WO2014208507A1

WO2014208507A1 - Intraocular-lens insertion instrument

Info

Publication number: WO2014208507A1
Application number: PCT/JP2014/066587
Authority: WO
Inventors: 佐藤　隆史
Original assignee: 興和株式会社
Priority date: 2013-06-24
Filing date: 2014-06-23
Publication date: 2014-12-31
Also published as: JPWO2014208507A1

Abstract

　Provided is a technique for making it possible to suppress fluctuation of an injection location, injection direction, or injection amount during injection of a viscoelastic substance in an intraocular-lens insertion instrument, and to supply an appropriate amount of the viscoelastic substance to an appropriate location of the intraocular-lens insertion instrument. An intraocular-lens insertion instrument for inserting a needle of an injector from a needle hole (13d) provided to a stage lid part (13) and injecting a viscoelastic substance such as hyaluronic acid into a stage part (12), then inserting a nozzle part (15) into an eye from an incised wound and discharging an intraocular lens (2) into the eye from a distal end (10a) of the nozzle part (15) inserted into the eye, wherein a receiving part having a needle abutting part (60), which is a recess for receiving a distal end of the needle of the injector, is provided to a surface of an inside of the stage part (12) facing the needle hole (13d).

Description

Intraocular lens insertion device

The present invention relates to an intraocular lens insertion device for inserting an intraocular lens into a patient's eyeball.

Conventionally, in surgery such as cataracts, 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 through this incision, and then the lens is removed. A treatment is performed in which an intraocular lens instead of the above is inserted into the eye through the incision and placed in the sac.

Particularly in recent years, when an intraocular lens is inserted into an eyeball through an incision, an insertion instrument as shown below is often used. That is, the distal end opening of the insertion cylinder part is inserted in the eyeball through the above-mentioned incision and the intraocular lens is slightly deformed in the instrument body while the distal opening of the insertion cylinder part provided at the distal end part of the instrument body is inserted. By pushing out with a rod-shaped plunger, the intraocular lens is released into the eyeball and inserted. By using such an insertion device, 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.

By the way, when the intraocular lens is inserted into the eyeball using the above insertion device, hyaluronic acid is used so that the intraocular lens can be smoothly moved in the insertion device toward the distal end opening of the insertion tube portion. In some cases, a viscoelastic substance such as is injected into the insertion device, and the viscoelastic material is interposed between the intraocular lens and the inner wall of the insertion device. Thereby, the frictional resistance between the intraocular lens and the insertion instrument is reduced, and the intraocular lens can move more smoothly in the insertion instrument. When injecting the viscoelastic material into the insertion device, the needle of the syringe is inserted into the insertion device through the hole provided in the insertion device, and the intraocular lens in the insertion device is inserted into the insertion device by the syringe. It was poured into the storage place.

However, in the past, it has often been left to the user's sense to what extent the needle of the syringe is advanced into the insertion device and the viscoelastic material is injected in which position the needle tip is located. Then, the distribution of the viscoelastic substance in the insertion device after injection may vary depending on the user. In addition, when the blunt needle of the syringe is moved too deeply into the insertion device, the tip of the blunt needle is tightly abutted against the inner wall of the opposite wall of the insertion device, and a sufficient amount of viscoelastic material is injected. In some cases, it was impossible. As described above, the injection position, injection direction, and injection amount when the viscoelastic substance is injected into the insertion device by the syringe varies, and friction resistance in the insertion device of the intraocular lens when the intraocular lens is inserted into the eyeball. In some cases, it has been difficult to reduce the amount of the water stably.

JP 2010-273986 A

The present invention has been devised in view of the above-described problems of the prior art, and the purpose thereof is an injection location, an injection direction, or an injection amount when a viscoelastic substance is injected into an intraocular lens insertion device. It is to provide a technique that suppresses a variation in the amount of the intraocular lens and makes it possible to supply an appropriate amount of the viscoelastic material to an appropriate place of the insertion device for the intraocular lens.

In order to solve the above problems, the present invention inserts a needle of a syringe through an insertion hole provided in a storage portion and injects a viscoelastic substance into the storage portion, and then inserts an insertion tube portion into the eyeball from an incision. In the intraocular lens insertion device that releases the intraocular lens into the eyeball from the distal end of the insertion tube portion inserted into the eyeball, the tip of the syringe needle is received in the opposite side of the insertion hole inside the storage portion. The most characteristic feature is that a receiving portion having a concave portion is provided.

More specifically, an instrument body having an insertion cylinder portion to be inserted into an incision formed in eyeball tissue and formed in a substantially cylindrical shape,
A storage unit that is provided integrally with or separately from the instrument body, and that can accommodate the intraocular lens in the instrument body by storing the intraocular lens;
A plunger that is pushed into the instrument body and presses the intraocular lens housed in the housing portion with a tip to release the intraocular lens into the eyeball from the tip of the insertion tube part;
With
After inserting a needle of a syringe through an insertion hole provided in the storage portion and injecting a viscoelastic substance into the storage portion, the intraocular lens is inserted from the distal end of the insertion tube portion inserted into the eyeball through the incision. An intraocular lens insertion device that inserts an intraocular lens into the eyeball by releasing into the eyeball,
A receiving portion having a recess for receiving the tip of the needle of the syringe is provided on the opposite side of the insertion hole inside the storage portion.

