WO2017047714A1 - 眼内レンズ挿入器具 - Google Patents
眼内レンズ挿入器具 Download PDFInfo
- Publication number
- WO2017047714A1 WO2017047714A1 PCT/JP2016/077327 JP2016077327W WO2017047714A1 WO 2017047714 A1 WO2017047714 A1 WO 2017047714A1 JP 2016077327 W JP2016077327 W JP 2016077327W WO 2017047714 A1 WO2017047714 A1 WO 2017047714A1
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- WO
- WIPO (PCT)
- Prior art keywords
- intraocular lens
- insertion device
- optical
- guide
- movement
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/1667—Instruments for inserting intraocular lenses into the eye with rotatable plungers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/167—Instruments for inserting intraocular lenses into the eye with pushable plungers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/1672—Instruments for inserting intraocular lenses into the eye with a two-stage plunger, e.g. rotatable and pushable or rotatable at different speeds
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/1678—Instruments for inserting intraocular lenses into the eye with a separate cartridge or other lens setting part for storage of a lens, e.g. preloadable for shipping
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
Definitions
- the present invention relates to an intraocular lens insertion device used when an intraocular lens is inserted into the eye.
- an intraocular lens in order to improve the operability of inserting an intraocular lens by the operator as much as possible, an intraocular lens is provided so as to hold a pair of support parts with an optical part.
- Some have a function of folding see, for example, Patent Document 1).
- Some conventional intraocular lens insertion devices include an extrusion member that pushes out an intraocular lens, and the intraocular lens is folded when the intraocular lens is pushed out by the extrusion member.
- the third aspect of the present invention is: The intraocular lens insertion according to the second aspect, wherein the guide mechanism guides the movement of the push member so that the tip portion of the push member is displaced upward while pushing the support portion. It is an instrument.
- the fourth aspect of the present invention is: The guide mechanism includes a lower guide slope having an inclined portion inclined obliquely upward from the upstream side to the downstream side in the movement direction of the push member, and from the upstream side to the downstream side in the movement direction of the push member. And an upper guide slope having an inclined portion inclined obliquely downward.
- the guide mechanism includes a suppressing portion that suppresses a lateral shake of a distal end portion of the pushing member that moves in a central axis direction of the insertion instrument main body. It is an intraocular lens insertion instrument as described in above.
- the sixth aspect of the present invention is: The eye according to the first aspect, wherein the guide mechanism includes a guide groove that guides the movement of the push-out member, and displaces the distal end portion of the push-out member in the left-right direction along the guide groove. It is an inner lens insertion device.
- the seventh aspect of the present invention is The guide mechanism is configured such that after the distal end portion of the pushing member comes into contact with the distal end portion of the support portion at a position shifted in one of the left and right directions from the position of the central axis of the insertion instrument body, the distal end portion of the pushing member is The intraocular lens according to the sixth aspect, characterized in that the movement of the push-out member is guided so as to be displaced in the other direction and come into contact with the optical unit at the position of the central axis of the insertion instrument main body. Insertion instrument.
- the eighth aspect of the present invention is A pair of left and right side wall guides for guiding the movement of the optical part of the intraocular lens pushed out of the lens installation part by the push member;
- the pair of left and right side wall guides have a guide surface that guides the optical portion of the intraocular lens pushed out from the lens installation portion by the pushing member, and temporarily stops the optical portion that moves along the guide surface.
- the intraocular lens insertion device according to any one of the first to seventh aspects, wherein the intraocular lens insertion device has a protruding portion for the purpose.
- the ninth aspect of the present invention provides In the lens installation part, a movement start position where the optical part of the intraocular lens starts to move is set, The intraocular lens insertion according to the eighth aspect, wherein the protrusion is disposed so as to contact the optical unit when the optical unit moves by a predetermined amount from the movement start position. It is an instrument.
- the tenth aspect of the present invention provides The intraocular lens insertion device according to the ninth aspect, wherein the predetermined amount is not less than 0.5 mm and not more than 1.0 mm.
- the eleventh aspect of the present invention is The intraocular lens insertion device according to any one of the eighth to tenth aspects, wherein a protruding dimension of the protruding portion is not less than 0.1 mm and not more than 0.5 mm.
- the twelfth aspect of the present invention provides The intraocular lens insertion device according to any one of the first to eleventh aspects, wherein the intraocular lens is pre-installed in the lens installation unit in advance.
- the thirteenth aspect of the present invention provides The intraocular lens insertion device according to any one of the first to twelfth aspects, wherein the intraocular lens is installed in an unloaded state in the lens installation unit.
- FIG. 1 is a perspective view showing an overall configuration of an intraocular lens insertion device according to an embodiment of the present invention. It is a sectional side view which shows the whole structure of the intraocular lens insertion instrument which concerns on embodiment of this invention. It is a perspective view which shows a state when the intraocular lens insertion instrument which concerns on embodiment of this invention is accommodated in the case. It is a perspective view which shows a state when taking out the intraocular lens insertion instrument which concerns on embodiment of this invention from a case.
- A) is a plane sectional view which shows the principal part structure of the intraocular lens insertion instrument which concerns on embodiment of this invention
- (B) is a sectional side view which shows the said principal part structure
- C) is (B FIG.
- FIGS. 1-10 are figures which show the mode of movement of an extrusion member accompanying rotation operation of an operation part in time series. It is a plane sectional view showing a mode that an intraocular lens is pushed out by an extrusion member in time series. It is a sectional side view which shows a mode that the intraocular lens is extruded by the extrusion member in time series. It is sectional drawing which shows the principal part of the intraocular lens insertion instrument which concerns on 2nd Embodiment of this invention.
- (A) is the schematic when an upper groove is seen from the position of the central axis of an insertion instrument main body
- (B) is from the position of the central axis of an insertion instrument main body.
- Schematic view when viewing the lower groove (C) is a diagram showing the cross-sectional structure of the upper groove at the position V1-V1 in (A)
- (D) is a diagram showing the cross-sectional structure of the lower groove at the position V2-V2 in (B)
- (A)-(C) are the figures (the 1) explaining operation
- (A), (B) is a figure (the 2) explaining operation
- It is the top view to which the principal part structure of the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention was expanded.
- It is a plane sectional view (the 1) which shows a mode when pushing an intraocular lens with an extrusion member in an intraocular lens insertion instrument concerning a 3rd embodiment of the present invention in time series.
- the main part of the intraocular lens insertion instrument which concerns on the comparison form of this invention shows the internal structure of the connection part of an insertion instrument main body and an insertion cylinder
- (A) is the figure which looked at the internal structure of the connection part from upper direction
- (B) is the perspective view which looked at the internal structure of the connection part from back.
