JP4520256B2 - Intraocular lens insertion device - Google Patents

Description

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

Conventionally, as one of the surgical methods for cataracts, a method of inserting an intraocular lens instead of the lens after extracting the lens is generally used. In order to insert an intraocular lens, first, an incision for inserting the intraocular lens is provided in the eyeball, and the cloudy crystalline lens inside the incision is crushed with an ultrasonic cataract surgical device or the like and sucked. Then, an intraocular lens is inserted through the incision at the place where the lens was.
Thus, when inserting an intraocular lens, the method of using the intraocular lens insertion instrument called an injector is common. As such an injector, a holder (cartridge) for placing an intraocular lens is used as a lens package (lens case) and is removable from the injector body. In such a cartridge, the intraocular lens is placed without being fixed, or the intraocular lens is fixed so as not to move within the cartridge, and the cartridge is attached to the injector body. After that, there is known one having a mechanism for releasing the fixed state (see Patent Document 1).
JP 2001-104363 A

However, when the cartridge is handled as a lens package without fixing the position of the intraocular lens, the intraocular lens may move in the cartridge during transportation or storage. If the intraocular lens moves within the cartridge, the support (loop) provided on the intraocular lens may be deformed or damaged. Moreover, when using the cartridge which fixes the position of an intraocular lens, after attaching to an injector main body, the effort of canceling | releasing a fixed state is produced.
In view of the above-described problems of the prior art, the present invention can suppress the movement of the intraocular lens even if the cartridge is used as a lens case, and can be used without any trouble after attaching the cartridge to the injector. It is an object of the present invention to provide an intraocular lens insertion device that can perform the insertion operation.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) In an intraocular lens insertion device for inserting a deformable intraocular lens into the eye, the insertion tube for placing an insertion tube portion to be inserted into an incision provided in the eyeball and the intraocular lens. A lens holding part having a mounting table provided on the base end side of the part, an insertion instrument main body having a mounting means for making the lens holding part detachable at the distal end part, and pushing out the intraocular lens from the insertion cylinder part For this purpose, the pushing means provided to be movable back and forth in the axial direction within the cylinder of the insertion instrument body, and the regulation means for regulating the movement of the intraocular lens placed on the mounting table before being mounted on the insertion instrument body And a lens restricting member that is detachably attached to the lens holding part, and has a contact member that comes into contact with a predetermined part of the insertion tool main body when the lens holding part is attached to the insertion tool main body , The lens regulating member is The lens holding portion is configured to be detached from the lens holding portion by using an external force applied to the contact member when the lens holding portion is attached to the insertion instrument body.

  The present invention can suppress the movement of the intraocular lens in the cartridge even if the cartridge is used as a lens case, and can perform the insertion operation of the intraocular lens without attaching trouble after the cartridge is attached to the injector. It can be carried out.

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram showing a configuration of an intraocular lens used in the present embodiment, and FIG. 2 shows an appearance of a lens holding portion (hereinafter referred to as a cartridge 10) in the intraocular lens insertion instrument used in the present embodiment. It is the shown outline external view. FIG. 3 is a diagram showing a configuration of a regulating member 20 that is attached to the cartridge 10 and regulates the movement of the intraocular lens 1 in the cartridge 10.
As shown in FIG. 1, the intraocular lens 1 includes an optical unit 2 having a predetermined refractive power and a support unit 3 for supporting the optical unit 2 in the eye. The optical part 2 of the intraocular lens 1 used in the present embodiment is a conventional foldable soft intraocular lens made of a simple substance such as HEMA (hydroxyethyl methacrylate) or a composite material of acrylic acid ester and methacrylic acid ester. It is formed from the material used. The support portion 3 is also made of a material conventionally used as a support portion for an intraocular lens, such as PMMA (polymethyl methacrylate).

