WO2012086797A1 - Instrument d'insertion d'une lentille intraoculaire - Google Patents

Instrument d'insertion d'une lentille intraoculaire Download PDF

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Publication number
WO2012086797A1
WO2012086797A1 PCT/JP2011/079902 JP2011079902W WO2012086797A1 WO 2012086797 A1 WO2012086797 A1 WO 2012086797A1 JP 2011079902 W JP2011079902 W JP 2011079902W WO 2012086797 A1 WO2012086797 A1 WO 2012086797A1
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WO
WIPO (PCT)
Prior art keywords
intraocular lens
distal end
slit
nozzle
insertion tube
Prior art date
Application number
PCT/JP2011/079902
Other languages
English (en)
Japanese (ja)
Inventor
雄二 名倉
Original Assignee
興和株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 興和株式会社 filed Critical 興和株式会社
Priority to JP2012549884A priority Critical patent/JP5836282B2/ja
Publication of WO2012086797A1 publication Critical patent/WO2012086797A1/fr

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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
    • 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
    • A61F2/167—Instruments for inserting intraocular lenses into the eye with pushable plungers

Definitions

  • the present invention relates to an intraocular lens insertion device for inserting an intraocular lens into a patient's eyeball.
  • an incision is made in the eye tissue such as the cornea (capsular membrane) and anterior lens capsule in the eyeball, and the lens in the capsule is removed and removed through this incision, An intraocular lens that replaces the crystalline lens is inserted into the eye through the incision and placed in the sac.
  • an insertion instrument as shown below is often used. That is, the distal end opening of the insertion tube portion provided at the distal end portion of the instrument body is inserted into the eyeball through the incision, and the distal end opening of the insertion tube portion is deformed in the instrument body.
  • the intraocular lens is inserted into the eyeball by pushing it out from the part with a rod-shaped plunger.
  • the intraocular lens can be easily inserted into the eyeball using the incision formed for the removal of the crystalline lens. Astigmatism and infection can be suppressed.
  • the distal end opening end surface of the distal end portion of the insertion tube portion is an inclined surface inclined with respect to a plane orthogonal to the central axis of the insertion tube portion, and the insertion tube portion of the distal end opening end surface is used.
  • a tilt angle with respect to a plane perpendicular to the central axis of the tip is formed larger on the base end side than on the tip end side, and the peripheral edge portion of the tip opening end face has a sharp edge shape with a tapered outer peripheral surface.
  • the insertion tube portion is provided with a slit
  • the insertion tube portion is broken by the restoring force of the intraocular lens when the intraocular lens passes through the insertion tube portion after the insertion tube portion is inserted into the incision.
  • unexpected deformation occurred.
  • the proximal end portion of the slit is deformed, and there is a possibility that the eyeball is damaged when the deformed proximal end portion passes through the incision.
  • the present invention has been devised in view of the above-mentioned problems of the prior art, and its purpose is to make it possible to further reduce the size of the incision necessary for the insertion work of the intraocular lens.
  • Another object of the present invention is to provide a technique capable of smoothing or stabilizing the insertion operation and the extraction operation of the insertion tube portion of the intraocular lens insertion device.
  • the insertion tube portion of the instrument body is provided with a slit extending rearward in the axial direction from the distal end opening, and the insertion amount of the insertion tube portion into the eye is restricted to a predetermined distance from the distal end of the insertion tube portion.
  • a step-shaped insertion restricting portion is provided, and the rear end of the slit is arranged on the rear side in the axial direction from the step-shaped portion of the insertion restricting portion.
  • an instrument body having a cylindrical shape (a cylindrical shape or a substantially cylindrical shape that is substantially a cylindrical shape) that accommodates an intraocular lens;
  • a pushing member that moves the intraocular lens forward in the axial direction by being inserted into the instrument body from the rear in the axial direction
  • the instrument body has an insertion tube portion provided at the distal end portion and reduced in outer diameter and inner diameter, and a distal end opening portion opened at the distal end of the insertion tube portion,
  • An insertion device for an intraocular lens that is inserted into the eye by being released from the distal end opening after being deformed small by passing the insertion tube through the intraocular lens by the push member,
  • the instrument body is A slit provided in the insertion tube portion so as to extend axially rearward from the tip opening,
  • a step-shaped insertion restricting portion that is provided at a predetermined distance from the distal end of the insertion tubular portion and restricts the amount of insertion of the insertion tubular portion into the eye; and The rear end of
  • the diameter of the insertion tube portion can be changed with a high degree of freedom. . Accordingly, the insertion tube portion can be inserted into the eyeball from a smaller incision. Further, when the intraocular lens passes through the insertion tube portion, the diameter of the insertion tube portion is appropriately enlarged due to the restoring force of the intraocular lens, so that the intraocular lens is inadvertently ejected from the distal end opening portion by the restoring force. Can also be suppressed. Furthermore, since the length of the slit is long, it is possible to suppress local action of the restoring force of the intraocular lens when the intraocular lens is inserted, and it is possible to suppress damage to the slit itself.
  • the proximal end portion which is the rear end of the slit
  • the proximal end portion is arranged behind the stepped portion of the insertion restricting portion, it does not enter the eyeball from the incision. Therefore, even if the rear end of the slit is deformed, it is possible to prevent the eyeball from being damaged or the insertion tube portion from being inserted and pulled out.
