US20010014808A1 - Insertion device for a deformable intraocular lens - Google Patents
Insertion device for a deformable intraocular lens Download PDFInfo
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- US20010014808A1 US20010014808A1 US09/372,966 US37296699A US2001014808A1 US 20010014808 A1 US20010014808 A1 US 20010014808A1 US 37296699 A US37296699 A US 37296699A US 2001014808 A1 US2001014808 A1 US 2001014808A1
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- Prior art keywords
- intraocular lens
- deformable intraocular
- enclosing member
- insertion device
- lens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/1664—Instruments for inserting intraocular lenses into the eye for manual insertion during surgery, e.g. forceps-like instruments
Definitions
- the present invention relates to an insertion device for inserting a deformable intraocular lens into the eye.
- a deformable intraocular lens examples include a deformable intraocular lens that is inserted into the eye in place of the natural lens when the latter is physically extracted because of cataracts, and a vision correction lens that is inserted into the eye for the sole purpose of vision correction.
- Implantation of an intraocular lens for treating cataract has been widely performed since 1949, when Ridley implanted for the first time an artificial lens, i.e., intraocular lens into the human eye in place of an opaqued natural lens during cataract surgery.
- an artificial lens i.e., intraocular lens into the human eye in place of an opaqued natural lens during cataract surgery.
- the intraocular lens used first had an optical portion made of polymethyl methacrylate (PMMA).
- PMMA polymethyl methacrylate
- the implantation of the intraocular lens was accompanied by complications which occurred after the cataract surgery.
- Many ophthalmologists have shown interest in the complications and have studied them.
- the optical portion is made of a hard material, an incision for implantation of such an intraocular lens must have a dimension somewhat greater than the diameter of the optical portion. Since an incision to be formed in the eyeball is large, in the degree of astigmatism after surgery increases due to suture of the incision.
- a method of surgery has been pointed out as a cause of the above-mentioned complications. That is, the conventional surgery for extracting a natural lens because of cataract has been performed by using an ECCE (extracapsular cataract extraction) operation technique in which a lens is extracted without crushing it. Since this operation technique has required formation of an incision of about 10 mm, the operation caused astigmatism quite often.
- ECCE extracapsular cataract extraction
- a technique called pharmacoemulsification (PEA) using an ultrasonic emulsification/suction apparatus has been developed recently. In this method, an opaqued natural lens is crushed and emulsified using ultrasonic waves emitted from a cylindrical ultrasonic chip, and is sucked for extraction.
- the size of an incision formed in the eyeball can be decreased to a size sufficient for insertion of the cylindrical ultrasonic chip.
- a crushed lens can be extracted through an incision of about 3 to 4 mm. Therefore, this method makes it possible to perform the extraction operation by forming only a small incision, which mitigates the astigmatism after the operation.
- the optical portion is made of a hard material, an incision for implantation of such an intraocular lens must have a dimension somewhat greater than the diameter of the optical portion, as mentioned above. In the case of a standard intraocular lens having an optical portion of 6.0 mm, an incision having a size equal to or greater than 6.5 mm must be formed.
- improved intraocular lenses In order to mitigate astigmatism after surgery, improved intraocular lenses have been developed which can decrease the size of incisions.
- improved lenses include an intraocular lens having an oval optical portion which is inserted into an incision such that its smaller radius is oriented in the direction of the incision, and an intraocular lens with an optical portion having a reduced diameter.
- each of these intraocular lenses still has a hard optical portion. Therefore, employment of these intraocular lenses decreases the incision size only to about 5.5 mm (i.e., only by about 1 mm).
- intraocular lenses themselves have been improved recently.
- Such an improved intraocular lens is disclosed in Japanese Patent Application Laid-Open (kokai) No. 58-146346.
- the intraocular lens at least an optical portion is made of a deformable elastic material having a predetermined memory characteristic.
- at least an optical portion is made of an elastic material having a predetermined memory characteristic, and supports are provided which are made of a material different from that of the optical portion and are adapted to support the optical portion within an eye.
- Japanese Patent Application Laid-Open (kokai) Nos as disclosed in Japanese Patent Application Laid-Open (kokai) Nos.
- FIGS. 32 to 35 show the conventional deformable intraocular lenses.
- the deformable intraocular lens shown in FIG. 32 is composed of a circular optical portion 2 and two symmetrically disposed supports 3 .
- the circular optical portion 2 is made of an elastic material having predetermined memory characteristics.
- the supports 3 are made of a material different from that of the optical portion 2 , and the bases 3 a of the supports 3 are embedded in the peripheral region of the optical portion 2 for fixing, while the wire-shaped tails 3 b are curved.
- the optical portion 2 has on the periphery thereof projections 2 a for reinforcing the positions where the bases 3 a of the supports 3 are embedded.
- Each of the deformable intraocular lenses shown in FIGS. 34 and 35 is composed of a circular optical portion 2 and a pair of thin plate-shaped support portions 4 that are integral with the optical portion 2 .
- the optical portion 2 like the optical portion 2 shown in FIG. 32, is made of an elastic material having predetermined memory characteristics.
- the support portions 4 are projected from the periphery of the optical port 2 in opposite directions.
- An insertion device disclosed in, for example, Japanese Patent Application Laid-Open (kokai) No. 7-23991 is used for deformable intraocular lenses, as shown in FIGS. 32 to 35 , each of which is composed of the optical portion 2 and the support portions 3 or 4 , of which at least the optical portion 2 has predetermined memory characteristics.
- the deformable intraocular lens 1 is folded in order to reduce its exterior size and is advanced along an insertion tube having, for example, a cylindrical shape, in order to be inserted into the eye through an incision formed in the eyeball.
- FIGS. 26 ( a ), 26 ( b ) and 27 show the structure and operation of the conventional insertion device.
- an enclosing member 5 of the insertion device having a hinge portion 6 is opened.
- a deformable intraocular lens is placed on a lens receiving section 7 such that the lens engages grooves 9 a and 9 b .
- the enclosing member 5 is closed so as to reduce the exterior size of the deformable intraocular lens and hold it.
- the grooves 9 a and 9 b become shallower toward the insertion-tube side of the lens receiving section 7 .
- the grooves 9 a and 9 b extend up to the rear end of the lens receiving section 7 while maintaining constant depth.
- the position where the lens is to be placed can be determined with reference to the converged portions. However, since the grooved structure continues unchanged to the rear end, no reference for positioning exists at the rear side, rendering the positioning difficult. Further, when the enclosing member 5 is closed, the deformable intraocular lens placed in the lens receiving section may move rearward.
- an engagement member 15 provided on a device body 12 is moved toward the lens receiving section 7 , while the closed state is maintained, so that the engagement member 15 engages the enclosing member 5 to maintain the closed state thereof.
- a push rod 13 of the insertion device is advanced to push forward the deformable intraocular lens received in the enclosing member 5 .
- the deformable intraocular lens is inserted into the eye through the tip end of a insertion tube 11 provided at the front end of the enclosing portion, which tip end can be inserted into the eye through a small incision formed on the eye ball.
- a hinge portion 6 projects outward with respect to the grooves 9 a and 9 b formed in the lens receiving section 7 . Therefore, when a deformable intraocular lens is placed on the lens receiving section 7 having such a configuration, as shown in FIG. 30, the deformable intraocular lens 1 interferes with the hinge portion 6 and curves. If the deformable intraocular lens 1 is allowed to remain in such a state for a long period of time, the lens 1 deforms with time.
- the operation of placing the deformable intraocular lens must be performed quickly, and therefore, the lens cannot be placed on the lens receiving section 7 in advance. That is, before insertion of the deformable intraocular lens into the eye, there is always required an operation for placing the lens on the lens receiving section 7 . Further, during the placement operation, the lens must be precisely placed at a proper position. However, the operation for precise and quick placement of the lens at a proper position is very difficult, because the intraocular lens and the lens receiving section 7 are both very small, resulting in the problem that an imprecise placement operation causes an insertion failure, such as abnormal insertion of the intraocular lens into the eye.
