JP5122259B2 - Intraocular lens insertion system - Google Patents

Description

  The present invention relates to an intraocular lens insertion system 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 clouded crystalline lens inside the incision is crushed by an ultrasonic cataract surgical device or the like and sucked. . Next, an intraocular lens is inserted into the place where the lens was located from the incision.

When inserting an intraocular lens in this way, a method of using an intraocular lens insertion device called an injector is common. As an injector, a cartridge for placing an intraocular lens is used as a lens package (lens case), and a handpiece and a cartridge for pushing the intraocular lens into the eye are integrated in advance. Also, an injector system (intraocular lens insertion system) is known that is fixed and held on a holder (packaging material) so that such an injector can be easily stored and transported (see, for example, Patent Document 1). In such a system as disclosed in Patent Document 1, in order to prevent damage or the like of the intraocular lens during transportation, the restriction member provided on the holder is inserted into the cartridge, and the eye is not subjected to stress. The movement of the inner lens is restricted. And when using such an injector, by removing an injector from a holder, the control member inserted in the cartridge is removed, and an intraocular lens is movable.
JP 2007-89915 A

  In a system such as Patent Document 1, the movement of the intraocular lens is regulated in a state where stress is not applied during storage, transportation, etc., but the intraocular lens is removed by removing the injector from the holder during surgery. The restriction on movement is released, and then the intraocular lens is bent and set in the injector. For this reason, in this type of system, it is necessary to prevent the intraocular lens from falling off and moving from the planned setting position of the intraocular lens after the movement restriction is released and before the intraocular lens is bent and set. I must.

  In view of the above prior art, the present invention suppresses unintentional behavior of an intraocular lens from the state in which the injector is stored and transported until it can be used, and allows the injector to be handled appropriately. It is a technical problem to provide an insertion system.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) It has an internal region composed of an insertion tube for inserting an intraocular lens from an incision of an eyeball and two halved members that can be opened and closed at the proximal end of the insertion tube, and the intraocular lens is placed in the region An intraocular lens insertion device having a lens deformation portion, and an extruding means for pushing out the intraocular lens from the lens deformation portion, and a holder for fixing and holding at least a part of the intraocular lens insertion device; In the intraocular lens insertion system comprising: a restricting member provided in the holder for restricting movement of the half member in the closing direction in a state where the intraocular lens insertion instrument is fixedly held by the holder. A restricting member that maintains the intraocular lens placed in the region without applying stress, and a restriction member that is provided on the intraocular lens insertion device and that is restricted by the restricting member. Biasing means for biasing the half member in a closing direction, and when the holder is removed from the intraocular lens insertion device, the regulation by the regulation member is released and the biasing is performed. The half member is closed until a stress is applied to the intraocular lens by the biasing force of the means.
(2) In the intraocular lens insertion system according to (1), the holder is a member for fixing and holding the entire intraocular lens insertion instrument, and the restriction member is configured such that the intraocular lens insertion instrument is fixed to the holder. A columnar member extending in the region from the opening formed by the two halved members, and having a lens storage section for storing the intraocular lens without applying stress to the tip thereof It is characterized by that.
(3) In the intraocular lens insertion system according to (1) or (2), the biasing means includes a contact portion that contacts the half member from the outside and a base portion that supports the contact portion, At least one of the contact portion and the base portion is provided with an elastic force, and the restriction member is removed from the intraocular lens insertion device, and the half member is opened in the natural state from the contact portion. A biasing force is applied to the split member in a direction in which the half member is closed.
(4) In the intraocular lens insertion system according to (3), the base is disposed on the outer wall of the insertion instrument main body, and is provided closer to the push-out shaft than the ridge line of the outer wall of the lens deformation portion. And

  According to the present invention, the unintended behavior of the intraocular lens can be suppressed from the state in which the injector is stored and transported until it can be used, and the injector can be handled appropriately.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic external view of an intraocular lens insertion system according to this embodiment. FIG. 1A is a diagram showing a state in which the injector 50 is fixedly held on the holder 30.

