WO2017030139A1

WO2017030139A1 - Intraocular lens inserting instrument

Info

Publication number: WO2017030139A1
Application number: PCT/JP2016/073969
Authority: WO
Inventors: 玄洋翠川
Original assignee: 興和株式会社
Priority date: 2015-08-18
Filing date: 2016-08-17
Publication date: 2017-02-23
Also published as: JPWO2017030139A1

Abstract

The present invention relates to an intraocular lens inserting instrument with which it is possible to stabilize the behavior of an intraocular lens during ejection thereof. This intraocular lens inserting instrument includes a substantially tubular instrument body having at its distal end an insertion tube portion (100) which inserts an intraocular lens into an eye, and a plunger which moves the intraocular lens to the distal end of the insertion tube portion (100), wherein: the insertion tube portion (100) has an opening portion (100a) for ejecting the intraocular lens; the open end surface of the opening portion (100a) is an inclined surface which is inclined relative to a surface orthogonal to the central axis (O) of the insertion tube portion; a frictional force imparting portion is provided in at least part of a second region (100g) of the inner wall surface of the insertion tube portion (100); the second region (100g) faces, across the central axis (O), a first region (100h) which extends a prescribed distance toward the rear end of the insertion tube portion (100) from a base end (100f) positioned on the side of the open end surface toward the rear end of the insertion tube portion; and the frictional force imparting portion causes a frictional force that is larger than a frictional force that is caused to act on the intraocular lens by means of the first region (100h) to act on the intraocular lens.

Description

Intraocular lens insertion device

The present invention relates to an intraocular lens insertion device.

Intraocular lenses that are inserted as a substitute for the lens for the replacement of the human turbid lens and the correction of refraction in the treatment of cataract are being put to practical use. In intraocular lens insertion surgery for cataract treatment, for example, a few millimeter incision wound (incision) is created at the edge of the cornea, and the lens is crushed and removed from the incision wound by ultrasonic phacoemulsification The intraocular lens is inserted and fixed.

In recent years, when an intraocular lens is inserted into an eyeball through an incision, a so-called preload (or preset) type intraocular lens insertion device in which the intraocular lens is previously placed in a storage unit is used. There are many. The user inserts the distal end opening of the insertion tube portion provided at the distal end portion of the instrument body into the eyeball through the above-mentioned incision, and in the state where the intraocular lens is slightly deformed in the instrument body, The intraocular lens is released and inserted into the eyeball by being pushed out from the tip opening by a rod-like plunger. 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.

Also, a rough surface is provided on the inner wall surface of the insertion tube portion in order to reduce the injection speed of the intraocular lens and the force required to move the intraocular lens when the intraocular lens is injected into the eye from the instrument body. Techniques have been proposed (see, for example, Patent Documents 1 to 3).

JP 2003-325571 A International Publication No. 2004/105649 Special Table 2002-54284 Publication

By the way, the distal end of the insertion tube portion of the intraocular lens insertion instrument may be formed to have a shape having a cross section that intersects at an angle other than a right angle with the central axis direction of the insertion tube portion (a so-called bamboo fluff shape). . In addition, providing such a shape at the front-end | tip of an insertion cylinder part is also called giving a bevel cut. In an intraocular lens insertion instrument with a bevel cut at the distal end of the insertion tube, when the intraocular lens is moved to the distal end of the insertion tube, when the part of the intraocular lens reaches the opening, the reached part Try to go outside the insertion tube first. As a result, the posture when the intraocular lens is ejected from the insertion tube part may become unstable, for example, tilted forward with respect to the traveling direction of the intraocular lens in the insertion tube part.

The technology of the present disclosure has been made in view of the above circumstances, and an object thereof is to provide an intraocular lens insertion device that can suitably stabilize the behavior of the intraocular lens at the time of emission. It is.

