JP2021053102A - Intraocular lens insertion instrument - Google Patents

Abstract

To provide an intraocular lens insertion instrument that suppresses rotation in the shaft circumference of an extrusion shaft and stabilizes a posture of an intraocular lens in a nozzle, when the intraocular lens is extruded by the extrusion shaft.SOLUTION: An intraocular lens insertion instrument is provided for inserting an intraocular lens into an eye. The intraocular lens insertion instrument has: a nozzle having a lumen shape where a passage for passing the intraocular lens is tapered toward a tip; an axial extruding member for pushing an outer periphery of the intraocular lens in a nozzle, and extruding the intraocular lens from the tip of the nozzle into the outside of the nozzle while folding the intraocular lens; a guide part for guiding the extruding member in the nozzle along the extrusion shaft; and a rotation suppression part for suppressing one-way rotation by abutting the outer periphery where the intraocular lens extruded by the extruding member is positioned in the one-way rotation side being easily rotated in the shaft circumference of the extruding member, when viewing the lumen shape in the orthogonal section perpendicular to the extrusion shaft of the extruding member.SELECTED DRAWING: Figure 12

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 foldable soft intraocular lens into the eye instead of the crystalline lens is generally 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.

As such an injector, the intraocular lens is folded into a small size by pushing out the intraocular lens with an extrusion member in a nozzle having a hollow passage where the passage area through which the intraocular lens passes gradually decreases toward the tip. It is known that the lens is ejected from the tip to the outside (see, for example, Patent Document 1).

Japanese Unexamined Patent Publication No. 2016-189925

In the injector as described above, when the intraocular lens in the nozzle is extruded by the extrusion member, an event may occur in which rotation is promoted in one direction around the axis of the extrusion shaft. Such an event may affect the open posture (restoration posture) of the intraocular lens immediately after the intraocular lens folded in the nozzle is ejected from the nozzle. Therefore, further improvement for stabilizing the posture of the intraocular lens ejected from the intraocular lens insertion device is desired.

Therefore, the present disclosure has been made to solve the above-mentioned problems, and when the intraocular lens is extruded by the extrusion member, the rotation of the intraocular lens around the axis of the extrusion shaft is suppressed to suppress the rotation of the intraocular lens in the nozzle. It is an object of the present invention to provide an intraocular lens insertion device that stabilizes the posture.

The intraocular lens insertion device provided by a typical embodiment of the present disclosure is an eye having a disk-shaped optical portion and a plurality of support portions extending radially outward from the outer peripheral edge portion of the optical portion. An intraocular lens insertion device that inserts an intraocular lens into an eye, a nozzle having a lumen shape in which a passage through which the intraocular lens passes tapers toward the tip, and an outside of the intraocular lens in the nozzle. While pushing the peripheral edge to fold the intraocular lens, a shaft-shaped extrusion member that pushes the intraocular lens from the tip of the nozzle to the outside of the nozzle and the extrusion member in the nozzle are guided along the extrusion shaft. Looking at the guide portion and the cavity shape in an orthogonal cross section orthogonal to the extrusion axis of the extrusion member, the intraocular lens extruded by the extrusion member is on the unidirectional rotation side where it is easy to rotate around the axis of the extrusion member. It has a rotation suppressing portion that suppresses the one-way rotation by abutting the outer peripheral edge portion to be located.

According to the intraocular lens insertion device of the present disclosure, when the intraocular lens is extruded by the extrusion member, the rotation of the extrusion shaft around the axis can be suppressed to stabilize the posture of the intraocular lens in the nozzle.

It is the whole perspective view which showed the intraocular lens insertion instrument. It is a perspective view which showed the plunger. It is a top view of an intraocular lens. It is a right side view of an intraocular lens. It is a schematic explanatory drawing which shows the state which the intraocular lens is installed in the installation part. It is a schematic explanatory drawing which shows the state which the extrusion of an intraocular lens by an extrusion member has started. It is a schematic explanatory drawing which shows the state which the intraocular lens moved toward a nozzle. It is a schematic explanatory drawing which shows the state which the intraocular lens has started to enter into a nozzle. It is a schematic explanatory drawing which shows the state which the intraocular lens is deformed in the nozzle. It is a schematic explanatory drawing which shows the state which the intraocular lens is further deformed in a nozzle. It is a schematic explanatory drawing which shows the state which the intraocular lens is folded in the nozzle. FIG. 7 is a cross-sectional view taken along the line XII-XII of FIG. FIG. 8 is a cross-sectional view taken along the line XIII-XIII of FIG. 9 is a cross-sectional view taken along the line XIV-XIV of FIG. FIG. 10 is a cross-sectional view taken along the line XV-XV of FIG. FIG. 11 is a cross-sectional view taken along the line XVI-XVI of FIG. FIG. 7 is a cross-sectional view taken along the line XVII-XVI of FIG. FIG. 8 is a cross-sectional view taken along the line XVIII-XVIII of FIG. 9 is a cross-sectional view taken along the line XIX-XIX of FIG. FIG. 10 is a cross-sectional view taken along the line XX-XX of FIG. FIG. 11 is a cross-sectional view taken along the line XXI-XXI of FIG. It is schematic explanatory drawing which shows the deformed state of the intraocular lens when the guide part is not formed in the nozzle. It is a schematic explanatory drawing which shows the deformed state of the intraocular lens in the case of the guide part which does not form the rotation suppression part in a nozzle. It is a schematic explanatory drawing which shows typically the relationship between the guide part which does not form a rotation suppression part and an intraocular lens, and the relationship between a guide part which constitutes a rotation suppression part, and an intraocular lens.

