JPH0723991A - Instrument for inserting deformable intraocular implant - Google Patents

Abstract

PURPOSE:To provide an instrument for inserting an intraocular implant, that can dispense with assembling an instrument main body and a wrapping member together, insert the intraocular implant into the implant holder of the wrapping member with good operability, and precisely hold the implant being deformed into a smaller shape. CONSTITUTION:A wrapping member 16 is provided integrally with the end of a cylindrical instrument main body 12, and an opening mechanism 18 is opened to put an intraocular implant in an implant holder provided in the wrapping member 16, and the opening mechanism 18 deforms the intraocular implant into a smaller shape. Then a locking member 27 mounted on the instrument main body 12 is moved to lock the opening mechanism 18 in a closed position, and the deformed intraocular implant 1 is held in the holder, then extruded from the holder via an insertion tube 21 by control of an extruding mechanism 13 mounted in the instrument main body 12, and is inserted into the eye through a small cut.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an insertion instrument for inserting a deformable intraocular lens into the eye instead of the crystalline lens after the crystalline lens has been removed due to a cataract.

[0002]

2. Description of the Related Art It is considered that in a surgical operation for removing a lens caused by a cataract, the smaller the incision created in the eyeball, the smaller the occurrence of postoperative astigmatism. Therefore, a technique called ultrasonic phacoemulsification (KPE) using an ultrasonic emulsification suction device has been developed. According to this procedure, the cloudy cloudy lens is crushed with an ultrasonic tip, emulsified and sucked by using the above-mentioned device, whereby the lens can be removed with an incision of about 4 mm, which is a conventional external cataract extraction (ECCE). It is possible to perform small incision surgery, compared with an incision of about 10 mm at the time of lens extraction.

[0003] Similar to the above-mentioned surgical incision, an intraocular lens that can be inserted from a small incision has appeared. Conventional intraocular lenses have an optical part made of a hard material such as glass or plastic, and the incision at the time of implantation is larger than the diameter of the optical part, usually 6.5 mm or more, and a small cut with KPE. Even if the lens was removed from the wound, the incision had to be expanded when inserting a hard intraocular lens.

On the other hand, Japanese Patent Application No. 58-18005 (Japanese Patent Laid-Open No. 58-146346) discloses a deformable intraocular lens which can be inserted through a small incision made in the eye. That is, as shown in FIG. 3, as a deformable intraocular lens 1, an optical part 2 formed of a deformable elastic body having a predetermined memory characteristic, and a support part 3 for supporting the optical part 2 in the eye. The support portion 3 is made of a flexible material different from that of the optical portion 2, the base portion 3a is embedded and fixed in the outer peripheral portion of the optical portion 2, and the linear tip portion 3b is curved to form two support portions. There was one in which 3 was arranged symmetrically. Also, FIG.
As shown in FIG. 3, there is also one in which two thin plate-like support portions 4 supporting the optical portion 2 are integrally protruded from the outer periphery of the optical portion 2 similar to the optical portion of FIG. It was

As a deformable intraocular lens insertion instrument, there is one disclosed in Japanese Patent Application No. 3-142067.
As shown in FIG. 5, this insertion instrument has a substantially tubular instrument body 5 having a mounting groove 5a having a narrow portion on the tip side as shown in FIG.
And a push-out mechanism 6 fitted into the tool body 5 and a push-out mechanism 7 having a male screw cylinder 7a screwed into a female screw of the tool body 5 for advancing and retracting the push-out shaft 6 and a lens having an opening / closing mechanism 8. The holding member 11 having the insertion tube 10 protruding is provided on the distal end side of the installation portion 9.

In order to insert the deformable intraocular lens 1 into the eye with this insertion instrument instead of the crystalline lens, the opening / closing mechanism 8 is opened in the lens setting portion 9 of the wrapping member 11 removed from the instrument body 5. In this state, install the intraocular lens 1,
By closing the opening / closing mechanism 8, the intraocular lens 1 is changed to a small shape, and while maintaining this shape, most of the holding member 11 is fitted into the tip portion of the instrument body 5 from the mounting groove 5a, and the holding member is held. 11 is advanced, the holding member 11 is detachably locked to the instrument body 5, and the insertion tube 10 is projected from the tip of the instrument body 5 to assemble the insertion instrument.

