WO2020032024A1 - Intraocular lens insertion implement - Google Patents

Intraocular lens insertion implement Download PDF

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Publication number
WO2020032024A1
WO2020032024A1 PCT/JP2019/030898 JP2019030898W WO2020032024A1 WO 2020032024 A1 WO2020032024 A1 WO 2020032024A1 JP 2019030898 W JP2019030898 W JP 2019030898W WO 2020032024 A1 WO2020032024 A1 WO 2020032024A1
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WO
WIPO (PCT)
Prior art keywords
intraocular lens
contact
lens
plunger
nozzle
Prior art date
Application number
PCT/JP2019/030898
Other languages
French (fr)
Japanese (ja)
Inventor
和馬 松本
Original Assignee
参天製薬株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 参天製薬株式会社 filed Critical 参天製薬株式会社
Priority to JP2020535787A priority Critical patent/JP7232253B2/en
Publication of WO2020032024A1 publication Critical patent/WO2020032024A1/en

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Classifications

    • 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

Definitions

  • the present invention relates to an intraocular lens insertion device.
  • An intraocular lens insertion device for extruding and releasing an intraocular lens held by a lens holder by a plunger is known as a conventional technique (for example, Patent Documents 1 to 3).
  • the intraocular lens insertion devices described in Patent Literatures 1 to 3 include a nozzle unit that discharges the intraocular lens while pressing the plunger to fold the intraocular lens held by the lens holder into a concave shape.
  • the nozzle portion has a configuration in which the inside diameter gradually decreases as going forward.
  • the intraocular lens mounted on the conventional intraocular lens insertion devices disclosed in Patent Documents 1 to 3 includes a lens unit, a front support unit, and a rear support unit. Further, the front support portion and the rear support portion have a loop shape formed to extend in a curved shape from the side surface of the lens portion.
  • a plate-type intraocular lens having a substantially rectangular outer shape in addition to the above-described lens having the loop-shaped front support portion and the rear support portion.
  • the plate-type intraocular lens is made of a material having flexibility as compared with an intraocular lens having a loop-shaped front support portion and a rear support portion. Therefore, when a plate-type intraocular lens is inserted into the eye using the intraocular lens insertion device disclosed in Patent Documents 1 to 3, the intraocular lens may be damaged.
  • An object of one embodiment of the present invention is to realize an intraocular lens insertion device that can be appropriately inserted into an eye without damaging a plate-type intraocular lens.
  • an intraocular lens insertion device is an intraocular lens insertion device to which a lens holder that holds an intraocular lens can be attached, and the intraocular lens insertion device is applicable to the intraocular lens.
  • a plunger for pushing out the intraocular lens, a nozzle portion for discharging the intraocular lens pushed out by the plunger to the outside while being folded, and a nozzle portion for ejecting the intraocular lens pushed out by the plunger are provided.
  • the portion is inserted into the guide path and bent rearward by contact with the front end of the guide path, and the base end is accommodated by the second contact portion bent rearward and deformed. It is characterized by having a recessed portion.
  • an intraocular lens insertion device that can be appropriately inserted into the eye without damaging the plate-type intraocular lens can be realized.
  • tip tip of the intraocular lens insertion tool which concerns on embodiment of this invention is shown, 3001 is a top view, and 3002 is the back view seen from the back.
  • FIG. 6001 shows a mode when a 2nd contact part has passed the guide slit of a nozzle part
  • 5002 shows 2nd.
  • a state when the contact portion contacts the front end of the guide slit of the nozzle portion is shown
  • reference numeral 5003 shows a condition after the second contact portion contacts the front end of the guide slit of the nozzle portion.
  • 6001 to 6005 is a view showing a cross-sectional shape of a tapered inner wall surface forming an inner cavity of the nozzle portion.
  • Reference numerals 7001 to 7005 each show another cross-sectional shape of the tapered inner wall surface forming the inner cavity of the nozzle portion.
  • Each of 8001 to 8005 is a diagram showing another cross-sectional shape of a ridge portion formed on a tapered inner wall surface forming a lumen of a nozzle portion.
  • the structure of the centering member attached to the annular enlarged portion is shown, where 9001 is a perspective view and 9002 is a sectional view.
  • 10001 is a front view showing the configuration of the centering member as viewed from the front side
  • 10002 is a cross-sectional view perpendicular to the front-rear direction showing the configuration of the centering member attached to the annular enlarged portion.
  • FIG. 1 is a perspective view showing an entire configuration of an intraocular lens insertion device 1 (hereinafter, referred to as an insertion device 1).
  • the insertion device 1 includes a cylindrical device main body 2, a distal tip 3, a lens holder 4 for holding an intraocular lens 7, a plunger 5, a guide path 6, a spring 8, , Is provided.
  • the tip 3 has a nozzle portion 32 connected to the apparatus main body 2.
  • the lens holder 4 can be attached to the apparatus main body 2.
  • the plunger 5 has a rod shape, and is configured to be inserted into the apparatus main body 2.
  • the guide path 6 is provided on the tip 3. Note that the lens holder 4 may be attached to the tip 3.
  • the axial direction of the plunger 5 is defined as the front-back direction.
  • the thickness direction of the intraocular lens 7 held by the lens holder 4 is defined as the up-down direction, and the direction perpendicular to both the front-rear direction and the up-down direction is defined as the left-right direction.
  • the tip 3 side of the insertion device 1 is defined as a front side, and the opposite side is defined as a rear side.
  • the guide path 6 side of the tip 3 is defined as an upper side, and the opposite side is defined as a lower side.
  • FIG. 2 is a top view showing the configuration of the intraocular lens 7 mounted on the lens holder 4 of the insertion device 1.
  • the intraocular lens 7 includes a lens portion 7a, a front support portion 7b, and a rear support portion 7c.
  • the lens portion 7a is a lens portion that functions as a crystalline lens after insertion into the eye.
  • the front support portion 7b and the rear support portion 7c have a function of supporting the lens portion 7a in the eye after insertion into the eye.
  • the front support portion 7b and the rear support portion 7c are provided symmetrically with respect to the lens portion 7a, and have a flat plate shape.
