the rear support portion, which is the support portion extending rearward from the optical portion, is bent onto the optical portion. Be prepared.

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

It is a perspective view which looked at the intraocular lens insertion instrument 10 from diagonally above right. It is a perspective view of the plunger 300 seen from diagonally above right. It is (a) plan view and (b) right side view of the intraocular lens 1. It is a perspective view which saw the extrusion member 310 from the lower right diagonally. It is a perspective view which saw the extrusion member 310 from the diagonally upper left. It is a right side view of the extrusion member 310. It is a front view of the extrusion member 310. It is a schematic explanatory drawing which shows the state of movement and deformation at the time of pushing out an intraocular lens 1. It is a perspective view which looked at the extrusion member 410 which does not have a pressing part 327 from the diagonally lower right side. It is a front sectional view at the substantially center in the front-rear direction of the nozzle 180 when the intraocular lens insertion device does not include the pressing portion 327. It is a front sectional view of the nozzle 180 of this embodiment at the substantially center in the front-rear direction.

<Overview>
The intraocular lens insertion device exemplified in the present disclosure inserts an intraocular lens into the eye through an insertion port at the front end through an internal passage. The intraocular lens includes a disk-shaped optical portion and one or more supports extending outward from the optical portion. The intraocular lens insertion device includes a nozzle and an extrusion member. The nozzle has a passage area narrower toward the front and an insertion port at the front end. The extruded member is rod-shaped and moves forward in the passage along the axis of the passage to push the intraocular lens forward. In addition, the extrusion member pushes the intraocular lens forward in the passage of the nozzle to fold the optical portion into a roll shape and support the inside of the folded optical portion in a state where the support portion is bent on the optical portion. Position the part. The intraocular lens insertion device exemplified in the present disclosure includes a pressing portion. The pressing portion presses the rear support portion downward, which is the optical portion side, in a state where the rear support portion, which is a support portion extending rearward from the optical portion, is bent onto the optical portion.

Here, in the present disclosure, the side opposite to the side where the center of the optical portion folded in a roll shape is located is the ceiling side (upper side) of the intraocular lens insertion device when viewed from the axis of the passage of the intraocular lens insertion device. And. That is, of the directions intersecting the axes of the passage, the side where the edges of the optical portions approach each other in the process of folding the optical portions in a roll shape is the ceiling side. The side opposite to the ceiling side is the bottom side (lower side). However, the vertical direction in the present disclosure does not specify the vertical direction when the intraocular lens insertion device is actually used. Therefore, the intraocular lens insertion device may be used in a state where the vertical direction defined in the present disclosure is reversed.

In the intraocular lens insertion device exemplified in the present disclosure, the pressing portion presses the rear support portion bent onto the optical portion toward the optical portion. As a result, in a state where the support portion is appropriately pressed toward the optical portion side, the optical portion can be easily folded so as to wrap the support portion. Therefore, the space on the ceiling side in the passage of the nozzle is easily secured. When the space on the ceiling side is secured, the optical part is folded into a roll shape, and even if the edge part of the optical part is located on the ceiling side in the passage, the edge of the optical part is in the space secured by the pressing part. It becomes easier for the parts to escape. Therefore, it becomes difficult for the intraocular lens to enter between the inner wall of the nozzle and the extrusion member. In addition, the possibility that the support portion is sandwiched between both edges of the folded optical portion is reduced. Further, the possibility that the support portion is not arranged inside the optical portion that is folded into a roll shape is reduced. Therefore, the intraocular lens is appropriately inserted into the eye.

The extruded member may include a lower protrusion that projects forward from the lower part of the front end face. In this case, when the intraocular lens is pushed forward by the extrusion member, the lower protrusion prevents the intraocular lens from shifting downward from the front end surface of the extrusion member. Therefore, even if the entire intraocular lens is pressed downward by the pressing portion, it is difficult for a part of the intraocular lens to enter between the bottom surface of the extrusion member and the inner wall of the nozzle.