  As shown in FIG. 2, the cartridge 10 is placed on which the insertion portion 11 having a tapered shape whose diameter gradually decreases (thinner) toward the tip and the intraocular lens 1 shown in FIG. The part 12 is integrally formed. The cartridge 10 is entirely made of synthetic resin and is a disposable type that is discarded after one use. Further, the cartridge 10 itself is used as a lens case for storing the intraocular lens 1. The cartridge 10 is attached to an intraocular lens insertion instrument main body 30 (see FIG. 5) described later.

  The insertion portion 11 has a hollow cylindrical shape, and the folded intraocular lens 1 is sent out through the hollow portion. Moreover, the mounting part 12 is formed of two halved members 12a and 12b, and as shown in FIG. 1, the lower edges of the halved members 12a and 12b are connected by a hinge part 13 and can be opened and closed. It has become. Reference numerals 14a and 14b denote mounting tables (surfaces) provided on the half members 12a and 12b, respectively, and the shape (wall surface shape) of the mounting surface on which the intraocular lens 1 is placed is along the direction in which the intraocular lens 1 is bent. It has a curved surface. In addition, the half members 12a and 12b connected by the hinge part 13 are half opened so that the state which has the space | interval which pinches | interposes the intraocular lens 1 from both sides in the state which is not attached to the instrument main body 30 can be maintained. It is the composition which is. With such a configuration, even when the intraocular lens 1 is placed on the placement unit 12, the intraocular lens 1 is sandwiched from both sides without applying stress sufficient to bend the intraocular lens 1. The left-right movement of the intraocular lens 1 is restricted.

  Further, when the half members 12a and 12b are closed, the wall surface shape (mounting surface shape) of the mounting table is deformed and substantially coincides with the proximal end side opening shape (semicircular shape) of the insertion portion 11. Yes. 15a and 15b are covers provided on the upper portions of the half members 12a and 12b. When the half member 12a and the half member 12b are closed, the tops of the placement table 14a and the placement table 14b are provided. It is formed to cover. In addition, the convex part 16 formed so that it might extend toward the mounting base from the upper direction of the mounting base along the longitudinal direction of the cover 15b is provided in the edge part of the cover 15b. When the intraocular lens 1 set in the cartridge 10 is bent, the convex portion 16 serves to restrict the bending so as to always be performed along the inner wall surface (mounting surface) of the mounting table.

  Reference numeral 17 denotes a flat gripping part provided on the side surface of the half member 12a and used when the user holds the cartridge 10 in his / her hand. The grip portion 17 also serves to fix the cartridge 10 to the instrument body 30. Reference numeral 18 denotes a wing provided on the opposite side of the gripping part 17 via the placement part 12. The wing 18 also serves to fix the cartridge 10 to the instrument body 30 in the same manner as the grip portion 17.

  FIG. 3A is a view showing the appearance of the regulating member 20 that regulates the movement of the intraocular lens in the cartridge 10. The regulating member 20 is provided on the left and right sides of the shaft plate 21 having a semi-ring-shaped fitting portion 22 for fitting to the proximal end of the insertion portion 11 of the cartridge 10 shown in FIG. When the cartridge 10 is mounted on the instrument body 30, the cartridge 10 hits a predetermined portion of the instrument body, and then extends downward from the bottom surface of the shaft plate 21 and the contact member 23 for removing the regulating member 20 from the cartridge 10 by the subsequent mounting operation. And a pair of protrusions 24a and 24b for restricting the back and forth movement of the intraocular lens 1 in the cartridge 10.

  The protrusions 24a and 24b are each formed with a predetermined interval at which the intraocular lens 1 can be sandwiched therebetween. Here, the predetermined interval at which the intraocular lens 1 can be sandwiched is not only the interval at which the intraocular lens 1 can be sandwiched and fixed, but the intraocular lens 1 is positioned between the pair of protrusions. However, it has a certain gap, but includes an interval that can restrict the movement of the intraocular lens back and forth. As shown in the figure, the protrusions 24a and 24b have taper parts 25a and 25b that extend in the left-right direction (lateral direction) from the protrusions 24a and 24b and whose tips are tapered downward. Is formed. The tips of the taper portions 25a and 25b are formed at a height that abuts against the side surface of the half member 12b, and before the cartridge 10 is mounted on the instrument body 30, the closing of the half member 12b is suppressed. At the time of mounting 10, it plays an auxiliary role for removing the regulating member 20 from the cartridge 10.

