JP7035384B2 - Intraocular lens insertion device - Google Patents

Description

The present disclosure relates to an intraocular lens insertion device that inserts an intraocular lens into the eye.

Conventionally, as one of the surgical methods for cataract, a method of inserting a bendable soft intraocular lens into the eye instead of the removed crystalline lens has been used. In addition, an intraocular lens may be inserted in front of the crystalline lens in order to correct the refractive power of the eye. An intraocular lens insertion device called an injector may be used to insert the intraocular lens into the eye.

The intraocular lens insertion device may fold the intraocular lens in a state where the support portion of the intraocular lens is deformed and positioned on the optical portion (so-called "tacking" is performed). By tacking, the possibility of damage to the support portion is reduced. In the intraocular lens insertion device described in Patent Document 1, a linear moving portion for moving the support portion in a direction approaching the optical portion and an optical portion contact portion for pushing the optical portion forward are provided on the front end side of the rod-shaped extrusion member. Has been done. By moving the extrusion member forward, both movement and tacking of the intraocular lens are performed. The intraocular lens is inserted into the eye through a passage in the nozzle.

Japanese Unexamined Patent Publication No. 2016-19608

When the intraocular lens is moved and tacked by the rod-shaped extruded member, at least a part of the folded intraocular lens may get into the space between the extruded member and the inner wall of the nozzle. In the conventional intraocular lens insertion device, a large load is likely to be applied to the portion of the intraocular lens that has entered between the extrusion member and the inner wall of the nozzle. When a large load is applied to the intraocular lens, damage (for example, cracking) may occur.

A typical object of the present disclosure is to provide an intraocular lens insertion device capable of appropriately inserting an intraocular lens into the eye.

An intraocular lens insert provided by a exemplary embodiment in the present disclosure is a deformable intraocular with an optic and one or more supports that curve outward from the optic. An intraocular lens insertion device that inserts a lens into the eye from an insertion port at the front end through an internal passage, and the passage area becomes narrower toward the front, and a nozzle having the insertion port at the front end and the above. It comprises a rod-shaped extrusion member that pushes the intraocular lens forward by moving forward in the passage along an extrusion axis that is the axis of the passage, and the extrusion member is on the front end side of the extrusion member. An optical portion contact portion that is formed and contacts the optical portion to push the optical portion forward, and an optical portion contact portion that is formed above the optical portion contact portion on the front end side of the extruded member and extends rearward from the optical portion. Of the support portion contact portion that contacts the rear support portion that is the support portion and moves the rear support portion in a direction approaching the optical portion, and the left side surface and the right side surface of the extruded member, the intraocular lens. When the side surface on the side where the base end of the rear support portion is located is the first side surface, the optical portion is formed behind the optical portion contact portion and the support portion contact portion in the first side surface. The first depressed portion that is recessed inward on the extrusion shaft side of the first side surface of the contact portion and the support portion contact portion, and the support that protrudes laterally from the upper end portion of the first side surface. It is provided with an upper rib that continuously extends from the front end portion of the portion contact portion to the first depressed portion.

According to the intraocular lens insertion device in the present disclosure, the intraocular lens is appropriately inserted into the eye.

It is a perspective view which looked at the intraocular lens insertion instrument 10 from diagonally above right. It is a perspective view which looked at the plunger 300 from the diagonally upper right. It is (a) plan view and (b) right side view of the intraocular lens 1. FIG. It is a perspective view which looked at the extrusion member 310 from the diagonally upper right. It is a perspective view which saw the extrusion member 310 from the diagonally upper left. It is a right side view of the extrusion member 310. It is a front view of the extrusion member 310. It is a schematic explanatory drawing which shows the state of movement and deformation at the time of pushing out an intraocular lens 1. It is a front sectional view at the substantially center in the front-rear direction of the nozzle 180 when the intraocular lens 1 is passing. It is a front sectional view of the insertion part 182 when the intraocular lens 1 is passing.