- (A)) is a figure which shows the mode of the movement of the intraocular lens in the intraocular lens insertion instrument which concerns on the comparison form of this invention.
- FIG. 9 shows an internal structure of a connection portion between an insertion device main body and an insertion tube as a main part of an intraocular lens insertion device according to a fourth embodiment of the present invention.
- FIG. 1 is a perspective view of the internal structure of the connecting portion as seen from the rear.
- (A) is a figure which shows the mode of the movement of the intraocular lens within the intraocular lens insertion instrument which concerns on 4th Embodiment of this invention.
- (A)-(D) are figures which show the structural example of the protrusion part in 4th Embodiment of this invention.
- FIG. 1 is a perspective view showing the overall configuration of an intraocular lens insertion device according to an embodiment of the present invention
- FIG. 2 is a side sectional view showing the overall configuration of the intraocular lens insertion device according to an embodiment of the present invention. .
- the illustrated intraocular lens insertion device 1 is provided as a disposable product, and is used when an intraocular lens is inserted into the eye.
- the intraocular lens insertion device 1 is a preload type in which an intraocular lens is previously installed.
- the intraocular lens is installed in advance in a lens installation unit (to be described later) when the intraocular lens insertion device 1 is shipped from the factory.
- the Z1 direction and the Z2 direction correspond to the height direction (vertical direction) of the intraocular lens insertion device 1.
- a horizontal plane parallel to the X1 direction, the X2 direction, the Y1 direction, and the Y2 direction is used, and a plane perpendicular to the horizontal plane is a vertical plane.
- the symbol J in the figure indicates the central axis of the intraocular lens insertion device 1.
- the case 100 has a space in which the intraocular lens insertion device 1 can be accommodated, and the intraocular lens insertion device 1 is accommodated in this space.
- the open / close lid 101 is closed when the intraocular lens insertion device 1 is accommodated in the case 100 (FIG. 3), and is opened when the intraocular lens insertion device 1 is removed from the case 100 (FIG. 4). .
- the intraocular lens insertion device 1 housed in the case 100 is pressed from above by the open / close lid 101.
- the open / close lid 101 is opened, the upper portion of the case 100 is opened.
- the opening / closing operation of the opening / closing lid 101 is performed by the manufacturer or user of the intraocular lens insertion device 1.
- the injection lid 102 is for injecting a viscoelastic substance.
- a small hole is formed in the injection lid 102, and a part of the injection lid 102 is formed in a funnel shape around the hole.
- the injection lid 102 is partially connected to the opening / closing lid 101 so as to move together with the opening / closing lid 101.
- the case 100 is provided with numerals 106, 107, 108 with numbers.
- the numbers given to the respective marks 106, 107, and 108 indicate the procedure of work to be performed by the user when taking out the intraocular lens insertion device 1 from the case 100.
- arrows attached to the marks 107 and 108 indicate the directions of work to be performed by the user.
- the mark 106 with the numeral “1” indicates that the operation of injecting the viscoelastic material through the injection lid 102 should be performed.
- a mark 107 with the numeral “2” indicates that the opening / closing lid 101 should be opened in the direction of the arrow, and a mark 108 with the numeral “3” is in the direction of the arrow. It shows that the operation of taking out the inner lens insertion device 1 should be performed.
- the intraocular lens insertion device 1 is roughly provided with an insertion device body 2, an operation unit 3, an insertion tube 4, and a pushing member 5.
- Each part of the intraocular lens insertion device 1 is made of resin.
- the insertion instrument body 2 is formed in a cylindrical shape as a whole.
- a hollow portion that allows movement of the pusher member 5 in the X1 direction and the X2 direction is formed inside the insertion instrument body 2.
- a lens installation portion 6 is provided at the distal end portion of the insertion instrument body 2.
- the lens installation portion 6 is formed so as to protrude forward from the lower outer peripheral wall of the insertion instrument body 2.
- the intraocular lens 7 is installed in the lens installation unit 6 (see FIG. 5). Further, the central axis J of the intraocular lens insertion instrument 1 coincides with the central axes of the insertion instrument body 2, the operation unit 3, and the insertion cylinder 4.
- a one-piece type intraocular lens 7 made of a soft material such as silicone elastomer or soft acrylic is handled.
- the intraocular lens 7 includes an optical unit 8 that performs an optical function, and a pair (two) of support units 9a and 9b that extend outwardly from the outer peripheral edge of the optical unit 8 in an arc shape. Yes.
- the optical unit 8 is formed in a circular shape in plan view.
- the pair of support portions 9a and 9b are each formed in an elongated arm shape.
- a guide slope 11 is formed on the upper surface of the lens installation portion 6.
- the guide slope 11 constitutes a guide mechanism that guides the movement of the pushing member 5 when the pushing member 5 moves in the central axis direction of the insertion instrument body 2.
- the guide slope 11 is formed on the movement path of the pushing member 5 in a state where a part of the lens installation portion 6 protrudes (lifts) upward.
- the guide slope 11 includes an inclined portion 11a inclined with respect to the horizontal plane, a top portion 11b that cannot be inclined, and a step portion 11c that is perpendicular to the horizontal plane. ing.
- the inclined portion 11a is inclined in a state of gradually becoming higher from the rear to the front of the lens installation portion 6. In other words, the inclined portion 11a is inclined obliquely upward from the upstream side to the downstream side in the moving direction of the pushing member 5.
- the top part 11b is formed in a state of extending horizontally from the uppermost part of the inclined part 11a.
- the step portion 11c is formed in a state where the step portion 11c falls vertically from the tip of the top portion 11b.
- the lens installation unit 6 is formed with a pair of left and right concave grooves (not shown).
- the pair of concave grooves are formed on the left and right side walls defining the lens installation portion 6 of the insertion instrument body 2 so as to face each other.
- the pair of concave grooves are fitted to the left and right outer peripheral parts of the optical unit 8, thereby restricting the vertical movement of the optical unit 8.
- the intraocular lens 7 has one support unit 9 a disposed in front of the lens installation unit 6 and the other support unit 9 b disposed in the rear of the lens installation unit 6. Installed at. In the lens installation unit 6, the intraocular lens 7 is installed (placed) almost horizontally with the rear edge of the optical unit 8 facing the stepped portion 11 c of the guide slope 11. In FIG. 2, the notation of the intraocular lens 7 is omitted.
- the operation unit 3 is coaxially connected to the rear end portion of the insertion instrument body 2. In this connected state, the operation unit 3 is supported so as to be rotatable around the central axis of the insertion instrument body 2.
