JP6575761B2 - Intraocular lens insertion device - Google Patents

Description

  The present invention relates to an intraocular lens insertion device.

  Intraocular lenses that are inserted as a substitute for the lens for the replacement of the human turbid lens and the correction of refraction in the treatment of cataract are being put to practical use. In intraocular lens insertion surgery for cataract treatment, for example, a several millimeter incisional wound (incision) is provided at the edge of the cornea, and the lens is crushed and removed from the incision by ultrasonic phacoemulsification The intraocular lens is inserted and fixed.

  In recent years, when an intraocular lens is inserted into an eyeball from an incision, an insertion device in which an intraocular lens is loaded in a cartridge in advance is often used. The user inserts the distal end opening of the insertion tube portion provided at the distal end portion of the instrument body into the eyeball through the above-mentioned incision, and in the state where the intraocular lens is slightly deformed in the instrument body, The intraocular lens is released and inserted into the eyeball by being pushed out from the tip opening by a rod-like plunger. By using such an insertion device, the intraocular lens can be easily inserted into the eyeball using the incision formed for the removal of the crystalline lens. Astigmatism and infection can be suppressed.

  In general, an intraocular lens has a lens body and a support portion connected to the lens body. When the intraocular lens is inserted into the eyeball using the above insertion instrument, the intraocular lens is folded to match the inner wall shape of the insertion tube portion as the plunger moves the intraocular lens toward the distal opening side. It becomes a state. At this time, if the intraocular lens is simply pushed out by the plunger, the position of the intraocular lens is not determined in the insertion tube portion, and the behavior of the intraocular lens cannot be stabilized. Therefore, in Patent Document 1, Patent Document 2, and Patent Document 3, it is proposed to provide a configuration for stabilizing the behavior of the intraocular lens in the insertion tube portion at the distal end portion of the plunger.

JP 2012-50713 A JP-A-5-103803 JP 2009-18809 A

  However, in the intraocular lens insertion device shown in Patent Document 1 or Patent Document 2, the distal end portion of the plunger is merely provided with a configuration for receiving the support portion of the intraocular lens at the distal end portion of the plunger. Even after receiving the support part of the intraocular lens, the position of the support part may still change and the intraocular lens may behave abnormally. In addition, in the intraocular lens insertion device disclosed in Patent Document 3, there is a possibility of causing a so-called forward tilt emission in which the lens is tilted forward and emitted from the nozzle tip.

  The technology disclosed herein has been made in view of the above circumstances, and an object thereof is to realize an intraocular lens insertion device that can further stabilize the behavior of the intraocular lens.

  The intraocular lens insertion device of the present disclosure has an insertion tube portion that is inserted into the eye in a state in which the intraocular lens having a lens body and a long support portion having one end connected to the lens body is folded at the tip. A substantially cylindrical instrument body, a housing part that accommodates the intraocular lens in an instrument body, and an intraocular lens pushing member that slides within the instrument body and pushes the intraocular lens into the insertion cylinder part. An intraocular lens insertion device comprising: an outer peripheral surface of a distal end portion of an intraocular lens pushing member, and when the intraocular lens is moved to the insertion tube portion, a posture of at least one end side of the support portion is set. Posture regulating means for regulating is provided. This stabilizes the behavior of the intraocular lens by regulating the posture of the base portion of the support part in a direction that prevents the IOL from being forward tilted when the intraocular lens is released into the eye from the insertion part. Tilt ejection can be prevented.

  In addition, when the intraocular lens is released from the nozzle into the eye, the posture restricting means is configured such that at least a part of one end side of the support portion is upward (that is, the intraocular lens when the intraocular lens is stored in the storage unit). It is controlled to behave in the direction of the front side of the optical axis of the intraocular lens. In addition, the distal end portion of the intraocular lens pushing member further includes a cutout portion for housing the support portion, which is located on the optical axis front side of the intraocular lens housed in the housing portion, and the posture regulating means It is provided in a band-shaped region extending from the position on the rear side of the optical axis of the intraocular lens housed in the housing portion of the surface that comes into contact with the inner lens to the cutout portion. Further, the posture restricting means may be a groove into which a part of the support part is fitted, a pair of convex parts extending in parallel with each other and in contact with a part of the support part, or one of the support parts. It may be a rough surface provided in a strip shape so that the frictional force between the two portions increases.