<Overview>
The intraocular lens insertion device exemplified in the present disclosure has an intraocular lens having a disk-shaped optical portion and a plurality of support portions extending radially outward from the outer peripheral edge portion of the optical portion in the eye. It is an intraocular lens insertion device to be inserted. The intraocular lens insertion device includes a nozzle, an extrusion member, a guide portion, and a rotation restraining portion. The nozzle has a lumen shape in which the passage through which the intraocular lens passes tapers toward the tip. The extrusion member is a shaft-shaped member that pushes the intraocular lens from the tip of the nozzle to the outside of the nozzle while folding the intraocular lens by pushing the outer peripheral edge of the intraocular lens in the nozzle. The guide portion guides the extrusion member in the nozzle along the extrusion shaft. The rotation restraint is an outer peripheral edge located on the unidirectional rotation side where the intraocular lens extruded by the extrusion member is easily rotated around the axis of the extrusion member when the cavity shape is viewed in an orthogonal cross section orthogonal to the extrusion axis of the extrusion member. The parts are brought into contact with each other to suppress one-way rotation.

In the intraocular lens insertion device of the present disclosure, when the shape of the cavity is viewed in a cross section orthogonal to the extrusion axis of the extrusion member, the intraocular lens extruded by the extrusion member is easily rotated around the axis of the extrusion member on the unidirectional rotation side. It has a rotation suppressing portion that suppresses one-way rotation by abutting the outer peripheral edge portion located at. Therefore, when the intraocular lens is extruded by the extrusion shaft, the rotation of the extrusion shaft around the axis can be suppressed and the posture of the intraocular lens in the nozzle can be stabilized.

Further, the rotation suppressing portion of the intraocular lens insertion device has a reference point at which a virtual line orthogonal to the inner surface of the nozzle facing the guide portion from the extrusion shaft of the extrusion member intersects as a reference point, and the shape of the nozzle cavity is formed from the reference point. Of both circumferences up to the ends on both sides, the circumference on the one-way rotation side may be set shorter. As a result, the circumference on the one-way rotation side is set short depending on the configuration of the rotation suppression unit. As a result, when the intraocular lens is extruded by the extrusion shaft, the outer peripheral edge portion located on the unidirectional rotation side first comes into contact with the rotation suppression portion, so that the posture of the intraocular lens in the nozzle can be stabilized.

Further, the difference in both peripheral lengths in the shape of the lumen of the nozzle of the intraocular lens insertion device may be changed so as to gradually decrease toward the tip of the nozzle. As a result, the rotational posture of the intraocular lens around the extrusion axis can be gradually corrected and sent out from the tip of the nozzle.

Further, the intraocular lens in the nozzle of the intraocular lens insertion device has a positional relationship in which the root portion of the front support portion located on the tip side of the nozzle of the support portion does not overlap with the virtual line, and the rotation suppression unit. May be provided on the side where the root portion of the front support portion is not arranged with the virtual line as a boundary. The intraocular lens in the nozzle has an asymmetrical posture on the side where the root portion of the front support portion is arranged and the side where the root portion of the front support portion is not arranged with the virtual line as a boundary. Therefore, the intraocular lens deformed in a roll shape around the extrusion axis has different forces in the open posture (restoration posture) on the left and right. Here, the side on which the root portion of the front support portion is arranged may have higher rigidity than the side on which the root portion of the front support portion is not arranged. Therefore, the intraocular lens in the nozzle tends to rotate around the extrusion shaft toward the side where the root portion of the front support portion is not arranged (unidirectional rotation). Therefore, it is possible to stabilize the rotational posture around the extrusion axis of the intraocular lens by having a rotation suppressing portion at a portion toward unidirectional rotation.

Further, the intraocular lens insertion device may have a configuration in which both circumferences in the shape of the lumen of the nozzle are different by providing a rotation suppressing portion in the guide portion. By providing the rotation suppressing portion in the guide portion, the rotation suppressing portion can be simply configured.
<First Embodiment>
Hereinafter, the first embodiment, which is one of the typical embodiments in the present disclosure, will be described with reference to FIGS. 1 to 16. In the following description, the directions shown in each figure are such that the direction toward the tip of the main body 100 of the intraocular lens insertion device 10 toward the tip of the nozzle 180 side (lower left side of the paper surface in FIG. 1) is the front of the intraocular lens insertion device 10. The direction of the pressing portion 370 of the plunger 300 (upper right side of the paper surface in FIG. 1) is the rear of the intraocular lens insertion device 10. Further, the upper side of the paper surface of FIG. 1 is the upper side of the intraocular lens insertion device 10, the lower side of the paper surface of FIG. 1 is the lower side of the intraocular lens insertion device 10, and the lower right side (front side) of the paper surface of FIG. 1 is the intraocular lens insertion device. The left side of 10 and the upper left side (back side) of the paper surface in FIG. 1 are the right side of the intraocular lens insertion device 10.

<Overall configuration of intraocular lens insertion device 10>
The overall configuration of the intraocular lens insertion device 10 of the first embodiment will be described with reference to FIG. The intraocular lens insertion device 10 is used to insert a deformable intraocular lens 1 (see FIGS. 3 and 4, details will be described later) 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 is a rod-shaped member, and can move in the front-rear direction (direction along the extrusion shaft A) in the passage inside the main body 100. The plunger 300 moves forward along the extrusion shaft (axis of the passage) A to push out the intraocular lens 1 filled in the main body 100.

The main body 100 and the plunger 300 of the first embodiment are made of a resin material. The intraocular lens insertion device 10 may be formed by injection 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 first 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 first 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 100>
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 180 from the rear to the front.

