JP5850315B2 - Intraocular lens - Google Patents

Description

  The present invention relates to an intraocular lens installed in the eye of a subject's eye.

  A technique is generally known in which an intraocular lens is inserted into the eye (in the sac) after the lens has been removed by cataract surgery. The intraocular lens includes an optical unit that has a predetermined refractive power and substitutes for a crystalline lens, and a pair of support units that support the optical unit in the eye. For example, a foldable one-piece intraocular lens in which an optical part and a support part are integrally formed is known (see Patent Document 1).

  Such an intraocular lens is inserted into the eye in a state of being bent slightly by an intraocular lens insertion device (hereinafter referred to as an injector). In particular, in the case of a one-piece intraocular lens, in order to suppress the twisting of the support portion that is likely to occur when it is bent in the injector and to stabilize the release operation in the eye, It may be folded while a part is placed on the optical part.

  Further, in order to reduce the burden on the patient by making the incision formed in the eyeball as small as possible, it is preferable that the tip shape of the injector is small. Therefore, it is required that the intraocular lens be bent as small as possible in the injector.

JP-T-2005-507286

  However, if the optical part of the one-piece type intraocular lens is folded with a part of the support part placed thereon, the maximum value of the cross-sectional area perpendicular to the direction of the extrusion axis of the intraocular lens increases, and the injector It will be disadvantageous when making the tip shape smaller. In order to avoid this, a configuration in which the length of the support portion is shortened in order to place the support portion only on the peripheral edge (edge) that avoids the central region of the optical portion is conceivable, but the length of the support portion is short. When the intraocular lens is installed in the eye, it may be difficult to stably hold the optical unit by the support unit.

  An object of the present invention is to provide an intraocular lens that can be folded in a small size using an injector and can be stably held in the eye in view of the above-described problems of the prior art.

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

(1) In the intraocular lens folded and a support portion integrally formed with the optical portion and the optical Faculty, the support portion is connected to said optical unit, said support upon folding of the intraocular lens A base end portion having a constricted portion serving as a base point when the entire portion is bent inward, and a predetermined curved shape along a crystalline lens capsule of a human eye, and is placed on the optical portion when the intraocular lens is bent. and a tip portion that is, the a transition for connecting the base end portion and the said distal portion, wherein with the width of the portion leading to the tip portion of the width of the portion leading to the proximal end portion is narrower A transition portion formed so that the thickness decreases from the proximal end portion toward the distal end portion, and the transition portion is formed so that the thickness of the distal end portion is thinner than the thickness of the proximal end portion. And the cross-sectional area of the tip is closer to the open end It is characterized by gradually becoming smaller .

  ADVANTAGE OF THE INVENTION According to this invention, while being able to fold an intraocular lens small using an injector, the intraocular lens which can be stably hold | maintained in an eye can be provided.

  Embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a configuration diagram of a one-piece type intraocular lens 100. FIG. 1A shows a front view and FIG. 1B shows a side view. The intraocular lens 100 includes an optical unit 110 having a predetermined refractive power and a pair of loop-shaped support units 120 connected to the optical unit 110.

  The one-piece type intraocular lens 100 includes a bendable flexibility using an intraocular lens insertion device (to be referred to as an injector hereinafter), a resilience to return from the folded state to the original state, and a support portion. 120 is formed of a known soft intraocular lens material so as to have a repulsive force capable of holding the optical unit 110 in the eye. For example, as the intraocular lens material, a simple substance such as HEMA (hydroxyethyl methacrylate), a composite material of acrylic acid ester and methacrylic acid ester, or the like is used. By performing molding processing, cutting processing, or the like using these materials, the optical unit 110 and the support unit 120 are integrally formed.

  The optical unit 110 is a disk-shaped member that gives a predetermined refractive power to the surgical eye, and includes a front surface 111 positioned on the cornea side in the eye, a rear surface 112 positioned on the retina side in the eye, and a front surface 111. An outer peripheral portion (hereinafter referred to as an edge) 115 having a predetermined width (thickness) is connected to the rear surface 112. The front surface 111 and the rear surface 112 are formed as curved surfaces having a predetermined curvature. At least the rear surface 112 of the outer peripheral portion 115 is connected to an edge (the figure number is omitted) having a shape (angle) that comes into contact with (intrudes into) the posterior capsule when the intraocular lens 100 is attached to the eye. ing. When the edge of the outer peripheral portion 115 is brought into close contact with the posterior capsule, the proliferation of corneal epithelial cells is suppressed, and white turbidity due to subsequent cataract is less likely to occur.