An intraocular lens insertion instrument according to one aspect of the present disclosure includes a substantially cylindrical instrument body having an insertion tube portion for inserting an intraocular lens into the eye, and a plunger that moves the intraocular lens to the distal end of the insertion tube portion. The insertion tube portion has an opening for emitting the intraocular lens, and the opening end surface of the opening is with respect to a surface orthogonal to the central axis of the insertion tube portion. A first inclined surface that extends a predetermined length from the proximal end located on the rear end side of the insertion tube portion of the opening end surface to the rear end side of the insertion tube portion, of the inner wall surface of the insertion tube portion. Friction force for causing a friction force larger than the friction force acting on the intraocular lens by the first region to act on the intraocular lens in at least a part of the second region facing the region across the central axis A granting unit is provided. Thereby, the attitude | position of the intraocular lens at the time of an intraocular lens moving to the exterior of an insertion cylinder part from an opening part can be controlled suitably, and the behavior at the time of injection | emission can be stabilized.

Further, the frictional force applying portion may be further provided in a region extending a predetermined length from the proximal end to the distal end side of the insertion tube portion. Furthermore, the frictional force imparting portion may have a rough surface structure provided on the inner wall surface of the insertion tube portion. Alternatively, the frictional force applying part may be a protrusion that protrudes from the inner wall surface of the insertion cylinder part toward the central axis. The region extending a predetermined length toward the rear end side of the insertion tube portion may be configured to extend from the proximal end by the length of the radius of the lens body of the intraocular lens. And the intraocular lens may be accommodated beforehand in the accommodating part of the intraocular lens of the intraocular lens insertion device.

According to the technology disclosed herein, it is possible to provide an intraocular lens insertion device that can suitably stabilize the behavior of the intraocular lens upon ejection.

Fig.1 (a) and FIG.1 (b) are figures which show schematic structure of the intraocular lens insertion instrument in one Embodiment. FIG. 2A and FIG. 2B are diagrams illustrating a schematic configuration of an intraocular lens according to an embodiment. It is a figure which shows schematic structure of the nozzle main body in one Embodiment. FIG. 4A and FIG. 4B are diagrams showing a schematic configuration of a positioning member in one embodiment. Fig.5 (a) and FIG.5 (b) are figures which show schematic structure of the plunger in one Embodiment. It is a side view near the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one Embodiment. It is a perspective view near the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one Embodiment. It is a side view which shows the positional relationship of the insertion cylinder part in the vicinity of the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in a comparative example, and an intraocular lens. It is a side view which shows the positional relationship of the insertion cylinder part in the vicinity of the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one Embodiment, and an intraocular lens. It is a side view near the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one modification. It is a side view which shows the positional relationship of the insertion cylinder part in the vicinity of the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one modification, and an intraocular lens. It is a side view near the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one modification. It is a side view which shows the positional relationship of the insertion cylinder part in the vicinity of the front-end | tip of the insertion cylinder part of the intraocular lens insertion instrument in one modification, and an intraocular lens.

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

FIG. 1 shows a schematic configuration of the insertion instrument 1 of the present embodiment. 1A is a plan view of the insertion instrument 1 when the stage lid 13 is opened, and FIG. 1B is a side view of the insertion instrument 1 when the stage lid 13 is closed. The nozzle body 10 of the insertion instrument 1 is a cylindrical member having a substantially rectangular cross section, and includes a rear end portion 10b that is largely open at one end portion and an insertion tube portion 100 that is narrowed to the other end portion. The nozzle part 15 and the front-end | tip part 10a are provided. As shown in FIG.1 (b), the front-end | tip part 10a is opening diagonally. The plunger 30 is inserted into the nozzle body 10 and can reciprocate.

In the following description, the direction from the rear end 10b of the nozzle body 10 to the front end 10a is the front direction, the opposite direction is the rear direction, the front side of the page in FIG. 1A is the upper direction, and the reverse direction is the lower 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 pressed by the plunger 30 Corresponds to the rear 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 into the front end side of the nozzle body 10. A stage portion 12 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 opens to the upper side of the nozzle body 10 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. With this positioning member 50, the intraocular lens 2 is stably positioned on the stage portion 12 even before use (during transportation).