  Furthermore, the intraocular lens insertion device of the present disclosure may be configured such that a concave portion for receiving a part on the other end side with respect to one end of the support portion is provided on the outer peripheral surface of the distal end portion. As a result, the tip of the support portion of the intraocular lens is allowed to escape into the recess, so that the tip of the support portion is sandwiched between the pushing member of the intraocular lens and the insertion tube portion of the instrument body, and the intraocular lens is abnormal. The behavior is preferably prevented.

  According to the technique disclosed herein, an intraocular lens insertion device that can further stabilize the behavior of the intraocular lens can be realized.

It is a figure which shows schematic structure of the insertion instrument of the intraocular lens in one Embodiment. It is a figure which shows schematic structure of the intraocular lens in one Embodiment. It is a figure which shows schematic structure of the nozzle main body in one Embodiment. It is a figure which shows schematic structure of the positioning member in one Embodiment. It is a figure which shows schematic structure of the plunger in one Embodiment. It is a figure which shows schematic structure of the front-end | tip part of the plunger in one Embodiment. It is a figure which shows the front-end | tip part and intraocular lens of the plunger in one Embodiment. It is a figure which shows the front-end | tip part and intraocular lens of the plunger in one Embodiment. It is sectional drawing which shows the positional relationship of the front-end | tip part of the plunger in one Embodiment, the support part of an intraocular lens, and a nozzle part. It is a figure which shows schematic structure of the front-end | tip part of the plunger in the modification 1. FIG. It is a figure which shows schematic structure of the front-end | tip part of the plunger in the modification 2.

  Embodiments of the present invention will be described below with reference to the drawings.

〔Example〕
In FIG. 1, schematic structure of the insertion instrument 1 of this embodiment is shown. 1A is a plan view of the insertion instrument 1 when the stage lid 13 is opened, and FIG. 1B is a side view of the insertion instrument 1 when the stage lid 13 is closed. The insertion instrument 1 includes a nozzle body 10 as an instrument body, a plunger 30 as an intraocular lens pushing member, a stage part 12 and a stage lid part 13 as a storage part for an intraocular lens. The stage unit 12 is provided integrally with the nozzle body 10 or separately. A plunger 30 is inserted into the nozzle body 10. The intraocular lens 2 is set on the stage unit 12. The stage unit 12 is formed integrally with the stage lid unit 13. FIG. 1 shows a state in which the stage lid 13 is opened.

  The nozzle body 10 of the insertion instrument 1 is formed in a cylindrical shape having a substantially rectangular cross section, and one end of the insertion tool 1 is greatly open (hereinafter, the side having the large opening is referred to as a rear end 10b), and the end on the other side. Includes a nozzle portion 15 and a tip portion 10a which are narrowed down. As shown in FIG.1 (b), the front-end | tip part 10a is opening diagonally. The plunger 30 is inserted into the nozzle body 10 and can reciprocate.

  In the following description, the direction from the rear end 10b of the nozzle body 10 to the front end 10a is the front direction, the opposite direction is the rear direction, the front side of the page in FIG. 1A is the upper direction, and the reverse direction is the lower direction. In FIG. 1B, the front side of the page is the left direction, and the opposite direction is the right direction. In this case, the upper side is the front side of the optical axis of the lens body 2a, which will be described later, the lower side is the rear side of the optical axis of the lens body 2a, the front side is the front side in the pressing direction by the plunger 30, and the rear side is the rear side in the pressing direction by the plunger 30. Corresponds to the side.

  Near the rear end portion 10 b of the nozzle body 10, there is integrally provided a holding portion 11 that protrudes in a plate shape and hooks a finger when the user pushes the plunger 30 toward the distal end side of the nozzle body 10. A stage portion 12 for setting the intraocular lens 2 is provided on the rear side of the nozzle portion 15 in the nozzle body 10. The stage portion 12 is configured such that the upper side of the nozzle body 10 is opened by opening the stage lid portion 13. Further, a positioning member 50 is attached to the stage portion 12 from the lower side of the nozzle body 10. By this positioning member 50, the intraocular lens 2 is stably held in the stage portion 12 even before use (during transportation).