After assembling as described above, the operating portion 7b at the terminal end of the male screw cylinder 7a of the pushing mechanism 7 of the insertion instrument is rotated to move the retracted pushing shaft 6 forward so that the tip of the pushing shaft 6 is advanced. The intraocular lens 1 is pushed out from the lens installation portion 9 of the enclosing member 11 through the insertion tube 10 by a part, and the intraocular lens 1 is inserted into the eye from a small incision of about 4 mm created in the eyeball.
The optical part 2 of the intraocular lens 1 is returned from the small deformed shape to a large shape such as the shape before the deformation based on the memory characteristic, and the operation with the small incision as described above can be performed from both sides of the intraocular lens and the insertion instrument. I have to.

The instrument body 5 of the insertion instrument and the pushing mechanism 7
The extruding shaft 6 and the male screw cylinder 7a are made of metal, and the holding member 11
Is an integrally molded product of flexible synthetic resin.

[0009]

However, in the above-described conventional deformable intraocular lens insertion instrument, since the instrument body and the wrapping member are separate parts, the wrapping member is provided outside the instrument body. When the intraocular lens is installed, that is, the intraocular lens is placed in the lens installation part of the packaging member, and the optical part of the intraocular lens is closed while the opening / closing mechanism is closed and deformed into a small shape, and is wrapped. It is necessary to position and lock the member in the instrument body and assemble the insertion instrument, and the workability of this assembly operation is not good.

During the above-mentioned operation, when the opening / closing mechanism provided in the lens installation part provided in the enclosing member opens, the intraocular lens put in the lens installation part pops out from the installation part or the inside of the installation part. Even if it is displaced, the holding member is locked to the instrument body, and the extrusion shaft of the extrusion mechanism is moved forward, the intraocular lens cannot be pushed out, or the intraocular lens is properly inserted into the eye. There was a problem that things became difficult.

The present invention solves the above-mentioned problems,
The operation of assembling the instrument body and the wrapping member is not required, and the intraocular lens can be put into the lens setting part of the wrapping member, deformed into a small shape and held, and the workability is improved. It is an object of the present invention to provide a deformable intraocular lens insertion device that does not cause protrusion or displacement of the intraocular lens and can be inserted into the eye through a properly small incision.

[0012]

SUMMARY OF THE INVENTION The present invention is a deformable intraocular lens comprising an optical portion formed of a deformable elastic body having a predetermined memory characteristic and a support portion for supporting the optical portion in the eye. In the insertion instrument, a holding member is integrally provided on the distal end side of a substantially cylindrical instrument body, and a lens installation portion having an opening / closing mechanism for slightly deforming the intraocular lens is provided on the distal end side of the holding member. , An insertion tube is continuously provided on the tip side of the installation section, and an extrusion mechanism having an extrusion shaft for ejecting an intraocular lens from the tip of the insertion tube is attached to the instrument body, and the opening / closing mechanism is locked in a closed state. The locking member is attached to the instrument body so as to be able to move back and forth.

[0013]

In the deformable intraocular lens insertion instrument according to the present invention, since the instrument main body and the wrapping member are integrated, the opening / closing mechanism of the wrapping member is opened and the intraocular lens is inserted into the lens installation portion to open and close. By closing the mechanism, the intraocular lens placed in the lens installation part is transformed into a small shape, and the locking member attached to the instrument body is moved to the lens installation part side to lock the opening / closing mechanism in the closed state. The intraocular lens can be held in the lens installation portion, the operation of assembling the instrument body and the wrapping member is not necessary, and the operation of holding the intraocular lens can be performed easily and in a short time, and the workability is good.

Further, the lens deformed into a small shape by being placed in the lens installation portion can be locked in the closed state by simply moving the locking member, so that the intraocular lens in the lens installation portion can be locked. There is no popping out or displacement.Therefore, the intraocular lens placed in the lens installation part can be pushed out from the insertion tube of the holding member by the operation of the pushing mechanism, and it can be inserted accurately into the eye from a small incision, and the safety is also high. .