The main body tubular portion 110 is formed in a tubular shape extending in the front-rear direction. The main body cylinder 110 is located on the rear end side of the main body 100. A flange portion 111 projecting outward from the outer peripheral surface is provided at a position on the rear end side in the longitudinal direction of the main body cylinder portion 110. The user hangs a finger on the collar portion 111 at the time of use and grips the collar portion 111.

The installation portion 130 is connected to the front end side of the main body cylinder portion 110. The installation unit 130 includes an installation unit main body 134, a top plate unit 132, and the like. The installation unit main body 134 is a box-shaped member and has an open upper portion. The intraocular lens 1 before being extruded by the plunger 300 is installed (filled) inside the installation unit main body 134 in the installation unit 130 (see FIGS. 5 to 11).

The top plate portion 132 is a lid member that is arranged so as to straddle the nozzle 180 and the installation portion main body 134 and covers the upper openings thereof. The top plate portion 132 may be formed by injection molding using a resin material (for example, polypropylene), cutting by cutting out the resin, or the like. The top plate portion 132 of the first embodiment includes a plate-shaped portion 136 and a guide portion 140 (see FIG. 12). The plate-shaped portion 136 has a flat plate shape and is formed so as to cover the openings of the nozzle 180 and the installation portion main body 134.

As shown in FIGS. 12 to 16, the guide portion 140 is provided with a groove shape that guides the extrusion member 310 of the plunger 300 along the extrusion direction (extrusion shaft A). The groove shape of the guide portion 140 is such that an arcuate groove having substantially the same diameter as the outer peripheral surface of the rod-shaped extrusion member 310 of the plunger 300, which will be described later, is provided along the extrusion shaft A. The groove shape of the guide portion 140 is composed of a first protrusion 141 and a second protrusion 142.

The first protrusion 141 and the second protrusion 142 are formed along the extrusion direction (extrusion shaft A) of the extrusion member 310 of the plunger 300. That is, the first protrusion 141 and the second protrusion 142 are provided in succession along the extrusion shaft A on both sides of the groove shape of the guide portion 140 (both left and right ends intersecting the extrusion shaft A). The first protrusion 141 constitutes one wall surface 141a of the guide portion 140, and projects from the plate-shaped portion 136 to the side where the intraocular lens 1 is arranged (the back side of the paper surface in FIG. 5). The second protrusion 142 constitutes the other wall surface 142a of the guide portion 140, and projects from the plate-shaped portion 136 to the side where the intraocular lens 1 is arranged (the back side of the paper surface in FIG. 5).

The nozzle 180 is connected to the front end side of the installation portion 130 as shown in FIGS. 5 to 11. The passage area in the nozzle 180 becomes smaller toward the front because the intraocular lens 1 is deformed slightly in the process of pushing the intraocular lens 1 forward. That is, the nozzle 180 has a lumen shape in which the passage through which the intraocular lens 1 passes tapers toward the tip. A cylindrical insertion portion 182 is provided at the front end of the nozzle 180. The insertion portion 182 is inserted into the eye. An insertion port 183, which is an opening for ejecting the intraocular lens 1 forward from the internal passage, is formed at the front end of the insertion portion 182. The insertion port 183 is provided with a notch (bevel) whose tip is cut diagonally. The passage inside the main body 100 (see FIG. 1) penetrates from the rear end of the main body cylinder 110 (see FIG. 1) to the insertion port 183 at the front end of the nozzle 180. The details of the cavity shape of the nozzle 180 will be described later.

<Plunger 300>
The schematic configuration of the plunger 300 will be described with reference to FIG. The plunger 300 of the first embodiment includes an extrusion member 310, a shaft base portion 350, and a pressing portion 370.

The pressing portion 370 is formed at the rear end of the plunger 300. The pressing portion 370 is a plate-shaped member extending in a direction orthogonal to the extrusion axis A (see FIG. 1). The pressing portion 370 is a portion that the user's finger comes into contact with when the user pushes the plunger 300 forward.

The shaft base portion 350 is a rod-shaped member extending forward from the front end side of the pressing portion 370. In the first 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, 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 surface at the lower part of the front end of the shaft base portion 350 becomes an inclined surface formed at a predetermined position of the main body portion 100. It touches and stops. As a result, the front end of the plunger 300 is prevented from excessively protruding from the insertion port 183 (see FIG. 1).

The extrusion member 310 is a rod-shaped member and extends forward from the front end of the shaft base 350 along the axial direction of the extrusion shaft A. The extrusion member 310 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 member 310 is such that it can pass through the insertion port 183 of the main body 100. The extrusion member 310 moves forward along the extrusion shaft A in the passage of the main body 100 to tackle the intraocular lens 1 and discharge the intraocular lens 1 into the eye through the insertion port 183.

<Intraocular lens 1>
An example of the intraocular lens 1 inserted into the eye by the intraocular lens insertion device 10 will be described with reference to FIGS. 3 and 4. The intraocular lens 1 includes an optical unit 2 and a support unit 3. The intraocular lens 1 of the first embodiment is a so-called one-piece type intraocular lens in which the optical portion 2 and the support portion 3 are integrally molded. In the intraocular lens 1 used in the first embodiment, the optical portion 2 and the front support portion 3A and the rear support portion 3B, which are a pair of support portions 3, are integrally molded. In the intraocular lens 1, as a material of a flexible material, for example, a single substance such as BA (butyl acrylate) or HEMA (hydroxyethyl methacrylate), or various soft resin materials such as a composite material of an acrylic acid ester and a methacrylic acid ester is used. Can be adopted. Although the so-called one-piece type intraocular lens 1 has been illustrated in the first embodiment, at least a part of the techniques exemplified in the present disclosure is a so-called three-piece in which the optical portion 2 and the support portion 3 are formed of separate members. It can also be applied to type intraocular lenses.