  Reference numeral 100 denotes an intraocular lens insertion system. The intraocular lens insertion system 100 is roughly divided into an intraocular lens insertion device 50 (hereinafter referred to as an injector) for inserting an intraocular lens 1 (see FIG. 2) that can be roughly deformed into the eye, and the injector 50 is fixedly held. It consists of a holder 30 for doing. The injector 50 mounts an intraocular lens 1 that can be bent when used, and deforms (bends) the intraocular lens 1 to insert it into the eye (hereinafter referred to as a cartridge). ), And an insertion instrument body 20 (hereinafter referred to as a handpiece) for mounting the cartridge 10 at the tip and delivering the intraocular lens 1. The holder 30 fixes and packages the entire injector 50. In use, the injector 50 is removed from the holder 30, and the intraocular lens is delivered from the injector 50. The injector 50 is a disposable type (disposable type) that is molded from resin or the like and discarded after being used once. As will be described in detail later, a biasing member (biasing means) 60 that contacts the cartridge 10 has a base 61 fixed to the outer periphery of the handpiece 20.

  FIG. 1B is a perspective view of the holder 30. A protective wall 32 is provided around the base portion 31 and serves to protect the injector 50 held by the holder 30 from four directions. Further, bases 33 a and 33 b serving as attachment means for attaching and fixing the injector 50 to the base portion 31 are provided so as to extend upward from the base portion 31. The base 33a is provided so as to sandwich the cylindrical portion of the handpiece 20 from both sides, and the base 33b is provided so as to support the push rod (extrusion shaft) 25 from below.

The base 33a is arranged so that two members face each other, and a countersink on an arc is provided above the members so that the cylindrical portion of the handpiece 20 is fitted. At the upper end of the base 33b, a countersink on an arc for accommodating the push rod 25 is provided. The holder 30 is provided with a holding base (regulating member) 34 on which the intraocular lens 1 is placed and held. The horizontal width of the holding table 34 is shorter than the diameter of the optical unit 2, and the holding table 34 extends in a columnar shape by a predetermined amount in the direction in which the injector 50 is removed from the holder 30. Further, a recess 35 for placing the optical unit 2 of the intraocular lens 1 is provided at the upper end of the holding table 34. Moreover, as shown in the drawing, the side walls 34a formed in front and back by the depression 35 have a curved surface matching the diameter and circumference of the optical part 2 of the intraocular lens 1, and the intraocular lens 1 ( When the optical part 2) is placed, the optical part 2 is sandwiched without applying stress from the front-rear direction by the side wall 34a (has a slight gap). The holding base 34 is a member that restricts the movement of the intraocular lens 1 in the horizontal direction by housing the intraocular lens 1 in the recess 35, and also serves as a lens storage unit that stores the intraocular lens 1. Become. In addition, the holder 30 is made by integral molding from resin, and is made disposable like the injector 50.

FIG. 2 is a schematic configuration diagram for explaining the configuration of the intraocular lens 1 placed on the cartridge 10. The intraocular lens 1 inserted into the eye using the injector 50 includes an optical unit 2 having a predetermined refractive power and a loop-shaped support unit 3 for supporting the optical unit 2 in the eye. The optical part 2 of the intraocular lens 1 is formed from a material that can be bent (deformed), and for example, a single material such as HEMA (hydroxyethyl methacrylate) or a composite material of an acrylate ester and a methacrylate ester is used. Can do.

  FIG. 3 is a perspective view showing a schematic configuration of the cartridge 10 which is a lens deforming portion of the present embodiment. As shown in the drawing, the cartridge 10 has an insertion portion (insertion tube) 11 having a tapered shape whose diameter gradually decreases (thinner) toward the tip, and a placement portion 12 on which the intraocular lens 1 is installed. Are integrally formed.

  The insertion portion 11 to be inserted into an incision provided in the eyeball has a hollow cylindrical shape, and the folded intraocular lens 1 is sent out through the hollow portion. The mounting portion 12 provided on the proximal end side of the insertion portion 11 is formed of two halved members 12a and 12b. It can be opened and closed. The half member 12 a is integrally joined to the proximal end of the insertion portion 11, and the half member 12 b can be opened and closed with respect to the half member 12 a by the hinge portion 13. The outer walls of the half members 12a and 12b (surfaces integrated by the hinge portion 12) have curved surfaces. Note that a biasing member 60 described later is brought into contact with the outer wall of the half member 12b. Note that the intraocular lens 1 is placed (positioned) in an internal region formed by the half members 12a and 12b. 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. The cartridge 10 is fixed to the handpiece 20 by fitting a wing 18 provided on the side wall of the half member 12a into a mounting portion of the handpiece 20 described later.

  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. Reference numerals 15a and 15b denote 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 downward direction from the upper direction of a 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.

  The half members 12a and 12b are provided with fitting members 17a and 17b which are fitted to each other. As shown in the drawing, the fitting members 17a and 17b are members extending upward from the surfaces of the covers 15a and 15b, and the fitting member 17a has a recess for closing the fitting members 17a and 17b together. The member 17b is provided with a hook that fits into the aforementioned recess. When the half members 12a and 12b are closed, the fitting members 17a and 17b are closed, the recesses and the hooks are fitted, and the half members 12a and 12b are in a state from a half-open state by the hinge portion 13 to a closed state. Moved to.