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT An embodiment of the present invention will be described below with reference to FIGS.
Will be described with reference to. In FIG. 1, reference numeral 12 is a substantially tubular instrument body, and the large-diameter end side portion 12a of the instrument body 12 is shown.
A screw 12c is formed in a short range on the outer peripheral surface, and a screw 14a is screwed into the male screw 12c for forming on the inner peripheral surface of the operating cylinder 14 provided in the pushing mechanism 13.

The push-out mechanism 13 has an end portion of the push-out shaft 15 inserted coaxially into the operating cylinder 14 so that the end portion of the push-out shaft 15 can be rotated around the axis with respect to the operating cylinder 14. The axial movement is restrained and supported, and the distal end side portion of the push-out shaft 15 is inserted into the instrument body 12 coaxially therewith to extend to the tip side of the instrument body 12, and with respect to the instrument body 12 by appropriate means not shown. The rotation is restricted, and a slightly large diameter extrusion portion 15a is formed at the tip of the extrusion shaft 15. The end surface of the operating cylinder 14 is closed by an appropriate means.

As shown in FIG. 2, the distal end side portion 12b of the instrument body 12 is fixed to the instrument body 12 coaxially with the distal end side cylinder body 17 of the holding member 16 which will be described later. There is. The holding member 16 forms a distal end side tubular body 20 via a lens installation portion 19 having an opening / closing mechanism 18 on the distal end side of the distal side tubular body 17, and a tapered insertion barrel 21 at the distal end side of the distal end side tubular body 20. Is projected, and these parts are arranged coaxially.

The lens installation portion 19 is a distal end side cylinder body 17.
The fixed half-split cylinder 22 is integrally provided between the end-side cylinder 20 and the tip-side cylinder 20, and the movable half-split cylinder 23 facing the fixed half-split cylinder 22 is provided between the end-side cylinder 17 and the tip-side cylinder 20. The movable half-split cylinder 22 and the movable half-split cylinder 23 are connected at their lower edges by hinges 24.

A fixed holding plate 25 and a movable holding plate 26 are projected upward from the upper edges of the fixed half-split cylinder 22 and the movable half-split cylinder 23, respectively.
5a is formed. Further, a notch 23a is formed in the upper part on the terminal side of the movable half-split tube 23, and the movable pressing plate 26 has the notch 23a.
It is provided only in the portion where a is not formed. The movable half-split cylinder 23, the hinge portion 24, and the movable presser plate 25 constitute the opening / closing mechanism 18, and when the open / close mechanism 18 is closed, the movable presser plate 26 abuts on the fixed presser plate 25, and the movable half-split cylinder 2
3 is in contact with the fixed half-split cylinder 22, and these are connected to the end side cylinder 1
7. It has a tubular shape concentric with the tip side tubular body 20.

The distal end portion 12b of the instrument body 12 and the distal end cylindrical body 17 of the wrapping member 16 are coaxial and continuous with the same outer diameter, and a cylindrical transparent locking member 27 is slid in the axial direction thereof. A locking groove 27a extending along the axial direction is formed in the upper part on the tip side of the locking member 27 so that the rotation around the axis can be restrained and fitted. Then, the locking member 27 is locked in the closed state of the opening / closing mechanism 18 in which the locking groove 27a is in contact with the fixed pressing plate 25 and the movable pressing plate 26 of the holding member 16 when moving forward, and the pressing plate 2 is moving when moving backward.
The opening / closing mechanism 18 is opened by being separated from the terminals 5 and 26. The instrument body 12, the operating cylinder 14, the pushing shaft 15, and the locking member 26 are each formed of a synthetic resin molded product, and the holding member 16 is formed of a flexible synthetic resin integrally molded product. .

In order to insert the deformable intraocular lens 1 shown in FIG. 3 into the eye using the insertion device of this embodiment, the pushing shaft 15 of the pushing mechanism 13 and the tubular locking member 27 are used. It is retracted, and the opening / closing mechanism 18 provided on the holding member 16 is opened, that is, the movable holding plate 25 and the movable half-cylinder 23 are opened as shown in FIG. In this state, the diameter of the optical portion 2 of the intraocular lens 1 is located on the hinge portion 24 in the lens installation portion 19, and one support portion 3 is fixed to the fixed half tube 2.
The intraocular lens 1 is positioned and installed so that it projects forward from the second side and the other support part 3 projects rearward toward the movable half-divided tube 23 side.