- the operation unit 3 is formed in a cylindrical shape.
- a plurality of ridges 3 a are formed on the outer peripheral surface of the operation unit 3.
- Each protrusion 3 a is formed in parallel with the longitudinal direction of the operation unit 3.
- the operation unit 3 is a portion that is rotated by a user such as an operator when the intraocular lens 7 is pushed out by the pushing member 5.
- a first screw part 3b is formed on the inner peripheral surface of the operation part 3.
- the first screw part 3b constitutes a female screw.
- the first screw portion 3b is formed over almost the entire central axis direction of the operation portion 3.
- An abutting portion 3 c is formed at the rear end portion of the operation portion 3.
- the abutting portion 3c is formed by bending inward so that the opening diameter of the rear end portion of the operation portion 3 is reduced.
- the abutting portion 3 c is a portion against which the rear end portion of the plunger portion 17 is abutted so that the plunger portion 17 does not protrude rearward from the rear end portion of the operation portion 3.
- the support portion 9b is pushed in while the tip portion of the rod portion 18 is displaced upward along the inclined portion 11a of the guide slope 11. For this reason, the operation
- the lower groove 13 and the upper groove 14 are formed in order to suppress the lateral deflection of the distal end portion of the pushing member 5, but a structure other than the groove is adopted as long as the same function is achieved. May be.
- the guide groove 21 is curved with respect to the central axis J when the lens installation portion 6 is viewed from above. Specifically, in the moving direction of the pushing member 5, the upstream side (right side in the figure) of the guide groove 21 curves in the right direction Y1 so as to be away from the position of the central axis J, and the downstream side of the guide groove 21 (see FIG. Middle, left side) is curved in the left direction Y2 so as to approach the position of the central axis J.
- the tip of the rod portion 18 is fitted in the guide groove 21.
- the distal end portion of the rod portion 18 moves along the guide groove 21 while fitting into the guide groove 21.
- the start end portion 21a of the guide groove 21 serving as a movement start side is positioned on the central axis J in the left-right direction, and the guide on the opposite side thereof.
- the terminal portion 21b of the groove 21 is also located on the central axis J in the left-right direction.
- the tip of the rod portion 18 starts to move from the starting end portion 21a (see FIG. 13) of the guide groove 21 located on the central axis J, as shown in FIG.
- the distal end portion of the rod portion 18 is guided by the guide mechanism and intersects the central axis of the insertion instrument body 2. It is the structure which displaces to the direction (this embodiment left-right direction). With this configuration, when the distal end portion of the rod portion 18 is brought into contact with the support portion 9b and the optical portion 8 in order by the movement of the pushing member 5, the support portion 9b can be bent into an expected shape. This point will be described in more detail.
- the tip of the rod portion 18 is brought into contact with the tip of the support portion 9b at a position shifted in the right direction Y1 from the position of the central axis J, and then the rod portion 18 is contacted.
- the tip of the lens is displaced in the left direction Y2, and is brought into contact with the optical unit 8 at the position of the central axis J.
- FIG. 16 shows the internal structure of the connection part of the insertion instrument body and the insertion tube as the main part of the intraocular lens insertion instrument according to the comparative embodiment of the present invention.
- FIG. 16 (A) shows the internal structure of the connection part from above.
- FIG. 5B is a perspective view of the internal structure of the connecting portion viewed from the rear.
- the position of the optical unit 8 when the intraocular lens 7 is disposed at the initial position is a position at which the optical unit 8 starts to move when the intraocular lens 7 is pushed out by the pushing member 5. For this reason, the movement start position of the optical part 8 in the lens installation part 6 is set using the edge part 15a.
- the separation distance of the pair of side wall guides 22 and 22 in the left-right direction is as follows.
- the outer diameter of the optical portion 8 is the same as or slightly larger than that.
- the nozzle part 4b (FIG. 1) of the insertion cylinder 4 from the connection part 22c with the 1st guide surface 22a.
- the intraocular lens 7 installed in the lens installation unit 6 when the intraocular lens 7 installed in the lens installation unit 6 is pushed out by the rod unit 18 of the pushing member 5, the intraocular lens 7 starts to move from the initial position.
- the optical unit 8 moves forward (X1 direction) while being guided by the left and right first guide surfaces 22a.
- the left and right edges of the optical unit 8 reach the connecting portion 22c between the first guide surface 22a and the second guide surface 22b.
- the connecting portion 22c the first guide surface 22a and the second guide surface 22b are smoothly connected. For this reason, the optical unit 8 moves forward without being caught by the connecting portion 22c.
- the optical unit 8 moves further forward while being guided by the left and right second guide surfaces 22b.
- the separation distance between the left and right second guide surfaces 22b is gradually reduced toward the front, and the space in the insertion tube 4 is also gradually reduced accordingly.
- the optical portion 8 is gradually curved while being guided by the left and right second guide surfaces 22b, and finally is rounded and folded.
- the lens installation portion 6 is formed with a pair of left and right concave grooves that limit the amount of displacement of the optical portion 8 in the vertical direction. In the initial state, the left and right outer peripheral portions of the optical unit 8 are disposed in the corresponding concave grooves, thereby restricting the vertical movement of the optical unit 8. However, when the optical unit 8 starts moving in a state where the bending deformation of the support portion 9b is insufficient, the outer peripheral portion of the optical portion 8 is moved before the tip portion of the support portion 9b rides on the surface of the optical portion 8.
- FIG. 18 shows the internal structure of the connection part between the insertion tool body and the insertion tube as the main part of the intraocular lens insertion tool according to the fourth embodiment of the present invention.
- FIG. 18 (A) shows the internal structure of the connection part. The figure seen from the upper part, (B) is the perspective view which looked at the internal structure of the connection part from back.
- the fourth embodiment is intended to solve problems that may occur in the above comparative example.
- the difference between the fourth embodiment and the comparative example is the configuration of the pair of side wall guides 22 and 22. Specifically, in the comparative embodiment, the first guide surface 22a and the second guide surface 22b of each side wall guide 22 are smoothly connected, but in the fourth embodiment, the first guide surface 22a Without connecting the second guide surface 22b smoothly, a protruding portion 22d is formed in the connecting portion 22c.
- the protruding portion 22d is for temporarily stopping the optical portion 8 of the intraocular lens 7 pushed out by the pushing member 5.
- the protrusion 22d is formed so that the second guide surface 22b protrudes by a predetermined dimension Ly from the first guide surface 22a to the inner side (closer to the central axis J of the intraocular lens insertion device 1) at the connecting portion 22c. .