- insertion of a lens into the eye for the sole purpose of vision correction has recently been performed as an application of the above-mentioned intraocular lens insertion technique—which has been used for treatment of cataracts.
- the above-described insertion device can be used when the deformable vision correction lens is to be inserted into the eye through a small incision.
- the above-described insertion device has enabled insertion of a deformable intraocular lens, such as a deformable intraocular lens for cataract treatment or a deformable vision correction lens, into the eye through a small incision.
- a deformable intraocular lens such as a deformable intraocular lens for cataract treatment or a deformable vision correction lens
- a first object of the present invention is to provide an insertion device for a deformable intraocular lens, which device allows an operator to omit an operation of placing a lens on an enclosing member, through an operation of engaging the peripheral edge of the lens with the enclosing member in advance.
- a second object of the present invention is to provide an insertion device for a deformable intraocular lens, which device prevents movement of a lens after placement on the enclosing member and lets the operator know a location in the lens receiving section where the lens to be placed.
- a third object of the present invention is to provide an insertion device for a deformable intraocular lens, which device allows simultaneous performance, for simplified operation, of two independent operations of deforming a lens and bringing the deformed lens into a held state.
- the insertion device for a deformable intraocular lens has a structure in which a plurality of hinge portions provided in the enclosing member allow the peripheral edge of a deformable intraocular lens to engage the enclosing member, so that the lens can be held by the enclosing member in a state in which the optical portion of the lens substantially does not come into contact the enclosing portion.
- the insertion device for a deformable intraocular lens according to the present invention may have another structure which allows the peripheral edge of a deformable intraocular lens to engage the enclosing member without use of the hinge portions and which deforms the deformable intraocular lens with movement of the lens.
- the insertion device for a deformable intraocular lens has a structure in which grooves are formed in the lens receiving section of the enclosing member such that the grooves converge at the front and rear ends of the lens receiving section.
- the insertion device for a deformable intraocular lens has a structure in which the operation of closing the enclosing member to deform an intraocular lens within the enclosing member to thereby reduce its exterior size and the operation of bringing the deformed lens into a held state can be performed simultaneously through a single operation; i.e., movement of a holder of the insertion device.
- FIG. 1 is a plan view of an insertion device for a deformable intraocular lens according to a first embodiment of the present invention
- FIG. 2 is an enlarged view of a main portion of FIG. 1;
- FIG. 3 is a sectional view taken along line A-A in FIG. 2;
- FIG. 4 is an enlarged view of a main portion of FIG. 2;
- FIG. 5 is a sectional view taken along line B-B in FIG. 3;
- FIG. 6 is a sectional view taken along line C-C in FIG. 3;
- FIG. 7 is a sectional view taken along line D-D in FIG. 3;
- FIG. 8 is a plan view showing a state in which an intraocular lens placed in the insertion device of FIG. 1 has been deformed
- FIG. 9 is an enlarged view of a portion of FIG. 8;
- FIG. 10 is a sectional view taken along line E-E in FIG. 9;
- FIG. 11 is an enlarge sectional view taken along line F-F in FIG. 9;
- FIG. 12 is a plan view of the enclosing member of an insertion device for a deformable intraocular lens according to a second embodiment of the present invention in which grooves each have a converging portion having a different shape;
- FIG. 13 is a plan view of the enclosing member of an insertion device for a deformable intraocular lens according to a third embodiment of the present invention in which grooves each have a converging portion having a different shape;
- FIG. 14 is an enlarged sectional view of the enclosing member of an insertion device for a deformable intraocular lens according to a fourth embodiment of the present invention in which a lens is placed on the enclosing member in advance;
- FIG. 15 is an enlarged sectional view showing a state in which the enclosing member shown in FIG. 14 is closed and held by an engagement member;
- FIGS. 16 ( a ) and 16 ( b ) show a main portion of an insertion device for a deformable intraocular lens according to a fifth embodiment of the present invention, wherein FIG. 16( a ) is a plan view of the device with a cap member removed, and FIG. 16( b ) is a bottom view of the cap member;
- FIG. 17 is a sectional view taken along line G-G in FIG. 16 with the cap member attached;
- FIG. 18 is an enlarged sectional view taken along line H-H in FIG. 17;
- FIGS. 19 ( a ) and 19 ( b ) show an insertion device for a deformable intraocular lens according to a sixth embodiment of the present invention, wherein FIG. 19( a ) is a plan view of the device, and FIG. 19( b ) is a side view of the device;
- FIGS. 20 ( a ) and 20 ( b ) show a holder used in the insertion device according to the sixth embodiment of the present invention, wherein FIG. 20( a ) is a plan view of the holder, and FIG. 20( b ) is a side view of the holder;
- FIG. 21 is an enlarged sectional view taken along line I-I in FIG. 19( b );
- FIG. 22 is a side view showing a method of fitting the enclosing member into the holder
- FIG. 23 is an enlarged sectional view taken along line J-J in FIG. 22;
- FIG. 24 is a side view showing a state in which the enclosing member has been fitted into the holder
- FIG. 25 is a sectional view taken along line K-K in FIG. 24;
- FIGS. 26 a ) and 26 ( b ) show a conventional insertion device, wherein FIG. 26( a ) is a plan view of the device, and FIG. 26( b ) is a side view of the device;
- FIG. 27 is an enlarged sectional view taken along line L-L in FIG. 26( b );
- FIGS. 28 ( a ) and 28 ( b ) show a state in which the enclosing member of the insertion device of FIG. 26 is engaged with the engagement member, wherein FIG. 28( a ) is a plan view of the device, and FIG. 28( b ) is a side view of the device;
- FIG. 29 is an enlarged sectional view taken along line M-M in FIG. 28( b );
- FIG. 30 is an enlarged sectional view showing a state in which a deformable intraocular lens is placed on the lens receiving section of the insertion device of FIG. 26;
- FIG. 31 is an enlarged sectional view showing a state in which the enclosing member shown in FIG. 30 is closed and held by an engagement member;
- FIG. 32 is an enlarged plan view of a deformable intraocular lens
- FIG. 33 is an enlarged plan view of another deformable intraocular lens
- FIG. 34 is an enlarged plan view of still another deformable intraocular lens.
- FIG. 35 is an enlarged plan view of still another deformable intraocular lens.
- FIGS. 1 to 7 shows an insertion device according to a first embodiment of the present invention.
- numeral 10 denotes a body of the insertion device
- numeral 1 denotes a deformable intraocular lens for cataract treatment
- numeral 5 denotes an enclosing member built into the body 10
- numerals 6 a and 6 b each denote a hinge portion provided on the enclosing member 5
- numeral 7 denotes a lens receiving section which is formed upon opening of the enclosing member 5 in order to receive the intraocular lens 1
- numeral 8 denotes a holder which is provided on the body 10 and is adapted to close the enclosing member 5 and maintain the closed state
- numeral 9 denotes an annular retainer member for maintaining the enclosing member 5 in an opened state when the deformable intraocular lens 1 is to be placed on the lens receiving section 7
- numeral 11 denotes a push rod which is inserted
- the cylindrical base portion 5 a of the enclosing member 5 is inserted and fixed to the tip end of the cylindrical body 10 .
- the enclosing member 5 has the lens receiving section 7 at a longitudinal center portion thereof, and an insertion tube 15 is integrally formed on the front side of the lens receiving section 7 .
- the insertion tube 15 is tapered such that its diameter decreases toward the tip end.
- the enclosing member 5 has a lower portion having a semicircular cross section, and a pair of quadrant-shaped upper portions connected to the lower portion via the hinges 6 a and 6 b .
- the enclosing member 5 When the upper portions (i.e., the enclosing member 5 ) are closed, the enclosing member 5 forms a closed cylindrical shape.
