WO2016056091A1

WO2016056091A1 - Ophthalmic auxiliary tool

Info

Publication number: WO2016056091A1
Application number: PCT/JP2014/077008
Authority: WO
Inventors: 武井手; 正樹福井; 素脩見川; 英一上村; 芳雄鈴木
Original assignee: 株式会社ユニバーサルビュー
Priority date: 2014-10-08
Filing date: 2014-10-08
Publication date: 2016-04-14
Also published as: JP5869742B1; JPWO2016056091A1

Abstract

The purpose of the present invention is to maintain the internal pressure balance between the aqueous humor and the vitreous body across the crystalline lens in an ophthalmic surgery accompanied by the transplantation of the cornea. An open sky tool (101) can be used in the transplantation of the cornea or the transplantation of the cornea associated with an intraocular surgery, and is equipped with: a cover part (10) which is arranged inside an eye ball and can prevent the leakage of an intraocular fluid from the inside of the eye toward the outside of the eye; multiple support parts (12) of each of which one end is attached to the peripheral part of the cover part (10) to support the cover part (10); and foot parts (14) each of which is attached to the other end of each of the support parts (12) to support the support parts (12).

Description

Ophthalmic aid

The present invention relates to an ophthalmic aid that can be used for corneal transplantation alone or in combination with corneal transplantation that involves combined surgery such as cataract surgery or vitreous surgery.

When performing corneal transplantation, a corneal open wound may accompany, causing so-called expulsive bleeding that causes choroidal bleeding due to instability due to release of intraocular pressure, or irritating the iris / lens / vitreous body With symptoms. In addition, due to its instability, there is a current situation that makes corneal suturing difficult.

Furthermore, when performing cataract surgery or vitreous surgery at the same time as corneal transplant surgery, the cornea scheduled for transplantation is often opaque, such as turbidity, and in that state, even if a microscope is used, the lens behind the cornea The vitreous cavity could not be observed and it was sometimes difficult to perform cataract surgery or vitreous surgery. For this reason, when performing two operations at the same time, cataract surgery or vitreous surgery is performed with the cornea of the recipient (recipient) excised in advance using a trepan or femtosecond laser, etc. After surgery, corneal transplantation is performed.

Here, in general cataract surgery, a part of the transplanter's cornea is incised, an instrument is inserted from there to remove the clouded lens from the lens capsule, and then the intraocular lens is substituted for the lens in the lens capsule. (Intraocular lens, sometimes referred to as IOL in the following) is inserted to perform treatment aimed at replacing a clouded lens with an IOL.

However, in cataract surgery performed at the same time as corneal transplant surgery, if the cornea of the transplanted part is excised from the eyeball, internal fluid such as aqueous humor leaks out of the eye from the opening after the cornea excision. When the front and back pressures are different, the vitreous body behind the lens works to push the lens forward, and if the chin pelvis is fragile, the chin ligament tears due to the vitreous force pushing the lens forward The probability and the risk are much higher than normal cataract surgery.

Similarly, in vitrectomy, a wound opening is prepared from the sclera to allow reflux fluid, illumination, and intraocular control instruments to be taken in and out, and vitrectomy in the vitreous cavity and treatment of the retinal tissue will be performed. The pressure inside the vitreous cavity is not constant and the operation is not performed safely.

Therefore, as a method for reducing or avoiding these difficulty levels and risks in cataract surgery and vitreous surgery performed simultaneously with corneal transplantation surgery, Patent Document 1 discloses that a turbid cornea is punched and a temporary artificial cornea is opened as a cornea. An artificial cornea that is sewn to the sclera of the eyeball using a plurality of stitching holes made in the outer periphery after being attached to the outer part, thereby ensuring transparency in the eye is described. Has been. According to such a method, it is possible to prevent the contact lens for surgery placed on the artificial cornea from being displaced or dropped out.

JP 2008-119316 A

However, the artificial cornea disclosed in Patent Document 1 mainly secures intraocular transparency by being attached to the opening of the cornea. For this reason, there is a problem that aqueous humor leaks from the inside of the eye to the outside of the eye when the corneal opening is formed. Moreover, the internal pressure balance between the aqueous humor and the vitreous body sandwiching the crystalline lens, which has been maintained before the opening is formed, is disrupted by resection of the cornea. As a result, in the artificial cornea of Patent Document 1, there is a concern that corneal transplantation cannot be performed while the intraocular pressure is maintained, or that the chin band is torn.