  FIG. 3B shows a state in which the regulating member 20 is attached to the cartridge 10, and FIG. 3C is a cross-sectional view of the state in which the regulating member 20 is attached to the cartridge 10 when viewed from the side. As shown in FIG. 3B, when the restriction member 20 is attached, the fitting portion 22 is fitted to the proximal end portion of the insertion portion 11 of the cartridge 10 to prevent the restriction member 20 from being easily detached from the cartridge 10. . As shown in FIG. 3C, in the state where the regulating member 20 is attached to the cartridge 10, the intraocular lens 1 is positioned between the protrusion 24a and the protrusion 24b.

  FIG. 4 is a diagram illustrating an example of a state in which the cartridge 10 to which the regulating member 20 is attached is used as a lens package. Reference numeral 100 denotes a base used for fixing the cartridge 10. Protrusions 100 a to 100 d for fixing the cartridge 10 are formed on the base 100. The protrusions 100a to 100d are formed on the base 100 with the same width as the front, rear, left, and right of the cartridge 10 or at intervals slightly shorter than each other, so that the cartridge 10 is placed and sandwiched as shown in the figure. To fix it. The protrusions 100b and 100d are in the above-described half-opened state (the state in which the mounting portion 12 of the cartridge 10 is not attached to the instrument main body 30 and has an interval enough to sandwich the intraocular lens 1 from both sides). It is formed on the base 100 at intervals that can be maintained, and the cartridge 10 is sandwiched from both sides. Reference numeral 101 denotes a bag covering the base 100. The base 100 with the cartridge 10 attached is sealed in a state of being put in the bag 101, sterilized, and transported or stored.

FIG. 5 is a perspective view showing an external configuration of a cylindrical instrument body 30 generally called a handpiece, and FIG. 6 is a cross-sectional view showing an internal configuration of the instrument body.
As shown in the figure, a mounting portion 31 for attaching and detaching the cartridge 10 is provided at the tip of the instrument main body 30. The mounting part 31 has a shape in which the tip of the instrument body 30 is substantially halved, and a convex part 32 is formed at the tip thereof symmetrically with respect to the push rod 40 that passes through the center of the instrument body 30. . In addition, fixing portions 33 for sandwiching and fixing the cartridge 10 from both sides are formed symmetrically with respect to the push rod 40 at the base end of the mounting portion 31.

  The convex part 32 is located slightly above the central axis of the instrument body 31, and the distance (interval) between the convex parts 32 provided on the left and right is slightly narrower (shorter) than the inner diameter of the instrument body 30. ing. Further, the tip of the convex portion 32 is bent toward the proximal end side of the instrument main body 30, and forms a concave portion 32 a into which the grip portion 17 provided on the cartridge 10 and the front side portion of the wing 18 can be inserted. The fixing part 33 is located slightly above the central axis of the instrument body 30, and the distance between the fixing parts 33 provided on the left and right is slightly narrower (shorter) than the inner diameter of the instrument body 30. Further, the width between the concave portion 32a and the fixing portion 33 is substantially equal to the width in the front-rear direction of the grip portion 17 and the wing 18 of the cartridge 10, and the front side of the grip portion 17 and the wing 18 is inserted into the concave portion 32a. In the meantime, the gripping portion 17 and the wing 18 can be accommodated.