- a groove 13 is formed on the inner surface of each quadrant-shaped upper portion.
- a converging portion 14 is formed at the insertion-sleeve-side and the body-side of the groove 13 . In the converging portion 14 , the depth of the groove 13 decreases gradually to zero.
- the lens receiving section 7 may have an elliptical cross section or a rectangular cross section when the enclosing member 5 is closed. Also, the cross-sectional shape of the grooves 13 may be changed freely.
- the enclosing member 5 is preferably formed from a plastic having elasticity.
- the base end 8 b of the cylindrical holder 8 is slidably fit onto the outer circumference of the tip end portion of the body 10 .
- the tapered front portion of the holder 8 has a tapered inner wall 12 whose diameter decreases toward the tip end of the holder 8 .
- the holder 8 has an opening 8 a formed in the upper and longitudinal center portion thereof.
- the portion of the enclosing member 5 corresponding to the lens receiving section 7 where the hinges 6 a and 6 b are provided is located to face the opening 8 a .
- the annular retainer member 9 is slidably fitted onto the enclosing member 5 and the holder 8 at the longitudinal center thereof.
- a cut-away portion 9 a is formed in the upper portion of the retainer member 9 over the entire length thereof.
- the lens receiving section 7 for receiving the deformable intraocular lens 1 .
- the quadrant-shaped upper portions may be brought into an opened state by the retainer member 9 in advance.
- the deformable intraocular lens 1 is placed in the lens receiving section 7 such that the peripheral edges of the deformable intraocular lens 1 engage with the grooves 13 of the quadrant-shaped upper portions.
- the deformable intraocular lens 1 can be placed while the converging portions 14 are used as a reference for positioning. In addition, since movement of the deformable intraocular lens 1 along the pushing-out direction is restricted within a range defined by the converging portions 14 , the deformable intraocular lens 1 is prevented from moving within the lens receiving section 7 after placement of the deformable intraocular lens 1 immediately before insertion thereof or in advance.
- FIGS. 5 to 7 shows cross sections respectively taken along lines B-B, C-C, and D-D in FIG. 3.
- the grooves 13 are formed at only the portion where the deformable intraocular lens 1 is placed, and at the front and rear sides of that portion, the grooves 13 disappear due to the converging portions 14 .
- the hinge portions 6 a and 6 b are provided at two circumferential positions, the hinge portions 6 a and 6 b do not interfere with the deformable intraocular lens 1 supported by the opposed grooves 13 , and the enclosing member 5 comes into contact with the deformable intraocular lens 1 through only the peripheral edge thereof.
- the deformable intraocular lens 1 is held in an uncurved state in order to prevent generation of plastic deformation with time.
- a lubricant is applied dropwise to an inner surface of the enclosing member 5 in an area beneath the deformable intraocular lens.
- the holder 8 is slid toward the body 10 side, as shown in FIGS. 8 to 11 . Due to this sliding movement of the holder 8 , the tip ends of the quadrant-shaped upper portions opposite the hinge portions 6 a and 6 b come into contact with the tapered inner wall 12 of the holder 8 , so that the quadrant-shaped upper portions are closed gradually.
- the longitudinal center portion of the enclosing member 5 where the quadrant-shaped upper portions and the hinge portions 6 a and 6 b exist are inserted into the smallest-inner-diameter portion of the holder 8 , so that the quadrant-shaped upper portions of the enclosing member 5 are held in an closed state as shown in FIG. 11.
- the exterior size of the deformable intraocular lens 1 is gradually reduced to the smallest size.
- the tip end of the insertion tube 15 is inserted into the eye through an incision formed on the eyeball, and the push rod 11 is advanced.
- the deformable intraocular lens 1 is pushed out from the tip end of the insertion tube 15 via the interior of the insertion tube 15 , which is contiguous with the lens receiving section 7 , and is placed in the eye.
- the groove 13 provided in the lens receiving section 7 has the converging portion 14 at the insertion-tube-side and the body-side thereof, when the deformable intraocular lens 1 is placed in the lens receiving section 7 , the position of the deformable intraocular lens 1 can be determined precisely. Further, since once placed the deformable intraocular lens 1 can be fixedly held within the range defined by the converging portions 14 , the deformable intraocular lens 1 can be placed in the lens receiving section 7 in advance. This eliminates operation of placing the deformable intraocular lens 1 immediately before surgery. Further, the lens placed in advance can be held without causing positional shift.
- the deformable intraocular lens 1 can be deformed through a simple operation; i.e., sliding of the holder 8 .
- each of the converging portions 14 of the opposed grooves 13 has a length and shape substantially corresponding to the shape of the optical portion of the deformable intraocular lens 1 to be used.
- each of the converging portions 14 of the opposed grooves 13 has a length and shape substantially corresponding to the shape of support portions oppositely projecting from the optical portion of the deformable intraocular lens 1 , which shape is similar to that shown in FIG. 34.
- the structures of these embodiments allow the deformable intraocular lens 1 to be placed at the designed position more stably, so that insertion of the lens 1 into the eye can be made more reliable.
- the insertion devices of the second and third embodiments are identical to that of the first embodiment in terms of structure and operation. Therefore the reference numerals in FIGS. 12 and 13 are assigned to correspond to those used in the first embodiment.
- the enclosing member is closed and held in the closed state through sliding movement of the holder.
- this structure may be replaced with other suitable structures.
- numeral 5 denotes an enclosing member of the insertion device
- numerals 5 a and 5 b denotes right and left press plates extending upward from the quadrant-shaped upper portions
- numerals 6 a and 6 b each denote a hinge portion provided on the enclosing member 5
- numeral 7 denotes a lens receiving section which is formed upon opening of the enclosing member 5 in order to receive the intraocular lens 1
- numeral 15 denotes an engagement member which is provided separately from the body and adapted to close the quadrant-shaped upper portions and hold the closed state.
- the enclosing member 5 of the insertion device according to the fourth embodiment differs from the enclosing member 5 having a single hinge 6 shown in FIGS. 26 ( a ), 26 ( b ), 27 , 28 ( a ), 28 ( b ), and 29 in that two hinges 6 a and 6 b are provided at circumferential positions.
- the deformable intraocular lens 1 for cataract treatment is placed in the lens receiving section 7 such that the peripheral edge of the lens 1 engages the grooves 9 a and 9 b . Subsequently, the right and left press plates 5 a and 5 b are brought into contact with each other in order to reduce the exterior size of the lens 1 and hold it.
- the deformable intraocular lens 1 can be placed in the lens receiving section 7 in advance and then inserted into the eye in the same manner as in the first embodiment.
- FIG. 16( a ) is a plan view of the device with a cap member removed; and FIG. 16( b ) is a bottom view of the cap member; FIG. 17 is a sectional view taken along line G-G in FIG. 16; and FIG. 18 is an enlarged sectional view taken along line H-H in FIG. 17.
- the deformable intraocular lens 1 used in this embodiment is composed of a circular optical portion 2 , a pair of thin plate-shaped support portions 4 , and a peripheral edge portion 4 a .
- the deformable intraocular lens 1 is made of an elastic material having predetermined memory characteristics.
- the support portions 4 are projected from the periphery of the optical portion 2 in opposite directions (vertical opposite directions in FIG. 35), and the peripheral edge portion 4 a are slightly projected from the optical portion 2 rightward and leftward in FIG. 35.
- Numeral 5 denotes an enclosing member for receiving the deformable intraocular lens 1 , and the base portion of the enclosing member 5 is inserted and fixed to the tip end of the body 12 of the insertion device.
- the enclosing member 5 has a lens receiving section 7 at a longitudinal center portion thereof projected from the body 12 .
- the enclosing member 5 has an opening 5 d at the upper side of the center portion.
- Right and left recess grooves 9 a and 9 b are formed on the upper end surfaces of the enclosing member 5 .
- a tapered insertion tube 11 is integrally formed on the front side of the lens receiving section 7 .