  • the front support portion 7b is formed so as to cover a front side surface of the lens portion 7a.
  • the rear support portion 7c is formed so as to cover a rear side surface of the lens portion 7a.
  • the intraocular lens 7 is a plate-type intraocular lens whose outer shape is substantially rectangular, and the rectangle is formed by a lens portion 7a, a front support portion 7b, and a rear support portion 7c.
  • the lens portion 7a, the front support portion 7b, and the rear support portion 7c are made of a material having flexibility, and are formed to be flexibly deformable.
  • a single piece type in which the lens portion 7a, the front support portion 7b, and the rear support portion 7c are integrally formed will be described as an example.
  • the device main body 2 has a configuration in which the distal end tip 3 is engaged with the front, an annular enlarged portion 22 that can be gripped by an operator on the outer surface of the front end, and a flange that the operator holds by holding a finger on the outer surface of the rear end. And a holding portion 23 in a shape of a circle.
  • the apparatus main body 2 is formed using a resin such as polycarbonate having impact resistance.
  • the annular enlarged portion 22 is formed of, for example, a plurality of annular protrusions.
  • the annular expanding portion 22 and the holding portion 23 may have any shape as long as they can perform required functions.
  • the holding portion 23 may be formed by a protrusion or the like that allows a finger to be hooked, instead of a flange shape.
  • the surgeon grasps the annular enlarged portion 22 with the other hand and holds the intraocular lens 7 in the order of the front support portion 7b, the lens portion 7a, and the rear support portion 7c. Release into the patient's eye.
  • the provision of the annular enlarged portion 22 makes it easier for the surgeon to grasp the insertion instrument 1 and enhances the operability of the insertion instrument 1.
  • the distal tip 3 has an emission portion 31 from which the intraocular lens 7 is emitted, a nozzle portion 32 whose inner diameter gradually decreases toward the front, and a rectangular portion 33 having a rectangular outer periphery with an open side surface. are doing.
  • the distal tip 3 is connected to the device main body 2 by engaging the rectangular portion 33 with the device main body 2.
  • the nozzle portion 32 is configured such that the distance between the mutually facing side walls forming the lumen becomes smaller toward the front, and has opposed tapered side walls.
  • the guide path 6 is formed on the upper surfaces of the nozzle section 32 and the rectangular section 33.
  • the guide path 6 includes a guide slit 61 and a guide groove 62.
  • the configuration for engaging the tip 3 with the apparatus main body 2 may be any configuration such as, for example, engagement between a locking claw and a locking hole.
  • the tip 3 is formed using a resin such as polypropylene or polyamide having chemical resistance and flexibility.
  • the insertion device 1 has a configuration in which the lens holder 4 holding the intraocular lens 7 can be attached.
  • the insertion device 1 according to the present embodiment may have a form in which the lens holder 4 is separated or a form in which the lens holder 4 is attached.
  • the surgeon inserts the lens holder 4 into the opening formed on the side surface of the rectangular portion 33.
  • the rectangular part 33 can be said to be an installation part on which the lens holder 4 is installed. Note that the lens holder 4 may be inserted into the opening of the rectangular portion 33 before use of the insertion device 1, or may be inserted into the opening of the rectangular portion 33 when the insertion device 1 is used.
  • the lens holder 4 has a housing part 41 that forms a housing space for housing the intraocular lens 7, and a knob part 42 provided to protrude laterally from the housing part 41.
  • the accommodation section 41 has openings formed on both the front side and the rear side.
  • the space inside the housing portion 41 and the space inside the nozzle portion 32 communicate with each other through an opening formed on the rear side of the housing portion 41.
  • the operator grasps the knob 42 and inserts the lens holder 4 into an opening formed on the side surface of the rectangular portion 33, so that the intraocular lens 7 is inserted. 1 is attached.
  • the lens holder 4 is formed using a resin such as polypropylene having chemical resistance.
  • the plunger 5 includes a plunger body having a rear shaft portion 51, a pressing portion 52, and a center shaft portion 53, and a lens contact member 54 (tip portion).
  • the rear side shaft portion 51 is located on the rearmost side of the plunger 5.
  • the rear shaft portion 51 is a portion that is exposed to the outside when the plunger 5 is in the initial position where the plunger 5 is inserted into the apparatus main body 2.
  • the rearward movement of the rear shaft 51 is restricted by a stopper provided at the rear end of the apparatus main body 2.
  • the pressing portion 52 is formed in a flange shape on the peripheral surface on the rear side of the rear side shaft portion 51. The operator moves the plunger 5 toward the distal end by pushing the pressing portion 52 toward the apparatus main body 2.
  • the lens contact member 54 is configured to be separable from the plunger body. However, the lens contact member 54 may be configured integrally with the plunger main body and cannot be separated from the plunger main body.
  • the “tip portion” here includes both the lens contact member 54 configured to be separable from the plunger main body and the lens contact member 54 configured integrally with the plunger main body.
  • the center shaft 53 is connected to the front side of the rear shaft 51 and is a shaft having a smaller diameter than the rear shaft 51.
  • a lens contact member 54 that contacts the rear support portion 7c of the intraocular lens 7 is attached to the distal end of the center shaft portion 53.
  • a spring 8 is provided along the outer peripheral surface of the center shaft portion 53. Accordingly, the reaction force is received from the spring 8 when the plunger 5 is pushed, and the intraocular lens 7 can be prevented from vigorously jumping out of the lens contact member 54 of the plunger 5.
  • the position of the spring 8 is not particularly limited.
  • the spring 8 may be disposed between the pressing portion 52 of the plunger 5 and the rear end of the apparatus main body 2, provided that the spring 8 receives a reaction force from the elastic member when the plunger 5 is pressed. Good.
