JP6427896B2 - Intraocular lens insertion device and intraocular lens insertion system - Google Patents

Description

  The present invention relates to an intraocular lens insertion device and an intraocular lens insertion system for inserting a spectacle lens into the eye.

  Conventionally, a technique of inserting an intraocular lens instead of a crystalline lens after extracting the crystalline lens is generally used as one of the surgical methods for cataract. A soft intraocular lens is used to reduce the incision in the patient's eye that is provided to insert the intraocular lens, and the intraocular lens is bent slightly with an intraocular lens insertion device and inserted into the eye. It has been. As a soft intraocular lens, an intraocular lens having an optical unit that provides diopter of a patient's eye and a support unit that supports the optical unit in the eye is widely used.

  As an intraocular lens insertion device that inserts a soft intraocular lens into the eye, an intraocular lens insertion device that pushes an intraocular lens by locking a support portion to an extrusion rod is known (Patent Document 1).

JP2012-125355A

  However, since the intraocular lens insertion device of Patent Document 1 pushes the support portion above the push-out rod and pushes it out, when the intraocular lens is ejected from the insertion portion, the tip of the push-out rod is located between the support portion and the lens capsule. Located between. When the push rod is pulled back to the cornea side of the patient's eye, the support portion may be caught by the uneven shape of the push rod, and the intraocular lens may move in an unintended direction. The operator needs to move the distal end of the push rod toward the lens capsule, sufficiently pull the push rod away from the support, and then pull the push rod back toward the incision, which complicates the operation.

  An object of the present invention is to provide an intraocular lens insertion device or an intraocular lens insertion system that can easily eject an intraocular lens.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) A cylindrical insertion part having an optical part and a support part extending outward from the peripheral part of the optical part and having a deformable intraocular lens whose front face is directed toward the cornea in the eye and having an opening at the tip An intraocular lens insertion device that is inserted into the eye by advancing a rod-like push member, wherein the push member is provided on the distal end side of the push shaft and pushes out the optical part; A locking portion that is provided on the base end side and that faces the front side of the support portion and locks the support portion, and the locking portion is formed in a recessed shape that is recessed toward the center of the extrusion shaft. The base end surface of the engaging portion facing the distal end direction of the extrusion shaft is continuously inclined in one lateral direction with respect to the axial direction of the extrusion shaft .
(2) A deformable intraocular lens having an optical part and a support part extending outward from a peripheral part of the optical part and having a front face directed toward the cornea in the eye is prefilled, with the intraocular lens at the tip An intraocular lens insertion system in which a rod-like push-out member is advanced into a cylindrical insertion portion having an opening to be inserted into the eye, wherein the push-out member is provided on the distal end side of the push-out shaft, and the optical unit is An extruding part for extruding, and an engaging part provided on a proximal end side from the extruding part and facing the front surface side of the supporting part, and engaging the supporting part, wherein the engaging part includes the extrusion shaft It is formed in a depressed shape that is depressed toward the center, and the base end surface facing the distal end direction of the extrusion shaft among the locking portions is continuously inclined in one lateral direction with respect to the axial direction of the extrusion shaft. It is characterized by being.

  ADVANTAGE OF THE INVENTION According to this invention, the intraocular lens insertion instrument or intraocular lens insertion system which can inject | emit an intraocular lens easily can be provided.

It is the perspective view which looked at the intraocular lens insertion instrument of this embodiment from diagonally upward. It is the perspective view which looked at the intraocular lens insertion instrument of FIG. 1 from diagonally downward. It is a perspective view from diagonally downward of the state which opened the set member. It is the perspective view which looked at the plunger from diagonally downward. It is a figure which shows the front-end | tip vicinity of a plunger, (a) Bottom view, (b) It is a left view. It is a figure of the intraocular lens used by this embodiment, (a) Top view, (b) It is a side view. It is the figure which mounted the intraocular lens in the mounting part, (a) Bottom view, (b) It is sectional drawing of the state seen from the side surface. It is sectional drawing of the mounting part at the time of starting insertion. (A) The cross-sectional view of the deformation | transformation mechanism provided in the insertion part, (b) The bottom view which shows the folded intraocular lens. It is a perspective view of the state where the intraocular lens was discharged. It is a figure which shows the 1st modification of a latching | locking part, and is a cross-sectional view seen from the front end side of the extrusion member. It is a figure which shows the 2nd example of a change of a latching | locking part, and is a cross-sectional view seen from the front end side of the extrusion member.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. In the following description, the direction of the distal end portion 122 of the main body 100 (lower left side in FIG. 1) is the distal end direction (front), and the direction of the pressing portion 220 of the plunger 200 (upper right side of FIG. 1) is the base end. The direction (rear) is described. In addition, the upper side, the lower side, the lower right side, and the upper left side in FIG. 1 are described as the upper, lower, right, and lower sides of the intraocular lens insertion device 10, respectively.

  Further, in the intraocular lens insertion device 10 of the present embodiment, the direction when pushing the intraocular lens 1 (see FIG. 1) and the direction when filling the intraocular lens 1 (see FIG. 2) are inverted up and down. Used in the state

  An intraocular lens insertion device 10 according to this embodiment shown in FIG. 1 is used to send a deformable intraocular lens 1 into the eye. FIG. 1 is a diagram showing a vertical direction of an intraocular lens insertion device 10 held by the operator or an assistant when the intraocular lens 1 is completely filled and starts to push out the intraocular lens 1. FIG. 2 is a diagram illustrating the up-down direction of the intraocular lens insertion device 10 that is held by the hand of an operator or assistant when the intraocular lens insertion device 10 is filled with the intraocular lens 1. In the intraocular lens insertion device 10 of the present embodiment, the vertical direction of the intraocular lens insertion device 10 when filling the intraocular lens 1 is different from the vertical direction when the intraocular lens 1 starts to be pushed out. Reverse with respect to the extrusion axis A of the instrument 10.