- a cap member 5 e which can be fitted into the opening 5 d is provided as a part of the enclosing member 5 .
- the cap member 5 e has right and left recess grooves 9 c and 9 d on the lower end surfaces.
- numeral 13 denotes a push rod which has a cut groove 13 a at the tip end thereof.
- the deformable intraocular lens 1 shown in FIG. 35 is placed into the lens setting section 7 through the opening 5 d , and the cap member 5 e is fitted to the opening 5 d .
- the right and left edge portions 4 a of the optical portion 2 face and engage the right and left recess grooves 9 a and 9 b of the enclosing member 5 and the right and left recess grooves 9 c and 9 d of the cap member 5 e in such a manner that the optical portion 2 of the deformable intraocular lens 1 substantially does not contact the enclosing member 5 including the cap member 5 e.
- a lubricant is applied dropwise to an area beneath the lens 1 and to the inner surface of the cap member 5 e , and the cap member 5 e is fitted to the opening 5 d to close the opening 5 d .
- the push rod 13 is advanced so that the rear support portion 4 of the deformable intraocular lens 1 is received by the cut groove 13 a formed at the tip of the push rod 13 , and is advanced further in order to advance the deformable intraocular lens 1 .
- the lens 1 When the deformable intraocular lens 1 passes through the tapered inner wall portion of the enclosing member 5 , the lens 1 reaches in the vicinity of the tip end of the insertion tube 11 , while the exterior size of the lens 1 is reduced gradually. In this state, the tip end of the insertion tube 11 is inserted into an incision formed on the eyeball, and the push rod 13 is further advanced to insert the lens 1 into the eye.
- the insertion devices of the fifth embodiment is substantially identical to that of the first embodiment in terms of structure and operation. Therefore, the deception therefor will be omitted.
- the cap member 5 e may be connected to the enclosing member 5 such that the opening 5 d can be opened and closed through swing motion of the cap member 5 e .
- a structure shown in FIG. 18 may employed. That is, engagement projections 5 f are projected from the front and rear surfaces of the cap member 5 e , and engagement depressions 5 g are formed in the front and rear walls of the opening 5 d of the enclosing member 5 such that the engagement projections 5 f and the engagement depressions 5 g can be engaged with each other.
- the base portion of the enclosing member 5 may be removably attached or fixedly attached to the body 12 of the insertion device.
- the holder is used to close the quadrant-shaped upper portions and to maintain the closed state.
- the first embodiment may be modified such that the quadrant-shaped upper portions are closed manually, and the closed sate is maintained through use of an engagement member.
- numeral 10 denotes a body of the insertion device
- numeral 5 denotes an enclosing member of the insertion device
- numerals 6 a and 6 b each denote a hinge portion providing on the enclosing member 5
- numeral 7 denotes a lens receiving section which is formed upon opening of the enclosing member 5 in order to receive the intraocular lens 1
- numeral 8 denotes a holder which is provided separately from the body 10 and adapted to close the quadrant-shaped upper portions and hold the closed state.
- the holder 8 has a tapered outer surface at the tip end thereof, and a slit 8 c is formed in the upper portion of the holder 8 over the entire length thereof. Further, at the center of the holder 8 is formed a through hole 8 d through which an unillustrated push rod is inserted.
- the retainer member used in the first embodiment is omitted. Since the members other than the above-described members are identical to those of the first embodiment, the descriptions therefor will be omitted.
- the lens receiving section 7 is formed on the enclosing member 5 .
- the deformable intraocular lens 1 is placed in the lens receiving section 7 .
- a lubricant or the like is preferably applied to the lens receiving section 7 .
- the enclosing member 5 into which the deformable intraocular lens 1 is placed is fitted into the holder 8 as shown in FIGS. 22 and 23.
- the enclosing member 5 is accommodated within the holder 8 , and is maintained in a completely closed state as shown in FIGS. 24 and 25.
- the exterior size of the deformable intraocular lens is reduced. Since the size of the deformable intraocular lens can be reduced through the operation of fitting the enclosing member into the holder, the operation is very easy.
- the enclosing member and the holder are preferably formed of a transparent material such as a transparent resin. In this case, since the state of the deformed intraocular lens can be checked, the degree of safety is increased.
- the enclosing member and the holder or the engagement member are preferably formed of a transparent material such as a transparent resin. In this case, since the state of the deformed intraocular lens can be checked, the degree of safety is increased.
- the enclosing member is formed of a transparent material such as a transparent resin and the holder is formed of an opaque material such as metal or opaque resin
- an opening serving as an observation window may be formed in the holder in order to allow an operator to check the state of the deformed intraocular lens. In this case as well, the degree of safety is increased.
- the enclosing member has two hinges. However, a larger number of hinge portions may be provided. The above-describe benefits of the present invention can be attained in this case as well.
- the holder is an independent part.
- the holder is integrally built in the body of the insertion device.
- the enclosing member having hinge portions may be formed as an independent part.
- the holder and the enclosing member having hinge portions are integrated together and are independent of the body of the insertion device.
- the enclosing member is integral with the body of the insertion device.
- the enclosing member may have a structure that allows removable attachment of the enclosing member to the body. In this case, the enclosing member and/or the body may be repeatedly used through sterilization.
- a push rod is employed to push out a deformable intraocular lens into the eye.
- other mechanisms may be employed to push out the deformable intraocular lens into the eye.
- the enclosing member is formed of a transparent material such as a transparent resin, the state of the deformed intraocular lens can be checked, so that the degree of safety is increased.
- a deformable intraocular lens is held such that only the peripheral edge portion of the lens contacts the enclosing member.
- a deformable intraocular lens having support portions projected from the optical portion with an angle in addition to the structure for supporting the peripheral portion of the lens, there may be employed a structure for supporting the support portions of the lens by a part of the enclosing member or another independent member in order to maintain the angle formed between the support portions and the optical portion.
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- Oral & Maxillofacial Surgery (AREA)
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- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
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Abstract
Description
- 1. Field of the Invention
- The present invention relates to an insertion device for inserting a deformable intraocular lens into the eye. Examples of such a deformable intraocular lens include a deformable intraocular lens that is inserted into the eye in place of the natural lens when the latter is physically extracted because of cataracts, and a vision correction lens that is inserted into the eye for the sole purpose of vision correction.
- 2. Description of the Related Art
- Implantation of an intraocular lens for treating cataract has been widely performed since 1949, when Ridley implanted for the first time an artificial lens, i.e., intraocular lens into the human eye in place of an opaqued natural lens during cataract surgery.
- The intraocular lens used first had an optical portion made of polymethyl methacrylate (PMMA). The implantation of the intraocular lens was accompanied by complications which occurred after the cataract surgery. Many ophthalmologists have shown interest in the complications and have studied them. As a result, most of the problems have been solved. However, since the optical portion is made of a hard material, an incision for implantation of such an intraocular lens must have a dimension somewhat greater than the diameter of the optical portion. Since an incision to be formed in the eyeball is large, in the degree of astigmatism after surgery increases due to suture of the incision.
- A method of surgery has been pointed out as a cause of the above-mentioned complications. That is, the conventional surgery for extracting a natural lens because of cataract has been performed by using an ECCE (extracapsular cataract extraction) operation technique in which a lens is extracted without crushing it. Since this operation technique has required formation of an incision of about 10 mm, the operation caused astigmatism quite often. To solve this problem, a technique called pharmacoemulsification (PEA) using an ultrasonic emulsification/suction apparatus has been developed recently. In this method, an opaqued natural lens is crushed and emulsified using ultrasonic waves emitted from a cylindrical ultrasonic chip, and is sucked for extraction. When this method is used, the size of an incision formed in the eyeball can be decreased to a size sufficient for insertion of the cylindrical ultrasonic chip. A crushed lens can be extracted through an incision of about 3 to 4 mm. Therefore, this method makes it possible to perform the extraction operation by forming only a small incision, which mitigates the astigmatism after the operation. However, since the optical portion is made of a hard material, an incision for implantation of such an intraocular lens must have a dimension somewhat greater than the diameter of the optical portion, as mentioned above. In the case of a standard intraocular lens having an optical portion of 6.0 mm, an incision having a size equal to or greater than 6.5 mm must be formed. Therefore, even if an opaqued natural lens is extracted through a small incision using pharmacoemulsification, the incision must be widened so as to insert an intraocular lens. Accordingly, the problem of astigmatism occurring after surgery due to the large incision has not been solved.