According to the present invention, the needle for injecting the viscoelastic substance by injecting the viscoelastic substance into the storage part after receiving the needle of the syringe in the receiving part provided on the opposite side of the insertion hole in the storage part. It is possible to suppress the variation of the tip position of the material and to stabilize the injection site of the viscoelastic substance.

In the present invention, the recess of the receiving part may be formed by a conical depression having a bottom outer diameter larger than the diameter of the needle of the syringe.

That is, when the shape of the recess of the receiving part is a conical shape having a bottom outer diameter larger than the diameter of the needle of the syringe, when the user inserts the needle of the syringe from the insertion hole and enters the inside of the storage part In addition, by bringing the tip of the needle of the syringe into contact with the area where the conical recess is formed, the tip position of the needle of the syringe can be automatically guided to the center of the cone. Thereby, it becomes possible to stabilize the tip position of the needle of the syringe when injecting the viscoelastic substance more easily.

Further, in the present invention, the recess of the receiving portion is formed between the tip of the needle of the syringe and the surface of the recess of the receiving portion when the tip of the needle of the syringe having the shape of a cylindrical end surface is brought into contact. You may make it have the shape which a clearance gap produces.

Here, in the case where the needle of the syringe is a blunt needle whose tip has a shape of a cylindrical end surface (the end surface of the cylinder, that is, an end surface having a hollow circular cross section), the needle of the syringe is brought into strong contact with a flat surface. In such a case, there is no gap in which the viscoelastic substance is discharged, and it may be difficult to inject a desired amount of the viscoelastic substance into the storage portion even if the pusher (plunger) of the syringe is pressed strongly. On the other hand, when the concave portion of the receiving portion has a shape that creates a gap between the tip of the needle of the syringe and the surface of the concave portion of the receiving portion, the user strongly brings the needle of the syringe into contact with the receiving portion. Even so, it becomes possible to stably inject the viscoelastic substance from the gap.

In the present invention, the concave portion of the receiving portion is formed of a viscoelastic material provided so that the viscoelastic material discharged from the tip of the needle of the syringe received in the receiving portion flows in a predetermined direction. A passage may be connected.

According to this, when the viscoelastic material is discharged from the tip of the syringe needle while being received in the recess of the receiving portion, the viscoelastic material is caused to flow in the storage portion along the passage in a predetermined direction. be able to. Therefore, it becomes possible to control the distribution of the viscoelastic substance in the storage part after the injection of the viscoelastic substance. For example, if a plurality of passages having different cross-sectional areas and directions are connected to the recesses of the receiving portion, the location and amount of the viscoelastic material to be supplied can be controlled in detail. Furthermore, since a necessary amount of viscoelastic material can be supplied to a necessary place, it is possible to reduce the waste of the viscoelastic material.

Further, in the present invention, one or a plurality of through holes are formed in the storage portion,
A positioning member that is attached from the outside of the storage unit, penetrates the through-hole, enters the storage unit, and places an intraocular lens stored in the storage unit to regulate the position;
The receiving portion may be provided on the positioning member.

Here, the intraocular lens insertion device regulates the position of the intraocular lens stored in the storage unit before use, and before the operation of inserting the intraocular lens into the eyeball, Some include a positioning member that can be moved to move the intraocular lens in the storage unit. In the intraocular lens insertion device provided with the positioning member, one or a plurality of through holes are formed in the storage portion, and when the positioning member is attached, the position restricting projection provided on the positioning member is inserted into the through hole. It penetrates the hole and enters the inside of the storage unit, and the position is regulated by placing an intraocular lens.

In the present invention, in such an intraocular lens insertion device, a receiving portion may be provided on the positioning member. According to this, since the positioning member is removed at the time of inserting the intraocular lens into the eyeball, it is possible to suppress the receiving portion from affecting the movement of the intraocular lens in the insertion instrument and the operation of the plunger. . Also, if a viscoelastic material is to be injected after the positioning member is removed, the receiving part does not exist in the storage part, but instead a through hole exists, so the needle of the syringe is applied to the receiving part. It cannot be touched. As a result, it is possible to automatically notify an error in the work order by the user.

In the present invention, the receiving portion provided on the positioning member is provided on the positioning member and on which the intraocular lens is placed with respect to the optical axis direction of the intraocular lens disposed in the storage portion. It may be located on the rear side of the optical axis from the mounting surface.

Here, it is desirable that the viscoelastic substance is interposed between the intraocular lens and the inner wall of the instrument main body, which is in contact with the intraocular lens when the intraocular lens is moved. Usually, the intraocular lens moves within the instrument body while the surface on the rear side of the optical axis of the intraocular lens is in contact with the inner wall of the instrument body. In the present invention, when the viscoelastic substance is injected into the storage portion with the positioning member attached to the insertion instrument, the receiving portion is disposed on the rear side of the optical axis from the surface on which the intraocular lens is placed. Therefore, it is possible to more reliably supply the viscoelastic substance between the surface on the rear side of the optical axis of the intraocular lens and the lower surface of the instrument body. Therefore, according to the present invention, it is possible to more reliably interpose a viscoelastic substance between the intraocular lens and the surface that is the inner wall of the instrument main body and is in contact with the intraocular lens when the intraocular lens is moved. Become.

In the present invention, the receiving portion may be provided on the front side in the pressing direction of the intraocular lens by the plunger with respect to the intraocular lens housed in the housing portion.

