JP5209331B2 - 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 cataract, a technique is generally used in which a crystalline lens is removed and then a foldable soft intraocular lens is inserted instead of the crystalline lens. In order to insert a foldable intraocular lens, an incision made on the patient's eye can be created as much as possible by inserting an intraocular lens into the eye while using an intraocular lens insertion device called an injector. The diameter is small. Such an injector pushes out an intraocular lens installed inside by an extruding rod called a plunger so that the intraocular lens is bent out of the tip while being bent out. In such an injector, the intraocular lens is made smaller from a state in which the intraocular lens is not bent or slightly bent by passing through a passage having a substantially constant inner diameter through a passage in which the inner diameter gradually decreases. It has a configuration for transitioning to a folded (rounded) state.
JP 2005-046497 A

  Since the conventional injector as shown in Patent Document 1 passes through a passage having a substantially constant inner diameter through a passage where the inner diameter gradually decreases, the working pressure (pushing load) during the pushing operation of the intraocular lens changes. Arise. Therefore, the conventional injector has a problem that even if the intraocular lens is caught on the way and the operating pressure changes, it is difficult to grasp the abnormality.

  In view of the above-described problems of the prior art, the present invention provides an intraocular lens insertion device that suppresses changes in operating pressure during normal operation in the push-out operation of an intraocular lens and makes it easy to determine whether the operation is normal. It is a technical issue to provide.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) A placement part for placing an intraocular lens, and an insertion part for inserting the intraocular lens from an incision provided in front of the placement part and provided in the eyeball. A lens holding portion comprising an insertion portion having an inner shape for rounding the intraocular lens placed on the placement portion, a cylindrical insertion device body having the lens holding portion at the tip, and the insertion portion A push-out means provided so as to be capable of moving back and forth in the axial direction within the cylinder of the insertion instrument body to push out the intraocular lens from the push-out rod and a tip of the push-out rod. An extruding means having a head portion provided and abutting against the intraocular lens;
In an intraocular lens insertion device comprising:
An interference portion provided in the passage of the push rod, which pushes the push rod to apply a predetermined operating pressure to the push rod while the push rod pushes the intraocular lens toward the insertion portion. An interference portion that contacts and generates a frictional force with the extrusion rod;
The push rod has a smaller diameter due to the internal shape of the insertion portion, and the push rod with respect to the interference portion in a range where frictional force generated by contact between the insertion portion and the intraocular lens increases. The axial region has a treatment or shape for reducing the frictional force with the interference part, or a shape for preventing the push bar and the interference part from contacting with each other in the region.
(2) In the intraocular lens insertion device according to (1), the interference portion is a member provided in a convex shape on an inner wall upper portion in the passage, and an axial region of the push rod is provided in the convex shape. It is a recessed part for not contacting with the formed member.
(3) In the intraocular lens insertion device according to (1) or (2), the interference portion has a predetermined length from the inner wall of the passage located at the upper portion of the intraocular lens placed on the mounting portion to the rear. It is a convex member that extends only, and guides the bending direction of the intraocular lens.

According to the present invention, it is possible to suppress a change in the operating pressure during normal operation in the push-out operation of the intraocular lens, it is easy to determine whether the intraocular lens is clogged, and it is possible to grasp whether the intraocular lens is operating normally. Easy to do.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a schematic external view showing the external appearance of an intraocular lens insertion device 1 used in the present embodiment. FIG. 1A shows the intraocular lens insertion device 1 as viewed from above, and FIG. 1B shows the state as viewed from the side.

  The intraocular lens insertion device 1 includes an insertion unit for inserting an intraocular lens from an incision formed in the eyeball in order from the side to be inserted into the eyeball, and a mounting for installing the intraocular lens 40 (see FIG. 2). A lens holding portion 10 (hereinafter referred to as a cartridge) that is provided with a placement portion, a cylindrical portion (insertion instrument main body, handpiece) 20 on which the cartridge 10 is mounted (placed at the tip), and a cartridge 10 And an extrusion means (plunger) 30 for inserting the inside of the cylindrical portion 20 and pushing the intraocular lens 40 outward from the tip of the cartridge 10 mounted on the cylindrical portion 20.

