JP5771907B2 - Intraocular lens and intraocular lens insertion device - Google Patents

Description

The present invention relates to an intraocular lens used as a substitute for a crystalline lens of a patient's eye, and to an intraocular lens to which an astigmatic power is given, and an intraocular lens insertion device.

  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 can be made on a patient's eye by inserting an intraocular lens into the eye while using an intraocular lens insertion device called an injector. Only small diameter is set.

  In recent years, a bendable intraocular lens (hereinafter referred to as a toric intraocular lens) given a predetermined astigmatism power in consideration of astigmatism of a patient's eye that existed before surgery has been known (hereinafter referred to as a toric intraocular lens). For example, see Patent Document 1).

US 2009/0279048

  In such a toric intraocular lens, the thickness (edge thickness) of the side surface (outer edge) is the thickest at the position of the astigmatism axis determined by the astigmatism power applied to the optical unit, and the edge thickness decreases as the distance from the astigmatic axis increases. Become. However, when the conventional toric intraocular lens is installed and pushed out to the injector, the edge thickness state with respect to the bending direction of the optical part is not taken into consideration, and the cross-sectional area of the rounded intraocular lens increases depending on the bending direction. The problem that it is easy to occur will arise.

In the present invention, in view of the above-described problems of the prior art, when pushing a toric intraocular lens with an astigmatic power using an injector, the intraocular lens can be folded smaller and suitably pushed into the eye. intraocular lenses that can be, and the object to provide an intraocular lens insertion device.

  In order to solve the above problems, the present invention is characterized by having the following configuration.

(1 ) The intraocular lens in the present invention has an opening diameter that becomes narrower as it approaches the tip, an insertion part that bends the intraocular lens and sends it into the eye, and a placement part on which the intraocular lens is placed. A bendable intraocular lens that is inserted into the eye with an intraocular lens insertion device having an extrusion means for pushing out the intraocular lens placed on the placement part to the insertion part , an optical unit for a predetermined astigmatic power is applied, and a support portion of the curved shape extending from the light faculties, the proximal end portion of the supporting portion extending from the optical unit, on the basis of the said cylindrical power optical unit The optical part is formed at the edge position of the optical part which is not on the axis of the astigmatic axis formed on the optical axis, and the optical part is bent around the astigmatic axis by the insertion part .
( 2 ) The intraocular lens insertion device according to the present invention has an opening diameter that becomes narrower as it approaches the distal end, an insertion portion that bends the intraocular lens and sends it into the eye, and a cylindrical body having the insertion portion at the distal end. In an intraocular lens insertion instrument comprising: a placement unit that places the intraocular lens; and an extrusion unit that pushes the intraocular lens placed on the placement unit into the insertion unit. The intraocular lens includes an optical part having a predetermined astigmatism power, and a curved support part extending from the edge of the optical part that is not on the axis of the astigmatism axis formed on the optical part based on the astigmatism power. a toric intraocular lenses, and the extrusion direction of the extrusion unit, the toric and direction of the astigmatic axis of the intraocular lens, but the toric intraocular lens to the mounting section to be substantially the same direction in advance In the set state It is wrapped, the optical unit is characterized in that it is bent around the cylinder axis by the insertion portion.
( 3 ) The intraocular lens insertion device according to the present invention has an opening diameter that becomes narrower as it approaches the distal end, an insertion portion that bends the intraocular lens and sends the intraocular lens into the eye, and a cylindrical body having the insertion portion at the distal end. In an intraocular lens insertion instrument comprising: a placement unit that places the intraocular lens; and an extrusion unit that pushes the intraocular lens placed on the placement unit into the insertion unit. The intraocular lens is a toric intraocular lens having a predetermined astigmatism power, and the placing portion is arranged so that the push-out direction of the pushing means and the direction of the astigmatic axis of the toric intraocular lens are substantially in the same direction. The toric intraocular lens is packed in a preset state, and the toric intraocular lens is bent around the astigmatic axis by the insertion portion .

The toric intraocular lens astigmatic power is applied to the extrusion by using an injector, it is possible to fold the smaller intraocular lenses, preferably intraocular lenses that can the be extruded into the eye, and intraocular lens insertion Can provide.

  Embodiments of the present invention will be described below with reference to the drawings. In the present invention, the astigmatic axis determined by the astigmatic power of the foldable toric intraocular lens and the push-out axis of the injector can be matched, so that the intraocular lens can be folded smaller and smaller using the injector. It is an object of the present invention to provide a toric intraocular lens design method capable of realizing intraocular injection through an incision, and an intraocular lens designed using such a design method.

