JP5666214B2 - 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, it is composed of a soft optical part that can be bent as a substitute for the lens and a support part called a loop for fixing and holding the optical part in the eye after extracting the lens as one of the surgical methods for cataract A method of inserting an intraocular lens is generally used.

An intraocular lens insertion device called an injector is used to insert a foldable intraocular lens. The injector has a tapered tip, and when the intraocular lens installed inside is pushed toward the tip of the injector by a rod-shaped push member called a plunger, the intraocular lens becomes smaller in accordance with the inner wall shape. It can be bent. Then, the intraocular lens is folded into a small diameter and delivered into the eye, so that the incision provided in the patient can be made as small as possible, reducing the burden on the patient and reducing the postoperative astigmatism. Occurrence can be suppressed.
Further, in the insertion part of the intraocular lens insertion instrument as described above, a notch called a bevel is formed at the distal end of the insertion part in order to easily insert the insertion part into the eye from an incision (for example, a patent Reference 1).

See JP-A-8-24282

  When using an intraocular lens insertion device with a notch formed at the tip, fold it with the tip inserted into the eye from the incision formed in the patient's eye with the notch surface (slope) facing down. The delivered intraocular lens is delivered into the eye. However, when the intraocular lens is folded using the intraocular lens insertion device, the folding direction is determined to some extent, but the folding method is not always the same. For this reason, it is difficult to determine the opening direction after the folded intraocular lens is delivered from the tip, and the surgeon rotates the instrument body around the axis while observing the behavior of the opened intraocular lens. It may be necessary to adjust the open state of the.

  In view of the above-described problems of the prior art, the present invention can stabilize the opening behavior of the intraocular lens in the sac and can easily deliver the intraocular lens without adjusting the open state. It is a technical problem to provide a lens insertion device.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) In the intraocular lens insertion device for delivery to the eye in a state in which the loop-shaped support portion folded intraocular lens which is integrally formed extending outwardly from the outer edge of the optical portion and the optical portion, the distal end A passage having a tapered shape having a region where the inner diameter gradually decreases as it goes to the distal end, and an insertion portion for inserting the intraocular lens into the eye by bending the intraocular lens by passing through the passage A cylindrical portion main body, and a rod-like push-out member provided so as to be movable back and forth in the push-out axis direction inside the cylindrical portion main body to push out the intraocular lens from the insertion portion
A distal end portion of the push-out member is used to determine an opening direction of the intraocular lens delivered from the distal end of the insertion portion by holding a part of the support portion when the intraocular lens is pushed out from the insertion portion. A holding portion is formed, and the holding portion is configured to hold the support portion that is submerged between the pushing member and the inner wall of the inserting portion between the pushing member and the inner wall. Including a recess formed so as to cut out a part of the side of the extrusion member from the distal end toward the proximal end, and the recess is formed after the optical portion is bent along the inner wall of the insertion portion. The optical part centered on the sandwiched support part by sandwiching the support part extending rearward from the bent optical part between the side of the notched extrusion member and the inner wall The opening direction of the Supporting the opening direction defined by said recess is defined uniformly by the axial said sandwiched support portion, the distal end of the insertion portion, which is sandwiched by said recess and said inner wall part against one surface of the optical part to open outside of the in the opening direction thus the insertion portion defined uniformly as axis, the notch having an inclined surface facing the said surface is formed, a cutout downward When the intraocular lens is delivered in a state, one surface of the optical unit is opened so as to face the inclined surface of the notch .

  According to the present invention, the opening behavior of the intraocular lens in the sac can be stabilized, and the intraocular lens can be easily delivered without adjusting the open state.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is an explanatory diagram of a configuration of a one-piece type intraocular lens 1.

  The intraocular lens 1 is composed of an optical part 2 having a predetermined refractive power and a pair of support parts 3 for supporting the optical part 2 in the eye, and a simple substance such as HEMA (hydroxyethyl methacrylate), acrylic The optical part 2 and the support part 3 are integrated by cutting, molding, etc., using materials that are conventionally used for soft intraocular lenses that can be bent, such as a composite material of acid ester and methacrylate. Formed.