Next, the movable pressing plate 26 and the movable half-split cylinder 2
3 is closed to fit the fixed holding plate 25 and the fixed half-split cylinder 22, and the movable and fixed half-split cylinders 23, 22 are deformed into a small shape in which the optical portion 2 is bent into two folds to be mounted on the lens installation portion 19. Hold.

In this holding state, the locking member 27 is moved forward, the locking groove 27a is fixed, and the movable pressing plates 25 and 26 are forcibly fitted, so that these pressing plates 25 and 26 are locked in the closed state. To do. Subsequently, by manually rotating the operating cylinder 14 of the pushing mechanism 13 by hand, the female screw 14a of the operating cylinder 14 and the male screw 12c of the instrument body 12 are screw-fitted, whereby the pushing shaft 15 moves forward together with the operating cylinder 14. To do.

As the push-out shaft 15 advances, the push-out portion 15a at the tip end thereof comes into contact with the optical portion 2 of the intraocular lens 1 and pushes the push-out portion 15a to insert the intraocular lens 1 through the distal end side cylinder 20 into the insertion tube. 21 is pushed out of the instrument, and the lens is inserted into the eye through a small incision.

In the intraocular lens 1, the distal end of the insertion tube 21 enters the eye through the incision, so that when the insertion tube 21 exits, the deformation of the optical section 2 causes an elastic restoring force based on the memory characteristic. As a result, it becomes a predetermined shape such as returning to a large shape before bending, and is transplanted while being supported in the eye by the support portion 3. It is preferable that the intraocular lens 1 is pushed out together with the lubricating liquid in order to smoothly advance the intraocular lens 1 in the insertion tube 21.

As described above, in the insertion instrument of this embodiment, the wrapping member 16 is fixed to the instrument body 12 and these are integrated, so that the deformable intraocular lens 1 is placed in the wrapping member 16. While maintaining the installed state, that is, the state in which the lens installation portion 19 of the wrapping member 16 is closed, the operation of assembling the wrapping member and the instrument body as in the above-described conventional example is eliminated, and the wrapping operation is performed during the assembling operation. The lens installation portion of the member is opened, and it is possible to prevent the deformable intraocular lens in the installation portion from popping out of the lens installation portion 19 or being displaced in the installation portion 19.

Further, in the insertion instrument of this embodiment, the tubular locking member 27 which fits the instrument body 12 and the distal end side cylinder body 17 of the wrapping member 16 is attached to the mounting portion 19 side of the wrapping member 16. By sending it, the opening / closing mechanism 18 of the lens installation part 19 can be secured in a closed state, so that a reliable and safe operation can be performed, and the operation of sending the locking member 27 to the lens installation part 19 side is easy. The operation of transforming the inner lens 1 from a large shape to a small shape and closing the opening / closing mechanism 18 can be performed in a short time, and the operability is excellent.

Since the tubular locking member 27 is a molded product of transparent synthetic resin, when the deformable intraocular lens 1 is installed in the lens installation portion 19, the opening / closing mechanism 18 and the like are engaged. It is possible to see through from the outside of the stopper member 27, the installation state of the intraocular lens 1 can be confirmed, and safety is improved.

In this embodiment, since the instrument body 12, the operating cylinder 14 of the pushing mechanism 13, the pushing shaft 15, the holding member 16 and the locking member 27 constituting the inserting instrument are molded articles of synthetic resin, the inserting instrument is used. Can be made inexpensive and can be disposable.

Further, in the intraocular lens 1, the support portion 3 is formed of a flexible material different from that of the optical portion 2, and the tip portion 3 of the support portion 3 is formed.
When b is curved, the curved front end portion 3a of the support portion 3 protruding to the rear of the optical portion 2 forms a notch 23a at the upper end of the movable half-divided cylinder 23 of the opening / closing mechanism 18. However, by eliminating the movable holding plate 26 above the notch 23a, the pushing portion 15a of the pushing shaft 15 does not interfere with the curved tip portion of the supporting portion 3 protruding rearward.