- the separation distance between the left and right side wall guides 22 and 22 is shorter than the diameter of the optical unit 8 due to the protrusion of the protrusion 22d. For this reason, when the intraocular lens 7 installed at the initial position of the lens installation unit 6 is pushed out by the pushing member 5, the left and right edges of the optical unit 8 are caught by the corresponding protrusions 22d.
- the protrusion 22d does not contact the optical unit 8 when the optical unit 8 is disposed at the movement start position, and the optical unit 8 moves by a predetermined amount M (see FIG. 19A) from the movement start position. It arrange
- the predetermined amount M is preferably not less than 0.5 mm and not more than 1.0 mm, and more preferably not less than 0.6 mm and not more than 0.8 mm.
- the predetermined amount M is set to be shorter than the moving distance of the optical unit 8 until the outer peripheral portion of the optical unit 8 is removed from the left and right concave grooves. Thereby, before the outer peripheral part of the optical part 8 remove
- the intraocular lens 7 installed in the lens installation unit 6 when the intraocular lens 7 installed in the lens installation unit 6 is pushed forward by the rod unit 18 of the pushing member 5, the intraocular lens 7 starts to move from the initial position.
- the optical unit 8 moves forward (X1 direction) while being guided by the left and right first guide surfaces 22a.
- the left and right edges of the optical unit 8 reach the connecting portion 22c between the first guide surface 22a and the second guide surface 22b.
- a projecting portion 22d is formed at the connecting portion 22c.
- FIGS. 19A and 19B the left and right edges of the optical unit 8 come into contact with and catch the corresponding protrusions 22d, and the optical unit 8 is temporarily stopped by this catch.
- the optical unit 8 moves forward while being guided by the left and right second guide surfaces 22b.
- the separation distance between the left and right second guide surfaces 22b is gradually reduced toward the front, and the space in the insertion tube 4 is also gradually reduced accordingly.
- the optical portion 8 is gradually curved while being guided by the left and right second guide surfaces 22b, and finally is rounded and folded.
- the tip of the support portion 9b is on the surface of the optical portion 8, the optical portion 8 is likely to bend in the direction of embedding the support portion 9b.
- the optical part 8 is easily deformed on the side on which the support part 9b is placed, but is difficult to deform on the opposite side. For this reason, even when the optical unit 8 starts moving at an earlier timing than expected, the direction in which the optical unit 8 bends can be determined in one direction (the direction in which the support unit 9b is held).
- any structure may be adopted as the structure of the projecting part 22d as long as the optical part 8 can be temporarily stopped.
- the protrusion 22d may be formed so as to be perpendicular to the first guide surface 22a, and as shown in FIG. 20B, the first guide surface 22a
- the protrusion d may be formed so as to form an obtuse angle, or the protrusion 22d is formed in a round shape from the first guide surface 22a to the second guide surface 22b as shown in FIGS. May be.
- the protrusion part 22d was formed in the connection part 22c of the 1st guide surface 22a and the 2nd guide surface 22b, it is not restricted to this,
- the middle of the 1st guide surface 22a or a 2nd guide A protrusion 22d may be formed in the middle of the surface 22b for the same purpose as described above.
- the preload type intraocular lens insertion device 1 has been described as an example.
- the present invention is not limited to this, and the user who uses the intraocular lens insertion device is intraocularly each time. You may apply to the intraocular lens insertion instrument of the type which installs a lens.
- the rod portion 18 of the pushing member 5 is configured to be elastically deformable, and when the pushing member 5 is moved forward, the rod portion 18 is elastically deformed so that the tip portion of the rod portion 18 is moved.
- this invention is not restricted to this.
- it is good also as a structure which connects the plunger part 17 and the rod part 18 mutually, and supports the rod part 18 so that rotation is possible by the connection part of both.
- a pair of left and right concave grooves are formed in the lens installation unit 6 in order to limit the amount of displacement of the optical unit 8 in the vertical direction, but other configurations may be used.
- a pair of left and right pressing portions are formed inside the insertion tube 4 and the intraocular lens 7 is installed in the lens installation unit 6 and the insertion tube 4 is mounted, the left and right sides of the optical unit 8 It is good also as a structure by which a holding
- a pressing portion 16 is formed inside the insertion tube 4, and the vertical displacement amount of the optical portion 8 is limited by the pressing portion 16. Is adopted.
- tip part of the rod part 18 to an up-down direction is employ
- adopted in the said 3rd Embodiment, the front-end
- the present invention is not limited to this.
- a configuration in which the tip portion of the rod portion 18 is displaced in both the vertical direction and the horizontal direction may be adopted by appropriately combining the embodiments. If this configuration is employed, the tip of the support portion 9b can be more reliably placed on the surface of the optical portion 8.
- the guide groove 21 is curved in the right direction Y1 at the portion from the start end portion 21a to the intermediate portion 21c of the guide groove 21.
- the present invention is not limited to this, and the guide groove is not limited thereto.
- 21 may be arranged so as to be shifted in the right direction Y1 with respect to the central axis J, and a portion from the starting end 21a to the intermediate portion 21c may be formed straight along the central axis J.
- the guide mechanism for guiding the movement of the pushing member 5 the movement of the tip of the rod portion 18 is changed to the guide slopes 11 and 12, the grooves 13 and 14, the guide groove 21 or the like.
- the present invention is not limited to this, and by contact with a portion other than the distal end portion of the rod portion 18 (for example, an intermediate portion or a proximal end portion side of the rod portion 18), You may employ
- characteristic configurations of the first to fourth embodiments can be combined with each other as long as there is no particular trouble.
- the configuration of the fourth embodiment may be applied to an intraocular lens insertion device that does not include a guide mechanism that guides the movement of the pushing member.
- An intraocular lens insertion device for inserting an intraocular lens having an optical part and a support part extending from the optical part into the eye, An insertion instrument body provided with a lens installation part in which the intraocular lens is installed; A pushing member that pushes out the intraocular lens from the lens installation section by moving in the direction of the central axis of the insertion instrument body; A pair of left and right side wall guides that guide the movement of the optical part of the intraocular lens pushed out of the lens installation part by the push member; With The pair of left and right side wall guides have a guide surface that guides the optical portion of the intraocular lens pushed out from the lens installation portion by the pushing member, and temporarily stops the optical portion that moves along the guide surface.
- An intraocular lens insertion device characterized by having a protrusion for the purpose.
- Appendix 2 In the lens installation part, a movement start position where the optical part of the intraocular lens starts to move is set, The intraocular lens insertion device according to appendix 1, wherein the protruding portion is disposed so as to come into contact with the optical portion when the optical portion moves by a predetermined amount from the movement start position.