  FIG. 2 is a schematic external view showing the external appearance of the intraocular lens insertion device 10 used in the present embodiment. FIG. 2A shows the intraocular lens insertion device 10 as viewed from above, and FIG. 2B shows the state as viewed from the side. FIG. 3 is an explanatory diagram of the configuration of the push member 40 described later, and FIG. 4 is a schematic cross-sectional view showing the internal configuration of the intraocular lens insertion device 10.

  The intraocular lens insertion device 10 includes an insertion part 20 for placing the intraocular lens 1 therein, a cylinder body 30 having the insertion part 20 at the tip, and a cylinder body (hereinafter referred to as a cylinder) 30. The pusher member 40 is attached so as to be movable in the direction, and includes an extruding member 40 for extruding the intraocular lens 1.

  The insertion portion 20 is provided with an insertion tube 21 having a tapered shape having a region in which the inner diameter gradually decreases (thinner) toward the tip, and a lid member 20a. The intraocular lens 1 installed from the opening of the lid member 20a is bent small by passing through the inside of the insertion tube 21, and is sent out from the tip 21a. Further, the distal end 21a of the insertion tube 21 is formed with a notch (hereinafter referred to as a bevel) having a predetermined inclination angle with respect to the extrusion shaft, whereby the distal end 21a is passed through an incision formed in the patient's eye. So that it can be easily inserted into the eye.

  In the present embodiment, the bevel inclination direction (formation direction) of the distal end 21 a is determined in accordance with the opening direction of the intraocular lens 1. A detailed description of the relationship between the opening direction of the intraocular lens 1 and the inclination direction of the bevel will be described later.

  Inside the hollow cylindrical portion 30, a rod-like pushing member 40 called a plunger is inserted so as to be able to advance and retract in the axial direction through a passage connecting from the cylindrical portion 30 to the tip of the insertion portion 20. When the push-out member 40 pushes out the intraocular lens 1, the distal end 44 that comes into contact with the optical unit 2, the pressing portion 41 that is pressed by the surgeon, the shaft base portion 42 to which the pressing portion 41 is connected, and the distal end 44. And an extruding rod 43 that connects the shaft base 42 to each other.

  A holding part for holding a part of the support part 3 located on the rear side in the insertion part 20 in a state where the tip 44 is in contact with the optical part 41 is provided on the tip 44 side of the pushing member 40. Is formed. The holding portion includes a recess 45 formed so as to cut out a part of the push rod 43 from the distal end 44 of the push member 40 toward the base end, and a groove 46 formed in the distal end portion remaining by the recess 45.

  The concave portion 45 is formed on the side where the proximal end of the support portion 3 on the rear side of the intraocular lens 1 placed in the insertion portion 20 is located. Further, when the intraocular lens 1 is pushed out, the groove 46 is formed so that the rear support portion 3 is sandwiched between the concave portions 45, in other words, when the intra-insertion lens 21 is sandwiched between the inner wall of the insertion tube 21 and the distal end side wall of the push rod 43. Used to hold the part.

  The recess 45 is formed with an opening through which the rear support portion 3 can sink between the inner wall of the insertion cylinder 21 and the distal end portion of the push rod 43 in a state where the distal end side of the extrusion member 40 is positioned in the insertion cylinder 21. It is formed into a shape as In addition, the bottom 45a of the recess 45 is formed at a position that avoids a hard (hard) range in which at least the base portion of the support portion 3 on the rear side is hardly bent in a state where the tip 44 is in contact with the optical unit 2. . In this manner, the intraocular lens 1 can be pushed out from the distal end 21a without damaging the support portion 3 even when a part of the support portion 3 is sandwiched in the recess 45. Moreover, the groove | channel 46 of this embodiment should just be formed in the front-end | tip 44 side rather than the bottom 45a of the recessed part 45 (front-end | tip position of the support part 3 of the rear side). Thereby, a part of the support portion 3 is sandwiched between the grooves 46 by the pushing operation of the pushing means 40.

