JP3412106B2 - Deformable intraocular lens insertion device - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an inserter for inserting a deformable intraocular lens, and more particularly to a deformable intraocular lens inserter in which the shape of the tip of a pushing shaft is improved. Is.

[0002]

2. Description of the Related Art Heretofore, it has been widely practiced to insert an artificial intraocular lens in place of the crystalline lens extracted during cataract surgery. Since Ridley first inserted a polymethylmethacrylate (PMMA) intraocular lens into the human eye in 1949, many ophthalmologists have shown interest in the complications associated with intraocular lens implantation after cataract surgery. , I have been working on this problem, but at present, the main complications are (a) post-operative inflammation, (b) posterior capsule opacification,
It is believed that there will be four (c) intraocular lens deviations and (d) post-operative astigmatism.

Against these complications, (a) use of chemicals for post-operative inflammation, surface treatment of intraocular lens and improvement of biocompatibility, and (b) YAG for posterior capsule opacification.
The laser treatment and (c) the displacement of the intraocular lens can be dealt with by improving the support performance by the design of the support portion of the intraocular lens. However, (d) postoperative astigmatism is caused by the size of the surgical incision and the suturing of the incisional wound after the operation, which is a significant obstacle to the purpose of obtaining better visual acuity without glasses after the operation. Becomes And, postoperative astigmatism cannot be solved sufficiently though the use of an intraoperative keratometer and the incision method and the suturing method are devised, and this is said to be proportional to the size of the incision. Occurrence of posterior astigmatism is considered to be small.

[0004] For surgery with a small incision, an ultrasonic phacoemulsification suction device is used to remove the cloudy crystalline lens by crushing the crystalline lens with an ultrasonic tip, emulsifying and sucking it. (PEA) surgery enables removal of the lens with an incision of about 3-4 mm,
Compared to the incision of the conventional cataract extracapsular resection (ECCE), which is about 10 mm at the time of lens extraction, surgery with a small incision is possible.

However, the conventional intraocular lens has an optical part made of a hard material such as glass or resin, and in order to insert these intraocular lenses into the eye, an incision size larger than the diameter of the optical part. Since the incision is about 6.5 mm or more, even if the lens is removed from the small incision by ultrasonic phacoemulsification, the size of the incision can still be inserted to insert an intraocular lens with a hard optical part. Had to be larger.

Therefore, for example, Japanese Patent Application Laid-Open No. 58-146346.
As described in the publication, an intraocular lens that can be inserted from the aforementioned small incision has been developed, and these intraocular lenses are composed of an optical part and a support part, and at least the optical part has a predetermined memory. It is composed of a deformable elastic body having characteristics.

As disclosed in JP-A-58-146346, JP-A-4-212350, JP-A-5-103803, JP-A-5-103808, and JP-A-4-368229. , By transforming the optical part of the deformable intraocular lens by winding, bending, stretching, folding, and transforming it into a small shape from a large shape before deformation, from a small incision made on the eyeball We have developed an insertion tool that can insert an intraocular lens into the eye. By using these insertion tools, we have discovered the possibility of surgery with a small incision of about 4 mm from both the intraocular lens and the insertion method of the intraocular lens. ing.

That is, as shown in FIG. 9, as the deformable intraocular lens 1, a different shape from the optical portion 2 is provided on the outer peripheral portion of a circular optical portion 2 formed of a flexible material having a predetermined memory characteristic. The base portions 3a of the pair of support portions 3 formed of a flexible material are embedded and fixed, the linear protrusions 3b of the support portions 3 are curved, and the two support portions 3 are arranged symmetrically. There are a protrusion 2a for reinforcing the embedded portion of the base portion 3a on the outer periphery of the base, and a constitution similar to that of FIG. 9 except that the protrusion 2a is eliminated as shown in FIG. In addition, as shown in FIG. 11, a front and rear plate-shaped member made of a material having the same predetermined memory characteristic as in FIG. Two
In some cases, the two support portions 4 are opposed to each other and protruded.

A deformable intraocular lens 1 having an optical part 2 and a supporting part 3 or a supporting part 4 at least the optical part having a predetermined memory characteristic, such as that shown in FIGS. To insert an intraocular lens into an eye from an incision made in an eyeball by folding it from a large shape to a small shape, for example, by folding the shape into two and inserting it into the eye, see Japanese Patent Application Laid-Open No. The insertion device and the like disclosed in Japanese Patent Laid-Open No. 5-103808 are used.