  • the predetermined distance indicates the length to be inserted into the eyeball from the incision at the time of inserting the intraocular lens, or the upper limit value thereof.
  • the tip opening is provided so as to form an inclined surface inclined with respect to a surface orthogonal to the central axis of the insertion tube portion
  • the inclined surface may be inclined so that the front side in the optical axis direction of the intraocular lens at the distal end opening is closer to the front side of the insertion tube portion than the rear side in the optical axis direction.
  • the slit may be formed on the opposite side of the most distal end portion of the distal end opening as viewed from the distal end side of the insertion tube portion.
  • the intraocular lens when the intraocular lens is moved by the pushing member and passed through the insertion tube portion, it is folded and deformed so as to be convex forward in the optical axis direction.
  • the slit is formed on the opposite side of the most distal end portion of the distal end opening as viewed from the distal end side of the insertion tube portion, it becomes difficult for the central portion of the intraocular lens to contact the slit. Therefore, it can suppress that the center part of an intraocular lens is damaged by a slit, or that an intraocular lens protrudes from a slit.
  • the instrument body is When the intraocular lens is moved by the push-out member and passed through the insertion tube portion, the intraocular lens is viewed from the distal end side of the insertion tube portion toward the most distal portion of the distal end opening. You may make it further have a deformation
  • the intraocular lens in the method in which the intraocular lens is simply moved by the pushing member and passed through the insertion tube portion, the intraocular lens may be folded and deformed so as to be convex rearward in the optical axis direction depending on the situation. In that case, it is difficult to normally push out the intraocular lens from the distal end opening, and the intraocular lens may be damaged by the slit.
  • the intraocular lens when the deformation assisting means is seen from the distal end side of the insertion tube portion, the intraocular lens is convex toward the most distal portion side of the distal end opening, that is, the front side of the optical axis. Collapse and deform.
  • the intraocular lens can be more reliably folded and deformed so as to be convex toward the front of the optical axis, and the center of the intraocular lens can be more reliably damaged by the slit, or the intraocular lens can be removed from the slit. It can suppress that it protrudes.
  • the instrument main body has a reduced diameter portion that is provided behind the insertion tube portion and decreases in a substantially taper shape as the inner diameter of the instrument main body goes to the distal end side.
  • the deformation assisting means may have a multi-step taper structure in which the taper has a steeper inclination angle on the front end side than on the rear side in the reduced diameter portion.
  • the instrument body has a reduced diameter portion that is provided behind the insertion tube portion and decreases in a substantially taper shape as the inner diameter of the instrument body goes to the distal end side.
  • the taper has a multi-taper structure in which the inclination angle of the taper is steeper on the tip side than on the rear side in the reduced diameter portion.
  • the intraocular lens can be more reliably folded and deformed so as to be convex toward the front side of the optical axis, and the center of the intraocular lens can be more reliably damaged by the slit, or from the slit to the intraocular lens. Can be prevented from protruding.
  • the instrument main body has a reduced diameter portion that is provided behind the insertion tube portion and decreases in a substantially taper shape as the inner diameter of the instrument main body goes to the distal end side.
  • the deformation assisting means may be a peripheral support guide that is provided on the inner wall of the instrument body at the reduced diameter portion and supports the peripheral portion of the intraocular lens from the front side in the optical axis direction of the intraocular lens. .
  • the instrument main body has a reduced diameter portion that is provided behind the insertion tube portion and decreases in a substantially taper shape as the inner diameter of the instrument main body goes to the distal end side.
  • the peripheral portion support guide is provided on the inner wall of the instrument main body at the diameter portion and supports the peripheral portion of the intraocular lens from the front side in the optical axis direction of the intraocular lens.
  • This also makes it possible to fold and deform the intraocular lens so that it protrudes forward in the optical axis direction, and more reliably, the center of the intraocular lens is damaged by the slit, or from the slit to the eye. It can suppress that an inner lens protrudes.
  • the insertion restricting portion is provided on the rear side of the insertion cylindrical portion and on the distal end side of the reduced diameter portion, and has a cylindrical large diameter having an outer diameter larger than that of the insertion cylindrical portion.
  • a rear end of the slit is disposed on a side surface of the large diameter portion, and a small diameter portion that is a surface extending from the side surface of the insertion tube portion is formed around the rear end of the slit in the large diameter portion. You may make it do.
  • the insertion restricting portion a step portion whose outer diameter increases over substantially the entire circumference of the insertion tube portion is formed, and it is more reliably suppressed that the instrument body is excessively inserted into the eyeball. Is possible.
  • the rear end of the slit is disposed on the side surface of the large diameter portion, and the side surface of the insertion tube portion is extended around the rear end of the slit on the side surface of the large diameter portion (that is, the same diameter as the insertion tube portion). ) Since the small-diameter portion is formed, the degree of freedom of deformation at the rear end of the slit can be ensured.
  • the insertion tube portion can be smoothly deformed with a higher degree of freedom, so the length or diameter of the necessary incision can be reduced, and the insertion tube portion can be inserted and withdrawn more smoothly. It becomes possible to do.
  • the present invention may be a preset insertion system for an intraocular lens that is distributed in a state where the intraocular lens is accommodated in advance in any of the intraocular lens insertion devices described above.
  • the size of the incision required for the insertion operation of the intraocular lens can be further reduced, and the insertion operation and the extraction operation of the insertion device for the intraocular lens can be more smoothly or stabilized. Can do.