  The intraocular lens insertion device 10 includes a main body 100 and a plunger 200. The main body 100 is a cylindrical member and bends the intraocular lens 1 small. The plunger 200 is a rod-shaped member for pushing out the intraocular lens 1, and is attached to the main body 100 so as to move forward and backward as pushing means for the intraocular lens 1.

  Since the main body 100 and the plunger 200 are formed of a resin material, the intraocular lens insertion device 10 of the present embodiment can be easily discarded after use. The intraocular lens insertion device 10 may be formed by molding, cutting by resin cutting, or the like. By being formed of a resin material, the manufacturing cost of the intraocular lens insertion device 10 can be reduced, and can be provided to the user at a low cost.

In the intraocular lens insertion device 10 of the present embodiment, a lubricous coating process is performed on the cylindrical inner wall of the main body 100 in order to push out the adhesive soft intraocular lens 1. Note that the set member 146 has a part of the surface formed as a rough surface instead of performing the lubrication coating process. Moreover, the intraocular lens insertion device 10 of this embodiment is formed in colorless and transparent.
<Main body>

  The main body 100 includes an insertion unit 120 and a placement unit 140. The insertion portion 120 includes a substantially cylindrical insertion tube portion 124 having an open distal end portion 122 at the distal end. The placement unit 140 includes a placement surface 142 on which the intraocular lens 1 before extrusion is placed, an opening 144 in which an opening for placing the intraocular lens 1 on the placement surface 142 is formed, and the opening 144 is blocked. A plate-like set member 146 that can be opened and closed is provided (see FIG. 3).

  The distal end portion 122 is an inclined surface that is inclined with respect to a surface orthogonal to the extrusion axis A, and is an opening end surface 123 that is formed to be inclined in the direction of the rear surface 2B of the optical portion 2 of the placed intraocular lens 1. have. In other words, a bevel is formed so that the opening end surface 123 faces the rear surface 2B side of the intraocular lens 1 (downward in the intraocular lens insertion device 10). In addition, a notch 121 that is cut in a V shape toward the proximal end is formed at the proximal end of the opening end surface 123.

  Note that it is only necessary that the opening end surface 123 is formed so as to be inclined in the direction in which the locking portion 282 faces as viewed from the direction perpendicular to both the extrusion axis A and the direction in which the locking portion 282 faces. In other words, it is only necessary that the opening end surface 123 is formed so as to be inclined downward as viewed from the front end direction of the extrusion shaft A. When viewed from the front end direction of the extrusion shaft A (the side on which the set member 146 is located in FIG. 1) is 0 degree, it is inclined toward any direction within a range of −45 ° to + 45 ° including 0 °. An opening end face 123 is preferably formed. More preferably, it is formed toward 0 degree.

  In addition, the opening end surface 123 of this embodiment is formed in the shape equivalent to the shape which straightly cut the cylindrical front-end | tip part 122 from the direction which cross | intersects the extrusion axis | shaft A. The shape for cutting the front end portion 122 is not limited to straight advancement from the direction intersecting the extrusion axis A. The opening end surface 123 may be formed in a shape equivalent to a shape obtained by cutting the tip portion 122 at an asymmetric angle with respect to the extrusion axis A.

  Since the opening end surface 123 is inclined, the discharging direction of the intraocular lens 1 discharged from the distal end portion 122 is discharged while being bent in the direction in which the opening end surface 123 is inclined with respect to the direction of the extrusion axis A. Further, since the incision 121 is formed, when the distal end portion 122 is inserted into the incision of the patient's eye, the cylindrical distal end portion 122 is deformed so that the outer diameter becomes smaller.

  The insertion cylinder part 124 is formed in a tapered shape in which the cylindrical inner diameter gradually decreases toward the distal end of the extrusion shaft A. The intraocular lens 1 passing through the insertion tube portion 124 is gradually bent slightly along the inner wall of the cylindrical inner diameter. The insertion unit 120 includes a deformation mechanism 126 (see FIG. 9A) that deforms the front surface 2A of the intraocular lens 1 into a mountain fold shape.

  Specifically, the shape of the inner wall of the cross section of the cylindrical insertion tube portion 124 is formed asymmetrically between the upper side and the lower side. The shape of the inner wall in the direction facing the front surface 2A of the intraocular lens 1 is distorted outward, and the shape of the inner wall in the direction facing the rear surface 2B is formed as a flat surface (FIG. 9A). reference). A deformation mechanism 126 that combines a tapered tapered inner wall with a shape of an inner wall whose cross section is vertically asymmetric, and the front surface 2A of the intraocular lens 1 is deformed into a mountain fold (that is, convex toward the front side). Is formed.

  Further, the mounting portion 140 is connected to the proximal end side of the insertion tube portion 124. The placement unit 140 includes a placement surface 142 on which the intraocular lens 1 is placed, an opening 144, and a set member 146. The placement unit 140 is a place where the intraocular lens 1 is placed immediately before it is pushed out, and the intraocular lens 1 is placed on the placement surface 142 by an operator or an assistant (see FIG. 3).

  As shown in FIG. 3, an opening 144 is provided below the placement surface 142. The opening 144 has an opening area through which the intraocular lens 1 can pass. A plate-like set member 146 that shields the opening of the opening 144 is connected to the opening 144 by a hinge mechanism. The hinge shaft of the hinge mechanism extends in the left-right direction perpendicular to the extrusion shaft A. By the hinge mechanism, the set member 146 can be rotated toward the distal end of the push-out axis A of the intraocular lens insertion device 10. By opening the set member 146, the opening of the opening 144 is opened and closed.

  The set member 146 has an inner wall surface 147 that forms an inner wall of the mounting portion 140 that is cylindrical when closed. The inner wall surface 147 of the set member 146 is formed with an axial groove 148 that reduces the axial displacement of the plunger 200 and a rough surface portion 149 that is formed with a rough surface that reduces adhesion between the inner wall surface 147 and the intraocular lens 1. Has been. The axial groove 148 is a recessed groove extending in a direction parallel to the axis of the extrusion shaft A, and is formed by causing the surface of the inner wall surface 147 to be recessed.