Of the left side surface and the right side surface of the extruded member, the side surface on the side where the base end of the rear support portion of the intraocular lens is located is defined as the first side surface. The extruded member may include an upper rib that projects laterally from the top of the first side surface. The pressing portion may be formed on a surface of the upper rib that faces downward, and may be an inclined surface that is inclined downward toward the rear. In this case, the upper rib further suppresses a part of the intraocular lens from entering the gap between the inner wall on the ceiling side (upper side) of the nozzle and the extrusion member. Further, when the extruded member is pushed forward, the rear support portion wraps around below the upper rib, and the intraocular lens moves forward while the rear support portion is pressed toward the optical portion by the pressing portion which is an inclined surface. Therefore, only by pushing the extruded member forward, the intraocular lens moves forward appropriately in a state where the optical portion is folded so as to wrap the support portion.

A parallel surface extending parallel to the axis of the passage from the front end portion of the upper rib may be formed on the surface of the upper rib facing downward. The pressing portion, which is an inclined surface, may be formed behind the parallel surface. In this case, the rear support portion is pressed toward the optical portion by the pressing portion, so that a space is formed below the parallel surface. Therefore, when the optical portion is folded into a roll shape, a part of the intraocular lens easily escapes to the space below the parallel surface. Therefore, it becomes difficult for a part of the intraocular lens to enter the gap between the inner wall of the nozzle and the extrusion member. Further, by defining the positions of the parallel surface and the pressing portion, the timing at which the rear support portion is pressed toward the optical portion by the pressing portion is adjusted to an appropriate timing. For example, it is possible to suppress a problem that the rear support portion is pressed by the pressing portion before being sufficiently moved onto the optical portion and at least a part of the rear support portion wraps around below the optical portion. Therefore, the intraocular lens is more appropriately inserted into the eye.

However, it is also possible to omit the parallel surface of the upper rib. That is, the pressing portion, which is an inclined surface, may extend rearward from the front end portion of the upper rib. Even in this case, since the rear support portion is appropriately pressed toward the optical portion, the optical portion is properly folded so as to wrap the support portion.

The extruded member may include an optical portion contact portion and a support portion contact portion. The optical portion contact portion is formed on the front end side of the extrusion member, and comes into contact with 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 extruded member, and contacts the rear support portion to move the rear support portion in a direction closer to the optical portion. The upper rib may extend rearward from the front end of the support contact. In this case, the extrusion member is simply pushed forward to move the rear support portion onto the optical portion (that is, tacking the rear support portion), press the rear support portion toward the optical portion, and the entire intraocular lens. All forward movements are done properly.

However, it is also possible to perform tacking of the rear support portion by a member other than the extruded member. That is, the intraocular lens may be pushed forward by the extrusion member after the rear support portion is tacked by a member other than the extrusion member.

The front end surface of the support portion contact portion may be located in front of the front end surface of the optical portion contact portion. In this case, the rear support portion is easily pushed forward by the optical portion contact portion. Therefore, tacking of the rear support portion can be performed more appropriately.

The extruded member may further include a recess. The depressed portion is formed behind the front end portion of the first side surface, and is depressed inside the first side surface at the front end portion. When the rear support portion is pressed toward the optical portion by the pressing portion, it is possible that the load applied to the rear support portion (particularly, the base end portion of the rear support portion) increases. However, by forming the depressed portion, the rear support portion pressed by the pressing portion can escape to the depressed portion. Therefore, the possibility that the intraocular lens enters the gap between the inner wall of the nozzle and the extrusion member is further reduced.

<Embodiment>
Hereinafter, typical embodiments in the present disclosure will be described with reference to the drawings. In the following description, the direction of the main body 100 on the nozzle 180 side (lower left side of the paper surface in FIG. 1) is in front of the intraocular lens insertion device 10, and the direction of the pressed portion 370 of the plunger 300 (upper right side of the paper surface in FIG. 1). The side) is behind the intraocular lens insertion device 10. Further, the upper side of the paper surface of FIG. 1 is the ceiling side (upper side) of the intraocular lens insertion device 10, the lower side of the paper surface of FIG. 1 is the bottom surface side (lower side) of the intraocular lens insertion device 10, and the lower right side of the paper surface of FIG. 1 is the eye. The right side of the intraocular lens insertion device 10 and the upper left side of the paper surface in FIG. 1 are the left side of the intraocular lens insertion device 10. As described above, the specification of the direction in the present disclosure does not specify the direction when the intraocular lens insertion device 10 is actually used, and it is convenient for facilitating the explanation of the technique in the present disclosure. It is a regulation made for the purpose. Therefore, for example, the intraocular lens insertion device 10 may be used in a state where the vertical direction defined in the present disclosure is reversed.