  That is, in the insertion instrument 1, the intraocular lens 2 is on the stage unit 12 and the front side of the optical axis is on the upper side in a state where the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12. Is set as Then, after the stage lid 13 is closed, it is shipped and sold. Then, the user removes the positioning member 50 with the stage lid portion 13 closed, and then pushes the plunger 30 into the distal end side of the nozzle body 10. As a result, the intraocular lens 2 is pressed by the plunger 30 and moved to the nozzle part 15, and then the intraocular lens 2 is released into the eyeball from the distal end part 10a. In addition, the nozzle body 10, the plunger 30, and the positioning member 50 in the insertion instrument 1 are formed of a resin material such as polypropylene. Polypropylene is a material with a proven track record in medical equipment and high reliability such as chemical resistance.

  FIG. 2 is a diagram showing a schematic configuration of the intraocular lens 2. 4A is a plan view and FIG. 4B is a side view. The intraocular lens 2 is a so-called three-piece type. The intraocular lens 2 is formed of a lens body 2a having a predetermined refractive power and two beard-shaped support portions 2b, 2b connected to the lens body 2a for holding the lens body 2a in the eyeball. Has been. The lens body 2a and the support portion 2b are made of a flexible resin material. In the insertion instrument 1 according to the present embodiment, the intraocular lens 2 is set so that one of the two support portions 2b and 2b is disposed on the rear side of the lens body 2a and the other is disposed on the front side of the lens body. Is done.

  FIG. 3 shows a plan view of the nozzle body 10. As described above, in the nozzle body 10, the intraocular lens 2 is set on the stage unit 12. In this state, the intraocular lens 2 is pressed by the plunger 30 and released from the distal end portion 10a. In addition, a through hole 10 c whose cross-sectional shape changes according to a change in the outer shape of the nozzle body 10 is provided in the nozzle body 10. When the intraocular lens 2 is released, the intraocular lens 2 is deformed and folded according to a change in the cross-sectional shape of the through hole 10c in the nozzle body 10, and is formed on the patient's eyeball. It is released after being transformed into a shape that is easy to enter an incision.

  The tip 10a has a shape that is obliquely cut so that the upper area of the nozzle section 15 is in front of the lower area. Note that the shape of the tip portion 10a that is obliquely cut may be linearly obliquely cut when viewed from the left-right direction, or may have a bulge outward, that is, a curved shape. It may be cut into

  A stage groove 12 a having a width slightly larger than the diameter of the lens body 2 a of the intraocular lens 2 is formed in the stage portion 12. The dimension in the front-rear direction of the stage groove 12 a is set to be larger than the maximum width dimension including the support portions 2 b and 2 b extending on both sides of the intraocular lens 2. A set surface 12b is formed by the bottom surface of the stage groove 12a. The vertical position of the set surface 12b is set higher than the height position of the bottom surface of the through hole 10c of the nozzle body 10, and the set surface 12b and the bottom surface of the through hole 10c are connected by a bottom slope 10d. .

  The stage unit 12 and the stage lid unit 13 are formed integrally. The stage lid portion 13 has the same size in the front-rear direction as the stage portion 12. The stage lid portion 13 is connected by a thin plate-like connecting portion 14 formed by extending the side surface of the stage portion 12 to the stage lid portion 13 side. The connecting portion 14 is formed to be bendable at the center portion, and the stage lid portion 13 can be closed by overlapping the stage portion 12 from above by bending the connecting portion 14.

  In the stage lid part 13, ribs 13 a and 13 b are provided on the surface facing the set surface 12 b when the lid is closed in order to reinforce the stage lid part 13 and stabilize the position of the intraocular lens 2. A guide protrusion 13 c is provided as a guide on the upper side of the plunger 30.

  A positioning member 50 is detachably provided below the set surface 12b of the stage unit 12. FIG. 4 shows a schematic configuration of the positioning member 50. FIG. 4A shows a plan view of the positioning member 50, and FIG. 4B shows a left side view of the positioning member 50. The positioning member 50 is configured as a separate body from the nozzle main body 10, and has a structure in which a pair of side wall portions 51, 51 are connected by a connecting portion 52. At the lower ends of the respective side wall portions 51, holding portions 53, 53 extending outward and extending are formed.

  A pair of first mounting portions 54 and 54 are formed on the upper end portions of the side wall portions 51 and 51, respectively. Further, first positioning portions 55 and 55 are formed to protrude on the outer peripheral side of the upper end surfaces of the first placement portions 54 and 54. The distance between the inner diameters of the first positioning portions 55 and 55 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 2.