- Appendix 3 The intraocular lens insertion device according to Appendix 2, wherein the predetermined amount is not less than 0.5 mm and not more than 1.0 mm.
- Appendix 4 4. The intraocular lens insertion device according to any one of appendices 1 to 3, wherein a protruding dimension of the protruding portion is not less than 0.1 mm and not more than 0.5 mm.
Abstract
Description
本発明の第1の態様は、
光学部と当該光学部から延在する支持部とを有する眼内レンズを眼内に挿入する眼内レンズ挿入器具であって、
前記眼内レンズが設置されるレンズ設置部が設けられた挿入器具本体と、
前記挿入器具本体の中心軸方向に移動することにより、前記レンズ設置部から前記眼内レンズを押し出す押出部材と、
前記押出部材が前記挿入器具本体の中心軸方向に移動する際に、前記押出部材の移動をガイドするガイド機構と、
を備え、
前記押出部材の先端部は、前記挿入器具本体の中心軸方向に前記押出部材が移動する際に、前記眼内レンズの前記支持部に接触し且つ前記支持部を押し込みながら前記光学部に接触し、
前記ガイド機構は、前記押出部材の先端部が前記挿入器具本体の中心軸と交差する方向に変位するように、前記押出部材の移動をガイドする
ことを特徴とする眼内レンズ挿入器具である。
(第2の態様)
本発明の第2の態様は、
前記ガイド機構は、前記押出部材の移動をガイドするガイドスロープを備え、当該ガイドスロープに沿って前記押出部材の先端部を上下方向に変位させる
ことを特徴とする上記第1の態様に記載の眼内レンズ挿入器具である。
(第3の態様)
本発明の第3の態様は、
前記ガイド機構は、前記押出部材の先端部が上方に変位しながら前記支持部を押し込むように、前記押出部材の移動をガイドする
ことを特徴とする上記第2の態様に記載の眼内レンズ挿入器具である。
(第4の態様)
本発明の第4の態様は、
前記ガイド機構は、前記押出部材の移動方向の上流側から下流側に向かって斜め上方向に傾斜した傾斜部を有する下側ガイドスロープと、前記押出部材の移動方向の上流側から下流側に向かって斜め下方向に傾斜した傾斜部を有する上側ガイドスロープとを備える
ことを特徴とする上記第2または第3の態様に記載の眼内レンズ挿入器具である。
(第5の態様)
本発明の第5の態様は、
前記ガイド機構は、前記挿入器具本体の中心軸方向に移動する前記押出部材の先端部の横振れを抑制する抑制部を備える
ことを特徴とする上記第2~第4の態様のいずれか1つに記載の眼内レンズ挿入器具である。
(第6の態様)
本発明の第6の態様は、
前記ガイド機構は、前記押出部材の移動をガイドするガイド溝を備え、当該ガイド溝に沿って前記押出部材の先端部を左右方向に変位させる
ことを特徴とする上記第1の態様に記載の眼内レンズ挿入器具である。
(第7の態様)
本発明の第7の態様は、
前記ガイド機構は、前記押出部材の先端部が前記挿入器具本体の中心軸の位置から左右方向の一方にずれた位置で前記支持部の先端部に接触した後、前記押出部材の先端部が左右方向の他方に変位して前記挿入器具本体の中心軸の位置で前記光学部に接触するように、前記押出部材の移動をガイドする
ことを特徴とする上記第6の態様に記載の眼内レンズ挿入器具である。
(第8の態様)
本発明の第8の態様は、
前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部の移動をガイドする左右一対の側壁ガイドを備え、
前記左右一対の側壁ガイドは、前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部をガイドするガイド面を有するとともに、前記ガイド面に沿って移動する前記光学部を一時停止させるための突出部を有する
ことを特徴とする上記第1~第7の態様のいずれか1つに記載の眼内レンズ挿入器具である。
(第9の態様)
本発明の第9の態様は、
前記レンズ設置部には、前記眼内レンズの光学部が移動を開始する移動開始位置が設定されており、
前記突出部は、前記光学部が前記移動開始位置から所定量だけ移動したときに前記光学部と接触するように配置されている
ことを特徴とする上記第8の態様に記載の眼内レンズ挿入器具である。
(第10の態様)
本発明の第10の態様は、
前記所定量が0.5mm以上1.0mm以下である
ことを特徴とする上記第9の態様に記載の眼内レンズ挿入器具である。
(第11の態様)
本発明の第11の態様は、
前記突出部の突出寸法は、0.1mm以上0.5mm以下である
ことを特徴とする上記第8~第10の態様のいずれか1つに記載の眼内レンズ挿入器具である。
(第12の態様)
本発明の第12の態様は、
前記レンズ設置部に前記眼内レンズが予め設置されたプリロードタイプである
ことを特徴とする上記第1~第11の態様のいずれか1つに記載の眼内レンズ挿入器具である。
(第13の態様)
本発明の第13の態様は、
前記レンズ設置部では、前記眼内レンズが無負荷状態で設置される
ことを特徴とする上記第1~第12の態様のいずれか1つに記載の眼内レンズ挿入器具である。
本発明の実施形態においては、次の順序で説明を行う。
1.眼内レンズ挿入装置の構成
2.眼内レンズ挿入器具の組立方法
3.眼内レンズ挿入器具の使用方法
4.実施形態の効果
5.他の実施形態
6.変形例等
図1は本発明の実施形態に係る眼内レンズ挿入器具の全体構成を示す斜視図であり、図2は本発明の実施形態に係る眼内レンズ挿入器具の全体構成を示す側断面図である。
挿入器具本体2は、全体に筒状に形成されている。挿入器具本体2の内部には、X1方向およびX2方向への押出部材5の移動を許容する中空部が形成されている。挿入器具本体2の先端部にはレンズ設置部6が設けられている。レンズ設置部6は、挿入器具本体2の下側の外周壁から前方に突き出すように形成されている。眼内レンズ7は、このレンズ設置部6に設置される(図5参照)。また、眼内レンズ挿入器具1の中心軸Jは、挿入器具本体2、操作部3および挿入筒4の各中心軸に一致している。
レンズ設置部6の上面には、ガイドスロープ11が形成されている。ガイドスロープ11は、押出部材5が挿入器具本体2の中心軸方向に移動する際に、押出部材5の移動をガイドするガイド機構を構成するものである。ガイドスロープ11は、レンズ設置部6の一部を上方に突出(隆起)させた状態で、押出部材5の移動経路上に形成されている。ガイドスロープ11は、図5(C)に示すように、水平面に対して傾斜した傾斜部11aと、傾斜がつかない頂上部11bと、水平面に対して垂直をなす段差部11cと、を有している。傾斜部11aは、レンズ設置部6の後方から前方に向かって徐々に高位となる状態で傾斜している。換言すると、傾斜部11aは、押出部材5の移動方向の上流側から下流側に向かって斜め上方向に傾斜している。頂上部11bは、傾斜部11aの最上部から水平に延在する状態で形成されている。段差部11cは、頂上部11bの先端から垂直に落ち込んだ状態で形成されている。