  As shown in FIG. 2, a plurality of locking holes 180 (first locking holes 180A and second locking holes 180B) are formed on the bottom surface of the main body 100 closer to the base end side than the mounting portion 140. Yes. The first locking hole 180A and the second locking hole 180B are provided at different positions in the axial direction of the extrusion shaft A. The locking hole 180 is provided in order to temporarily stop the plunger 200 at a predetermined position when the plunger 200 advances the extrusion shaft A.

  When the locking hole 180 of the main body 100 and the locking projection 262 (see FIG. 4) formed on the plunger 200 are engaged, the sliding resistance when the plunger 200 travels changes, and the plunger 200 Can be locked in place. Note that the sliding resistance generated between the main body 100 and the plunger 200 is reduced (decreased) at the moment when the plunger 200 is advanced and the locking hole 180 and the plunger 200 are engaged.

  The position where the second locking hole 180B is formed is such that the second locking hole 180B and the locking projection 262 engage when the tip of the plunger 200 reaches a substantially middle point of the length of the insertion portion 120. It is formed as follows. When the second locking hole 180B and the locking projection 262 are engaged, the intraocular lens 1 is positioned inside the cylindrical insertion portion 120 and is bent.

  The first locking hole 180 </ b> A is provided to define the progress start position of the plunger 200. When the locking protrusion 262 and the first locking hole 180 </ b> A are in a position to be engaged, the pushing portion 284 and the locking portion 282 (details will be described later) of the pushing member 280 are positioned at the opening of the opening portion 144. (See FIGS. 3 and 7).

  Note that the intraocular lens insertion device 10 of the present embodiment is assembled in a state where the first locking hole 180A and the locking protrusion 262 are engaged. The completed intraocular lens insertion device 10 is housed in a case that accommodates the entire intraocular lens insertion device 10 and is transported to the site of use. The case maintains the engaged state between the first locking hole 180A and the locking protrusion 262. When the user opens the set member 146 with the intraocular lens insertion device 10 turned upside down, the pushing portion 284 and the locking portion 282 are positioned below the opening of the opening 144.

  Further, the main body 100 is formed with a gripping portion 160 that protrudes in the vertical direction from the exterior surface of the cylindrical main body 100 on the base end side from the mounting portion 140. The grasping portion 160 has an area that can be grasped by a finger of a hand when an operator or an assistant pushes out the plunger 200.

  The main body 100 includes an index 190 (see FIG. 1) that guides the placement direction of the intraocular lens 1 placed on the placement unit 140. The index 190 is located on the exterior surface (that is, the upper surface of the main body 100) on the back side of the placement surface 142, and is formed by making the exterior surface uneven in a predetermined shape. In the main body 100 of the present embodiment, the contour shape of the intraocular lens 1 is formed as the index 190. Since the main body 100 is formed of colorless and transparent, an operator or an assistant can visually recognize the indicator 190 formed on the exterior surface from the placement surface 142 side (that is, the bottom surface side).

  The index 190 of this embodiment is when the intraocular lens 1 is placed so that the front surface 2A of the optical unit 2 faces the placement surface 142 (that is, the front surface 2A and the placement surface 142 face each other). The contour shape of the intraocular lens 1 as viewed from above the mounting surface 142 (that is, the bottom surface side) is formed as an index 190 on the main body 100.

  The index 190 may be provided at a place other than the main body 100. For example, the index 190 may be provided in a case that houses the intraocular lens insertion device 10. Further, for example, the indicator 190 may be provided on a protective member that is attached when the intraocular lens insertion device 10 is transported and is removed when the intraocular lens 1 is inserted.

The index 190 is not limited to the contour shape of the intraocular lens 1 and may be described in other shapes or characters. The direction of the intraocular lens 1 placed on the placement unit 140 may be guided by the index 190. More preferably, the direction of the front surface 2 </ b> A of the intraocular lens 1 placed on the placement unit 140 and the direction of the support unit 3 may be guided by the index 190.
<Plunger>

  The plunger 200 will be described with reference to FIG. The plunger 200 includes a push member 280 that is in contact with the intraocular lens 1 at the tip. The plunger 200 includes an extrusion rod 260, a shaft base portion 240, and a pressing portion 220.

  At the base end of the plunger 200, a pressing portion 220 is formed on which the operator's finger abuts when the operator pushes the plunger 200 out. A plate-like member orthogonal to the extrusion axis A is formed on the pressing portion 220. A rod-shaped shaft base portion 240 extending in the direction of the extrusion shaft A is connected to the distal end side of the pressing portion 220.

  The shaft base portion 240 is connected to the shaft plate extending in the distal end direction of the extrusion shaft A, the upper end portion and the lower end portion of the shaft plate, and extends in the distal end direction of the extrusion shaft A, and the shaft plate, the top plate, and the bottom plate. And a vertical plate orthogonal to the extrusion axis A is formed. Due to the shaft plate, the top plate, the bottom plate, and the vertical plate, the shaft base portion 240 has rigidity that is difficult to bend even when stress is applied in the axial direction of the extrusion shaft A from the top, bottom, left, and right directions. In addition, the shaft base portion 240 serves as a rotation prevention mechanism that prevents shaft rotation of the plunger 200 including the pushing member 280 during extrusion of the plunger 200. Even if the plunger 200 is pushed out by the rotation prevention mechanism and the pushing member 280 jumps out from the tip end portion 122, the direction in which the opening end surface 123 is inclined and the direction of the locking portion 282 described later are maintained.

  An extrusion rod 260 is connected to the distal end side of the shaft base portion 240. The push rod 260 is formed with a shaft rod extending in the direction of the distal end of the push shaft A, and an overhanging plate extending in the left and right directions from the left and right ends of the shaft rod. Further, a locking projection 262 that protrudes toward the bottom surface and engages with the locking hole 180 of the main body 100 is formed at the base end of the shaft base portion 240.

