JP6091498B2 - Intraocular lens insertion device - Google Patents

Description

  The present invention relates to an intraocular lens insertion device used for inserting an intraocular lens into a sac.

  Conventionally, in surgery such as cataract, after removing the lens in the capsule through the incision provided in the eye tissue such as cornea (capsular) and anterior lens capsule part, removing the intraocular lens to replace the lens, A method of inserting from the incision and placing in the sac is employed.

  In particular, in recent years, for example, a technique using an intraocular lens insertion device as described in JP-A-2006-181269 (Patent Document 1) or JP-A-2010-46241 (Patent Document 2) has been widely adopted. ing. In general, the distal end of the insertion tube provided at the distal end of the tubular instrument body is inserted into the eye through the incision and is inserted from the proximal end of the instrument body. An intraocular lens is inserted into the eye by deforming the intraocular lens placed on the inner placement part into a small deformation and pushing it out from the distal end opening of the insertion tube part. With such an insertion device, it is possible to insert an intraocular lens without expanding the incision formed for the removal of the crystalline lens, so that the labor required for the operation can be reduced, as well as the occurrence of postoperative astigmatism and infection. Risk can also be reduced.

  By the way, when inserting an intraocular lens using such an intraocular lens insertion device, it is necessary to deform the intraocular lens small toward the insertion tube portion by the pushing member. Here, the intraocular lens is configured to include an optical part and a pair of support parts extending to both radial sides of the optical part, and the pair of support parts extend to the front end side and the rear end side of the instrument body. It is mounted on the mounting part of the instrument body. In particular, in a so-called single-piece type intraocular lens formed of a soft synthetic resin material in which both an optical part and a pair of support parts, which have been used in recent years, are foldable, the pair of support parts are thin-walled. The elongated shape extends from the outer peripheral edge of the optical part. Therefore, in the intraocular lens insertion device as described in Patent Document 1 or Patent Document 2, when the intraocular lens is deformed small toward the insertion tube portion, the optical portion of the intraocular lens is formed on the distal end surface of the pushing member. On the other hand, the support portion extending to the rear end side is pressed as much as possible so as not to be subjected to a load by the pushing member.

  However, in such an intraocular lens insertion device having such a conventional structure, the deformation of the support portion extending to the rear end side of the intraocular lens cannot be skillfully controlled, which causes various problems. For example, as described in Patent Document 1, when the support part is missed behind the front end surface of the extrusion member so that no load is applied to the support part, the soft and easy-to-adhere support part is the inner periphery of the instrument body. By sliding on the surface, there is a possibility that stress concentrates on the support portion and cracks occur. Further, FIG. 6 of Patent Document 2 shows a case in which the support portion on the rear end side is also pushed forward by the pushing member and deformed so as to be sandwiched between the folded optical portions. In this case, since the contact area between the support part on the rear end side and the optical part is increased, the support part on the rear end side is in close contact with the optical part, and the support is performed even after the intraocular lens is opened in the capsule. There is also a possibility that the adhesion between the optical part and the optical part may not be eliminated.

  Further, in any of the insertion instruments described in Patent Document 1 and Patent Document 2, the root portion of the support portion on the rear end side to the optical portion is on one side of the front end portion of the pushing member (Patent Document 1, FIG. 6). The left side of the plunger 25 of (b); left side of the extrusion shaft 22 of Patent Document 2 and FIG. 6, and the other side of the distal end portion of the extrusion member (Patent Document 1, of the plunger 25 of FIG. 6B) On the right side; Patent Document 2, the right side of the extrusion shaft 22 in FIG. 6), only the outer peripheral edge portion of the optical portion is present. Then, when the push-out member is pushed forward, the tip end portion of the push-out member easily shifts to the right side, and the vector direction in which the pushing force by the push-out member is transmitted is displaced from the axial direction of the instrument body, There is a possibility that the pushing force is not efficiently transmitted to the intraocular lens.

  In addition, in both cases of Patent Document 1 and Patent Document 2, since the outer peripheral edge of the optical part of the intraocular lens is directly pressed by the distal end surface of the pushing member, the outer peripheral part of the optical part of the intraocular lens On the other hand, there is a problem that local external force is applied and problems such as scratches and cracks are likely to occur.

JP 2006-181269 A JP 2010-46241 A

  The present invention has been made in the background as described above, and the problem to be solved is to stabilize the deformed state of the support portion extending to the rear end side of the intraocular lens, thereby supporting the support portion and It is an object of the present invention to provide an intraocular lens insertion device having a novel structure capable of reducing the occurrence of damage to the optical part and stabilizing the extrusion state of the intraocular lens by the pushing member.

  Hereinafter, embodiments of the present invention made to solve the above-described problems will be described. In addition, the component employ | adopted in each aspect as described below is employable by arbitrary combinations as much as possible.

That is, the first aspect of the present invention provides an intraocular lens for inserting an intraocular lens formed of a soft synthetic resin material in which both the optical part and the pair of longitudinal support parts can be folded. A lens insertion instrument, a cylindrical instrument body having a placement portion on which the intraocular lens is placed, and an intraocular lens inserted from the rear end of the instrument body. A push-out member that pushes into the eye from an insertion tube provided at the distal end, and the pair of support portions of the intraocular lens are extended to the front and rear ends of the instrument body. A base portion on one end side in the length direction of the support portion that is placed on the placement portion and extends toward the rear end side is positioned on one side in the width direction of the placement portion and the length of the support portion The tip of the other end in the direction is positioned on the other side in the width direction of the mounting portion. While the length direction of the intermediate portion of the support portion is in so that extend toward the other side from one side of spaced by the placing portion in the width direction to the rear side of the optical faculties of the pushing member The tip portion includes an intermediate contact surface that contacts an intermediate portion in the longitudinal direction of the support portion that is positioned between the optical portion and the push member in the push direction of the push member, and the intermediate contact surface the longitudinal middle portion in the supporting portion deformed allowed was to be pressed against the push out member along the distal end portion of the extrusion member with the side edge portions extending out toward the base end side of the pusher member A left-side contact surface and a right-side contact surface that are in contact with a left-side portion and a right-side portion in the length direction with the support interposed therebetween, and the support portion is provided with the left-side contact with the intermediate contact surface of the push-out member Surface and the right contact surface. In a state, in which it said intraocular lens by pushing member is adapted to be pushed into the insertion tube.