<Overview>
The intraocular lens insertion device exemplified in the present disclosure inserts an intraocular lens into the eye through an insertion port at the front end through an internal passage. The intraocular lens comprises an optical section and one or more supports extending outwardly curved from the optical section. The intraocular lens insertion device includes a nozzle and an extrusion member. The nozzle has a passage area narrower toward the front and has an insertion port at the front end. The extruded member is rod-shaped and moves forward in the passage along the axis of the passage, pushing the intraocular lens forward. The extruded member in the present disclosure includes an optical portion contact portion, a support portion contact portion, a first recessed portion, and an upper rib. The optical portion contact portion is formed on the front end side of the extrusion member, and comes into contact with the optical portion to push the optical portion forward. The support portion contact portion is formed above the optical portion contact portion on the front end side of the extruded member, and is in contact with the rear support portion, which is a support portion extending rearward from the optical portion, so that the rear support portion approaches the optical portion. Move to. Further, of the left side surface and the right side surface of the extruded member, the side surface on the side where the base end of the rear support portion of the intraocular lens is located is referred to as the first side surface. The first depressed portion is formed behind the optical portion contact portion and the support portion contact portion in the first side surface, and is recessed inward from the first side surface of the optical portion contact portion and the support portion contact portion. The upper rib projects laterally from the upper end portion of the first side surface and continuously extends from the front end portion of the support portion contact portion to the first depressed portion.

According to the intraocular lens insertion device exemplified in the present disclosure, even if a part of the intraocular lens enters between the first side surface of the extrusion member and the inner wall of the nozzle, the inserted portion can escape to the first depressed portion. In addition, when a part of the intraocular lens enters the gap between the upper surface of the extrusion member and the inner wall of the nozzle (hereinafter referred to as "upper gap"), the part of the intraocular lens is sandwiched between the upper gaps. The extruded member may be extruded. In this case, a particularly large load is applied to the portion sandwiched between the upper gaps. On the other hand, in the intraocular lens insertion device of the present disclosure, the upper rib suppresses a part of the intraocular lens from entering the upper gap from the first side surface side. Therefore, the load applied to the intraocular lens is reduced, and the intraocular lens is appropriately inserted into the eye.

In the present disclosure, the axial direction of the passage of the intraocular lens insertion device is the anteroposterior direction of the intraocular lens insertion device. The direction in which the optical portion contact portion and the support portion contact portion are lined up when viewed from the front is defined as the vertical direction of the intraocular lens insertion device. The direction that intersects vertically in both the anterior-posterior direction and the vertical direction is the left-right direction of the intraocular lens insertion device. Here, the proximal end of the posterior support portion of the intraocular lens (that is, the portion connected to the optical portion) is displaced to the left or right from the axis of the passage. In the present disclosure, of the left-right directions, the direction in which the base end of the rear support portion is located with respect to the axis of the passage is defined as the first direction, and the other direction is defined as the second direction. The first side surface of the extruded member is a surface facing the first direction.

The front end surface of the support portion contact portion may project further forward than the front end surface of the optical portion contact portion. In this case, tacking is performed in a state where the rear support portion is extended far forward by the support portion contact portion protruding forward. Therefore, tacking is performed more appropriately. On the other hand, when the front end surface of the support portion contact portion protrudes forward from the front end surface of the optical portion contact portion, the optics enter between the first side surface of the extrusion member and the inner wall of the nozzle as compared with the case where the front end surface does not protrude. The volume of the part increases. However, in the intraocular lens insertion device of the present disclosure, as described above, the influence of the intraocular lens entering between the extrusion member and the inner wall of the nozzle is suppressed by the first recessed portion and the upper rib. Therefore, while tacking is properly performed, damage to the intraocular lens is also suppressed.

However, the front end surface of the support portion contact portion may be located at the same position as the front end surface of the optical portion contact portion, or may be located behind the front end surface of the optical portion contact portion. Even in this case, the influence of the intraocular lens entering between the first side surface of the extruded member and the inner wall of the nozzle is appropriately suppressed.

The support portion contact portion is arranged unevenly on the left side and the right side with respect to the axis of the passage, on the side where the base end of the rear support portion of the intraocular lens is located (that is, the above-mentioned first direction). In this case, the support portion contact portion pushes forward the position of the rear support portion near the proximal end side. Therefore, the deformation movement of the rear support portion is stable and the movement amount is easily secured as compared with the case where the tip end side of the rear support portion is pushed forward. On the other hand, if the support portion contact portion is unevenly arranged in the first direction, the space between the first side surface of the extrusion member and the inner wall of the nozzle becomes narrow. However, in the intraocular lens insertion device of the present disclosure, as described above, the influence of the intraocular lens entering between the extrusion member and the inner wall of the nozzle is suppressed by the first recessed portion and the upper rib. Therefore, while tacking is properly performed, damage to the intraocular lens is also suppressed. However, even when the support portion contact portion is not arranged unevenly in the first direction, damage to the intraocular lens is suppressed by providing the first depressed portion and the upper rib.

