JPS5955250A - Forcept for extracting crystal - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a separator used by ophthalmologists when removing a crystalline lens, and in particular, to improve a separator for the entire crystalline lens, which is used when the entire crystalline lens is grasped near the equator and removed as a whole. This is related to 1.

Various techniques have been used to remove the crystalline lens in the past, such as: - Intracapsular lens extraction method, in which the front surface of the lens capsule is lightly pinched with a capsular bag and gently pulled out from the pupil while applying pressure from the surrounding area; Freezing method, which temporarily freezes the surface and removes the crystalline lens; ■ Method using a suction device to absorb and pull out the front surface of the lens by removing pressure; Removal methods and devices have been developed and implemented, such as the method of melting the crystalline lens and suctioning it through a thin tube, and the intracapsular extraction method of tearing the lens capsule and extracting only the nucleus and cortex inside. , there is a risk of damaging the lens capsule or causing damage to the tissues surrounding the water break, and there is also a concern that it may leave problems with the prognosis in terms of postoperative visual recovery and its deterioration.

In view of this point, the present inventor previously issued Patent No. 961769 (
As part of Japanese Patent Publication No. 53-39718), we have developed and provided a special lens for intracapsular extraction, which grips the entire crystalline lens near the equator and extracts the entire crystalline lens as it is.

In other words, this set consists of a pair of left and right gripping parts that clamp the crystalline lens, a clamping arm connected to these, a base, and a gripping part, and the gripping parts can be positioned against the front surface of the crystalline lens. The base part is rotatably supported on the gripping part, so that the gripping part can be opened along the crystalline lens with a rotational movement, and the gripping arm has a gripping surface. An inwardly bent part is provided to prevent the pupil from being unnecessarily expanded when the part is rotated and opened.

In other words, the clamping surface of the ophthalmoscope is used to create a recess that has as little negative impact on the surrounding tissues as possible, both when positioning the fascia relative to the front surface of the crystalline lens and when moving the fascia to both sides of the equator. In addition to being in contact with the front surface of the crystalline lens, the crystalline lens is to be clamped by a rectilinear movement after being separated with a rotational movement, and the unnecessary dilation of the pupil when the crystalline lens is rotated and opened is prevented at the inward bending part. This is something I tried to avoid.

This technique removes the entire crystalline lens by grasping it on both sides of the equator, so there is no risk of damaging the lens capsule, and since the extraction part is positioned and rotated along the surface of the lens, it removes the surrounding tissue. There was no risk of injury to the child, and a good prognosis was expected, making it an extremely desirable procedure.

However, the structure of the device included the following problems.

That is, the first point relates to the point of rotating and separating the pinching part. In order to make the trajectory of this pivoting and opening movement accurate, considerable precision is required in the bearing structure of the base of the grip, and its manufacture also requires advanced technology and strict examination of materials. shall be. Since it is a surgical instrument, it is natural that a structure that can withstand repeated sterilization and a selection of detergent materials are required. must be said to be inappropriate as a surgical instrument.
From this point of view, the shoe has the disadvantage that it requires considerable difficulty in manufacturing.

The second point relates to the operating state of Sekko. That is,
The structure is such that, after first being positioned on the front surface of the crystalline lens, the pinching parts are rotated apart and moved to both sides of the equator, and then moved straight in the direction of pinching the crystalline lens. 1
During the transition from the movement to the second movement, the operator had to shift the position of the finger to change the point of action on Setsuko, with Setsuko still inside the eyeball. Efforts have been made to ensure that Setsuko can be held in a stable state at all times due to the presence of the gripping part, but if possible, there is a W that may cause Setsuko to move unexpectedly.
It is preferable to avoid J construction.

Therefore, the object of this invention is to create a structure in which the stone itself performs only a single operation of opening and closing, like a general stone set, and in addition, like the previous invention, the crystalline lens can be moved at its equator. Grasp the whole body on both sides near the
To provide a lens extraction socket which enables intracapsular extraction of the crystalline lens without tearing the lens capsule or damaging surrounding tissues. As a result of research for this purpose, the inventors found that instead of giving the u-kko the function of rotating and opening the extraction part to the u-kko itself, as in the previous invention, the operator performs the action equivalent to the rotational movement. The idea was to create a structure that simply opens and closes in a straight line. The surrounding tissue must not be damaged by heat or linear opening/closing movements, and the structure must allow the operator to easily perform auxiliary rotational opening/closing movements. Therefore, the feature of this invention is that unlike the previous invention, the sewn is a sewn that simply makes a linear opening/closing movement without making a turning/opening movement, and can be operated by the operator with an auxiliary turning/opening movement. , the crystalline lens can be held between both sides of the lens, and there is no risk of damaging surrounding tissues during the entire surgical process from localization to removal of the crystalline lens.