The optical unit 2 applies a predetermined refractive power to the patient's eye. The shape of the optical unit 2 is a disk shape. The optical axis L of the optical unit 2 passes through the center of the optical unit 2 and extends in the vertical direction. The support portion 3 supports the optical portion 2 in the eye. As an example, the intraocular lens 1 of the first embodiment is provided with a front support portion 3A and a rear support portion 3B as a pair of support portions 3. Further, the front support portion 3A and the rear support portion 3B are curved and extend radially outward from the outer peripheral edge portion 2C of the optical portion 2, and are point-symmetrical with respect to the optical axis L which is the center of the optical portion 2. It is formed at the position. The front support portion 3A has a root portion 6A connected to the outer peripheral edge portion 2C of the optical portion 2 via a connection portion 4A, has a loop shape curved in the circumferential direction, and the tip portion 8A is open. (That is, the tip portion 8A is a free end). The rear support portion 3B has a root portion 6B connected to the outer peripheral edge portion 2C of the optical portion 2 via a connection portion 4B, has a loop shape curved in the circumferential direction, and the tip portion 8B is open (that is, the tip portion 8B is open). , The tip portion 8B is a free end). The optical unit 2 has a first surface 2A facing the plate-shaped portion 136 of the installation unit 130 and an opposite side of the first surface 2A as end faces in the L direction of the optical axis, and is a bottom surface of the installation unit 130. It has a second surface 2B that comes into contact with it.

<Cavity shape of nozzle 180>
The cavity shape of the nozzle 180 of the first embodiment will be described with reference to FIGS. 12 to 16. The lumen shape has a rotation suppressing portion 150. The rotation restraining unit 150 looks at the nozzle 180 in an orthogonal cross section orthogonal to the extrusion axis A of the extrusion member 310, and the intraocular lens 1 extruded by the extrusion member 310 is on the one-way rotation side where it is easy to rotate around the axis of the extrusion member 310. The outer peripheral edge portion 2C located at is brought into contact with the outer peripheral edge portion 2C to suppress one-way rotation.

The rotation suppression unit 150 is configured as follows. First, a line orthogonal to the inner surface of the nozzle 180 facing the guide portion 140 from the extrusion shaft A of the extrusion member 310 is defined as a virtual line V. Here, the intraocular lens 1 in the nozzle 180 has a positional relationship in which the root portion 6A of the front support portion 3A located on the insertion port 183 side of the nozzle 180 among the support portions 3 does not overlap with the virtual line V (). On the paper surface of FIG. 5, it is above the extrusion shaft A). Specifically, the root portion 6A of the front support portion 3A is located on the right side of the virtual line V as a boundary when the nozzle 180 is viewed in an orthogonal cross section orthogonal to the extrusion axis A of the extrusion member 310. The rotation suppressing portion 150 is provided on the left side of the front support portion 3A where the root portion 6A is not arranged with the virtual line V as a boundary.

The width WA1 is defined as the width WA1 between the virtual line V and the wall surface 141a forming the first protrusion 141 (the wall surface forming the first protrusion 141 and facing the direction away from the virtual line V), and the virtual line V and the first The width WB1 is defined as the width between the wall surface 142a forming the two protrusions 142 (the wall surface forming the second protrusion 142 and the side surface facing away from the virtual line V). At this time, the relationship between the two widths is larger in the width WB1 than in the width WA1 (width WA1 <width WB1). The wall surface 142a of the second protrusion 142 constituting the width WB1 is the rotation suppressing portion 150. Here, the width of the virtual line V and the wall surface 141a forming the first protrusion 141 is maintained substantially the same width from the width WA1 to the width WA4 toward the insertion port 183 side of the nozzle 180. On the other hand, the width of the virtual line V formed by the rotation suppressing portion 150 and the wall surface 142a forming the second protrusion 142 is the width WB1 toward the insertion port 183 side of the nozzle 180 (see FIGS. 5 to 11). The width gradually narrows in the width WB4.

Further, a point at which a virtual line V orthogonal to the inner surface of the nozzle 180 facing the guide portion 140 intersects with the extrusion shaft A of the extrusion member 310 is set as a reference point S. The peripheral lengths from the reference point S to both side ends (wall surface 141a or wall surface 142a) in the lumen shape of the nozzle 180 are defined as the peripheral length XA1 and the peripheral length XB1. The peripheral length XA1 refers to the inner surface length on the right side of the reference point S on the inner surface of the nozzle 180. The peripheral length XB1 refers to the inner surface length on the left side of the reference point S on the inner surface of the nozzle 180. Here, when the circumference XA1 and the circumference XB1 are compared, the circumference XB1 is set to be shorter than the circumference XA1 (perimeter XA1> circumference XB1). As described above, the rotation suppressing portion 150 makes the peripheral lengths XA1 and XB1 in the lumen shape of the nozzle 180 different depending on the difference in width between the wall surface 141a of the first protrusion 141 and the wall surface 142a of the second protrusion 142 in the guide portion 140. Consists of.

Further, the shape of the lumen of the nozzle 180 is such that the peripheral length XA1 located on the right side of the virtual line V is gradually shortened in the order of the peripheral lengths XA2, XA3, and XA4 toward the insertion port 183 side of the nozzle 180. Similarly, the perimeter XB1 located on the left side of the virtual line V is gradually shortened in the order of the perimeters XB2, XB3, and XB4 toward the insertion port 183 side of the nozzle 180. The peripheral length XA5 and the peripheral length XB5 located on the insertion port 183 side of the nozzle 180 have substantially the same length. That is, the shape of the lumen of the nozzle 180 changes so that the difference between the two circumferences with the virtual line V as the boundary gradually decreases toward the insertion port 183 of the nozzle 180.