  According to this aspect, the support portion extending to the rear end side of the instrument body is brought into contact with the intermediate contact surface and the left and right contact surfaces provided at the distal end portion of the pushing member, and an arbitrary intermediate portion in the longitudinal direction of the support portion is provided. A wide range of the intermediate portion in the longitudinal direction of the support portion across the left contact surface and the right contact surface sandwiching the portion and the right contact surface can be deformed along the tip portion, The deformed shape can be stabilized. As a result, the support part on the rear end side is deformed into an unexpected shape, and it slides on the inner surface of the instrument body during extrusion and breaks, or the intraocular lens is expanded in the sac by closely contacting the optical part. It is possible to reduce or prevent problems such as adversely affecting the system as much as possible.

  Further, by bending the intermediate portion of the rear end side support portion along the front end portion of the extrusion member, the root portion of the rear end side support portion to the optical portion and the front end portion of the rear end side support portion are pushed out by the extrusion member. It can be located in a well-balanced manner on both sides of the front end of the. As a result, both side surfaces of the front end portion of the extrusion member are stably supported by the rear end side support portion, and are prevented from being displaced to one side when the extrusion member is pushed out. Can be efficiently applied to the intraocular lens. In addition, since it is avoided that the rear end side support part is brought into contact over a wide range of the optical part, both the optical part and the pair of support parts are formed of a soft synthetic resin material that can be folded. In the lens, it is possible to stabilize the deformed shape while effectively avoiding the close contact between the optical portion and the support portion during the extrusion deformation.

  Further, since the intraocular lens is pushed out with the support portion on the rear end side being in contact with the front end portion of the pushing member, the pushing member directly presses the outer edge portion of the optical portion so that the outer edge of the optical portion is pressed. It is possible to prevent the occurrence of breakage and cracking of the part.

  According to a second aspect of the present invention, in the intraocular lens insertion device according to the first aspect, the support portion on the rear end side of the device main body is in most contact with the distal end portion of the pushing member. In the state, the support portion is in contact with the tip portion of the extrusion member over a length of 50% or more of the length dimension of the support portion.

  According to this aspect, since the maximum contact length between the support portion and the extrusion member is 50% or more of the length dimension of the support portion, no force is locally applied from the extrusion member, and the lens is applied. Damage is reduced. Furthermore, the deformed state of the support portion can be realized more stably, and the same effect as the first aspect can be realized more advantageously.

  According to a third aspect of the present invention, in the intraocular lens insertion device according to the first or second aspect, the distal end portion of the pushing member has a rod shape, and the distal end surface of the distal end portion is While the intermediate contact surface is formed, a pair of longitudinal notches extending from the distal end surface to the proximal end side of the extrusion member are formed on both side surfaces of the distal end portion, and the distal end portion of the extrusion member is formed. Is narrower than the base end portion, and the left contact surface and the right contact surface are constituted by the pair of cutout portions.

  According to this aspect, the front end surface of the rod-shaped push-out member is used as an intermediate contact surface, and the left and right side surfaces are formed as notches toward the base end side of the push-out member to form left and right side contact surfaces. Therefore, by pressing the intermediate part of the support part extending to the rear end side with the front end face (intermediate contact surface), the left and right side parts of the support part sandwiching the intermediate part can be easily aligned with the left and right contact surfaces. be able to. Thereby, the deformation | transformation shape of a support part can be implement | achieved stably and the effect similar to a 1st aspect can be implement | achieved easily and reliably.

  According to a fourth aspect of the present invention, in the intraocular lens insertion device according to any one of the first to third aspects, the intraocular lens is inserted between the placement portion and the insertion tube portion. While the deforming action part for deforming the optical part so as to be convex upward is formed, the lower end side of the intermediate contact surface of the push-out member extends toward the front end side of the push-out member. An inclined surface is included.

  According to this aspect, when the intraocular lens is folded in a mountain-fold shape that is convex upward, the support portion extending to the distal end side can be inserted between the optical portions, and the support portion on the distal end side The deformation state can be stabilized. Further, since the intermediate contact surface of the pushing member has an inclined surface with the lower end side extending toward the leading end side of the pushing member rather than the upper end side, the rear end side deforming along the leading end portion of the pushing member. The support portion can be positioned relatively above the intermediate contact surface. Accordingly, the outer peripheral edge portion of the optical part folded in a mountain shape that is convex upward can be stably pressed by the pushing member through the support part on the rear end side, and the optical part of the support part on the rear end side can be pressed. It is possible to advantageously prevent inconveniences such as entering into the part and the outer peripheral edge of the optical part being directly pressed by the pushing member.

  According to a fifth aspect of the present invention, in the intraocular lens insertion device according to the fourth aspect, a vertical surface that rises in a direction perpendicular to the axis of the push-out member is formed at the upper edge of the intermediate contact surface. Is formed.

  According to this aspect, even if the upward displacement force is applied to the support portion by the inclined surface, the vertical end surface is formed on the end edge portion on the upper end side, so that the support portion on the rear end side is the intermediate contact surface. The movement to the base end side of the pushing member can be prevented by the engagement between the support portion and the vertical surface, and the support portion can be stably maintained in a desired deformed shape.

  According to a sixth aspect of the present invention, in the intraocular lens insertion device according to the fourth or fifth aspect, an end edge portion on the lower end side of the intermediate contact surface has an inclination angle with respect to the inclined surface. A small gently inclined surface is formed.

  According to this aspect, since the gently inclined surface is formed at the end edge portion on the lower end side of the intermediate contact surface (front end surface) of the pushing member, the support portion on the rear end side comes into contact with the intermediate contact surface. In addition, the support portion can be smoothly guided upward, and the support portion can be separated from the intermediate contact surface downward to advantageously prevent problems such as the support portion being sandwiched between the pushing member and the instrument body. be able to.

  According to a seventh aspect of the present invention, in the intraocular lens insertion device according to any one of the first to sixth aspects, the intraocular lens is built in the mounting portion of the device body. Among the pair of support portions of the intraocular lens, the support portion extending to the rear end side of the instrument body is provided from the outer peripheral edge portion of the optical portion of the intraocular lens. It is obliquely extended in the axial direction of the instrument body and extends to the rear end side.

  According to this aspect, since the support portion on the rear end side obliquely extends in the axial direction of the instrument body and extends to the rear end side, the intermediate contact surface of the pushing member is used as the intermediate portion in the length direction of the support portion. It is possible to make contact advantageously, and the support portion on the rear end side can be advantageously deformed into a desired deformed shape.

  According to the intraocular lens insertion device of the present invention, by providing the intermediate contact surface and the left and right contact surfaces at the distal end portion of the pushing member, the support portion extending to the rear end side of the device body is brought into contact with these surfaces. Since the wide range of the intermediate portion in the longitudinal direction of the support portion can be deformed along the tip portion, the deformed shape of the support portion on the rear end side can be stabilized. As a result, the occurrence of damage to the support portion and the optical portion can be reduced, and the pushing state of the intraocular lens by the pushing member can be stabilized.