That is, in the insertion instrument 1, the intraocular lens 2 is placed on the stage unit 12 and the front side of the optical axis is on the upper side when the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12. Set to be. Then, after the stage lid 13 is closed, it is shipped and sold. Furthermore, at the time of use, the user inserts the needle into the stage portion 12 through the needle hole 20a of the insertion portion 20 through the needle hole 20a of the insertion portion 20 and injects the lubricant. Then, the user removes the positioning member 50 with the stage lid portion 13 closed, and then pushes the plunger 30 into the distal end side of the nozzle body 10.

Thereby, 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 10a. 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.

Further, a confirmation window portion 17 is formed on a part of the stage lid portion 13 by forming a thin portion. Note that how thin the confirmation window 17 in the stage lid 13 should be determined as appropriate based on the material forming the stage lid 13 and the visibility of the intraocular lens from the confirmation window 17. Good. In addition, by forming the confirmation window portion 17, an effect of reducing sink marks when the stage lid portion 13 is molded can be expected.

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. It is a so-called one-piece type. The intraocular lens 2 includes a lens body 2a having a predetermined refractive power, and two long flat plate-like support portions 2b connected to the lens body 2a for holding the lens body 2a in the eyeball. . The lens body 2a and the support portion 2b are made of a flexible resin material. In the insertion instrument 1 in the present embodiment, one of the two support portions 2b is disposed on the rear side of the lens body 2a, and the other support portion 2b is disposed on the front side of the lens body 2a. The intraocular lens 2 is set on the stage unit 12. In addition, let the support part arrange | positioned at the front side of the lens main body 2a be a front support part, and let the support part arrange | positioned at the rear side of the lens main body 2a be a back support part.

In the intraocular lens 2 in the present embodiment, the support portion 2b is subjected to a textured process. Thereby, when the intraocular lens 2 is pressed and moved by the plunger 30, the posture of the intraocular lens 2 can be stabilized. Specifically, for example, when the intraocular lens 2 is pressed and moved by the plunger 30, an appropriate frictional force is generated between the support portion 2 b and the inner wall surface of the nozzle body 10, whereby the intraocular lens 2 is moved to the nozzle. It can be prevented from rotating in the main body 10. In addition, since the support portion 2b is subjected to the embossing process, the support portion 2b can be prevented from sticking to the lens body 2a when the intraocular lens 2 is folded in the nozzle body 10. Further, in the present embodiment, as shown in FIG. 2B, a flat portion 2c is provided at the peripheral portion of the lens body 2a of the intraocular lens 2, that is, the connecting portion between the lens body 2a and the support portion 2b, and the front optical By adopting a configuration in which the effective optical part diameter of the part is reduced, the center thickness of the lens is reduced, the sectional area of the lens is also reduced, and a thin lens shape is realized.

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 is 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 is discharged after being transformed into a shape.

Further, the tip portion 10a has a so-called bevel cut shape that is obliquely cut so that the upper region of the nozzle portion 15 is in front of the lower region. In addition, although the detail of the front-end | tip of the nozzle part 15 which concerns on this embodiment is mentioned later, about the shape cut diagonally of this front-end | tip part 10a, it may be cut diagonally diagonally seeing from the left-right direction. However, it may be cut obliquely so as to have a bulge on the outside, that is, a curved shape.

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 extending on both sides of the intraocular lens 2. Further, a set surface 12b, which is a mounting surface for the intraocular lens, 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 portion 13,

ribs

13 a and 13 b for reinforcing the stage lid portion 13 and stabilizing the position of the intraocular lens 2 are provided on the surface facing the set surface 12 b when the lid is closed, and the upper side of the plunger 30. A guide protrusion 13c is provided as a guide. The stage lid portion 13 is provided with a needle hole 20a 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 needle hole 20 a is a hole that connects the outside of the stage unit 12 and the intraocular lens 2 housed in the stage unit 12 when the stage lid unit 13 is closed. The user inserts the needle of the syringe through the needle hole 20a before inserting the intraocular lens 2 and supplies hyaluronic acid, which is a viscoelastic substance, to a required position in the stage unit 12.