Therefore, the present invention was created in view of the above-described problems, and can maintain the internal pressure balance between the aqueous humor and the vitreous body with the lens sandwiched in a single corneal transplant or a corneal transplant involving ophthalmic surgery. An object of the present invention is to provide an ophthalmic auxiliary tool.

An ophthalmic aid according to the present invention solves the above-described problems, and as described in claim 1, is an ophthalmic aid that can be used at least during corneal transplantation of an eyeball or corneal transplantation involving intraocular surgery. A lid plug portion provided inside the eyeball for preventing leakage of internal liquid from the inside of the eye to the outside, and one end portion attached to a peripheral portion of the lid plug portion to support the lid plug portion And a plurality of legs attached to the other end of each of the plurality of support parts and supporting the support part.

According to the ophthalmic aid of the first aspect, when the cornea is excised by inserting the ophthalmic aid into the eye before resection of the cornea, and after the resection of the cornea, Misalignment can be prevented.

According to a second aspect of the present invention, the ophthalmic auxiliary tool according to the first aspect is such that the bottom area of the foot portion is set wider than the cross-sectional area of the support portion.

The ophthalmic aid according to claim 3 is the ophthalmic auxiliary tool according to claim 2, wherein one of the support portions and the other support portion are connected by the foot portions.

According to a fourth aspect of the present invention, in the ophthalmic auxiliary tool according to the first aspect, the lid plug portion has a dome shape with a raised central portion.

The ophthalmic assisting device according to claim 5 is the ophthalmic auxiliary device according to claim 4, wherein the lid plug portion has a scale indicating a moving position when the cornea is sutured.

The ophthalmic auxiliary tool according to claim 6 is the ophthalmic auxiliary tool according to claim 5, wherein the lid plug portion includes a lid plug portion main body and a protruding portion having a predetermined shape protruding from the surface of the lid plug portion main body.

According to the ophthalmic aid according to the present invention, when the cornea is excised, the lid plug portion of the ophthalmic aid is pressed against the cornea due to the pressure of the internal fluid such as aqueous humor, so that the airtightness in the anterior chamber is improved. Can be maintained. Therefore, it is possible to prevent leakage of internal fluid from the opening after cornea excision and from the opening after cornea excision, so that the risk of corneal transplantation with intraocular surgery and risk of expulsive bleeding can be reduced. Become.

It is a perspective view which shows the structural example of the open sky instrument 101 which concerns on the 1st Embodiment of this invention. 2 is a plan view showing a configuration example of an open sky apparatus 101. FIG. FIG. 3 is a cross-sectional view taken along line AA of the open sky device 101 shown in FIG. It is sectional drawing which shows the state example (the 1) with which the open sky instrument 101 was mounted | worn in the eye. It is a top view which shows the state example (the 2) with which the open sky instrument 101 was mounted | worn in the eye. FIG. 5 is an assembly diagram illustrating a configuration example of an insertion instrument 300. It is sectional drawing which shows the process example (the 1) of the cataract operation performed at the time of a cornea transplant. It is sectional drawing which shows the process example (the 2) of the cataract operation performed at the time of a cornea transplant. It is sectional drawing which shows the process example (the 3) of the cataract operation performed at the time of a cornea transplant. It is sectional drawing which shows the process example (the 4) of the cataract operation performed at the time of a cornea transplant. It is sectional drawing which shows the process example (the 5) of the cataract operation performed at the time of a cornea transplant. It is sectional drawing which shows the process example (the 6) of the cataract operation performed at the time of a cornea transplant. It is a top view which shows the structural example of the open sky instrument 102 which concerns on the 2nd Embodiment of this invention. It is a perspective view which shows the structural example of the open sky instrument 103 which concerns on the 3rd Embodiment of this invention. It is a top view which shows the structural example of the open sky instrument 103. FIG. It is a side view which shows the structural example of the open sky instrument 103. FIG. It is a top view which shows the structural example of the open sky instrument 104 which concerns on the 4th Embodiment of this invention. It is a side view which shows the structural example of the open sky instrument 104. FIG. It is a figure which shows the example of the state which mounted | wore the open sky instrument 104 in the eye.

Embodiments according to the present invention will be described in detail below with reference to the accompanying drawings. In addition, in this specification and drawing, about the component which has the substantially same function structure, duplication description is abbreviate | omitted by attaching | subjecting the same code | symbol.