The top view of the insertion instrument of the intraocular lens as one Embodiment of this invention. The side view of the insertion instrument. The top view of the insertion cylinder part in the insertion instrument. The side view of the insertion cylinder part. AA thru | or CC sectional drawing in FIG. The top view of the extrusion member in the insertion instrument shown in FIG. The side view of the extrusion member. The enlarged view of the front-end | tip part of the extrusion member shown in FIG. The enlarged view of the front-end | tip part of the extrusion member shown in FIG. Explanatory drawing for demonstrating the deformation | transformation state at the time of extrusion of an intraocular lens. Cross-sectional explanatory drawing equivalent to the XI-XI cross section of FIG. Cross-sectional explanatory drawing equivalent to the XII-XII cross section of FIG. The enlarged view of the front-end | tip part of the extrusion member as a modification of one Embodiment of this invention.

  Hereinafter, in order to clarify the present invention more specifically, embodiments of the present invention will be described in detail with reference to the drawings.

  First, FIG. 1 and FIG. 2 show an intraocular lens insertion device 10 as one embodiment of the present invention. The intraocular lens insertion instrument 10 is made of a synthetic resin, and is inserted from a cylindrical instrument body 16 having a placement portion 14 on which the intraocular lens 12 is placed, and a rear end portion 18 of the instrument body 16. The push-in member 22 is provided to push the intraocular lens 12 into the eye from the insertion tube part 20 provided at the distal end of the instrument body 16, and is provided with the intraocular lens 12 built in beforehand. In the following description, “front” refers to the pushing direction of the pushing member 22 (left direction in FIG. 1), and “upward” refers to the up direction in FIG. The left-right direction refers to the left-right direction of the intraocular lens insertion device 10 in the rear view (in FIG. 1, the upper side is the right and the lower side is the left).

  The intraocular lens 12 is a conventionally known intraocular lens, and includes an optical unit 24 that imparts optical characteristics, and a pair of support units that protrude from the optical unit 24 toward the outer peripheral side, that is, a front-end support unit 26 and a rear end. The side support portion 28 is included. The optical part 24 is supported by a pair of support parts 26 and 28 and is arranged in a positioned state in the lens capsule. As will be described later, the optical unit 24 includes an optical unit front surface 142 positioned on the front surface in the capsule and an optical unit rear surface 140 positioned on the vitreous body side in a state of being arranged in the lens capsule. The curvature of the rear surface 140 of the optical unit is appropriately set in consideration of required optical characteristics and the like. The optical part 24 and the pair of support parts 26 and 28 are made of the same material, and are specifically foldable as described in JP-A-10-24097, JP-A-11-56998, and the like. Soft synthetic resin material is used. Among them, in order to obtain an intraocular lens having excellent shape recoverability, it is desirable to employ a monomer containing one or more (meth) acrylic acid esters as shown in (i) below. Moreover, arbitrary monomers as shown in the following (ii) are appropriately blended. Furthermore, an additive as shown in the following (iii) is added if necessary.

(I) Containing monomer The linear, branched or cyclic alkyl (meth) acrylates as follows:
Methyl (meth) acrylate, ethyl (meth) acrylate, butyl (meth) acrylate, cyclohexyl (meth) acrylate, etc. Hydroxyl group-containing (meth) acrylates as follows:
Hydroxyethyl (meth) acrylate, hydroxybutyl (meth) acrylate, diethylene glycol mono (meth) acrylate, etc. Aromatic ring-containing (meth) acrylates such as the following:
Phenoxyethyl (meth) acrylate, phenyl (meth) acrylate, phenylethyl (meth) acrylate, etc. Silicon-containing (meth) acrylates such as the following:
Trimethylsiloxydimethylsilylmethyl (meth) acrylate, trimethylsiloxydimethylsilylpropyl (meth) acrylate, etc. Note that “(meth) acrylate” is a generic term for the two compounds “... acrylate” and “... methacrylate”. The same applies to other (meth) acrylic derivatives described later.

(Ii) Optional monomer (meth) acrylamide or a derivative thereof as follows:
(Meth) acrylamide, N, N-dimethyl (meth) acrylamide, etc. N-vinyllactams such as the following:
N-vinylpyrrolidone, etc. Styrene or its derivatives Crosslinkable monomers as follows:
Butanediol di (meth) acrylate, ethylene glycol di (meth) acrylate

(Iii) Additive Thermal polymerization initiator, photopolymerization initiator, photosensitizer, etc. Pigment, etc. Ultraviolet absorber, etc.

  In addition, the pair of support portions 26 and 28 are protruded in opposite directions from the outer peripheral portions opposed in the radial direction of the optical portion 24, and the protruding tip portions wrap around the optical portion 24 in the same direction. It has an inverted S shape in plan view, which is positioned at the tip.

  On the other hand, the instrument main body 16 has a main body cylinder portion 30 having a substantially cylindrical shape. A through-hole 32 that penetrates in the axial direction with a substantially rectangular cross-sectional shape is formed inside the main body cylinder portion 30. Further, a plate-like portion 34 that extends in a direction orthogonal to the extending direction of the main body cylinder portion 30 is integrally formed at a position slightly forward from the rear end portion of the main body cylinder portion 30.

  Further, a mounting portion 14 is formed in front of the main body cylinder portion 30 in the instrument main body 16. The mounting portion 14 is formed with a concave groove 36 that extends in the axial direction with a width that is slightly larger than the diameter of the optical portion 24 of the intraocular lens 12. The concave groove 36 is formed with an axial length dimension slightly larger than the maximum width dimension (the horizontal dimension in FIG. 1) including the pair of support portions 26 and 28 of the intraocular lens 12.

  Here, the concave groove 36 has an opening 38 opened upward, and a mounting surface 40 is formed on the bottom surface thereof. The placement surface 40 has a width dimension slightly larger than the minimum width dimension (the vertical dimension in FIG. 1) of the intraocular lens 12, and is larger than the maximum width dimension (the horizontal dimension in FIG. 1) of the intraocular lens 12. Is also a flat surface having a large axial length dimension. In addition, the height position of the mounting surface 40 is located above the height position of the bottom surface of the through hole 32 in the main body cylinder part 30, and the front end edge of the through hole 32 in the main body cylinder part 30 is A wall portion 42 (see FIG. 2) that extends upward from the bottom surface of the through hole 32 and connects to the rear end edge portion of the placement surface 40 is formed. In this way, the concave groove 36 communicates with the through hole 32, and the width dimension of the concave groove 36 is substantially equal to the width dimension of the through hole 32.