  In addition, a pair of second mounting portions 56 and 56 are formed at both ends of the connecting portion 52 in the front-rear direction and have a rectangular shape when viewed from above and project upward. The heights of the upper surfaces of the second mounting parts 56 and 56 are equal to the heights of the upper surfaces of the first mounting parts 54 and 54. Furthermore, second positioning portions 57 and 57 that protrude further upward are formed over the entire left and right direction of the second placement portions 56 and 56 on the outer portion of the upper surface of the second placement portions 56 and 56. . The distance between the insides of the second positioning portions 57 and 57 is set to be slightly larger than the diameter of the lens body 2 a of the intraocular lens 2. In addition, locking claws 58, 58 that slightly protrude in the front-rear direction are formed on the upper ends of the second placement portions 56, 56 over the entire left-right direction.

  The positioning member 50 is assembled from below the set surface 12 b of the nozzle body 10. The set surface 12b of the nozzle body 10 is formed with a set surface through hole 12c that penetrates the set surface 12b in the thickness direction. The outer shape of the set surface through-hole 12c is a substantially similar shape that is slightly larger than the shape of the first mounting portions 54 and 54 and the second mounting portions 56 and 56 of the positioning member 50 as viewed from above. When the positioning member 50 is attached to the nozzle body 10, the first placement portions 54 and 54 and the second placement portions 56 and 56 are inserted into the set surface through hole 12c from the lower side of the set surface 12b. , Protruding above the set surface 12b.

  At that time, the locking claws 58, 58 provided in the second positioning portions 57, 57 project to the set surface 12b via the set surface through hole 12c and are locked to the upper surface of the set surface 12b. Accordingly, the positioning member 50 is assembled from the lower side of the nozzle body 10, and the first placement portions 54 and 54 and the second placement portions 56 and 56 are fixed in a state of protruding from the set surface 12b. When the intraocular lens 2 is set on the setting surface 12b, the bottom surface of the outer peripheral portion of the lens body 2a is placed on the upper surfaces of the first placement portions 54 and 54 and the second placement portions 56 and 56. The Further, the position of the lens body 2a is restricted with respect to the horizontal direction (the direction horizontal to the set surface 12b) by the first positioning portions 55, 55 and the second positioning portions 57, 57.

  When the intraocular lens 2 is inserted into the eyeball, the positioning member 50 is removed from the nozzle body 10. As a result, the first placement portions 54 and 54 and the second placement portions 56 and 56 that supported the lens body 2a of the intraocular lens 2 are retracted from the set surface 12b, and the intraocular lens 2 is on the set surface 12b. Is movably mounted.

  Subsequently, the distal end portion 10a of the nozzle portion 15 of the nozzle body 10 is inserted into the incision provided in the eye tissue. Here, since the distal end portion 10a has an oblique opening shape, it can be easily inserted into the incision. Then, after inserting the nozzle portion 15 into the incision, the pressing plate portion 33 of the plunger 30 is pushed into the distal end side of the nozzle body 10. Thereby, the front-end | tip of the action part 31 of the plunger 30 contact | abuts to the lens body 2a outer periphery of the intraocular lens 2 set to the setting surface 12a, and the intraocular lens 2 is guided toward the front-end | tip part 10a by the plunger 30.

  FIG. 5 shows a schematic configuration of the plunger 30 according to the present embodiment. The plunger 30 has a length in the front-rear direction that is slightly larger than the nozzle body 10. And it forms from the action part 31 of the front end side based on a column shape, and the insertion part 32 of the rear end side based on a rectangular rod shape. And the action part 31 is comprised including the cylindrical part 31a made into the column shape, and the thin plate-shaped flat part 31b extended in the left-right direction of the cylindrical part 31a.

  A notch 31d is formed at the tip 31c of the action portion 31 which is also the tip of the plunger 30. As can be seen from FIG. 5, the notch 31 d is formed in a groove shape that opens upward in the action portion 31 and penetrates in the left-right direction. Further, as can be seen from FIG. 5B, the groove wall on the tip side of the notch 31 d is formed with an inclined surface that goes upward as it goes to the tip side of the action portion 31. The notch 31d is located on the front side of the optical axis of the intraocular lens 2 housed in the housing part composed of the stage part 12 and the stage lid part 13.