The extruded member may further include a lower rib that projects laterally from the lower end of the first recessed portion on the first side surface. In this case, the lower rib reduces the possibility that at least a part of the intraocular lens enters the gap formed by the bottom surface of the extrusion member and the inner wall of the nozzle from the first side surface side. Therefore, the load applied to the intraocular lens is further reduced.

The extruded member may further include an upper protrusion that projects forward from the upper end of the front end surface of the support contact. In this case, the possibility that the rear support portion is displaced upward from the support portion contact portion is reduced by the upper protrusion portion.

The extruded member may further include a lower protrusion that projects forward from the lower end of the front end surface of the optical contact. In this case, the possibility that the optical portion is displaced downward from the optical portion contact portion is reduced by the lower protrusion.

Of the left side surface and the right side surface of the extruded member, when the side surface opposite to the first side surface is used as the second side surface, the second side surface is recessed inward in the second side surface of the support portion contact portion. The portion may be formed. In this case, the space between the second side surface and the inner wall of the nozzle becomes large. Therefore, even if a part of the intraocular lens enters between the second side surface and the inner wall of the nozzle, the load applied to the intraocular lens is unlikely to increase.

The extruded member may further include a second side surface rib that extends laterally from the upper end of the second side surface and continuously extends from the front end to the rear end of the support contact. .. In this case, the second side surface rib prevents a part of the intraocular lens from entering the gap between the upper surface of the extrusion member and the inner wall of the nozzle from the second side surface side. Therefore, the possibility that a part of the intraocular lens is caught in the upper gap is further reduced. Needless to say, the second side surface rib and the second depressed portion may be provided together. In this case, at least a part of the second side surface rib extends laterally from the upper end of the second depressed portion.

<Embodiment>
Hereinafter, typical embodiments in the present disclosure will be described with reference to the drawings. In the following description, the direction of the main body 100 toward the nozzle 180 (lower left side of the paper surface in FIG. 1) is the front of the intraocular lens insertion device 10, and the direction of the pressing portion 370 of the plunger 300 (upper right side of the paper surface in FIG. 1). ) Is behind the intraocular lens insertion device 10. Further, the upper side of the paper surface of FIG. 1 is the upper side of the intraocular lens insertion device 10, the lower side of the paper surface of FIG. 1 is the lower side of the intraocular lens insertion device 10, and the lower right side of the paper surface of FIG. 1 is the right side of the intraocular lens insertion device 10. The upper left side of the paper surface in FIG. 1 is the left side of the intraocular lens insertion device 10.

(overall structure)
With reference to FIG. 1, the overall configuration of the intraocular lens insertion device 10 of the present embodiment will be described. The intraocular lens insertion device 10 is used to insert a deformable intraocular lens 1 (see FIG. 3 and the like) into the eye. The intraocular lens insertion device 10 includes a main body 100 and a plunger 300. The main body 100 has a substantially tubular shape, and the plunger 300 into which the intraocular lens 1 is inserted into the eye through the passage inside the main body 100 has a rod shape and moves in the front-rear direction through the passage inside the main body 100. be able to. The plunger 300 moves forward along the extrusion shaft (axis of the passage) A to push out the intraocular lens 1 filled in the main body 100.

The main body 100 and the plunger 300 of the present embodiment are made of a resin material. The intraocular lens insertion device 10 may be formed by molding, cutting by cutting out a resin, or the like. Since the intraocular lens insertion device 10 is made of a resin material, the user can easily dispose of the used intraocular lens insertion device 10.

In the present embodiment, the inner wall of the main body 100 is subjected to a lubrication coating treatment in order to smoothly insert the adhesive and soft intraocular lens 1 into the eye. Further, the intraocular lens insertion device 10 of the present embodiment is formed of colorless transparent or colorless translucent. Therefore, the user can easily visually recognize the deformed state of the intraocular lens 1 filled in the intraocular lens insertion device 10 from the outside of the intraocular lens insertion device 10.

(Main body)
The main body 100 will be described with reference to FIG. The main body 100 includes a main body cylinder 110, an installation 130, and a nozzle (insertion) 180.

The main body cylinder portion 110 is formed in a cylindrical shape extending in the front-rear direction, and is located on the base end side of the main body portion 100. An overhanging portion 111 to be gripped by the user is formed on the outer periphery slightly forward of the rear end of the main body cylinder portion 110.

The installation portion 130 is connected to the tip end side of the main body cylinder portion 110. The installation portion 130 is filled with the intraocular lens 1. Specifically, the installation unit 130 includes a holding unit 160 and a set unit 170. The holding portion 160 holds the intraocular lens 1 when the intraocular lens inserting device 10 is stored. The set portion 170 is provided so as to be rotatable about the axis of the tip portion. When the set portion 170 is rotated, the intraocular lens 1 held by the holding portion 160 moves to a standby position where it can be pushed out by the plunger 300 and is positioned.