Here, it is desirable that the viscoelastic substance is supplied to the front side in the pressing direction by the plunger of the intraocular lens in the storage unit. This is because when the intraocular lens is inserted into the eyeball, it automatically passes over the viscoelastic material when the intraocular lens is pressed by the plunger and starts to move. This is because a viscoelastic substance can be interposed between the surface in contact with the inner lens and the intraocular lens.

In the present invention, the receiving part is provided on the front side in the pressing direction of the intraocular lens by the plunger with respect to the intraocular lens housed in the housing part. This makes it possible to more reliably supply the viscoelastic substance to the front side in the pressing direction by the plunger of the intraocular lens, and finally, more reliably, the surface that contacts the intraocular lens and the eye when the intraocular lens moves. It becomes possible to have a state in which a viscoelastic substance is interposed between the inner lens and the inner lens.

In addition, about the means to solve the subject of the above-mentioned this invention, it can use combining as much as possible.

According to the present invention, variation in injection location, injection direction or injection amount when injecting a viscoelastic substance into an intraocular lens insertion device is suppressed, and an appropriate amount is placed in an appropriate location of the intraocular lens insertion device. A viscoelastic material can be supplied.

It is a figure which shows schematic structure of the insertion instrument of the conventional intraocular lens. It is a figure which shows schematic structure of an intraocular lens. It is a figure which shows schematic structure of the conventional nozzle body. It is a figure which shows schematic structure of the conventional positioning member. It is a figure which shows schematic structure of the conventional plunger. It is the schematic of the needle contact part in Example 1 of this invention, a needle contact stand, and a groove | channel. It is a figure for demonstrating the effect | action of the needle contact part in the Example 1 of this invention, a needle contact stand, and a groove | channel. It is a figure which shows schematic structure of the positioning member in Example 1 of this invention. It is a figure which shows schematic structure of the stage part vicinity of the nozzle main body in Example 1 of this invention. It is a top view in the state where the needle contact part, needle contact stand, and groove in Example 1 of the present invention were exposed from the set surface of the nozzle body. It is a figure shown about each aspect of the needle contact part in Example 2 of this invention. It is the schematic of the needle contact part in the Example 3 of this invention, a needle contact stand, and a groove | channel. It is the schematic of the needle contact part, needle contact stand, and groove | channel in Example 4 of this invention. It is a figure which shows schematic structure of the stage part vicinity of the nozzle main body in Example 5 of this invention.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.

[Example 1]
FIG. 1 shows a schematic configuration of a conventional intraocular lens insertion device 1 (hereinafter also simply referred to as an insertion device 1). 1A is a plan view, and FIG. 1B is a side view. The insertion instrument 1 is formed in a cylindrical shape having a substantially rectangular cross section, and one side is greatly opened (hereinafter, the side that is greatly opened is referred to as a rear end part 10b), and the insertion is narrowed to the end part on the other side. A nozzle main body 10 as an instrument main body including a nozzle portion 15 as a cylindrical portion and a tip portion 10a that opens obliquely, and a plunger 30 that is inserted into the nozzle main body 10 and can reciprocate. In the following, the direction from the rear end portion 10b of the nozzle body 10 to the front end portion 10a is the forward direction, the opposite direction is the rearward direction, the front side of the page in FIG. 1A is the upward direction, and the reverse direction is the downward direction. In FIG. 1B, the front side of the page is the left direction, and the opposite direction is the right direction. In this case, the upper side is the front side of the optical axis of the lens body 2a, which will be described later, the lower side is the rear side of the optical axis of the lens body 2a, the front side is the front side in the pressing direction by the plunger 30, and the rear side is the rear side in the pressing direction by the plunger 30. Corresponds to the side.

In the vicinity of the rear end portion 10b of the nozzle body 10, there is integrally provided a holding portion 11 that protrudes in a plate shape and hooks a finger when the user pushes the plunger 30 toward the front end side of the nozzle body 10. Further, a stage portion 12 as a storage portion for setting the intraocular lens 2 is provided on the rear 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 is opened by opening the stage lid portion 13. Further, a positioning member 50 is attached to the stage portion 12 from the lower side of the nozzle body 10. By this positioning member 50, the intraocular lens 2 is stably held in the stage portion 12 even before use (during transportation).

That is, in the insertion instrument 1, the intraocular lens 2 is on the stage unit 12 and the front side of the optical axis is on the upper side in a state where the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12. Is set as Then, after the stage lid 13 is closed, it is shipped and sold. Further, during use, the user removes the positioning member 50 while keeping the stage lid 13 closed, and then pushes the plunger 30 into the distal end side of the nozzle body 10. As a result, the intraocular lens 2 is pressed by the plunger 30 and moved to the nozzle part 15, and then the intraocular lens 2 is released into the eyeball from the distal end part 10 a. In addition, the nozzle body 10, the plunger 30, and the positioning member 50 in the insertion instrument 1 are formed of a resin material 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. 2A is a plan view and FIG. 2B is a side view. The intraocular lens 2 includes a lens body 2a having a predetermined refractive power, and two beard-shaped

support portions

2b and 2b that are provided integrally with the lens body 2a and hold the lens body 2a inside the eyeball. Is formed. The lens body 2a and the support portion 2b are made of a flexible resin material. In the insertion instrument 1 according to the present embodiment, the intraocular lens 2 is set so that one of the two

support portions

2b and 2b is disposed on the rear side of the lens body 2a and the other is disposed on the front side of the lens body. Is done.