  A cover member 44 is formed integrally with the instrument body 16 on the side of the concave groove 36 (on the right side in the present embodiment). The cover member 44 has an axial dimension substantially equal to the axial dimension of the concave groove 36 and is formed with a width that is slightly larger than the width dimension of the concave groove 36. Further, the cover member 44 is connected to the instrument main body 16 by a substantially thin plate-like connecting portion 46 formed by extending the upper edge of the mounting portion 14 to the side (right side in the present embodiment). . The connecting portion 46 is thinned at a bent portion 48 extending in the axial direction of the instrument main body 16 at a substantially central portion in the width direction, and can be bent at the bent portion 48. Accordingly, the cover member 44 is configured to be able to cover the opening 38 by bending the connecting portion 46 and overlapping the concave groove 36.

  Further, a pair of left and right guide plate portions 52 and 54 extending in the axial direction of the instrument main body 16 are integrally formed on the facing surface 50 that is opposed to the lens mounting surface 40 in the cover member 44. The left and right guide plate portions 52 and 54 are formed over the entire axial direction of the cover member 44 with a distance between the facing surfaces slightly smaller than the width dimension of the concave groove 36. In addition, the outer peripheral edge part of the opposing surface 50 is formed a little thick over the entire periphery, and the left and right guide plate parts 52 and 54 are further protruded from the outer peripheral edge part of the opposing surface 50. .

  Further, a central guide plate portion 56 extending in the axial direction of the instrument body 16 in parallel with the left and right guide plate portions 52 and 54 is integrally formed at a substantially central position between the opposing surfaces of the left and right guide plate portions 52 and 54 on the opposing surface 50. Has been. The central guide plate portion 56 has a height dimension that slightly protrudes from the outer peripheral edge portion of the opposing surface 50 formed thick, and extends from the outer peripheral edge portion over the entire axial length of the opposing surface 50. Are integrally formed.

  An engagement piece 60 is formed to protrude from the edge of the cover member 44 opposite to the connecting portion 46, while the end of the mounting portion 14 opposite to the cover member 44 protrudes outward. A protruding edge 62 is formed, and an engagement notch 64 is formed at a position corresponding to the engagement piece 60 in the protruding edge 62.

  Further, an appropriate number of injection holes 66 penetrating in the thickness direction are formed in the cover member 44 at appropriate positions, and an appropriate lubricant is supplied into the instrument body 16 as needed through the injection holes 66. It can be injected.

  Further, an insertion tube portion 20 is integrally formed at the front end portion of the instrument body 16 in front of the placement portion 14. The insertion cylinder part 20 is shown in FIG. 3 and FIG. The insertion tube portion 20 is formed with an outer shape that gradually tapers from the proximal end portion on the placement portion 14 side as a whole toward the distal end portion in the extending direction (left direction in FIG. 3). A through hole 68 penetrating the entire length in the extending direction is formed. One end of the through hole 68 is a base end opening 70 communicating with the mounting portion 14, and the end opposite to the base end opening 70 is a front end opening 72.

  In particular, as shown in FIG. 3, the insertion tube portion 20 in this embodiment includes a proximal end portion 74, an intermediate portion 76, and a distal end portion 78 in order from the placement portion 14 side. The base end portion 74 has a substantially constant cross-sectional shape and a shape extending in the axial direction. On the other hand, the intermediate portion 76 and the front end portion 78 have a tapered shape in which the cross-sectional area in the direction perpendicular to the axis gradually decreases toward the front end portion with a substantially constant area reduction ratio. Here, the area reduction rate per axial length of the intermediate portion 76 is larger than the area reduction rate per axial length of the tip portion 78, and the area per axial length of the insertion tube portion 20. The reduction ratio is maximized at the intermediate portion 76, while the area reduction ratio is sufficiently reduced at the tip portion 78, and extends straight with a substantially constant cross-sectional shape.

  The through-hole 68 is formed with a bottom surface 80 that is continuous from the lens mounting surface 40 without a step, and a top surface 82 that is opposed to the upper surface of the bottom surface 80. The width dimension of the bottom surface 80 is equal to the lens placement surface 40 of the placement part 14 at the base end part 74 and is a constant width dimension slightly larger than the outer diameter dimension of the optical part 24 of the intraocular lens 12. On the other hand, in the intermediate portion 76, the width is gradually changed from a slightly larger width dimension to a smaller width dimension than the outer diameter dimension of the optical portion 24 as it goes from the proximal end portion 74 side to the distal end portion 78 side. . In the present embodiment, in the through hole 68 whose width dimension gradually decreases toward the distal end portion, the range where the width dimension is larger than the outer diameter dimension of the optical portion 24 of the intraocular lens 12 is the introduction portion 84, A small range is set as the delivery portion 86, and the introduction portion 84 is formed to include a range where the width dimension of the through hole 68 is larger than the outer diameter dimension of the optical portion 24 in the base end portion 74 and the intermediate portion 76. Yes. Therefore, it is difficult for the intraocular lens 12 to enter the delivery unit 86 in a non-deformed free state, and the optical unit 24 is curved and deformed when it is fed into the delivery unit 86.

  Further, as shown in FIG. 5, the through hole 68 has a half-moon shape or a mirror shape at the proximal end opening 70, and is gradually deformed into a substantially oval shape as it goes to the distal end opening 72. Thereby, in the introducing | transducing part 84, the curvature radius of the bottom face 80 in the axial direction cross section of the instrument main body 16 is made larger than the curvature radius of the top | upper surface 82, and especially in this embodiment, the bottom face 80 in the introducing | transducing part 84. Is a flat surface with an infinite curvature radius. The bottom surface 80 at the distal end portion of the introducing portion 84 is formed with an inclined surface 88 that is gradually inclined upward as it goes forward in the axial direction. The flat surface is included. On the other hand, the top surface 82 of the through hole 68 is a flat surface having no step over the entire length in the axial direction.