  FIG. 4 is a schematic view showing the configuration of the handpiece 20. FIG. 4A is a perspective view showing a schematic configuration of the handpiece 10, and FIG. 4B is a schematic cross-sectional view. As shown in the drawing, the handpiece 20 has a cylindrical portion 26 that is a hollow cylinder, and a mounting portion 20 a for mounting the cartridge 10 is provided at the tip thereof. Further, an extrusion rod 25 serving as an extrusion means provided to be able to move forward and backward in the axial direction within the cylindrical portion 26 of the handpiece 20 in order to push out the intraocular lens 1 from the insertion portion 11 is provided on the outer periphery of the cylindrical portion 26. A handle 24 is provided as a member on which the operator puts a finger when the intraocular lens 1 is inserted.

  As shown in the figure, the mounting portion 20 a includes a guide 21, a gripping portion 22, and a fixing portion 23. The guide 21 has a shape in which the tip of the handpiece 20 is left about a quarter of the circumference. Further, fixing portions 23 a and 23 b for fixing and holding the base end of the wing 18 when the cartridge 10 is mounted are formed at both ends of the fixing portion 23 provided on the guide 21.

  The gripping portion 22 that grips the root portion of the insertion portion 11 is formed in a substantially C-shape consisting of an arc that is slightly longer than one half of the circumference so as to surround the central axis of the handpiece 20. The movement of the cartridge unit 10 is limited. Further, the fixing portion 23 is located slightly above the center axis of the handpiece 20 and restricts the movement of the inserted cartridge 10. Further, the gap between the grip portion 22 and the fixing portion 23a is substantially equal to the width in the front-rear direction from the base of the insertion portion 11 of the cartridge 10 to the ends of the half members 12a and 12b. It has a structure that fits. Further, the guide 21 holds the half member 12a of the cartridge 10 and restricts the movement of the cartridge 10. A groove 27 for attaching a biasing member 60 described later is formed on the outer periphery of the cylindrical portion 26 from the mounting portion 20a. The groove 27 is formed orthogonal to the push rod 25 so as to be fitted to the base of the C-shaped biasing member 60. Further, the groove 27 is formed with such a depth that a base portion of an urging member 60 described later does not come out of the ridge line of the handpiece 20.

  When the cartridge 10 is attached to the mounting portion 20a, the bottom surface of the half member 12a contacts the guide 21. Since the half member 12a has a circular shape, it is tightly fixed to the guide 21. The circumference of the guide 21 is about a quarter of the circumference of the cylindrical portion 26. For this reason, the guide 21 only fixes the half member 12a to the handpiece 20, and does not fix the half member 12b. Therefore, no force is generated in the direction of closing the half members 12a and 12b. Therefore, even when the handpiece 20 is attached to the cartridge 10, the cartridge 10 is maintained in a half-open state.

  FIG. 5 is a diagram illustrating the configuration of the urging member 60 attached to the handpiece 20. FIG. 5A is a perspective view of the urging member 60, and FIG. 5B is a side view of the urging member 60. The urging member 60 has a C-shaped base 61 that fits into the groove 27 described above, and one end fixed to the base 61, and when the urging member 60 is fixed to the handpiece 20, It is composed of a rod-like contact portion 62 extending for contact.

  In addition, the urging member 60 is molded from resin in the same manner as the handpiece 20 described above. Further, the contact portion 62 is configured to bend (reject) as indicated by an arrow in FIG. 5B with the joint portion 63 of the base portion 61 as a base end. In the state where the urging member 60 is attached to the handpiece 20, the abutting portion 62 abuts on the outer wall of the half member 12 b in the open state, and the shape and meat for urging the urging member 60 in the closing direction. Have a thickness. More specifically, when the urging member 60 is attached to the handpiece 20, the contact surface 62a is in contact with the inner wall (inside) of the outer wall surface of the half member 12b in the open state. The shape and thickness of the part 62 are determined. For this reason, when the contact portion 62 is in contact with the outer wall of the halved member 12b in the open state, the contact portion 62 is maintained in a slightly bent state. The biasing force is in the direction of closing the member 12b. The contact portion 62 is preferably positioned so as to contact the outer wall of the half member 12b near the hinge portion 13. This is because the amount of movement of the outer wall corresponding to the degree of opening of the half member 12b is small if it is close to the hinge portion 13.