- In order to mitigate astigmatism after surgery, improved intraocular lenses have been developed which can decrease the size of incisions. Examples of such improved lenses include an intraocular lens having an oval optical portion which is inserted into an incision such that its smaller radius is oriented in the direction of the incision, and an intraocular lens with an optical portion having a reduced diameter. However, each of these intraocular lenses still has a hard optical portion. Therefore, employment of these intraocular lenses decreases the incision size only to about 5.5 mm (i.e., only by about 1 mm).
- In order to solve the above-described fundamental problems, intraocular lenses themselves have been improved recently. Such an improved intraocular lens is disclosed in Japanese Patent Application Laid-Open (kokai) No. 58-146346. In the intraocular lens, at least an optical portion is made of a deformable elastic material having a predetermined memory characteristic. Alternatively, at least an optical portion is made of an elastic material having a predetermined memory characteristic, and supports are provided which are made of a material different from that of the optical portion and are adapted to support the optical portion within an eye. Moreover, as disclosed in Japanese Patent Application Laid-Open (kokai) Nos. 58-146346, 4-212350, 5-103803, 5-103808, 5-103809, and 7-23990 improved insertion tools have been proposed. Using these tools, the optical portion of an intraocular lens is compressed, rolled, bent, stretched, or folded so as to reduce its exterior size, thereby making it possible to insert the intraocular lens through a small incision. These intraocular lenses and insertion tools therefor make it possible to perform surgery by forming only a small incision, thereby mitigating astigmatism after surgery.
- FIGS.32 to 35 show the conventional deformable intraocular lenses. The deformable intraocular lens shown in FIG. 32 is composed of a circular
optical portion 2 and two symmetrically disposedsupports 3. The circularoptical portion 2 is made of an elastic material having predetermined memory characteristics. Thesupports 3 are made of a material different from that of theoptical portion 2, and thebases 3 a of thesupports 3 are embedded in the peripheral region of theoptical portion 2 for fixing, while the wire-shaped tails 3 b are curved. Theoptical portion 2 has on the periphery thereofprojections 2 a for reinforcing the positions where thebases 3 a of thesupports 3 are embedded. The deformableintraocular lens 1 shown FIG. 33 is configured in the same manner as is the deformable intraocular lens of FIG. 32 except that theprojections 2 a are omitted. Each of the deformable intraocular lenses shown in FIGS. 34 and 35 is composed of a circularoptical portion 2 and a pair of thin plate-shaped support portions 4 that are integral with theoptical portion 2. Theoptical portion 2, like theoptical portion 2 shown in FIG. 32, is made of an elastic material having predetermined memory characteristics. Thesupport portions 4 are projected from the periphery of theoptical port 2 in opposite directions. - An insertion device disclosed in, for example, Japanese Patent Application Laid-Open (kokai) No. 7-23991 is used for deformable intraocular lenses, as shown in FIGS.32 to 35, each of which is composed of the
optical portion 2 and thesupport portions optical portion 2 has predetermined memory characteristics. The deformableintraocular lens 1 is folded in order to reduce its exterior size and is advanced along an insertion tube having, for example, a cylindrical shape, in order to be inserted into the eye through an incision formed in the eyeball. - FIGS.26(a), 26(b) and 27 show the structure and operation of the conventional insertion device. First, an enclosing
member 5 of the insertion device having ahinge portion 6 is opened. A deformable intraocular lens is placed on a lens receivingsection 7 such that the lens engagesgrooves member 5 is closed so as to reduce the exterior size of the deformable intraocular lens and hold it. Thegrooves lens receiving section 7. However, thegrooves lens receiving section 7 while maintaining constant depth. Since thegrooves member 5 is closed, the deformable intraocular lens placed in the lens receiving section may move rearward. - After the operation of placing the intraocular lens on the
lens receiving section 7 and closing the enclosingmember 5, anengagement member 15 provided on adevice body 12 is moved toward thelens receiving section 7, while the closed state is maintained, so that theengagement member 15 engages the enclosingmember 5 to maintain the closed state thereof. - After completion of the entire operation for setting the lens, a
push rod 13 of the insertion device is advanced to push forward the deformable intraocular lens received in the enclosingmember 5. As a result, the deformable intraocular lens is inserted into the eye through the tip end of ainsertion tube 11 provided at the front end of the enclosing portion, which tip end can be inserted into the eye through a small incision formed on the eye ball. - However, in the conventional insertion device, a
hinge portion 6 projects outward with respect to thegrooves lens receiving section 7. Therefore, when a deformable intraocular lens is placed on thelens receiving section 7 having such a configuration, as shown in FIG. 30, the deformableintraocular lens 1 interferes with thehinge portion 6 and curves. If the deformableintraocular lens 1 is allowed to remain in such a state for a long period of time, thelens 1 deforms with time. - Accordingly, immediately before the lens is inserted into the eye the operation of placing the deformable intraocular lens must be performed quickly, and therefore, the lens cannot be placed on the
lens receiving section 7 in advance. That is, before insertion of the deformable intraocular lens into the eye, there is always required an operation for placing the lens on thelens receiving section 7. Further, during the placement operation, the lens must be precisely placed at a proper position. However, the operation for precise and quick placement of the lens at a proper position is very difficult, because the intraocular lens and thelens receiving section 7 are both very small, resulting in the problem that an imprecise placement operation causes an insertion failure, such as abnormal insertion of the intraocular lens into the eye. - Meanwhile, insertion of a lens into the eye for the sole purpose of vision correction has recently been performed as an application of the above-mentioned intraocular lens insertion technique—which has been used for treatment of cataracts. For the vision correction purpose as well, there has been developed a lens in which at least the optical portion is formed of a deformable elastic material having predetermined memory characteristics, as in the intraocular lens for cataract treatment, in order to reduce the size of an incision. The above-described insertion device can be used when the deformable vision correction lens is to be inserted into the eye through a small incision.
- That is, the above-described insertion device has enabled insertion of a deformable intraocular lens, such as a deformable intraocular lens for cataract treatment or a deformable vision correction lens, into the eye through a small incision.
- A first object of the present invention is to provide an insertion device for a deformable intraocular lens, which device allows an operator to omit an operation of placing a lens on an enclosing member, through an operation of engaging the peripheral edge of the lens with the enclosing member in advance.
- A second object of the present invention is to provide an insertion device for a deformable intraocular lens, which device prevents movement of a lens after placement on the enclosing member and lets the operator know a location in the lens receiving section where the lens to be placed.
- A third object of the present invention is to provide an insertion device for a deformable intraocular lens, which device allows simultaneous performance, for simplified operation, of two independent operations of deforming a lens and bringing the deformed lens into a held state.
- In order to achieve the first object, the insertion device for a deformable intraocular lens according to the present invention has a structure in which a plurality of hinge portions provided in the enclosing member allow the peripheral edge of a deformable intraocular lens to engage the enclosing member, so that the lens can be held by the enclosing member in a state in which the optical portion of the lens substantially does not come into contact the enclosing portion.
- The insertion device for a deformable intraocular lens according to the present invention may have another structure which allows the peripheral edge of a deformable intraocular lens to engage the enclosing member without use of the hinge portions and which deforms the deformable intraocular lens with movement of the lens.