The first thing that becomes a problem for J5 children like this is the truncation section. In the previous invention, since the pinching part landed on the bottom as if performing a pivoting motion, the clamping surface was made into a WJ structure that could be brought into contact with the front surface of the crystalline lens during localization to the front surface of the crystalline lens, and when rotating and separating, this clamping surface was approximately By turning 90 degrees, it was possible to make contact with both sides of the equator, and it was possible to maintain a positional relationship in which the outer surface of the crystalline lens and the clamping surface were always in contact with each other throughout the entire process. It is impossible for U-kko who only do this to achieve such a state of contact throughout the entire process.

However, if it is inevitable that the clamping surfaces are in contact with both sides of the crystalline lens, then when the clamping part is positioned in front of the crystalline lens in a case where the opening and closing movement is simply linear, it is natural that the clamping surfaces will also be in contact with each other. This means that we must maintain the same attitude. In other words, in order to make the clamping surface of the lens come into contact with the surface of both sides of the crystalline lens when clamping on both sides of the crystalline lens, the clamping surface of the clamp must be It takes a substantially perpendicular attitude to the surface of the crystalline lens. Moreover, since it moves from this state to both sides of the crystalline lens, the distance on the vertical line from the surface of the crystalline lens, that is, the height of the extraction part, acts as if to expand the gap between the crystalline lens and the iris when the front surface of the crystalline lens is localized. The iris is a very soft tissue, and it was necessary to take into consideration the impact on prognosis and to prevent unnecessary force from being applied to it.For this reason, the previous invention adopted a complicated movement form called a rotational separation motion. It is.

Therefore, in this invention, in order to solve this difficult problem, a specific shape is adopted as the shape of the knob. In other words, the shape of the knob is approximately elliptical, and the short axis is made as small as possible compared to the long axis, so that when the lens is orientated to the front surface of the crystalline lens, the short axis is approximately elliptical with respect to the surface of the crystalline lens. The point is that it is shaped so that it is located vertically. In theory, the smaller the dimension of the minor axis, the better from the above point of view, but in terms of sandwiching the crystalline lens on both sides,
If the short axis dimension is too small, it will not be possible to clamp and hold the crystalline lens in a stable state, so a certain limit exists. In addition, another preferable idea for the knob is to curve the clamping surface along the outer surface of the crystalline lens. That is, as mentioned above, since the pinching part is made into a flat ellipse shape with the short axis as small as possible, if left as is, the clamping surface is smaller than the pinching part of the previous invention, and there is a risk that the clamping state will lack stability. Therefore, it is preferable that the surface in the long sleeve direction be curved along the lens surface, especially along the lens surface on both sides. This compensates for the smallness of the clamping surface in the short axis direction and provides a gripping part that provides a more stable clamping state as a whole.

By the way, as mentioned above, the grip of the present invention is a lock that simply performs linear opening and closing motions, so after positioning the gripping portion on the front surface of the crystalline lens, it is necessary to move to the movement of gripping both sides of the crystalline lens. , the operator must rotate the setsuko and move the incision to both sides. In order to remove the crystalline lens, first insert the tube through an incision made at the outer edge of the cornea, close the surgical tube to the extent that it can pass through the pupil, and position it in front of the lens. The elastic force of the lens changes the angle in the direction of opening the jaws and causing the jaws to move along the outer surface of the crystalline lens to both sides.

It goes without saying that throughout the entire process of this removal surgery, the removal part and the clamping arm must be structured so as not to apply unnecessary pressure deformation to surrounding tissues such as the iris. Therefore, as mentioned above, in addition to making the shape of the pinching part oblate and elliptical, the left and right clamping arms are configured in a crossed shape when the pinching part is closed. The separation dimension is suppressed, and the clamping arm near the pupil passage part is provided with an inwardly bent part so that the pupil is not unnecessarily pushed open when the pupillary part is expanded.