  The pair of support parts 120 are formed at point-symmetrical positions on the edge 115 with respect to the center (optical axis L) of the optical part 110, one end is connected to the optical part 110 (edge 115), and the other end ( The tip P) is the open end. The support unit 120 extends a predetermined length while being bent inward (toward the optical unit 110) toward the tip in a state where the support unit 120 is bent by a predetermined angle around the optical axis L near the connection position with the optical unit 110. It is formed radially. With such a shape, the outer side of the support portion 120 is positioned along (in contact with) the lens capsule (hereinafter referred to as a capsule). Further, the rotation of the support 120 when the intraocular lens 100 is opened in the eye is suppressed.

  The support part 120 of the present embodiment includes a base end part 122 connected to the optical part 110, a front end part 123 at least a part of which is placed on the optical part 110 when the intraocular lens 100 is bent, and a base end part 122. And a transition part 125 that connects the tip part 123 to each other. A detailed description of the configuration of the support 120 will be described later.

  The outermost shape (maximum total length) of the intraocular lens 100 is based on the diameter of the capsule of the human eye so that the optical unit 110 is held by the stress applied to the support unit 120 when the intraocular lens 100 is installed in the sac. Also, it is preferably 9 mm or more and 15 mm or less. On the other hand, the diameter of the optical unit 110 is determined based on the size of the pupil of the surgical eye, and is, for example, 4 mm or more and 8 mm or less. For example, when the diameter of the sac of the surgical eye is 10 mm, the outermost diameter of the intraocular lens 100 may be determined to be a longer diameter (for example, about 11 mm to 15 mm).

  The support part 120 has a curved shape along the sac so that the conditions of the total length of the intraocular lens 100 and the diameter of the optical part 110 are satisfied. For example, the length of the support part 120 is a line segment connecting the intermediate point w1 of the width wa of the base end part 122 near the connection position of the optical part 110 with the edge and the center (optical axis L) of the optical part 110, An angle θ formed by a line segment connecting the tip P of the support part 120 and the center (optical axis L) of the optical part 110 is formed to be 50 ° or more and 90 ° or less. When the angle θ is less than 50 °, it is difficult to secure a contact area between the sac and the support portion 120 (tip portion 123), and the intraocular lens 110 is difficult to be stably supported in the eye. On the other hand, when the angle θ is larger than 90 °, the support portion 120 may be easily entangled with a plunger described later when the injector 10 is bent.

  The base end portion 122 connected to the optical unit 110 has a strength that cannot be bent by the stress applied to the support unit 120 when the intraocular lens 100 is bent using the injector 10, and the intraocular lens 100 enters the eye. At the time of attachment, a cross-sectional area (width and thickness) that can hold the optical unit 110 by a repulsive force generated by a stress applied from the sac is formed. For example, the width wc and the thickness d2 of the base end part 122 are preferably 0.6 mm or more and 1.5 mm or less. More preferably, it is formed in a range of 0.7 mm to 1.1 mm. In addition, on the side where the proximal end portion 122 and the optical portion 110 are connected and not in contact with the sac in the eye, the inner side is formed so that a part of the width (cross-sectional area) of the proximal end portion 122 is narrowed (smaller). The constricted part 124 is formed by curving a part of (inner circumference). The constricted portion 124 has a thickness and a width necessary for bending the support portion 120 (the distal end portion 123 and the transition portion 125) integrally based on the stress applied to the distal end portion 123 when the intraocular lens 100 is bent. doing.

  The transition part 125 has a role of connecting the base end part 122 and the front end part 123 having different cross-sectional areas. That is, the transition portion 125 is formed such that the width of the portion connected to the distal end portion 123 is narrower than the width of the portion connected to the proximal end portion 122, and the thickness of the transition portion 125 is equal to the proximal end portion 122 (thickness). It is formed so as to become thinner from d2) toward the tip portion 123 (thickness d1). That is, the maximum value of the cross-sectional area of the transition portion 125 is gradually reduced from the base end portion 122 to the tip end portion 123, and the base end portion 122 and the tip end portion 133 are smoothly connected by the transition portion 125. .

  Specifically, the cross-sectional area (width, thickness) of the transition portion 125 has a length that is located outside the lens capsule in an open state by a force applied to the tip portion 123 when the intraocular lens 100 is bent. While allowing the portion 123 to bend to a position corresponding to the outer peripheral diameter (circle R) of the lens capsule, the distal end portion 123 corresponds to the outer diameter of the lens capsule by further applying a force to the distal end portion 123. When positioned inside the position (the position of the circle R), the constricted portion 124 is formed to have a width and thickness such that the entire support portion 120 (the tip portion 123 and the transition portion 125) is integrally bent.