As shown in FIG. 1, 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. FIG. 4A shows a plan view of the positioning member 50, and FIG. 4B shows a left side view of the positioning member 50. 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.

A pair of first mounting

portions

54 and 54 projecting upward are formed inside the

side wall portions

51 and 51. Further,

first positioning portions

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

first placement portions

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

first positioning portions

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

Also, a pair of second mounting

portions

56 and 56 projecting upward are formed inside the

side wall portions

51 and 51. 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 that protrude further upward are formed on the outer portions of the upper surfaces of the

second placement portions

56 and 56 over the entire left and right direction of the

second placement portions

56 and 56. . The distance between the inner sides of the

second positioning portions

57 and 57 is set to be slightly larger than the diameter dimension of the lens body 2 a of the intraocular lens 2.

Furthermore, a third placement portion 58 on which a part of the front support portion of the support portion 2b of the intraocular lens 2 is placed is formed inside the

side wall portions

51 and 51. Further, a third positioning portion 59 that protrudes further upward from the third placement portion 58 is formed. A part of the front support part comes into contact with the third positioning part 59. And the 4th mounting part 60 in which a part of back support part is mounted among the support parts 2b of the intraocular lens 2 is formed inside the

side wall parts

51 and 51. As shown in FIG. Furthermore, the 4th positioning part 61 which protrudes further upwards from the 4th mounting part 60 is formed. A part of the rear support part comes into contact with the fourth positioning part 61. As shown in FIG. 4B, the heights of the upper surfaces of the fourth mounting portion 60 and the fourth positioning portion 61 are higher than the heights of the upper surfaces of the first to third mounting portions and the first to third positioning portions. Is also provided to be low. On the other hand, on the outside of the

side wall portions

51, 51, a rotation preventing wall portion 62 for preventing unnecessary rotation when the positioning member 50 is removed is provided.

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 substantially similar to the shape of the first to fourth placement portions and the first to fourth positioning portions of the positioning member 50 as viewed from above. When the positioning member 50 is attached to the nozzle body 10, the first to fourth placement portions and the first to fourth positioning portions are inserted into the set surface through hole 12c from the lower side of the set surface 12b, and the set surface It protrudes above 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 2a is restricted with respect to the horizontal direction (the direction horizontal to the set surface 12b) by the

first positioning portions

55, 55 and the

second positioning portions

57, 57. Furthermore, the two support portions 2b of the intraocular lens 2 are placed on the upper surfaces of the third placement portion 58 and the fourth placement portion 60, respectively. Further, the positions of the two support portions 2b are restricted with respect to the horizontal direction by the third positioning portion 59 and the fourth positioning portion 61, respectively.

FIG. 5 shows a schematic configuration of the plunger 30. The plunger 30 has a slightly larger longitudinal length 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. 5B, the notch 31 c is formed in a groove shape that opens downward 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 downward as it goes to the distal end side of the action portion 31.

Further, slits 31d and 31f are formed in the middle of the front and rear direction of the left and right flat portions 31b and in the vicinity of the base ends. The

slits

31d and 31f are formed to have a substantially L shape including a cut extending in the left-right direction and a cut extending in the front-rear direction. Moreover,

movable pieces

31e and 31g are formed in the flat part 31b by forming

slits

31d and 31f. The

movable pieces

31e and 31g perform a so-called axis deviation prevention function so that the cylindrical portion 31a is positioned at the center in the left-right direction of the nozzle body 10 when the plunger 30 moves in the nozzle body 10. In this embodiment, two pairs of

movable pieces

31e and 31g are formed, but only one pair or three or more pairs may be formed.

The insertion portion 32 has a substantially H-shaped cross section as a whole, and the horizontal and vertical dimensions thereof are set slightly smaller than the through hole 10 c 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 upward from the insertion portion 32 and that can move 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 10e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32a are engaged. The relative position between the nozzle body 10 and the plunger 30 in the initial 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. Also in the insertion part 32, a substantially L-shaped slit composed of a notch extending in the left-right direction and a notch extending in the front-rear direction may be formed, similarly to the

slits

31d and 31f. The slit formed in the insertion portion 32 in this way also functions to prevent the axis deviation of the plunger 30.