  • the plunger 5 When the plunger 5 is pushed from the initial position to the front-back direction from the initial position in a state where the plunger 5 is at the initial position, the plunger 5 passes through the opening formed on the rear side of the housing portion 41. Then, the lens contact member 54 at the tip of the plunger 5 comes into contact with the rear support portion 7c of the intraocular lens 7. Then, the plunger 5 further advances to the distal end side, passes through an opening formed in the front side of the housing section 41, and advances into the distal end tip 3. At this time, the intraocular lens 7 is folded in a concave shape while passing through the nozzle portion 32 of the tip 3. Next, the intraocular lens 7 reaches the emission unit 31 in a state where the intraocular lens 7 is folded. The intraocular lens 7 that has reached the emission unit 31 is inserted into the eye from the cut side of the emission unit 31 in the order of the front support unit 7b, the lens unit 7a, and the rear support unit 7c.
  • a front support portion and a rear support portion are formed so as to extend in a curved manner from the side surface of the lens portion. It has a loop shape.
  • the intraocular lens 7, which is the above-mentioned plate-type intraocular lens, is made of a material having flexibility as compared with the intraocular lens having the loop-shaped front support portion and the rear support portion. Therefore, when a plate-type intraocular lens 7 is inserted into the eye using a conventional intraocular lens insertion device equipped with an intraocular lens, the intraocular lens 7 may be damaged.
  • the object of the insertion device 1 according to the present embodiment is to properly insert the plate-type intraocular lens 7 into the eye without damaging it.
  • the contact area of the plunger 5 with the intraocular lens 7 is large. Therefore, it is desirable that the dimension of the lens contact member 54 of the plunger 5 is large. Further, from the viewpoint of transmitting the pressing force of the plunger 5 to the intraocular lens 7 without loss, it is desirable that the material of the lens contact member 54 has some rigidity.
  • the lens contact member 54 passes through lumens having different wall dimensions, such as the rectangular portion 33, the nozzle portion 32, and the discharge portion 31, of the distal end tip 3. For this reason, it is preferable that the lens contact member 54 be configured so that when the plunger 5 is pushed in, the plunger 5 smoothly passes through all the lumens of the rectangular portion 33, the nozzle portion 32, and the discharge portion 31.
  • FIG. 3 shows a schematic configuration of the tip 3, where 3001 in FIG. 3 is a top view and 3002 in FIG. 3 is a rear view as viewed from the rear. 4 shows a configuration of the lens contact member 54, where 4001 in FIG. 4 is a perspective view, and 4002 in FIG. 4 is a top view as viewed from above.
  • the guide path 6 provided in the tip 3 is composed of a guide slit 61 and a guide groove 62.
  • the guide slit 61 is provided so as to penetrate the upper surface of the nozzle portion 32.
  • the guide groove 62 is provided on the upper surface of the rectangular portion 33 facing the lens holder 4. Both the guide slit 61 and the guide groove 62 are formed parallel to the axis X of the nozzle part 32. More specifically, the guide slit 61 and the guide groove 62 are provided along the axis X of the nozzle part 32.
  • the lens contact member 54 has a base end portion 55, a first contact portion 56, a second contact portion 57, and a concave portion 58.
  • the first contact portion 56 and the second contact portion 57 are provided to extend forward from the base end portion 55.
  • the recess 58 is not provided so as to protrude from the outer surface 55a of the base end portion 55, and is formed to be recessed from the outer surface 55a.
  • the first contact portion 56 is a portion that contacts the rear support portion 7c of the intraocular lens 7, and has two extension portions 56a (first extension portions) that extend forward from the base end portion 55.
  • the two extending portions 56a have a configuration that can be deformed so that the distance between the two extending portions 56a changes in the left-right direction.
  • the left-right direction is the direction in which the tapered side walls forming the lumen of the nozzle portion 32 face each other.
  • the front end of the extension 56a has a contact plane 56b perpendicular to the front-rear direction so that the front end of the extension 56a can contact the rear support 7c of the intraocular lens 7 with a larger area.
  • the extension portion 56a is formed such that the size in the left-right direction decreases from the contact plane 56b toward the base end portion 55, and is tapered toward the base end portion 55. With such a shape, the two extending portions 56a have a structure that can be deformed in the left-right direction.
  • the first contact portion 56 may have a plurality of extending portions 56a as long as the extending portions 56a can be changed in the left-right direction, and are not limited to two.
  • the second contact portion 57 is disposed above the first contact portion 56. Further, the second contact portion 57 has an extension portion 57a (second extension portion) extending forward from the base end portion 55. The extension portion 57a is provided so as to protrude above the base end portion 55.
  • the intraocular lens 7 is stored in the lens holder 4 having an opening equal to or smaller than the entrance of the nozzle unit 32 in the front-rear direction.
  • the lens holder 4 has a cylindrical structure, not a structure having a tapered side wall as large as the nozzle portion 32.
  • the second abutment portion 57 has a shape protruding above the base end portion 55, so that the lens with respect to the intraocular lens 7 at the initial position in the lens holder 4.
  • the contact point of the contact member 54 is widened. For this reason, the displacement of the contact point of the lens contact member 54 in the intraocular lens 7 can be reduced, and the intraocular lens 7 can reliably reach the inlet of the nozzle unit 32 without mistake.
  • the second contact portion 57 is disposed between the two extending portions 56a of the first contact portion 56.
  • the second contact portion 57 is configured to bend and deform rearward when an external force on the rear side is applied to the contact inclined surface 57b.
  • the contact inclined surface 57b is a surface that is inclined upward and forward in the front-rear direction. By making the contact inclined surface 57b such an inclined surface, the second contact portion 57 is smoothly bent rearward.
  • the rear support portion 7c When the intraocular lens 7 is pressed in a state where the rear support portion 7c is in contact with the first contact portion 56, the rear support portion 7c may be deformed upward, such as being bent upward. is there.
  • the second contact portion 57 contacts such an upwardly deformed portion of the intraocular lens 7.
  • the second contact portion 57 has a shape protruding above the base end portion 55, and the contact inclined surface 57b is a surface inclined forward and upward in the front-rear direction. Therefore, the front end of the second contact portion 57 contacts a deformed portion of the intraocular lens 7 with a larger area.
  • the extension portion 57a of the second contact portion 57 is formed such that the size in the vertical direction decreases from the contact inclined surface 57b toward the base end portion 55, and has a tapered shape toward the base end portion 55. Has become.