<First Embodiment>
[Configuration Example of Ophthalmic Auxiliary Device (hereinafter referred to as Open Sky Device 101)]
The open sky device 101 according to the present invention is mounted in a patient's eye at the time of corneal transplantation accompanied by ophthalmic surgery, etc., so that the internal pressure balance before and after the lens is improved when the cornea is excised and after the cornea excision. Therefore, it is possible to prevent leakage of internal liquid from the inside of the eye to the outside of the eye.

As shown in FIGS. 1 to 4, the open sky device 101 according to the first embodiment includes a lid plug portion 10, a plurality of support portions 12, and a plurality of foot portions 14. The lid plug portion 10 is formed in a bowl shape that is circular when viewed in plan and is curved so as to follow the cornea shape of the eyeball. In other words, the lid plug portion 10 has a dome shape in which the central portion is raised according to the cornea shape of the eyeball. Of course, the lid portion 10 may be given a predetermined thickness and refractive power to have a lens function.

The plurality of support portions 12 are columnar bodies having a predetermined length, and one end portions thereof are attached to the peripheral edge portion of the lid plug portion 10 and the other end portions thereof are along the curved surface (tangent line) of the lid plug portion 10. It extends diagonally downward. In this example, as shown in FIG. 2, two support portions 12 are attached at positions that are symmetrical with respect to the center line O of the lid plug portion 10.

A foot 14 is attached to each other end of the support portion 12. In this example, a configuration is adopted in which one set of support portions 12 is received and supported by one foot portion 14. The foot portion 14 is formed in an arc shape so as to follow the circumferential direction of the lid plug portion 10. In this example, the two support portions 12 are arranged such that, for example, the interval between the support portions 12 is θ1 = 60 degrees at the left and right positions with respect to the center line O. It is arranged and joined in a form that supports it.

As shown in FIG. 3, the bottom area S1 of the arc in the longitudinal direction of the foot portion 14 shown in FIG. 2 is larger than the cross-sectional area S2 (for example, the narrowest portion) that cuts the height direction of the support portion 12. (S1> S2). This is because the support portion 12 is supported by the foot portion 14 having a bottom area several times larger than the cross-sectional area of the support portion 12.

As shown in FIG. 4, the lid plug portion 10 is attached to the inside of the cornea 20 so that the opening faces the inside of the eye, and when the cornea 20 is excised, it tries to leak to the outside through the excision. Has the function of blocking internal liquid. Further, when the lid plug portion 10 is mounted in the eye, the lid plug portion 10 is supported by the cornea 20 by contacting the inner surface side of the cornea 20. The support portion 12 supports the lid plug portion 10 and has a function of preventing the lateral displacement of the lid plug portion 10 when the foot portion 14 receives a force for pushing out the crystalline lens 38 by the vitreous body 40.

Before the cornea excision, the foot 14 comes into contact with the corner of the position avoiding the iris 42 (anterior chamber 35) in a stable state when the open sky device 101 is initially mounted in the eye. When excising the cornea and after the cornea excision, the foot 14 exerts a function of struggling (resisting) the internal pressure from the lens 38 pushed out from the vitreous body 40 toward the opening of the cornea 20. . That is, the support portion 12 and the foot portion 14 exclusively support the lid plug portion 10 until a certain amount of internal pressure is applied to the lid plug portion 10. When the internal pressure gradually increases against the tension force described above and a certain amount of internal pressure is applied, the foot 14 comes into contact with the corner of the anterior chamber 35 and the lid plug 10 is moved in the left-right direction. Prevents rotation and the like.

Examples of the material of the cap part 10, the support part 12, and the foot part 14 constituting the open sky device 101 include, for example, an ultraviolet absorber / pig collagen-containing HEMA, a crosslinked acrylic ester copolymer, an ultraviolet absorber-containing acrylic- Methacrylic crosslinked copolymer, UV-absorbing yellow soft acrylic resin, UV-absorbing high refractive index silicone, polyvinylidene fluoride (PVDF), blue light absorber: ethyl methacrylamide, acrylic resin containing UV / blue light absorber, poly A methyl methacrylate resin or the like can be used. As long as the material of the lid plug part 10, the support part 12, and the foot | leg part 14 is selected and used from the material mentioned above, how to combine does not ask | require. The compositions may be the same combination or different compositions. In addition, it is preferable to use a transparent material for the cap part 10 so that the state in the eye such as a crystalline lens can be seen through from the operator side at the time of surgery.