  FIG. 2 is a diagram showing the configuration of the intraocular lens 40. The intraocular lens 40 includes an optical unit 41 having a predetermined refractive power and a pair of support units 42 called a loop for supporting the optical unit 41 in the eye. The optical unit 41 of the intraocular lens 40 used in the present embodiment is a flexible intraocular lens that can be bent conventionally, such as 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 42 is also formed of a material conventionally used as a support portion for an intraocular lens, such as PMMA (polymethyl methacrylate). In the intraocular lens 40 used in the present embodiment, the optical unit 41 and the support unit 41 having a thin loop shape (C shape or J shape) are separately created using the above-described intraocular lens material. Thereafter, a three-piece type intraocular lens obtained by integration is used.

  3 and 4 are diagrams showing the configuration of the cartridge 10. As shown in the drawing, the cartridge 10 has an insertion portion (insertion cylinder) 11 having a tapered shape whose diameter gradually decreases (thinner) toward the tip, and a placement portion 12 on which the intraocular lens 40 is installed. It is integrally formed. The cartridge 10 is entirely made of synthetic resin and is a disposable type that is discarded after one use. For this reason, the cartridge 10 is preferably manufactured by molding with resin or the like.

  The mounting portion 12 is formed of two halved members 12a and 12b, and the lower edges of the halved members 12a and 12b are connected by a hinge portion 13 as shown in FIG. It has become. The mounting tables 14a and 14b on which the intraocular lens 40 is placed are provided on the half members 12a and 12b, respectively. The shape (wall surface shape) of the mounting surface on which the intraocular lens 40 is placed has a curved surface along the direction in which the intraocular lens 40 is bent. The insertion portion 11 provided at the base end of the mounting portion 12 has a hollow cylindrical shape, and the folded (folded) intraocular lens 40 is sent out from the distal end of the insertion portion 11 to the outside through the hollow portion. It is like that.

  Further, when the half members 12a and 12b are closed, the wall surface shape (mounting surface shape) of the mounting bases 14a and 14b is deformed so as to substantially coincide with the proximal end opening shape (semicircular shape) of the insertion portion 11. (See FIG. 4). Further, the outer shape of the mounting portion 12 when the half members 12a and 12b are closed is substantially matched with the inner wall shape of the cylindrical portion 20 described later. Further, as shown in FIG. 3B, the mounting table 14a (14b) has a support portion 42 (on the insertion portion 11 side) positioned rearward when the optical portion 41 (indicated by a dotted line) of the intraocular lens 40 is placed. Is formed in such a size that it slightly protrudes backward from the mounting table 14a (14b).

  In the intraocular lens insertion device 1 of the present embodiment, when the intraocular lens 40 is placed on the cartridge 10, the support portion 42 located behind the intraocular lens 40 faces the traveling direction of the intraocular lens 40. It is supposed to be placed on the left side. The full length of the half member 12a is longer than the full length of the half member 12b, and the half member 12a is formed to be longer on the proximal end side of the cartridge 10. Thus, by changing the overall lengths of the half members 12a and 12b, a space is provided for removing the support portion 42 located rearward when the cartridge 10 is mounted from the axis of the push rod (extrusion shaft) 31 described later. Can do.

  The covers 15a and 15b are provided on the upper part of each of the half members 12a and 12b, and cover the top of the mounting table 14a and the mounting table 14b when the half member 12a and the half member 12b are closed. Is formed. Further, the end of the cover 15b is formed to extend from the upper side of the mounting tables 14a and 14b toward the mounting tables 14a and 14b, and is a convex member that is a convex member extending a predetermined length along the axial direction. A portion 16 is provided. When the intraocular lens 40 set in the cartridge 10 is bent, the convex portion 16 serves to guide the folding (folding) direction so as to always follow the inner wall surfaces (mounting surfaces) of the mounting tables 14a and 14b. . The convex portion 16 has an axial length that exceeds the width of the optical portion 41 and is formed at least behind the intraocular lens 40 placed on the mounting table 14. Thus, the convex part 16 will be formed in the inner wall upper part of the channel | path through which the extrusion stick | rod 31 mentioned later passes. In addition, the convex part 16 contacts a part of the extrusion rod 31 that is advanced when the intraocular lens 40 is pushed out to generate a frictional force, and the operating pressure of the pushing means 30 required to push out the intraocular lens 40. It also serves as an interference part and an interference means that increase (extrusion load).