  • FIG. 1 shows a schematic configuration of an intraocular lens insertion device 1 (hereinafter also simply referred to as an insertion device 1) in the present embodiment.
  • 1A is a plan view
  • FIG. 1B is a side view.
  • the insertion instrument 1 includes a nozzle body 10 as an instrument body formed in a cylindrical shape having a substantially rectangular cross section.
  • One side of the nozzle body 10 has a large opening (hereinafter, the side with the large opening is referred to as a rear end portion 10b), and a nozzle portion 15 as an insertion tube portion with a narrow diameter is provided at the other end portion.
  • a tip portion 10 a that opens obliquely is provided at the end of the nozzle portion 15.
  • the insertion instrument 1 includes a plunger 30 as an extrusion member that is inserted into the nozzle body 10 and can reciprocate.
  • a plunger 30 as an extrusion member that is inserted into the nozzle body 10 and can reciprocate.
  • the direction from the front end portion 10a to the rear end portion 10b of the nozzle body 10 is the front-rear direction, and in FIG. And
  • a stage portion 12 for setting the intraocular lens 2 is provided on the rear end side of the nozzle portion 15 in the nozzle body 10.
  • the stage portion 12 is configured such that the upper side of the nozzle body 10 (the front side perpendicular to the paper surface in FIG. 1A) is opened by opening the stage lid portion 13.
  • a positioning member 50 is attached to the stage portion 12 from the lower side of the nozzle body 10 (the back side perpendicular to the paper surface in FIG. 1A). By this positioning member 50, the intraocular lens 2 is stably held in the stage portion 12 before use (during transportation).
  • the intraocular lens 2 is set on the stage unit 12 in a state where the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12 at the time of manufacture. Then, after the stage lid 13 is closed, it is shipped and sold, and the user removes the positioning member 50 while the stage lid 13 is closed. Then, a viscoelastic substance is injected from an injection port (not shown) provided in the stage lid 13, and then the plunger 30 is pushed into the distal end side of the nozzle body 10, thereby pressing the intraocular lens 2 with the plunger 30, The intraocular lens 2 is pushed out from the part 10a.
  • an injection port not shown
  • the material of the nozzle body 10, the plunger 30, and the positioning member 50 in the insertion instrument 1 is formed of a resin such as polypropylene.
  • Polypropylene is a material with a proven track record in medical equipment and high reliability such as chemical resistance.
  • FIG. 2 is a diagram showing a schematic configuration of the intraocular lens 2.
  • FIG. 2A is a plan view, more specifically, a view seen from the front side of the optical axis.
  • FIG. 2B is a side view, more specifically, a view seen from a direction perpendicular to the optical axis.
  • the intraocular lens 2 is formed of a lens body 2a having a predetermined refractive power, and two beard-shaped support portions 2b, 2b that are provided on the lens body 2a and hold the lens body 2a in the eyeball. ing.
  • the lens body 2a is made of a flexible resin material.
  • FIG. 3 shows a plan view of the nozzle body 10.
  • the intraocular lens 2 is set on the stage unit 12. In this state, the intraocular lens 2 is pushed out from the distal end portion 10a by being pressed by the plunger 30.
  • the nozzle body 10 is provided with a through-hole 10c whose cross-sectional shape changes according to a change in the outer shape of the nozzle body 10.
  • the intraocular lens 2 is pushed out, the intraocular lens 2 is deformed in accordance with a change in the cross-sectional shape of the through hole 10c in the nozzle body 10 and easily enters an incision formed in the patient's eyeball. It will be extruded after being transformed into.
  • a stage groove 12 a having a width slightly larger than the diameter of the lens body 2 a of the intraocular lens 2 is formed in the stage portion 12.
  • the dimension in the front-rear direction of the stage groove 12 a is set to be larger than the maximum width dimension including the support portions 2 b and 2 b extending on both sides of the intraocular lens 2.
  • a set surface 12b is formed by the bottom surface of the stage groove 12a.
  • the vertical position of the set surface 12b (position perpendicular to the paper surface of FIG. 3) is above the height position of the bottom surface of the through hole 10c on the rear side of the stage portion 12 in the nozzle body 10 (perpendicular to the paper surface of FIG. 3).
  • the set surface 12b and the bottom surface of the through hole 10c are connected by a bottom slope 10d.
  • the stage portion 12 and the stage lid portion 13 are integrally formed.
  • the stage lid portion 13 has the same longitudinal dimension as the stage portion 12.
  • the stage lid portion 13 is connected by a thin plate-like connecting portion 14 formed by extending the side surface of the stage portion 12 to the stage lid portion 13 side.
  • the connecting portion 14 is formed to be bendable at the center portion, and the stage lid portion 13 can be closed by overlapping the stage portion 12 from above by bending the connecting portion 14.
  • ribs 13 a and 13 b are provided on the surface facing the set surface 12 b when the lid is closed in order to reinforce the stage lid 13 and stabilize the position of the intraocular lens 2.
  • a guide protrusion 13 c is provided as a guide for the plunger 30.
  • FIG. 4 shows a schematic configuration of the positioning member 50.
  • 4A shows a plan view
  • FIG. 4B shows a side view.
  • the left-right direction corresponds to the front-rear direction of the present embodiment
  • the up-down direction in FIG. 4A corresponds to the left-right direction of the present embodiment
  • the positioning member 50 is configured as a separate body from the nozzle body 10, and has a structure in which a pair of side wall portions 51 and 51 are connected by a connecting portion 52. At the lower ends of the respective side wall portions 51, holding portions 53, 53 extending outward and extending are formed.