  And the groove | channel 31e from the front end surface 31f of the front-end | tip part 31c to the notch part 31d is provided in the left side surface of the front-end | tip part 31c. The groove 31e is a means for regulating the posture of a part of the support part 2b of the intraocular lens 2 on the lens body 2a side, and the support part 2b when the intraocular lens 2 is moved to the tip 10a of the nozzle part 15. It is also means for restricting the movement of the part. Here, the posture of the support portion 2b of the intraocular lens 2 is the longitudinal direction of the support portion 2b on the outer peripheral surface of the distal end portion 31c, and is also a direction perpendicular to the longitudinal direction of the support portion 2b.

  Furthermore, a concave portion 31g that is recessed toward the central axis of the cylindrical portion 31a is provided on the right side surface of the tip portion 31c. The recessed part 31g is a recessed part for holding a part of the support part 2b of the intraocular lens 2 different from the part held by the groove 31e. Moreover, the convex part 31h which protrudes toward the upper side from the outer peripheral surface of the cylindrical part 31a is provided in the outer peripheral surface above the front-end | tip part 31c. The convex part 31h is a convex part for preventing the support part 2b of the intraocular lens 2 from escaping backward from the cutout part 31d to the cylindrical part 31a. Details of the structure and function of each part of the tip 31c will be described later.

  The insertion portion 32 has a substantially H-shaped cross section as a whole, and the horizontal and vertical dimensions thereof are set slightly smaller than the through hole 10 c of the nozzle body 10. In addition, a disc-shaped pressing plate portion 33 is formed at the rear end of the insertion portion 32 so as to spread in the vertical and horizontal directions.

  A claw portion 32 a that protrudes toward the upper side of the insertion portion 32 and can be moved up and down by the elasticity of the material of the plunger 30 is formed at a portion of the insertion portion 32 that is ahead of the center in the front-rear direction. When the plunger 30 is inserted into the nozzle body 10, the locking hole 10 e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32 a engage with each other. The relative position between the nozzle body 10 and the plunger 30 in the state is determined. It should be noted that the claw portion 32a and the locking hole 10e are formed at the positions where the distal end of the action portion 31 is located on the rear side of the lens body 2a of the intraocular lens 2 set on the stage portion 12 in the engaged state. The support portion 2b on the rear side of the main body 2a is set so that the cutout portion 31d can be supported from below.

  FIG. 6 is an enlarged view showing an outline of the distal end portion 31c of the action portion 31 of the plunger 30 in the present embodiment. 6 (a) is a top view, FIG. 6 (b) is a left side view, FIG. 6 (c) is a bottom view, FIG. 6 (d) is a right side view, FIG. 6 (e) is a front view, and FIG. f) shows a partially enlarged view of the front view of FIG. As shown in FIG. 6 (f), the groove 31 e in the tip surface 31 f has a predetermined angle from the central axis O with respect to the plane P including the central axis O of the cylindrical portion 31 a and extending in the left-right direction (horizontal direction). Is provided.

  As will be described later, when the plunger 30 is pushed into the distal end portion 10 a side of the nozzle body 10 and the intraocular lens 2 moves to the distal end portion 10 a of the nozzle portion 15, a support portion on the rear side of the intraocular lens 2. By fitting 2b into the groove 31e, the posture of the support portion 2b is regulated. Further, the support part 2b on the rear side of the intraocular lens 2 is sandwiched between the groove 31e and the inner wall of the nozzle part 15, so that the movement of the support part 2b is restricted. Thereby, the intraocular lens 2 is suppressed so as not to exhibit an abnormal behavior. Therefore, the predetermined angle from the central axis O is a groove 31e in which the support portion 2b of the intraocular lens 2 is provided in the distal end surface 31f when the intraocular lens 2 is moved to the distal end portion 10a by the plunger 30. It is determined as appropriate so that it falls within the range. In the present embodiment, the groove 31e is a V-shaped groove. Further, the width and depth of the groove 31e in the distal end surface 31f can be set as appropriate so that the support portion 2b of the intraocular lens 2 is favorably sandwiched between the groove 31e and the inner wall of the nozzle portion 15.

  Further, as shown in FIGS. 6B and 6C, in the present embodiment, the groove 31e is a groove formed with a uniform width along the side surface of the distal end portion 31c. As shown in FIG. 6B, the groove 31e has a predetermined inclination angle with respect to the central axis O of the cylindrical portion 31a. In this embodiment, since the intraocular lens 2 is a three-piece type, it may be set on the set surface 12b of the stage unit 12 so as to be convex upward. When the intraocular lens 2 is set on the setting surface 2b of the stage unit 12 in this way, the intraocular lens 2 is folded when moved to the tip 10a of the nozzle unit 15 by the plunger 30. Sometimes, the base part of the support part 2b of the intraocular lens 2, that is, the part of the support part 2b closer to the lens body 2a is near the lower end of the tip surface 31f of the tip part 31c, as will be described with reference to FIGS. It moves to the position where it contacts. Here, the lower end of the front end surface 31 f is an end portion located on the rear side of the optical axis of the intraocular lens housed in the housing portion constituted by the stage portion 12 and the stage lid portion 13.