FIG. 3 shows a plan view of the nozzle body 10. As described above, in the nozzle body 10, the intraocular lens 2 is set on the stage unit 12. In this state, the intraocular lens 2 is pressed by the plunger 30 and released from the distal end portion 10a. In addition, a through hole 10 c whose cross-sectional shape changes according to a change in the outer shape of the nozzle body 10 is provided in the nozzle body 10. When the intraocular lens 2 is released, the intraocular lens 2 is deformed according to 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 released after being transformed into a shape.

Further, the tip portion 10a has a shape cut obliquely so that the upper region of the nozzle portion 15 is in front of the lower region. Note that the shape of the tip portion 10a that is obliquely cut may be linearly obliquely cut when viewed from the left-right direction, or may have a bulge outward, that is, a curved shape. It may be cut 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 is set higher than the height position of the bottom surface of the through hole 10c of the nozzle body 10, and 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 size in the front-rear direction 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.

In the stage lid 13,

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 on the upper side of the plunger 30. The stage lid portion 13 is provided with a needle hole 13d as an insertion hole for injecting hyaluronic acid into the stage portion 12 with a syringe before the operation of inserting the intraocular lens 2 into the eyeball. The user inserts the needle of the syringe through the needle hole 13 d before inserting the intraocular lens 2 and supplies hyaluronic acid to a necessary position in the stage unit 12.

A positioning member 50 is detachably provided below the set surface 12b of the stage portion 12. FIG. 4 shows a schematic configuration of the positioning member 50. 4A shows a plan view, and FIG. 4B shows a left side view. The positioning member 50 is configured as a separate body from the nozzle main body 10, and has a structure in which a pair of

side wall portions

51, 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.

Further, a pair of 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. Further,

first positioning portions

55 and 55 are formed to protrude on the outer peripheral side of the upper end surfaces of the

first placement portions

54 and 54. The distance between the inner diameters of the

first positioning portions

55 and 55 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 2.

Further, 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 heights of the upper surfaces of the second mounting

parts

56 and 56 are equal to the heights of the upper surfaces of the first mounting

parts

54 and 54. Furthermore,

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 distance between the insides of the

second positioning portions

57 and 57 is set to be slightly larger than the diameter of the lens body 2 a of the intraocular lens 2. In addition, locking

claws

58 and 58 that slightly protrude in the front-rear direction are formed on the upper ends of the

second placement portions

56 and 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 a set surface through hole 12c that penetrates 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 mounting

portions

54 and 54 and the second mounting

portions

56 and 56 of the positioning member 50 as viewed from above. When the positioning member 50 is attached to the nozzle body 10, the

first placement portions

54 and 54 and the

second placement portions

56 and 56 are inserted into the set surface through hole 12c from the lower side of the set surface 12b. , Protruding above the set surface 12b.

At that time, the locking

claws

58, 58 provided in the

second positioning portions

57, 57 project to the set surface 12b through the set surface through hole 12c and are locked to the upper surface of the set surface 12b. Thus, 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. When the intraocular lens 2 is set on the setting 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 Further, the position of the lens body 2 a is restricted with respect to the horizontal direction by the

first positioning portions

55 and 55 and the

second positioning portions

57 and 57.

FIG. 5 shows a schematic configuration of a conventional plunger 30. 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. And the action part 31 is comprised including the cylindrical part 31a made into 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. As can be seen from FIG. 5, the notch 31 c is formed in a groove shape that opens upward in the action portion 31 and penetrates in the left-right direction. Further, as can be seen from FIG. 5B, the groove wall on the distal end side of the cutout portion 31 c is formed with an inclined surface that goes upward as it goes to the distal end side of the action portion 31.

On the other hand, the insertion part 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. In addition, 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 a portion of the insertion portion 32 that is ahead of the center in the front-rear direction. When the plunger 30 is inserted into the nozzle body 10, the locking hole 10 e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32 a engage with each other. The relative position between the nozzle body 10 and the plunger 30 in the state is determined. It should be noted that the claw portion 32a and the locking hole 10e are formed at the positions where the distal end of the action portion 31 is located on the rear side of the lens body 2a of the intraocular lens 2 set on the stage portion 12 in the engaged state. The support portion 2b on the rear side of the main body 2a is set so that the cutout portion 31c can be supported from below.

Before the intraocular lens 2 of the insertion instrument 1 configured as described above is stored, 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 nozzle body 10 from below the set surface 12b. Thereby, the

1st mounting parts

54 and 54 and the 2nd mounting

parts

56 and 56 of the positioning member 50 are hold | maintained in the state protruded to the set surface 12b.

Next, the lens main body 2a of the intraocular lens 2 is mounted on the upper surfaces of the first mounting

sections

54 and 54 and the second mounting

sections

56 and 56 with the

support sections

2b and 2b oriented in the front-rear direction of the nozzle main body 10. Placed and positioned. In this state, since the outer peripheral portion of the lens body 2a is in contact with the

first placement portions

54 and 54 and the

second placement portions

56 and 56, the central portion of the intraocular lens 2 is supported in an unloaded state. ing. In this state, the support portion 2 b on the rear side of the intraocular lens 2 is supported by the bottom surface of the notch portion 31 c of the plunger 30.