The deformable intraocular lens insertion device according to the present invention is not limited to the intraocular lens shown in FIG.
The intraocular lens in which the supporting portion 4 is integrally projected from the outer periphery of the deformable optical unit 2 shown in FIG. 4 can be used similarly to the intraocular lens shown in FIG. 3 described above. In the case of the intraocular lens shown in FIG. 4, the movable half-cylinder is not formed with a notch, and the end of the movable holding plate is located at a position corresponding to the end of the fixed holding plate. It is preferred that the dimensions are equal.

Further, in the insertion device according to the present invention, the distal end side cylinder of the holding member may be fixed to the tip of the container body by adhesion or the like, and the locking member is not necessarily limited to the cylindrical shape. The locking member, which has a groove formed in the lower portion of the tubular body over the entire length, may be elastically deformed and attached to the distal end side of the instrument body. In this case, the instrument body and the wrapping member are integrally molded. You can also

[0033]

As described above, according to the present invention, the deformable intraocular lens includes the optical portion formed of the deformable elastic body having a predetermined memory characteristic and the support portion for supporting the optical portion in the eye. A lens insertion instrument, in which a wrapping member is integrally provided on the distal end side of a substantially cylindrical instrument body, and a lens installation section having an opening / closing mechanism for slightly deforming the intraocular lens is provided on the distal end side of the wrapping member. Provided, the insertion tube is continuously provided on the distal end side of the installation portion, and the extrusion mechanism having an extrusion shaft for pushing out the intraocular lens from the distal end of the insertion tube is attached to the instrument main body,
Since the locking member for locking the opening / closing mechanism in the closed state is attached to the instrument body so as to be able to move forward and backward, the following effects can be obtained.

That is, in the deformable intraocular lens insertion instrument according to the present invention, since the instrument main body and the wrapping member are integrated, the opening / closing mechanism of the wrapping member is opened to insert the intraocular lens into the lens installation portion. , By closing the opening / closing mechanism, the intraocular lens put in the lens installation part is deformed into a small shape, and the locking member attached to the instrument body is moved to the lens installation part side to lock the opening / closing mechanism in the closed state. As a result, the intraocular lens can be held in the lens installation portion, the operation of assembling the instrument body and the wrapping member becomes unnecessary, and the operation of holding the intraocular lens can be performed easily and in a short time, and the workability is good.

In addition, the lens deformed into a small shape by being placed in the lens setting portion can be locked in the closed state only by moving the locking member, so that the intraocular lens in the lens setting portion can be locked. There is no popping out or displacement.Therefore, the intraocular lens placed in the lens installation part can be pushed out from the insertion tube of the holding member by the operation of the pushing mechanism, and it can be inserted accurately into the eye from a small incision, and the safety is also high. .

[Brief description of drawings]

FIG. 1 is a partially cutaway perspective view showing a deformable intraocular lens insertion device according to an embodiment of the present invention.

FIG. 2 is a perspective view of a holding member of the insertion device shown in FIG.

FIG. 3 is an enlarged front view showing an example of a deformable intraocular lens.

FIG. 4 is an enlarged front view showing another example of the deformable intraocular lens.

FIG. 5 is a perspective view showing a deformable intraocular lens insertion device according to a conventional example.

[Explanation of Codes] 1 intraocular lens 2 optical part 3 support part 12 instrument body 13 extrusion mechanism 14 operation cylinder 15 extrusion shaft 15a extrusion part 16 enclosing member 17 end side cylinder 18 opening / closing mechanism 19 lens installation part 20 tip side cylinder Body 21 Insertion tube 22 Fixed half-split tube 23 Movable half-split tube 24 Hinge part 25 Fixed holding plate 26 Movable holding plate 27 Locking member

Claims (1)

[Claims] 1. An apparatus for inserting a deformable intraocular lens, which comprises an optical section formed of a deformable elastic body having a predetermined memory characteristic, and a support section for supporting the optical section in the eye, comprising: A wrapping member is integrally provided on the distal end side of the tubular instrument body, and a lens installation portion having an opening / closing mechanism for slightly deforming the intraocular lens is provided on the distal end side of the wrapping member, and the distal end side of this installation portion is provided. An insertion cylinder is provided in series, and an extrusion mechanism having an extrusion shaft that pushes out an intraocular lens from the tip of this insertion cylinder is attached to the instrument body, and a locking member that locks the opening / closing mechanism in a closed state can be advanced and retracted. A deformable intraocular lens insertion device characterized by being attached to a device body.