  The inclined portions 17a and 17b are provided to facilitate insertion of the intraocular lens 40 onto the mounting table 14a and the mounting table 14b from the proximal end side of the cartridge 10. Further, a flat plate-like gripping portion 18 that is gripped when the user holds the cartridge 10 is provided on the side surface of the half member 12a.

  As shown in FIG. 4A, the cartridge 10 having such a configuration mounts the intraocular lens 40 when the mounting portion 12 is open (the two halved members are separated). By setting the mounting table 14a and the mounting table 14b, and then mounting the cartridge 10 on the cylindrical portion 20, the split member 12a and the half member 12b are closed as shown in FIG. The placed intraocular lens 40 can be stressed and bent. Accordingly, the cartridge 10 has an internal structure that bends the intraocular lens 40. Moreover, the internal passage of the insertion part 11 has a shape which becomes thin as it goes ahead. Therefore, the intraocular lens 40 bent by the placement unit 12 has a smaller diameter (folded and rounded) when passing through the internal passage of the insertion unit 11, and is sent out from the distal end of the insertion unit 11.

  FIG. 5 is a perspective view schematically showing the external configuration of the cylindrical portion 20. Details of the internal configuration of the cylindrical portion 20 will be described with reference to FIG. As shown in the figure, a mounting portion 21 for attaching and detaching the cartridge 10 is provided at the tip of the cylindrical portion 20. The mounting portion 21 has a shape in which the distal end of the cylindrical portion 20 is substantially halved, with a convex portion 22 at the distal end and a concave portion 23 at the proximal end symmetrical with respect to the push rod 31 that passes through the center of the cylindrical portion 20. Each is formed. Further, the convex portion 22 is located slightly above the central axis of the cylindrical portion 20, and the distance between the convex portions 22 provided on the left and right is slightly narrower (shorter) than the inner diameter of the cylindrical portion 20. . Such a shape of the convex portion 22 serves as a guide that restricts the half members 12a and 12b that are opened when the cartridge 10 is mounted to the mounting portion 21 in a closing direction and limits the width thereof. The snap-in structure that locks the mounted cartridge 10 and prevents it from being easily detached from the cylindrical portion 20 is provided. Note that the left and right edges of the mounting portion 21 also serve as guides for restricting the halving member in the closing direction, like the convex portion 22. In addition, a head portion 50 that abuts on the optical portion 41 of the intraocular lens 40 is provided at the tip of the push rod 31 (details will be described later).

  Next, the internal configuration of the intraocular lens insertion device 1 configured by combining the cartridge 10 and the cylindrical portion 20 will be described. FIG. 6 is a schematic cross-sectional view of the intraocular lens insertion device 1. In the figure, the intraocular lens 40 is bent by mounting the cartridge 10 on the mounting portion 21. In addition, illustration of the support part 42 was abbreviate | omitted for the simplicity of description.

  As shown in FIG. 6, the inside of the cylindrical portion 20 is hollow, and the pushing means 30 is inserted through the passage connecting from the cylindrical portion 20 to the tip of the cartridge 10 (insertion portion 11) so as to advance and retreat in the axial direction. Has been. The push-out means 30 has a head 50 at the tip, a push-out rod 31 for pushing out the intraocular lens 40, a shaft base 32 provided integrally with one end of the pressing portion 33 and in contact with the inner wall of the cylindrical portion 20, an operator It is comprised from the press part 33 pressed in the case of extrusion operation of the intraocular lens 40 by.

  The push rod 31 is a shaft rod that is thinner than the diameter of the shaft base 32, and is attached to the tip of the shaft base 32. When the pressing portion 33 is pushed in the axial direction and the shaft base portion 32 is moved forward, the intraocular lens 40 is pushed forward from the cartridge 10 attached to the tip of the cylindrical portion 20. The push rod 31 (pushing means 30) serves to feed the intraocular lens 40 out from the insertion portion 11. For this reason, the diameter of the push rod 31 is set to a size (diameter) that can pass through the insertion portion 11 and the internal passage of the cartridge 10, and is formed smaller than the shaft base portion 32. Further, the tip of the push rod 31 has a loop (support portion 42) positioned on the rear side of the intraocular lens 40 set in the cartridge 10 when pushing the intraocular lens 40 between the push rod 31 and the passage. The narrow portion 34 having a smaller diameter is formed by a predetermined length so as not to be entangled (pinched) and damaged. Further, a head portion 50 is formed at the distal end (the most advanced) of the slender portion 34 to abut against the intraocular lens 40 and press. The head portion 50 is designed to be the same as or smaller than the diameter of the push bar 31. Note that when the intraocular lens 40 is pushed out, the slender portion 34 has a length required to suppress the interference with the rear support portion 42 (entanglement of the support portion 42).