[Dimension example of Open Sky fixture 101]
Next, an example of the dimension of the open sky apparatus 101 according to the present invention will be described. FIG. 5 is a plan view showing a state when the open sky device 101 according to the first embodiment is mounted in the eye. As shown in FIG. 5, the diameter D1 of the opening 20a formed in the cornea 20 at the time of corneal transplantation differs depending on the transplant target range of the patient's cornea 20, but generally, for example, D1 = 7.5 to 8.0 mm. Preferably, it is set in the range of D1 = 7.75 mm. In addition, although the example which cut off the opening part 20a in planar view circular shape was demonstrated in this example, it is not limited to this.

The diameter D2 of the cap part 10 constituting the open sky device 101 is set to a diameter larger than the diameter D1 of the opening 20a formed in the cornea 20, for example, D2 is set in a range of 9.5 to 10.5 mm. Is done. By setting the lid plug portion 10 in the range of the diameter D2 = 9.5 to 10.5 mm, it is possible to make the outer shape larger than the diameter D1 of the opening 20a. It is possible to reliably prevent the outside liquid from coming off and to prevent the internal liquid from leaking to the outside.

In addition, the contact between the peripheral edge of the lid stopper 10 and the inner surface of the cornea 20 located at the peripheral edge of the opening 20a can provide a force that resists the pushing force by the vitreous body 40, and the lens 38 The internal pressure balance between the intervening aqueous humor and the vitreous body 40 can be maintained.

The outer diameter D3 of the open sky device 101 is set in a range of D3 = 10 to 14 mm, for example. By setting the open sky device 101 in the range of the outer diameter D3 = 10 to 14 mm, the open sky device 101 can be accommodated in the eye and the displacement of the open sky device 101 in the eye can be prevented. it can.
[Manufacturing Method of Open Sky Apparatus 101]
Next, an example of a method for manufacturing the open sky device 101 according to the present invention will be described. In the following, the first to third methods will be described, but the present invention is not limited to these manufacturing methods, and known methods can be appropriately employed.

As a first method, one of the above-mentioned materials is selected, and each shape in which the lid stopper portion 10, the support portion 12, and the foot portion 14 are developed is cut out from the selected material. The open sky fixture 101 is manufactured by thermoforming by combining these members into a three-dimensional shape.

As a second method, a mold modeled on the three-dimensional shape of the open sky device 101 is manufactured, and then the above-described material is injected into the manufactured mold to cover the cap part 10, the support part 12, and the foot part. The open sky device 101 is manufactured by simultaneously molding the 14 parts.

As a third method, one of the above-mentioned materials is selected, and each shape obtained by developing the lid portion 10, the support portion 12, and the foot portion 14 is cut out from the selected material. The open sky device 101 is manufactured by combining these members in a three-dimensional shape and joining them with an adhesive.

[Configuration example of insertion device]
Next, a configuration example of the insertion instrument 300 used when the open sky instrument 101 is inserted into the eye will be described. FIG. 6 shows an example of the configuration of the insertion instrument 300. As shown in FIG. 6, the insertion instrument 300 includes a storage tube 310 and an extrusion member 320.

The storage tube 310 is a long cylindrical body, and is configured such that the opening cross-sectional area gradually narrows toward the tip. For example, the storage tube 310 has the opening cross-sectional shapes a, b, c, d, and e shown in FIG. An insertion portion 312 is formed at the distal end of the storage tube 310 so that the open sky instrument 101 can be smoothly deployed (opened) in the eye. The opening diameter of the insertion portion 312 is selected to be smaller than the diameter of the opening formed in the cornea 20 (see the opening 20c in FIG. 7A).

The push-out member 320 is a long rod-shaped member having a diameter smaller than the diameter of the storage tube 310 and is slidably mounted in the storage tube 310. A groove 322 for holding (engaging) the open sky device 101 and pushing it forward is formed at the distal end of the pushing member 320. A handle 324 is provided at the rear end of the push member 320 for the operator to grasp. The insertion device 300 is not limited to the push-out type, and may be a screw type in which a spiral shape is applied to the inside of the storage tube 310 and the outside of the push-out member 320.