- In order to achieve the second object, the insertion device for a deformable intraocular lens according to the present invention has a structure in which grooves are formed in the lens receiving section of the enclosing member such that the grooves converge at the front and rear ends of the lens receiving section.
- In order to achieve the third object, the insertion device for a deformable intraocular lens according to the present invention has a structure in which the operation of closing the enclosing member to deform an intraocular lens within the enclosing member to thereby reduce its exterior size and the operation of bringing the deformed lens into a held state can be performed simultaneously through a single operation; i.e., movement of a holder of the insertion device.
- Various other objects, features and many of the attendant advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description of the preferred embodiments when considered in connection with the accompanying drawings, in which:
- FIG. 1 is a plan view of an insertion device for a deformable intraocular lens according to a first embodiment of the present invention;
- FIG. 2 is an enlarged view of a main portion of FIG. 1;
- FIG. 3 is a sectional view taken along line A-A in FIG. 2;
- FIG. 4 is an enlarged view of a main portion of FIG. 2;
- FIG. 5 is a sectional view taken along line B-B in FIG. 3;
- FIG. 6 is a sectional view taken along line C-C in FIG. 3;
- FIG. 7 is a sectional view taken along line D-D in FIG. 3;
- FIG. 8 is a plan view showing a state in which an intraocular lens placed in the insertion device of FIG. 1 has been deformed;
- FIG. 9 is an enlarged view of a portion of FIG. 8;
- FIG. 10 is a sectional view taken along line E-E in FIG. 9;
- FIG. 11 is an enlarge sectional view taken along line F-F in FIG. 9;
- FIG. 12 is a plan view of the enclosing member of an insertion device for a deformable intraocular lens according to a second embodiment of the present invention in which grooves each have a converging portion having a different shape;
- FIG. 13 is a plan view of the enclosing member of an insertion device for a deformable intraocular lens according to a third embodiment of the present invention in which grooves each have a converging portion having a different shape;
- FIG. 14 is an enlarged sectional view of the enclosing member of an insertion device for a deformable intraocular lens according to a fourth embodiment of the present invention in which a lens is placed on the enclosing member in advance;
- FIG. 15 is an enlarged sectional view showing a state in which the enclosing member shown in FIG. 14 is closed and held by an engagement member;
- FIGS.16(a) and 16(b) show a main portion of an insertion device for a deformable intraocular lens according to a fifth embodiment of the present invention, wherein FIG. 16(a) is a plan view of the device with a cap member removed, and FIG. 16(b) is a bottom view of the cap member;
- FIG. 17 is a sectional view taken along line G-G in FIG. 16 with the cap member attached;
- FIG. 18 is an enlarged sectional view taken along line H-H in FIG. 17;
- FIGS.19(a) and 19(b) show an insertion device for a deformable intraocular lens according to a sixth embodiment of the present invention, wherein FIG. 19(a) is a plan view of the device, and FIG. 19(b) is a side view of the device;
- FIGS.20(a) and 20(b) show a holder used in the insertion device according to the sixth embodiment of the present invention, wherein FIG. 20(a) is a plan view of the holder, and FIG. 20(b) is a side view of the holder;
- FIG. 21 is an enlarged sectional view taken along line I-I in FIG. 19(b);
- FIG. 22 is a side view showing a method of fitting the enclosing member into the holder;
- FIG. 23 is an enlarged sectional view taken along line J-J in FIG. 22;
- FIG. 24 is a side view showing a state in which the enclosing member has been fitted into the holder;
- FIG. 25 is a sectional view taken along line K-K in FIG. 24;
- FIGS. 26a) and 26(b) show a conventional insertion device, wherein FIG. 26(a) is a plan view of the device, and FIG. 26(b) is a side view of the device;
- FIG. 27 is an enlarged sectional view taken along line L-L in FIG. 26(b);
- FIGS.28(a) and 28(b) show a state in which the enclosing member of the insertion device of FIG. 26 is engaged with the engagement member, wherein FIG. 28(a) is a plan view of the device, and FIG. 28(b) is a side view of the device;
- FIG. 29 is an enlarged sectional view taken along line M-M in FIG. 28(b);
- FIG. 30 is an enlarged sectional view showing a state in which a deformable intraocular lens is placed on the lens receiving section of the insertion device of FIG. 26;
- FIG. 31 is an enlarged sectional view showing a state in which the enclosing member shown in FIG. 30 is closed and held by an engagement member;
- FIG. 32 is an enlarged plan view of a deformable intraocular lens;
- FIG. 33 is an enlarged plan view of another deformable intraocular lens;
- FIG. 34 is an enlarged plan view of still another deformable intraocular lens; and
- FIG. 35 is an enlarged plan view of still another deformable intraocular lens.
- Embodiments of the present invention will be described with reference to the accompanying drawings.
- FIGS.1 to 7 shows an insertion device according to a first embodiment of the present invention. In FIGS. 1 to 7, numeral 10 denotes a body of the insertion device; numeral 1 denotes a deformable intraocular lens for cataract treatment; numeral 5 denotes an enclosing member built into the
body 10;numerals member 5; numeral 7 denotes a lens receiving section which is formed upon opening of the enclosingmember 5 in order to receive theintraocular lens 1,numeral 8 denotes a holder which is provided on thebody 10 and is adapted to close the enclosingmember 5 and maintain the closed state; numeral 9 denotes an annular retainer member for maintaining the enclosingmember 5 in an opened state when the deformableintraocular lens 1 is to be placed on thelens receiving section 7; and numeral 11 denotes a push rod which is inserted into thebody 10 and adapted to push out the deformableintraocular lens 1. - The
cylindrical base portion 5 a of the enclosingmember 5 is inserted and fixed to the tip end of thecylindrical body 10. The enclosingmember 5 has thelens receiving section 7 at a longitudinal center portion thereof, and aninsertion tube 15 is integrally formed on the front side of thelens receiving section 7. Theinsertion tube 15 is tapered such that its diameter decreases toward the tip end. At a portion corresponding to thelens receiving section 7, the enclosingmember 5 has a lower portion having a semicircular cross section, and a pair of quadrant-shaped upper portions connected to the lower portion via thehinges member 5 forms a closed cylindrical shape. Agroove 13 is formed on the inner surface of each quadrant-shaped upper portion. A convergingportion 14 is formed at the insertion-sleeve-side and the body-side of thegroove 13. In the convergingportion 14, the depth of thegroove 13 decreases gradually to zero. - No limitation is imposed on the cross-sectional shape of the
lens receiving section 7 at the time when the enclosingmember 5 is closed, and thelens receiving section 7 may have an elliptical cross section or a rectangular cross section when the enclosingmember 5 is closed. Also, the cross-sectional shape of thegrooves 13 may be changed freely. The enclosingmember 5 is preferably formed from a plastic having elasticity. Thebase end 8 b of thecylindrical holder 8 is slidably fit onto the outer circumference of the tip end portion of thebody 10. The tapered front portion of theholder 8 has a taperedinner wall 12 whose diameter decreases toward the tip end of theholder 8. - As shown in FIG. 3 and other drawings, the
holder 8 has anopening 8 a formed in the upper and longitudinal center portion thereof. The portion of the enclosingmember 5 corresponding to thelens receiving section 7 where thehinges opening 8 a. Theannular retainer member 9 is slidably fitted onto the enclosingmember 5 and theholder 8 at the longitudinal center thereof. A cut-awayportion 9 a is formed in the upper portion of theretainer member 9 over the entire length thereof. - As described above, in the insertion device for a deformable intraocular lens according to the first embodiment, when the quadrant-shaped upper portions of the enclosing
member 5 are opened, there is formed thelens receiving section 7 for receiving the deformableintraocular lens 1. At this time, the quadrant-shaped upper portions may be brought into an opened state by theretainer member 9 in advance. Subsequently, the deformableintraocular lens 1 is placed in thelens receiving section 7 such that the peripheral edges of the deformableintraocular lens 1 engage with thegrooves 13 of the quadrant-shaped upper portions. Since the convergingportions 14 are formed on the insertion-sleeve-side and the body-side of thegroove 13, the deformableintraocular lens 1 can be placed while the convergingportions 14 are used as a reference for positioning. In addition, since movement of the deformableintraocular lens 1 along the pushing-out direction is restricted within a range defined by the convergingportions 14, the deformableintraocular lens 1 is prevented from moving within thelens receiving section 7 after placement of the deformableintraocular lens 1 immediately before insertion thereof or in advance. - FIGS.5 to 7 shows cross sections respectively taken along lines B-B, C-C, and D-D in FIG. 3. As is apparent from these drawings, the