  • first mounting portions 54 and 54 are formed on the upper end portions of the respective side wall portions 51 and 51 so that the shape seen from above is an arc shape and protrudes upward.
  • first positioning portions 55, 55 are formed to protrude from the outer peripheral side of the upper end surface of the first placement portion 54. The distance between the inner diameters of the first positioning portion 55 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 2.
  • a pair of second placement portions 56 and 56 are formed at both ends of the connecting portion 52 in the front-rear direction, and the shape seen from above is a rectangular shape and protrudes upward.
  • the height of the upper surface of the second placement portion 56 is equal to the height of the upper end surface of the first placement portion 54.
  • second positioning portions 57 and 57 are formed on the outer surface of the second placement portions 56 and 56, and the second positioning portions 57 and 57 project further upward over the entire left and right direction of the second placement portions 56 and 56. ing.
  • the separation between the insides of the second positioning portions 57 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2.
  • locking claws 58 and 58 that slightly protrude in the front-rear direction are formed at the upper end portion of the second placement portion 56 over the entire left-right direction.
  • the positioning member 50 is assembled from below the set surface 12b of the nozzle body 10.
  • the set surface 12b of the nozzle body 10 is formed with four set surface through holes 12c penetrating the set surface 12b in the thickness direction.
  • the outer shape of the set surface through-hole 12c is a substantially similar shape that is slightly larger than the shape of the first placement portion 54 and the second placement portion 56 of the positioning member 50 as viewed from above.
  • the positioning member 50 is assembled from the lower side of the nozzle body 10, and the first placement portions 54 and 54 and the second placement portions 56 and 56 are fixed in a state of protruding from the set surface 12b.
  • the bottom surface of the outer peripheral portion of the lens body 2a is placed on the upper surfaces of the first placement portions 54 and 54 and the second placement portions 56 and 56.
  • the position of the lens body 2a is restricted in the front-rear and left-right directions by the first positioning portions 55, 55 and the second positioning portions 57, 57.
  • FIG. 5 shows a schematic configuration of the plunger 30.
  • FIG. 5A is a plan view
  • FIG. 5B is a side view.
  • the plunger 30 has a length in the front-rear direction that is slightly larger than the nozzle body 10. And it forms from the action part 31 of the front end side based on a column shape, and the insertion part 32 of the rear end side based on a rectangular rod shape.
  • the action part 31 is comprised including the cylindrical part 31a formed in the column shape, and the thin plate-shaped flat part 31b extended in the left-right direction of the cylindrical part 31a.
  • a notch 31 c is formed at the tip of the action part 31.
  • the cutout portion 31 c is formed in a groove shape that opens upward in the action portion 31 and penetrates in the left-right direction.
  • the end surface on the front end side of the cutout portion 31 c is formed as an inclined surface that goes upward as it goes to the front end side of the action portion 31.
  • the insertion portion 32 has a substantially H-shaped cross section as a whole, and the horizontal and vertical dimensions thereof are set slightly smaller than the through hole 10c of the nozzle body 10.
  • a disc-shaped pressing plate portion 33 is formed at the rear end of the insertion portion 32 so as to spread in the vertical and horizontal directions.
  • a claw portion 32 a that protrudes toward the upper side of the insertion portion 32 and can be moved up and down by the elasticity of the material of the plunger 30 is formed at the tip side of the insertion portion 32 in the front-rear direction center.
  • the locking hole 10e provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32a engage with each other, whereby the nozzle in the initial state is engaged.
  • a relative position between the main body 10 and the plunger 30 is determined.
  • the claw portion 32a and the locking hole 10e are formed at the positions where the tip of the action portion 31 is located behind the lens body 2a of the intraocular lens 2 set on the stage portion 12 in the engaged state. It is set so that the notch 31c can support the support part 2b behind 2a from below.
  • the plunger 30 is inserted into the nozzle body 10 and disposed at the initial position. Further, as described above, the positioning member 50 is attached to the stage unit 12 from below the set surface 12b. Thereby, the 1st mounting part 54 and the 2nd mounting part 56 of the positioning member 50 are hold
  • the lens body 2a of the intraocular lens 2 is placed and positioned on the upper end surfaces of the first placement part 54 and the second placement part 56 with the support parts 2b and 2b facing the front-rear direction of the nozzle body 10.
  • the central portion of the intraocular lens 2 is supported in an unloaded state.
  • the support portion 2 b of the intraocular lens 2 is supported by the bottom surface of the notch portion 31 c of the plunger 30.
  • the second mounting portion 56 constitutes a stopper that prevents the plunger 30 from moving forward.
  • the plunger 30 cannot advance unless the positioning member 50 is removed from the nozzle body 10. It is in a state.
  • the positioning member 50 is removed from the nozzle body 10.
  • the first placement portion 54 and the second placement portion 56 that have supported the lens body 2a of the intraocular lens 2 are retracted from the set surface 12b, and the intraocular lens 2 is placed on the set surface 12b.
  • the set surface 12b is a flat surface, the intraocular lens 2 can be stably placed, and the width dimension of the stage groove 12a is slightly smaller than the diameter dimension of the lens body 2a of the intraocular lens 2. Since the degree is large, rotation of the intraocular lens 2 in the circumferential direction on the set surface 12b is also suppressed.