The effects of adopting the technique illustrated in the first embodiment will be described with reference to FIGS. 5 to 11 and 12 to 16. First, the operator moves the intraocular lens 1 held by the installation unit 130 to a standby position where it can be pushed out by the plunger 300.

As shown in FIG. 5, in the intraocular lens 1 installed in the installation portion 130, the root portion 6A of the front support portion 3A is located on the right side (upper side in FIG. 5) with respect to the extrusion shaft A, and the rear support portion 3B. The root portion 6B of the lens is located on the left side (lower side in FIG. 5) with respect to the extrusion shaft A. The intraocular lens insertion device 10 of the first embodiment is a so-called preset type device in which the intraocular lens 1 is pre-filled inside. However, the technique exemplified in the present disclosure can also be applied to an intraocular lens insertion device or the like in which the intraocular lens 1 is filled inside immediately before the intraocular lens 1 is inserted into the patient's eye.

The operator injects a filler (for example, a viscoelastic substance, water, etc.) 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. 5, the extrusion member 310 of the plunger 300 comes into contact with a part of the rear support portion 3B of the intraocular lens 1.

As shown in FIG. 6, when the plunger 300 is further pushed forward, the rear support portion 3B moves in the direction approaching the optical portion 2 (that is, forward) by the extrusion member 310. After that, the rear support portion 3B is deformed and moved onto the first surface 2A of the optical portion 2 (the front side in the drawing of FIG. 6) and folded, and the tip portion 8B of the rear support portion 3B faces forward. As a result, the rear support portion 3B is tacked.

As shown in FIGS. 7 and 12, when the plunger 300 is pushed further forward, the intraocular lens 1 reaches the nozzle 180 and begins to contact the inner wall of the tapered nozzle 180. At this time, since the inner wall of the nozzle 180 has a curved surface, the intraocular lens 1 begins to deform in a roll shape along the inner wall. Here, the intraocular lens 1 of the first embodiment tends to rotate toward the left side around the axis of the extrusion shaft A (unidirectional rotation). Therefore, in the intraocular lens 1, the outer peripheral edge portion 2C located on the unidirectional rotation side comes into contact with the rotation suppressing portion 150 (wall surface 142a), and the unidirectional rotation is suppressed.

As shown in FIGS. 8 and 13, when the plunger 300 is pushed further forward, the intraocular lens 1 is further deformed into a roll shape along the inner wall of the nozzle 180. At this time, the intraocular lens 1 is suppressed from rotating in one direction by maintaining a state in which the outer peripheral edge portion 2C located on the one-way rotation side is in contact with the rotation suppressing portion 150. Further, the front support portion 3A comes into contact with the inner wall of the tapered nozzle 180. Specifically, the root portion 6A of the front support portion 3A comes into contact with the inner wall on the right side of the nozzle 180 and receives stress, so that the front support portion 3A is deformed in a direction approaching the optical portion 2 (that is, rearward). Further, the vicinity of the tip portion 8A of the front support portion 3A comes into contact with the inner wall on the left side of the nozzle 180 and receives stress, so that it begins to deform rearward.

As shown in FIGS. 9 and 14, when the plunger 300 is pushed further forward, the intraocular lens 1 is further deformed in a roll shape along the inner wall of the nozzle 180. At this time, the intraocular lens 1 is suppressed from rotating in one direction by maintaining a state in which the outer peripheral edge portion 2C located on the one-way rotation side is in contact with the rotation suppressing portion 150. Further, the front support portion 3A is deformed in a direction closer to the optical portion 2 (that is, rearward), and the tip portion 8A is further deformed toward the rear.

As shown in FIGS. 13 and 14, there is a gap D between the wall surface 141a of the first protrusion 141 and the outer peripheral edge portion 2C facing the wall surface 141a. As a result, when the plunger 300 is pushed forward, the intraocular lens 1 has a margin of deformation around the extrusion shaft A, so that the extrusion load is unlikely to become heavy. As a result, for example, the occurrence of cracks in the intraocular lens 1 due to the plunger 300 biting into the intraocular lens 1 is likely to be suppressed, and the force (pressing pressure) required to advance the plunger 300 is unlikely to increase. ..

As shown in FIGS. 10 and 15, when the plunger 300 is pushed further forward, the intraocular lens 1 is further deformed in a roll shape along the inner wall of the nozzle 180. At this time, the intraocular lens 1 is suppressed from rotating in one direction by maintaining a state in which the outer peripheral edge portion 2C located on the one-way rotation side is in contact with the rotation suppressing portion 150. Further, the front support portion 3A is deformed and moved onto the first surface 2A of the optical portion 2 (the front side in the drawing of FIG. 10) and folded, and the tip portion 8A of the front support portion 3A faces rearward. That is, the front support portion 3A is tacked.

As shown in FIGS. 11 and 16, when the plunger 300 is further pushed forward, the intraocular lens 1 is folded into a small size with the front support portion 3A and the rear support portion 3B tacked. After that, the intraocular lens 1 is inserted into the eye through the insertion port 183.

Here, when the insertion portion 182 is inserted into the lens capsule, the intraocular lens insertion device 10 inserts the opening of the insertion port 183 in a posture facing the posterior capsule of the lens. When the intraocular lens 1 whose rotation is suppressed in one direction by the rotation suppressing unit 150 is delivered from the insertion slot 183, it is delivered with the following behavior. Immediately before the intraocular lens 1 is delivered from the insertion port 183, the tacked rear support portion 3B is sandwiched between the extrusion member 310 and the inner wall of the nozzle 180, and the optical portion 2 is the axis of the extrusion shaft A. It begins to develop into an open posture (restored posture) while rotating around. When the posterior support portion 3B is finally sent out from the insertion port 183, the intraocular lens 1 has the first surface 2A facing the anterior capsule and the second surface 2B (see FIG. 4) facing the posterior capsule. It is placed in the crystalline lens sac in a posture.