  The overhang plate reduces the lateral deflection of the push rod 260. The locking projection 262 is formed as a blade-like member that is inclined and extended toward the proximal direction from the lower end of the shaft rod (the upper end in the state of FIG. 4 in which the top and bottom are inverted). Due to the blade shape, the locking projection 262 has elasticity in the vertical direction. When stress in a direction intersecting the axial direction of the extrusion shaft A is applied to the locking projection 262, the tip end portion of the locking projection 262 is bent. While the plunger 200 is moving, the locking protrusion 262 advances through the main body 100 in a bent state.

  A rod-shaped push member 280 is connected to the tip of the push rod 260. On the distal end side of the pushing member 280, a pushing portion 284 that pushes out the optical portion 2 of the intraocular lens 1 is formed. A locking part for locking the support part 3 facing the front side of the support part 3 of the intraocular lens 1 (that is, in a state facing the front side of the support part 3) on the proximal side from the push-out part 284 282 is formed (see FIG. 5).

  Specifically, the pushing member 280 has a rod-shaped shaft 281 formed at the base end. A proximal end surface 286 is formed on the distal end side of the shaft rod 281. The base end surface 286 is a base end of the locking portion 282. A plate-like flat plate portion 283 extending in the distal direction parallel to the extrusion axis A is connected to the upper end portion of the base end surface 286 (that is, the lower end in FIG. 5B).

  In the intraocular lens insertion device 10 of the present embodiment, the end portion 292 of the proximal end surface 286 in the distal direction of the extrusion axis A is disposed at a position 3 to 4 mm from the extrusion portion 284. Further, the base end surface 286 may be inclined in the direction of the extrusion axis A (lower left direction in FIG. 5B). By tilting in the direction of the extrusion axis A, it is considered that the rear support portion 3B is less likely to come off from the locking portion 282 during the extrusion of the intraocular lens 1. In addition, a projection or projection plate that is parallel to the extrusion axis A and extends in the distal direction is provided at the end of the base end surface 286 in a direction away from the flat plate portion 283 (the upper end in FIG. 5B). May be.

  A transition portion 287 whose cross-sectional area increases toward the tip is connected to the tip of the flat plate portion 283. The transition portion 287 is formed with a release slope 288 inclined in the proximal direction. That is, the release inclined surface 288 is inclined with respect to a plane orthogonal to the extrusion axis A so as to face in a direction away from the extrusion axis A (upward in FIG. 5B).

  A locking portion 282 for locking the support portion 3 of the intraocular lens 1 is formed by the base end surface 286, the flat plate portion 283, and the transition portion 287. The locking portion 282 may form a depressed portion 291 in which a rod-like pushing member 280 is depressed toward the center of the pushing shaft A. The depressed portion 291 is formed with a depressed amount in which the sectional area in the axial direction of the depressed portion 291 is larger than the sectional area of the transverse section of the support portion 3.

  By locking the support portion 3 with the locking portion 282 (in this embodiment, the base end surface 286 of the locking portion 282), the support portion 3 extends rearward when the intraocular lens 1 is pushed out, and becomes an extrusion member 280. Tangling is suppressed. Therefore, the phenomenon in which the support part 3 is damaged can be reduced. Further, when the intraocular lens 1 is ejected, the support portion 3 entangled with the pushing member 280 eliminates the need to rotate the intraocular lens insertion device 10 while the intraocular lens 1 is ejected.

In the intraocular lens insertion device 10 of the present embodiment, when the set member 146 opened when the intraocular lens 1 is placed is closed, the depressed portion 291 is interposed between the pushing member 280 and the inner wall surface 147 of the set member 146. Is formed in a direction perpendicular to the extrusion axis A. The support portion 3 has a shape that crosses the formed gap. In addition, a gap due to the depressed portion 291 formed between the pushing member 280 and the inner wall of the main body 100 continues to the distal end portion 122. Therefore, when the intraocular lens 1 is inserted, even if the set member 146 faces downward and the intraocular lens 1 is pushed out, the locking of the support portion 3 by the locking portion 282 is not released.
In addition, since the latching | locking part 282 latches the support part 3, it has the effect | action which pushes out the intraocular lens 1 with the extrusion part 284. FIG. The support portion 3 may be sandwiched between the depressed portion 291 and the cylindrical inner wall.

A rod-like extrusion part 284 is connected to the tip of the transition part 287. The push-out unit 284 includes a contact surface 289 that contacts the optical unit 2 of the intraocular lens 1 at the tip. At the upper end and the lower end of the contact surface 289, a plate-like protruding plate 290 protruding in the distal direction is formed. The contact surface 289 is formed as a surface perpendicular to the extrusion shaft A. The contact surface 289 of the push-out portion 284 of this embodiment is in contact with the edge 2 </ b> C of the intraocular lens 1. The overhang plate 290 is formed so that the edge 2 </ b> C does not come off from the contact surface 289 during the extrusion of the intraocular lens 1.
<Intraocular lens>

  An example of the intraocular lens 1 that can be applied to the intraocular lens insertion device 10 of the present embodiment will be described with reference to FIG. In addition, the intraocular lens insertion device 10 of this embodiment has the optical part 2 and the support part 3 extended outside from the peripheral part of the optical part 2, and the front surface 2A can be deformed so as to be directed to the cornea side in the eye. It is preferable to use a simple intraocular lens 1.

  Moreover, the support part 3 formed in the loop shape is suitable. Further, a support portion 3 formed of an open loop type in which one end is connected to the optical portion 2 and the other end is in a released state is more preferable. Moreover, the support part 3 formed with a thin filamentous filament type is more suitable. However, the present invention can also be applied to intraocular lenses other than these preferred examples.

  The intraocular lens 1 includes an optical unit 2 that gives a predetermined refractive power to the patient's eye, and a support unit 3 that supports the optical unit 2 in the eye. The optical unit 2 is formed with a circular front surface 2A and a rear surface 2B having different refractive powers.