When inserting the intraocular lens 2 into the eyeball using the insertion device 1, first, a needle of a syringe is inserted through the needle hole 13d, and hyaluronic acid is injected into a necessary portion. Next, the positioning member 50 is removed from the nozzle body 10. As a result, the

first placement portions

54 and 54 and the

second placement portions

56 and 56 that supported the lens body 2a of the intraocular lens 2 are retracted from the set surface 12b, and the intraocular lens 2 is on the set surface 12b. Is movably mounted.

Subsequently, the distal end portion 10a of the nozzle portion 15 of the nozzle body 10 is inserted into the incision provided in the eye tissue. Here, since the distal end portion 10a has an oblique opening shape, it can be easily inserted into the incision. And after inserting the nozzle part 15 in an incision, the press board part 33 of the plunger 30 is pushed in the front end side of the nozzle main body 10 in the state. Thereby, the front-end | tip of the action part 31 of the plunger 30 contact | abuts to the lens body 2a outer periphery of the intraocular lens 2 set to the setting surface 12a, and the intraocular lens 2 is guided toward the front-end | tip part 10a by the plunger 30.

By the way, when the intraocular lens 2 is inserted into the eyeball using the insertion instrument 1, hyaluronic acid is injected into the stage portion 12 by inserting the needle of the syringe through the needle hole 13d as described above. As a result, the frictional resistance between the intraocular lens 2 and the through hole 10c when the intraocular lens 2 is pressed by the plunger 30 can be reduced, and the intraocular lens 2 can be more smoothly released into the eyeball. It has become.

In that case, it is desirable that a sufficient amount of hyaluronic acid is supplied to the rear side of the optical axis of the intraocular lens 2. This is because the weight of the intraocular lens 2 usually acts on the rear side of the optical axis of the intraocular lens 2, so that a larger frictional resistance is generated between the rear surface of the intraocular lens 2 and the bottom surface of the through hole 10 c. Depending on what happens. Further, it is desirable that a sufficient amount of hyaluronic acid is also supplied to the front side of the intraocular lens 2 in the pressing direction by the plunger 30. This is because the hyaluronic acid is filled in the front side of the intraocular lens 2 in the pressing direction, so that when the intraocular lens 2 moves to the front side, the surface on the rear side of the optical axis of the intraocular lens 2 and the through hole 10c automatically. This is because it can be distributed between the bottom surface.

However, in the conventional intraocular lens insertion device 1, the state of the needle when the needle of the syringe is inserted from the needle hole 13 d and hyaluronic acid is injected may be left to the user's sense. Therefore, for example, when the amount of the needle entering the stage portion 12 is too small, the hyaluronic acid discharged from the tip of the needle is supplied only to the front side of the optical axis of the intraocular lens 2, and the plunger of the intraocular lens 2 In some cases, the pressure is not sufficiently supplied between the front surface in the pressing direction 30 and the surface on the rear side of the optical axis of the intraocular lens 2 and the bottom surface of the through hole 10c. As a result, the frictional resistance during movement of the intraocular lens 2 may not be sufficiently reduced.

Further, when the amount of the needle entering the stage portion 12 is too large and the tip of the needle strongly contacts the set surface 12b, the needle tip hole is blocked, particularly when the needle is a blunt needle, and the hyaluron In some cases, the acid could not be sufficiently injected. Furthermore, since there is no target of the needle tip after inserting the needle from the needle hole 13d, the position of the needle tip when injecting hyaluronic acid varies, and as a result, the distribution in the stage portion 12 after the injection of hyaluronic acid is distributed. In some cases, the intraocular lens is inserted every time it is inserted.

On the other hand, in the present embodiment, the needle as a concave portion composed of a conical depression having a bottom outer diameter larger than the needle diameter is a target of the needle tip after the needle is inserted into the stage portion 12 from the needle hole 13d. The contact portion is provided on the set surface 12b side of the through hole 10c. In addition, a groove for guiding the hyaluronic acid injected from the needle in a desired direction is connected to the needle contact portion.

FIG. 6 shows the vicinity of the needle contact portion 60 in the present embodiment. 6A is a plan view, and FIG. 6B is a cross-sectional view taken along the section AA. In the present embodiment, the needle contact portion 60 is formed by providing a needle contact base 61 having a substantially rectangular parallelepiped shape with a conical recess having a bottom outer diameter larger than the needle diameter. In this embodiment, the needle contact base 61 is formed with three grooves 62a to 62c. The grooves 62a to 62c are formed radially from the middle of the side surface of the needle contact portion 60, which is a conical depression. The depth is formed so as to be deeper than the apex portion of the needle contact portion 60. In this embodiment, the receiving portion includes a needle contact portion 60, a needle contact base 61, and grooves 62a to 62c.

In this embodiment, the needle contact base 61 is provided on the positioning member 50 as described later. Therefore, when the positioning member 50 is attached to the nozzle body 10, the needle contact base 61 is held in a state of protruding from the set surface 12b through the set surface through hole 12d as shown in FIG. 6B. The

FIG. 7 shows the action of the needle contact portion 60, the needle contact base 61, and the grooves 62a to 62c (hereinafter also referred to as “the needle contact portion 60 etc.”) in the hyaluronic acid injection operation. In the operation of injecting hyaluronic acid, a needle 65 that is a blunt needle is made to enter from a needle hole 13 d provided in the stage lid portion 13. At this time, the needle contact base 61 and the needle contact portion 60 can be visually recognized from the outside through the normally transparent stage portion 12 or the stage lid portion 13, so that the needle 65 is moved to the back of the nozzle body 10 for this purpose. Let it enter.