  • the nozzle portion 15 is inserted from the distal end portion 10a side of the nozzle body 10 into the incision provided in the eye tissue.
  • the pressing plate portion 33 of the plunger 30 is pushed into the tip end side of the nozzle body 10.
  • FIG. 6B shows a view of the vicinity of the nozzle portion 15 in the conventional nozzle body 10 as seen from the lower side in the vertical direction.
  • FIG. 6A is a view of the nozzle portion 15 as viewed from the tip side.
  • the outer shape of the nozzle body 10 as a whole has a shape that gradually tapers from the stage portion 12 side toward the nozzle portion 15 side.
  • a taper portion 10f is formed as a reduced diameter portion whose cross-sectional area is gradually reduced.
  • the taper portion 10f is configured such that the cross-sectional area is reduced by reducing the width dimension of the bottom surface and the top surface toward the nozzle portion 15 side.
  • the bottom surface of the rear end portion of the taper portion 10f is formed with an inclined surface 10g inclined so as to rise upward toward the tip end side, and a step is provided by the inclined surface 10g.
  • a pair of introduction protrusions 10h extending in the front-rear direction of the nozzle body 10 is formed with the center of the bottom surface in the left-right direction.
  • the introduction protrusion 10h is provided in the longitudinal direction of the axially inclined surface 10g, and is formed in a linear shape that protrudes slightly upward from the bottom surface on the rear end side of the taper portion 10f and extends in parallel with each other. ing.
  • the front end portion of the introduction protrusion 10h formed on the inclined surface 10g gradually becomes higher as the inclined surface 10g goes to the tip side so that the front end portion of the introduction surface 10g has the same height at the front end portion of the inclined surface 10g. Is formed.
  • the separation distance between the introduction protrusions 10 h is slightly larger than the width of the action portion 31 of the plunger 30.
  • the nozzle portion 15 is formed on the tip end side of the taper portion 10f in the through hole 10c.
  • the through hole 10c is formed to extend straight with a substantially constant cross-sectional area. ing.
  • the through hole 10c is opened at the tip 10a, and a tip opening 10j is formed.
  • the tip opening portion 10j is formed by cutting the nozzle portion 15 in the nozzle body 10 obliquely so as to go to the rear side as it goes downward (front side in FIG. 6). That is, the upper end portion 100 at the upper end of the distal end portion 10a extends forward from the lower end portion 101 at the lower end.
  • the nozzle portion 15 is formed with a slit 10m extending rearward from the tip lower end portion 101 of the tip opening 10j.
  • the slit 10m in the present embodiment is formed to extend rearward from the tip opening 10j with substantially the same width.
  • FIG. 7 shows the operation of the slit 10m.
  • no load is applied to the nozzle portion 15, and the nozzle portion 15 extends straight as described above. It has a cylindrical shape.
  • FIG. 7 (b) shows a state in which the nozzle portion 15 is inserted into the incision 3 a formed in the eyeball 3.
  • the diameter of the incision 3 a is set slightly smaller than the diameter of the nozzle portion 15.
  • a load in the direction of reducing the incision 3a acts on the nozzle portion 15 by the eyeball 3. Accordingly, the nozzle portion 15 is deformed so that the width of the slit 10m particularly on the front end side becomes narrow. Due to such an action, the nozzle portion 15 can be inserted into the smaller incision 3a.
  • FIG. 7C shows a state when the intraocular lens 2 is inserted into the eyeball 3 through the nozzle portion 15.
  • the nozzle unit 15 is restored by the restoring force of the intraocular lens 2 that is slightly deformed by the taper unit 10f of the through hole 10c. The shape returns to the direction before deformation against the load from the incision 3a.
  • the intraocular lens 2 can be formed in the nozzle portion 15, it is possible to insert the intraocular lens 2 using a smaller incision, and when the intraocular lens 2 passes through the nozzle portion 15. Since the nozzle portion 15 is deformed in the expanding direction, the intraocular lens 2 can be prevented from jumping out from the distal end opening portion 10j by its own restoring force, and the intraocular lens 2 can be inserted more smoothly.
  • the slit 10m as described above is formed in the nozzle portion 15, the slit 10m itself is broken by the restoring force of the deformed intraocular lens 2 during the insertion operation, causing unexpected deformation in the nozzle portion 15. After the insertion of the intraocular lens 2, it may be difficult to smoothly pull out the nozzle portion 15 from the eyeball 3. Further, when the nozzle portion 15 is inserted into the incision 3a, as can be seen from FIG. 7B, the base end portion 10n as the rear end of the slit 10m is deformed, and the nozzle portion 15 is inserted into the slit 10m. When the proximal end portion 10n is inserted into the eyeball 3, the deformed proximal end portion 10n may damage the eyeball.
  • FIG. 8 shows a view of the vicinity of the nozzle portion 15 according to the present embodiment.
  • the slit 10 m is rearward of a portion corresponding to the maximum length to be inserted into the eyeball 3 from the tip of the nozzle portion 15 (hereinafter also referred to as an insertion limit point) 10 p.
  • the insertion prohibiting portion 10q is formed by increasing the outer shape of the portion on the rear side of the insertion limit point 10p in the nozzle portion 15.
  • the insertion prohibiting portion 10q corresponds to an insertion restricting portion and a large diameter portion in the present embodiment.
  • the insertion prohibition part 10q in a present Example has the taper-shaped step part 10l in the front end side.