In addition, the shape of the fixing portion 33 serves as a guide that restricts the halved members 12a and 12b that are opened when the cartridge 10 is mounted to the mounting portion 31 in a closing direction and limits the width thereof. It has a snap-in structure that locks the mounted cartridge 10 and prevents it from being easily detached from the instrument body 30. Note that the left and right edge portions of the mounting portion 31 also serve as guides for restricting the half members 12a and 12b in the closing direction, like the fixing portion 33.
Moreover, as shown in FIG. 6, the inside of the instrument body 30 is hollow, and an extrusion rod 40 is inserted through the instrument body 30 so as to advance and retreat in the axial direction of the instrument body 30. The push rod 40 moves forward in the instrument main body 30 to push the intraocular lens 1 forward from the cartridge 10 mounted on the mounting portion 31 of the instrument main body 30 and to send it out from the tube tip to the outside.

In the intraocular lens insertion device having the above-described configuration, the mounting operation of the cartridge 10 described above will be described with reference to FIGS.
As shown in FIGS. 7 (a) and 8 (a), before the cartridge 10 is mounted on the instrument main body 30, the intraocular lens 1 contacts the mounting table 14a, 14b with an edge (edge). While contacting, it is placed in the mounting portion 12 in an inclined state without being bent. More specifically, as shown in FIG. 3 (c), while the intraocular lens 1 is positioned between the protrusion 24a and the protrusion 24b of the regulating member 20, the side that contacts the mounting table 14a is turned up. It mounts in the inclined state which turned down the side which contact | abuts the mounting base 14b. At this time, the edge of the intraocular lens 1 is in contact with the mounting tables 14a and 14b. By placing the intraocular lens 1 in such a state, the left and right movements of the intraocular lens are restricted by the mounting tables 14a and 14b, and the forward and backward movements are restricted by the protrusions 24a and 24b. Moreover, as shown to Fig.8 (a), the half member 12b is contact | abutted to the taper part 25a (25b), and the further closing is controlled.

  When the cartridge 10 is attached to the instrument main body 10, the push rod 40 is pulled out to the proximal end side of the instrument main body 30, and the grip portion 17 (wing 18) of the cartridge 10 is inserted into the recess 32 a provided in the attachment portion 31. While the front side is fitted, the bottom surface of the mounting portion 12 (half member 12a, 12b) is pressed against a predetermined portion (the fixing portion 33 in this embodiment). At this time, the bottom surface of the contact member 23 of the regulating member 20 comes into contact with the convex portion 32 of the instrument body 30. When the cartridge 10 is further pressed against the mounting portion 31 in order to mount the cartridge 10 on the instrument main body 30, an external force that lifts the contact member 23 upward is generated, whereby the fitting portion 22 of the regulating member 20 is inserted into the insertion portion of the cartridge 10. 11 will be removed.

Further, by pressing the bottom surface (lower part) of the mounting portion 12 against the fixing portion 33, the fixing portion 23 guides the half member 12 a and the half member 12 b to be closed. When the mounting portion 12 is further pushed into the mounting portion 31, the half member 12b shown in FIG. 8A pushes the tapered portion 25a (25b). The tapered portion 25a (25b) converts an external force generated by being pressed by the half member 12b into an external force that lifts upward due to its shape.
As described above, the regulating member 20 is naturally removed from the cartridge 10 by the external force applied to the contact member 23 and the tapered portion 25a (25b), and as shown in FIG. 7B, the half member 12a and the half member 12b will be attached to the attachment part 31 in a closed state.

  When the half member 12a and the half member 12b are closed, the cartridge 10 is in a state as shown in FIG. At this time, since the width (interval) between the mounting table 14a and the mounting table 14b is narrow, the intraocular lens 1 is pushed from the left and right directions on the wall surface of the mounting table. As a result, stress is applied to the intraocular lens 1, and the intraocular lens 1 is bent along the wall surfaces (mounting surfaces) of the mounting tables 14a and 14b. When the intraocular lens 1 is bent to the opposite side, the upper surface of the intraocular lens hits the convex portion 16 and the bending in that direction is restricted, so that the mounting tables 14a and 14b are finally provided. It will be bent along the wall surface.