The nozzle 180 is connected to the tip end side of the installation portion 130. The passage area in the nozzle 180 becomes narrower toward the front because the intraocular lens 1 is slightly deformed in the process of pushing the intraocular lens 1 forward. That is, the nozzle 180 is formed with a tapered internal space. The tip of the nozzle 180 is provided with a cylindrical insertion portion 182 whose tip is cut diagonally. The insertion portion 182 is inserted into the eye. An insertion port 183, which is an opening for ejecting the intraocular lens 1 forward from the internal passage, is formed at the tip of the insertion portion 182. The passage inside the main body 100 penetrates from the rear end of the main body cylinder 110 to the insertion port 183 at the tip of the nozzle 180.

(Plunger)
The schematic configuration of the plunger 300 will be described with reference to FIG. The plunger 300 of the present embodiment includes an extrusion member 310, an extrusion rod 330, a shaft base portion 350, and a pressing portion 370.

The pressing portion 370 is formed at the base end of the plunger 300. The pressing portion 370 is a plate-shaped member extending in a direction orthogonal to the extrusion axis A. The finger of the user comes into contact with the pressing portion 370 when the user pushes the plunger 300 forward.

The shaft base portion 350 is a rod-shaped member extending forward from the tip end side of the pressing portion 370. In the present embodiment, the shaft base portion 350 is formed so that the shape of the cross section orthogonal to the extrusion shaft A is substantially H-shaped. By inserting the shaft base portion 350 into the main body cylinder portion 110 having a substantially rectangular cross section orthogonal to the extrusion shaft A, rotation of the extrusion shaft A of the plunger 300 with respect to the main body portion 100 in the circumferential direction is suppressed. .. When the plunger 300 moves forward and reaches the position where the insertion of the intraocular lens 1 into the eye is completed, the inclined portion 353 formed at the lower tip of the shaft base portion 350 is formed at a predetermined position of the main body portion 100. Contact the sloped surface. As a result, the tip of the plunger 300 is prevented from excessively protruding from the insertion slot 183 (see FIG. 1).

The extrusion rod 330 is a rod-shaped member and extends forward from the tip of the shaft base 350 along the axial direction of the extrusion shaft A. The extrusion rod 330 is formed so that the shape of the cross section orthogonal to the extrusion axis A is substantially circular. Further, the thickness of the extrusion rod 330 is such that it can pass through the insertion port 183 of the main body 100. The extrusion member 310 is connected to the tip of the extrusion rod 330. The extrusion member 310 moves forward along the extrusion shaft A in the passage of the main body 100 to tack the intraocular lens 1 and discharge the intraocular lens 1 into the eye through the insertion slot 183. The detailed configuration of the extrusion member 310 will be described later.

(Intraocular lens)
An example of the intraocular lens 1 inserted into the eye by the intraocular lens insertion device 10 will be described with reference to FIG. The intraocular lens 1 includes an optical unit 2 and a support unit 3. The intraocular lens 1 of the present embodiment is a so-called one-piece intraocular lens in which the optical portion 2 and the support portion 3 are integrally molded. As the material of the intraocular lens 1, for example, various soft materials such as a simple substance such as BA (butyl acrylate) and HEMA (hydroxyethyl methacrylate) and a composite material of an acrylic acid ester and a methacrylic acid ester can be adopted.

The optical unit 2 applies a predetermined refractive power to the patient's eye. The support portion 3 supports the optical portion 2 in the eye. As an example, the intraocular lens 1 of the present embodiment is provided with a pair of support portions 3. However, the number of support portions 3 is not limited to two. In the present embodiment, when the intraocular lens 1 is installed in the installation portion 130, the support portion 3 extending from the optical portion 2 toward the nozzle 180 (that is, forward) is referred to as a front support portion 3A, and the optical portion 2 is used. The support portion 3 extending from the plunger 300 toward the plunger 300 (that is, rearward) is referred to as a rear support portion 3B.

The pair of support portions 3 extend outward from the peripheral portion of the optical portion 2. The support portion 3 has a loop shape curved in the circumferential direction, and the tip of the support portion 3 is a free end. The pair of support portions 3 have a control shape with respect to the center of the optical portion 2 and extend in the same circumferential direction. Therefore, the straight line connecting the base end portions 4 of the pair of support portions 3 passes through the center of the optical portion 2.