(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 a 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 tubular shape, and the intraocular lens 1 is inserted into the eye through a passage inside the main body 100. The plunger 300 has a rod shape and can move in the front-rear direction in the passage inside the main body 100. The plunger 300 pushes out the intraocular lens 1 filled in the main body 100 by moving forward along the extrusion shaft (passage shaft) A.

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

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

(Main body)
The main body 100 will be described with reference to FIG. The main body 100 includes a main body cylinder 110, an installation 130, and a nozzle (insertion) 180.

The main body tubular portion 110 is formed in a tubular shape extending in the front-rear direction, and is located on the base end side (rear portion) of the main body portion 100. An overhanging portion 111 gripped by the user is formed on the outer periphery slightly forward of the rear end of the main body cylinder portion 110.

The installation portion 130 is connected to the tip end side of the main body cylinder portion 110. The installation portion 130 is filled with the intraocular lens 1. Specifically, the installation unit 130 includes a holding unit 160 and a set unit 170. The holding portion 160 holds the intraocular lens 1 when the intraocular lens insertion device 10 is stored. The set portion 170 is rotatably provided about the axis of the tip portion. When the set portion 170 is rotated, the intraocular lens 1 held by the holding portion 160 moves to a standby position where it can be pushed out by the plunger 300 and is positioned.

The nozzle 180 is connected to the tip end side of the installation portion 130. The passage area in the nozzle 180 becomes narrower toward the front because the intraocular lens 1 is slightly deformed in the process of pushing the intraocular lens 1 forward. That is, the nozzle 180 is formed with a tapered internal space. A cylindrical insertion portion 182 whose tip is obliquely cut is provided at the tip of the nozzle 180. 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 the internal passage, is formed at the tip of the insertion portion 182. The passage inside the main body 100 penetrates from the rear end of the main body cylinder 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 an extrusion member 310, an extrusion rod 330, a shaft base portion 350, and a pressed portion 370.

The pressed portion 370 is formed at the base end of the plunger 300. The pressed portion 370 is a plate-shaped member extending in a direction orthogonal to the extrusion shaft A. The finger of the user comes into contact with the pressed portion 370 when the user pushes the plunger 300 forward.

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

The extrusion rod 330 is a rod-shaped member and extends forward from the tip of the shaft base 350 along the axial direction of the extrusion shaft A. The extrusion rod 330 is formed so that the shape of the cross section orthogonal to the extrusion shaft A is substantially circular. Further, the thickness of the extrusion rod 330 is such that it can pass through the insertion port 183 of the main body 100. The extrusion member 310 is connected to the tip of the extrusion rod 330. The extrusion member 310 moves forward along the extrusion shaft A in the passage of the main body 100 to tack the intraocular lens 1 and discharge the intraocular lens 1 into the eye through the insertion port 183. The detailed configuration of the extrusion 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) and HEMA (hydroxyethyl methacrylate), and a composite material of an acrylic acid ester and a methacrylic acid ester can be adopted.

The optical unit 2 applies a predetermined refractive power to the patient's eye. The support portion 3 supports the optical portion 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 unit 130, the support unit 3 extending from the optical unit 2 toward the nozzle 180 (that is, forward) is referred to as a front support unit 3A, and the optical unit 2 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 have a control shape with respect to the center of the optical portion 2, and extend in the same circumferential direction. Therefore, the 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 extrusion 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, the front end portion of the extrusion member 310 is provided with a support portion contact portion 313, an optical portion contact portion 314, an upper protrusion portion 315, and a lower protrusion portion 316.

The support portion contact portion 313 deforms and moves the rear support portion 3B in the direction closer to the optical portion 2 (that is, forward) by contacting the rear support portion 3B of the intraocular lens 1. That is, the support portion contact portion 313 tacks the rear support portion 3B. The support portion contact portion 313 is provided above the optical portion contact portion 314 of the front end portion of the extrusion member 310. Therefore, as will be described in detail later, when the rear support portion 3B is pushed forward by the support portion contact portion 313, the rear support portion 3B moves above 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 unit contact portion 314 pushes the optical unit 2 forward by coming into contact with the optical unit 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 extrusion 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 unit 2 is not easily damaged.