Then, the tip of the needle 65 is brought into contact with the needle contact portion 60. In this state, the tip of the needle 65 is brought into contact with the conical side surface of the needle contact portion 60, so that the position of the tip of the needle 65 is automatically corrected near the center of the needle contact portion 60. At that time, a gap is formed between the tip of the needle 65 and the needle contact portion 60 at the connection portion between the grooves 62 a to 62 c and the needle contact portion 60. When hyaluronic acid is injected in this state, hyaluronic acid discharged from the tip of the needle 65 is received by the needle contact portion 60 and then flows into the grooves 62a to 62c and flows through the grooves 62a to 62c. It spreads to part 12.

Thus, by providing the needle contact portion 60, first, the target of entry after the needle 65 is inserted from the needle hole 13d can be clarified. Then, by bringing the needle 65 into contact with the needle contact portion 60, the tip position of the needle 65 is corrected to a certain location, and variation in position can be suppressed. And since it is comprised so that a clearance gap can always be produced between the front-end | tip of the needle 65 and the needle contact part 60, the front-end | tip of the needle 65 is obstruct | occluded and it becomes difficult to discharge | release hyaluronic acid. Inconvenience can be suppressed. Furthermore, by providing the grooves 62a to 62c, it is possible to efficiently supply hyaluronic acid injected from the tip of the needle 65 to a necessary place.

FIG. 8 shows a schematic diagram of the positioning member 50 provided with the needle contact portion 60 and the like. FIG. 8A is a plan view and FIG. 8B is a side view. As shown in FIG. 8B, the height of the needle contact portion 60 is set lower than the height of the

first placement portions

54 and 54 and the

second placement portions

56 and 56. This indicates that the presence of the needle contact portion 60 and the needle contact base 61 does not affect the installation of the intraocular lens 2 at the initial position, and the hyaluronic acid discharged from the needle 65 is set. This shows that sufficient supply is possible between the surface 12b and the lower surface of the intraocular lens 2, that is, the surface on the rear side of the optical axis. In FIG. 8, the direction and number of the grooves can have various modes, and are not limited to the modes as shown in FIG.

FIG. 9 shows a view of the vicinity of the stage portion 12 of the nozzle body 10 in the present embodiment. In addition to the four set surface through holes 12c, a set surface through hole 12d for penetrating and exposing the needle contact portion 60 and the like is provided.

FIG. 10 is a plan view showing a state in which the needle contact portion 60 of this embodiment is exposed from the set surface 12b of the nozzle body 10. As can be seen from the drawing, by attaching the positioning member 50 provided with the needle contact portion 60 and the like from the lower side of the stage portion 12, the needle contact is made through the set surface through hole 12d provided in the set surface 12b. The part 60 and the like are exposed on the set surface 12b. When the stage lid portion 13 is closed and the needle 65 is inserted through the needle hole 13d and advanced to the back, the tip of the needle 65 comes into contact with the needle contact portion 60.

In the present embodiment, the needle contact portion 60 and the like are disposed on the left front side of the intraocular lens 2. The groove 62a is formed on the left side with respect to the needle contact portion 60, and the groove 62b and the groove 62c are formed on the right side. As a result, the hyaluronic acid injected from the needle 65 is mainly supplied to the front portion of the intraocular lens 2.

As described above, in the present embodiment, the needle connected to the grooves 62a to 62c is formed of a conical depression at the position of the stage 12 facing the needle hole 13d when the stage lid 13 is closed. A contact portion 60 was provided. Thereby, when the user inserts the needle 65 from the needle hole 13d and enters it to the back by using the conical side surface of the needle contact portion 60, the tip position of the needle 65 can be corrected appropriately. become.

At this time, since the side surfaces of the conical depressions are connected to the grooves 62a to 62c, a gap can always be provided between the tip of the needle 65 and the surface of the needle contact portion 60. However, even if the needle 65 is strongly inserted into the stage portion 12, a sufficient amount of hyaluronic acid can be injected into the stage portion 12. In this embodiment, of the three grooves 62a to 62c, the groove 62a is disposed on the side surface side of the stage groove 12a, and the

grooves

62b and 62c are disposed on the front side of the intraocular lens 2. The heights of the needle contact portion 60 and the like were set lower than the heights of the

first placement portions

54 and 54 and the

second placement portions

56 and 56. Thus, a sufficient amount of hyaluronic acid can be supplied between the front side of the intraocular lens 2, the surface on the rear side of the optical axis of the intraocular lens 2, and the set surface 12b.

Furthermore, in the present embodiment, the needle contact portion 60 and the like are provided on the positioning member 50 so as to be removable from the stage portion 12. Accordingly, it is possible to prevent the needle contact portion 60, the needle contact base 61, and the grooves 62a to 62c from affecting the operation of the intraocular lens 2 and the plunger 30 in the nozzle body 10. Further, for example, when the user tries to inject hyaluronic acid after removing the positioning member 50, the needle 65 penetrates the set surface through hole 12d and penetrates the stage portion 12, so that the user can work. It is possible to automatically notify that the order is incorrect.

[Example 2]
Next, a second embodiment of the present invention will be described. In this embodiment, the case where the needle contact portion does not have a groove for allowing hyaluronic acid to flow will be described. 11 (a) to 11 (c) show different aspects of the present embodiment. FIG. 11 (a) is similar to the example shown in FIG. 6 in that it has a needle contact portion 70 formed of a conical depression, but instead of the grooves 62a to 62c, a rectangular parallelepiped depression 72a. This is an example in which ˜72c is further arranged.