  • the connecting portion 57c of the second contact portion 57 with the base end portion 55 has the smallest vertical size. With such a shape, the second contact portion 57 is configured to bend and deform rearward at the connecting portion 57c when an external force on the rear side is applied to the contact inclined surface 57b.
  • the second contact portion 57 is provided so as to protrude forward from the first contact portion 56.
  • the upwardly deformed portion of the intraocular lens 7 is locked by the second contact portion 57 in front of the contact portion between the first contact portion 56 and the rear support portion 7c of the intraocular lens 7. Is done. Therefore, the upwardly deformed portion of the intraocular lens 7 is prevented from interfering with the contact portion between the first contact portion 56 and the rear support portion 7c.
  • the second contact portion 57 is provided along the axis X of the nozzle portion 32 when viewed from above.
  • the plunger 5 passes through the rectangular portion 33 with the second contact portion 57 of the lens contact member 54 inserted into the guide groove 62.
  • the second contact portion 57 passes while being inserted into the guide slit 61.
  • the plunger 5 is arranged such that the second contact portion 57 contacts the front end of the guide slit 61 by being pushed further forward.
  • the second contact portion 57 bends and deforms rearward at the connecting portion 57c.
  • the bent and deformed second contact portion 57 is accommodated in the concave portion 58. Therefore, it is preferable that the size of the concave portion 58 is larger than or the same as the size of the second contact portion 57. Further, it is preferable that the concave portion 58 has a configuration in which the front side is opened, and is provided directly behind the connecting portion 57c between the base end portion 55 and the second contact portion 57.
  • the lens contact member 54 has the first contact portion 56 and the second contact portion 57, so that the initial position of the intraocular lens 7 stored in the lens holder 4 is
  • the size of the lens contact member 54 can be increased, and the contact area of the plunger 5 with the intraocular lens 7 can be increased. Accordingly, the displacement of the contact point of the lens contact member 54 in the intraocular lens 7 is reduced, and the pushing operation of the plunger 5 ensures that the intraocular lens 7 reaches from the lens holder 4 to the entrance of the nozzle portion 32. Can be.
  • the second contact portion 57 protruding upward is accommodated in the concave portion 58 by contact with the front end portion of the guide slit 61, the eye of the lens contact member 54 while the plunger 5 passes through the nozzle portion 32.
  • the dimension of the contact surface with the inner lens 7 can be reduced.
  • the lens contact member 54 increases the contact area with the intraocular lens 7 in the lens holder 4 having a relatively large opening in the front-rear direction during the pushing operation of the plunger 5, and Caught securely and extruded to the nozzle part 32. Then, it passes through the nozzle part 32 while deforming (shrinking in the vertical direction) into a shape in which the contact area with the intraocular lens 7 becomes small. Since the lens abutting member 54 is structured to be pushed out in the front-rear direction while being deformed, the plunger 5 can be pushed forward smoothly without increasing the resistance in the direction opposite to the pushing-out direction.
  • FIG. 5 is a plan view showing a state of the lens contact member 54 when the plunger 5 passes through the nozzle portion 32.
  • FIG. Reference numeral 5001 in FIG. 5 shows a state in which the second contact portion 57 passes through the guide slit 61 of the nozzle portion 32.
  • reference numeral 5002 in FIG. 5 shows a state where the second contact portion 57 contacts the front end of the guide slit 61 of the nozzle portion 32.
  • reference numeral 5003 in FIG. 5 shows a state after the second contact portion 57 has contacted the front end of the guide slit 61 of the nozzle portion 32.
  • the plunger 5 has the first contact portion 56 in contact with the rear support portion 7c of the intraocular lens 7.
  • the second contact portion 57 contacts an upwardly deformed portion of the intraocular lens 7. Further, the second contact portion 57 is in a state of being inserted into the guide slit 61 of the nozzle portion 32.
  • the plunger 5 When the plunger 5 is further pushed in a state in which the first contact portion 56 is in contact with the rear support portion 7c of the intraocular lens 7, the intraocular lens 7 is released in a state of being folded by the nozzle portion 32. It passes through the part 31 and is released from the insertion device 1 to the outside.
  • the volume of the lumen of the nozzle portion 32 increases toward the rear side. Therefore, in the nozzle portion 32, the intraocular lens 7 has a large lumen volume near the entrance of the nozzle portion 32, so that the plunger 5 pushes the intraocular lens 7 out of the axis X and is easily valley-folded and deformed upward. Easier to do. Then, as it moves toward the front side, it is difficult to be deformed upward, and it is stably folded symmetrically about the axis X.
  • the lens contact member 54 is brought into contact with the upwardly deformed portion of the intraocular lens 7 and the rear support portion 7c in the vicinity of the entrance of the nozzle portion 32 so as to contact the intraocular lens 7. It is preferable that the contact area of the nozzle portion 32 is increased and the contact area with the intraocular lens 7 is reduced smoothly by bringing the contact section only into contact with the rear support section 7c near the exit of the nozzle section 32.
  • the lens contact member 54 in the vicinity of the entrance of the nozzle portion 32, the lens contact member 54 is moved by the first contact portion 56 and the second contact portion 57 to the rear support portion 7c and the intraocular.
  • the configuration is such that it contacts the upwardly deformed portion of the lens 7, and the contact area with the intraocular lens 7 is large.
  • the lens contact member 54 near the outlet of the nozzle portion 32, the lens contact member 54 has a configuration in which only the rear support portion 7c is in contact with the first contact portion 56, and the contact area with the intraocular lens 7 is small. Has become.
  • the lens contact member 54 is deformed such that the contact area between the lens contact member 54 and the intraocular lens 7 increases near the entrance of the nozzle portion 32 and decreases near the exit of the nozzle portion 32. Therefore, stable folding of the intraocular lens 7 can be realized.
  • the second contact portion 57 is bent and deformed by being in contact with the front end of the guide slit 61 and is accommodated in the concave portion 58, and the contact between the plunger 5 and the intraocular lens 7 is made.