  • the diameter of the insertion prohibition portion 10q is larger than the length (or diameter) of the incision 3a.
  • the taper angle of the step portion 101 is a steep angle of 45 degrees or more, for example.
  • the through hole 10c in the present embodiment has a first taper in which the width dimension of the bottom surface and the top surface is gradually reduced from the stage portion 12 side to the nozzle portion 15 side.
  • a second taper portion 10s in which the width dimension of the bottom surface and the top surface is steeperly smaller than that of the first taper portion 10r as it goes from the stage portion 12 side to the nozzle portion 15 side. It has been.
  • the taper part is divided into two stages, and the lens body 2a of the intraocular lens 2 is passed by passing the intraocular lens 2 first through the gentle taper part and then through the steep taper part. It can be deformed gently at the beginning and abruptly thereafter.
  • the intraocular lens 2 can be more reliably folded and deformed in the direction shown in FIG. 8A, that is, in the direction in which the intraocular lens body 2a is convex on the side opposite to the slit 10m. Further, the support portion 2b on the front side of the intraocular lens 2 is reliably bent backward by the action of the second tapered portion 10s. Therefore, since the deformation of the intraocular lens 2 is performed more reliably in both the lens body 2a and the support portion 2b, the operation when releasing the intraocular lens 2 from the nozzle portion 15 is stable, and the intraocular lens 2 can be easily inserted into the eyeball 3. The lens 2 can be inserted.
  • the first taper portion 10r and the second taper portion 10s correspond to a multi-step taper structure and deformation assisting means in this embodiment.
  • FIG. 9 shows a cross-sectional view of the syringe 10 in the present embodiment.
  • 9A shows the AA cross section in FIG. 8
  • FIG. 9B shows the BB cross section in FIG. 8
  • FIG. 9C shows the CC cross section in FIG.
  • Each sectional view also shows the shape of the lens body 2a of the intraocular lens 2 when passing through the section.
  • FIG. 9 (a) in this embodiment, at least the guides 10t, 10t that contact the left and right outer peripheral portions of the lens body 2a from above in the through hole 10c corresponding to the first taper portion 10r. Is formed.
  • the guides 10t and 10t guide the left and right outer peripheral portions of the lens body 2a so as not to be displaced upward, so that the intraocular lens 2 is 9 can be prevented from being deformed so as to protrude downward in FIG. That is, the lens body 2a can be more reliably deformed so as to be convex upward in FIG. 9, as shown in FIGS. 9B and 9C.
  • the guides 10t and 10t correspond to a peripheral portion support guide and deformation assisting means in this embodiment.
  • a two-step taper structure of the first taper portion 10r and the second taper portion 10s is adopted. Is not limited to two stages. Three or more taper portions may be used, or a taper angle may be changed smoothly in a curved shape.
  • the insertion prohibiting portion 10q in the present embodiment has a cylindrical shape larger in diameter than the nozzle portion 15, but the shape of the insertion prohibiting portion 10q is not limited thereto. Other shapes may be used as long as the nozzle portion 15 can be prevented from being inserted into the incision 3a beyond the insertion limit point. For example, it is good also as a stopper shape which a part of outer periphery of the nozzle part 15 protruded to the outer peripheral side.
  • the shape of the stepped portion 101 is not necessarily a tapered shape, and may be a curved surface having a circular longitudinal cross section, or another curved surface shape may be adopted. A step portion having a rectangular longitudinal section may be adopted.
  • the base end portion of the slit of the nozzle portion is located on the side surface of the insertion prohibition portion having a diameter larger than that of the nozzle portion, but an area having the same thickness as the nozzle portion is formed around the base end portion of the slit.
  • the provided example will be described.
  • FIG. 10 shows a view of the vicinity of the nozzle portion 15 according to this embodiment as viewed from the lower side in the vertical direction.
  • the slit 20m in the present embodiment is narrower than the slit 10m in the first embodiment.
  • a nozzle extension portion 20t as a small diameter portion having the same diameter as the nozzle portion 15 is formed around the base end portion 20n of the slit 20m in the insertion prohibition portion 10q.
  • Other configurations are substantially the same as those of the first embodiment.
  • the degree of freedom of deformation at the base end portion 20n of the slit 20m can be maintained relatively high. Therefore, the nozzle part 15 can be smoothly deformed with a higher degree of freedom. Further, since the insertion prohibiting portion 10q is provided around the nozzle extension portion 20t as in the first embodiment, the nozzle portion 15 can be prevented from being inserted too deeply into the eyeball.
  • the slit 20m in the present embodiment is narrower than the slit 10m in the first embodiment, the width of the slit itself may be equal to or greater than that of the first embodiment.
  • FIG. 11 shows a view of the vicinity of the nozzle portion 15 according to the present embodiment as seen from the lower side in the vertical direction.
  • the slit 30m in the present embodiment has the narrowest width at the base end 30n, and has a V-shape that increases in width toward the distal end opening 10j.
  • a nozzle extension portion 30t having the same diameter as the nozzle portion 15 is formed around the base end portion 30n of the slit 30m in the insertion prohibition portion 10q.
  • the degree of freedom of deformation at the base end portion 30n of the slit 30m becomes relatively high, and the deformable amount of the nozzle portion 15 increases as it goes to the tip end side of the nozzle portion 15. Then, as shown in FIG. 11 (b), when the nozzle portion 15 is inserted into the incision 3a of the eyeball 3, the distal end side of the nozzle portion 15 can be made thinner by deformation, and the shorter or smaller diameter can be obtained. It is possible to perform an intraocular lens insertion operation with the incision 3a.