When the open sky device 101 is inserted into the eye, the open sky device 101 is inserted from the rear end side of the storage tube 310, and then the pushing member 320 is inserted from the rear end side of the storage tube 310. Subsequently, by slowly pushing the pushing member 320 forward, the open sky device 101 is regulated by the opening cross-sectional shapes a, b, c, d, e of the storage tube 310 shown in FIG. It is folded and pushed. When the open sky device 101 reaches the tip of the storage tube 310, the open sky device 101 is injected into the eye via the insertion portion 312 at the tip, and expands and returns to the original shape shown in FIG. . It should be noted that an injector for inserting an IOL can be used for the insertion instrument 300.

[Example of cataract surgery with corneal transplant surgery]
Next, an example of a corneal transplantation operation process involving a cataract operation using the open sky device 101 according to the first embodiment will be described. FIGS. 7A to 7C and FIGS. 8A to 8C show an example of a process at the time of corneal transplantation with cataract surgery.

In a corneal transplant operation accompanied by a cataract operation, as shown in FIG. 7A, first, a transplant target site 20b of the patient's cornea 20 is determined. Subsequently, an opening 20c for inserting the insertion instrument 300 or the like is formed in the cornea 20 portion other than the transplant target site 20b of the patient (peripheral portion of the transplant target site). The opening 20c is formed with an incision so that a valve function can be obtained by a known surgical technique. The opening width of the opening 20c is, for example, about 3.0 mm.

Next, as shown in FIG. 7B, the storage tube 310 of the insertion instrument 300 in which the open sky instrument 101 is accommodated is inserted into the eye through the opening 20c, and the pushing member 320 is pushed out into the eye to open the sky. The instrument 101 is inserted inside the cornea 20.

The open sky device 101 inserted into the eye spreads (expands) inside the cornea 20 and is mounted inside the cornea 20 as shown in FIG. 7C. At this time, the lid plug portion 10 of the open sky device 101 abuts on the inner surface of the cornea 20 and abuts on the corner where the foot 14 avoids the iris 42. Each of the foot portions 14 receives and supports the lid plug portion 10 via the support portion 12.

Next, when the open sky device 101 is mounted on the inside of the cornea 20, as shown in FIG. 8A, the transplant target site 20b is excised from the cornea 20 of the patient. According to this example, even when the transplant target site 20b is excised, the internal fluid in the eye can be blocked by the lid plug portion 10 of the open sky device 101, so that leakage of the internal fluid in the eye can be prevented. .

Further, since the lid plug portion 10 of the open sky device 101 is supported by the cornea 20 around the opening 20a, the cap 14 is stretched by the foot portion 14 when the transplant target site 20b is excised and after it is excised ( Can straddle). As a result, in cataract surgery, vitreous surgery, etc. performed simultaneously with corneal transplant surgery, the risk to the patient can be reduced (reduced) and the difficulty of transplant surgery can be avoided as compared with the conventional method.

Next, as shown in FIG. 8B, when the transplant target site 20b can be excised from the cornea 20 of the patient, the lens 38 is removed by a generally performed surgical method, and then the intraocular lens 500 is placed in the eye. insert. At this time, since the lid stopper 10 has transparency, the operation can be performed with good visibility. When the insertion of the intraocular lens 500 is completed, the open sky device 101 is taken out through the opening 20a. Thereafter, as shown in FIG. 8C, the opening 20a of the patient is previously placed in the opening 20a of the cornea 20 excised by the patient. The donor's cornea 20d excised according to the above is fitted and sutured. Through such a series of steps, corneal transplantation involving cataract surgery or the like is performed. Corneal transplantation is not limited to cataract surgery.

As described above, according to the open sky apparatus 101 as the first embodiment, the four support parts 12 that support the dome-shaped lid part 10 are provided, and the other end part of each of the support parts 12 is provided. Are arranged in such a manner that an arcuate foot portion 14 is attached and supports the support portion 12.

With this configuration, it is possible to prevent the right and left misalignment of the lid plug portion 10 after the open sky device 101 is inserted into the eye and before the cornea 20 is excised. Moreover, when the cornea 20 is excised, and after the excision, when the pressure of the internal fluid such as aqueous humor is applied to the cap plug portion 10, the cap plug portion 10 is pressed against the cornea 20 by the internal pressure. As a result, the airtightness in the anterior chamber can be maintained. Therefore, since the leakage of internal fluid from the opening 20a to the outside can be prevented when the cornea 20 is excised and after the excision, the difficulty and risk at the time of cornea transplantation accompanied by intraocular surgery can be reduced. .