As shown in FIG. 7, when the extrusion member 310 is viewed from the front along the extrusion shaft A, both the support portion contact portion 313 and the optical portion contact portion 314 face forward. Therefore, only by pushing the plunger 300 forward, the rear support portion 3B is tacked and the optical portion 2 is pushed forward.

As shown in FIG. 6, in the present embodiment, the front end surface of the support portion contact portion 313 projects further forward than the front end surface of the optical portion contact portion 314. In this case, tacking is performed in a state where the rear support portion 3B is extended far forward by the support portion contact portion 313 projecting forward from the optical portion contact portion 314. Therefore, the accuracy of tacking is improved. Further, the connecting 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 so as to face diagonally 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, the support portion contact portion 313 is positioned at the base end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 in the left-right direction centered on the extrusion shaft A. It is unevenly arranged on the side (on the right side in this embodiment). This action will be described later.

As shown in FIGS. 4 to 6, the upper protrusion 315 projects forward from the upper end of the front end surface of the support contact portion 313. The upper protrusion 315 prevents the rear support portion 3B from shifting upward from the support portion contact portion 313. As a result, the problem that the rear support portion 3B does not contact the support portion contact portion 313 is suppressed, so that tacking can be easily performed appropriately. Further, the lower protrusion 316 projects forward from the lower end of the front end surface of the optical contact portion 314. The lower protrusion 316 prevents the optical portion 2 from shifting downward from the optical portion contact portion 314. As a result, the problem that the optical unit 2 is pinched between the bottom surface of the extrusion member 310 and the inner wall of the nozzle 180 is suppressed. The phrase "upper end of the front end surface of the support portion contact portion 313" does not limit the upper protrusion 315 to be exactly located at the upper end of the front end surface. That is, the upper protrusion 315 may be arranged near the upper end of the support contact portion 313. Similarly, the lower protrusion 316 may be arranged in the vicinity of the lower end of the optical contact portion 314.

Next, the configuration on the right side of the extrusion member 310 will be described. In the following description, of the left side surface and the right side side surface of the extrusion member 310, the side surface on the side where the base end 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 is located is referred to. The first side surface 320 (see FIGS. 4 and 6). In the present embodiment, the first side surface 320 is the right side surface of the extrusion member 301. Of the left side surface and the right side side surface of the extruded member 310, the side surface opposite to the first side surface 320 (the left side surface in this embodiment) is referred to as a second side surface 325 (see FIG. 5). As shown in FIG. 4, on the right side of the extrusion member 310, a first recessed portion 321, an upper rib 322, and a lower rib 323 are provided.

The first depressed portion 321 is formed behind the support portion contact portion 313 and the optical portion contact portion 314 of the first side surface (right side surface in the present embodiment) 320 of the extrusion member 310. The first depressed portion 321 is a portion of the support portion contact portion 313 and the optical portion contact portion 314 that is recessed inward (to the left in this embodiment) of the first side surface 320A. The first depressed portion 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 (for example, in the vicinity of the base end portion 4B of the rear support portion 3B in a tacked state). Becomes a space to escape. Therefore, it becomes difficult for the intraocular lens 1 to enter between the inner wall of the nozzle 180 on the ceiling side and the surface of the extrusion member 310 on the ceiling side. Therefore, by forming the first depressed portion 321, the load applied to the intraocular lens 1 is reduced, and the occurrence of damage to the intraocular lens 1 is suppressed.

As shown in FIG. 4, between the first side surface 320A of the support portion contact portion 313 and the optical portion contact portion 314 and the side surface 321A of the innermost recessed portion 321 of the first recessed portion 321 face diagonally backward. It is smoothly connected by the inclined surface 321B. Therefore, there is no sharp step between the first side surface 320A of the support portion contact portion 313 and the optical portion contact portion 314 and the side surface 321A of the innermost portion of the first recessed portion 321. Therefore, when a part of the intraocular lens 1 that has escaped to the first depressed portion 321 returns to the front, it is possible to prevent the intraocular lens 1 from being damaged by a sudden step.