  • the area becomes smaller. Therefore, according to the configuration of the insertion device 1, the lens contact member 54 can be smoothly deformed without hindering the pushing operation of the plunger 5.
  • the first contact portion 56 has a structure in which the two extending portions 56a can be deformed in the left-right direction.
  • the two extending portions 56a are deformed by the contact with the tapered surface of the nozzle portion 32 so that the distance in the left-right direction is reduced, so that the lens contact member 54 is smoothly moved. Is inserted into the discharge part 31.
  • the dimension of the lens contact member 54 can be increased, the contact area of the plunger 5 with the intraocular lens 7 can be increased, and when the plunger 5 is pushed in.
  • the lens contact member 54 can smoothly pass through the lumen of the tip 3. Therefore, it is possible to realize the insertion device 1 that can be appropriately inserted into the eye without damaging the plate-type intraocular lens 7 made of a flexible material.
  • the plunger 5 moves forward with the second contact portion 57 of the lens contact member 54 inserted into the guide slit 61 of the nozzle portion 32.
  • the plunger 5 moves forward in the rectangular portion 33 with the second contact portion 57 sliding in the guide groove 62 of the rectangular portion 33.
  • the second contact portion 57 of the lens contact member 54 moves in the guide groove 62 and the guide slit 61 along the axis X. Therefore, rattling or displacement of the plunger 5 in the left-right direction is prevented during the pushing operation. That is, the configuration in which the second contact portion 57 and the guide path 6 are combined also contributes to the centering function of the plunger 5 during the pushing operation of the plunger 5.
  • the guide slit 61 and the guide groove 62 are provided along the axis X of the nozzle 32 when viewed from above.
  • the guide slit 61 and the guide groove 62 are arranged so as to overlap with the axis X when viewed from above.
  • the guide slit 61 and the guide groove 62 only need to be arranged so that the axis of the plunger 5 and the axis X of the nozzle portion 32 can be maintained during the pushing operation of the plunger 5. That is, the guide slit 61 and the guide groove 62 may be arranged in parallel with the axis X, and may be shifted from the axis X.
  • the guide path that guides the lens contact member 54 of the plunger 5 and is parallel to the axis X of the nozzle portion 32 is the guide slit 61.
  • the guide path in the insertion device 1 according to the present embodiment may be any structure that can guide the lens contact member 54, and is not limited to the guide slit 61 that is a through groove.
  • the guide path is formed with a bottomed groove. There may be.
  • the lens contact member 54 is preferably made of a material having a certain degree of rigidity from the viewpoint of transmitting the pressing force of the plunger 5 to the intraocular lens 7 without loss. Further, it is preferable that the material has toughness from the viewpoint of preventing loss during deformation and has a surface strength not too hard from the viewpoint of reducing damage to the intraocular lens 7.
  • Suitable materials for the lens contact member 54 include relatively flexible plastic materials such as polypropylene (PP), polyamide, and polyurethane, thermoplastic elastomers, and rubber-based resins.
  • the insertion device 1 is characterized by the shape of the tapered inner wall surface that forms the lumen of the nozzle part 32 because the intraocular lens 7 is folded line-symmetrically and folded in the nozzle part 32.
  • 6, 6001 to 6005 are views each showing a cross-sectional shape of the tapered inner wall surface 35 constituting the inner cavity 34 of the nozzle portion 32.
  • Each of 7001 to 7005 in FIG. 7 is a diagram showing another cross-sectional shape of the tapered inner wall surface 35 that forms the lumen 34 of the nozzle portion 32.
  • the IV line cross-sectional shape and the VV line cross-sectional shape correspond to the cross-sectional shapes 6001 and 7001 to 6005 and 7005, respectively.
  • the nozzle portion 32 includes a lumen 34, a tapered inner wall surface 35 constituting the lumen 34, and a ridge 36.
  • the ridge 36 is provided on the tapered inner wall surface 35 on the upper side, and protrudes downward.
  • two convex ridges 36 are provided with a vertical axis of symmetry of the nozzle 32 interposed therebetween. These two ridges 36 are arranged to be line-symmetric with respect to the axis of symmetry of the nozzle 32.
  • the protruding ridge portion 36 is provided so as to avoid at least the tip end portion of the nozzle portion 32.
  • the intraocular lens 7 moved to the nozzle part 32 by the pushing operation of the plunger 5 is folded valley by the guide slit 61 near the position opening of the nozzle part 32 and moves forward. Then, the valley-folded intraocular lens 7 moves forward while being folded by the action of the tapered inner wall surface 35.
  • the traveling axis of the intraocular lens 7 may be shifted.
  • the intraocular lens 7 whose traveling axis is displaced in this way rotates and moves along the tapered inner wall surface 35. As a result, there is a possibility that the intraocular lens 7 will not be folded due to the line-symmetric valley fold.
  • the rotational movement of the intraocular lens 7 along the tapered inner wall surface 35 is restricted by the provision of the ridge 36 on the nozzle 32.
  • the valley-folded intraocular lens 7 is moved forward by the plunger 5
  • the left-right end of the intraocular lens 7 is formed on the tapered inner wall surface 35.
  • the movement along is locked by the ridge 36.
  • the locking of the end portion of the intraocular lens 7 by the convex ridge portion 36 is released in the vicinity of the tip end of the nozzle portion 32 where the convex ridge portion 36 is not provided.
  • the intraocular lens 7 is folded line-symmetrically and valley-folded in the nozzle portion 32.
  • the protruding ridge portion 36 is provided behind the front end of the guide slit 61. Is preferred. In the vicinity of the inlet of the nozzle portion 32, the ridge portion 36 does not necessarily need to be provided on the rear side of the guide slit 61. The reason is that the left and right ends of the intraocular lens 7 do not reach the position of the convex portion 36 of the tapered inner wall surface 35 near the entrance of the nozzle portion 32.
  • the cross-sectional shapes 6001 to 6005 of the tapered inner wall surface 35 forming the inner cavity 34 of the nozzle portion 32, which are perpendicular to the front-rear direction, are vertically long in the vertical direction.