  FIG. 1 is a schematic external view of a one-piece type toric intraocular lens (hereinafter referred to as an intraocular lens) 100 created by the intraocular lens design method of the present embodiment. Here, FIG. 1A is a schematic external view of a toric intraocular lens 100 having an astigmatic power, FIG. 1B is a schematic cross-sectional view of the intraocular lens 100 taken along the astigmatic axis A, and FIG. ) Is a schematic cross-sectional view when cut in a direction perpendicular to the astigmatic axis A. FIG.

  The intraocular lens 100 includes an optical unit 110 for applying refractive power to the patient's eye and a pair of support units 120 for supporting the optical unit 110 in the eye. The optical unit 110 has a predetermined spherical power and astigmatism power, gives a predetermined refractive power to the patient's eye, and corrects the astigmatism of the patient's eye to give better vision. As shown in the figure, since the optical unit 110 has astigmatism power, the edge thickness d1 of the optical unit 110 in the direction of the astigmatism axis A is the edge thickness d2 of the optical unit 110 in an orthogonal cross section (FIG. 1C). It is thicker than In this embodiment, a mark M indicating the astigmatism axis A is attached near the outer edge (edge) of the optical unit 110, and the direction of the astigmatism axis A is set when the intraocular lens 100 is attached to the eye. It is easy to understand visually. The mark M is formed on the astigmatism axis on the front surface of the optical unit 110 by printing or an uneven shape.

  One end of the support 120 for supporting the optical unit 110 in the sac is a free end, and the other end (base end 121) is connected to the optical unit 110. Further, the support portion 120 of the present embodiment is formed so as to face point symmetry with respect to the center (geometric center) of the optical portion 110. The support unit 120 is connected to the optical unit 110 and extends a predetermined length along a substantially meridian direction of the optical unit 110, and is connected to the tip of the base end unit 121 and curved along the periphery of the optical unit. The arm portion 122 extends a predetermined length. Note that the entire arm portion 122 is configured to be bent at a joint position with the base end portion 121 when stress is applied.

  The optical unit 110 and the support unit 120 as described above can be bent, such as a composite material of acrylic ester and methacrylic ester, and have a repulsive force necessary for fixing the intraocular lens 100 in the sac. It is formed from a material for a soft intraocular lens. The intraocular lens 100 uses the intraocular lens material described above, and the optical unit 110 and the support unit 120 are integrally formed by cutting, molding, or the like.

  Next, FIG. 2 shows an example of the intraocular lens insertion device 1 used in this embodiment. FIG. 2 shows the intraocular lens insertion device 1 as viewed from above. The intraocular lens insertion device 1 is illustrated in order to install an intraocular lens 100 and an insertion unit 11 including a distal end 11a for inserting an intraocular lens from an incision formed in the eyeball in order from the side to be inserted into the eyeball. A lens holding portion 10 (hereinafter referred to as a cartridge) having an abutment mounting portion and having an inner wall for holding an intraocular lens therein, and an insertion instrument body on which the cartridge 10 is mounted (placed at the tip). Extruding means (plan) for pushing the intraocular lens 100 out from the tip of the cartridge 10 attached to the cylindrical part 20 through the cylindrical part (insertion instrument body, handpiece) 20 and the inside of the cartridge 10 and the cylindrical part 20 Jar) 30.

  Next, a design method of the toric intraocular lens 100 will be described with reference to a flowchart of the design method of FIG. First, in step 101, in order to determine the shape of the optical unit 110, the spherical power and the astigmatic power given to the optical unit 110 are determined. Thereby, taking into account the refractive index of the material of the optical unit 110, the front and back curves (curved surfaces) of the optical unit 110 are determined, and the direction of the astigmatism axis A is determined by the given astigmatism power.

  Next, in step 102, the intraocular lens 100 is placed on the injector 100 so that the direction of the astigmatic axis A (mark M) of the optical unit 110 and the direction of the extrusion axis of the injector 1 (extrusion direction of the extrusion means 30) substantially coincide. Determine the orientation of the. Thereby, at the time of extrusion of the intraocular lens 100, the side where the edge thickness of the optical part 110 orthogonal to the astigmatic axis A is thin becomes the left and right inner wall surfaces of the injector. When the intraocular lens 100 is bent in such a manner that the astigmatic axis A formed on the optical unit 110 is aligned with the extrusion axis of the injector 1, the side with the thinner edge of the optical unit 110 is bent. The sectional area of the folded (folded) intraocular lens 100 can be further reduced, and the intraocular lens 100 can be pushed out from the tip 11a having a smaller diameter. In order to fold the intraocular lens 100 smaller, it is preferable that the astigmatism axis A and the extrusion axis coincide with each other, but the astigmatism axis A is substantially equal to the extrusion axis (within ± 10 degrees). Even in the case of an angle, the effect of making the intraocular lens 100 smaller can be sufficiently exhibited.