  After the cartridge 10 is mounted on the mounting portion 31, the push rod 40 is pushed to move the push rod 40 forward. The push rod 40 moves in the cylinder of the instrument body 30 toward the tip, and pushes the intraocular lens 1 toward the front insertion portion 11. When the intraocular lens 1 enters the insertion portion 11 and the opening diameter of the insertion portion 11 becomes narrower, the intraocular lens 1 is bent along the wall surface inside the insertion portion 11 (rounded). As a result, the intraocular lens 1 bent slightly from the distal end of the insertion portion 11 is pushed into the eye.

  According to such a configuration, the restriction member 20 is naturally detached from the cartridge 10 with the operation of attaching the cartridge 10 to the attachment portion 31 by the snap-in method, so that the intraocular lens can be easily bent and set. The movement restriction of the intraocular lens 1 can be released. Further, when the cartridge 10 is mounted on the mounting portion 31, the gripping portion 17 is positioned in the horizontal direction with respect to the intraocular lens insertion instrument 1, so that it can be easily handled sensuously in the snap-in method.

  In the above embodiment, the cartridge 10 is snapped in from above the mounting portion 31, but is not limited thereto. For example, before the cartridge is mounted on the instrument body, a restriction member for restricting the movement of the intraocular lens is attached to the cartridge, and the intraocular lens is not bent and is not bent. When the cartridge is mounted on the instrument main body, a part of the regulation member may be in contact with a predetermined part of the instrument main body and an external force may be applied so as to remove the regulation member from the cartridge. With such a configuration, when the mounting operation is performed, the restriction member is detached from the cartridge, stress is applied to the intraocular lens, and the intraocular lens is bent and set, so that the restriction of movement is released. Become.

  In this embodiment, when the cartridge is mounted on the instrument body, the placed intraocular lens is bent. However, the present invention is not limited to this. The part may be in contact with a predetermined portion of the instrument body and an external force is applied so that the regulating member is removed from the cartridge, and the intraocular lens does not necessarily have to be bent when the cartridge is mounted.

It is the figure which showed the structure of the intraocular lens used by this embodiment. It is a figure showing the composition of the cartridge in this embodiment. It is the figure which showed the state which attached the restriction member to the structure of the restriction member and the cartridge. It is the figure which showed the state which used the cartridge as a lens package. It is the perspective view which showed the external appearance of the cylinder part in this embodiment. It is sectional drawing which showed the internal structure of the cylinder part. It is the figure which showed the state before cartridge mounting and after mounting. It is the figure which showed the state of the intraocular lens before cartridge mounting and after mounting.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Intraocular lens 10 Cartridge 15a, 15b Cover 17 Gripping part 18 Wing 20 Control member 22 Fitting part 23 Contact part 24a, 24b Protrusion part 30 Instrument body 31 Mounting part 40 Extrusion stick

Claims (1)

In an intraocular lens insertion device for inserting a deformable intraocular lens into an eye, an insertion tube portion to be inserted into an incision provided in an eyeball and a base of the insertion tube portion for placing the intraocular lens A lens holding part having a mounting table provided on the end side, an insertion instrument main body having a mounting means that allows the lens holding part to be detachable at the tip part, and the above-mentioned in order to push out the intraocular lens from the insertion cylinder part and extrusion means disposed axially to be moved forward and backward within the cylinder of the insertion device body, and restricting means for restricting the movement of the intraocular lens placed in the mounting table before attachment to the insertion device body, wherein A lens restricting member that is detachably attached to the lens holding part and has a contact member that comes into contact with a predetermined part of the insertion instrument main body when the lens holding part is attached to the insertion instrument main body. The member is the lens holder. Intraocular lens insertion tool characterized in that it is configured to disengage from the lens holding portion with the external force applied to the contact member when attaching the parts to the insertion device body.