The upper rib 322 is a rib-shaped member that projects laterally (to the right in this embodiment) from the upper end of the first side surface (right side in this embodiment) 320 of the extrusion member 310. The upper rib 322 extends continuously from the front end portion of the support portion contact portion 313 to the first depressed portion 321. Although the details will be described later, the upper rib 322 prevents a part of the intraocular lens 1 from entering the gap between the upper surface of the extrusion member 310 and the inner wall of the nozzle 180 on the ceiling side from the first side surface 320 side. The upper rib 322 does not have to be strictly formed at the upper end of the first side surface 320. That is, the upper rib 322 may be arranged near the upper end portion of the first side surface 320.

As shown in FIGS. 4 and 6, the intraocular lens insertion device 10 includes a pressing portion 327. The pressing portion 327 presses the rear supporting portion 3B toward the optical portion 2 side (that is, the lower side) in a state where the rear supporting portion 3B is bent onto the optical portion 2. The pressing portion 327 of the present embodiment is formed on a surface of the upper rib 322 that faces downward, and is an inclined surface that is inclined downward toward the rear. That is, the pressing portion 327, which is an inclined surface, is inclined so as to face diagonally forward on the bottom surface of the upper rib 322. The details of the action of the pressing portion 327 will be described later.

Further, a parallel surface 328 is formed on the surface of the upper rib 322 facing downward. The parallel surface 328 extends rearwardly parallel to the axis of the extrusion member 310 parallel to the axis of the passage from the front end of the upper rib 322. The pressing portion 327, which is an inclined surface, is formed behind the parallel surface 328. The details of the action of the parallel plane 328 will also be described later.

The lower rib 323 projects laterally (to the right in the present embodiment) from the lower end of the first recessed portion 321 on the first side surface (right side in the present embodiment) 320 of the extrusion member 310. The lower rib 323 prevents a part of the intraocular lens 1 from entering the gap formed by the bottom surface of the extrusion member 310 and the inner wall of the nozzle 180 from the first side surface 320 side. The lower rib 323 does not have to be strictly formed at the lower end of the first side surface 320 as well as the upper rib 322.

Next, the configuration on the left side of the extrusion member 310 will be described. As shown in FIG. 5, of the second side surface (left side surface in this embodiment) 325 of the extrusion member 310, a second recessed portion 326 that is recessed inward is formed on the left side of the support portion contact portion 313. .. The second depressed portion 326 is a space in which a part of the deformed intraocular lens 1 escapes. Therefore, by providing the second recessed portion 326, it becomes difficult to apply a load to a part of the intraocular lens 1 that enters the left side of the extrusion member 310.

(Movement and deformation of intraocular lens)
With reference to FIG. 8, the state of movement and deformation of the intraocular lens 1 from the installation portion 130 to the nozzle 180 when the intraocular lens 1 is inserted into the eye by the intraocular lens insertion device 10 of the present embodiment. explain.

First, the operator rotates the set portion 170 (see FIG. 1) to push out the intraocular lens 1 held by the holding portion 160 (see FIG. 1) of the installation portion 130 by the plunger 300. Move to a standby position where Here, as shown in FIG. 8A, the proximal end portion 4B of the rear support portion 3B of the intraocular lens 1 held by the holding portion 160 is displaced in either the left or right direction with respect to the extrusion shaft A. ing. As an example, in the present embodiment, the base end portion 4B of the rear support portion 3B is located on the right side (lower side in FIG. 8) with respect to the extrusion shaft A. Therefore, in the present embodiment, the right direction of the intraocular lens insertion device 10 is the direction of the first side surface 320 side described above, and the left direction is the direction of the second side surface 325 side described above. The direction in which the support portion 3 of the intraocular lens 1 extends may be the opposite direction to that of the present embodiment. In this case, the direction on the side of the first side surface 320 described above is the left direction of the intraocular lens insertion device 10.

Further, when the set portion 170 (see FIG. 1) is rotated and the intraocular lens 1 is moved to the standby position, the rear support portion 3B is moved by the positioning portion 171 (see FIG. 8A) of the set portion 170. , Positioned in a state of being moved to the ceiling side (upper side) of the optical unit 2. As a result, when the rear support portion 3B is tacked, which will be described later, the rear support portion 3B moves above the optical portion 2 which is a desirable position. It is also possible to change the configuration for positioning the rear support portion 3B on the ceiling side of the optical portion 2.