  • the nozzle portion 15 when the nozzle portion 15 is gradually pushed into the incision 3a when the intraocular lens is inserted, the nozzle portion 15 is also gradually deformed and thinned, so that it can easily cope with the short or small-diameter incision 3a. .
  • FIG. 12 shows a second mode in the present embodiment.
  • the slit 40m is formed in a V shape continuously from the portion of the tip opening 40j having the substantially maximum width. Even with such a configuration, the distal end side of the nozzle portion 15 can be made thinner by deformation, and the intraocular lens can be inserted with a shorter or smaller diameter incision 3a.
  • the length L1 from the tip of the nozzle 15 to the insertion limit point 10p is 4 to 7 mm
  • the length L2 of the nozzle extension 40t is 0.5 to 2 mm
  • the diameter D1 of the nozzle 15 is 2 to 3 mm
  • the shape of the slit in a present Example it can change suitably and is not limited to the shape mentioned above.
  • the above is an example about the value of L1, L2, D1, and D2, and you may employ
  • Each embodiment has described a so-called preset system in which an intraocular lens is loaded in advance on an intraocular lens insertion device, but the present invention is not limited to this, and the intraocular lens insertion device and intraocular lens are not limited thereto.
  • the present invention can also be applied to a so-called separate inserter for storing lenses separately and loading the intraocular lens immediately before the insertion into the eyeball.
  • the intraocular lens to be inserted has been described as an example using a so-called three-piece type in which the lens body (optical part) and the support part are made of different materials, but the lens body (optical part)
  • the present invention can also be applied to an insertion instrument for inserting a so-called one-piece intraocular lens in which the support part is integrally molded.

Abstract

La présente invention concerne une technologie qui est non seulement capable de réduire la taille des incisions nécessaires pour insérer des lentilles intraoculaires, mais aussi capable de réaliser plus en douceur ou de manière plus stable l'insertion et le retrait du tube d'insertion de l'instrument d'insertion de la lentille intraoculaire. Une fente (10m) s'étendant vers l'arrière dans la direction axiale à partir de l'ouverture d'extrémité (10j) est fournie sur la partie canule (15) du corps principal de canule et une partie d'inhibition de l'insertion (10q), qui régit le degré auquel la partie canule (15) est insérée dans l'œil, est fournie au niveau de la partie (10p) correspondant à la longueur maximale de l'insertion dans l'œil (3) depuis la pointe de la partie canule (15) (également dénommée limite d'insertion inférieure). L'extrémité de base (10n) de la fente (10m) est disposée derrière l'épaulement (101) de la partie d'inhibition de l'insertion (10q) dans la direction axiale.
PCT/JP2011/079902 2010-12-22 2011-12-22 Instrument d'insertion d'une lentille intraoculaire WO2012086797A1 (fr)

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Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014084355A1 (fr) * 2012-11-29 2014-06-05 興和株式会社 Dispositif d'insertion de lentille intraoculaire
FR3011174A1 (fr) * 2012-09-07 2015-04-03 Sarl M D J Dispositif d'injection d'une lentille intraoculaire de traitement de la cataracte et ensemble de traitement de la cataracte correspondant
WO2015076308A1 (fr) * 2013-11-19 2015-05-28 興和株式会社 Instrument d'insertion de lentille intraoculaire
WO2018003853A1 (fr) * 2016-06-28 2018-01-04 Hoya株式会社 Instrument d'insertion de lentille intraoculaire
EP3222247A4 (fr) * 2014-11-19 2018-07-11 Kowa Company Ltd. Outil d'insertion de cristallin artificiel
US10172706B2 (en) 2015-10-31 2019-01-08 Novartis Ag Intraocular lens inserter
US10188506B2 (en) 2012-06-04 2019-01-29 Alcon Pharmaceuticals, Ltd. Intraocular lens inserter
JP2019034193A (ja) * 2018-11-01 2019-03-07 株式会社ニデック 眼内レンズ挿入器具および眼内レンズ挿入システム
US10568735B2 (en) 2017-01-13 2020-02-25 Alcon Inc. Intraocular lens injector
US10588780B2 (en) 2015-03-04 2020-03-17 Alcon Inc. Intraocular lens injector
US10799339B2 (en) 2015-09-16 2020-10-13 Hoya Corporation Intraocular lens injector