操作部3は、挿入器具本体2の後端部に同軸上に連結されている。この連結状態において、操作部3は、挿入器具本体2の中心軸回りに回転自在に支持される。操作部3は、円筒状に形成されている。操作部3の外周面には、複数の突条部3aが形成されている。各々の突条部3aは、操作部3の長手方向と平行に形成されている。操作部3は、押出部材5で眼内レンズ7を押し出す際に、術者などのユーザーによって回転操作される部分となる。その際、操作部3の外周部に複数の突条部3aを形成しておけば、ユーザーの指が突条部3aに引っ掛かるため、操作部3を回転操作しやすくなる。なお、本明細書においては、眼内レンズ挿入器具1の状態として、ユーザーが操作部3を回転操作する前の状態を初期状態という。
挿入筒4は、レンズ設置部6に設置された眼内レンズ7を眼内に挿入する際に、眼内レンズ7を小さく折り畳んだ状態で眼内に導くためのものである。挿入筒4は、中空の挿入筒本体4aと、細い管状のノズル部4bと、を一体に有している。挿入筒4は、挿入器具本体2の先端部に装着されている。この装着状態において、挿入器具本体2のレンズ設置部6は、挿入筒4の挿入筒本体4a内に収容して配置されている。挿入筒本体4aの内部の空間は、ノズル部4bに向かって徐々に狭められている。これは、レンズ設置部6から挿入筒4へと押し出される眼内レンズ7を小さく折り畳むためである。眼内レンズ7は、最終的には一対の支持部9a,9bを光学部8で抱き込むように小さく丸めて折り畳まれる。
押出部材5は、挿入器具本体2の中心軸方向に移動可能に設けられている。押出部材5は、挿入器具本体2の中心軸方向(X1方向)に移動することにより、レンズ設置部6から眼内レンズ7を押し出すものである。その際、押出部材5は、挿入器具本体2と操作部3と挿入筒4とが形成する中空部内を移動する。
次に、眼内レンズ挿入器具1の組立方法について説明する。
まず、眼内レンズ挿入器具1を構成する部材(2,3,4,5)を用意したら、操作部3に押出部材5を取り付ける。具体的には、押出部材5のプランジャ部17の後端部に操作部3の先端の開口部をかぶせるように嵌め込んで、操作部3を回転させる。これにより、操作部3の内周面に形成した第1のネジ部3bと、プランジャ部17の後端部に設けた第2のネジ部17aとが互いに噛み合う。このため、押出部材5の回転を規制しながら操作部3を回転させると、操作部3の回転にしたがってプランジャ部17が操作部3の内部に挿入されていく。このとき、プランジャ部17の後端部が操作部3の突き当て部3cに突き当たるまで、操作部3を回転させる。
次に、眼内レンズ挿入器具1の使用方法について説明する。
まず、ユーザーは、滅菌バッグ等からケース100と一緒に眼内レンズ挿入器具1を取り出す。
まず、操作部3を回転操作したときの押出部材5の動作について説明する。
操作部3を一方向に回転操作すると、第1のネジ部3bと第2のネジ部17aとの噛み合いにより、押出部材5が前方に移動する。このとき、押出部材5のプランジャ部17は、挿入器具本体2の中空部に嵌合しつつ、挿入器具本体2の中心軸方向(X1方向)に真っ直ぐに移動する。また、押出部材5は、操作部3の回転操作にしたがって図6(A)~(D)に示すように移動する。
上述のように押出部材5を移動させると、ロッド部18の先端部は、レンズ設置部6から眼内レンズ7を押し出すように前進移動する。その際、ロッド部18の先端部は、ガイドスロープ11によってガイドされることにより、主に4つの段階を経てレンズ設置部6を通過する。その様子を図7(A)~(D)の平断面図および図8(A)~(D)の側断面図に示す。以下、各段階について詳しく説明する。
第1の段階は、図7(A)および図8(A)に示すように、ロッド部18の先端部が支持部9bに接触する段階である。このとき、ロッド部18の先端部がレンズ設置部6に進出することで、ロッド部18先端の第1接触部18aが支持部9bの先端側に接触する。また、支持部9bの先端側は第1接触部18aの上に乗り上がるかたちで支持される。
第2の段階は、図7(B)および図8(B)に示すように、ロッド部18の先端部が支持部9bに接触しながら支持部9bを押し込む段階である。このとき、ロッド部18の先端部がガイドスロープ11の傾斜部11aに達すると、ロッド部18の先端部に上向きの力が加わる。そうすると、ロッド部18の先端部は、ロッド部18自身の弾性変形により上方に変位する。このため、ロッド部18の先端部は、ガイドスロープ11の傾斜部11aに沿って上方に変位しながら支持部9bを押し込むように前進移動する。これにより、支持部9bは徐々に曲げられる。また、支持部9bの先端側は徐々に持ち上げられる。
第3の段階は、図7(C)および図8(C)に示すように、ロッド部18の先端部が光学部8に接触する段階である。このとき、ロッド部18の先端部は、ガイドスロープ11の頂上部11bに達してそこを通過することにより、光学部8に接触する。具体的には、ロッド部18の先端部に形成されている第2接触部18bが光学部8の縁に接触する。また、支持部9bは、ロッド部18の前進移動によってさらに大きく曲げられる。具体的には、支持部9b全体が略U字形をなすように光学部8側に曲げられる。また、ロッド部18の先端部が光学部8に接触する前に、支持部9bの先端側が適度に持ち上げられる。このため、支持部9bの先端部が光学部8の縁に引っ掛かりにくくなり、この状況で支持部9bの先端部が光学部8の面上に乗り上げられる。
第4の段階は、図7(D)および図8(D)に示すように、ロッド部18の先端部が支持部9bと光学部8とに接触しながら眼内レンズ7全体を押し込む段階である。このとき、ロッド部18の先端部には上記ロッド部18自身の弾性変形による反力によって下向きの力を働いているため、ロッド部18の傾斜面18cは下側ガイドスロープ11のエッジ部分(段差部11cの上端)に押しつけられる。このため、ロッド部18の先端部は、ガイドスロープ11の段差部11cを通過した直後から、傾斜面18cの傾斜にしたがって徐々に下方に変位し、最終的に元の高さ位置に戻る。
本発明の実施形態においては、押出部材5が挿入器具本体2の中心軸方向に移動する際に、ロッド部18の先端部がガイド機構にガイドされて挿入器具本体2の中心軸と交差する方向(本形態では上下方向)に変位する構成になっている。この構成により、押出部材5の移動によってロッド部18の先端部を支持部9bと光学部8に順に接触させる際に、光学部8と支持部9bとの間に適度な高低差をつけることができる。このため、支持部9bの先端部を光学部8の面上に確実に乗せることが可能となる。