In order to insert a deformable intraocular lens from a small incision using the insertion instrument, the lens installation portion provided in the holding member of the insertion instrument is opened, and the intraocular lens is attached to this installation portion. The intraocular lens is installed and closed to close the intraocular lens to a small shape by folding the intraocular lens from the large shape before deformation into two, and the intraocular lens is installed in the installation section. After that, the push-out shaft is moved forward by the manual operation of the push-out mechanism of the insertion tool, and the intraocular lens in the installation section is pushed out by the flat distal end surface orthogonal to the axial direction of the extrusion shaft, and inside the insertion tube connected to the distal end side of the installation section. The intraocular lens is inserted into the eye through the tip of the insertion tube inserted into the incision.

[0011]

However, in the above-described deformable intraocular lens insertion device, when the intraocular lens is inserted, an external force by the pushing shaft in the insertion tube of the insertion device is applied to the intraocular lens. It acts only in the pushing direction, and the intraocular lens is not restricted in the rotation direction in the insertion tube.
Therefore, in the insertion cylinder of the insertion instrument, the intraocular lens is rotationally displaced in the circumferential direction of the cylindrical portion, and there is a problem that a desired directionality cannot be obtained.

In the intraocular lens shown in FIGS. 9 and 10, the optical part is made of a deformable elastic material having a predetermined memory characteristic, and the support part is made of a different material for supporting the optical part in the eye. A material such as a resin that has sufficient hardness to increase the fixing strength of the optical part and to have flexibility for fixing the optical part on the optical axis even if it receives compression or other stress in the eye. Since it has a spring function in a linear form and the base portion of the supporting portion is embedded in the outer peripheral portion of the optical portion, the following problems occur.

That is, when the intraocular lens is folded in two and is inserted into the insertion tube of the insertion device, the base portion embedded in the optical portion of the linear support portion is arranged in the pushing direction of the intraocular lens. On the other hand, the front side is located on the right side, the back side is located on the left side, or the front side is located on the left side, and the back side is located on the right side, and the front and rear and the left and right are asymmetrical. When the intraocular lens is pushed out, the direction is not constant when the intraocular lens is pushed out, and the insertion cylinder is properly inserted into the desired site. There was a problem that it was difficult.

Further, even in a deformable intraocular lens in which two plate-like support parts are integrally opposed to each other from the outer periphery of the optical part, such as the one shown in FIG. 11, the support part located at the rear part. Is pressed against the flat tip surface of the insertion shaft of the insertion tool,
Since the intraocular lens is not constrained in the rotation direction around the axis of the insertion tube, there is a problem that it rotates within the insertion tube. The present invention solves the above-mentioned problems, and the deformable intraocular lens can be accurately inserted into a desired site in the eye in a fixed direction without rotating or twisting. , An intraocular lens insertion device is provided.

[0015]

According to a first aspect of the present invention, a deformable intraocular lens having an optical portion made of an elastic material and a supporting portion, at least the optical portion having a predetermined memory characteristic, is deformed. Then, an extrusion shaft for extruding the deformed intraocular lens from the tip of the insertion tube into a small shape and an extrusion mechanism for advancing this extrusion shaft are provided in the instrument body, and the rotation of the extrusion shaft is constrained. In a possible intraocular lens insertion device, a cross section in a direction perpendicular to the extrusion axis of a portion of the distal end of the extrusion shaft that comes into contact with the deformed intraocular lens is formed in an asymmetric shape with respect to the center of the extrusion axis. is there.

According to a second aspect of the invention, in the instrument for inserting an intraocular lens according to the first aspect of the invention, the portion of the extruding shaft tip portion that abuts on the folded rear side portion of the intraocular lens is the rear side portion. In addition to being formed in a shape corresponding to the above, a tip projection portion is formed in the upper portion of the distal end portion of the extrusion shaft so as to be in close contact between the opposite upper portions of the intraocular lens.

According to a third aspect of the invention, in the intraocular lens insertion device according to the second aspect of the invention, the intraocular lens includes a circular optical portion made of a deformable material having a predetermined memory characteristic, and an optical portion. It has a pair of support parts made of different kinds of flexible materials and having a base part embedded and fixed to the outer peripheral part of the optical part, and a protrusion for reinforcing the base part of the support part is provided on the outer periphery of the optical part.
The linear protrusion of the support portion protruding from the protrusion of the optical portion is curved to make the support portion symmetrical with respect to the center of the optical portion. On one side, a notch for supporting one side located at the rear side of the folded optical part of the intraocular lens is formed, and at the other side the projection located at the rear side is put, and Forming a notch through which the linear protrusion of the supporting portion located in the side portion is inserted, the other end of the optical part is supported by the front end of the other end of the upper part, and the tip formed at the upper part between the notch parts The protrusions are arranged so as to be closely interposed between the opposed upper portions of the folded optical portion.