Next, the operator injects a lubricant (viscoelastic substance) into the installation portion 130 using an injector or the like, and starts the movement of the plunger 300 forward. As a result, as shown in FIG. 8A, the support portion contact portion 313 of the extrusion member 310 (see FIGS. 4 to 7) comes into contact with the rear support portion 3B of the intraocular lens 1.

When the plunger 300 is pushed further forward, as shown in FIG. 8B, the rear support portion 3B is moved (bent) toward the optical portion 2 by the extrusion member 310. As described above, the support portion contact portion 313 is provided above the optical portion contact portion 314. Further, the rear support portion 3B is positioned on the ceiling side (above) of the optical portion 2 in the standby position. Therefore, the rear support portion 3B deforms and moves upward of the optical portion 2, and the tip of the rear support portion 3B faces forward. As a result, the rear support portion 3B is tacked.

Further, as described above, the support portion contact portion 313 is positioned at the base end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 in the left-right direction centered on the extrusion shaft A. It is unevenly arranged on the side (on the right side in this embodiment). In this case, the support portion contact portion 313 pushes the position of the rear support portion 3B close to the base end portion 4B forward. Therefore, the deformation movement of the rear support portion 3B is stable and the movement amount is easily secured as compared with the case where the tip end side of the rear support portion 3B is pushed.

When the plunger 300 is pushed further forward, the optical portion contact portion 314 (see FIGS. 4 to 7) of the extrusion 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 portion 3A comes into contact with the inner wall of the tapered nozzle 180. As a result, the front support portion 3A deforms and moves upward of the optical portion 2, and the tip of the front support portion 3A faces rearward. That is, the front support portion 3A is tacked.

When the plunger 300 is pushed further forward, the optical portion 2 of the intraocular lens 1 also comes into contact with the inner wall of the tapered nozzle 180. As a result, as shown in FIG. 8D, the intraocular lens 1 is folded into small pieces with the front support portion 3A and the rear support portion 3B tacked. Here, the front support portion 3A and the rear support portion 3B are tacked to the ceiling side (upper side) of the optical portion 2. Further, the optical unit 2 is folded while being in contact with the bottom surface of the tapered nozzle 180. Therefore, the left and right edges (upper and lower in FIG. 8D) of the optical unit 2 are gradually above the center of the optical unit 2 so as to sandwich the tacked front support portion 3A and the rear support portion 3B inward. It is folded into. That is, the optical unit 2 is bent so as to be valley-folded toward the bottom surface side (the back side in FIG. 8D).

As shown in FIG. 8 (e), the intraocular lens 1 is folded small enough to be pushed forward. The vicinity of the base 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 extrusion member 310 and the inner wall of the nozzle 180. When the extruding member 310 is further pushed forward, the intraocular lens 1 is inserted into the eye through the insertion slot 183.

Here, with reference to FIGS. 9 and 10, the configuration of the extrusion member 410 and the intraocular lens when the intraocular lens 10 does not include the pressing portion 327 (see FIGS. 4, 6, and 7). The state of movement and deformation of the lens 1 will be described. The only difference between the extruded member 410 illustrated in FIGS. 9 and 10 and the extruded member 310 illustrated in FIGS. 4 to 7 is the presence or absence of the pressing portion 327 on the downward facing surface of the upper rib 422. The composition of is common. Therefore, among FIGS. 9 and 10, the members that can adopt the same configuration as the extrusion member 310 illustrated in FIGS. 4 to 7 are designated by the same reference numerals as those used in FIGS. 4 to 7, and the same reference numerals are given. The description is omitted or simplified.

The extruded member 410 shown in FIG. 9 includes an upper rib 422 projecting laterally (to the right in this embodiment) from the upper end portion of the first side surface 320, similarly to the extruded member 310 illustrated in FIGS. 4 to 7. .. However, the downward-facing surface of the upper rib 422 shown in FIG. 9 is a surface parallel to the axis of the extrusion member 410 from the front end portion to the rear end portion. That is, in the extrusion member 410 shown in FIG. 9, the pressing portion 327, which is an inclined surface, is not formed on the surface of the upper rib 422 facing downward.