Next, FIG. 6 shows the insertion tube portion 100 of the intraocular lens insertion device 1 according to this embodiment. In the insertion tube portion 100, the through hole 10c is formed to extend substantially linearly with a substantially constant cross-sectional area. Furthermore, the through-hole 10c is opened in the insertion cylinder part 100, and the front-end | tip opening part 100a is formed. The tip opening 100a corresponds to an example of the opening. A tip region 100b is formed on the tip portion 10a side of the tip opening 100a. Further, the tip region 100b is provided with a flat projection 100c. The protrusion 100c is a member that extends in the push-out direction of the plunger 30 in the nozzle body 10, that is, in the movement direction of the intraocular lens 2 (the front-rear direction in the figure).

As shown in FIG. 6, the distal end opening portion 100a is formed by cutting the insertion tube portion 100 obliquely so as to move backward in the downward direction in the figure. That is, in the insertion cylinder part 100, the upper end side is extended forward from the lower end side. As shown in FIG. 6, the opening end surface of the tip opening portion 100 a is an inclined surface inclined with respect to a plane orthogonal to the central axis O extending in the front-rear direction of the nozzle body 10, and the insertion cylinder of the nozzle body 10 In the portion 100, the tip opening portion 100a opens downward.

Further, as shown in FIG. 6, the tip opening 100 a is configured to have a bending point G at which the curvature of the contour line changes greatly in the side view. In the distal end opening 100a, the distal end portion 10a side from the bending point G is defined as the distal end region 100b, and the rear end portion 10b side from the bending point G is defined as the proximal end region 100d. More specifically, as shown in FIGS. 6 and 7, the insertion tube portion 100 includes a body portion 100e, a proximal end region 100d, and a distal end in the order from the rear end portion 10b of the nozzle body 10 toward the distal end portion 10a. It has the area | region 100b and the projection part 100c.

When the insertion tube portion 100 is divided by a cross section (virtual plane) perpendicular to the central axis O, the trunk portion 100e is a portion on the rear end portion 10b side from the plane F, and the proximal end region 100d is the plane E and the plane. In the portion between F, the tip region 100b corresponds to the portion between the plane D and the plane E, and the protrusion 100c corresponds to the portion on the tip portion 10a side from the plane D. The protrusion 100c is a plate-like member that is formed so that the upper surface of the tip region 100b protrudes toward the tip 10a, and is substantially parallel to the central axis O.

The inclination angle with respect to the plane orthogonal to the central axis O of the inclined surface in the distal end region 100b is set smaller than the inclination angle with respect to the plane orthogonal to the central axis O of the inclined surface in the proximal end region 100d. Therefore, the side wall of the tip region 100b is formed so as to rise steeply in the vertical direction when the tip opening 100a is viewed from the side. Thus, by providing the side wall of the distal end region 100b high immediately after the protrusion 100c, the intraocular lens 2 can be guided into the lens capsule while being stably held.

The proximal end region 100d is connected to the body 100e while gradually increasing the height of the side wall of the distal end region 100b in the vertical direction. The side wall of the distal end region 100b is a member that extends in the optical axis direction (vertical direction in the drawing) of the intraocular lens 2 positioned on the stage portion 12. The extending direction of the side wall of the tip region 100b (the vertical direction in the figure) is the pushing direction of the plunger 30 in the nozzle body 10, the moving direction of the intraocular lens 2, and the extending direction of the protrusion 100c (in the figure). , The front-rear direction).

The trunk portion 100e has a hollow cylindrical shape. As shown in FIG. 6, the thickness of the bottom surface side of the trunk portion 100e is gradually reduced toward the tip portion 10a side. And in the position of the plane F, the trunk | drum 100e and the base end area | region 100d are comprised so that those outer periphery may connect smoothly. As shown in FIGS. 6 and 7, the height of the side wall in the vertical direction of the base end region 100d is configured to gradually decrease. For this reason, the outer periphery of the proximal end region 100d can be smoothly connected to both the trunk portion 100e and the distal end region 100b.