grooves 13 are formed at only the portion where the deformableintraocular lens 1 is placed, and at the front and rear sides of that portion, thegrooves 13 disappear due to the convergingportions 14. Further, since thehinge portions hinge portions intraocular lens 1 supported by theopposed grooves 13, and the enclosingmember 5 comes into contact with the deformableintraocular lens 1 through only the peripheral edge thereof. Thus, the deformableintraocular lens 1 is held in an uncurved state in order to prevent generation of plastic deformation with time. Preferably, in order to attain a sufficient lubrication effect, before the deformableintraocular lens 1 is deformed a lubricant is applied dropwise to an inner surface of the enclosingmember 5 in an area beneath the deformable intraocular lens. - Subsequently, the
holder 8 is slid toward thebody 10 side, as shown in FIGS. 8 to 11. Due to this sliding movement of theholder 8, the tip ends of the quadrant-shaped upper portions opposite thehinge portions inner wall 12 of theholder 8, so that the quadrant-shaped upper portions are closed gradually. Thus, the longitudinal center portion of the enclosingmember 5 where the quadrant-shaped upper portions and thehinge portions holder 8, so that the quadrant-shaped upper portions of the enclosingmember 5 are held in an closed state as shown in FIG. 11. During the above-described operation, the exterior size of the deformableintraocular lens 1 is gradually reduced to the smallest size. Subsequently, the tip end of theinsertion tube 15 is inserted into the eye through an incision formed on the eyeball, and thepush rod 11 is advanced. As a result, the deformableintraocular lens 1 is pushed out from the tip end of theinsertion tube 15 via the interior of theinsertion tube 15, which is contiguous with thelens receiving section 7, and is placed in the eye. - In the above-described embodiment, since the
groove 13 provided in thelens receiving section 7 has the convergingportion 14 at the insertion-tube-side and the body-side thereof, when the deformableintraocular lens 1 is placed in thelens receiving section 7, the position of the deformableintraocular lens 1 can be determined precisely. Further, since once placed the deformableintraocular lens 1 can be fixedly held within the range defined by the convergingportions 14, the deformableintraocular lens 1 can be placed in thelens receiving section 7 in advance. This eliminates operation of placing the deformableintraocular lens 1 immediately before surgery. Further, the lens placed in advance can be held without causing positional shift. - Moreover, after being placed in the
lens receiving section 7, the deformableintraocular lens 1 can be deformed through a simple operation; i.e., sliding of theholder 8. - Next, insertion devices according to second and third embodiments of the present invention will be described with reference to FIGS. 12 and 13. In the insertion device of the second embodiment shown in FIG. 12, each of the converging
portions 14 of theopposed grooves 13 has a length and shape substantially corresponding to the shape of the optical portion of the deformableintraocular lens 1 to be used. In the insertion device of the third embodiment shown in FIG. 13, each of the convergingportions 14 of theopposed grooves 13 has a length and shape substantially corresponding to the shape of support portions oppositely projecting from the optical portion of the deformableintraocular lens 1, which shape is similar to that shown in FIG. 34. The structures of these embodiments allow the deformableintraocular lens 1 to be placed at the designed position more stably, so that insertion of thelens 1 into the eye can be made more reliable. - Other than the above-described features, the insertion devices of the second and third embodiments are identical to that of the first embodiment in terms of structure and operation. Therefore the reference numerals in FIGS. 12 and 13 are assigned to correspond to those used in the first embodiment.
- In the above-described first through third embodiments, the enclosing member is closed and held in the closed state through sliding movement of the holder. However, this structure may be replaced with other suitable structures.
- Next, an insertion device according to a fourth embodiment of the present invention will be described with reference to FIGS. 14 and 15. In FIGS. 14 and 15,
numeral 5 denotes an enclosing member of the insertion device;numerals numerals member 5; numeral 7 denotes a lens receiving section which is formed upon opening of the enclosingmember 5 in order to receive theintraocular lens 1; and numeral 15 denotes an engagement member which is provided separately from the body and adapted to close the quadrant-shaped upper portions and hold the closed state. - That is, the enclosing
member 5 of the insertion device according to the fourth embodiment differs from the enclosingmember 5 having asingle hinge 6 shown in FIGS. 26(a), 26(b), 27, 28(a), 28(b), and 29 in that twohinges - In a state where the right and
left press plates intraocular lens 1 for cataract treatment is placed in thelens receiving section 7 such that the peripheral edge of thelens 1 engages thegrooves left press plates lens 1 and hold it. - Therefore, the deformable
intraocular lens 1 can be placed in thelens receiving section 7 in advance and then inserted into the eye in the same manner as in the first embodiment. - Next, an insertion device according to a fifth embodiment of the present invention will be described with reference to FIGS.16(a), 16(b), 17 and 18. FIG. 16(a) is a plan view of the device with a cap member removed; and FIG. 16(b) is a bottom view of the cap member; FIG. 17 is a sectional view taken along line G-G in FIG. 16; and FIG. 18 is an enlarged sectional view taken along line H-H in FIG. 17. As shown in FIG. 35, the deformable
intraocular lens 1 used in this embodiment is composed of a circularoptical portion 2, a pair of thin plate-shapedsupport portions 4, and aperipheral edge portion 4 a. The deformableintraocular lens 1 is made of an elastic material having predetermined memory characteristics. Thesupport portions 4 are projected from the periphery of theoptical portion 2 in opposite directions (vertical opposite directions in FIG. 35), and theperipheral edge portion 4 a are slightly projected from theoptical portion 2 rightward and leftward in FIG. 35. -
Numeral 5 denotes an enclosing member for receiving the deformableintraocular lens 1, and the base portion of the enclosingmember 5 is inserted and fixed to the tip end of thebody 12 of the insertion device. The enclosingmember 5 has alens receiving section 7 at a longitudinal center portion thereof projected from thebody 12. The enclosingmember 5 has anopening 5 d at the upper side of the center portion. Right and leftrecess grooves member 5. A taperedinsertion tube 11 is integrally formed on the front side of thelens receiving section 7. Acap member 5 e which can be fitted into theopening 5 d is provided as a part of the enclosingmember 5. Thecap member 5 e has right and leftrecess grooves cut groove 13 a at the tip end thereof. - The deformable
intraocular lens 1 shown in FIG. 35 is placed into thelens setting section 7 through theopening 5 d, and thecap member 5 e is fitted to theopening 5 d. As a result, the right and leftedge portions 4 a of theoptical portion 2 face and engage the right and leftrecess grooves member 5 and the right and leftrecess grooves cap member 5 e in such a manner that theoptical portion 2 of the deformableintraocular lens 1 substantially does not contact the enclosingmember 5 including thecap member 5 e. - In the fifth embodiment, after the
cap member 5 e is removed from theopening 5 d to allow an operator to observe the deformableintraocular lens 1, a lubricant is applied dropwise to an area beneath thelens 1 and to the inner surface of thecap member 5 e, and thecap member 5 e is fitted to theopening 5 d to close theopening 5 d. Subsequently, thepush rod 13 is advanced so that therear support portion 4 of the deformableintraocular lens 1 is received by thecut groove 13 a formed at the tip of thepush rod 13, and is advanced further in order to advance the deformableintraocular lens 1. When the deformableintraocular lens 1 passes through the tapered inner wall portion of the enclosingmember 5, thelens 1 reaches in the vicinity of the tip end of theinsertion tube 11, while the exterior size of thelens 1 is reduced gradually. In this state, the tip end of theinsertion tube 11 is inserted into an incision formed on the eyeball, and thepush rod 13 is further advanced to insert thelens 1 into the eye. - Except the above-described features, the insertion devices of the fifth embodiment is substantially identical to that of the first embodiment in terms of structure and operation. Therefore, the deception therefor will be omitted.