  A pair of guide rails 90, 90 projecting toward the top surface 82 is formed at the center in the width direction of the bottom surface 80 of the introduction portion 84. The guide rail 90 is a ridge extending linearly in the axial direction of the instrument body 16 over a predetermined dimension. In particular, the guide rail 90 in this embodiment is positioned at the distal end portion of the inclined surface 88 with the distal end portion slightly exceeding the distal end portion of the introduction portion 84. In particular, the distal end portion of the guide rail 90 extends to a position where the width dimension of the bottom surface 80 of the intermediate portion 76 in the lens pushing direction is smaller than the outer diameter dimension of the optical portion 24 of the intraocular lens 12. On the other hand, the rear end portion of the guide rail 90 extends beyond the rear end portion of the introduction portion 84 to the lens placement surface 40, and is the most advanced surface of the pushing member 22 positioned at an initial position described later. It is positioned slightly forward from 130 in the lens pushing direction. In particular, in the present embodiment, the tip of the guide rail 90 is gradually sucked into the bottom surface 80 as it goes to the tip by increasing the slope 88 as it goes forward in the axial direction. Thus, the height is equal to the bottom surface 80. On the other hand, the rear end portion of the guide rail 90 is preferably an inclined surface that gradually protrudes from the lens placement surface 40 toward the top surface 82 in the extending direction of the guide rail 90. In this way, there is a risk of the pushing member 22 being caught on the guide rail 90, or the rear end portion of the guide rail 90 is positioned in front of the lens placement surface 40, so that the intraocular lens 12 is being pushed out. The possibility of getting caught when riding on the guide rail 90 from the rear can be reduced.

  The pair of guide rails 90, 90 are formed substantially parallel to each other at a predetermined distance in the width direction of the bottom surface 80 across the center in the width direction of the bottom surface 80. The separation distance is preferably substantially equal to the width dimension of a rod-shaped portion 110 (described later) of the pushing member 22, and is slightly smaller than the width dimension of the rod-shaped portion 110 in this embodiment. As a result, the pair of guide rails 90, 90 in the present embodiment are positioned on both sides of the rod-like portion 110 in the direction perpendicular to the axis of the instrument body 16 when the push-out member 22 is pushed. Further, particularly in the present embodiment, the pair of guide rails 90 and 90 are formed substantially parallel to each other, and the separation distance in the width direction of the instrument main body 16 between the pair of guide rails 90 and 90 is that of the guide rail 90. It is substantially constant over the entire length.

  Further, a pair of side rails 92 and 92 projecting toward the bottom surface 80 are formed at both ends in the width direction of the top surface 82 of the introduction portion 84. The side rail 92 is a protrusion that extends linearly in the axial direction of the instrument body 16 over a predetermined dimension. In particular, the side rail 92 according to the present embodiment has a distal end slightly beyond the introduction portion 84 and is positioned substantially equal to the distal end portion of the guide rail 90 in the axial direction of the insertion tube portion 20, while the rear end portion is It is positioned in the proximal end opening 70 which is the rear end portion of the introduction portion 84, and is formed including the top surface 82 of the introduction portion 84. Further, particularly in the present embodiment, the front end portion of the side rail 92 is gradually sucked into the inner surface of the through hole 68 toward the front end so as to be equal to the inner surface of the through hole 68. . On the other hand, the rear end portion of the side rail 92 is preferably an inclined surface that gradually protrudes from the top surface 82 toward the bottom surface 80 in the extending direction of the side rail 92. In this way, the risk of the intraocular lens 12 being caught on the side rail 92 can be reduced. Further, particularly in the present embodiment, the pair of side rails 92 and 92 are formed substantially parallel to each other, and the separation distance in the width direction of the instrument main body 16 between the pair of side rails 92 and 92 is the same as that of the side rail 92. It is substantially constant over the entire length.

  As described above, the instrument main body 16 in the present embodiment is an integrally molded product including the main body cylinder portion 30, the placement portion 14, the cover member 44, and the insertion cylinder portion 20. Note that the instrument body 16 is formed of a light-transmitting member, and is accommodated in the instrument body 16 through the cover member 44 even when the opening 38 of the placement portion 14 is covered with the cover member 44. The intraocular lens 12 is visible.

  The pushing member 22 is inserted into the through hole 32 from the rear side of the instrument main body 16 having such a structure and assembled to the instrument main body 16. The extrusion member 22 is shown in FIGS. The extrusion member 22 is formed of, for example, the same material as that of the instrument body 16 and has a substantially rod shape having an axial length dimension slightly larger than the axial length dimension of the instrument body 16. The action portion 106 and the insertion portion 108 having a substantially rectangular rod shape are integrally formed.

  The action part 106 is configured to include a rod-like part 110 having a substantially rod shape extending on the central axis of the pushing member 22 and a thin plate-like flat part 112 extending on both sides in the width direction of the rod-like part 110. The flat portion 112 extends from the rear end portion of the rod-shaped portion 110 toward the distal end direction with a width dimension equal to that of the insertion portion 108, and is slightly rearward from the front end of the rod-shaped portion 110 from a substantially intermediate portion in the length direction of the rod-shaped portion 110. A sharpened portion 114 having a width that is gradually reduced toward the portion is formed. Here, the top view shape of the sharpened portion 114 is a shape that follows the horizontal sectional shape of the intermediate portion 76 in the through hole 68 of the insertion tube portion 20.

  The rod-shaped portion 110 has a substantially oval-shaped constant cross-sectional shape and is configured to extend straight in the axial direction. The tip surface of the rod-shaped portion 110 is an intermediate contact surface 116, while the rod-shaped portion 110 is intermediate between both side surfaces of the rod-shaped portion 110. A pair of longitudinal cutouts extending from the contact surface 116 to the base end side of the extrusion member 22 is formed so that the tip end portion 118 of the rod-like portion 110 is narrower than the base end portion. The left contact surface 120 and the right contact surface 122 are configured by the notch. The intermediate contact surface 116 forms an inclined surface whose lower end side extends from the upper end side toward the tip end side of the rod-shaped portion 110, and the intermediate contact surface 116 has a rod-shaped portion at the upper edge of the intermediate contact surface 116. While a vertical surface 124 rising in the direction perpendicular to the axis 110 is formed, a gently inclined surface 126 having a smaller inclination angle than the intermediate contact surface 116 is formed at the lower edge of the intermediate contact surface 116. . Thus, the tip end portion 118 of the rod-like portion 110 is formed with substantially the same width as a whole. Note that the tip end surface 130 of the extrusion member 22 is formed at the tip end portion in the axial direction of the gently inclined surface 126 and has a narrower width than the gently inclined surface 126.

  On the other hand, the insertion part 108 is formed with an axial dimension slightly larger than the axial dimension of the through hole 32. The insertion portion 108 has a substantially H-shaped transverse cross-sectional shape as a whole, and the width and height are slightly smaller than the width and height of the through-hole 32. In addition, a disc-shaped pressing plate portion 132 that extends in a direction perpendicular to the axis is integrally formed at the rear end edge portion of the insertion portion 108.