According to a fourth aspect of the invention, in the intraocular lens insertion device according to the second aspect of the invention, the intraocular lens includes a circular optical portion made of a deformable material having a predetermined memory characteristic, and an optical portion. A pair of support parts made of different kinds of flexible materials, in which the base part is embedded and fixed in the outer peripheral part of the optical part, and the linear protruding parts of the support parts protruding from the outer periphery of the optical part are curved,
The support part is made symmetrical with respect to the center of the optical part, and the extrusion shaft is
The upper part of the tip part is projected toward the tip side, and one side part of the upper part is formed with a cutout part for supporting one side part located in the rear part of the folded optical part of the intraocular lens, and the rear part is formed on the other side part. A notch is formed through which the protruding portion of the support located at the side portion passes, and a notch that supports the other side of the optical unit is formed at the upper end of the notch.

According to a fifth aspect of the present invention, in the intraocular lens insertion device according to the second aspect of the invention, the intraocular lens is made of a deformable material having a predetermined memory characteristic, and the front and rear of the circular optical portion. The plate-shaped support parts are projected integrally,
The extrusion shaft has notches on both sides of the tip,
At the ends of these cutouts, a support surface for supporting the rear end of the support located at the rear part of the intraocular lens is formed, and at the upper part between the cutouts, the support part located at the rear part faces each other. A tapered trapezoidal tip projecting portion is provided which is in close contact with the upper part of the side surface and is interposed between these side surfaces.

[0019]

In the intraocular lens insertion device according to the first aspect of the present invention, the deformable intraocular lens is folded into two in the form of a wrapping member.
A suitable cross-sectional shape such as a letter shape or an M shape, preferably a double-folded shape, is folded into a small shape for enclosing, and in this state, the pushing mechanism is manually operated to move the pushing shaft forward, and the tip portion of the pushing shaft is pushed. When inserting the intraocular lens through the insertion tube into the eye by the, the portion of the extruding shaft tip portion that comes into contact with the folded rear side portion of the intraocular lens has an asymmetric shape with respect to the extruding shaft center. Since it is formed as described above, an optimal shape can be selected as appropriate according to the shape of the intraocular lens, and the intraocular lens can uniformly apply force. Therefore, not only to prevent the intraocular lens from rotating when moving the intraocular lens by advancing the extrusion shaft, but also to prevent the intraocular lens from being scratched or damaged by the extrusion shaft. You can

The invention of claim 2 describes the invention of claim 1 more specifically in terms of the shape of the extruding shaft tip, and the part of the extruding shaft tip portion that abuts on the folded rear side portion of the intraocular lens, Since it is formed in a shape corresponding to the rear side portion, both sides of the folded portion of the intraocular lens can be pushed substantially evenly. At the same time, the tip projections provided on the top of the tip of the pushing shaft are closely intervened between the two opposite upper parts of the intraocular lens, so that the intraocular lens can be rotated around its axis in the insertion tube. Can be prevented and the directionality can be made constant. Therefore, without rotating the intraocular lens in the insertion tube, the intraocular lens can be accurately inserted into a desired site in the eye from a small incision in a fixed direction.

The intraocular lens insertion device according to the third and fourth aspects of the invention corresponds to the first and second embodiments for inserting the deformable intraocular lens shown in FIGS. 9 and 10 into the eye. And in the notch formed on the other side of the tip of the extrusion shaft,
By passing the linear protrusion of the support located at the rear part of the intraocular lens, this protrusion is pushed by the tip of the extrusion shaft and elastically deforms or remains until after it is inserted into the eye. It can be prevented from being deformed.

The base portion of the support portion embedded in the optical portion is left-right asymmetrical due to folding of the intraocular lens into two folds, and the left-right asymmetric spring function of the base portion causes the intraocular lens to rotate in the insertion tube. To twist or twist
The tip projections formed on the upper part between the notch on one side and the other side of the extruding shaft tip part are prevented from each other by closely interposing them between the opposite parts of the folded optical part. The intraocular lens can be accurately inserted into the eye in a fixed direction.

Further, in the third aspect of the invention, of the pair of projections for reinforcing the base portion of the supporting portion provided on the outer periphery of the optical portion of the intraocular lens, the protrusion is located at the rear side portion of the folded intraocular lens. By inserting the protrusion into the notch formed on the other side of the extruding shaft tip, the both ends of the optical part are pushed almost evenly by the extruding shaft tip without being obstructed by the protrusion located on the rear side. It is possible to prevent rotation and twist of the intraocular lens.

The instrument for inserting an intraocular lens according to claim 5 is
The intraocular lens corresponding to the third embodiment for inserting the deformable intraocular lens shown in FIG. 11 into the eye, wherein the intraocular lens is folded by the end faces of the notches formed on both sides of the tip of the pushing shaft. Pushing the end surface of the plate-shaped support portion located in the rear side portion, providing a tapered trapezoidal protrusion on the upper portion between the notches,
Since the protruding portion is brought into contact with the upper portions of the opposite side surfaces of the supporting portion located in the rear portion of the intraocular lens, the outer periphery of the supporting portion located in the rear portion by the tip portion of the pushing shaft is advanced when the pushing shaft is advanced. Can be pushed evenly over a large range, and even if the support part is plate-shaped, it can be pushed stably, and the intraocular lens can be rotated or twisted around the axis of the insertion tube. There is no.