(Extruded member)
The configuration of the extrusion member 310 in the plunger 300 of the present embodiment will be described in detail with reference to FIGS. 4 to 7. As shown in FIGS. 4 to 7, the front end portion of the extrusion member 310 is provided with a support portion contact portion 313, an optical portion contact portion 314, an upper protrusion portion 315, and a lower protrusion portion 316.

The support portion contact portion 313 deforms and moves the rear support portion 3B in a direction approaching the optical portion 2 (that is, forward) by contacting the rear support portion 3B of the intraocular lens 1. That is, the support portion contact portion 313 tacks the rear support portion 3B. The support portion contact portion 313 is provided above the optical portion contact portion 314 in the front end portion of the extrusion member 310. Therefore, although the details will be described later, when the rear support portion 3B is pushed forward by the support portion contact portion 313, the rear support portion 3B moves above the optical portion 2. The support portion contact portion 313 is formed in a curved shape that is convex toward the front. Therefore, the rear support portion 3B is not easily damaged.

The optical unit contact portion 314 pushes the optical unit 2 forward by coming into contact with the optical unit 2 of the intraocular lens 1. The optical portion contact portion 314 is provided below the support portion contact portion 313 in the front end portion of the extrusion member 310. The optical portion contact portion 314 is formed in a curved shape that is convex toward the front, similarly to the support portion contact portion 313. Therefore, the optical unit 2 is not easily damaged.

As shown in FIG. 7, when the extrusion member 310 is viewed from the front along the extrusion shaft A, both the support portion contact portion 313 and the optical portion contact portion 314 face forward. Therefore, only by pushing the plunger 300 forward, the rear support portion 3B is tacked and the optical portion 2 is pushed forward.

As shown in FIG. 6, in the present embodiment, the front end surface of the support portion contact portion 313 projects further forward than the front end surface of the optical portion contact portion 314. In this case, tacking is performed in a state where the rear support portion 3B is extended far forward by the support portion contact portion 313 projecting forward from the optical portion contact portion 314. Therefore, the accuracy of tacking is improved. Further, the connection surface 318 connecting the front end surface of the support portion contact portion 313 and the front end surface of the optical portion contact portion 314 is inclined so as to face diagonally forward. Therefore, the optical portion 2 in contact with the connection surface 318 is smoothly guided to the optical portion contact portion 314.

As shown in FIG. 7, the support portion contact portion 313 is located at the base end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 in the left-right direction centered on the extrusion shaft A. It is unevenly arranged on the side (on the right side in this embodiment). This effect will be described later.

As shown in FIGS. 4 to 6, the upper protrusion 315 projects forward from the upper end of the front end surface of the support contact portion 313. The upper protrusion 315 suppresses the rear support portion 3B from shifting upward from the support portion contact portion 313. As a result, the problem that the rear support portion 3B does not come into contact with the support portion contact portion 313 is suppressed, so that tacking can be easily performed appropriately. Further, the lower protrusion 316 projects forward from the lower end of the front end surface of the optical contact portion 314. The lower protrusion 316 suppresses the optical portion 2 from shifting downward from the optical portion contact portion 314. As a result, the problem that the optical unit 2 is sandwiched between the bottom surface of the extrusion member 310 and the inner wall of the nozzle 180 is suppressed. The phrase "upper end of the front end surface of the support portion contact portion 313" does not limit the upper protrusion 315 to be strictly located at the upper end of the front end surface. That is, the upper protrusion 315 may be arranged in the vicinity of the upper end of the support contact portion 313. Similarly, the lower protrusion 316 may be arranged in the vicinity of the lower end portion of the optical portion contact portion 314.

As shown in FIG. 7, many configurations (in this embodiment, a support portion contact portion 313, an optical portion contact portion 314, an upper protrusion portion 315, and a lower protrusion portion 316) are provided at the front end portion of the extrusion member 310. There is a need. Therefore, it is very difficult to secure a space between the extruded member 310 and the inner wall of the nozzle 180 by simplifying the configuration of the front end portion of the extruded member 310. If the space between the extrusion member 310 and the inner wall of the nozzle 180 is narrow, the load applied to a part of the intraocular lens 1 that enters this space becomes large. However, the intraocular lens insertion device 10 of the present embodiment is provided with the configuration described below (for example, the first recessed portion 321 and the upper rib 322) to suppress an increase in the load applied to the intraocular lens 1. can do.

Next, the configuration on the right side of the extrusion member 310 will be described. As shown in FIG. 4, on the right side of the extrusion member 310, a first recessed portion 321, an upper rib 322, and a lower rib 323 are provided.