  In this embodiment, the urging member includes a C-shaped base and a contact portion. However, the biasing member is not limited to this, and a mechanism for bending the intraocular lens by opening and closing the two halved members. On the other hand, any structure may be used as long as it abuts against at least one half member and always has a biasing force in the closing direction. For example, the urging member can be formed integrally with the injector body without being a separate part.

  FIG. 6 is a diagram illustrating a state in which the urging member 60 is attached to the injector 50 fixed to the holder 30. FIG. 6A is a top view, and FIG. 6B is a side view. As shown in the drawing, a contact portion 62 extends in the direction from the base portion 61 attached to the groove 27 of the handpiece 20 to the insertion portion 11. The contact portion 61 is in contact with the outer wall of the half member 12b of the cartridge 10 attached to the handpiece 20 in a slightly bent state. The holding base 34 that holds (stores) the intraocular lens 1 is inserted into the inner region through an opening (gap) formed in a state where the two half members 12a and 12b are half open, and the half member 12a. , 12b, the intraocular lens 1 is placed (positioned), and the half member 12a and the half member 12b are half-opened in accordance with the horizontal width of the holding base 34.

  Next, the role of the urging member 60 will be described. FIG. 7 is a sectional view of the cartridge 10 portion. 7A is a cross-sectional view in the AA direction of FIG. 6, and FIG. 7B is a state in which the holding base 34 is removed from the state of FIG. 7A (the injector 50 is removed from the holder 30). FIG.

  As described above, the horizontal width of the holding base 34 is shorter than the diameter of the optical unit 2, and a part of the mounted optical unit 2 protrudes from the recess 35 in the horizontal direction. The horizontal width of the holding base 34 restricts (limits) the closing of the biased half members 12a and 12b, and the intraocular lens 1 placed in the inner region by the restriction of the closing is divided into half members 12a and 12b. The lateral width is maintained so that no stress is applied to the intraocular lens 1 without contact with the inner walls (mounting tables 14a and 14b).

  Further, the height of the holding table 34 is set such that the mounting tables 14a and 14b positioned above the holding table 34 have a distance (interval) that restricts the upward disengagement of the intraocular lens 1 placed in the recess 35. Is set.

  Thus, the intraocular lens 1 placed in the recess 35 of the holding base 34 is covered with the cartridge 10 (with the optical part 2 of the intraocular lens 1 placed in a state where it does not contact the inner wall of the placement part 12. It is located in the hollow part formed in the mounting part 12). With such a configuration, the intraocular lens 1 and the injector 50 are protected.

  In the state of FIG. 7A, the urging member 60 (contact portion 62) is always urging in the direction in which the half members 12a and 12b are closed. In this state, as shown by an arrow D, when the injector 50 is removed from the holder 30 in the upper part of the figure, the holding base 34 that restricts the movement of the half member 12b in the closing direction is eliminated. The member 12b is urged by the abutting portion 62 to close. At this time, the interval between the half members 12a and 12b is narrowed.

  At this time, since the external force is applied in the direction in which the half members 12a and 12b are closed (arrow C direction), the state moves from FIG. 7A to FIG. 7B, and the intraocular lens 1 is half. The members 12a and 12b are held in contact with the inner walls of the members 12a and 12b and are stressed. Thus, in the operation of removing the injector 50 from the holder 30, the intraocular lens 1 is hooked on the mounting portion 12, and the halving members 12 a and 12 b that have received the urging force are closed, whereby the intraocular lens 1 is moved into the cartridge. 10 is held. Thereby, when the injector 50 is removed from the holder 30, the intraocular lens 1 is not easily dropped from the cartridge 10. In addition, the unintended behavior of the intraocular lens can be suppressed from when the injector is stored and transported until it can be used, and the injector can be handled appropriately.

  Although detailed explanation is omitted, when the intraocular lens 1 is delivered from the injector, the operator closes the half members 12a and 12b by hand from the state of FIG. The half members 12a and 12b are closed together by fitting 17a and 17b. At this time, the intraocular lens 1 is bent along the wall surfaces (inner walls) of the mounting tables 14a and 14b. Thereafter, the folded intraocular lens 1 is delivered from the insertion portion 11 by pushing the push rod 25 in the axial direction.

  In addition, in this embodiment demonstrated above, it was set as the structure which attaches an urging member to a handpiece, However, it is not restricted to this. It may be configured to be attached to the cartridge 10. For example, a member that is formed in a C shape and has elasticity so as to cover the half members 12 a and 12 b may be fitted into the cartridge 10.