  Further, a locking portion 134 is formed slightly forward from the axial intermediate portion of the insertion portion 108. The locking portion 134 is formed with a claw portion 136 that protrudes into a through-hole penetrating in the axial direction of the insertion portion 108 and protrudes upward from the insertion portion 108. Then, the claw portion 136 is engaged with the locking hole 138 penetrating in the thickness direction on the upper surface of the main body cylinder portion 30 in a state where the pushing member 22 is inserted into the main body cylinder portion 30 of the instrument main body 16. Thus, the pushing member 22 is held in an inserted state in which the relative position with respect to the instrument body 16 is positioned. Note that the claw portion 136 and the locking hole 138 are formed at the positions where the distal end surface 130 of the pushing member 22 is in the engaged state and the support portion on the rear end side of the intraocular lens 12 accommodated in the placement portion 14. It is set to be a position slightly separated from the rear in the extrusion direction from 28. In addition, you may form the latching | locking part 134 and the latching hole 138 in the lower surface and side surface of the insertion instrument 10, for example.

  In the insertion device 10 for the intraocular lens 12 having such a structure, the distal end portion of the pushing member 22 is inserted into the main body cylindrical portion 30 of the device main body 16 from behind, and the claw portion 136 is locked in the locking hole 138. It is assumed that it is in the initial position.

  In addition, the intraocular lens 12 faces the lens placement surface 40 of the placement portion 14 in which the cover member 44 is opened in advance and the optical portion rear surface 140 faces the lens placement surface 40 and the intraocular lens 12. The pair of support portions 26 and 28 are placed in a state where they extend obliquely from the outer peripheral edge portion of the optical portion 24 of the intraocular lens 12 in the axial direction of the instrument body 16 and extend to the front end side and the rear end side. . Thereafter, the bent portion 48 is bent, and the opening 38 of the placement portion 14 is covered with the cover member 44, so that the intraocular lens 12 is set in the instrument main body 16 in the accommodated state. Note that the cover member 44 is maintained in the closed state by the engagement piece 60 being engaged with the engagement notch 64.

  In the mounting state on the lens mounting surface 40, the intraocular lens 12 is positioned slightly spaced forward from the most distal surface 130 of the pushing member 22 set at the initial position in the pushing direction. In addition, since the width dimension of the concave groove 36 is slightly larger than the diameter dimension of the optical unit 24 in the intraocular lens 12, the circumferential rotation of the intraocular lens 12 on the lens placement surface 40 is also possible. It has been stopped. Further, particularly in the present embodiment, the guide rail 90 extends to the lens placement surface 40, so that the center of the rear surface 140 of the optical part of the intraocular lens 12 in the placement state on the lens placement surface 40. The portion and the pair of support portions 26 and 28 are configured to come into contact with the guide rail 90.

  As described above, the intraocular lens 12 is accommodated in the insertion instrument 10. And the insertion instrument 10 in this embodiment is packaged and delivered after sterilization etc. are made in the state which accommodated the intraocular lens 12. FIG. The intraocular lens does not necessarily have to be accommodated in the insertion instrument 10 in advance, and may be placed on the placement surface 40 during treatment.

  A specific procedure in which the insertion instrument 10 according to the present embodiment, which is provided by incorporating the intraocular lens 12 and is used for an operation such as a cataract, will be described with reference to FIGS.

  After taking out from a package, it is desirable to inject | pour into the inside of the mounting part 14 or the insertion cylinder part 20 the lubricant which has viscoelastic substances, such as sodium hyaluronate, as a main component first. In particular, in the present embodiment, an injection hole 66 penetrating in the thickness direction is formed in the cover member 44, and the lubricant can be injected through the injection hole 66 with the cover member 44 closed. However, the lubricant may be injected from, for example, the distal end opening 72 of the insertion tube portion 20, or the cover member 44 is opened once and injected from the opening portion 38 of the mounting portion 14, or once the extrusion member. 22 may be pulled out from the instrument body 16 and injected from the rear end 18 of the rear end of the through hole 32.

  Subsequently, the distal end opening 72 of the insertion tube portion 20 is inserted into an incision provided in the eye tissue. Here, in this embodiment, since the distal end opening 72 has an oblique opening shape, insertion into the incision can be easily performed.

  And the press plate part 132 of the extrusion member 22 is pushed in to the instrument main body 16 side, maintaining the insertion state of the insertion cylinder part 20 to an incision. Accordingly, as shown in FIGS. 10A and 10B and FIGS. 11A and 11B, the central portion of the support portion 28 on the rear end side of the intraocular lens 12 placed on the lens placement surface 40. Then, the intermediate contact surface 116 of the pushing member 22 is brought into contact with the pushing member 22, and the pushing member 22 guides the intraocular lens 12 toward the proximal end opening 70. Here, the support portion 28 on the rear end side is placed on the guide rail 90, so that it is provided at the end edge portion on the lower end side of the intermediate contact surface 116 without being caught by the most distal surface 130 of the pushing member 22. Guided to the intermediate contact surface 116 through the gently inclined surface 126. Similarly, the rear end portion of the outer peripheral edge of the optical part 24 of the intraocular lens 12 is also guided to the intermediate contact surface 116 of the push member 22 through the gently inclined surface 126. Since the intermediate contact surface 116 of the pushing member 22 has an inclined surface with the lower end side extending toward the leading end side of the pushing member 22 rather than the upper end side, the rear end of the support portion 28 and the optical portion 24 on the rear end side. The portion is guided above the intermediate contact surface 116. However, as shown in FIGS. 11A and 12A, the rear end side of the intraocular lens 12 is supported by the central guide plate portion 56 and the left and right guide plate portions 52 and 54 provided in the cover member 44. Since the upward displacement of the portion 28 and the optical portion 24 is limited, the support portion 28 on the rear end side of the intraocular lens 12 and the rear end portion of the optical portion 24 on the intermediate contact surface 116 are substantially the same. Due to the height position, the pusher 22 can guide the optical unit 24 toward the proximal end opening 70 via the support 28 on the rear end side.

  The intraocular lens 12 fed into the introduction portion 84 (base end portion 74) through the base end opening 70 has a bottom surface 80 at the center portion of the rear surface 140 of the optical unit as shown in FIG. 12B. The side rails 92 protruded from the top surface 82 are brought into contact with both end portions of the optical unit front surface 142 in the direction orthogonal to the extrusion direction, respectively. As a result, stress toward the top surface 82 is applied to the central portion of the rear surface 140 of the optical unit, while stress toward the bottom surface 80 is applied to both side ends of the optical unit front surface 142 in the direction orthogonal to the extrusion direction. As a result, the optical unit 24 of the intraocular lens 12 is deformed into a mountain-fold state in which the optical unit front surface 142 is convex toward the top surface 82. In short, in the present embodiment, the deformation acting portion is configured including the guide rail 90 and the side rail 92.