[0025]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show the intraocular lens insertion device according to the first embodiment. The insertion device of the first embodiment is
As shown in FIG. 1, an instrument body 11 having a substantially cylindrical shape, an extrusion shaft 12 fitted to the instrument body 11, and a screw (not shown) screwed to form an inner peripheral surface of the instrument body 11. The pushing mechanism 14 having the screw cylinder 13 and the wrapping member 18 having the insertion cylinder 17 protruding from the distal end side of the lens installation portion 16 having the hinge portion 15 are provided. Has a mounting groove 11a formed on the tip side along the axial direction of the instrument body 11, and the push-out shaft 12 is axially restrained and rotatably connected to the male screw cylinder 13 to rotate with respect to the instrument body 11. The movement is restrained.

The lens installation portion 16 of the holding member 18 is
As shown in FIG. 2, the fixed half tube 1 is attached to the end of the insertion tube 17.
9 is integrally provided, and a movable half-split cylinder 20 facing the fixed half-split cylinder 19 is provided close to the end of the insertion cylinder 17 so as to be openable and closable, and a lower edge of the fixed half-split cylinder 19 and the movable half-split cylinder 20 is provided. The parts are connected by a hinge part 15, and fixed and movable pressing plates 21 and 22 are projected on the fixed and movable half-split cylinders 19 and 20, respectively.

The movable half-split cylinder 20, the hinge portion 15 and the movable pressing plate 22 constitute an opening / closing mechanism. When the opening / closing mechanism is closed, the movable pressing plate 22 abuts the fixed pressing plate 21 and the insertion cylinder 17 is inserted. It is designed to be a coaxial cylinder.
The insertion cylinder 17 has an inner diameter on the proximal end side that is equal to the inner diameter of the tubular portion with which the movable half-divided cylinder abuts, and only the tip portion 17a is tapered. The above-mentioned configuration is disclosed in
The configuration is almost the same as that described in Japanese Patent No. 103808.

In the insertion device of the first embodiment, as shown in FIGS. 3 and 4, the distal end portion 23 of the pushing shaft 12 has a flat cross-section with an oval shape, that is, the upper and lower surfaces are cut out to form a horizontal plane. 23a, and the upper portion 23b and the lower portion 23c are projected toward the tip side. Furthermore, a tip cutout portion 23d is formed in a plane concave arc shape on one side of the top portion 23b, and the other side of the tip portion 23 has an axial direction. A cutout portion 23e having an arc-shaped cross section is formed on the whole, and the extrusion shaft 12 is provided on both side surfaces other than the cutout portions 23d and 23e.
An arc surface 23f concentric with the shaft center is formed, and a small diameter portion 24 is connected to the end side of the tip portion 23.

The insertion cylinder 17 of the holding member 18 is shown in FIG.
As shown in FIG. 2, the base end side part 17b is formed in an oval-shaped cross section having upper and lower surfaces as horizontal planes 17c.
7a forms the tip 17d in a circular shape, and the upper and lower horizontal surfaces 1
7c is formed in a taper shape that gradually reduces the width, and the tip portion 17a
In this case, notches 17e are formed at three positions in the circumferential direction at angular intervals of 120 ° over the entire axial direction. Then, the insertion tube 17 has an upper surface 23a of the tip portion 23 of the pushing shaft 12,
The lower surface 23c is configured to slide without a gap.

The insertion tool of the first embodiment is used for the intraocular lens 1 shown in FIG. 9. To insert the intraocular lens 1 into the eye, the movable holding plate 22 of the holding member 18 and the movable half-split tube are used. 20 is opened, the pair of supporting portions 3 of the intraocular lens are respectively positioned on one side of the front side and the other side of the rear side, and the optical section 2 is installed above the hinge section 15 with an appropriate gap, and the movable holding plate is provided. 22
And, the movable half-split cylinder 20 is closed to fit the fixed holding plate 21 and the fixed half-split cylinder 19, and the optical part 2 is folded in half in the half-split cylinders 19 and 20 to form a small shape. Position and hold.

In this holding state, the mounting groove 1 of the instrument main body 11
From the base end side of 1a, the half-split cylinders 19 and 20 and the insertion cylinder 17
To the inside of the instrument main body 11 and holding the pressing plates 21 and 22 projecting outside the instrument main body 11 in the hand with the closing, to advance the holding member 18 to the tip side of the instrument main body 11, and press the pressing plate 21,
22 is engaged with and supported by the narrow end portion of the mounting groove 11a, is attached to the instrument body 11, and the insertion tube 17 is projected from the tip of the instrument body 11.