The first depressed portion 321 is formed behind the support portion contact portion 313 and the optical portion contact portion 314 in the first side surface (right side surface in this embodiment) 320 of the extrusion member 310. The first depressed portion 321 is a portion of the support portion contact portion 313 and the optical portion contact portion 314 that is recessed inward (to the left in this embodiment) of the first side surface 320A. The first depressed portion 321 is a part of the intraocular lens 1 that has entered between the first side surface 320 and the inner wall of the nozzle 180 (for example, in the vicinity of the base end portion 4B of the rear support portion 3B in a tacked state). Becomes a space to escape. Therefore, by forming the first depressed portion 321 the load applied to the intraocular lens 1 is reduced, and the occurrence of damage to the intraocular lens 1 is suppressed.

As shown in FIG. 4, the space between the first side surface 320A of the support portion contact portion 313 and the optical portion contact portion 314 and the side surface 321A of the innermost portion of the first recessed portion 321 faces diagonally backward. It is smoothly connected by the inclined surface 321B. Therefore, there is no sharp step between the first side surface 320A of the support portion contact portion 313 and the optical portion contact portion 314 and the side surface 321A of the innermost portion of the first recessed portion 321. Therefore, when a part of the intraocular lens 1 that has escaped to the first depressed portion 321 returns to the front, it is possible to prevent the intraocular lens 1 from being damaged by a sharp step.

The upper rib 322 is a rib-shaped member that projects laterally (to the right in the present embodiment) from the upper end portion of the first side surface (right side in the present embodiment) 320 of the extrusion member 310. The upper rib 322 extends continuously from the front end portion of the support portion contact portion 313 to the first depressed portion 321. Although the details will be described later, the upper rib 322 allows a part of the intraocular lens 1 to enter the gap 200 (see FIG. 9) between the upper surface of the extrusion member 310 and the inner wall of the nozzle 180 from the first side surface 320 side. Suppress. The upper rib 322 does not have to be strictly formed at the upper end of the first side surface 320. That is, the upper rib 322 may be arranged near the upper end portion of the first side surface 320.

The lower rib 323 projects laterally (to the right in the present embodiment) from the lower end of the first recessed portion 321 in the first side surface (right side in the present embodiment) 320 of the extrusion member 310. The lower rib 323 prevents a part of the intraocular lens 1 from entering the gap formed by the bottom surface of the extrusion member 310 and the inner wall of the nozzle 180 from the side of the first side surface 320. It should be noted that the lower rib 323 does not have to be strictly formed at the lower end of the first side surface 320 as well as the upper rib 322.

Next, the configuration on the left side of the extrusion member 310 will be described. As shown in FIG. 5, of the second side surface (left side surface in this embodiment) 325 of the extrusion member 310, the second recessed portion 326 that is recessed inward is formed on the left side of the support portion contact portion 313. .. The second depressed portion 326 is a space in which a part of the deformed intraocular lens 1 escapes. Therefore, by providing the second recessed portion 326, it becomes difficult to apply a load to a part of the intraocular lens 1 that enters the left side of the extrusion member 310.

(Movement and deformation of intraocular lens)
With reference to FIGS. 8 to 10, the movement and deformation of the intraocular lens 1 from the installation portion 130 to the nozzle 180 when the intraocular lens 1 is inserted into the eye by the intraocular lens insertion device 10 of the present embodiment. The state of is explained.

First, the operator rotates the set portion 170 (see FIG. 1) to push out the intraocular lens 1 held by the holding portion 160 (see FIG. 1) of the installation portion 130 by the plunger 300. Move to a possible standby position. Here, as shown in FIG. 8A, the proximal end portion 4B of the rear support portion 3B in the intraocular lens 1 held by the holding portion 160 is displaced in either the left or right direction with respect to the extrusion shaft A. ing. As an example, in the present embodiment, the base end portion 4B of the rear support portion 3B is located on the right side (lower side in FIG. 8) with respect to the extrusion shaft A. Therefore, in the present embodiment, the right direction of the intraocular lens insertion device 10 is the above-mentioned first direction, and the left direction is the above-mentioned second direction. The direction in which the support portion 3 of the intraocular lens 1 extends may be the opposite direction to that of the present embodiment. In this case, the above-mentioned first direction is the left direction of the intraocular lens insertion device 10.

Next, the operator injects a lubricant (viscoelastic substance) into the installation portion 130 using an injector or the like, and starts the movement of the plunger 300 forward. As a result, as shown in FIG. 8A, the support portion contact portion 313 of the extrusion member 310 (see FIGS. 4 to 7) comes into contact with the rear support portion 3B of the intraocular lens 1.