  In the present embodiment described above, the holder is configured to fix the handpiece and to fix and hold the entire injector, but is not limited thereto. The holder may be configured to fix and hold at least a part of the injector provided with the aforementioned urging member. Specifically, in the injector 50 of the present embodiment, it is placed on the mounting table 14 of the cartridge 10, and the movement of the intraocular lens (intraocular lens placed in the internal region) placed on the mounting table 14 is regulated. For this purpose, there is a configuration in which a restriction member that is inserted into the inner region of the cartridge 10 from the opening of the cartridge 10 is used, and a holder that is attached to the distal end side (around the cartridge 10) of the injector 50 is used. Similar to the above-described embodiment, this restricting member restricts the half members 12a and 12b from closing and prevents the intraocular lens in the cartridge 10 from being stressed. The width of the lens is such that the lens is placed on the mounting table 14 (the optical unit is in contact with the mounting table 14). For example, two columnar members (members having the same width as in the above-described embodiment) that are respectively inserted in the front-rear direction of the intraocular lens are provided in the holder, and are maintained without applying stress to the intraocular lens. At this time, since the cartridge 10 is urged in the closing direction by the urging member 60, the cartridge 10 receives a force in the closing direction and is placed in the cartridge 10 in the same manner as described above even in the removing operation of the holder. Stress is applied to the intraocular lens. Thus, the unintended behavior of the intraocular lens can be suppressed from when the injector 50 is stored and transported until it can be used, and the injector 50 can be handled appropriately.

1 is a schematic external view of an intraocular lens insertion system 100 and a holder 30 according to the present embodiment. It is a schematic block diagram for demonstrating the structure of the intraocular lens 1 mounted in a cartridge. FIG. 2 is a perspective view illustrating a schematic configuration of a cartridge 10 that is a lens deforming portion of the present embodiment. FIG. 3 is a schematic diagram showing a configuration of a handpiece 20. It is a figure explaining the urging member. FIG. 3 is a peripheral view of the cartridge 10 of the intraocular lens insertion system 100. 1 is a cross-sectional view of an intraocular lens insertion system 100. FIG.

DESCRIPTION OF SYMBOLS 1 Intraocular lens 2 Optical part 10 Cartridge 12 Mounting part 12a, 12b Half member 13 Hinge part 14a, 14b Mounting base 20 Insertion tool main body 25 Extrusion stick 26 Cylindrical part 30 Holder 50 Injector 60 Energizing member 100 Intraocular lens insertion system

Claims (4)

A lens deforming portion having an internal region composed of an insertion tube for inserting an intraocular lens from an incision of an eyeball and two halved members that can be opened and closed at a proximal end of the insertion tube, and placing the intraocular lens in the region An intraocular lens insertion device having a pushing means for pushing out the intraocular lens from the lens deforming portion, and a holder for fixing and holding at least a part of the intraocular lens insertion device. In the inner lens insertion system,
A restricting member provided in the holder, wherein the intraocular lens insertion device restricts the movement of the half member in the closing direction in a state where the intraocular lens insertion device is fixedly held by the holder and is placed in the region. A regulating member that maintains the lens without applying stress,
A biasing means provided in the intraocular lens insertion device for biasing the half member in a direction to close the half member in a state where the regulation by the regulation member is applied;
Have
When the holder is removed from the intraocular lens insertion device, the restriction by the restriction member is released, and the half member is closed until the intraocular lens is stressed by the urging force of the urging means. An intraocular lens insertion system. 2. The intraocular lens insertion system according to claim 1, wherein the holder is a member for fixing and holding the entire intraocular lens insertion instrument, and the restriction member is in a state where the intraocular lens insertion instrument is fixed to the holder. A columnar member extending from the opening formed by the two halved members toward the region, and having a lens storage portion for storing the intraocular lens without applying stress to the tip thereof. Intraocular lens insertion system. The intraocular lens insertion system according to claim 1 or 2,
The biasing means includes a contact portion that contacts the half member from the outside, and a base portion that supports the contact portion.
Giving at least one of the contact part and the base part an elastic force,
The regulating member is removed from the intraocular lens insertion device, and a biasing force is applied to the half member from the contact portion in a natural state in which the half member is opened in a direction to close the half member. An intraocular lens insertion system. 4. The intraocular lens insertion system according to claim 3, wherein the base is disposed on the outer wall of the insertion instrument body, and is provided closer to the push-out shaft than a ridge line of the outer wall of the lens deforming unit. Inner lens insertion system.

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