  With the above-described configuration, the support portion 120 bends with the base constricted portion 124 as a base point due to the stress applied to the distal end portion 123, so that the entire support portion 120 is inside via the base constricted portion 124. The optical lens 110 is bent toward the optical unit 110 side, and the total length of the bent intraocular lens is easily made smaller (compact).

  The transition portion 125 is a cross-sectional area (stress (compressive force) applied from the sac when the intraocular lens 100 is attached to the eye, and generates a repulsive force necessary to bring the distal end 123 along the sac ( Strength). Thereby, even if the cross-sectional area of the distal end portion 123 is formed so thin as not to generate a repulsive force, the distal end portion 123 is suitably positioned along the sac along with the repulsive force generated in the transition portion 125. Become.

  In addition, when the transition part 125 sets the outer diameter of the standard sac in the human eye (circle R in FIG. 1) with the optical axis L of the optical part 110 as the reference center, at least the transition part 125 is on the outer periphery of the sac. (On the circle R). For example, when the diameter of the sac of a human eye is 9 mm, the constricted portion 125 is formed so as to be located outside the circle R having a diameter of 9 mm with the optical axis L of the optical unit 110 as the center. Further, as described above, the distal end P of the distal end portion 123 is formed so as to be located outside the outer periphery (circle R) of the sac.

  When the intraocular lens 100 is opened, the transition portion 125 is positioned outside the diameter of the sac, so that when the intraocular lens 100 is attached to the eye, the transition portion 125 to which stress is applied from the sac is formed on the sac. It will be compressed inward, and will be located along the sac together with the tip 123 by the repulsive force generated by this.

  The distal end portion 123 has a role of stabilizing the position of the optical unit 110 by being contacted along the sac. In addition, the distal end portion 123 of the present embodiment is formed thin enough to be positioned along the sac by the repulsive force generated in the support portion 120 (the transition portion 123) in a state where the intraocular lens 100 is attached in the eye. The For example, it is assumed that the maximum value of the width wb (and the thickness d1) of the distal end portion 123 of this embodiment is 0.05 mm or more and 0.45 mm or less. More preferably, it is 0.1 mm or more and 0.35 mm or less. If the maximum value of the width wb (and thickness d1) of the distal end portion 123 is smaller than 0.1 mm, the possibility that the support portion 120 is damaged when the intraocular lens 100 is bent increases. On the other hand, when the maximum values of the width and the thickness are larger than 0.35 mm, there is a high possibility that the entire support portion 120 is not easily positioned along the sac due to the repulsive force generated at the distal end portion 123. Note that the width and thickness (cross-sectional area) of the distal end portion 123 may be appropriately selected according to the type of intraocular lens material so that the above condition can be satisfied.

  Further, when the intraocular lens 100 is bent by the injector, when the support part is placed on the optical part (the area including the central part) when the intraocular lens 100 is bent by the injector because the tip part 123 has a narrow width (cross-sectional area). In addition, an increase in the maximum value of the cross-sectional area of the intraocular lens when viewed from the direction perpendicular to the extrusion axis can be suppressed. Therefore, in this embodiment, the amount of increase in the cross-sectional area when the distal end portion 123 is placed near the center (optical axis L) of the optical unit 110 is suppressed. That is, when the entire support part 120 is bent onto the optical part 110 via the constricted part 124, the transition part is moved from the tip part 123 so that the tip part 123 reaches the center (optical axis L) of the optical part 110. The length up to 125 can be formed long. And since the front-end | tip part 123 is formed long, when the intraocular lens 100 is attached to a sac, the wide area | region of the front-end | tip part 123 which comprises the support part 120 comes to contact a sac, The lens 100 is positioned more stably in the sac.

  Further, since the distal end portion 123 is formed to be thin, the support portion 120 is easily separated from the optical portion 110 when the intraocular lens 100 is opened in the sac. Since the foldable intraocular lens 100 has a predetermined viscosity, when the intraocular lens 100 is opened in the eye when the intraocular lens 100 is opened in the eye when the support unit 120 is bent on the optical unit 110, the support unit 120. May adhere to the optical unit 110 and may not leave. Therefore, as in the present embodiment, the distal end portion 123 of the support unit 120 is thinned so that the contact area with the optical unit 110 is reduced as much as possible. 120 becomes easily separated. Further, a fine unevenness (rough surface) may be provided in a predetermined range (for example, a range in contact with the optical unit 110) from the tip P of the tip part 123, so that the tip part 123 can be more easily separated from the optical part 110. .