The recesses 72a to 72c cause a gap between the tip of the needle 65 and the surface of the needle contact portion 70 when the needle 65, which is a blunt needle, is brought into contact with the needle contact portion 70, and thereby hyaluronic acid Is reliably discharged from the needle 65 to the stage portion 12. That is, the hyaluronic acid discharged from the tip of the needle 65 is received by the needle contact portion 70, discharged to the outside of the needle 65 through the recesses 72 a to 72 c, and supplied to the stage portion 12.

FIG. 11B shows an example in which a needle contact portion 80 made of a conical depression is provided and the surface of the side surface of the needle contact portion 80 is intentionally roughened. When the needle 65 is brought into contact with the rough surface, a gap is appropriately formed between the needle 65 and the needle contact portion 80 due to the unevenness of the rough surface. And the hyaluronic acid discharged | emitted from the needle 65 is discharged | emitted outside from this clearance gap, and is supplied to the stage part 12. FIG.

FIG. 11C shows a mode in which a needle contact portion 90 made of a quadrangular pyramid-like depression is provided instead of the needle contact portion 60 made of a conical depression. In this case, when the needle 65 is brought into contact with the needle contact portion 90, a gap is always generated between the tip of the needle 65 and the surface of the needle contact portion 90. And the hyaluronic acid discharged | emitted from the needle 65 is discharged | emitted outside from this clearance gap, and is supplied to the stage part 12. FIG.

As described above, in this embodiment, the case where the groove is not connected to the needle contact portion has been described. Even when the groove is not connected to the needle contact portion, the needle contact portion can function as a target of the needle 65 after the user inserts the needle 65 from the needle hole 13d. . In addition, since the needle contact portion is formed as a conical depression, the position of the tip of the needle 65 can be corrected toward the center of the needle contact portion. Further, by forming a gap between the tip of the needle 65 and the needle contact portion, even when the user strongly presses the needle 65 against the needle contact portion, hyaluronic acid is released from the tip of the needle 65. It becomes possible to discharge smoothly.

Example 3
Next, Embodiment 3 of the present invention will be described. In the present embodiment, an example in which the needle contact portion is not a conical shape but a cylindrical depression will be described. FIG. 12 shows a schematic view of the vicinity of the needle contact portion 100 and the needle contact base 101 in the present embodiment. 12A is a plan view, and FIG. 12B is a cross-sectional view taken along the section AA. The needle contact portion 100 in this embodiment is formed by a cylindrical recess.

Further, as in the first embodiment, grooves 62 a to 62 c are connected to the needle contact portion 100. When the tip of the needle 65 is brought into contact with the needle contact portion 100, the function of correcting the tip to the center of the recess is not exhibited, but even with this configuration, the user can remove the needle 65 from the needle hole 13d. Has a function as a target after being inserted into the stage portion 12. In addition, since gaps due to the grooves 62a to 62c are surely formed between the tip of the needle 65 and the bottom surface of the needle contact portion 100, even in this case, a sufficient amount of hyaluronic acid is supplied from the tip of the needle 65. It can be supplied to the stage unit 12.

Further, also in this embodiment, since the grooves 62a to 62c are connected to the needle contact portion 100, the grooves 62a to 62c are caused to flow into the hyaluronic acid discharged from the needle 65, and a desired place in the stage portion 12 is obtained. It becomes possible to supply to.

Example 4
Next, a fourth embodiment of the present invention will be described. In the present embodiment, the needle contact portion is formed by a conical depression, but an example in which the mode of the groove is different from that of the first embodiment will be described. 13A and 13B are schematic views of the vicinity of the needle contact portion in the present embodiment. FIG. 13 (a) shows an embodiment in which three grooves 112a to 112c extending in the same direction are connected to a needle contact portion 110 formed of a conical depression formed on the needle contact base 111. Indicates. According to this aspect, when the needle 65 is brought into contact with the needle contact portion 110 and hyaluronic acid is discharged from the tip, the hyaluronic acid is caused to flow in the grooves 112a to 112c, so that the entire amount of hyaluronic acid is the same. It is possible to guide in the direction. Thus, for example, when it is desired to supply all the hyaluronic acid to the front side of the intraocular lens 2, all the grooves 112a to 112c may be formed to extend toward the front side of the intraocular lens 2.

Then, it is possible to control the supply location of hyaluronic acid more efficiently. Furthermore, since a required amount of hyaluronic acid can be supplied to a required place, waste of hyaluronic acid can be reduced. Of course, the form of the grooves is not limited to the form of FIG. The direction in which the grooves extend and the number of the grooves may be appropriately determined according to the positional relationship between the needle contact portion 110 and the needle contact base 111 in the stage portion 12 and the intraocular lens 2. Thereby, it becomes possible to supply hyaluronic acid to a desired place with a higher degree of freedom. Of course, the cross-sectional area of each groove may be changed.

FIG. 13B shows a state in which the needle contact portion 120 formed of a conical depression formed on the needle contact base 121 is connected to the lateral holes 112a to 112c instead of the groove. In this aspect, compared with the case where the groove is connected to the needle contact portion 120, the flowing hyaluronic acid does not overflow from the upper surface, so that hyaluronic acid can be more reliably supplied to a desired place. Is possible.