  With such a configuration, when the intraocular lens 1 starts to be delivered from the distal end of the insertion tube 21 and the folded optical part 2 starts to open, the rear support part 3 is held in the insertion part 21. For this reason, the opening behavior of the optical unit is performed using the held supporting unit 3 as an axis. For this reason, the opening direction of the optical unit 2 at the time of opening is uniformly determined regardless of the state of folding of the optical unit 2 in the insertion tube 21. In addition, since a part of the support part 3 is sandwiched between the recesses 45, the optical part 2 can be released away from the pushing member 40 vigorously even when the opening speed of the optical part 2 is fast. It will be suppressed.

At this time, the inclination direction of the bevel of the distal end 21 a is formed in accordance with the opening direction of the intraocular lens 1. Specifically, since the rear support part 3 is held in the insertion cylinder 21, the opening direction of the folded optical part 2 is uniformly determined, so that the intraocular lens (optical part 2) is inserted into the insertion cylinder 21. The bevel is formed on the tip 21a so that one surface of the optical part 2 and the bevel (inclined surface of the notch) face each other in a completely opened state. In other words, when the optical unit 2 is sent out with the bevel facing downward, the bevel is formed on the holding unit so that the opened optical unit 2 is horizontal with respect to the extrusion shaft. As a result, the operator can easily open the intraocular lens in the sac simply by pressing the push member 40 (without rotating the insertion portion 20).
In addition, an axial part 33 for performing the axial alignment of the pushing member 40 is formed inside the above-described cylindrical part 30, and the axial shake accompanying the movement of the pushing means 40 in the front-rear direction is prevented, The optical unit 2 and the tip 44 come into contact with each other in a constant state.

Next, an extrusion operation of the intraocular lens 1 using the intraocular lens insertion device 10 having the above configuration will be described. Here, FIG. 5 shows an explanatory view of the opening operation of the intraocular lens 1.
First, the operator (user) places the intraocular lens 1 at a predetermined position in the insertion portion 20 from the opening at the position of the lid member 20a using a lever or the like. Then, the tip 21a is inserted into the eye so that the bevel is aligned with the incision (so that it faces downward). When the pressing portion 41 is pushed in from this state, as shown in FIG. 5A, the folding position of the rear support portion 3 sinks into the recess 45 and a part of the support portion 3 (the tip of the bending position is more advanced than the folding position). Side) is sandwiched between the grooves 46. Then, the tip 44 comes into contact with the optical unit 2. When the intraocular lens 1 is pushed into the insertion portion 20 in this state, the optical portion 2 is gradually bent along the inner wall w of the insertion portion 20 because the opening diameter of the insertion portion 20 is narrowed. Go (rolled up). In addition, a part of the support portion 3 that has entered the recess 45 is gradually sandwiched between the push rod 43 and the inner wall w.

  When the optical unit 2 is further pushed in the state as described above, the optical unit 2 is sent out from the tip 21a and gradually opened. At this time, as shown in FIG. 5B, the rear support portion 3 sandwiched between the recess 45 and the groove 46 is left in the insertion portion 20. As a result, the opening direction of the optical unit 2 is determined in one direction with the position of the support unit 3 sandwiched between the recess 45 and the groove 46 as an axis. Moreover, it is suppressed that the intraocular lens 1 leaves | separates from the front-end | tip 21a vigorously because a part of support part 3 is pinched | interposed into the recessed part 45. FIG. Furthermore, since the inclination direction of the bevel of the tip 11a is formed in accordance with the opening direction of the optical part 41, the optical part 2 is stably opened (without the occurrence of inclination or the like) at the position of the opening part of the bevel. Become so.

  When the pushing means 40 is further pushed forward and the groove 46 and the recess 45 are positioned in the sac, the support portion 3 is separated from the groove 46 and the recess 45 by the restoring force as shown in FIG. And it comes to be arrange | positioned along a sac by the stress added from the inside of an eye, and the optical part 2 comes to be suitably hold | maintained in the eye by the support part 3. FIG.

  As described above, when the intraocular lens is pushed out, the intraocular lens is opened around the support portion left in the insertion portion, so that the opening direction of the intraocular lens is determined as one direction. Further, since the inclination direction of the bevel at the distal end of the insertion portion is formed in accordance with the opening direction of the intraocular lens, the operator can easily position the intraocular lens in the sac easily by a single pushing operation. It becomes like this.