  By using the intraocular lens 100 having the above-described configuration, when the intraocular lens 100 using the injector 1 is bent, the stress applied to the support unit 120 is concentrated on the constricted portion 124, and the constricted portion is constricted. The entire support portion 120 is bent (flexed) onto the optical portion 110 with the portion 124 as a base point. The total length of the folded intraocular lens 100 can be reduced (compact). Further, when the intraocular lens 100 is pushed out, an operation of pushing the support part 120 located away from the optical part 110 becomes unnecessary, and the intraocular lens 100 can be pushed into the eye more easily. In addition, since the cross-sectional area of the distal end portion 123 on which the optical unit 110 is placed is thin, even if the distal end portion 123 is placed on the central portion of the optical unit 110, the smallest incision can be made without increasing the diameter of the distal end 11. Then, the intraocular lens 100 can be pushed out.

  Further, when the intraocular lens 100 pushed into the eye is opened in the sac, a repulsive force is generated by the stress applied to the support part 120 by the stress applied from the sac, and the entire intraocular lens 100 is held. It becomes like this. Further, the support portion 120 (the transition portion 125) is compressed by the sac, so that a repulsive force necessary for the distal end portion 123 to follow the sac is generated, and the outer peripheral region of the distal end portion 123 (the entire support portion 120) becomes the sac. It comes to contact suitably along. In particular, in the present embodiment, since the distal end portion 123 can be formed long, the contact area of the support portion 120 in the sac becomes wider, and the intraocular lens 100 is positioned more stably in the sac.

  Next, the configuration of the injector will be described. FIG. 2 is a schematic external view of the injector 1. FIG. 3 is an explanatory diagram of the configuration of the plunger 40. The injector 1 includes a cylindrical body (hereinafter referred to as a main body) 30, an extrusion member (hereinafter referred to as a plunger) 40, and a lid portion 60. The main body 30 includes an insertion portion 10 and a placement portion 20. . Such an injector 1 is formed by molding using a resin material or the like, or cutting by cutting out a resin.

  The insertion portion 10 of the main body 30 has a hollow cylindrical shape having a region (inner wall shape) in which the inner diameter of the passage gradually decreases (thinner) toward the tip, and the intraocular lens 100 is externally attached to the tip 11. A notch (bevel) is formed for delivery. The intraocular lens 100 that has passed through the insertion unit 10 is folded small along the inner wall of the insertion unit 10 and sent out from the distal end 11 to the outside. The placement unit 20 of the main body 30 is formed at the proximal end of the insertion unit 10 and forms a space (gap) where the intraocular lens 100 is located. In addition, a placement surface on which the intraocular lens 100 is placed in the use state is positioned.

  The plunger 40 is a member that pushes the intraocular lens 100 into the insertion portion 10 to be folded into a small size, and pushes the intraocular lens 100 from the tip into the eye. The plunger 40 is connected to the pressing portion 41 pressed by the operator, the shaft base portion 42 connected to the pressing portion 41, the push rod 43 connected to the shaft base portion 42, and the tip of the push rod 43. And a tip 44 that contacts the optical unit 110 when the lens 100 is pushed out.

  Further, an inclined surface (not shown) extending in the axial direction and having a predetermined inclination is formed on the back surface side of the tip 44. When the plunger 40 is pushed in, the tip 44 is once lifted by the inclined surface, so that a tucking operation for placing a part of the rear-side support part 120 (tip part 123) on the optical part 110 is suitably performed. With the configuration as described above, the plunger 40 is inserted through a passage connecting from the main body 30 to the distal end of the insertion portion 20 so as to advance and retreat in the axial direction.

  Next, the operation | movement at the time of attaching the intraocular lens 100 in an eye using the injector 10 of the above structures is demonstrated. FIG. 4 is an explanatory view of the pushing operation of the intraocular lens 100 in the injector 10.

  First, the operator places a known viscoelastic substance from the opening or the tip 11 (not shown) from the state in which the intraocular lens 100 is placed on the push-out shaft (mounting surface) of the mounting unit 20 and the lid unit 60 is closed. Injection into the insertion portion 10. When the installation of the intraocular lens is completed and the pusher 41 is pushed by the operator, the distal end 44 of the plunger 40 is moved toward the distal end 11. Then, as shown in FIG. 4A, a part of the rear support portion 120 is pushed by the tip 44.