Next, by rotating the male screw cylinder 13 of the pushing mechanism 14, the male screw that is in the retracted position by the screw fitting between the male screw cylinder 13 and the screw formed on the inner peripheral surface of the instrument body 11 is rotated. The push-out shaft 12 is advanced together with the cylinder 13 without rotating about the axis. By advancing the extrusion shaft 12,
The tip portion 23 contacts the optical portion 2 of the intraocular lens 1.
That is, as shown in FIG.
3 has a tip notch 23d provided on one side of the upper portion 23b.
The protrusion 2a and the supporting portion 3 which are in contact with one side of the upper portion of the optical portion 2 folded into a folded shape and are provided in the other side of the tip portion 23 and which have a notch 23e having an arcuate cross section and which are located in the rear portion of the optical portion 2 The linear protruding portion 3b of the upper part 23b is allowed to move forward, and the other end of the upper part 23b contacts the other side part of the optical part 2.

In this state, by continuing the forward movement of the pushing shaft 12, the optical portion 2 is pushed out from the tip 17d of the insertion tube 17 inserted into the incision and inserted into the eye. At this time, the distal end portion 23 of the pushing shaft 12 stably moves straight in the insertion cylinder 17 while being in contact with the inner surface of the proximal side portion 17b of the insertion cylinder 17 with a large area of the upper and lower surfaces. Since the notch 17e is formed at three positions in the circumferential direction over the entire axial direction, the notch 17e opens, and the notch 17e of the insertion tube 17 elastically deforms to expand the inner diameter. Even if the tip portion 17a is tapered, the optical portion 2 that has been folded to have a small shape gradually returns to the shape before the deformation and comes out from the tip portion 17a of the insertion tube 17, so that a small cutting Even with a retractor, it can be inserted into the intraocular lens 1 within the eye.

Further, as described above, the tip end portion 23 of the push-out shaft 12 is formed in a shape corresponding to the rear side portion of the optical portion 2 and is in contact with this portion, and the tip end protrusion of the upper portion 23b is formed. Since the distal end portion 23 moves straight through the upper portion of the optical portion 2 that opposes in a convex arc shape , the optical portion 2 does not rotate about its axis in the insertion tube 17 and has a directivity. And the support portion 3 embedded in the optical portion 2
Due to the left and right asymmetrical spring functions of the base 3a, the intraocular lens 1 does not rotate or twist in the insertion tube 17. Therefore, the deformable intraocular lens 1 can be accurately inserted into a desired site in the eye in a fixed direction.

5 and 6 show the main parts of the insertion device according to the second embodiment. The insertion instrument according to the second embodiment is different from the above-described first embodiment in the shape of the distal end portion 23 of the pushing shaft 12, and is different from the first embodiment in that it is used for the deformable intraocular lens 1 shown in FIG. Except that it is different, the configuration and operation are the same. As shown in FIGS. 5 and 6, the extrusion shaft 12
The front end portion 23 of the notch 2 has an arcuate cross section formed on the other side.
3e is made smaller than that of the first embodiment, and the notch 23
An arc surface 23 concentric with the extrusion shaft 12 by the amount by which e is reduced
with increasing the width of the f, in correspondence with the plane concave arcuate distal notch 23d formed on one side of the upper 23b, a smaller flat concave arc shape at the tip notch 23g which is formed on the other side of the upper 23b Other than that, it has the same structure as the tip portion 23 of the extrusion shaft 12 of the first embodiment.

To insert the deformable intraocular lens 1 shown in FIG. 10 into the eye with the insertion tool of the second embodiment,
As in the case of the first embodiment described above, the optical part 2 is folded in two and made into a small shape and held by the holding member,
The holding member is attached to the instrument body, and in this state, the pushing mechanism is operated to move the pushing shaft forward without rotating.

As shown in FIG. 6, when the push-out shaft 12 is moved forward, the tip 23 of the optical axis 2 is formed by folding the tip notches 23d and 23g provided on both sides of the upper portion 23b into two folds. Respectively, and the linear protrusion 3b of the support portion 3 located on the rear side of the optical portion 2 enters the notch 23e provided on the other side of the tip portion 23 so as to be able to move forward.

In this state, by continuing the forward movement of the pushing shaft 12, the optical unit 2 is pushed out from the tip of the insertion tube 17 inserted into the incision and inserted into the eye. At this time, similarly to the first embodiment, the distal end portion 23 of the push-out shaft 12 stably moves straight along the proximal end side portion of the insertion tube, and the optical portion 2 that is folded and has a small shape gradually. By returning from the distal end portion of the insertion tube while returning to the shape before the deformation, the intraocular lens 1 can be inserted into the eye even with a small incision.