  The optical part 24 of the intraocular lens 12 that has undergone the initial deformation in the mountain-folded state by the introduction part 84 is modeled in FIG. 12C (see also FIGS. 10C and 11C). As shown in FIG. 5, the intermediate portion 76 is deformed to be smaller and rounded. There, the optical unit 24 is deformed along the inner surface shape of the through hole 68, and the mountain-folded state is further advanced, and the optical unit front surface 142 is rounded with the top surface 82 being brought into contact therewith. Then, the optical unit 24 is modeled as shown in FIG. 12D (see also FIGS. 10D and 11D) in accordance with the through-hole 68 gradually becoming an oval shape as it goes to the tip. As shown specifically, the distal end portion 78 of the insertion tube portion 20 is rounded down into a substantially oval shape.

  As described above, when the fold state of the optical unit 24 is further advanced so that the optical unit front surface 142 is brought into contact with the top surface 82, the rear end side support portion 28 is also moved to the rear end portion of the optical unit 24. It is pushed and guided further upward along the inclined surface of the intermediate contact surface 116, and reaches the vertical surface 124 at or near the upper edge of the intermediate contact surface 116. That is, the rear end portion of the support portion 28 and the optical portion 24 on the rear end side of the intraocular lens 12 at the front end portion 118 of the push-out member 22 can be set at substantially the same height position. The optical part 24 can be guided toward the distal end part 78 of the insertion cylinder part 20 through the support part 28.

  Similarly to the optical portion 24, the rear end side support portion 28 is gradually reduced according to the through hole 68 as it goes to the front end portion, so that the rear end side support portion is supported as shown in FIG. With the portion 28 in contact with the intermediate contact surface 116 and the left and right contact surfaces 120, 122 provided at the distal end portion 118 of the pushing member 22, the intraocular lens 12 is directed toward the distal end portion 78 of the insertion tube portion 20. I can guide you.

As described above, since the wide range of the intermediate portion in the longitudinal direction of the support portion 28 on the rear end side can be deformed into a substantially S shape along the front end portion 118 of the extrusion member 22, the support on the rear end side is supported. The deformed shape of the portion 28 can be stabilized. This also is deformed into a shape unexpected rear end of the support portion 28, Ri damaged by sliding on the inner surface of the equipment main body 16 occurs during extrusion, in sac by close contact with the optical section 24 Problems such as adverse effects on the deployment of the intraocular lens 12 can be reduced or prevented as much as possible.

  Further, by bending the intermediate portion of the support portion 28 on the rear end side along the tip portion 118 of the extrusion member 22, the root portion and the tip portion of the support portion 28 on the rear end side to the optical portion 24 are extruded. The member 22 can be positioned in a balanced manner on both side portions 120 and 122 of the front end portion 118 of the member 22. As a result, the rear end side support portion 28 is stably supported by the front end portion 118 of the extrusion member 22, that is, the intermediate contact surface 116 and the left and right contact surfaces 120 and 122. Therefore, when the intraocular lens 12 is pushed out to the insertion tube portion 20 by the pushing member 22, the pushing member 22 is prevented from being displaced to one side, and the pushing force by the pushing member 22 is efficiently applied to the intraocular lens 12. Can affect. In the state in which the rear end side support portion 28 is most in contact with the front end portion 118 of the extrusion member 22, the rear end side is extended over a length of 50% or more of the length of the rear end side support portion 28. It is desirable that the support portion 28 is in contact with the front end portion 118 of the pushing member 22.

  In addition, since the rear end side support portion 28 is prevented from contacting the optical portion 24 over a wide range, the close contact between the rear end side support portion 28 and the optical portion 24 during the extrusion deformation is effectively avoided. However, the deformed shape can be stabilized. Further, since the intraocular lens 12 is pushed out while the rear end side support portion 28 is in contact with the front end portion 118 of the pushing member 22, the pushing member 22 directly presses the outer peripheral edge portion of the optical unit 24. It is possible to prevent the outer peripheral edge of the optical unit 24 from being broken or cracked.

  Further, since the intermediate contact surface 116 of the pushing member 22 has an inclined surface with the lower end side extending toward the leading end side of the pushing member 22 rather than the upper end side, the intermediate contact surface 116 is deformed along the leading end portion 118 of the pushing member 22. The support portion 28 on the rear end side can be positioned relatively above the intermediate contact surface 116. Accordingly, the outer peripheral edge portion of the optical portion 24 folded in the shape of a mountain that is convex upward can be stably pressed by the pushing member 22 through the support portion 28 on the rear end side, and the support on the rear end side is supported. It is possible to advantageously prevent problems such as entering the optical part 24 of the part 28 and the outer peripheral edge of the optical part 24 being directly pressed by the pushing member 22.

  Further, even if an upward displacement force acts on the support portion 28 on the rear end side due to the inclined surface of the intermediate contact surface 116, the vertical surface 124 is provided at the end edge portion on the upper end side of the intermediate contact surface 116. Therefore, the fact that the rear end side support portion 28 moves over the intermediate contact surface 116 and moves to the base end portion side of the pushing member 22 is related to the relationship between the rear end side support portion 28 and the vertical surface 124 of the intermediate contact surface 116. Therefore, the support portion 28 on the rear end side can be stably maintained in a desired deformed shape.

  Further, the distal end side support portion 26 positioned forward in the pushing direction of the intraocular lens 12 enters the rounded optical portion 24 as the optical portion 24 is rounded according to the inner surface shape of the through hole 68. Is done. As a result, a tacking state is expressed in the intraocular lens 12 in the through hole 68.

  And the intraocular lens 12 is sent to the front-end | tip opening part 72 of the insertion cylinder part 20, maintaining this tacking state. In this case, since the distal end opening 72 has an oblique shape, the deformed state of the intraocular lens 12, that is, according to the present embodiment, the tucked state is maintained longer and gradually exposed from the distal end opening 72. It can be made. Accordingly, the intraocular lens 12 can be pushed out from the instrument body 16 in a tucked state and inserted into the sac, and the contact of the support part 26 on the distal end side preceding the optical part 24 into the sac is suppressed. The risk of reversal of the intraocular lens 12 accompanying this can be reduced.

  Further, in a state where the intraocular lens 12 is placed on the placement surface 40, the support portion 28 on the rear end side obliquely extends in the axial direction of the instrument main body 16 and extends toward the rear end side. The base side of the support portion 28 is positioned on one side surface (lower side in FIG. 10) of the concave groove 36, and the front end side of the support portion 28 on the rear end side is the other side surface side of the concave groove 36 (FIG. 10). (Middle, upper side). Thereby, the intermediate contact surface 116 of the pushing member 22 can be advantageously brought into contact with the longitudinal intermediate portion of the support portion 28 on the rear end side, and the support portion 28 on the rear end side is advantageously deformed into a desired deformed shape. Can be made.