US10849738B2 (en) 2015-09-16 2020-12-01 Hoya Corporation Intraocular lens injector
US11000367B2 (en) 2017-01-13 2021-05-11 Alcon Inc. Intraocular lens injector
US11033382B2 (en) 2016-06-28 2021-06-15 Hoya Corporation Intraocular lens injector
US11617643B2 (en) 2007-05-30 2023-04-04 Hoya Corporation Intraocular lens insertion device
EP4238537A1 (fr) * 2022-03-02 2023-09-06 Nidek Co., Ltd. Instrument d'insertion de lentille intraoculaire

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002514466A (ja) * 1998-05-11 2002-05-21 ジェイ・スチュアート・カミング 眼内レンズの挿入器具
JP2002542884A (ja) * 1999-04-30 2002-12-17 アラーガン・セイルズ・インコーポレイテッド 眼内レンズ挿入装置およびその使用方法
JP3861138B2 (ja) * 2001-09-04 2006-12-20 キヤノンスター株式会社 眼内レンズの挿入器具
JP2008544816A (ja) * 2005-07-01 2008-12-11 アドバンスト メディカル オプティクス， インコーポレーテッド 低刺激の柔軟な先端部を有する眼内レンズ挿入装置
JP2009240728A (ja) * 2008-03-31 2009-10-22 Nidek Co Ltd 眼内レンズ挿入器具

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002514466A (ja) * 1998-05-11 2002-05-21 ジェイ・スチュアート・カミング 眼内レンズの挿入器具
JP2002542884A (ja) * 1999-04-30 2002-12-17 アラーガン・セイルズ・インコーポレイテッド 眼内レンズ挿入装置およびその使用方法
JP3861138B2 (ja) * 2001-09-04 2006-12-20 キヤノンスター株式会社 眼内レンズの挿入器具
JP2008544816A (ja) * 2005-07-01 2008-12-11 アドバンスト メディカル オプティクス， インコーポレーテッド 低刺激の柔軟な先端部を有する眼内レンズ挿入装置
JP2009240728A (ja) * 2008-03-31 2009-10-22 Nidek Co Ltd 眼内レンズ挿入器具

Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11617643B2 (en) 2007-05-30 2023-04-04 Hoya Corporation Intraocular lens insertion device
US11938019B2 (en) 2007-05-30 2024-03-26 Hoya Corporation Intraocular lens insertion device
US10188506B2 (en) 2012-06-04 2019-01-29 Alcon Pharmaceuticals, Ltd. Intraocular lens inserter
US10485657B2 (en) 2012-06-04 2019-11-26 Alcon Pharmaceuticals, Ltd. Intraocular lens inserter
FR3011174A1 (fr) * 2012-09-07 2015-04-03 Sarl M D J Dispositif d'injection d'une lentille intraoculaire de traitement de la cataracte et ensemble de traitement de la cataracte correspondant
JPWO2014084355A1 (ja) * 2012-11-29 2017-01-05 興和株式会社 眼内レンズの挿入器具
CN104812337A (zh) * 2012-11-29 2015-07-29 兴和株式会社 眼内透镜插入装置
US9855138B2 (en) 2012-11-29 2018-01-02 Kowa Company, Ltd. Intraocular lens insertion device
WO2014084355A1 (fr) * 2012-11-29 2014-06-05 興和株式会社 Dispositif d'insertion de lentille intraoculaire
CN104812337B (zh) * 2012-11-29 2018-03-16 兴和株式会社 眼内透镜插入装置
KR102202985B1 (ko) * 2012-11-29 2021-01-13 코와 가부시키가이샤 안내 렌즈의 삽입 기구
KR20150090898A (ko) * 2012-11-29 2015-08-06 코와 가부시키가이샤 안내 렌즈의 삽입 기구
US10195019B2 (en) 2013-11-19 2019-02-05 Kowa Company, Ltd. Intraocular lens insertion apparatus
JPWO2015076308A1 (ja) * 2013-11-19 2017-03-16 興和株式会社 眼内レンズの挿入器具
WO2015076308A1 (fr) * 2013-11-19 2015-05-28 興和株式会社 Instrument d'insertion de lentille intraoculaire
EP3222247A4 (fr) * 2014-11-19 2018-07-11 Kowa Company Ltd. Outil d'insertion de cristallin artificiel
US10507099B2 (en) 2014-11-19 2019-12-17 Kowa Company, Ltd. Intraocular lens insertion apparatus
US10588780B2 (en) 2015-03-04 2020-03-17 Alcon Inc. Intraocular lens injector
US10849738B2 (en) 2015-09-16 2020-12-01 Hoya Corporation Intraocular lens injector
US10799339B2 (en) 2015-09-16 2020-10-13 Hoya Corporation Intraocular lens injector
US10172706B2 (en) 2015-10-31 2019-01-08 Novartis Ag Intraocular lens inserter
WO2018003853A1 (fr) * 2016-06-28 2018-01-04 Hoya株式会社 Instrument d'insertion de lentille intraoculaire
EP3476374A4 (fr) * 2016-06-28 2020-03-11 Hoya Corporation Instrument d'insertion de lentille intraoculaire
JPWO2018003853A1 (ja) * 2016-06-28 2019-04-18 Hoya株式会社 眼内レンズ挿入器
US11033382B2 (en) 2016-06-28 2021-06-15 Hoya Corporation Intraocular lens injector
JP6998303B2 (ja) 2016-06-28 2022-01-18 Hoya株式会社 眼内レンズ挿入器
KR102431214B1 (ko) * 2016-06-28 2022-08-09 호야 가부시키가이샤 안내 렌즈 삽입기
KR20190021236A (ko) * 2016-06-28 2019-03-05 호야 가부시키가이샤 안내 렌즈 삽입기
CN109414345A (zh) * 2016-06-28 2019-03-01 Hoya株式会社 眼内透镜插入器
US10568735B2 (en) 2017-01-13 2020-02-25 Alcon Inc. Intraocular lens injector
US11000367B2 (en) 2017-01-13 2021-05-11 Alcon Inc. Intraocular lens injector
JP2019034193A (ja) * 2018-11-01 2019-03-07 株式会社ニデック 眼内レンズ挿入器具および眼内レンズ挿入システム
EP4238537A1 (fr) * 2022-03-02 2023-09-06 Nidek Co., Ltd. Instrument d'insertion de lentille intraoculaire

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