Next, the contents of comparison between the configuration of the intraocular lens insertion device 10 of the present embodiment and the configuration different from the configuration will be described.

FIG. 22 shows a schematic explanatory view showing a deformed state of the intraocular lens 1 when the guide portion 140 is not configured in the nozzle 180. If the guide portion 140 is not provided in the nozzle 180, the intraocular lens 1 may rotate too much toward the unidirectional rotation side, which is easy to rotate around the axis of the extrusion member 310, and may not be folded symmetrically (for example,). There is a state in which the optical axis L of the folded optical unit 2 faces the left-right direction). That is, when the intraocular lens 1 is extruded by the extrusion member 310, it is assumed that the rotation of the extrusion shaft A around the axis cannot be suppressed and the posture of the intraocular lens 1 in the nozzle 180 cannot be stabilized.

FIG. 23 shows a schematic explanatory view showing a deformed state of the intraocular lens 1 in the case of the guide portion 240 in which the rotation suppressing portion 150 is not configured in the nozzle 180. The deformation of the intraocular lens 1 when the first protrusion 241 and the second protrusion 242 are symmetrically shaped guide portions 240 will be examined. Since the guide portion 240 does not include the rotation suppressing portion 150, the intraocular lens 1 is likely to rotate toward the unidirectional rotation side, which is easy to rotate around the axis of the extrusion member 310, and may not be folded symmetrically. For example, there is a state in which the outer peripheral edge portion 2C located on the unidirectional rotation side, which is easily rotated around the axis of the extrusion member 310, is turned up so that the folding is not deformed symmetrically. That is, when the intraocular lens 1 is extruded by the extrusion member 310, it is assumed that the rotation of the extrusion shaft A around the axis cannot be suppressed and the posture of the intraocular lens 1 in the nozzle 180 cannot be stabilized.

In contrast to the above-described aspects of FIGS. 22 and 23, since the guide portion 140 (see FIGS. 12 to 16) in the present embodiment includes the rotation suppressing portion 150, the rotation of the extrusion shaft A around the axis is suppressed. Therefore, the posture of the intraocular lens 1 in the nozzle 180 can be stabilized. That is, since the intraocular lens insertion device 10 of the first embodiment includes the rotation suppressing unit 150, the optical unit 2 is folded into a roll shape while maintaining the state in which the optical axis L of the optical unit 2 faces in the vertical direction ( (See FIGS. 12 to 16).

In FIG. 24, the relationship between the guide unit 240 and the intraocular lens 1 (corresponding to the above-mentioned intraocular lens insertion device of FIG. A schematic explanatory view schematically showing the relationship between the lens 1 and the intraocular lens 1 (corresponding to the intraocular lens insertion device 10 of the first embodiment) is shown. Note that the figure is shown by omitting the illustration of the support portion 3 of the intraocular lens 1. Further, the shapes of the guide portions 140 and 240 are schematically shown. Since the nozzle 180 has a tapered shape, the intraocular lens 1 is deformed in a foldable shape in the forward direction (traveling direction side) in advance. Here, when the rotation suppressing portion 150 is not configured in the guide portion 240 (that is, the state shown in FIG. 23), the intraocular lens 1 rotates toward the second protrusion 242, which is the one-way rotation side. Then, the portion P of the outer peripheral edge portion 2C of the intraocular lens 1 is in a point contact state with the front end portion 242F of the second protrusion 242, and the contact pressure becomes high, and cracks due to stress concentration occur at this portion P. Can occur. Further, since the position where the outer peripheral edge portion 2C comes into contact with the front end portion 242F (site P) and the position R where the extrusion member 310 (see FIGS. 5 to 11) pushes out the intraocular lens 1 are far apart, the extrusion member 310 May easily bite into the intraocular lens 1. On the other hand, the relationship between the guide portion 140 including the rotation suppressing portion 150 and the intraocular lens 1 will be examined. Since the outer peripheral edge portion 2C of the intraocular lens 1 comes into contact with the contact surface 150F extending in the front-rear direction of the rotation suppressing portion 150, the contact pressure is dispersed and stress concentration is less likely to occur. As a result, cracks due to the stress concentration described above are unlikely to occur. Further, in the guide portion 140 including the rotation suppressing portion 150, the distance between the base end (part Q) of the contact surface 150F and the position (part R) where the extrusion member 310 pushes out the intraocular lens 1 is the same as the above-mentioned part P. Since it is shorter than the distance to the portion R, it is difficult for the extrusion member 310 to bite into the intraocular lens 1. The more the extruded member 310 bites into the intraocular lens 1, for example, the more easily a crack is likely to occur in the portion R of the intraocular lens 1 in contact with the extruded member 310. Further, for example, as the extrusion member 310 bites into the intraocular lens 1 and the optical portion 2 wraps around the front end side surface of the extrusion member 310, a part of the optical portion 2 is arranged between the side surface of the plunger 300 and the inner wall of the nozzle 180. Therefore, the force (pushing pressure) required to move the plunger 300 forward is likely to be required (that is, the operability is deteriorated).

<Second Embodiment>
Next, a second embodiment, which is one of the typical embodiments in the present disclosure, will be described with reference to FIGS. 17 to 21. The second embodiment has a nozzle 280 lumen shape different from that of the nozzle 180 in the first embodiment. The configuration of the nozzle 280 other than the cavity shape is the same as that of the first embodiment, and thus detailed description thereof will be omitted. For example, the installation portion 230, the top plate portion 232, the installation portion main body 234, and the plate-shaped portion 236 are substantially the same as the installation portion 130, the top plate portion 132, the installation portion main body 134, and the plate-shaped portion 136 in the first embodiment, respectively. Since each figure has the same configuration, only a reference numeral is given to each figure, and detailed description thereof will be omitted.