  Next, in step 103, the attachment position of the support part 120 to the optical part 110 is determined. As for the attachment position of the support part 120, the optical part is positioned so that the direction of the astigmatism axis A is substantially equal to the direction of the extrusion axis (about ± 10 degrees), and the base end part 121 is located on the astigmatism axis A. It is determined so as to be the edge position of the optical unit 110 that avoids the top. If it does in this way, it will be suppressed that the base end part 121 will be pushed by the extrusion means 30 at the time of extrusion of the intraocular lens 100, and troubles, such as the support part 120 being damaged, will arise.

  Further, as shown in FIG. 1, when the mounting position of the support part 120 is point-symmetric with respect to the center of the optical part 110, the position of the base end part 121 is on the above-described astigmatism axis A. The shortest distance from the base end 121 to the inner wall with respect to the left and right inner walls of the injector at the position where the optical unit 110 is installed in the state where the optical unit 110 is installed on the injector with the axis aligned. The formation position of the base part 121 on the edge of the optical part 110 is determined so as to be longer than the shortest distance from the edge of the optical part 110 to the edge of the optical part 110 (including the case where the edge and the inner wall are in contact with each other). In other words, when the optical unit 110 is installed in the injector 1, the base end 121 of the support unit is prevented from contacting the inner wall before the edge of the optical unit 110. In the present embodiment, the base end portion 121 of the support portion 120 is designed to be formed at a rotational position of 30 degrees from the astigmatic axis A. By designing so that the base end portion 121 of the support portion 120 does not come into contact with the left and right inner walls of the injector before the edge of the optical portion 110, the intraocular lens 100 is pushed to the base end portion 121 when the intraocular lens 100 is pushed out. Can be prevented from rotating around the fulcrum.

  By forming the intraocular lens 100 by the above design method, the intraocular lens 100 can be suitably pushed out in a state where the astigmatic axis A and the extrusion axis of the injector 1 coincide. As a result, the side having a small edge thickness and a small cross-sectional area can be bent in the cartridge 10, and the intraocular lens 100 can be folded more small, so that the eye in a smaller incision can be obtained using the injector 1. The inner lens can be injected (see FIG. 1).

  Next, an operation of injecting the toric intraocular lens 100 designed as described above into the eye using the intraocular lens insertion device 1 will be described. First, the operator (user) places the intraocular lens 100 on the cartridge 10 so that the astigmatic axis A (mark M) of the optical unit 110 and the extrusion axis of the injector 1 coincide with each other using a lever or the like. At this time, in this embodiment, the base end part 121 of the support part 120 comes to the position which avoided the range on the extrusion axis | shaft A and the area where only the base end part 121 contacts an inner wall. Next, the distal end 11a of the insertion portion 11 is inserted into the patient's eye from which the crystalline lens has been removed. From this state, the pushing means 30 is pushed and moved forward.

  FIG. 4 is a schematic cross-sectional view of the inside of the cartridge 10 as viewed from above. As the push-out means 30 is pushed in, the tip of the push-out means 30 comes into contact with the edge of the optical unit 110. When the pusher 30 is further pushed, the intraocular lens 100 enters the insertion portion 11. At this time, the optical part 110 is bent along the inner wall w of the insertion part 11 (rounded down) as the opening diameter of the insertion part 11 becomes gradually narrower.

  Further, as the optical unit 110 is pushed, the opening diameter of the insertion unit 11 becomes narrower, and the optical unit 110 is folded further smaller in the insertion unit 11. And the intraocular lens 100 is sent out from the front-end | tip 11a to an intraocular by the front-end | tip of the extrusion means 30 moving to the front-end | tip 11a vicinity of the insertion part 11. At this time, in this embodiment, the astigmatism axis A of the optical unit 110 and the extrusion axis of the pushing means 30 coincide with each other, so that the astigmatism axis of the optical unit 110 can be seen from FIGS. 1B and 1C. The side having a thin edge perpendicular to A is bent toward the inner wall w side of the injector, is bent smaller in the insertion portion 11, and can be pushed out from the tip 11a having a smaller diameter. As a result, the intraocular lens 100 is injected into the eye with a smaller incision.