Further, in the tip portion 23 of the pushing shaft 12, the upper portion 23b is formed in a shape corresponding to the rear side portion of the optical portion 2 of the intraocular lens 1, and a portion for contacting this portion is formed.
Since the tip end 23 of the upper portion 23b is interposed between the upper portions of the optical portions 2 facing each other in a convex arc shape , the tip portion 23 moves straight, so that the tip notch portions 23d and 23g are provided on both sides of the upper portion 23b to form a substantially even eye. Since both sides of the upper portion of the inner lens 1 are pushed out, the optical section 2 does not have to rotate around its axis in the insertion tube 17, so that the directionality can be kept constant and the optical section 2 is embedded in the optical section 2. The left and right asymmetrical spring functions of the base portion 3a of the supporting portion 3 do not cause the intraocular lens 1 to rotate or twist in the insertion tube 17 and prevent the intraocular lens 1 from moving in a fixed direction in the eye. It can be inserted accurately at the desired site.

It should be noted, first, the insertion device of the second embodiment, linear protrusions of the support portion 3 of the notch 23e in the intraocular lens 1 of the cross-section concave arc provided at the tip portion 23 of the pushing shaft 12 Since the protruding portion 3b is passed through, the protruding portion 3b is not pushed by the tip portion 23 and elastically deformed, or is not deformed remaining after being inserted into the eye.

7 and 8 show the main parts of the insertion device according to the third embodiment. The insertion instrument according to the third embodiment differs from the first and second embodiments in the shape of the distal end portion 23 of the pushing shaft 12, and the first and second embodiments are applicable to the deformable intraocular lens 1 shown in FIG. The configuration and operation are the same as those described above, except that the second embodiment is different.

[0042] As shown in FIGS. 7 and 8, the distal end portion 23 of the pushing shaft 12 is formed to the lower symmetrically notches 23h cross section concave arc on either side of the distal end portion 23, upper 23b is
A support surface 23i perpendicular to the base side of the upper portion 23b has a narrow tip-shaped protruding portion protruding toward the tip side.
The horizontal planes 23a of the upper and lower surfaces are extended to the distal end side of the extrusion shaft 12 having a large cross-sectional area, and the small-diameter portion having a small cross-sectional area provided in the first and second embodiments is eliminated to correspond to the small-diameter portion. The end side from the portion to be formed is similar to that of the first embodiment.

To insert the deformable intraocular lens 1 shown in FIG. 11 into the eye with the insertion tool of the third embodiment,
The support portion 4 formed integrally with the optical portion 2 is positioned before and after the optical portion 2, and as shown in FIG.
The first except that it was folded in two and made into a small shape.
As in the embodiment, the holding member is held by the holding member, and the holding member is attached to the instrument body. In this state, the pushing mechanism is operated to move the pushing shaft forward without rotating it.

As shown in FIG. 8, when the push-out shaft 12 is moved forward, the tip portion 23 of the tip end portion 23 is located at the rear side portion in which the support surfaces 23i provided on both sides of the base portion of the upper portion 23b are curved in two folds. The tip projections of the narrow upper portion 23b, which come into contact with the rear ends respectively, are located between the side edges of the supporting portions 4 located at the rear portion and facing each other, and the upper both side surfaces of the tip projections are attached to these side edges. Contact each other.

In this state, by continuing the forward movement of the pushing shaft 12, the intraocular lens 1 is pushed out from the tip of the insertion tube 17 inserted into the incision and inserted into the eye. At this time, in the same manner as in the first embodiment, the distal end portion 23 of the pushing shaft 12 stably advances straight in the insertion tube at the base end side portion of the insertion tube and is folded to have a small shape. While the part 2 and the support part 4 gradually return to the shape before the deformation, the part 2 and the support part 4 come out from the distal end part of the insertion tube,
The intraocular lens 1 can be inserted into the eye.

Further, the tip portion 23 of the push-out shaft 12 has a shape corresponding to the rear side portion of the support portion 4 whose upper portion 23b is located at the rear side portion of the optical portion 2 of the intraocular lens 1 and is in contact with this. Is formed, and the front end protruding portion of the upper portion 23b is formed into a tapered flat trapezoidal shape, and the support portion 4 located at the rear side portion is formed.
Since the tip portion 23 goes straight while being interposed between the upper portions of
The optical part 2 and the front and rear support parts 4 do not rotate around their axes in the insertion tube 17, and the directionality is kept constant, and the intraocular lens 1 is moved in a fixed direction to a desired position in the eye. Can be inserted properly.