When the plunger 300 is pushed further forward, as shown in FIG. 8B, the rear support portion 3B is moved (bent) toward the optical portion 2 by the extrusion member 310. As described above, the support portion contact portion 313 is provided above the optical portion contact portion 314. Therefore, the rear support portion 3B is deformed and moved upward of the optical portion 2, and the tip of the rear support portion 3B faces forward. As a result, the rear support portion 3B is tacked.

Further, as described above, the support portion contact portion 313 is located at the base end portion 4B (see FIG. 8A) of the rear support portion 3B of the intraocular lens 1 in the left-right direction centered on the extrusion shaft A. It is unevenly arranged on the side (on the right side in this embodiment). In this case, the support portion contact portion 313 pushes the position of the rear support portion 3B near the base end portion 4B forward. Therefore, the deformation movement of the rear support portion 3B is stable and the movement amount is easily secured as compared with the case where the tip end side of the rear support portion 3B is pushed.

When the plunger 300 is pushed further forward, the optical portion contact portion 314 (see FIGS. 4 to 7) of the extrusion member 310 comes into contact with the optical portion 2, and the entire intraocular lens 1 moves forward. As shown in FIG. 8C, when the intraocular lens 1 reaches the nozzle 180, the front support portion 3A comes into contact with the inner wall of the tapered nozzle 180. As a result, the front support portion 3A is deformed and moved upward of the optical portion 2, and the tip of the front support portion 3A faces backward. That is, the front support portion 3A is tacked.

When the plunger 300 is pushed further forward, the optical portion 2 of the intraocular lens 1 also comes into contact with the inner wall of the tapered nozzle 180. As a result, as shown in FIG. 8D, the intraocular lens 1 is folded into small pieces with the front support portion 3A and the rear support portion 3B tacked.

As shown in FIG. 8 (e), the intraocular lens 1 is folded small enough to be pushed forward. The vicinity of the base end portion 4B of the rear support portion 3B and the vicinity of the rear end portion of the optical portion 2 enter between the first side surface 320 of the extrusion member 310 and the inner wall of the nozzle 180. Since the passage area of the nozzle 180 becomes narrower toward the front, the space between the first side surface 320 and the inner wall of the nozzle 180 gradually becomes narrower. As a result, the load applied to the rear support portion 3B may gradually increase. However, the first recessed portion 321 (see FIG. 4 and the like) is formed on the first side surface 320 of the extrusion member 310 of the present embodiment. The rear support portion 3B that has entered between the first side surface 320 and the inner wall of the nozzle 180 can escape to the first recessed portion 321. Therefore, the increase in the load applied to the rear support portion 3B is suppressed by the first depressed portion 321.

Further, as shown in FIG. 9, a gap 200 is formed between the upper surface of the extrusion member 310 and the inner wall of the nozzle 180. As the passage area of the nozzle 180 becomes narrower, a part of the intraocular lens 1 may be caught in the gap 200. If the extrusion member 310 is pushed forward with a part of the intraocular lens 1 sandwiched between the gaps 200, the intraocular lens 1 may be damaged or the like. As the passage area of the nozzle 180 becomes narrower, a part of the intraocular lens 1 is pressed against the entrance of the gap 200 and becomes more likely to be pinched.

However, the extrusion member 310 of the present embodiment is formed with an upper rib 322. As shown in FIG. 9, the upper rib 322 functions to prevent a part of the intraocular lens 1 from entering the gap 200 from the first side surface 320 side. Therefore, a part of the intraocular lens 1 is not sandwiched by the gap 200 and wraps around below the upper rib 322. As a result, as shown in FIG. 10, the intraocular lens 1 smoothly moves forward without being sandwiched by the gap 200 even in the insertion portion 182 having the narrowest passage area. Therefore, the possibility that the intraocular lens 1 is damaged or the like is reduced.