  As mentioned above, although embodiment of this invention was explained in full detail, these are illustration to the last, Comprising: This invention is not limited at all by the specific description in these embodiment.

  In the present embodiment, the distal end portion 118 of the rod-shaped portion 110 is formed with substantially the same width as a whole, but the distal end portion 118 of the rod-shaped portion 110 may be gradually narrowed forward in the axial direction. As a result, the rear end side support portion 28 can be brought into contact with the front end portion 118 of the pushing member 22, that is, the left and right contact surfaces 120, 122 in a wider range.

  Further, in the present embodiment, the intermediate contact surface 116 and the vertical surface 124 of the front end portion 118 of the rod-shaped portion 110 that contacts the support portion 28 on the rear end side have a planar shape, but as shown in FIG. Thus, the curved surface may be convex forward in the axial direction (leftward in FIG. 13). As a result, a substantially S-shaped bend along the front end portion 118 of the support portion 28 on the rear end side can be advantageously developed, and the support portion on the rear end side on the front end portion 118 of the pushing member 22, i. 28 can be more closely attached.

  In addition, although the gently inclined surface 126, the intermediate contact surface 116, and the vertical surface 124 of the front end portion 118 of the rod-shaped portion 110 that comes into contact with the support portion 28 on the rear end side are flat, they are downward in side view (FIG. 9). The curved surface may be convex in the middle or downward direction. Accordingly, the support portion 28 on the rear end side can be more smoothly guided to the front end portion 118 of the push member 22, that is, the gently inclined surface 126, the intermediate contact surface 116, and the vertical surface 124. The gently inclined surface 126, the intermediate contact surface 116, and the vertical surface 124 may be one curved surface.

  Furthermore, in this embodiment, although the case where the support part 28 of the rear end side was mounted on the guide rail 90 was described, the same effect is acquired even if it does not exist. For example, when the support portion 28 on the rear end side comes into contact with the intermediate contact surface 116 due to the provision of the gently inclined surface 126 at the lower edge of the intermediate contact surface 116, the rear end side support is supported. The portion 28 can be smoothly guided upward.

  Further, in this embodiment, the deforming action part is configured to include the guide rail 90 and the side rail 92, but may be adopted as long as the optical part 24 of the intraocular lens 12 is deformed to be convex upward. It is.

10: Insertion instrument, 12: Intraocular lens, 14: Placement part, 16: Instrument body, 18: Rear end part, 20: Insertion cylinder part, 22: Extruding member, 24: Optical part, 26: Support on the front end side Part: 28: support part on the rear end side, 40: mounting surface, 44: cover member, 70: base end opening part, 74: base end part, 76: intermediate part, 78: front end part, 80: bottom face, 82 : Top surface, 84: introduction part, 90: guide rail, 92: side rail, 106: action part, 110: bar part, 112: flat part, 116: intermediate contact surface, 118: tip part (bar part), 120 : Left contact surface, 122: right contact surface, 124: vertical surface, 126: gently inclined surface, 140: rear surface of optical unit, 142: front surface of optical unit

Claims (7)

An intraocular lens insertion device for inserting an intraocular lens formed of a soft synthetic resin material in which both the optical part and the pair of longitudinal support parts can be folded,
A cylindrical instrument body having a placement portion on which the intraocular lens is placed;
A push-out member that is inserted from the rear end of the instrument body and pushes the intraocular lens into the eye from an insertion tube provided at the tip of the instrument body,
The pair of support portions of the intraocular lens are placed on the mounting portion so as to extend to the front end side and the rear end side of the instrument body, and the length direction in the support portion extends to the rear end side. The base portion on one end side is positioned on one side in the width direction of the mounting portion, and the tip portion on the other end side in the length direction of the supporting portion is positioned on the other side in the width direction of the mounting portion. Accordingly, while the length direction of the intermediate portion of the support portion is in so that extend toward the other side from one side of spaced by the placing portion in the width direction to the rear side of the optical faculties,
An intermediate contact surface that contacts an intermediate portion in the longitudinal direction of the support portion, which is positioned between the optical portion and the extrusion member in the extrusion direction of the extrusion member , the length in the support portion deformed is allowed to be pressed is the extrusion member along the distal end portion of the extrusion member with the side edges of the intermediate contact surfaces extending out toward the base end side of the pusher member A left contact surface and a right contact surface that are in contact with a left side portion and a right side portion in the length direction sandwiching the middle portion in the length direction are provided, respectively.
The intraocular lens is pushed out to the insertion tube portion by the push member while the support portion is in contact with the intermediate contact surface, the left contact surface, and the right contact surface of the push member. An insertion device for an intraocular lens,   In the state where the support portion on the rear end side of the instrument body is in contact with the tip portion of the push member, the support portion extends over a length of 50% or more of the length dimension of the support portion. The intraocular lens insertion device according to claim 1, wherein is in contact with the distal end portion of the pushing member.   The distal end portion of the extrusion member has a rod shape, and the distal end surface of the distal end portion is the intermediate contact surface, while the proximal end of the extrusion member extends from the distal end surface to both side surfaces of the distal end portion. A pair of longitudinal cutouts extending toward the part side are formed so that the distal end portion of the pushing member is narrower than the base end portion, and the left contact surface and the The intraocular lens insertion device according to claim 1 or 2, wherein the right contact surface is configured. While the deforming action part for deforming the optical part of the intraocular lens to be convex upward is formed between the placing part and the insertion tube part,
The intraocular lens according to any one of claims 1 to 3, wherein the intermediate contact surface of the push-out member includes an inclined surface whose lower end side extends toward the front end side of the push-out member than the upper end side thereof. Insertion instrument.   The intraocular lens insertion device according to claim 4, wherein a vertical surface that rises in a direction perpendicular to the axis of the push-out member is formed at an edge portion on the upper end side of the intermediate contact surface.   The intraocular lens insertion device according to claim 4 or 5, wherein a gently inclined surface having an inclination angle smaller than that of the inclined surface is formed at an end edge portion on the lower end side of the intermediate contact surface.   It is provided in a state where the intraocular lens is built in the mounting part of the instrument body, and extends to the rear end side of the instrument body among the pair of support parts of the intraocular lens. The said support part is diagonally crossed in the axial direction of the said instrument main body from the outer peripheral edge part of the said optical part of the said intraocular lens, and has extended to the said rear end side. Intraocular lens insertion instrument.

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