  Here, it is assumed that the tip portion 123 is first pushed by the plunger 40. At this time, in the present embodiment, the transition portion 125 formed so that the cross-sectional area (width, thickness) decreases from the base end portion 122 toward the front end portion 123, and the distal end portion 123 having a different cross-sectional area (width, thickness). The base end portion 122 is smoothly connected. Therefore, the stress applied by the plunger 40 is not concentrated at the switching position between the distal end portion 123 and the transition portion 125 and between the transition portion 125 and the proximal end portion 122 but concentrated at the constricted portion 124 formed at the base. . As a result, as shown in FIG. 4B, the entire support portion 120 can be bent via the constricted portion 124, and the distal end portion 123 of the support portion 120 bent from the base is placed on the optical portion 110. Tucking will be performed. Similarly, the front support 120 is also bent by the stress applied from the inner wall of the injector 1 and placed on the optical unit 110.

  In the present embodiment, the distal end portion 123 is placed up to a position reaching the central portion (on the axis L) of the optical unit 110, but the sectional area of the distal end portion 123 is formed to be thin enough to be along the sac. Even if the distal end portion 123 is placed on the central portion of the optical unit 110, the amount of increase in the cross-sectional area of the intraocular lens 100 when viewed from the direction perpendicular to the extrusion shaft is suppressed.

  When the pressing portion 41 is further pressed from the state in which the tip 44 is in contact with the edge 115, the optical portion 110 and the support portion 120 are integrally formed by the pressure applied to the optical portion 110 as shown in FIG. It is gradually bent along the inner wall of the insertion portion 10. At this time, since the entire support unit 120 is bent and placed on the optical unit 110, the total length of the intraocular lens 100 is shortened, and the intraocular lens is suitably placed into the eye simply by pushing the optical unit 110. It will be pushed out.

  When the pushing portion 41 is further pushed, the bent intraocular lens 100 is delivered from the tip 11 into the eye. And it comes to be gradually opened in the sac by the restoring force. At this time, since the tip end portion 123 of the support portion 120 is formed thin and the contact area with the optical portion 110 is reduced, the tip end 123 of the support portion 120 is easily separated from the optical portion 110. Thereby, an operator's operation which arises when the support part 120 sticks to the optical part 110, and the burden of the patient accompanying it are reduced.

  When the intraocular lens 100 is gradually opened in the sac, the entire intraocular lens 100 is held by the base end part 122 due to the repulsive force generated by the support 120 being bent by the stress applied from the sac. Further, the entire distal end portion 123 is suitably positioned along (in contact with) the sac, and the attachment position of the intraocular lens 100 is stably maintained.

  The configuration of the present invention is not limited to the above. For example, the cross-sectional area of the front end portion 123 may be gradually reduced as it approaches the open end P. Further, the cross-sectional area of the front end portion 123 (a predetermined range near the open end P) placed on the optical unit 110 may be particularly small. In this way, when the intraocular lens 100 is tacked in the injector 1, an increase in the cross-sectional area of the intraocular lens 100 can be further suppressed.

  Further, even if the support portion 120 is formed such that the cross-sectional area gradually decreases from the base end portion 122 toward the tip end portion 123 without dividing the base end portion 122, the tip end portion 123, and the transition portion 125. good. Also in this case, the shape of the support part 120 (cross-sectional area at each part) may be determined so as to satisfy the above-described requirements.

It is a block diagram of a 1 piece type intraocular lens. It is the external appearance schematic of an injector. It is explanatory drawing of a structure of a plunger. It is explanatory drawing of the extrusion operation | movement of the intraocular lens in an injector.

DESCRIPTION OF SYMBOLS 100 Intraocular lens 110 Optical part 120 Support part 122 Base end part 123 Front end part 124 Constriction part 125 Transition part

Claims (2)

In a foldable intraocular lens having an optical part and a support part formed integrally with the optical part,
The support part is
And connected to said optical portion, said proximal portion having a base point becomes constricted portion when the bending the entire support portion inwardly upon folding of the intraocular lens,
A distal end portion having a predetermined curved shape along the crystalline lens capsule of the human eye and placed on the optical portion when the intraocular lens is bent;
A transition section for connecting the said distal portion and said proximal portion, the distal end from the proximal portion with the width of the portion leading to the tip portion of the width of the portion leading to the proximal end portion is narrower A transition part formed so that the thickness is reduced toward the part,
The transition portion is formed so that the thickness of the distal end portion is thinner than the thickness of the proximal end portion ,
An intraocular lens characterized in that a cross-sectional area of the tip portion gradually decreases as it approaches the open end . The intraocular lens of claim 1,
When the outer diameter of a standard lens capsule in the human eye is set with the center of the optical portion as a reference center, the transition portion is located on the outer periphery of the lens capsule and the tip of the distal end is the tip of the lens capsule. An intraocular lens, wherein the intraocular lens is formed so as to be located outside the outer periphery.