  Further, the upper portion (upper surface) of a part of the extrusion rod 31 is designed to be at a height position in contact with the convex portion 16 in the extrusion process. Here, as shown in FIG. From the rear to the rear, a contact portion 61, a recessed portion 62, a contact portion 63, a recessed portion 64, and a contact portion 65 are formed on the outer wall of the push bar 31 along the axial direction. The concave portions 62 and 64 are formed inward from the outermost diameter of the push rod 31 so as not to contact the convex portion 16 when the push rod 31 proceeds. Further, the contact portions 61, 63, 65 are the same height as the head portion 50. More specifically, the diameter (thickness) of the push rod 31 positioned at the head portion 50 and the contact portions 61, 63, 65 with respect to the distance (interval) between the placement surface of the placement table 14 and the convex portion 16. Is slightly larger (about 0.01 mm to 0.2 mm). The diameter of the push rod 31 for contacting the space between the mounting surface of the mounting table 14 and the convex portion 16 is a small folded (rounded) eye near the tip of the insertion portion 11. What is necessary is just to be designed so that it may be in the fitting state from which the operating pressure of the same level as the operating pressure required in order to push out the inner lens 40 is obtained. In addition, in the drawing, it is schematically illustrated, but it is preferable that a portion where the contact portions 61, 63, 65 and the concave portions 62, 64 are in contact with each other is a smooth ridge line. Thereby, the contact of the extrusion rod 31 and the convex part 16 becomes smooth in an extrusion process.

  Next, the change of the operating pressure of the extrusion means 30 (extrusion rod 31) accompanying the extrusion process (movement process of the extrusion rod 31) of the intraocular lens 40 is demonstrated. 7 is a schematic cross-sectional view of the vicinity of the cartridge 10 in a state where the head unit 50 is in contact with the optical unit 41. FIG. 8 is a view of the vicinity of the cartridge 10 in a state in which the head unit 50 is released from contact with the convex portion 16. 9 is a schematic cross-sectional view of the vicinity of the cartridge 10 in a state where the optical part 41 starts to have a smaller diameter in the inner shape of the insertion part 11, and FIG. 10 shows a part of the optical part 41 in the insertion part 11. FIG. 11 is a schematic cross-sectional view of the vicinity of the cartridge 10 in a state where the optical unit 41 is delivered from the insertion unit 11.

  7 and 8, the support portion 42 is shown on a cross-sectional view for convenience of explanation, and a portion overlapping the head portion 50 and the thin portion 34 is indicated by a dotted line. When the intraocular lens 40 is folded by the cartridge 10, the front (front) support portion 42 extends forward on the inner wall in the cartridge 10. On the other hand, the rear (rear) support portion 42 hangs down in a state where no stress is applied from the rear end (base end) of the cartridge 10.

  As shown in FIG. 7, since the contact portion 61 is above the head portion 50, the contact portion 61 is in contact with the convex portion 16 (in the path formed by the convex portion 16 and the mounting surface 14). When the head unit 50 is fitted), the head unit 50 comes into contact with the optical unit 41. As a result, the upward movement of the push bar 31 is suppressed and pressed downward (mounting table 14), and the head unit 50 can contact the optical unit 41 without riding on the optical unit 41. In addition, frictional force is generated by the contact between the contact portion 61 and the convex portion 16, and the operating pressure in the extrusion process is increased.

  When the push bar 31 is pushed in the axial direction from the state of FIG. 7, the optical part 41 is pushed out and moved forward from the convex part 16 as shown in FIG. 8. Here, the contact between the contact portion 61 and the convex portion 16 is released (released), but the next contact portion 63 contacts the convex portion 16 simultaneously with the opening or before the contact portion 61 is opened. Since it is configured, a predetermined operating pressure is maintained. At this time, since the push bar 31 is fitted in the passage, the head unit 50 can push the optical unit 41 into the insertion unit 11 without riding on the optical unit 41.