<Cavity shape of nozzle 280>
The lumen shape of the nozzle 280 of the second embodiment will be described with reference to FIGS. 17 to 21. The lumen shape has a rotation suppressing portion 250. The rotation restraining unit 250 looks at the nozzle 280 in an orthogonal cross section orthogonal to the extrusion axis A of the extrusion member 310, and the unidirectional rotation side in which the intraocular lens 1 extruded by the extrusion member 310 is likely to rotate around the axis of the extrusion member 310. The outer peripheral edge portion 2C located at is brought into contact with the outer peripheral edge portion 2C to suppress one-way rotation.

The rotation suppressing unit 250 is configured as follows. First, a line orthogonal to the inner surface of the nozzle 280 facing the guide portion 240 from the extrusion shaft A of the extrusion member 310 is defined as a virtual line V. Here, the intraocular lens 1 in the nozzle 280 has a positional relationship in which the root portion 6A of the front support portion 3A located on the tip side of the nozzle 280 of the support portions 3 (see FIGS. 3 and 4) does not overlap with the virtual line V. (On the paper in FIG. 5, it is above the extrusion shaft A). Specifically, the root portion 6A of the front support portion 3A is located on the right side of the virtual line V as a boundary when the nozzle 280 is viewed in an orthogonal cross section orthogonal to the extrusion axis A of the extrusion member 310. The rotation suppressing portion 250 is provided on the left side where the root portion 6A of the front support portion 3A is not arranged with the virtual line V as a boundary.

The rotation suppressing portion 250 in the second embodiment is a wall surface forming a protrusion 249 in which the inner wall of the nozzle 280 projects inward, and is configured on a side surface facing away from the virtual line V. Here, the width WA1 is defined between the virtual line V and the wall surface 241a forming the first protrusion 241. In the second embodiment, the width WC1 between the virtual line V and the wall surface 242a forming the second protrusion 242 is substantially the same width as the width WA1. Further, the width WB1 is defined between the virtual line V and the side surface of the rotation suppressing portion 250 at the protrusion 249. At this time, the relationship between the two widths is larger in the width WB1 than in the width WA1 (width WA1 <width WB1). Here, the width of the virtual line V and the wall surface 241a forming the first protrusion 241 is maintained substantially the same width from the width WA1 to the width WA3 toward the insertion port 183 side (see FIGS. 5 to 11) of the nozzle 280. doing. Further, the width of the virtual line V and the wall surface 242a forming the second protrusion 242 is maintained substantially the same width from the width WC1 to the width WC3 toward the insertion port 183 side of the nozzle 280. On the other hand, the width between the virtual line V and the side surface of the rotation suppressing portion 250 at the protrusion 249 gradually narrows from the width WB1 to the width WB4 toward the insertion port 183 side of the nozzle 280.

Further, the point where the virtual line V orthogonal to the inner surface of the nozzle 280 facing the guide portion 240 from the extrusion shaft A of the extrusion member 310 intersects is set as a reference point S. The perimeters from the reference point S to the ends on both sides in the lumen shape of the nozzle 280 are the perimeter XA1 and the perimeter XB1. The peripheral length XA1 refers to the inner surface length on the right side of the reference point S on the inner surface of the nozzle 280. The peripheral length XB1 refers to the inner surface length on the left side of the reference point S on the inner surface of the nozzle 280. Here, when the circumference XA1 and the circumference XB1 are compared, the circumference XB1 is set to be shorter than the circumference XA1 (perimeter XA1> circumference XB1). As described above, the rotation suppressing portion 250 is configured by making the peripheral lengths XA1 and XB1 in the lumen shape of the nozzle 280 different by the first protrusion 241 in the guide portion 240 and the rotation suppressing portion 250.

Further, the shape of the lumen of the nozzle 280 is such that the peripheral length XA1 located on the right side of the virtual line V is gradually shortened in the order of the peripheral lengths XA2, XA3, and XA4 toward the insertion port 183 side of the nozzle 280. Similarly, the perimeter XB1 located on the left side of the virtual line V is gradually shortened in the order of the perimeters XB2, XB3, and XB4 toward the insertion port 183 side of the nozzle 280. The peripheral length XA5 and the peripheral length XB5 located on the insertion port 183 side of the nozzle 280 have substantially the same length. That is, the cavity shape of the nozzle 280 is changed so that the difference between the two circumferences with the virtual line V as the boundary gradually decreases toward the insertion port 183 of the nozzle 280. Since the action and effect of the intraocular lens insertion device in the second embodiment are substantially the same as those in the first embodiment, detailed description thereof will be omitted.

As described above, according to the intraocular lens insertion device according to the first embodiment and the second embodiment of the present disclosure, the extruded member 310 is viewed in a cross section orthogonal to the extruded axis A of the extruded member 310 when the cavity shape is viewed. The intraocular lens 1 extruded by the above has rotation suppressing portions 150 and 250 that suppress the unidirectional rotation by abutting the outer peripheral edge portion 2C located on the unidirectional rotation side that easily rotates around the axis of the extrusion member 310. Therefore, when the intraocular lens 1 is extruded by the extrusion shaft A, the rotation of the extrusion shaft A around the axis can be suppressed, and the posture of the intraocular lens 1 in the nozzles 180 and 280 can be stabilized.