  Therefore, in the present embodiment, as shown in FIG. 6B, on the outer peripheral surface of the distal end portion 31c of the plunger 30, the groove 31e extends obliquely upward from the vicinity of the lower end of the distal end surface 31f and reaches the cutout portion 31d. Formed as. In this embodiment, when pushing the plunger 30 and moving the intraocular lens 2 to the distal end of the insertion tube part, the root part of the support part 2b of the intraocular lens 2 fits into the groove 31e, and the intraocular lens 2 Since the support portion 2b is sandwiched between the groove 31e and the inner wall of the nozzle portion 15, the behavior of the intraocular lens 2 when being released from the opening of the distal end portion 10a can be stabilized. When a so-called one-piece type intraocular lens is used instead of the three-piece type intraocular lens 2, the one-piece type intraocular lens is set to be convex downward on the set surface 12 b of the stage portion 12. There is a case. When the intraocular lens is set on the set surface 12 b of the stage unit 12 in this way, the support unit for the intraocular lens and the plunger 30 when the one-piece type intraocular lens is moved to the tip end unit 10 a of the nozzle unit 15. The positional relationship with the distal end portion 31c is different from the support portion 2b of the three-piece intraocular lens 2 described above. Therefore, when a one-piece type intraocular lens is used, the position where the groove 31e is provided on the outer peripheral surface of the distal end portion 31c of the plunger 30 and the extending direction may be appropriately changed.

  If the groove 31e is not provided in the cylindrical portion 31a, the support portion 2b is clamped by the cylindrical portion 31a of the plunger and the inner wall of the nozzle portion 15 when the plunger 30 is pushed in, and the intraocular lens 2 is attached to the distal end portion 10a. May not be released from the opening. However, in the present embodiment, by providing the groove 31e, such a phenomenon can be suitably prevented and not only can the behavior of the intraocular lens 2 be stabilized, but also the intraocular lens 2 can be more reliably released into the eye. The effect can also be expected.

  When the support portion 2b of the intraocular lens 2 is fitted into the groove 31e, a portion of the support portion 2b that is closer to the tip than the portion held by the groove 31e extends to the cutout portion 31d. The support portion 2b extending to the notch portion 31d is bent so as to be accommodated in the notch portion 31d so as not to advance in the rearward direction of the cylindrical portion 31a by the wall portion 31i and the convex portion 31h. Therefore, the convex portion 31h has a function of increasing the possibility that the tip of the support portion 2b is received from the cutout portion 31d into the concave portion 31g described later. For this reason, the support part 2b is accommodated in the notch part 31d in the bent state.

  The concave portion 31g is provided to escape the tip of the support portion 2b bent in contact with the convex portion 31h or the wall portion 31i in the cutout portion 31d. The concave portion 31g is formed on the side surface of the tip end portion 31c opposite to the side where the groove 31e is provided with respect to the central axis O. Further, as shown in FIGS. 6A and 6C, the side surface of the tip 31c of the recess 31g is recessed toward the central axis O. Thereby, the part extended in the recessed part 31g among the support parts 2b will be in the state accommodated in the clearance gap formed by the recessed part 31g and the inner wall of the nozzle part 15. FIG.

  Next, FIGS. 7 and 8 show the positional relationship between the support portion 2b of the intraocular lens 2 and the distal end portion 31c of the plunger 30 when the intraocular lens 2 moves to the distal end portion 10a of the nozzle portion 15. FIG. 7 and 8, the nozzle portion 15 is not shown. When the intraocular lens 2 moves to the distal end portion 10 a of the nozzle portion 15 by pushing the plunger 30, the lens body 2 a of the intraocular lens 2 is folded according to the shape of the inner wall of the nozzle portion 15. The outer periphery of the rear side of the lens body 2 a abuts on the front end surface 31 f of the front end portion 31 c of the plunger 30, and the support portion 2 b on the rear side of the intraocular lens 2 is a groove 31 e of the front end portion 31 c of the plunger 30. It will be in a state fitted in.