  At this time, the support part 42 is extended as the optical part 41 advances. The front support portion 42 extends along the mounting table 14 and the insertion portion 11, and the rear support portion 42 extends within the space formed by the slender portion 34 and the recess 62. Therefore, the thin portion 34 and the concave portion 62 form a space for escaping the rear support portion 42 that is extended along with the movement of the optical portion 41, and the length of the concave portion 62 and the thin portion 34 (the convex portion). 16, the axial length of the region not in contact with the mounting table 14) is formed around the tip so that the extended support portion 42 does not abut (interfere) with the moving push bar 31. In this space, the length is set so as to accommodate the support portion 42 extended along with the extrusion operation. The length of the recessed part 62 and the thin part 34 should just be a grade which escapes the support part 42. FIG. If the lengths of the recess 62 and the slender portion 34 are too long, the push rod 31 is likely to bend (bend), and the push rod 31 may be off-axis. For this reason, it is preferable that the lengths of the concave portion 62 and the thin portion 34 are short enough to allow the support portion 42 to escape.

  With such a configuration, the rear support portion 42 is less likely to be damaged and the head portion 50 is difficult to ride on the optical portion 41, and the intraocular lens 40 is preferably pushed out. Note that the convex portion 16 is preferably arranged over the optical portion 41 in order to suppress the head portion 50 from climbing up.

  When the push rod 31 is further pushed forward from the state of FIG. 8, the optical part 41 is rounded to a smaller diameter due to the inner shape of the insertion part 11 as shown in FIG. 9, and the intraocular lens 40 (optical part 41). And the inner wall of the passage begins to increase. At this time, the contact part 63 moves to the front of the convex part 16 and is released from contact with the convex part 16, and the concave part 64 is positioned below the convex part 16. On the other hand, although the frictional force generated between the inner wall of the insertion portion 11 and the optical portion 41 is increased, the convex portion 16 and the push rod 31 are not in contact with each other. Will be suppressed. Note that the intraocular lens 40 is pushed forward from the mounting table 14, and the push rod 31 and the convex bar 31 are protruded in order to offset the increase in frictional force caused by the optical part 41 being gradually rounded by the inner shape of the insertion part 11. By determining the shape of the push rod 31 or the convex portion 16 so that the contact with the portion 16 gradually becomes gentle, from the start of the extrusion of the intraocular lens 40 to immediately before the opening of the intraocular lens 40 (conventionally, the operating pressure is reduced). It is possible to bring the operating pressure up to a point where the pressure starts to drop rapidly to a substantially constant value.

  With such a configuration, it is possible to suppress a change in the operating pressure from the start of pushing of the intraocular lens 40 to immediately before the opening, so that even if an abnormality such as the intraocular lens 40 clogging in the insertion portion 11 occurs. It becomes easy to notice abnormalities from the feeling of the operating pressure (for example, the operating pressure suddenly increases).

  When the push rod 31 is further pushed forward from the state of FIG. 9, a part of the optical part 41 starts to come out from the tip of the insertion part 11 and opens as shown in FIG. 10. Here, in the extrusion process from the state of FIG. 9 to the state of FIG. 10, the optical part 41 is rounded in the insertion part 11, so that the operating pressure of the extrusion process is high. Thereafter, when a part of the optical unit 41 comes out from the distal end of the insertion unit 11 and begins to be opened, the frictional force between the inner wall of the insertion unit 11 and the optical unit 41 decreases.

  When the intraocular lens 40 is further pushed by the push rod 31, it is generated due to the close contact between the inner wall (passage) of the insertion portion 11 and the optical portion 41 in accordance with the sending degree of the optical portion 41 from the distal end of the insertion portion 11. The frictional force is reduced and the operating pressure is greatly changed (decreased).

  For this reason, the frictional force between the push bar 31 and the convex portion 16 is increased again in accordance with the state in which a part of the optical portion 41 starts to be sent from the distal end of the insertion portion 11, so that there is no sudden change in the operating pressure. To. In the present embodiment, the contact portion 65 is configured to come into contact with the convex portion 16 in accordance with a state in which a part of the optical portion 41 starts to be sent out from the distal end of the insertion portion 11. As a result, a predetermined frictional force is generated between the abutment portion 65 and the convex portion 16, and a rapid change in the operating pressure is suppressed.