Example 5
Next, a fifth embodiment of the present invention will be described. In the present embodiment, an example in which the needle contact portion is not provided on the positioning member 50 but directly on the set surface 12b of the nozzle body 10 will be described. FIG. 14 shows the arrangement of the needle contact portion and the like in this embodiment.

FIG. 14A is a plan view of the vicinity of the stage unit 12 according to this embodiment. FIG. 14B is a cross-sectional view of the stage portion 12 by a cross section passing through the needle contact base 12f. The stage portion 12 of this embodiment is provided with two bank-

like guides

10f and 10f that prevent the columnar portion 31a of the plunger 30 from swinging and hold the intraocular lens 2 thereon. The

guides

10f and 10f can prevent the plunger 30 from sideways and operate the plunger 30 more stably.

In this embodiment, the needle contact portion 12e, the needle contact base 12f, and the groove are formed integrally with the set surface 12 by molding. The height of the needle contact base 12f is set lower than the height of the

guides

10f and 10f. Therefore, in this embodiment, even if the needle contact portion 12e, the needle contact base 12f, and the groove are directly formed on the set surface 12b, the operation of the intraocular lens 2 and the plunger 30 is not affected.

According to the present embodiment, the needle contact portion 12e, the needle contact base 12f, and the groove can be formed on the set surface 12b with a simpler configuration and method. In the present embodiment, the height of the needle contact base 12f is protruded upward from the set surface 12b in a state where it is lower than the height of the

guides

10f and 10f. However, the height of the needle contact base 12f may be the same as that of the set surface 12b. That is, in this case, the needle contact portion and the groove which are conical depressions are formed on the set surface 12b. Even in this case, the needle contact portion 12e and the groove can be formed on the set surface 12b with a simpler configuration and method.

In the above embodiment, the one-piece type intraocular lens in which the lens body 2a of the intraocular lens 2 and the

support portions

2b and 2b are integrally formed has been described as an example. However, the

support portions

2b and 2b are used as the lens body. Needless to say, the present invention can also be applied to a three-piece intraocular lens formed of a member different from 2a. The present invention is not limited to a preset type that is distributed in a state where the intraocular lens 2 is set on the stage unit 12, or an intraocular type in which a user sets the intraocular lens 2 on the stage unit 12 before surgery. It is also applicable to lens insertion instruments. In the above embodiment, hyaluronic acid has been described as an example of the viscoelastic substance, but it goes without saying that the present invention can also be applied when other viscoelastic substances are injected into the stage portion 12.

DESCRIPTION OF SYMBOLS 1 ... Insertion instrument 2 ... Intraocular lens 10 ... Nozzle main body 12 ... Stage part 13 ... Stage cover part 15 ... Nozzle part 30 ... Plunger 31 ... Action part 50 ...

Positioning members

60, 70, 80, 90, 100, 110, 120 ...

Needle contact portions

61, 71, 81, 91, 101, 111, 121 ...

Needle contact bases

62a, 62b, 62c ···groove

Claims

An instrument body having an insertion tube portion to be inserted into an incision formed in the eyeball tissue and formed in a substantially cylindrical shape;
A storage unit that is provided integrally with or separately from the instrument body, and that can accommodate the intraocular lens in the instrument body by storing the intraocular lens;
A plunger that is pushed into the instrument body and presses the intraocular lens housed in the housing portion with a tip to release the intraocular lens into the eyeball from the tip of the insertion tube part;
With
After inserting a needle of a syringe through an insertion hole provided in the storage portion and injecting a viscoelastic substance into the storage portion, the intraocular lens is inserted from the distal end of the insertion tube portion inserted into the eyeball through the incision. An intraocular lens insertion device that inserts an intraocular lens into the eyeball by releasing into the eyeball,
An intraocular lens insertion device comprising a receiving portion having a recess for receiving the tip of the needle of the syringe on a face of the insertion hole inside the storage portion.
The intraocular lens insertion device according to claim 1, wherein the concave portion of the receiving portion is formed by a conical depression having a bottom outer diameter larger than the diameter of the needle of the syringe.
The concave portion of the receiving portion has a shape in which a gap is generated between the tip of the needle of the syringe and the surface of the concave portion of the receiving portion when the tip of the needle of the syringe having the shape of a cylindrical end surface is brought into contact. The intraocular lens insertion device according to claim 1, wherein the intraocular lens insertion device is provided.
The recess of the receiving part is connected to a viscoelastic substance passage provided so that the viscoelastic substance discharged from the tip of the needle of the syringe received in the receiving part flows in a predetermined direction. The insertion device for an intraocular lens according to any one of claims 1 to 3, wherein the insertion device is an intraocular lens.
One or a plurality of through holes are formed in the storage portion,
A positioning member that is attached from the outside of the storage unit, penetrates the through-hole, enters the storage unit, and places an intraocular lens stored in the storage unit to regulate the position;
The intraocular lens insertion device according to any one of claims 1 to 4, wherein the receiving portion is provided in the positioning member.
The receiving part provided on the positioning member is arranged on the optical axis direction of the intraocular lens arranged in the storage part, and the optical axis is located behind the placement surface provided on the positioning member on which the intraocular lens is placed. The intraocular lens insertion device according to claim 5, wherein the intraocular lens insertion device is located on a side.
The said receiving part is provided in the pressing direction front side of the said intraocular lens by the said plunger with respect to the intraocular lens accommodated in the said accommodating part, The Claim 1 characterized by the above-mentioned. Intraocular lens insertion instrument.