  As shown in FIG. 7, along the groove 31e of the distal end portion 31c, the proximal end side of the support portion 2b of the intraocular lens 2, that is, a part on the lens body 2a side is fitted. Moreover, the part of the front end side from the part fitted in the groove | channel 31e among the support parts 2b is extended to the notch part 31d. As shown in FIG. 8, the support part 2b extended to the notch part 31d is in contact with the convex part 31h and the wall part 31i. Of the support portion 2b, the portion on the tip side from the portion in contact with the convex portion 31h or the wall portion 31i extends into the concave portion 31g while curving in the space surrounded by the notch portion 31d and the inner wall of the nozzle portion 15. Go. If there is no concave portion 31g, the distal end portion of the support portion 2b is sandwiched between the outer peripheral surface of the distal end portion 31c of the plunger 30 and the inner wall of the nozzle portion 15, and the intraocular lens 2 cannot be released into the eye. there is a possibility. On the other hand, in this embodiment, by providing the recessed portion 31g, the tip portion of the support portion 2b is prevented from being sandwiched between the outer peripheral surface of the tip portion 31c of the plunger 30 and the inner wall of the nozzle portion 15. .

  FIG. 9 shows a partially enlarged view of a cross section in a plane perpendicular to the central axis O when the support portion 2b is fitted in the groove 31e. As shown in FIG. 9, the support portion 2 b is in contact with the inner surfaces 32, 32 of the groove 31 e and the inner wall 15 a of the nozzle portion 15. Therefore, the support portion 2b is not sandwiched between the outer peripheral surface 31j of the tip portion 31c and the inner wall 15a of the nozzle portion 15 by fitting in the groove 31e. Further, movement of the support portion 2b is restricted so as not to be disengaged from the groove 31e by being sandwiched between spaces between the inner surfaces 32, 32 of the groove 31e and the inner wall 15a of the nozzle portion 15. As a result, the behavior of the lens body 2 connected to the support portion 2b in the nozzle portion 15 is also stabilized.

  The above is the description of the present embodiment, but the configuration of the insertion portion and the like is not limited to the above-described embodiment, and various modifications can be made within the scope that does not lose the technical idea of the present invention. Is possible. For example, in the above description, the recess 31g of the distal end portion 31c of the plunger 30 is formed in a V shape in the top view as shown in FIG. 6A, but the distal end of the support portion 2b is If it can be made to extend between the recessed part 31g and the inner wall of the nozzle part 15, the shape of the recessed part 31g can be changed suitably. Moreover, also about the convex part 31h, if the support part 2b can be made not to extend to the back side of the cylindrical part 31a, the protrusion shape of the recessed part 31h can be changed suitably. Moreover, you may comprise the front-end | tip part 31c of the plunger 30 combining the modification demonstrated below and said embodiment suitably.

  Two modifications of the above embodiment are shown below. In the following description, components corresponding to the components in the above-described embodiment are denoted by the same reference numerals, and the description thereof is omitted unless otherwise specified.

[Modification 1]
In FIG. 10, the schematic of the front-end | tip part 31c of the plunger 30 in the modification 1 is shown. As shown in FIG. 10A, in the first modification, a pair of convex portions 31k and 31k projecting from the outer peripheral surface 31j of the tip portion 31c are formed instead of the groove 31e in the above embodiment. The convex portions 31k and 31k extend in parallel to each other from the front end surface 31f to the cutout portion 31d. FIG. 10B shows a cross-sectional view similar to FIG. 9 when the support portion 2 b of the intraocular lens 2 is sandwiched between the convex portions 31 k and 31 k and the inner wall 15 a of the nozzle portion 15. FIG.10 (c) is sectional drawing which shows only the front-end | tip part 31c in FIG.10 (b).

  As can be seen from FIGS. 10B and 10C, the inner walls 33, 33 of the convex portions 31k, 31k facing each other and the side surface 34 between the convex portions 31k, 31k of the outer peripheral surface 31j of the tip portion 31c are formed. Then, the movement of the support portion 2b is regulated by sandwiching the support portion 2b with the inner wall 15a of the nozzle portion 15 in contact with the support portion 2b. Moreover, since the convex parts 31k and 31k extend from the front end surface 31f to the notch part 31d, the convex parts 31k and 31k regulate the posture of the support part 2b so that the support part 2b extends to the notch part 31d. Note that the shape, height and spacing of the protrusions 31k and 31k, the inclination angle of the inner wall 33 with respect to the outer peripheral surface 31j, the surface shape of the side surface 34, and the like can be changed as appropriate. In the above description, the support portion 2b is in contact with the inner wall 15a of the nozzle portion 15, the inner walls 33 and 33 of the convex portions 31k and 31k, and the outer peripheral surface 31j of the tip portion 31c. Even in the case where all of these do not come into contact and a slip occurs, the deviation can be allowed as long as it does not interfere with the posture regulation of the support portion 2b.