The intraocular lens insertion instrument according to the present invention can be appropriately modified, for example, by fixing the wrapping member to the instrument main body or forming it integrally with the instrument body, without departing from the scope of the claims. The tip of the cylinder and the extrusion shaft is up,
It is preferable that the lower surface and the horizontal surface have a flat cross-sectional shape, and if the insertion cylinder has a shape in which both or one of the upper surface of the tip portion of the extrusion shaft and the arc-shaped side surface with the lower surface slide without a gap. However, it is preferable that the top surface and the bottom surface of the tip portion of the extrusion shaft slide like a gap as in the above embodiment without any gap.

[0048]

As described above, in the intraocular lens insertion device according to the invention of claim 1, the deformable intraocular lens is folded in a suitable cross-sectional shape such as a two-fold shape, preferably in a two-fold shape. In this state, the extrusion mechanism is manually operated in this state to advance the extrusion shaft, and when the intraocular lens is inserted into the eye through the insertion tube by the distal end of the extrusion shaft, the eye at the distal end of the extrusion shaft Since the portion that comes into contact with the folded rear portion of the inner lens is formed in an asymmetric shape with respect to the center of the extrusion axis, the shape can be appropriately selected according to the folded portion of the intraocular lens. As concrete shapes, the following shapes as claimed in claims 2 to 5 are conceivable, and various effects are exhibited.

In the intraocular lens insertion device according to the second aspect of the present invention, the portion of the distal end of the pushing shaft that contacts the folded rear side portion of the intraocular lens is formed in a shape corresponding to the rear side portion of the intraocular lens. Therefore, both sides of the folded part of the intraocular lens can be pushed almost evenly, and the tip projection part provided on the upper part of the tip part of the pushing shaft is closely contacted between the opposite upper parts of the intraocular lens. Since it is intervened, it is possible to prevent the intraocular lens from rotating around its axis in the insertion tube, and to keep the directionality constant. Therefore, without rotating the intraocular lens in the insertion tube, the intraocular lens can be accurately inserted into a desired site in the eye from a small incision in a fixed direction.

The intraocular lens insertion device according to the third and fourth aspects of the present invention is suitable for insertion of the intraocular lens shown in FIGS. 9 and 10, and has a notch formed on the other side of the tip of the pushing shaft. To
By passing the linear protrusion of the support located at the rear part of the intraocular lens, this protrusion is pushed by the tip of the extrusion shaft and elastically deforms or remains until after it is inserted into the eye. It can be prevented from being deformed.

The base portion of the support portion embedded in the optical portion is left-right asymmetrical due to the folding of the intraocular lens into two folds, and the left-right asymmetrical spring function of the base portion causes the intraocular lens to rotate in the insertion tube. To twist or twist
The tip projections formed on the upper part between the notch on one side and the other side of the extruding shaft tip part are prevented from each other by closely interposing them between the opposite parts of the folded optical part. The intraocular lens can be accurately inserted into the eye in a fixed direction.

Further, in the third aspect of the invention, of the pair of protrusions for reinforcing the base of the supporting portion provided on the outer periphery of the optical portion of the intraocular lens, the protrusion is located at the rear side portion of the folded intraocular lens. By inserting the protrusion into the notch formed on the other side of the extruding shaft tip, the both ends of the optical part are pushed almost evenly by the extruding shaft tip without being obstructed by the protrusion located on the rear side. It is possible to prevent rotation and twist of the intraocular lens.

The instrument for inserting an intraocular lens according to a fifth aspect of the present invention is suitable for inserting the intraocular lens shown in FIG. 11, and the eye is folded by the end faces of the notches formed on both sides of the tip of the pushing shaft. The distal end surface of the plate-shaped support portion located in the rear portion of the inner lens is pressed, and a tapered trapezoidal protrusion is provided in the upper portion between the notches, and the protrusion is positioned in the rear portion of the intraocular lens. Since it is brought into contact with the upper portions of the opposite side surfaces of the supporting portion, the outer periphery of the supporting portion located at the rear portion can be uniformly pushed by the tip portion of the pushing shaft in a large range when the pushing shaft advances, and the supporting portion is Even if it is plate-shaped, it can be pushed stably, and the intraocular lens does not rotate or twist around the axis of the insertion tube.

[Brief description of drawings]

FIG. 1 is a partially cutaway perspective view showing a deformable intraocular lens insertion device according to a first embodiment of the present invention.

FIG. 2 is an enlarged perspective view of a holding member of the insertion device shown in FIG.

FIG. 3 is an enlarged perspective view of a tip end portion of a pushing shaft of the insertion device shown in FIG.

FIG. 4 is an enlarged plan view for explaining the operation in which the insertion tube of the insertion device shown in FIG. 1 is cut vertically.

FIG. 5 is an enlarged perspective view showing a distal end portion of a pushing shaft of a deformable intraocular lens insertion instrument according to a second embodiment of the invention.

FIG. 6 is an enlarged plan view for explaining the operation in which the insertion tube of the insertion device according to the second embodiment is cut vertically.