As described above, in the intraocular lens insertion device 10, a part of the intraocular lens 1 gets into the space between the extrusion member 310 and the inner wall of the nozzle 180. In particular, as shown in FIG. 9, a part of the rear support part 3B enters the space between the first side surface 320 of the extrusion member 310 and the inner wall of the nozzle 180 in addition to the part of the optical part 2. Further, in the present embodiment, as described above, the support portion contact portion 313 of the extrusion member 310 is unevenly arranged on the first side surface 320 side (right side in FIG. 9). Therefore, the space on the side of the first side surface 320 is narrow. Further, in the present embodiment, the front end surface of the support portion contact portion 313 projects forward from the front end surface of the optical portion contact portion 314. Therefore, the volume of the optical portion 2 that enters between the first side surface 320 and the inner wall of the nozzle 180 is increased as compared with the case where the front end surface of the support portion contact portion 313 does not project forward from the front end surface of the optical portion contact portion 314. do. Therefore, a large load is likely to be applied to a part of the intraocular lens 1 that has entered between the first side surface 320 and the inner wall of the nozzle 180. However, the intraocular lens insertion device 10 of the present embodiment is provided with the first recessed portion 321 and the upper rib 322, so that the increase in the load applied to the intraocular lens 1 can be suppressed.

The techniques disclosed in the above embodiments are merely examples. Therefore, it is possible to modify the techniques exemplified in the above embodiments. For example, the intraocular lens insertion device 10 of the above embodiment includes a plurality of configurations in order to suppress an increase in the load applied to the intraocular lens 1. However, even if all of these configurations are not adopted and only a part of the configurations are adopted, the increase in the load applied to the intraocular lens 1 is suppressed. For example, the extruded member 310 may be provided with an upper rib 322 without the first recessed portion 321. Further, the extrusion member 310 may include a first recessed portion 321 without providing the upper rib 322.

Further, in the above embodiment, the upper rib 322 is provided on the first side surface 320, but the rib is not provided on the upper end portion of the second side surface 325. However, ribs (second side surface ribs) may also be provided at the upper end of the second side surface 325. In this case, the second side surface rib extends laterally (to the left in this embodiment) from the upper end portion of the second side surface 325, and is continuous from the front end portion to the rear end side of the support portion contact portion 313. May be extended. In this case, the second side surface rib prevents a part of the intraocular lens 1 from entering the gap 200 between the upper surface of the extrusion member 310 and the inner wall 185 of the nozzle 180 from the second side surface 325 side.

Further, in the intraocular lens insertion device 10 of the above embodiment, as shown in FIG. 9, the upper rib 322 provided on the extrusion member 310 suppresses a part of the intraocular lens 1 from entering the upper gap 200. do. However, it is possible to change this configuration. For example, instead of the upper rib 322 of the extrusion member 310, a rib protruding inward from the inner wall of the nozzle 180 may be provided. Even in this case, the possibility that a part of the intraocular lens 1 is caught in the gap 200 is reduced.

1 Intraocular lens 2 Optical part 3 Support part 3B Rear support part 4 Base end part 10 Intraocular lens insertion device 180 Nozzle 183 Insertion port 300 Plunger 310 Extruding member 313 Support part contact part 314 Optical part contact part 315 Upper protrusion 316 Lower protrusion 320 First side surface 321 First depression 322 Upper rib 323 Lower rib A Extruded shaft

Claims (3)

A deformable intraocular lens with an optic and one or more supports that curve outward from the optic is inserted into the eye through an internal passage through an insertion slot at the anterior end. It is an intraocular lens insertion device
The passage area becomes narrower toward the front, and the nozzle having the insertion port at the front end and the nozzle.
A rod-shaped extrusion member that pushes the intraocular lens forward by moving forward in the passage along the extrusion axis , which is the axis of the passage.
Equipped with
The extruded member is
An optical portion contact portion formed on the front end side of the extruded member and contacting the optical portion to push the optical portion forward.
A direction in which the rear support portion approaches the optical portion by contacting the rear support portion, which is the support portion that is formed above the optical portion contact portion on the front end side of the extruded member and extends rearward from the optical portion. With the support contact part to be moved to
When the side surface of the left side surface and the right side surface of the extruded member on the side where the base end of the rear support portion of the intraocular lens is located is defined as the first side surface, the optical portion of the first side surface is used. A first depressed portion formed behind the contact portion and the support portion contact portion and recessed inward on the extrusion shaft side of the first side surface of the optical portion contact portion and the support portion contact portion.
An upper rib that projects laterally from the upper end of the first side surface and continuously extends from the front end of the support contact portion to the first recessed portion.
An intraocular lens insertion device characterized by being equipped with. The intraocular lens insertion device according to claim 1.
An intraocular lens insertion device, wherein the front end surface of the support portion contact portion projects further forward than the front end surface of the optical portion contact portion. The intraocular lens insertion device according to claim 1 or 2.
The intraocular lens insertion device, characterized in that the support portion contact portion is biased to the side of the left side and the right side of the shaft where the proximal end of the rear support portion of the intraocular lens is located.

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