[Modification 2]
In FIG. 11, the schematic of the front-end | tip part of the plunger in the modification 2 is shown. As shown in FIG. 11A, in the second modification, a rough surface 31m having a roughness higher than that of the surrounding region is formed on the side surface of the tip 31c instead of the groove 31e in the above-described embodiment. Similar to the groove 31e, the rough surface 31m extends from the tip surface 31f to the notch 31d. FIG. 11B is a cross-sectional view similar to FIG. 9 when the support portion 2b of the intraocular lens 2 is sandwiched between the rough surface 31m and the inner wall 15a of the nozzle portion 15.

  In the second modification, the rough surface 31m plays a role of regulating the posture of the support portion 2b so that the support portion 2b extends to the cutout portion 31d. Further, by making the roughness of the rough surface 31m larger than the surrounding area, the plunger 30 moves the intraocular lens 2 to the tip portion 10a of the nozzle portion 15, and the support portion 2b of the intraocular lens 2 becomes rough. When the support portion 2b is sandwiched between 31m and the inner wall 15a of the nozzle portion 15, a static frictional force generated between the support portion 2b and the rough surface 31m causes the support portion 2b to move between the outer peripheral surface 31j and the inner wall 15a of the nozzle portion 15. Can be regulated not to move. In addition, the range which provides the rough surface 31m in the outer peripheral surface 31j of the front-end | tip part 31c, the roughness of the rough surface 31m, etc. can be changed suitably.

  In the above-described three embodiments, an example in which a part of the support portion is housed in the groove has been described. However, the present invention is not limited to this, and the support portion is upward (that is, an intraocular lens is inserted). Behave in the direction of the optical axis of the intraocular lens when it is set on the instrument) to prevent the optical part of the intraocular lens from tilting forward too much when the intraocular lens is released from the tip of the nozzle. Therefore, it is only necessary that the support portion be restricted in the direction so that the support portion does not move upward. For example, the plunger may be provided with a notch or a protrusion.

DESCRIPTION OF SYMBOLS 1 Insertion tool 2 Intraocular lens 2a Lens main body 2b Support part 10 Nozzle main body 15 Nozzle part 30 Plunger 31a Columnar part 31c Plunger tip part 31d Notch part 31e Groove 31f Tip surface 31g Concave part 31h, 31k Convex part 31i Wall part 31j Tip part Outer peripheral surface of 31m rough surface

Claims (3)

A substantially cylindrical instrument body having an insertion tube portion inserted into the eye in a folded state of an intraocular lens having a lens body and a long support portion having one end connected to the lens body; and
A storage section for storing the intraocular lens in the instrument body so as to be disposed;
An intraocular lens pushing member that slides within the instrument body to move the intraocular lens to the insertion tube and pushes it into the eye;
An intraocular lens insertion device comprising:
A posture regulating means for regulating a posture of at least a part of the one end side of the support portion when the intraocular lens moves to the insertion tube portion on the outer peripheral surface of the distal end portion of the intraocular lens pushing member. provided it is,
The distal end portion of the intraocular lens pushing member further has a cutout portion for housing the support portion, which is located on the optical axis front side of the intraocular lens housed in the housing portion,
The posture restricting means reaches the notch portion from a position on the rear side of the optical axis of the intraocular lens accommodated in the accommodating portion of the surface of the tip portion that contacts the intraocular lens, and the one of the support portions. An intraocular lens insertion device, wherein the groove is a groove into which a portion is fitted .   The posture regulating means regulates that at least a part of the one end side of the support portion behaves in the optical axis front side direction of the intraocular lens housed in the housing portion. Item 2. An intraocular lens insertion device according to Item 1. The intraocular lens insertion device according to claim 1 or 2 , wherein a concave portion for receiving a part of the other end side with respect to the one end of the support portion is provided on an outer peripheral surface of the tip portion. .

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