  • the cross-sectional shape of the tapered inner wall surface 35 can be appropriately set in accordance with the dimensions of the intraocular lens 7, folding behavior, and the like, and is not limited to the cross-sectional shapes 6001 to 6005 shown in FIG.
  • the cross-sectional shape of the tapered inner wall surface 35 may be cross-sectional shapes 7001 to 7005 horizontally long in the left-right direction as shown in FIG.
  • the number of the ridges 36 is not particularly limited as long as the number is arranged symmetrically with respect to the axis of symmetry of the nozzle 32.
  • a configuration provided with a single protruding portion 36a may be used as in the cross-sectional shapes 8001 to 8005 shown in FIG.
  • the protruding ridge portion 36 a has a shape symmetrical with respect to the axis of symmetry of the nozzle portion 32, and is provided so as to avoid at least the tip portion of the nozzle portion 32.
  • the nozzle portion 36a has a shape such that the width in the left-right direction decreases toward the tip end side of the nozzle portion 32. Even in the cross-sectional shapes 8001 to 8005 shown in FIG. 8, the intraocular lens 7 is folded line-symmetrically in the nozzle portion 32.
  • the centering member 9 is a member that regulates such rattling of the plunger 5.
  • FIG. 9 shows a configuration of the centering member 9 attached to the annular enlarged portion 22, 9001 in FIG. 9 is a perspective view, and 9002 in FIG. 9 is a cross-sectional view. Also, 10001 in FIG. 10 is a front view showing the configuration of the centering member 9 as viewed from the front side, and 10002 in FIG. 10 shows the configuration of the centering member 9 attached to the annular enlarged portion 22 in the vertical direction.
  • FIG. 9 shows a configuration of the centering member 9 attached to the annular enlarged portion 22 in the vertical direction.
  • the centering member 9 is provided on the annular enlarged portion 22 of the apparatus main body 2.
  • the position of the centering member 9 in the apparatus main body 2 is not limited to the annular enlarged portion 22.
  • the plunger 5 is attached to the centering member 9 such that the lens contact member 54 is located on the front side.
  • the spring 8 is arranged on the rear side of the centering member 9. With such a configuration, the lens contact member 54 of the plunger 5 moves only forward of the centering member 9 and does not move rearward.
  • the annular enlarged portion 22 includes a plurality of annular protrusions
  • the centering member 9 is provided between the annular protrusions, as shown by 9002 in FIG.
  • the centering member 9 has two lower locking claws 91, a plunger insertion portion 92, and an upper locking piece 93.
  • the plunger insertion portion 92 is provided between the lower locking claw 91 and the upper locking piece 93, and the center shaft portion 53 of the plunger 5 is inserted.
  • a through hole is provided above the annular enlarged portion 22 so that the plunger insertion portion 92 can penetrate vertically. Further, two through holes through which the lower locking claw 91 can pass are provided below the annular enlarged portion 22.
  • the lower locking claw 91 is locked by penetrating two through holes provided below the annular enlarged portion 22 and hooking the through hole from outside the annular enlarged portion 22.
  • the upper locking piece 93 is locked by contacting from the outside with the edge of the upper through hole of the annular enlarged portion 22 through which the plunger insertion portion 92 penetrates.
  • the centering member 9 may be separate from the apparatus main body 2 or may be formed integrally with the apparatus main body 2.
  • An intraocular lens insertion device is an intraocular lens insertion device to which a lens holder for holding an intraocular lens can be attached, the device having a front end portion abutting on the intraocular lens, A plunger for pushing out the intraocular lens, and a nozzle portion for discharging the intraocular lens pushed out by the plunger to the outside while being folded, wherein the nozzle portion has a guide path parallel to the axis of the nozzle portion.
  • the distal end portion has a proximal end portion, and first and second contact portions extending forward from the proximal end portion, and the second contact portion is inserted into the guide path.
  • the guide path is bent rearward by contact with a front end of the guide path, and the base end has a recess in which the second contact part bent rearward is deformed.
  • the nozzle portion has tapered side walls facing each other, and the first abutment portion extends from the base end portion. It may be configured to have a plurality of first extension portions extending forward, and the first extension portions can be deformed such that a distance between the first extension portions changes in a direction facing the tapered side wall.
  • the second contact portion has a second extension portion extending forward from the base end portion, It is preferable that the connecting portion between the second extending portion and the base end be bent.
  • the second contact portion is disposed above the first contact portion, and the guide path is It is preferable that the nozzle is formed on the upper surface of the nozzle along the axis of the nozzle.
  • An intraocular lens insertion device is the intraocular lens insertion device according to the first to fourth aspects, wherein the second contact portion is provided so as to protrude forward from the first contact portion. Preferably, there is.
  • the intraocular lens insertion device is preferably configured such that, in aspects 1 to 5, the guide path is formed on the upper surface of the nozzle portion along the axis.
  • Intraocular lens insertion device 2 Device body 3 Tip 4 Lens holder 5 Plunger 6 Guide path 7 Intraocular lens 32 Nozzle 54 Lens contact member (tip) 55 Base end portion 55a Outer surface 56 First contact portion 56a Extension portion (first extension portion) 57 Second contact part 57a Extension part (second extension part) 57c Connecting part 58 Recess 61 Guide slit (guide path) 62 Guide groove X axis

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Abstract

The purpose of the present invention is to appropriately insert a plate-type intraocular lens into an eye without damaging the intraocular lens. This insertion implement (1) has a lens contact member (54) that has a second contact part (57) that is inserted into a guide slit (61) and bends backward as a result of contact with a front end part of the guide slit (61). A recess (58) that accommodates the backwardly bent second contact part (57) is formed in a base end part (55).

Description

眼内レンズ挿入器具Intraocular lens insertion device
　本発明は、眼内レンズ挿入器具に関する。 The present invention relates to an intraocular lens insertion device.