FIG. 7 is an enlarged perspective view showing a distal end portion of the pushing shaft of the deformable intraocular lens insertion instrument according to the third embodiment of the present invention.

FIG. 8 is an enlarged plan view for explaining the operation in which the insertion tube of the insertion device according to the fourth embodiment is cut vertically.

FIG. 9 is an enlarged plan view showing an example of a deformable intraocular lens.

FIG. 10 is an enlarged plan view showing another example of the deformable intraocular lens.

FIG. 11 is an enlarged plan view showing still another example of the deformable intraocular lens.

[Explanation of symbols]

1 Deformable intraocular lens 2 Optics 2a protrusion 3 Support 3a base 3b Linear protrusion 4 Support 11 Instrument body 11a mounting groove 12 Extrusion shaft 13 male screw cylinder 14 Extrusion mechanism 15 Hinge part 16 Lens installation section 17 insertion tube 17a tip 17b Base end side 17c Horizontal plane 17d tip 17e notch 18 Holding member 19 fixed halves 20 movable halves 21 Fixed presser plate 22 Movable presser plate 23 Tip of extrusion shaft 23a Horizontal plane 23b upper part 23c lower part 23d tip notch 23e Notch 23f circular surface 23g Tip notch 23h notch 23i support surface 24 Small diameter part

Claims (5)

(57) [Claims] 1. A deformable intraocular lens having an optical part made of an elastic material and a supporting part, at least the optical part having a predetermined memory characteristic, is folded to be deformed into a small shape, and the deformed intraocular lens is inserted from the distal end of the insertion tube. An extruding shaft for extruding the deformed intraocular lens and an extruding mechanism for advancing this extruding shaft are provided in the instrument body, and the rotation of the extruding shaft is restrained. Insertion of a deformable intraocular lens, characterized in that a section of a tip end of the shaft in contact with the deformed intraocular lens in a direction perpendicular to the extrusion shaft is formed in an asymmetric shape with respect to the center of the extrusion shaft. Equipment. 2. A portion of the extruding shaft tip portion, which comes into contact with the folded rear side portion of the intraocular lens, is formed in a shape corresponding to the rear side portion, and an intraocular portion is formed above the extruding shaft tip portion. The deformable intraocular lens insertion device according to claim 1, wherein a distal end protrusion is formed between the upper portions of both sides of the lens facing each other so as to be in close contact with each other. 3. The intraocular lens comprises a circular optical part made of a deformable material having a predetermined memory characteristic, and a flexible material different from the optical part, and a base part is embedded and fixed in the outer peripheral part of the optical part. A pair of supporting portions is provided, and a protrusion that reinforces the base portion of the supporting portion is provided on the outer periphery of the optical portion, and the linear protrusion portion of the supporting portion that protrudes from the protrusion of the optical portion is curved to form the supporting portion. It is symmetric with respect to the center of the optical part, and the pushing shaft has an upper part of the distal end protruding toward the distal end, and one side located on the rear part of the folded optical part of the intraocular lens. Forming a notch for supporting the portion, inserting the projection located at the rear part on the other side, and forming a notch through which the linear protrusion of the support located at the rear part passes, The other side of the optical part is supported by the front end of the other side, and the tip protrusion formed on the upper part between the notches is folded. 3. The deformable intraocular lens insertion device according to claim 2, wherein the optical parts are closely disposed between the opposed upper parts. 4. The intraocular lens comprises a circular optical part made of a deformable material having a predetermined memory characteristic, and a flexible material different from the optical part, and a base is embedded and fixed to the outer peripheral part of the optical part. And a pair of supporting portions, the linear protruding portion of the supporting portion projecting from the outer periphery of the optical portion is curved, and the supporting portion is symmetrical with respect to the center of the optical portion. To the tip side and form a notch on one side of the upper part that supports one side located at the rear part of the folded optical part of the intraocular lens, and on the other side at the rear part 3. The deformable apparatus according to claim 2, wherein a cutout portion is formed through which the protruding portion of the supporting portion is formed, and a cutout portion that supports the other side portion of the optical portion is formed at an upper end of the cutout portion. Intraocular lens insertion tool. 5. The intraocular lens is made of a deformable material having a predetermined memory characteristic, and a plate-shaped support portion is integrally projected in front of and behind the circular optical portion. Forming notches on both sides, at the ends of these notches, forming a supporting surface for supporting the rear end of the supporting part located at the rear part of the folded intraocular lens, the upper part between the notches. 3. The deformable apparatus according to claim 2, further comprising: a tapered trapezoidal tip protruding portion that is in close contact with the upper portions of the opposite side surfaces of the support portion located at the rear side portion and that is interposed between these side surfaces. Intraocular lens insertion tool.