続いて、本発明の他の実施形態について説明する。本発明の他の実施形態はいくつか存在するため、便宜上、先述した実施形態(図1~図8)を第1実施形態とし、他の実施形態はそれぞれ第2実施形態、第3実施形態等とする。また、本発明の他の実施形態においては、先述した実施形態(第1実施形態)と同様の部分に同じ符号を付して説明する。
以下に本発明の第2実施形態について説明する。
本発明の第2実施形態においては、先述した第1実施形態と比較して、押出部材5の移動をガイドするガイド機構の構成が異なる。すなわち、第1実施形態においては、挿入器具本体2のレンズ設置部6にガイドスロープ11を形成し、このガイドスロープ11によってガイド機構を構成したが、第2実施形態においては、後述するように押出部材5の移動経路の上側と下側にそれぞれガイドスロープを設け、これらのガイドスロープによってガイド機構を構成している。また、第2実施形態のガイド機構は、押出部材5の先端部の横振れを抑制する抑制部を備えている。
本第2実施形態においては、押出部材5の移動をガイドするガイド機構が、下側ガイドスロープ11と上側ガイドスロープ12によって構成されている。下側ガイドスロープ11は、上記第1実施形態で述べたガイドスロープ11(図5)と同様に、傾斜部11a、頂上部11bおよび段差部11cによって構成されている。上側ガイドスロープ12は、傾斜部12aによって構成されている。下側ガイドスロープ11は挿入器具本体2のレンズ設置部6上に形成され、上側ガイドスロープ12は挿入筒4の内側の上壁部に形成されている。また、押出部材5の移動方向(X1方向)において、上側ガイドスロープ12の傾斜部12aは、下側ガイドスロープ11の傾斜部11aよりも下流側に配置されている。
ユーザーが操作部3を回転操作すると、押出部材5が前方に移動する。このとき、押出部材5のロッド部18は、図11および図12に示すように移動する。
すなわち、本発明の第2実施形態においては、押出部材5の移動をガイドするガイド機構を下側ガイドスロープ11と上側ガイドスロープ12によって構成している。このため、押出部材5のロッド部18先端部を上下方向に変位させる動作をより安定的に行わせることができる。
以下に本発明の第3実施形態について説明する。
一般に、ワンピースタイプの眼内レンズ7は、非常に軟らかい材料で構成されているため、ロッド部18で支持部9bを押し込んだときに、支持部9bが設計上想定している形状に曲がらず、その形状が大きく崩れてしまうおそれがある。このような現象が生じると、ロッド部18で支持部9bを押し込んでも、支持部9bの先端部を規定通りに光学部8の面上に乗せることができなくなる。
そこで、本発明の第3実施形態においては、眼内レンズ7全体が軟質の材料で構成されているワンピースタイプの眼内レンズ7を取り扱う場合に好適な眼内レンズ挿入器具1について述べる。ただし、本発明の第3実施形態に係る眼内レンズ挿入器具1は、ワンピースタイプ以外の眼内レンズを取り扱い場合にも適用可能である。
以下に、レンズ設置部6の構成について、図13を用いて詳しく説明する。
レンズ設置部6には、ガイド溝21が形成されている。ガイド溝21は、押出部材5が挿入器具本体2の中心軸方向に移動する際に、押出部材5の先端部の移動をガイドするガイド機構を構成するものである。ガイド溝21は、レンズ設置部6において光学部8が配置される領域の手前に、レンズ設置部6の上面を凹状にへこませた状態で形成されている。ガイド溝21は、レンズ設置部6を上方から見た場合に、中心軸Jに対してカーブしている。具体的には、押出部材5の移動方向において、ガイド溝21の上流側(図中、右側)は中心軸Jの位置から離れるように右方向Y1にカーブし、ガイド溝21の下流側(図中、左側)は中心軸Jの位置に近づくように左方向Y2にカーブしている。
以下に本発明の第4実施形態について説明する。
本発明の第4実施形態においては、先述した第1実施形態と比較して、挿入器具本体2と挿入筒4の構成が異なる。なお、ここでは最初に本発明の比較形態について説明し、その後で本発明の第4実施形態について説明する。
まず、比較形態においては、各々の側壁ガイド22が有する第1ガイド面22aと第2ガイド面22bとを滑らかにつないでいる。このため、眼内レンズ7の光学部8は、つなぎ部分22cで停止することなく第1ガイド面22aと第2ガイド面22bに沿って移動する。そうした場合、眼内レンズ7の物理的な特性によっては、次のような不具合を招くおそれがある。
本第4実施形態と上記比較形態との違いは、一対の側壁ガイド22,22の構成にある。具体的には、上記比較形態では、各々の側壁ガイド22が有する第1ガイド面22aと第2ガイド面22bとを滑らかにつないでいるが、本第4実施形態では、第1ガイド面22aと第2ガイド面22bとを滑らかにつながずに、それらのつなぎ部分22cに突出部22dを形成している。
また、上記第4実施形態においては、第1ガイド面22aと第2ガイド面22bのつなぎ部分22cに突出部22dを形成したが、これに限らず、第1ガイド面22aの途中または第2ガイド面22bの途中に、上記同様の目的で突出部22dを形成してもよい。
本発明の技術的範囲は上述した実施の形態に限定されるものではなく、発明の構成要件やその組み合わせによって得られる特定の効果を導き出せる範囲において、種々の変更や改良を加えた形態も含む。
(付記1)
光学部と当該光学部から延在する支持部とを有する眼内レンズを眼内に挿入する眼内レンズ挿入器具であって、
前記眼内レンズが設置されるレンズ設置部が設けられた挿入器具本体と、
前記挿入器具本体の中心軸方向に移動することにより、前記レンズ設置部から前記眼内レンズを押し出す押出部材と、
前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部の移動をガイドする左右一対の側壁ガイドと、
を備え、
前記左右一対の側壁ガイドは、前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部をガイドするガイド面を有するとともに、前記ガイド面に沿って移動する前記光学部を一時停止させるための突出部を有する
ことを特徴とする眼内レンズ挿入器具。
(付記2)
前記レンズ設置部には、前記眼内レンズの光学部が移動を開始する移動開始位置が設定されており、
前記突出部は、前記光学部が前記移動開始位置から所定量だけ移動したときに前記光学部と接触するように配置されている
ことを特徴とする上記付記1に記載の眼内レンズ挿入器具。
(付記3)
前記所定量が0.5mm以上1.0mm以下である
ことを特徴とする上記付記2に記載の眼内レンズ挿入器具。
(付記4)
前記突出部の突出寸法は、0.1mm以上0.5mm以下である
ことを特徴とする上記付記1~3のいずれか1つに記載の眼内レンズ挿入器具。
2…挿入器具本体
3…操作部
4…挿入筒
5…押出部材
6…レンズ設置部
7…眼内レンズ
8…光学部
9a…支持部(前方支持部)