  In addition, although the example in which both a recessed part and a groove | channel are formed in the extrusion means 40 as a holding part is shown above, it is not restricted to this. For example, as shown in the second embodiment of the intraocular lens insertion device in FIG. 6, when the opening speed of the intraocular lens is relatively slow (slow), a groove is formed as a holding portion formed in the pushing means 40. Only 46 may be formed. In this case, the groove 46 is formed on the tip 44 side with respect to the tip of the support portion 3 (position farthest from the optical portion 2) in a state where the tip 44 and the optical portion 2 are in contact with each other. good. In this way, the opening direction of the intraocular lens can be stabilized in one direction using the pushing means 40 having a simpler configuration.

Furthermore, as shown in the third embodiment of the intraocular lens insertion device in FIG. Also in this case, when the optical part 2 is opened in the sac, a part of the support part 3 sandwiched between the recesses 45 is left in the insertion part 21, so that the opening direction of the intraocular lens 1 is uniform. It becomes stable in the direction.
In addition to this, when the optical unit 2 is opened in the sac, a part of the rear support unit 3 serves as an axis so that the opening direction of the optical unit 2 is determined in one direction. What is necessary is just to have the insertion instrument.

It is explanatory drawing of a structure of 1 piece type intraocular lens. It is the schematic external view which showed the external appearance of the intraocular lens insertion instrument. It is explanatory drawing of a structure of the extrusion member of an intraocular lens insertion instrument. It is the cross-sectional schematic diagram which showed the internal structure of the intraocular lens insertion instrument. It is explanatory drawing of opening operation | movement of an intraocular lens. It is explanatory drawing of the extrusion member of 2nd Embodiment of an intraocular lens insertion instrument. It is explanatory drawing of the extrusion member of 3rd Embodiment of an intraocular lens insertion instrument.

DESCRIPTION OF SYMBOLS 1 Intraocular lens 2 Optical part 3 Support part 10 Intraocular lens insertion instrument 20 Insertion part 21a Tip 30 Cylindrical body 40 Extrusion member 45 Concave part 46 Groove

Claims (2)

In an intraocular lens insertion device for delivering an intraocular lens in which an optical part and a loop-shaped support part extending outward from an outer edge part of the optical part are integrally formed into a folded state,
A passage having a tapered shape having a region where the inner diameter gradually decreases toward the distal end, and an insertion portion for bending the intraocular lens into a small amount by passing through the passage is inserted into the distal end. A cylindrical body provided for,
A rod-like push-out member provided so as to be capable of moving forward and backward in the push-out axis direction inside the cylindrical portion main body in order to push out the intraocular lens from the insertion portion;
With
A distal end portion of the push-out member is used to determine an opening direction of the intraocular lens delivered from the distal end of the insertion portion by holding a part of the support portion when the intraocular lens is pushed out from the insertion portion. A holding part is formed,
The holding part is configured to hold the support part that is submerged between the pushing member and the inner wall of the insertion part between the pushing member and the inner wall, from the distal end of the pushing member toward the base end. Including a recess formed to cut out a part of the side of the extruded member;
Said recess, after the optical unit is bent along the inner wall of the insertion portion, the supporting portion extending rearward from the optical portion which is bent, the a side of the notched said extruded member By being sandwiched between the inner wall, the opening direction of the optical part with the sandwiched support part as an axis is defined in one direction,
The opening direction defined by the recess is uniformly determined by using the sandwiched support portion as an axis,
The distal end of the insertion portion, to the one surface of the optical part to open a support portion which is sandwiched by said recess and said inner wall outside the opening direction defined uniformly as axial Thus the insertion portion , A notch having a slope facing the surface is formed, and when the intraocular lens is delivered with the notch facing downward, one surface of the optical unit faces the slope of the notch. Released,
An intraocular lens insertion device. The intraocular lens insertion device according to claim 1, wherein the holding portion is formed with a groove for sandwiching a part of the support portion.

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