  Since the front surface 2A and the rear surface 2B have different optical characteristics, the optical unit 2 is installed in a predetermined direction within the eye of the patient's eye. The optical unit 2 of the intraocular lens 1 of the present embodiment is designed so that the front surface 2A is installed toward the cornea of the patient's eye. In addition, the rear surface 2B is directed toward the retina of the patient's eye by setting the front surface 2A toward the cornea of the patient's eye.

  An edge 2 </ b> C having a side surface connecting the front surface 2 </ b> A and the rear surface 2 </ b> B is formed in the peripheral portion of the optical unit 2. The intraocular lens 1 of the present embodiment has two support portions 3 (a front support portion 3A and a rear support portion 3B). The support part 3 is a thin thread-like filament type, and has a circular cross section. The support part 3 is distorted in the circumferential direction of the optical part 2 toward the tip of the support part 3. Moreover, the support part 3 is formed as an open loop whose tip is an open end. The support unit 3 is connected to different positions on the periphery of the optical unit 2. Further, the support portion 3 extends toward the outside of the optical portion 2.

The material of the optical part 2 is a material such as a simple substance such as HEMA (hydroxyethyl methacrylate) or a conventional foldable soft intraocular lens such as a composite material of acrylic ester and methacrylic ester. May be. The material of the support part 3 may be a material conventionally used as a support part of an intraocular lens, such as PMMA (polymethyl methacrylate). The optical unit 2 and the support unit 3 have deformable elasticity, but have a shape retention characteristic that prevents the support unit 3 from sagging even when the front surface 2A of the optical unit 2 of the intraocular lens 1 is directed upward. ing.
<How to use>

  A user (for example, an operator or an assistant) takes out the intraocular lens insertion device 10 from the case in which the intraocular lens insertion device 10 is accommodated. Subsequently, the user holds the intraocular lens insertion device 10 by hand and opens the set member 146. Note that the set member 146 may be accommodated in the case in an open state. By storing the set member 146 in the case in an open state, the user does not need to open the set member 146 during use.

  Subsequently, the user rotates the intraocular lens insertion device 10 so that the opening 144 that appears by opening the setting member 146 faces upward (that is, the opened setting member 146 is positioned on the upper surface side). Manipulate.

  Subsequently, the user injects a viscoelastic material (not shown) into the placement unit 140. In addition, the adhesiveness of the adhesive soft intraocular lens 1 is reduced by injecting the viscoelastic substance. By the viscoelastic substance, the intraocular lens 1 can be suitably advanced without being caught on the inner walls of the cylindrical insertion portion 120 and the placement portion 140.

  Subsequently, the user refers to the index 190 provided on the exterior side of the main body 100 from the inner surface side of the main body 100 through the mounting surface 142 to which the viscoelastic substance is applied, and holds the intraocular lens grasped with an insulator or the like. The intraocular lens 1 is placed on the placement unit 140 so that the front surface 2A of the first optical unit 2 faces the placement surface 142 of the placement unit 140 (see FIG. 7).

  At this time, the optical unit 2 comes into contact with the mounting surface 142 of the main body 100 from above (that is, from the bottom side of the intraocular lens insertion instrument 10), and the rear support unit 3B contacts the locking unit 282 of the plunger 200 from above. Abutted. Note that the intraocular lens insertion device 10 of the present embodiment is manufactured in a state in which the locking protrusion 262 of the plunger 200 is engaged with the first locking hole 180 </ b> A of the main body 100. In addition, the intraocular lens insertion device 10 is accommodated in the case in a state where the first locking hole 180A and the locking protrusion 262 are engaged, and is transported to the use site.

  Since the first locking hole 180A and the locking projection 262 are transported in an engaged state, the user places the mounting member 146 when the user removes the intraocular lens insertion device 10 and opens the set member 146 at the site of use. The pushing member 280 is positioned so that the pushing portion 284 and the locking portion 282 overlap a part of the surface 142.

  Subsequently, the user rotates the set member 146 in the proximal direction to close the set member 146. Subsequently, the user rotates the intraocular lens insertion device 10 about 180 ° with respect to the extrusion axis A, and holds the intraocular lens insertion device 10 so that the set member 146 faces downward (see FIG. 8).

  Subsequently, the user pushes out the pressing portion 220 of the plunger 200 and advances the plunger 200 to a position where the locking protrusion 262 engages with the second locking hole 180B. While the locking projection 262 of the plunger 200 moves from the first locking hole 180 </ b> A to the second locking hole 180 </ b> B, the intraocular lens 1 has an inner wall that forms a tapered hollow shape of the insertion portion 120 and a deformation mechanism 126. The transformation begins to take place. When the locking projection 262 of the plunger 200 reaches the second locking hole 180B, the front surface 2A of the intraocular lens 1 is deformed into a mountain fold by the deformation mechanism 126 (see FIG. 9).

  Subsequently, the surgeon inserts the distal end portion 122 into the peripheral portion of the cornea of the patient's eye lying upward on the operating table or the incision formed in the sclera. Subsequently, the surgeon inserts the distal end portion 122 from the incision toward the anterior capsular incision, and positions the distal end portion 122 so that the anterior capsulotomy and the open end surface 123 of the distal end portion 122 face each other. Let

  Subsequently, the surgeon pushes in the pressing portion 220 of the plunger 200. When the pressing part 220 is pushed in and the engagement between the locking protrusion 262 of the plunger 200 and the second locking hole 180B is released, the intraocular lens 1 is bent further smaller as it moves to the distal end of the insertion part 120. The intraocular lens 1 is discharged from the distal end portion 122 toward the lens capsule. The optical part 2 of the folded intraocular lens 1 starts to be restored slowly after passing through the opening of the distal end part 122. The surgeon pushes the pressing portion 220 of the plunger 200 until the pushing portion 284 and the locking portion 282 are exposed from the distal end portion 122. In addition, when the base end of the main body 100 and the blade-like pressing portion 220 are in contact with each other, a large resistance force is generated, and the advance limit of the plunger 200 is reached.