  Further, when the push-out rod 31 is advanced, the entire optical unit 41 is delivered from the distal end of the insertion unit 11 as shown in FIG. At this time, the friction between the optical part 41 and the inner wall of the insertion part 11 is eliminated, and the operating pressure in the extrusion process is mainly the frictional force accompanying the contact between the convex part 16 and the contact part 65.

  As described above, in the extrusion process shown in FIGS. 7 to 11, changes in the operating pressure in the extrusion process are suppressed. In addition, it is preferable that the operating pressure of an extrusion process is made substantially constant. Further, by changing the frictional force of the extrusion means 30 (here, the extrusion rod 31) and the cartridge 10 (here, the convex portion 16) in the extrusion process, the operating pressure in the extrusion process of the intraocular lens can be reduced with a simple configuration. The intraocular lens can be suitably extruded.

  The operation of the intraocular lens insertion device 1 having the above configuration will be described. The operator (user) holds the cartridge 10 by holding the grip portion 18 of the cartridge 10 with one hand, and picks up the intraocular lens 40 with the other hand using a lever. The picked up intraocular lens 40 is inserted into the cartridge 10 from the proximal end side and placed on the mounting tables 14a and 14b. When no stress is applied to the cartridge 10, the half members 12a and 12b are opened as shown in FIG. 4A, and the intraocular placed on the mounting tables 14a and 14b. The lens 40 is also held in an unfolded state (a state in which no stress is applied).

  When the cartridge 10 is mounted on the cylindrical portion 20, the push rod 31 is pulled out to the proximal end side of the cylindrical portion 20, and the grip portion 18 (proximal end side) of the cartridge 10 is inserted into the concave portion 23 provided in the mounting portion 21. The bottom surface of the mounting portion 12 (half member 12a, 12b) is pressed against the convex portion 22 (or the left and right edges of the mounting portion 21). By pressing the bottom surface (lower part) of the mounting portion 12 against the convex portion 22 (or the left and right edge portions of the mounting portion 21), the convex portion 22 guides the half member 12a and the half member 12b to close together. It will be. When the mounting portion 12 is further pushed into the mounting portion 21, as shown in FIG. 4B, the half member 12a and the half member 12b are attached to the mounting portion 21 in a closed state. It becomes.

  Thus, in the state where the half member 12a and the half member 12b are closed, the width (interval) between the mounting table 14a and the mounting table 14b is narrowed, so that the eyes are placed on the wall surfaces of the mounting tables 14a and 14b. The inner lens 40 is pushed from the left-right direction. As a result, stress is applied to the intraocular lens 40, and the intraocular lens 40 is bent along the wall surfaces (mounting surfaces) of the mounting tables 14a and 14b.

  After the cartridge 10 is mounted on the mounting portion 21, the pressing portion 33 is pushed in a state where the insertion portion 11 is inserted into the patient's eye from which the crystalline lens has been removed in advance, and the shaft base portion 32 and the push rod 31 are moved forward. After the contact portion 61 contacts the convex portion 16, the head unit 50 contacts the optical unit 41. Further, when the pressing portion 33 is pushed, the intraocular lens 40 enters the insertion portion 11, and when the opening diameter of the insertion portion 11 becomes narrower, the intraocular lens 40 is bent along the wall surface inside the insertion portion 11. It will be (rounded). At this time, the support part 42 is extended. Moreover, the frictional force between the extrusion rod 31 and the convex portion 16 is reduced. Further, when the pressing portion 33 is pushed forward, the intraocular lens 40 starts to be pushed out from the distal end of the insertion portion 11, and accordingly, the contact portion 65 and the convex portion 16 come into contact with each other, and the push rod 31 and the convex portion 16 contact each other. Increases frictional force. When the pressing portion 33 is pushed from this state, the entire intraocular lens 40 is pushed out (sent out) from the distal end of the insertion portion 11.

  In the above-described series of steps of pushing the intraocular lens 40, the change in the working pressure of the pushing means 30 is suppressed (preferably, the working pressure is made substantially constant). Specifically, the operating pressure in the step before the head portion 50 abuts on the intraocular lens 40 (the head portion 50 and the convex portion 16 contact), and the bent intraocular lens 40 is the inner shape of the insertion portion 11. The working pressure in the step of making the diameter smaller by the above, the working pressure in the step in which a part of the intraocular lens 40 starts to be delivered from the tip of the insertion portion 11 (the frictional force between the intraocular lens 40 and the insertion portion 11 starts to decrease). In all the steps, the change in the operating pressure is suppressed. Thereby, in the extrusion process of the intraocular lens 40, the intraocular lens insertion device 1 becomes easy to handle. In addition, since the change in the operating pressure during normal operation is suppressed in the extrusion process of the intraocular lens 40, it is easy to determine when the intraocular lens 40 is clogged, etc., and grasp whether the normal operation is in progress. Easy to do.