As shown in FIG. 10, when an intraocular lens insertion device not provided with the pressing portion 327 is used, the support portion 3 (for example, the rear support portion 3B) in the bent state (that is, the tacked state) is changed. The position of the optical unit 2 with respect to the upper surface (the surface on the ceiling side) may be higher than the appropriate position. In the state shown in FIG. 10, the space on the ceiling side of the space in the passage of the nozzle 180 is narrowed by the rear support portion 3B above the appropriate position. The edges 2R, 2L, etc. of the optical unit 2 are folded toward the ceiling side while sliding on the inner wall of the nozzle 180. Therefore, when the space on the ceiling side in the nozzle 180 is narrow, the edges 2R, 2L, etc. of the optical portion 2 sliding on the inner wall of the nozzle 180 have a gap 200 between the inner wall on the ceiling side of the nozzle 180 and the extrusion member 410. Easy to get in. As a result, problems such as damage to the intraocular lens 1 may occur.

Further, when the support portion 3 (for example, the rear support portion 3B) is above an appropriate position, between one edge portion 2R and the other edge portion 2L of the optical portion 2 that is folded toward the ceiling side. In some cases, the support portion 3 may be pinched. In addition, the support portion 3 may not be properly arranged inside the optical portion 2 that is folded into a roll shape. In these cases, problems such as damage to the support portion 3 are likely to occur. Further, the optical portion 2 may not be bent by an appropriate amount due to the influence that the support portion 3 is above an appropriate position. In this case, the load applied to the nozzle 180 when pushing the intraocular lens 1 forward in the nozzle 180 and the load required for pushing may increase.

The state of movement and deformation of the intraocular lens 1 when the intraocular lens insertion device 10 of the present embodiment is used with reference to FIG. 11 and the like will be described in more detail. As shown in FIG. 11, in the present embodiment, the pressing portion 327 presses the rear support portion 3B in a bent state on the optical portion 2 toward the optical portion 2. As a result, as shown in FIG. 8 (e), the optical portion 2 is easily folded so as to wrap the rear support portion 3B inward. Therefore, the space on the ceiling side (upper part) in the passage of the nozzle 180 is easily secured. When the space on the ceiling side is secured, even if the edges 2R, 2L, etc. of the optical unit 2 are located on the ceiling side in the passage, the edges 2R, 2L, etc. can easily escape to the space secured by the pressing unit 327. Become. Therefore, it becomes difficult for the intraocular lens 1 to enter between the inner wall on the ceiling side of the nozzle 180 and the surface on the ceiling side of the extrusion member 310. Further, the possibility that the support portion 3 is sandwiched between the both edge portions 2R and 2L of the folded optical portion is reduced. Further, the possibility that the support portion 3 is not arranged inside the optical portion 2 that is folded into a roll shape is reduced. Therefore, the intraocular lens 1 is appropriately inserted into the eye.

Further, the pressing portion 327 of the present embodiment is an inclined surface formed on a surface facing downward of the upper rib 322. Therefore, when the extrusion member 310 is pushed forward, the rear support portion 3B wraps around below the upper rib 322, and the rear support portion 3B is pressed toward the optical portion 2 side by the pressing portion 327 which is an inclined surface, and the intraocular lens. 1 moves forward. Therefore, simply by pushing the extrusion member 310 forward, the intraocular lens 1 moves forward in a state where the optical portion 2 is properly folded so as to wrap the support portion 3.

Further, as shown in FIG. 6, the pressing portion 327 of the present embodiment is formed behind the parallel surface 328. Therefore, the rear support portion 3B is pressed downward by the pressing portion 327, so that a space (“S” in FIG. 6) can be easily secured in the lower portion near the parallel surface 328. As a result, when the optical unit 2 is folded into a roll shape, the intraocular lens 1 (for example, the optical unit 2) easily escapes into the space S. Therefore, it becomes more difficult for a part of the intraocular lens 1 to enter between the inner wall of the nozzle 180 on the ceiling side and the surface of the extrusion member 310 on the ceiling side. Further, by defining the positions of the parallel surface 328 and the pressing portion 327, the timing at which the rear support portion 3B is pressed toward the optical portion 2 side by the pressing portion 327 is adjusted to an appropriate timing.