  The toric intraocular lens 100 pushed into the eye is restored in shape, is placed along the sac by the stress applied from within the eye, and is suitably held in the eye by the support 120. From this state, the surgeon confirms the position of the mark M attached to the optical unit 110, and uses the hook or the like whose tip is a key to change the attachment direction of the intraocular lens (the direction of the astigmatic axis A). Adjust with.

  In the above description, the method for designing a one-piece toric intraocular lens is described as an example. However, the present invention is not limited to this. For example, when designing a three-piece toric intraocular lens obtained by integrating the optical unit 110 and the support unit 120 after forming them separately, the intraocular lens design method of the present invention is used. Can be applied.

  Furthermore, in this embodiment, the intraocular lens is installed in the cartridge when inserted into the patient's eye, but the present invention is not limited to this. The astigmatic axis of the optical unit is substantially aligned with the direction of the extrusion axis, and the intraocular lens is pre-set on the cartridge so that no stress is applied (unfolded state), and the sterilized, packaged, etc. Even in the case of an intraocular lens insertion device integrated with an inner lens, injection by a small incision can be realized by using the intraocular lens of the present invention.

  In this embodiment, after determining the shape of the optical unit, the direction of the astigmatic axis when the intraocular lens is placed is determined, and then the mounting position of the support unit is determined. It is not something that can be done. That is, the order of the above-described steps 101 to 103 may be changed. For example, the outer diameter shape of the optical unit is first determined, then the mounting position of the support unit is determined, and then the direction of the astigmatic axis of the optical unit is changed. You may determine so that it may correspond with an extrusion axis | shaft substantially.

1 is a schematic external view of an intraocular lens. It is an example of an intraocular lens insertion instrument. It is a flowchart of a design method. It is a schematic diagram of a cross section when the inside of the cartridge is viewed from above.

A Astigmatic axis M mark 1 Intraocular lens insertion instrument 100 Intraocular lens 110 Optical part 120 Support part 121 Base end part

Claims (4)

An insertion portion that has an opening diameter that becomes narrower as it approaches the tip, and bends the intraocular lens and sends it into the eye;
A placement section for placing the intraocular lens;
Extrusion means for pushing out the intraocular lens placed on the placement part to the insertion part;
In a foldable intraocular lens that is inserted into the eye with an intraocular lens insertion device having
An optical unit provided with a predetermined astigmatism power;
A curved support portion extending from the optical portion;
It said proximal portion of said support portion extending from the optical portion is formed in the edge position of the optical unit that do not the axis of the astigmatic axis formed on the optical unit on the basis of the astigmatic power,
The intraocular lens , wherein the optical part is bent around the astigmatic axis by the insertion part .   The intraocular lens of claim 1,
  The intraocular lens, wherein the push-out direction of the push-out means and the direction of the astigmatism axis of the intraocular lens are set in substantially the same direction. An insertion portion that has an opening diameter that becomes narrower as it approaches the distal end, bends the intraocular lens and sends it into the eye , a cylindrical body having the insertion portion at the distal end, and a placement portion on which the intraocular lens is placed And an intraocular lens insertion device having pushing means for pushing out the intraocular lens placed on the placement portion to the insertion portion,
The intraocular lens includes an optical part having a predetermined astigmatism power, and a curved support part extending from the edge of the optical part that is not on the axis of the astigmatism axis formed on the optical part based on the astigmatism power. Toric intraocular lens
And the extrusion direction of the extrusion unit, wherein the direction of the astigmatic axis of the toric intraocular lenses, but are packed with substantially the state where the toric intraocular lens portion before described as a same direction is set in advance ,
The intraocular lens insertion device , wherein the optical unit is bent around the astigmatic axis by the insertion unit . An insertion portion that has an opening diameter that becomes narrower as it approaches the distal end, bends the intraocular lens and sends it into the eye , a cylindrical body having the insertion portion at the distal end, and a placement portion on which the intraocular lens is placed And an intraocular lens insertion device having pushing means for pushing out the intraocular lens placed on the placement portion to the insertion portion,
The intraocular lens is a toric intraocular lens having a predetermined astigmatism power;
The toric intraocular lens is packed in a state in which the toric intraocular lens is set in advance in the mounting portion so that the pushing direction of the pushing means and the direction of the astigmatic axis of the toric intraocular lens are substantially the same direction ,
The intraocular lens insertion instrument , wherein the toric intraocular lens is bent about the astigmatic axis by the insertion portion .

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