Moreover, the internal pressure balance between the aqueous humor and the vitreous body 40 with the lens 38 interposed therebetween can be maintained, and the force that the vitreous body 40 tries to push up the lens 38 can be suppressed. As a result, it is possible to prevent the chin band 36 from being broken (see FIG. 4).

In addition, according to the first embodiment, since the intraocular mounting of the transparent and dome-shaped open sky device 101 is maintained even after removing the transplant target site 20b of the cornea 20 that has lost transparency, The surgeon can perform cataract surgery, vitreous surgery or the like while observing with a microscope through the open sky instrument 101.

<Second Embodiment>
In the second embodiment, as shown in FIG. 9, the lid plug portion 10 constituting the open sky instrument 102 is provided with a scale M used when the cornea is sutured. It is different from the open sky apparatus 101. In addition, since the structure and function of other open sky apparatuses 102 etc. are the same as that of the open sky apparatus 101 of the said 1st Embodiment, the same code | symbol is attached | subjected to a common component and detailed description Is omitted.

First, a configuration example of the open sky apparatus 102 according to the second embodiment will be described. In FIG. 9, the open sky instrument 102 includes a lid plug portion 10, a plurality of support portions 12, and a plurality of foot portions 14. On the peripheral portion on the surface side of the lid plug portion 10, a scale M indicating a hand moving position when the cornea is sutured is provided at regular intervals along the circumferential direction. In this example, since it is assumed that the cornea to be transplanted is sutured with the needle 16, the scale M is provided at intervals of θ2 = 22.5 °, for example. In addition, the arrangement | positioning space | interval of the scale M is not limited to this example. The scale M can be formed by, for example, coloring or engraving the surface of the lid stopper 10.

Next, an example of a corneal transplant operation step accompanied by a cataract operation using the open sky device 102 according to the second embodiment will be described. The operation process until the intraocular lens 500 is inserted into the eye is the same as the operation process of FIGS. 7A to 7C, FIGS. 8A, and 8B described in the first embodiment, and thus detailed description will be given. Is omitted. In this example, the open sky device 102 is mounted in the eye, the insertion of the intraocular lens 500 shown in FIG. 8C is completed, and the donor cornea 20d is opened with the open sky device 102 remaining in the eye. It is premised on the state fitted in the portion 20a.

With this as a precondition, the cornea 20d is sutured using the scale M of the lid stopper 10 as a mark. When the cornea 20d is sutured, ophthalmic forceps (not shown) are inserted from the opening 20c, and the open sky device 102 is cut into small pieces by operating the forceps in the eye to separate the open sky devices 102 from the eye. And take it out. Through such a series of steps, a corneal transplant operation accompanied by a cataract operation is performed.

As described above, according to the second embodiment, since the scale M indicating the needle moving position when the cornea 20d is sutured is provided on the peripheral edge portion of the lid plug portion 10, the operator sutures the cornea 20d in the cornea transplantation. It can be used as a landmark when doing so. Thereby, more accurate stitching can be performed.

<Third Embodiment>
In 3rd Embodiment, as shown in FIG. 10, the arrangement | positioning and structure of the support part 12 and the leg part 14 which comprise the open sky instrument 103 differ from the open sky instrument 101 of 1st Embodiment. In addition, since the structure and function of the other open sky apparatus 103 are the same as that of the open sky apparatus 101 of the said 1st Embodiment, the same code | symbol is attached | subjected to a common component and detailed description is abbreviate | omitted. To do.

As shown in FIG. 10 to FIG. 12, the open sky instrument 103 includes a lid stopper portion 10, a plurality of support portions 12, and a plurality of foot portions. One end of each of the plurality of support portions 12 is attached to the peripheral portion of the lid plug portion 10. In this example, three support portions 12 are provided, and these three support portions 12 are arranged and joined to the peripheral edge portion of the lid stopper portion 10 so that an interval of θ3 = 120 degrees is provided. The foot portion 14 is formed in an arc shape along the circumferential direction of the lid plug portion 10, and a substantially central portion thereof is attached to the other end portion of the support portion 12. In this example, the form which receives and supports one support part 12 with one leg part 14 is taken.