Furthermore, in this embodiment, as shown in FIG. 6, a rough surface 100 g is provided on a portion constituting the upper surface of the inner wall surface of the insertion tube portion 100 between the plane F and the plane H. The rough surface 100g corresponds to an example of a frictional force applying unit. Moreover, since the process etc. for providing the rough surface 100g in the inner wall surface of the insertion cylinder part 100 are known, detailed description is abbreviate | omitted here. Further, on the inner wall surface of the insertion tube portion 100, a rough surface is not provided on a surface 100h facing the rough surface 100g with the central axis O interposed therebetween. Note that the surface 100h corresponds to an example of a first region. Moreover, the area | region in which the rough surface 100g of the inner wall surface of the insertion cylinder part 100 is provided corresponds to an example of a 2nd area | region.

In the present embodiment, of the inner wall surface of the insertion tube portion 100, a rough surface 100g is applied to the surface facing the opening base end 100f across the central axis O, and the opening base end 100f is formed with respect to the central axis O. The surface 100h on one side is not roughened. That is, the rough surface 100 g is not continuous over the entire circumference of the insertion tube portion 100. As described above, in the present embodiment, in the vertical direction of the insertion tube portion 100, the two surfaces facing each other across the central axis O of the inner wall surface of the insertion tube portion 100 pass through the insertion tube portion 100. The frictional force acting on the lens body 2a is different. The roughness of the rough surface 100g may be set to such an extent that the lens body 2a of the intraocular lens 2 is not damaged.

Further, in the present embodiment, the rough surface 100g is an opening portion base located on the rear end side of the insertion tube portion 100 of the opening end surface of the tip opening portion 100a in a side view of the insertion tube portion 100 as shown in FIG. It is applied to a region extending a predetermined length L from the end 100f to the rear end side of the insertion tube portion. An example of the predetermined length L includes the radius of the lens body 2a of the intraocular lens 2 loaded in the intraocular lens insertion device 1, but the length L is not limited to this.

Next, as a comparative example of the present embodiment, the behavior of the intraocular lens 2 when the rough cylindrical surface 100g is not provided in the insertion tube portion 100 of the intraocular lens insertion device 1 will be described with reference to FIG. explain. FIG. 8 shows the lens body 2a of the intraocular lens 2, and the illustration of the plunger 30 for moving the support portion 2b and the intraocular lens 2 is omitted. Moreover, in the following description, the same code | symbol is attached | subjected about the structure corresponding to said embodiment, and detailed description is abbreviate | omitted. In the following description, when the lens body 2a of the intraocular lens 2 is moved to the distal end of the insertion tube portion 100, both the left and right ends of the lens body 2a are folded downward in the insertion tube portion 100. It has become.

When the above-described rough surface 100g is not provided on the inner wall surface of the insertion tube portion 100 of the intraocular lens insertion instrument 1, when the intraocular lens 2 is moved to the distal end of the insertion tube portion 100 by the plunger 30, as shown in FIG. In addition, the lens body 2a of the folded intraocular lens 2 moves from the part reaching the opening base end 100f to the outside of the insertion tube part 100. Since the opening base end 100f is provided downward in the vertical direction of the insertion tube portion 100, the lens body 2a is folded while moving outward from the opening portion 100a to the outside of the insertion tube portion 100. The shape returns from. As a result, the intraocular lens 2 moves to the outside of the insertion tube portion 100 in a posture inclined downward as shown in FIG.

Originally, the distal end shape of the insertion tube portion 100 is formed on the assumption that the lens body 2a of the intraocular lens 2 is emitted in the forward direction of the insertion tube portion 100 from the distal end opening portion 100a. However, as in this comparative example, when the lens body 2a is emitted from the distal end opening 100a in a direction other than the front direction of the insertion tube 100, the intraocular lens 2 exhibits unexpected behavior of the user, and as a result. In some cases, the intraocular lens 2 is not preferably injected into the eye.