  In the embodiment described above, the shape of the outer wall of the push rod 31 is changed along the axial direction, and the degree of contact between the push rod 31 and the convex portion 16 provided on the inner wall of the passage of the cartridge 10 is changed to thereby change the convex shape. Although the frictional force between the portion 16 and the push bar 31 is changed to make the operating pressure of the push means 30 substantially constant, the present invention is not limited to this. An interference portion is provided in the passage of the extrusion rod, and the frictional force between the extrusion means 30 and the interference portion is changed in the extrusion process so that the operating pressure of the extrusion means 30 (extrusion rod 31) is substantially constant. . For example, it is assumed that the extruding rod is formed by extending the thin rod with the same diameter in the axial direction, and the extruding rod 31 and the convex portion 16 are always in contact in the extrusion process. A surface treatment such as polishing or roughening the surface of a certain region along the axial direction of the extrusion rod may be used to change the frictional force at the contact surface between the convex portion 16 and the extrusion rod in the extrusion process.

  In the above-described embodiment, the push rod 31 and the convex portion 16 provided in the cartridge 10 are in contact with each other to generate a frictional force. However, the present invention is not limited to this. The operating pressure of the advancing pushing means 30 may be substantially constant. An interference portion is provided in the passage through which the pushing rod passes, and the shaft base 32 (included in the pushing rod in the pushing means) and the cartridge 10 or the cylinder portion 20 are provided. Any structure may be used as long as it is in contact with the provided member and generates a frictional force. Specifically, it is possible to provide a concave portion on the outer wall of the shaft base portion 32 and provide a convex portion serving as an interference portion on the inner wall of the cylindrical portion 20.

  In the present embodiment described above, when the intraocular lens 40 starts to be sent out from the insertion portion 11, the push rod 31 and the convex portion 16 are brought into contact with each other, and the push-out means 30 at the time of sending the intraocular lens 40. Although it is configured to suppress a change in operating pressure, it is not limited to this. When the intraocular lens 40 is delivered from the distal end of the insertion portion 11, a frictional force is generated between the extrusion means 30, the cartridge 10, and the cylindrical portion 20 in order to suppress changes in the operating pressure of the extrusion means 30. It only has to be. For example, two protrusions that are paired in a convex shape in the horizontal direction are formed from the outer wall of the head section 50 (projections are formed on both side surfaces of the head section 50). This pair of protrusions comes into contact with the inner wall of the insertion portion 11 as the head portion 50 advances. When the intraocular lens 40 starts to be sent out from the tip of the insertion portion 11 and the frictional force between the intraocular lens 40 and the insertion portion 11 starts to decrease, the pair of protrusions causes the friction between the push rod 31 and the insertion portion 11. Have a role to increase power. Thereby, when an intraocular lens is sent out from the insertion part 11, the change of the operating pressure of the extrusion means 30 is suppressed. Note that the pair of protrusions is not limited to a configuration that protrudes in the horizontal direction with respect to the head unit 50. What is necessary is just the structure which protrudes from the head part 50 so that two protrusions may become a pair, and contacts the inner wall of the insertion part 11. FIG. For example, it may be provided in the vertical direction. A pair of protrusions may be provided on the push rod 31.

  In the present embodiment described above, the outer wall of the shape that contacts the convex portion 16 or the shape that does not contact the convex portion 16 is formed on the upper portion along the axial direction of the extrusion rod 31, In addition to this configuration, the contact degree between the interference portion and the push rod may be changed to reduce the frictional force. For example, it is good also as a structure which changes the frictional force which generate | occur | produces in the convex part 16 and the extrusion stick | rod 31 by changing the width | variety of the outer wall of the extrusion stick | rod 31 which contacts the convex part 16 (it says the direction orthogonal to the advancing / retreating direction). . Moreover, it is good also as a structure which changes the space | interval of the convex part 16 used as the channel | path which an extrusion rod passes, and the mounting base 14 in an axial direction. Thereby, the operating pressure of the extrusion means 30 can be finely adjusted.