9b…支持部(後方支持部)
11…ガイドスロープ(下側ガイドスロープ)
12…上側ガイドスロープ
13…下溝
14…上溝
18…ロッド部
21…ガイド溝
22…側壁ガイド
22a…第1ガイド面
22b…第2ガイド面
22c…つなぎ部
22d…突出部
Claims (13)
- 光学部と当該光学部から延在する支持部とを有する眼内レンズを眼内に挿入する眼内レンズ挿入器具であって、
前記眼内レンズが設置されるレンズ設置部が設けられた挿入器具本体と、
前記挿入器具本体の中心軸方向に移動することにより、前記レンズ設置部から前記眼内レンズを押し出す押出部材と、
前記押出部材が前記挿入器具本体の中心軸方向に移動する際に、前記押出部材の移動をガイドするガイド機構と、
を備え、
前記押出部材の先端部は、前記挿入器具本体の中心軸方向に前記押出部材が移動する際に、前記眼内レンズの前記支持部に接触し且つ前記支持部を押し込みながら前記光学部に接触し、
前記ガイド機構は、前記押出部材の先端部が前記挿入器具本体の中心軸と交差する方向に変位するように、前記押出部材の移動をガイドする
ことを特徴とする眼内レンズ挿入器具。 - 前記ガイド機構は、前記押出部材の移動をガイドするガイドスロープを備え、当該ガイドスロープに沿って前記押出部材の先端部を上下方向に変位させる
ことを特徴とする請求項1に記載の眼内レンズ挿入器具。 - 前記ガイド機構は、前記押出部材の先端部が上方に変位しながら前記支持部を押し込むように、前記押出部材の移動をガイドする
ことを特徴とする請求項2に記載の眼内レンズ挿入器具。 - 前記ガイド機構は、前記押出部材の移動方向の上流側から下流側に向かって斜め上方向に傾斜した傾斜部を有する下側ガイドスロープと、前記押出部材の移動方向の上流側から下流側に向かって斜め下方向に傾斜した傾斜部を有する上側ガイドスロープとを備える
ことを特徴とする請求項2または3に記載の眼内レンズ挿入器具。 - 前記ガイド機構は、前記挿入器具本体の中心軸方向に移動する前記押出部材の先端部の横振れを抑制する抑制部を備える
ことを特徴とする請求項2~4のいずれか1項に記載の眼内レンズ挿入器具。 - 前記ガイド機構は、前記押出部材の移動をガイドするガイド溝を備え、当該ガイド溝に沿って前記押出部材の先端部を左右方向に変位させる
ことを特徴とする請求項1に記載の眼内レンズ挿入器具。 - 前記ガイド機構は、前記押出部材の先端部が前記挿入器具本体の中心軸の位置から左右方向の一方にずれた位置で前記支持部の先端部に接触した後、前記押出部材の先端部が左右方向の他方に変位して前記挿入器具本体の中心軸の位置で前記光学部に接触するように、前記押出部材の移動をガイドする
ことを特徴とする請求項6に記載の眼内レンズ挿入器具。 - 前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部の移動をガイドする左右一対の側壁ガイドを備え、
前記左右一対の側壁ガイドは、前記押出部材によって前記レンズ設置部から押し出される前記眼内レンズの光学部をガイドするガイド面を有するとともに、前記ガイド面に沿って移動する前記光学部を一時停止させるための突出部を有する
ことを特徴とする請求項1~7のいずれか1項に記載の眼内レンズ挿入器具。 - 前記レンズ設置部には、前記眼内レンズの光学部が移動を開始する移動開始位置が設定されており、
前記突出部は、前記光学部が前記移動開始位置から所定量だけ移動したときに前記光学部と接触するように配置されている
ことを特徴とする請求項8に記載の眼内レンズ挿入器具。 - 前記所定量が0.5mm以上1.0mm以下である
ことを特徴とする請求項9に記載の眼内レンズ挿入器具。 - 前記突出部の突出寸法は、0.1mm以上0.5mm以下である
ことを特徴とする請求項8~10のいずれか1項に記載の眼内レンズ挿入器具。 - 前記レンズ設置部に前記眼内レンズが予め設置されたプリロードタイプである
ことを特徴とする請求項1~11のいずれか1項に記載の眼内レンズ挿入器具。 - 前記レンズ設置部では、前記眼内レンズが無負荷状態で設置される
ことを特徴とする請求項1~12のいずれか1項に記載の眼内レンズ挿入器具。
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JP2017539981A JPWO2017047714A1 (ja) | 2015-09-16 | 2016-09-15 | 眼内レンズ挿入器具 |
KR1020187003739A KR20180056634A (ko) | 2015-09-16 | 2016-09-15 | 안내 렌즈 삽입 기구 |
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AU2016324545A AU2016324545A1 (en) | 2015-09-16 | 2016-09-15 | Intraocular lens insertion tool |
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- 2016-09-15 WO PCT/JP2016/077327 patent/WO2017047714A1/ja active Application Filing
- 2016-09-15 SG SG11201801775TA patent/SG11201801775TA/en unknown
- 2016-09-15 AU AU2016324545A patent/AU2016324545A1/en not_active Abandoned
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Also Published As
Publication number | Publication date |
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EP3351212B2 (en) | 2023-08-23 |
US10849738B2 (en) | 2020-12-01 |
EP3351212A1 (en) | 2018-07-25 |
JPWO2017047714A1 (ja) | 2018-07-05 |
EP3351212A4 (en) | 2019-06-12 |
US20180250125A1 (en) | 2018-09-06 |
SG11201801775TA (en) | 2018-04-27 |
EP3351212B1 (en) | 2020-08-05 |
AU2016324545A1 (en) | 2018-04-12 |
KR20180056634A (ko) | 2018-05-29 |
CN107920891A (zh) | 2018-04-17 |
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