Next, the behavior of the intraocular lens 2 in the present embodiment when the insertion tube portion 100 of the intraocular lens insertion instrument 1 is provided with the rough surface 100g will be described with reference to FIG. Like FIG. 8, FIG. 9 shows the lens body 2a of the intraocular lens 2, and the illustration of the plunger 30 for moving the support portion 2b and the intraocular lens 2 is omitted.

When the rough surface 100g is provided on the inner wall surface of the insertion tube portion 100 as described above, the lens body 2a is moved to the tip of the insertion tube portion 100 while being in contact with the rough surface 100g by the pressing movement of the plunger 30. . At this time, a dynamic frictional force acts on the contact surface of the lens body 2a with the rough surface 100g by the rough surface 100g in the direction opposite to the traveling direction of the lens body 2a, that is, on the rear end side of the insertion tube portion 100. This dynamic friction force is a force that pulls the lens body 2a in the direction opposite to the advancing direction of the lens body 2a, that is, the rear end side of the insertion tube portion 100.

Here, the lens body 2a of the intraocular lens 2 folded in the insertion tube portion 100 moves to the outside of the insertion tube portion 100 from a portion reaching the opening base end 100f. Similarly to the case of FIG. 8, the opening base end 100f is provided downward in the vertical direction of the insertion tube portion 100, and therefore the lens body 2a is inserted downward from the distal end opening 100a. An attempt is made to move outside the tube portion 100. However, in the case of FIG. 9, the dynamic friction force described above is a force that pulls the lens body 2 a toward the rear end side of the insertion tube portion 100. Then, when a force pulling the lens body 2a toward the rear end side of the insertion tube portion 100 is exerted, a portion of the lens body 2a on the front end side of the insertion tube portion 100 is pulled upward.

As a result, as shown in FIG. 9, the traveling direction of the distal end side of the insertion tube portion 100 of the lens body 2a is closer to the central axis O than in the case of FIG. That is, by providing the insertion tube portion 100 with the rough surface 100g, the emission direction from the distal end of the insertion tube portion 100 of the intraocular lens 2 becomes closer to the front direction of the insertion tube portion 100. Therefore, compared with the case of FIG. 8, possibility that the intraocular lens 2 will show a user's unexpected behavior becomes low, and the intraocular lens 2 is inject | emitted in an eye more suitably.

The above is the description of the present embodiment, but the configuration of the insertion portion and the like is not limited to the above-described embodiment, and various modifications can be made within the scope that does not lose the technical idea of the present invention. Is possible. For example, the shape of the distal end of the insertion tube portion 100 is not limited to the above, and the length of the inner wall of the insertion tube portion 100 in the front-rear direction becomes different with the center axis O interposed therebetween by bevel cutting. It suffices to be configured. It is good also as a structure which does not provide the bending point G at the front-end | tip of the insertion cylinder part 100. FIG. The rough surface 100g may be divided into a plurality of regions on the inner wall surface of the insertion tube portion 100. The rough surface 100g is provided with a rough surface different from the rough surface 100g on a surface other than the surface 100h, based on the idea of “controlling” the posture of the intraocular lens 2 emitted from the distal end opening portion 100a of the insertion tube portion 100. Also good. For example, when another rough surface is provided on the inner wall surface of the insertion tube portion 100 on the right inner wall surface in the left-right direction of the insertion tube portion 100 in addition to the rough surface 100g, the intraocular lens 2 is emitted from the distal end opening portion 100a. In this case, the intraocular lens 2 can be emitted rightward without tilting forward. Therefore, by providing a rough surface, the lens emission behavior when the intraocular lens 2 is emitted into the eye is controlled to be a desired behavior, and further, the positional adjustment (fixation) of the intraocular lens 2 in the eye is performed. Also useful.

Furthermore, the configuration of the above embodiment and the configuration in the modification described below can be combined as appropriate.

The following are two examples of modifications of the above embodiment. In the following description, the same reference numerals are given to configurations corresponding to the above-described embodiment, and detailed description thereof is omitted.