As described above, according to the third embodiment, after the open sky device 103 is inserted into the eye and before the cornea 20 is excised, the lid plug portion 10 of the cap 10 is inserted in the same manner as in the first embodiment. Misalignment of the left and right can be prevented. Furthermore, when the cornea 20 is excised and after the excision, the internal pressure balance between the aqueous humor sandwiching the crystalline lens 38 and the vitreous body 40 can be maintained, and the force that the vitreous body 40 tries to push up the crystalline lens 38 can be suppressed. As a result, it is possible to prevent the chin band 36 from being broken.

<Fourth embodiment>
In the fourth embodiment, as shown in FIG. 13, the first embodiment described above is provided in that a protrusion 32 for preventing displacement of the open sky instrument 104 and securing a visual field area is provided on the surface portion of the lid plug portion 30. It is different from the open sky apparatus 101 of the form. In addition, since the structure and function of the other open sky apparatus 104 are the same as that of the open sky apparatus 101 of the said 1st Embodiment, the same code | symbol is attached | subjected to a common component and detailed description is abbreviate | omitted. To do.

In FIG. 13, the open sky instrument 104 includes a lid plug portion 30, a plurality of support portions 12, and a plurality of foot portions 14. The lid plug portion 30 includes a lid plug portion main body 31 and a protruding portion 32. As shown in FIG. 14, the protruding portion 32 is a stepped planar portion protruding from the surface portion of the lid plug portion main body 31, and has a shape and size corresponding to the opening 20a formed in the cornea 20 shown in FIG. It is constituted by. Specifically, the protrusion 32 has a circular shape in plan view (see FIG. 13) corresponding to the shape of the opening 20a, and the diameter D4 shown in FIG. 15 is selected to be equal to or smaller than the diameter D1 of the opening 20a. Is done. Moreover, the thickness of the protrusion part 32 should just be a thickness which can be engaged with the opening edge part of the cornea 20. FIG.

Thus, according to the fourth embodiment, when the open sky device 104 is mounted in the eye, the protrusion 32 is disposed inside the opening 20a of the cornea 20 (see FIG. 15). . Thereby, even when a lateral (horizontal) force is applied to the open sky device 104, the stepped portion constituting the protrusion 32 is caught (engaged) with the opening edge of the cornea 20. Misalignment can be reliably prevented.

Furthermore, in the first embodiment, when the internal pressure in the eyeball is increased during the intraocular surgery and the reflux liquid oozes out, in the first embodiment, the reflux liquid or the like is not applied to the upper outer peripheral edge of the open sky device 104. Stagnated in the rules. On the other hand, according to the fourth embodiment, the reflux liquid can be forcibly excluded into the annular groove 33 formed by the outer peripheral edge of the protrusion 32 and the inner peripheral edge of the cornea 20. Thereby, it becomes possible to secure a wider field of view than in the first embodiment.

It should be noted that the technical scope of the present invention is not limited to the above-described embodiment, and includes those in which various modifications are made to the above-described embodiment without departing from the spirit of the present invention. For example, the dimensions of the

open sky devices

101, 102, 103, 104 are not limited to the above numerical values.

DESCRIPTION OF SYMBOLS 10 Lid part 12 Support part 14 Foot part 20 Cornea 20a Opening part 20b The site | part 101,102,103,104 to be transplanted Open sky apparatus (ophthalmic auxiliary tool)

Claims

An ophthalmic aid that can be used at least during corneal transplantation of an eyeball or corneal transplantation involving intraocular surgery,
A cap part provided on the inside of the eyeball for preventing leakage of internal fluid from the inside of the eye to the outside of the eye;
A plurality of support portions that are attached to the peripheral portion of the lid plug portion and support the lid plug portion;
An ophthalmic aid comprising: a plurality of feet attached to and supported by the other end of each of the plurality of support portions.
The ophthalmic aid according to claim 1, wherein the bottom area of the foot portion is set wider than the cross-sectional area of the support portion.
The ophthalmic aid according to claim 2, wherein the one support portion and the other support portion are connected by the foot portion.
2. The ophthalmic aid according to claim 1, wherein the lid plug portion has a dome shape with a raised central portion.
5. The ophthalmic aid according to claim 4, wherein the cap part has a scale indicating a position of moving a needle when the cornea is sutured.
The said lid stopper part is an ophthalmic auxiliary tool of Claim 5 provided with the lid stopper part main body and the protrusion part of the predetermined shape which protruded from the surface of the said lid stopper part main body.