Further, the extrusion member 310 includes a first recessed portion 321. Therefore, the vicinity of the rear end portion of the rear support portion 3B pressed by the pressing portion 327 can escape to the first depressed portion 321. Therefore, even if the intraocular lens 1 is folded small and the load applied to the intraocular lens 1 increases, the intraocular lens 1 remains between the inner wall of the nozzle 180 on the ceiling side and the surface of the extrusion member 310 on the ceiling side. It becomes even more difficult to enter.

The techniques disclosed in the above embodiments are merely examples. Therefore, it is possible to modify the techniques exemplified in the above embodiments. For example, the intraocular lens insertion device 10 of the above embodiment includes a plurality of configurations in order to properly insert the intraocular lens 1 into the eye. However, it is also possible to adopt only a part of these configurations without adopting all of them. For example, the extrusion member 310 may include a pressing portion 327 without providing the first depressed portion 321.

Further, in the above embodiment, the pressing portion 327 that presses the tacked rear support portion 3B toward the optical portion 2 side is an inclined surface formed on a surface facing downward of the upper rib 322. However, it is also possible to change the configuration of the pressing portion. For example, instead of the inclined surface, a protrusion or the like may be formed on the extruded member as a pressing portion. Further, a pressing portion may be provided on a member other than the extruded member. For example, the pressing portion may be a button or the like operated downward by the user.

1 Intraocular lens 2 Optical part 3 Support part 3B Rear support part 10 Intraocular lens insertion device 180 Nozzle 183 Insertion port 310 Extruding member 313 Support part contact part 314 Optical part contact part 315 Upper protrusion 316 Lower protrusion 320 First Side surface 321 First depressed portion 322 Upper rib 327 Pressing portion 328 Parallel surface

Claims (5)

Intraocular lens in which a deformable intraocular lens having a disk-shaped optical portion and one or more support portions extending outward from the optical portion is inserted into the eye through an internal passage through an insertion port at the front end. It is a lens insertion device
The passage area becomes narrower toward the front, and the nozzle having the insertion port at the front end
A rod-shaped extrusion member that pushes the intraocular lens forward by moving forward in the passage along the axis of the passage.
With
The extruded member is folded by pushing the intraocular lens forward in the passage of the nozzle to fold the optical portion into a roll shape while the support portion is bent on the optical portion. While positioning the support part inside the optical part,
The intraocular lens insertion device is
The rear support portion, which is the support portion extending rearward from the optical portion, is provided with a pressing portion that presses the rear support portion downward on the optical portion side in a state of being bent onto the optical portion. An intraocular lens insertion device characterized by. The intraocular lens insertion device according to claim 1.
The extruded member
Of the left side surface and the right side surface of the extruded member, when the side surface of the intraocular lens on which the base end of the rear support portion is located is defined as the first side surface, the side surface is lateral to the upper side of the first side surface. With an upper rib that protrudes toward
The pressing part is
An intraocular lens insertion device characterized in that the upper rib is formed on a downwardly facing surface and is an inclined surface that is inclined downward toward the rear. The intraocular lens insertion device according to claim 2.
On the downwardly facing surface of the upper rib, a parallel surface extending rearward in parallel with the axis of the passage is formed from the front end portion of the upper rib.
An intraocular lens insertion device characterized in that the pressing portion, which is an inclined surface, is formed behind the parallel surface. The intraocular lens insertion device according to claim 2 or 3.
The extruded member
An optical portion contact portion formed on the front end side of the extruded member and contacting the optical portion to push the optical portion forward.
A support portion contact portion formed above the optical portion contact portion on the front end side of the extruded member and contacting the rear support portion to move the rear support portion in a direction approaching the optical portion.
With
An intraocular lens insertion device in which the upper rib extends rearward from the front end portion of the support portion contact portion. The intraocular lens insertion device according to any one of claims 1 to 4.
The extruded member
When the side surface of the left side surface and the right side surface of the extruded member on the side where the base end of the rear support portion of the intraocular lens is located is the first side surface, the front end portion of the first side surface is used. An intraocular lens insertion device, which is formed rearward and further includes a recessed portion at the front end portion that is recessed inward from the first side surface.

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