10, a plurality of pleated protrusions 100i are provided between the plane F and the plane H on the inner wall surface of the insertion tube portion 100 instead of the rough surface 100g. As the material of the protrusion 100i, an elastic material such as rubber can be used in consideration of the fact that the protrusion 100i does not damage the lens body 2a when the lens body 2a of the intraocular lens 2 contacts the protrusion 100i. Moreover, you may form the protrusion 100i by giving an undercut process to the inner wall face of the insertion cylinder part 100 in which the protrusion 100i is provided.

Thus, even when the projection 100i is provided on the inner wall surface of the insertion tube portion 100, the lens body is the same as the case where the rough surface 100g is provided when the lens body 2a of the intraocular lens 2 comes into contact with the projection 100i. A dynamic friction force acts on the lens body 2a in a direction opposite to the traveling direction of 2a. As a result, as shown in FIG. 11, the direction of emission from the distal end of the insertion tube portion 100 of the intraocular lens 2 becomes closer to the front direction of the insertion tube portion 100 than in the case of FIG. Is less likely to exhibit unexpected behavior of the user, and the intraocular lens 2 is more suitably injected into the eye.

Next, in the modification shown in FIG. 12, a rough surface 100j is provided on the inner wall surface of the insertion tube portion 100 between the plane E and the plane H of the inner wall surface of the insertion tube portion 100. That is, in the present modification, as shown in FIG. 12, the insertion tube portion 100 is provided with a predetermined length L ′ in the front-rear direction including the opening base end 100f in a side view. An example of the predetermined length L ′ is the diameter of the lens body 2 a of the intraocular lens 2 loaded in the intraocular lens insertion device 1, but the length L ′ is not limited to this.

Thus, by providing the rough surface 100j on the inner wall surface of the insertion tube portion 100, the lens body 2a of the intraocular lens 2 moving in the insertion tube portion 100 is roughened as compared with the case of FIG. The contact range becomes larger. As a result, the dynamic frictional force acting on the lens body 2a in the direction opposite to the traveling direction of the lens body 2a is larger than that in the case of FIG. 9, and as shown in FIG. It is expected that the injection direction is closer to the front direction of the insertion tube portion 100.

DESCRIPTION OF SYMBOLS 1 Intraocular lens insertion instrument 2 Intraocular lens 2a Lens main body 2b Support part 10 Nozzle main body 10a Tip part 10b of nozzle main body Rear end part 100 of nozzle main body

Insertion cylinder part

100g, 100j Rough surface 100i Protrusion

Claims

An intraocular lens insertion instrument having a substantially cylindrical instrument body having an insertion cylinder part at the tip for inserting an intraocular lens into the eye, and a plunger for moving the intraocular lens to the tip of the insertion cylinder part. ,
The insertion tube portion has an opening for emitting the intraocular lens,
The opening end surface of the opening is an inclined surface that is inclined with respect to a surface orthogonal to the central axis of the insertion tube portion,
Of the inner wall surface of the insertion tube portion, the central axis extends to a first region extending a predetermined length from the proximal end located on the rear end side of the insertion tube portion of the opening end surface to the rear end side of the insertion tube portion A frictional force imparting portion is provided in at least a part of the second region facing each other with a frictional force acting on the intraocular lens larger than the frictional force acting on the intraocular lens by the first region. An intraocular lens insertion device.
2. The intraocular lens insertion device according to claim 1, wherein the frictional force applying portion is further provided in a region extending a predetermined length from the proximal end to the distal end side of the insertion tube portion.
2. The intraocular lens insertion device according to claim 1, wherein the frictional force imparting portion has a rough surface structure provided on an inner wall surface of the insertion tube portion.
2. The intraocular lens insertion device according to claim 1, wherein the frictional force applying part is a protrusion protruding from the inner wall surface of the insertion tube part toward the central axis.
The region extending a predetermined length toward the rear end side of the insertion tube portion extends from the base end by the length of the radius of the lens body of the intraocular lens. The intraocular lens insertion device according to any one of the above.
The intraocular lens insertion according to any one of claims 1 to 5, wherein the intraocular lens is stored in advance in a storage part of the intraocular lens of the intraocular lens insertion device. Instruments.