　レンズホルダに保持された眼内レンズをプランジャによって押し出して放出する眼内レンズ挿入器具が従来技術として知られている（例えば特許文献１～３）。特許文献１～３に記載の眼内レンズ挿入器具は、プランジャの押込み動作によって、レンズホルダに保持された眼内レンズを凹状に折り畳みつつ眼内レンズを放出するノズル部を備えている。このノズル部は、前方へ行くに従い内径が徐々に小さくなる構成となっている。 内 An intraocular lens insertion device for extruding and releasing an intraocular lens held by a lens holder by a plunger is known as a conventional technique (for example, Patent Documents 1 to 3). The intraocular lens insertion devices described in Patent Literatures 1 to 3 include a nozzle unit that discharges the intraocular lens while pressing the plunger to fold the intraocular lens held by the lens holder into a concave shape. The nozzle portion has a configuration in which the inside diameter gradually decreases as going forward.
特許５４１５４５２号公報Japanese Patent No. 5415452 特許３７７９８１９号公報Japanese Patent No. 3779819 特許５２３６６３８号公報Japanese Patent No. 5,236,638
　特許文献１～３に開示された従来の眼内レンズ挿入器具に搭載される眼内レンズは、レンズ部と、前方支持部と、後方支持部とを備えている。そして、前方支持部及び後方支持部が、レンズ部側面から曲線状に延び出るように形成されたループ形状を有している。 The intraocular lens mounted on the conventional intraocular lens insertion devices disclosed in Patent Documents 1 to 3 includes a lens unit, a front support unit, and a rear support unit. Further, the front support portion and the rear support portion have a loop shape formed to extend in a curved shape from the side surface of the lens portion.
　市販されている眼内レンズには、上述したループ形状の前方支持部及び後方支持部を有するレンズ以外に、外形形状が略矩形であるプレート型眼内レンズがある。プレート型眼内レンズは、ループ形状の前方支持部及び後方支持部を有する眼内レンズと比較して、柔軟性を有する素材で構成されている。それゆえ、特許文献１～３に開示された眼内レンズ挿入器具を使用してプレート型の眼内レンズを眼内で挿入した場合、眼内レンズが破損するおそれがある。 内 Among commercially available intraocular lenses, there is a plate-type intraocular lens having a substantially rectangular outer shape in addition to the above-described lens having the loop-shaped front support portion and the rear support portion. The plate-type intraocular lens is made of a material having flexibility as compared with an intraocular lens having a loop-shaped front support portion and a rear support portion. Therefore, when a plate-type intraocular lens is inserted into the eye using the intraocular lens insertion device disclosed in Patent Documents 1 to 3, the intraocular lens may be damaged.
　本発明の一態様は、プレート型の眼内レンズを破損することなく、適切に眼内に挿入することが可能な眼内レンズ挿入器具を実現することを目的とする。 An object of one embodiment of the present invention is to realize an intraocular lens insertion device that can be appropriately inserted into an eye without damaging a plate-type intraocular lens.
　上記の課題を解決するために、本発明の一態様に係る眼内レンズ挿入器具は、眼内レンズを保持するレンズホルダを取り付け可能な眼内レンズ挿入器具であって、前記眼内レンズに当接する先端部を前方に備え、前記眼内レンズを押出すプランジャと、前記プランジャにより押出された眼内レンズを折り畳みつつ外部へ放出するノズル部と、を備え、前記ノズル部は、当該ノズル部の軸線と平行な案内路を有し、前記先端部は、基端部と、前記基端部から前方へ延びた第１および第２の当接部と、を有し、前記第２の当接部は、前記案内路へ挿入されるとともに、前記案内路の前方端部との当接により後方へ折れ曲がり変形し、前記基端部は、後方へ折れ曲がり変形した前記第２の当接部が収容される凹部を有することを特徴としている。 In order to solve the above problems, an intraocular lens insertion device according to one embodiment of the present invention is an intraocular lens insertion device to which a lens holder that holds an intraocular lens can be attached, and the intraocular lens insertion device is applicable to the intraocular lens. A plunger for pushing out the intraocular lens, a nozzle portion for discharging the intraocular lens pushed out by the plunger to the outside while being folded, and a nozzle portion for ejecting the intraocular lens pushed out by the plunger are provided. A guide path parallel to the axis, the distal end having a proximal end, and first and second abutments extending forward from the proximal end; The portion is inserted into the guide path and bent rearward by contact with the front end of the guide path, and the base end is accommodated by the second contact portion bent rearward and deformed. It is characterized by having a recessed portion.
　本発明の一態様によれば、プレート型の眼内レンズを破損することなく、適切に眼内に挿入することが可能な眼内レンズ挿入器具を実現できる。 According to one aspect of the present invention, an intraocular lens insertion device that can be appropriately inserted into the eye without damaging the plate-type intraocular lens can be realized.