Further, depending on the configuration of the rotation suppressing portions 150 and 250, the peripheral lengths XB1 to XB4 on the one-way rotation side are set shorter than the peripheral lengths XA1 to XA4. As a result, when the intraocular lens 1 is extruded by the extrusion shaft A, the outer peripheral edge portion 2C located on the unidirectional rotation side first comes into contact with the rotation suppression portions 150 and 250, so that the intraocular lens in the nozzles 180 and 280 The posture of 1 can be stabilized.

The difference in both peripheral lengths in the lumen shape of the nozzles 180 and 280 of the intraocular lens insertion device changes so as to gradually decrease toward the insertion port 183 which is the tip of the nozzle. As a result, the rotational posture of the intraocular lens 1 around the extrusion shaft A can be gradually corrected and sent out from the insertion port 183 which is the tip of the nozzles 180 and 280.

Further, the intraocular lens 1 in the nozzles 180 and 280 has an asymmetrical posture on the side where the root portion 6A of the front support portion 3A is arranged and the side where the root portion 6A is not arranged with the virtual line V as a boundary. Therefore, the intraocular lens 1 deformed in a roll shape around the extrusion shaft A has a different force in the direction of the open posture (restoration posture). Here, the side on which the root portion 6A of the front support portion 3A is arranged has higher rigidity than the side on which the root portion 6A of the front support portion 3A is not arranged. Therefore, the intraocular lens 1 in the nozzles 180 and 280 tends to rotate around the extrusion shaft A toward the side where the root portion 6A of the front support portion 3A is not arranged (unidirectional rotation). Therefore, by having the rotation suppressing portions 150 and 250 at the portions toward the unidirectional rotation, the rotational posture of the intraocular lens 1 around the extrusion shaft A can be stabilized.

Further, by providing the rotation suppressing portion 150 in the guide portion 140, the rotation suppressing portion 150 can be simply configured, and both peripheral lengths in the lumen shape of the nozzle 180 can be made different.

Although the embodiment of the present disclosure has been described above, the intraocular lens insertion device of the present disclosure is not limited to the above embodiment, and can be implemented in various other forms. For example, when the intraocular lens 1 tends to rotate in the direction opposite to that of the first embodiment (clockwise in FIG. 12), the rotation suppressing portion 150 may be provided on the first projection 141 side. That is, the width WA1 is made longer than the width WB1, and the rotation suppressing portion 150 is located on the unidirectional rotation side (first projection 141 side) where the intraocular lens 1 extruded by the extrusion member 310 is likely to rotate around the axis of the extrusion member 310. May be arranged.

1 Intraocular lens 2 Optical part 2A 1st surface 2B 2nd surface 2C Outer peripheral part 3 Support part 3A Front support part 4A Connection part 6A Root part 8A Tip part 3B Rear support part 4B Connection part 6B Root part 8B Tip part 10 eyes Intraocular lens insertion device 100 Main body 110 Main body cylinder 111 Narrow 130 Installation 132 Top plate 134 Installation main body 136 Plate-shaped 140 Guide 141 First protrusion 141a Wall surface 142 Second protrusion 142a Wall surface 150 Rotation suppression unit 180 Nozzle 182 Insertion part 183 Insertion port 230 Installation part 232 Top plate part 234 Installation part Main body 236 Plate-shaped part 240 Guide part 241 First protrusion 241a Wall surface 242 Second protrusion 242a Wall surface 249 Protrusion part 250 Rotation suppression part 280 Nozzle 300 Plunger 310 Extrusion Member 350 Shaft base 370 Pressing part A Extruded shaft L Optical axis V Virtual line S Reference point WA1 to WA4 Width WB1 to WB4 Width XA1 to XA5 Perimeter XB1 to XB5 Perimeter D Gap 240 Guide portion 241 First protrusion 242 Second protrusion 242F Front end 150F Contact surface

Claims (5)

An intraocular lens insertion device for inserting an intraocular lens having a disk-shaped optical portion and a plurality of support portions extending radially outward from the outer peripheral edge portion of the optical portion into the eye.
A nozzle having a lumen shape in which the passage through which the intraocular lens passes tapers toward the tip.
A shaft-shaped extrusion member that pushes the intraocular lens from the tip of the nozzle to the outside of the nozzle while folding the intraocular lens by pushing the outer peripheral edge of the intraocular lens in the nozzle.
A guide portion that guides the extrusion member in the nozzle along the extrusion shaft, and
Looking at the cavity shape in an orthogonal cross section orthogonal to the extrusion axis of the extrusion member, the outside lens located on the unidirectional rotation side where the intraocular lens extruded by the extrusion member tends to rotate around the axis of the extrusion member. A rotation suppressing portion that abuts the peripheral portion to suppress the one-way rotation,
Intraocular lens insertion device with. The intraocular lens insertion device according to claim 1.
The rotation suppression unit
A reference point is a point where a virtual line orthogonal to the inner surface of the nozzle facing the guide portion intersects with the extrusion shaft of the extrusion member.
An intraocular lens insertion device in which the circumference on the one-way rotation side is set shorter than the circumferences from the reference point to the ends on both sides in the lumen shape of the nozzle. The intraocular lens insertion device according to claim 2.
An intraocular lens insertion device in which the difference in both peripheral lengths in the shape of the lumen of the nozzle gradually decreases toward the tip of the nozzle. The intraocular lens insertion device according to claim 2 or 3.
The intraocular lens in the nozzle has a positional relationship in which the root portion of the front support portion located on the tip end side of the nozzle of the support portion does not overlap with the virtual line.
The rotation suppressing portion is an intraocular lens insertion device provided on the side where the root portion of the front support portion is not arranged with the virtual line as a boundary. The intraocular lens insertion device according to any one of claims 2 to 4.
An intraocular lens insertion device having a configuration in which both circumferences in the lumen shape of the nozzle are made different by providing the rotation suppressing portion in the guide portion.

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