  The intraocular lens 1 is ejected with the opening end face 123 facing the crystalline lens capsule, so that the intraocular lens 1 is inserted into the intraocular lens insertion device 10 so that the front surface 2A of the folded optical unit 2 faces the cornea. Discharged from. Further, since the front surface 2A of the optical unit 2 is folded in a mountain by the intraocular lens insertion instrument 10, the peripheral part of the optical unit 2 is restored from the retina side to the cornea side.

  In addition, since the intraocular lens 1 is ejected while the support portion 3 is locked to the pushing member 280, even if the intraocular lens 1 is ejected into the eye, the supporting portion 3 is not attached to the posterior capsule and the pushing member 280. (See FIG. 10).

  Subsequently, the surgeon pulls back the insertion portion 120 in which the push-out portion 284 and the locking portion 282 protrude from the cylindrical distal end portion 122 in the direction of the incision. At this time, the surgeon may adjust the direction in which the distal end portion 122 is directed, and may slightly retract the distal end of the distal end portion 122 in the corneal direction and then pull the insertion portion 120 back toward the incision.

  In addition, since the intraocular lens 1 is discharged | emitted so that the support part 3 may be located between the posterior capsule and the extrusion member 280, the intraocular lens insertion device 10 of this embodiment has a support part in the latching | locking part 282. Even if 3 is locked and pushed out, the pushing member 280 and the intraocular lens 1 can be easily separated in the eye.

  The insertion operation of the intraocular lens 1 by the intraocular lens insertion device 10 is completed by the insertion unit 120 being pulled back in the direction of the incision.

In addition, although the usage method which pulled back the insertion part 120 to the direction of an incision after discharge | emission of the intraocular lens 1 was shown, a different usage method is also considered. For example, after the intraocular lens 1 is discharged, a method in which the operator operates the plunger 200 and pulls back only the push-out member 280 protruding from the distal end portion 122 toward the proximal end of the intraocular lens insertion device 10 is also conceivable.
<Action and effect>

  As described above, the intraocular lens insertion device 10 of the present embodiment is provided on the proximal end side with respect to the pushing portion 284 and faces the front side of the support portion 3 so as to lock the support portion 3. Is formed on the extruded member 280. When the intraocular lens 1 is discharged into the eye, the intraocular lens 1 is discharged in such a positional relationship that the support portion 3 is on the capsular bag side and the pushing member 280 is on the cornea side.

  Alternatively, the opening end surface 123 inclined in a predetermined direction is formed at the distal end of the insertion portion 120, and the locking portion 282 is formed on the proximal end side from the extrusion portion 284 of the extrusion member 280. A locking portion 282 for locking the support portion 3 is formed on the surface side of the pushing member 280 in a predetermined direction facing the opening end surface 123. When the intraocular lens 1 is ejected into the eye with the opening end surface 123 facing the lens capsule, the intraocular lens 1 is ejected in such a positional relationship that the support portion 3 is on the lens capsule side and the pushing member 280 is on the cornea side. The

  The pushing member 280 is not caught on the support part 3 or the pushing part 280 is hardly caught on the pushing member 280. The intraocular lens insertion device 10 can be easily pulled back from the eye, and the intraocular lens 1 can be easily ejected. Since the possibility that the intraocular lens 1 moves carelessly after the intraocular lens 1 is discharged is reduced, the operator can quickly eject the intraocular lens 1.

  If the rear surface side of the support portion 3 is locked and the intraocular lens 1 is pushed out unlike the present invention, the support portion 3 is positioned on the cornea side and the pushing member 280 is positioned on the lens capsule side. The inner lens 1 is discharged. In this case, when the surgeon pulls back the push-out member 280, the support portion 3 is easily caught by the friction with the surface of the push-out member 280 or the uneven shape including the locking portion 282 formed on the push-out member 280. (Please refer to FIG. 10 describing the present invention for comparison).

  As a first method, when the push-out member is pulled back while the support portion 3 and the push-out member 280 are caught, the entire intraocular lens 1 moves in a direction away from the lens capsule. There is a trouble of moving the moved intraocular lens 1 in the direction of the sac with an insulator or the like. As a second method, in order to pull back the support part 3 and the pushing member 280 so as not to be caught, the tip of the pushing member 280 is once pushed toward the lens capsule so as to draw a J shape from the opposite side, and then pushed out. An operation for pulling back the member 280 is required.

  Each of the first method and the second method requires a delicate operation to eject the intraocular lens 1 and requires time to eject the intraocular lens. On the other hand, in the present invention, even when the support member 3 is locked to the pushing member 280 and discharged, the pushing member 280 can be easily pulled back in the direction of the incision.

  As the shape of the locking portion 282, for example, a locking portion 282 that is obliquely depressed with respect to the mounting surface 142 of the mounting portion 140 facing the front surface 2A of the optical unit 2 of the intraocular lens 1 is formed. May be. Further, a plurality of depressions that form the locking portion 282 may be provided (see FIG. 11). 11 and 12 are cross-sectional views corresponding to the axial positions of the flat plate portion 283 of the present embodiment.

  Further, for example, the shape of the cross section of the shaft rod 281 forming the push member 280 may be circular. Further, the direction of the depression may be from the side toward the axial direction of the pushing member 280 (see FIG. 12). The locking portion 282 formed on the push member 280 may not be formed at a position facing the rear surface side of the support portion 3. Moreover, what is necessary is just to lock the intraocular lens 1 to the latching | locking part 282 of the extrusion member 280 so that the latching | locking part 282 and the rear surface side of the support part 3 may not face.

  Further, in this embodiment, the intraocular lens insertion device 10 in which the push-out member 280 is advanced by the operator's hand pressing the plunger 200 is used, but the push-out member 280 may be advanced by other push-out means. Good. For example, an actuator may be used to advance the pushing member 280 electrically. Further, for example, a method of applying pressure to the pushing member 280 with a fluid or the like to advance the pushing member 280 can be considered.