The drawing shows an example of the above-mentioned insulator, in which a clamping arm 2.3 and a clamping part 4. 5 is provided. As shown in the figure, the picking part 4.5 has a flat elliptical shape with the short axis as small as possible compared to the long axis.
It is connected to the clamping arm 2.3 at one end in the long sleeve direction, and is configured so that the short axis is positioned approximately perpendicular to the surface of the crystalline lens during frontal orientation during crystal rest (see Figure 3B). .

Furthermore, the grip portion 4.5 is curved in the long sleeve direction, and is configured to have a curved surface that follows the outer surface of the crystalline lens when it is clamped on both sides of the crystalline lens (see FIG. 4B). As shown in Figure 3 △, the clamping arm 2.3 has a chiasm shape during occlusion to orient the acupuncture part on the anterior surface of the crystalline lens, and as shown in Figure 4B, the clamping arm 2.3 holds the acupuncture part in front of the crystalline lens. Inwardly bent portions 2a and 3a are provided to prevent the pupil from being unnecessarily pushed and dilated when the pupil is opened to avoid moving to both sides of the pupil. In FIGS. 3 and 4, C indicates the cornea, Ca indicates the incised mouth, and ■ indicates the iris.

The clamping arm in this embodiment has the following additional features.

As shown in FIG. 1A, the clamping arm 2.3, which extends horizontally from the main body 1 to the installation surface, is first tilted upward at an angle α, and then By bending it again, the inwardly bent portions 4a and 5a reach the opening portion 2.3, and the portion thereof is formed approximately horizontally with the installation surface. The inclination of the angle α is such that when inserting the extraction part and the clamping arm through the corneal wound and positioning the extraction part on the anterior surface of the crystalline lens, it is easy to insert and position the extraction part without being obstructed by the subject's forehead. This is to simplify the process and to prevent the wound opening from being unnecessarily widened by the clamping arms when moving the extraction part to both sides of the crystalline lens.

In addition, the reason why the area from this sloping part to the distal clamping part is returned to a horizontal state is that if the clamping part is provided on the extension line of the above-mentioned slanted part, the clamping arm and the main body, as well as the operator's This is to avoid the inconvenience of fingers blocking the surgical field of view.

As is clear from the detailed explanation above, the cushion according to the present invention is a cushion that only performs linear opening and closing motion, and it is a matter of course that it does not have a complicated bearing structure and is easy to manufacture.
Repeated disinfection like normal Seko Bureau.

Moreover, unlike the previous invention, there is no need to surgically change the position of the finger, and of course there is no risk of damaging surrounding tissues such as the iris during the entire process from localization to the front surface of the crystalline lens to extraction. It has been made with an extremely small structure, and provides the best one for intracapsular lens extraction.

[Brief explanation of the drawing]

FIG. 1 is an overall view of an embodiment of the V child according to the present invention, A is a front view, B is a plan view, and FIG.
Figure 3 Δ and B are explanatory diagrams showing the localization state to the front surface of the crystalline lens. In Figure 8, the right side is toward the forehead and the left side is toward the nose. be. FIGS. 4A and 4B are explanatory diagrams of a state in which the extraction part has been moved to both sides of the crystalline lens. 1... Body part 2, 3... Clipping arms 2a, 3a... Inward bending part 4.5... Picking part L...・・Crystalline lens■・
...Iris C ...Cornea Ca ...
・・Soguchi agent Patent attorney Oshima Sennan I Figure 3 Figure 4

Claims (1)

[Scope of Claims] 1. A crystalline lens extraction device consisting of a generally tweezers-shaped main body and a pair of left and right removal parts connected to the main body via a clamping arm, and capable of performing only linear opening and closing movements. In this case, the clamping arms have a cross-like shape when the pupillary part is closed, and the clamping arms in the pupillary passage part are provided with an inwardly bent part, and each pupillary part is bent as far as possible in the short axis direction compared to the long axis direction. For crystalline lens extraction, it has a small oblate elliptical shape and is connected to the clamping arm at the end in the long axis direction so that the short axis direction is located approximately perpendicular to the surface of the crystalline lens when the front surface of the crystalline lens is localized. Setsuko. 2. The lens extractor according to claim 1, wherein the long-sleeve direction surface of the extractor is curved along the surfaces of both sides of the crystalline lens.