  In the present embodiment described above, the intraocular lens 40 bent in advance by the mounting table 14 is pushed out by the pushing means 30, but the present invention is not limited to this. Any configuration may be employed as long as the intraocular lens 40 is pushed out by being folded (rounded) from the insertion portion 11. For example, an intraocular lens placed on a mounting table in a cartridge (lens holding portion) in a state where no stress is applied is folded in an inner shape of an insertion portion or the like in an extrusion process, and is sent from the distal end of the insertion portion. Can be mentioned.

  In the present embodiment described above, the slender portion 34 and the concave portion 62 formed with a smaller diameter than the push rod 31 are provided behind the vicinity of the head portion 50. However, this is because the intraocular lens 40 is a loop. This is because the support portion 42 has a shape, and is not necessarily required. When an intraocular lens having a support portion that is not in a loop shape is used, there is no risk of damage to the support portion in the extrusion process, and therefore the thin portion 34 and the concave portion 62 may be omitted.

It is the figure which showed the external appearance of the intraocular lens insertion instrument q in this embodiment. FIG. 3 is a diagram showing a configuration of an intraocular lens 40. It is a figure showing the appearance of cartridge 10 in this embodiment. FIG. 6 is a diagram showing a method for bending an intraocular lens by deformation of the cartridge 10. FIG. 3 is a diagram illustrating an external configuration of a cylindrical portion 20. It is the figure which showed the side surface cross section of the intraocular lens insertion instrument. 4 is a schematic cross-sectional view showing a state in which a head unit 50 is in contact with an optical unit 41. FIG. FIG. 4 is a schematic cross-sectional view showing a state where an optical part 41 reaches an insertion part 11. FIG. 4 is a schematic cross-sectional view showing a state where the optical part 41 is rounded to a smaller diameter with the inner shape of the insertion part 11. 4 is a schematic cross-sectional view showing a state in which a part of the optical unit 41 is delivered from the distal end of the insertion unit 11. FIG. 4 is a schematic cross-sectional view showing a state where the entire optical unit 41 is sent out from the insertion unit 11. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Intraocular lens insertion instrument 10 Cartridge 20 Cylindrical part 30 Extrusion means 31 Extrusion stick 34 Slender part 40 Intraocular lens 42 Support part 50 Head part 61, 63, 65 Contact part 62, 64 Recessed part

Claims (3)

A placement part for placing an intraocular lens, and an insertion part for inserting the intraocular lens from an incision provided in front of the placement part and provided in the eyeball. A lens holding portion including an insertion portion having an inner shape that rounds the intraocular lens placed on a placement portion; a cylindrical insertion device body that places the lens holding portion at a distal end; and An extruding means provided so as to be capable of moving back and forth in the axial direction within the cylinder of the insertion instrument body in order to extrude the inner lens, the extruding rod for extruding the intraocular lens, and provided at the tip of the extruding rod; An extruding means having a head part in contact with the intraocular lens;
In an intraocular lens insertion device comprising:
An interference portion provided in the passage of the push rod, which pushes the push rod to apply a predetermined operating pressure to the push rod while the push rod pushes the intraocular lens toward the insertion portion. An interference portion that contacts and generates a frictional force with the extrusion rod;
The push rod has a smaller diameter due to the internal shape of the insertion portion, and the push rod with respect to the interference portion in a range where frictional force generated by contact between the insertion portion and the intraocular lens increases. The intraocular region is characterized in that an axial region is formed with a treatment or shape for reducing a frictional force with the interference portion, or a shape for preventing the push rod and the interference portion from contacting with each other in the region. Lens insertion instrument. 2. The intraocular lens insertion device according to claim 1, wherein the interference portion is a member provided in a convex shape on an inner wall upper portion in the passage, and an axial region of the push rod is provided in the convex shape. An intraocular lens insertion device, wherein the intraocular lens insertion device is a recess for preventing contact with the lens. The intraocular lens insertion device according to claim 1 or 2, wherein the interference portion has a convex shape extending rearward from the inner wall of the passage located above the intraocular lens placed on the placement portion. An intraocular lens insertion device which is a member and guides the bending direction of the intraocular lens.

Images