  Also, the card ridge composed of the insertion portion 120, the placement portion 140, and the pushing member 280, or the preset type card ridge composed of the insertion portion 120, the placement portion 140, the pushing member 280, and the intraocular lens 1 is also applicable. The invention can be applied. It can be provided to the user as a cardridge type intraocular lens insertion device. Further, for example, the intraocular lens insertion device 10 may be a combination of the card ridge including the insertion portion 120 and the placement portion 140 of the present invention and the extrusion means including the extrusion member 280 of the present invention.

  In this embodiment, the three-piece type intraocular lens 1 in which the optical unit 2 and the support unit 3 are separate members is used. However, the type of intraocular lens applicable to the present invention is not limited to the three-piece type. For example, the present invention can be applied to a one-piece type intraocular lens in which the optical unit 2 and the support unit 3 are integrally formed of the same material.

  Further, in the present embodiment, the open loop type intraocular lens 1 in which the tip of the support portion 3 is a free end is used, but the shape of the support portion 3 applicable to the present invention is not limited to the open loop type. For example, an intraocular lens in which both ends of the support unit 3 are connected to the optical unit 2 may be used. Further, in the present embodiment, the intraocular lens 1 having a pair of support portions 3 (3A, 3B) is used. However, even if there is one support portion 3 or three or more support portions 3 are provided. Good.

  Further, for example, the present invention can be applied to an intraocular lens in which the optical unit 2 is formed by a plurality of lenses, and an adjusting intraocular lens in which the refractive power of the optical unit 2 is deformed by the force of the patient moving the ciliary body. It is done. That is, any deformable intraocular lens in which the support portion extends outward from the peripheral portion of the optical portion may be used.

  In addition, the intraocular lens insertion device 10 of the present embodiment can easily place the intraocular lens 1 on the placement unit 140 in a predetermined direction using the index 190. Damage to the intraocular lens 1 caused by a mistake in the placement direction of the intraocular lens 1 or a phenomenon in which the intraocular lens 1 is emitted in an unintended form is suppressed.

  Further, in the intraocular lens insertion device 10 of the present embodiment, when the set member 146 is opened, the placement surface 142 on which the intraocular lens 1 is placed appears, and the intraocular lens 1 is easily filled into the intraocular lens insertion device 10. it can. The set member 146 can open and close the corresponding portion of the inner wall of the intraocular lens insertion device 10 that faces the locking portion 282 at the position where the intraocular lens 1 is placed inside the intraocular lens insertion device 10.

  Since the set member 146 also serves as a part of the cylindrical inner wall of the main body 100, the total length of the intraocular lens insertion device 10 can be shortened. Moreover, the cross-sectional area of the cross section of the intraocular lens insertion device 10 can be reduced. The volume of the intraocular lens insertion device 10 can be reduced, and the operator can easily handle the intraocular lens insertion device 10.

  It should be noted that the intraocular lens insertion device 10 that allows the pushing member 280 to easily come into contact with the front side of the support portion 3 can be obtained only by combining the index 190 and the set member 146.

  In addition, the intraocular lens insertion device 10 of the present embodiment is configured such that the front surface 2A of the optical unit 2 is mountain-folded, so that when the folded intraocular lens 1 is discharged and restored, the peripheral portion of the optical unit 2 is It is restored from the retina side toward the cornea side. Since the edge of the optical unit 2 is restored from the retina side toward the cornea side, the possibility that the peripheral part of the optical unit 2 is in contact with the rear surface of the cornea is reduced. Further, when the push-out member 280 is pushed out, the support part 3 is difficult to come off from the locking part 282.

  Moreover, the intraocular lens insertion device 10 of this embodiment becomes easy to insert the insertion part 120 in the incision provided in a cornea because the opening end surface 123 of the front-end | tip part 122 inclines. Further, since the opening end surface 123 is inclined in the direction of the rear surface 2B of the optical unit 2, the discharged intraocular lens 1 is bent and discharged in the direction of the crystalline lens capsule. The intraocular lens 1 can be quickly placed on the lens capsule.

  Further, since the inclination direction of the opening end surface 123 and the direction in which the locking portion 282 is formed on the pushing member 280 are substantially the same direction, when the intraocular lens 1 is ejected toward the crystalline lens capsule, the support portion 3. Is the lens capsule side, and the pushing member 280 is on the cornea side. The pushing member 280 is not caught on the support part 3 or the pushing part 280 is hardly caught on the pushing member 280. Therefore, the intraocular lens insertion device 10 can be easily pulled back from the eye, and the intraocular lens 1 can be easily ejected.

  It should be noted that the intraocular lens 1 can be quickly installed only by the deformation mechanism 126 that deforms the front surface 2A of the optical unit 2 into a mountain fold and the opening end surface 123 that is inclined in the direction of the rear surface 2B. Becomes difficult to touch. There is an effect that the intraocular lens 1 can be easily inserted into the eye.

  Further, in the intraocular lens insertion device 10 of the present embodiment, the proximal end surface 286 facing the distal direction of the extrusion axis A among the surfaces of the locking portion 282 is the longitudinal direction of the intraocular lens 1 and the axial direction of the extrusion axis A. Inclined in either of the left and right directions intersecting both. Therefore, the bending load applied to the support portion 3 can be suitably released, and the bending load applied to the support portion 3 can be reduced. When the intraocular lens 1 is pushed out, the support 3 is broken, and the possibility that the intraocular lens 1 is damaged can be reduced.

  In addition, in the intraocular lens insertion device 10 of the present embodiment, the end portion 292 of the proximal end surface 286 in the distal direction of the extrusion axis A is disposed at a position 3 to 4 mm from the extrusion portion 284. When pushing out the intraocular lens 1, the support portion 3 can be suitably locked by the locking portion 282. As a result, the possibility that the support part 3 is damaged or the support part 3 is bent in an unintended direction is reduced. Therefore, the surgeon can quickly insert the intraocular lens 1.