- Although not illustrated in the drawings, the
cap member 5 e may be connected to the enclosingmember 5 such that theopening 5 d can be opened and closed through swing motion of thecap member 5 e. Further, a structure shown in FIG. 18 may employed. That is,engagement projections 5 f are projected from the front and rear surfaces of thecap member 5 e, andengagement depressions 5 g are formed in the front and rear walls of theopening 5 d of the enclosingmember 5 such that theengagement projections 5 f and theengagement depressions 5 g can be engaged with each other. - Further, the base portion of the enclosing
member 5 may be removably attached or fixedly attached to thebody 12 of the insertion device. - In the first embodiment, the holder is used to close the quadrant-shaped upper portions and to maintain the closed state. However, the first embodiment may be modified such that the quadrant-shaped upper portions are closed manually, and the closed sate is maintained through use of an engagement member.
- Next, an insertion device according to a sixth embodiment of the present invention will be described with reference to FIGS. 19 and 21. In FIGS.19 to 21, numeral 10 denotes a body of the insertion device; numeral 5 denotes an enclosing member of the insertion device;
numerals member 5; numeral 7 denotes a lens receiving section which is formed upon opening of the enclosingmember 5 in order to receive theintraocular lens 1; and numeral 8 denotes a holder which is provided separately from thebody 10 and adapted to close the quadrant-shaped upper portions and hold the closed state. - The
holder 8 has a tapered outer surface at the tip end thereof, and aslit 8 c is formed in the upper portion of theholder 8 over the entire length thereof. Further, at the center of theholder 8 is formed a throughhole 8 d through which an unillustrated push rod is inserted. The retainer member used in the first embodiment is omitted. Since the members other than the above-described members are identical to those of the first embodiment, the descriptions therefor will be omitted. - In the insertion device according to the sixth embodiment having the above-described structure, when the quadrant-shaped upper portions of the enclosing
member 5 is opened, thelens receiving section 7 is formed on the enclosingmember 5. Subsequently, the deformableintraocular lens 1 is placed in thelens receiving section 7. In order to obtain sufficient lubrication effect, a lubricant or the like is preferably applied to thelens receiving section 7. Subsequently, the enclosingmember 5 into which the deformableintraocular lens 1 is placed is fitted into theholder 8 as shown in FIGS. 22 and 23. Thus, the enclosingmember 5 is accommodated within theholder 8, and is maintained in a completely closed state as shown in FIGS. 24 and 25. - Through the above-described operation, the exterior size of the deformable intraocular lens is reduced. Since the size of the deformable intraocular lens can be reduced through the operation of fitting the enclosing member into the holder, the operation is very easy.
- In the sixth embodiment, the enclosing member and the holder are preferably formed of a transparent material such as a transparent resin. In this case, since the state of the deformed intraocular lens can be checked, the degree of safety is increased.
- In each of other embodiments, the enclosing member and the holder or the engagement member are preferably formed of a transparent material such as a transparent resin. In this case, since the state of the deformed intraocular lens can be checked, the degree of safety is increased.
- In the case where the enclosing member is formed of a transparent material such as a transparent resin and the holder is formed of an opaque material such as metal or opaque resin, an opening serving as an observation window may be formed in the holder in order to allow an operator to check the state of the deformed intraocular lens. In this case as well, the degree of safety is increased.
- In the first to fourth and sixth embodiments, the enclosing member has two hinges. However, a larger number of hinge portions may be provided. The above-describe benefits of the present invention can be attained in this case as well.
- In the above-described embodiments, the holder is an independent part. However, there can be employed a structure in which the holder is integrally built in the body of the insertion device. Also, the enclosing member having hinge portions may be formed as an independent part. Further, there can be employed a structure in which the holder and the enclosing member having hinge portions are integrated together and are independent of the body of the insertion device.
- In the above-described embodiments, descriptions have been given of the case where a deformable intraocular lens for cataract treatment is inserted into the eye. However, the present invention can be applied to the case where other kinds of deformable intraocular lens such as a vision correction lens is inserted into the eye. In the above-described embodiments, the enclosing member is integral with the body of the insertion device. However, the enclosing member may have a structure that allows removable attachment of the enclosing member to the body. In this case, the enclosing member and/or the body may be repeatedly used through sterilization.
- In the above-described embodiments, a push rod is employed to push out a deformable intraocular lens into the eye. However, other mechanisms may be employed to push out the deformable intraocular lens into the eye.
- In the fifth embodiment, when the enclosing member is formed of a transparent material such as a transparent resin, the state of the deformed intraocular lens can be checked, so that the degree of safety is increased.
- In the above-described embodiments, a deformable intraocular lens is held such that only the peripheral edge portion of the lens contacts the enclosing member. When a deformable intraocular lens having support portions projected from the optical portion with an angle is used, in addition to the structure for supporting the peripheral portion of the lens, there may be employed a structure for supporting the support portions of the lens by a part of the enclosing member or another independent member in order to maintain the angle formed between the support portions and the optical portion.
- Obviously, numerous modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the present invention may be practiced otherwise than as specifically described herein.
Claims (18)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US09/372,966 US6355046B2 (en) | 1997-03-07 | 1999-08-12 | Inserting device for deformable intraocular lens |
Applications Claiming Priority (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP9-53503 | 1997-03-07 | ||
JP5350397A JPH10243952A (en) | 1997-03-07 | 1997-03-07 | Insertion instrument for deformable lens for intraocular insertion |
JP9-55139 | 1997-03-10 | ||
JP5513997 | 1997-03-10 | ||
JP9-122373 | 1997-05-13 | ||
JP12237397A JPH10309293A (en) | 1997-05-13 | 1997-05-13 | Insertion instrument for deformable intraocular lens |
JP10-6300 | 1998-01-16 | ||
JP00630098A JP3665463B2 (en) | 1997-03-10 | 1998-01-16 | Deformable intraocular lens insertion device |
US09/032,211 US5947975A (en) | 1997-03-07 | 1998-02-27 | Inserting device for deformable intraocular lens |
US09/372,966 US6355046B2 (en) | 1997-03-07 | 1999-08-12 | Inserting device for deformable intraocular lens |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/032,211 Division US5947975A (en) | 1997-03-07 | 1998-02-27 | Inserting device for deformable intraocular lens |
Publications (2)
Publication Number | Publication Date |
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US20010014808A1 true US20010014808A1 (en) | 2001-08-16 |
US6355046B2 US6355046B2 (en) | 2002-03-12 |
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Application Number | Title | Priority Date | Filing Date |
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US09/032,211 Expired - Lifetime US5947975A (en) | 1997-03-07 | 1998-02-27 | Inserting device for deformable intraocular lens |
US09/372,966 Expired - Lifetime US6355046B2 (en) | 1997-03-07 | 1999-08-12 | Inserting device for deformable intraocular lens |
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Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/032,211 Expired - Lifetime US5947975A (en) | 1997-03-07 | 1998-02-27 | Inserting device for deformable intraocular lens |
Country Status (2)
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US (2) | US5947975A (en) |
CN (1) | CN100469340C (en) |
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Also Published As
Publication number | Publication date |
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US6355046B2 (en) | 2002-03-12 |
US5947975A (en) | 1999-09-07 |
CN100469340C (en) | 2009-03-18 |
CN1192887A (en) | 1998-09-16 |
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