  In addition, even if the formation position of the inclined base end face 286 or the end portion 292 is combined with the three-piece type intraocular lens, there is an effect that the three-piece type intraocular lens that can easily break the support portion 3 when it is bent greatly can be stably emitted. is there.

  The present invention can also be applied to an intraocular lens insertion system that is manufactured by filling the intraocular lens insertion device 10 with the intraocular lens 1 in advance and transported to the site of use. It is not necessary to fill the intraocular lens 1 at the site of use, and it can be used immediately. The intraocular lens 1 can be easily inserted into the eye.

  Moreover, when applying as an intraocular lens insertion system, the optical part 2 and the support part 3 may be formed of different materials, and the support part 3 may be filled with a filament type three-piece intraocular lens. In this case, even if the support part 3 is a three-piece intraocular lens that is difficult to bend and is difficult to tackle, the intraocular lens 1 can be suitably injected into the eye without the support part 3 being entangled.

  Further, the intraocular lens insertion device 10 of the present embodiment includes notch means (the locking hole 180 and the locking protrusion 262) that temporarily stops the advancing push member 280 at a predetermined position. The sliding resistance is changed at a predetermined position by the notch means. In this embodiment, sliding resistance increases. The operation of the intraocular lens insertion device 10 is facilitated by the notch means.

  The support portion 3 of the intraocular lens 1 can be easily brought into contact with the push-out member 280 by the set member 146 that opens above the placement surface 142 and the notch means that increases the sliding resistance. The intraocular lens 1 can be inserted stably without making the intraocular lens insertion device 10 complicated.

  Further, in the intraocular lens insertion device 10 of the present embodiment, the support portion 3 can be locked to the locking portion 282 simply by mounting the intraocular lens 1 on the mounting surface 142. A mechanism for locking the support portion 3 to the locking portion 282 of the pushing member 280 during extrusion becomes unnecessary, and the intraocular lens insertion device 10 can be manufactured at low cost.

  Further, the intraocular lens 1 is pushed out while the support portion 3 is locked by the locking portion 282. Therefore, the support portion 3 is not easily entangled with the plunger 200 while the intraocular lens 1 is traveling, and an operation for adjusting the direction of the intraocular lens 1 when the intraocular lens 1 is ejected is likely to be unnecessary.

  Moreover, in the intraocular lens insertion device 10 of this embodiment, the inner wall surface 147 which forms the cylindrical inner wall of the set member 146 that can be opened and closed has a rough surface portion 149 formed with a rough surface. Since the rough surface portion 149 is formed on the set member 146, adhesion between the intraocular lens 1 and the set member 146 can be reduced without performing a lubrication coating process on the set member 146. An inexpensive intraocular lens insertion device 10 can be provided.

  Further, in the intraocular lens insertion device 10 of the present embodiment, the set member 146 includes a rotating means that rotates in the distal direction of the push-out axis A by a hinge mechanism. Even if the set member 146 is closed after injecting the viscoelastic substance, the phenomenon that the viscoelastic substance is biased to one side in the left-right direction does not occur by closing the set member 146. Even with a simple configuration, it is possible to suitably apply the viscoelastic material to the mounting portion 140.

  In addition, in the intraocular lens insertion device 10 of the present embodiment, a notch 121 that is cut in a V shape toward the proximal end is formed at the proximal end of the inclined opening end surface 123. When inserting the insertion portion 120 into the incision, the outer diameter of the distal end portion 122 can be reduced. The insertion part 120 can be easily inserted into the incision.

  In addition, in the intraocular lens insertion device 10 of the present embodiment, a release slope 288 whose surface faces the proximal end is formed on the distal end side of the locking portion 282. Since the locking portion 282 faces the sac when the intraocular lens 1 is discharged, even if the release slope 288 and the support portion 3 come into contact with each other when the push-out member 280 is pulled back, the release slope 288 faces the support portion 3 in the direction of the sac. It works as an action to move to. The support portion 3 locked to the locking portion 282 can be easily pulled away from the pushing member 280.

2 Optical part 2B Rear surface 3A Front support part 3B Rear support part 120 Insertion part 140 Placement part 280 Pushing member 282 Locking part 284 Pushing part

Claims (3)

A deformable intraocular lens having an optical part and a support part extending outward from a peripheral part of the optical part and having a front surface directed toward the cornea in the eye is formed into a rod-like shape in a cylindrical insertion part having an opening at the tip. An intraocular lens insertion device for insertion into the eye by advancing the push member,
The extruded member is
An extruding part that is provided on the front end side of the extruding shaft and extrudes the optical part;
A locking portion that is provided on the base end side from the push-out portion and faces the front side of the support portion, and locks the support portion;
Equipped with a,
The locking portion is formed in a recessed shape that is recessed toward the center of the extrusion shaft, and a base end surface facing the distal direction of the extrusion shaft of the locking portion is left and right with respect to the axial direction of the extrusion shaft. An intraocular lens insertion device characterized by being continuously inclined in one direction . The intraocular lens insertion device according to claim 1,
The opening end surface provided at the distal end of the insertion portion is an inclined surface inclined with respect to a surface orthogonal to the extrusion axis for pushing out the intraocular lens, and the opening end surface is inclined in the direction of the rear surface of the optical unit. An intraocular lens insertion device which is formed. A deformable intraocular lens having an optical part and a support part extending outward from a peripheral part of the optical part and having a front surface facing the cornea in the eye is prefilled, and the intraocular lens has an opening at the tip. An intraocular lens insertion system that inserts into the eye by advancing a rod-shaped pushing member into a cylindrical insertion portion,
The extruded member is
An extruding part which is provided on the tip side of the extruding shaft and extrudes the optical part;
A locking portion that is provided on the base end side from the extrusion portion, faces the front side of the support portion, and locks the support portion;
With
The locking portion is formed in a recessed shape that is recessed toward the center of the extrusion shaft, and a base end surface facing the distal direction of the extrusion shaft of the locking portion is left and right with respect to the axial direction of the extrusion shaft. Inclined continuously in one direction
An intraocular lens insertion system.