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る。It is a perspective view showing the whole composition of the intraocular lens insertion device concerning the embodiment of the present invention. 本発明の実施形態に係る眼内レンズ挿入器具のレンズホルダに搭載される眼内レンズの構成を示す上面図である。It is a top view showing the composition of the intraocular lens mounted in the lens holder of the intraocular lens insertion device concerning the embodiment of the present invention. 本発明の実施形態に係る眼内レンズ挿入器具の先端チップの概略構成を示し、３００１は、上面図であり、３００２は、後方から見た背面図である。The schematic structure of the front-end | tip tip of the intraocular lens insertion tool which concerns on embodiment of this invention is shown, 3001 is a top view, and 3002 is the back view seen from the back. 本発明の実施形態に係る眼内レンズ挿入器具のレンズ当接部材の構成を示し、４００１は、斜視図であり、４００２は、上方から見た上面図である。The structure of the lens contact member of the intraocular lens insertion tool which concerns on embodiment of this invention is shown, 4001 is a perspective view, and 4002 is the top view seen from the upper direction. プランジャがノズル部を通過したときのレンズ当接部材の様子を示す平面図であり、５００１は第２当接部がノズル部の案内スリットを通過しているときの様子を示し、５００２は第２当接部がノズル部の案内スリットの前方端部に当接したときの様子を示し、５００３は第２当接部がノズル部の案内スリットの前方端部に当接した後の様子を示す。It is a top view which shows the mode of a lens contact member when a plunger passes a nozzle part, 5001 shows a mode when a 2nd contact part has passed the guide slit of a nozzle part, 5002 shows 2nd. A state when the contact portion contacts the front end of the guide slit of the nozzle portion is shown, and reference numeral 5003 shows a condition after the second contact portion contacts the front end of the guide slit of the nozzle portion. ６００１～６００５はそれぞれ、ノズル部の内腔を構成するテーパー内壁面の断面形状を示す図である。Each of 6001 to 6005 is a view showing a cross-sectional shape of a tapered inner wall surface forming an inner cavity of the nozzle portion. ７００１～７００５はそれぞれ、ノズル部の内腔を構成するテーパー内壁面の別の断面形状を示す図である。 Reference numerals 7001 to 7005 each show another cross-sectional shape of the tapered inner wall surface forming the inner cavity of the nozzle portion. ８００１～８００５はそれぞれ、ノズル部の内腔を構成するテーパー内壁面に形成された凸条部の別の断面形状を示す図である。Each of 8001 to 8005 is a diagram showing another cross-sectional shape of a ridge portion formed on a tapered inner wall surface forming a lumen of a nozzle portion. 環状拡大部に取り付けられたセンタリング部材の構成を示し、９００１は、斜視図であり、９００２は、断面図である。The structure of the centering member attached to the annular enlarged portion is shown, where 9001 is a perspective view and 9002 is a sectional view. １０００１は、センタリング部材の構成を示す前方側から見た正面図であり、１０００２は、環状拡大部に取り付けられたセンタリング部材の構成を示す前後方向に垂直な断面図である。10001 is a front view showing the configuration of the centering member as viewed from the front side, and 10002 is a cross-sectional view perpendicular to the front-rear direction showing the configuration of the centering member attached to the annular enlarged portion.
　以下、本発明の一実施形態について、詳細に説明する。図１は、眼内レンズ挿入器具１（以下、挿入器具１と記す）の全体構成を示す斜視図である。図１に示されるように、挿入器具１は、筒状の装置本体２と、先端チップ３と、眼内レンズ７を保持するレンズホルダ４と、プランジャ５と、案内路６と、スプリング８と、を備えている。先端チップ３は、装置本体２に接続されるノズル部３２を有している。また、レンズホルダ４は、装置本体２に取り付け可能となっている。また、プランジャ５は、棒状であり、装置本体２に内挿される構成となっている。また、案内路６は、先端チップ３に設けられている。なお、レンズホルダ４は、先端チップ３に取り付けられていてもよい。 Hereinafter, one embodiment of the present invention will be described in detail. FIG. 1 is a perspective view showing an entire configuration of an intraocular lens insertion device 1 (hereinafter, referred to as an insertion device 1). As shown in FIG. 1, the insertion device 1 includes a cylindrical device main body 2, a distal tip 3, a lens holder 4 for holding an intraocular lens 7, a plunger 5, a guide path 6, a spring 8, , Is provided. The tip 3 has a nozzle portion 32 connected to the apparatus main body 2. Further, the lens holder 4 can be attached to the apparatus main body 2. The plunger 5 has a rod shape, and is configured to be inserted into the apparatus main body 2. The guide path 6 is provided on the tip 3. Note that the lens holder 4 may be attached to the tip 3.
　なお、ここでは、プランジャ５の軸芯方向を前後方向とする。また、レンズホルダ４に保持された眼内レンズ７の厚さ方向を上下方向とし、前後方向及び上下方向の両方に垂直な方向を左右方向とする。また、挿入器具１の先端チップ３側を前方側とし、その反対側を後方側とする。また、先端チップ３における案内路６側を上方側とし、その反対側を下方側とする。 で は Here, the axial direction of the plunger 5 is defined as the front-back direction. The thickness direction of the intraocular lens 7 held by the lens holder 4 is defined as the up-down direction, and the direction perpendicular to both the front-rear direction and the up-down direction is defined as the left-right direction. Further, the tip 3 side of the insertion device 1 is defined as a front side, and the opposite side is defined as a rear side. The guide path 6 side of the tip 3 is defined as an upper side, and the opposite side is defined as a lower side.
　図２は、挿入器具１のレンズホルダ４に搭載される眼内レンズ７の構成を示す上面図である。図２に示されるように、眼内レンズ７は、レンズ部７ａと、前方支持部７ｂと、後方支持部７ｃとを備えている。レンズ部７ａは、眼内挿入後に水晶体として機能するレンズ部分である。前方支持部７ｂおよび後方支持部７ｃは、眼内挿入後にレンズ部７ａを眼内で支持する機能を有する。前方支持部７ｂおよび後方支持部７ｃは、レンズ部７ａに対して対称に設けられており、偏平な板形状である。前方支持部７ｂは、レンズ部７ａの前方の側面を覆うように形成されている。また、後方支持部７ｃは、レンズ部７ａの後方の側面を覆うように形成されている。眼内レンズ７は、外形形状が略矩形であるプレート型眼内レンズであり、当該矩形は、レンズ部７ａ、前方支持部７ｂ、後方支持部７ｃにより形成される。これらレンズ部７ａ、前方支持部７ｂ、及び後方支持部７ｃは、柔軟性を有する材質であり、可撓変形可能に形成されている。本実施形態では、レンズ部７ａ、前方支持部７ｂ及び後方支持部７ｃが一体的に成形されたシングルピース型を一例として説明する。 FIG. 2 is a top view showing the configuration of the intraocular lens 7 mounted on the lens holder 4 of the insertion device 1. As shown in FIG. 2, the intraocular lens 7 includes a lens portion 7a, a front support portion 7b, and a rear support portion 7c. The lens portion 7a is a lens portion that functions as a crystalline lens after insertion into the eye. The front support portion 7b and the rear support portion 7c have a function of supporting the lens portion 7a in the eye after insertion into the eye. The front support portion 7b and the rear support portion 7c are provided symmetrically with respect to the lens portion 7a, and have a flat plate shape. The front support portion 7b is formed so as to cover a front side surface of the lens portion 7a. The rear support portion 7c is formed so as to cover a rear side surface of the lens portion 7a. The intraocular lens 7 is a plate-type intraocular lens whose outer shape is substantially rectangular, and the rectangle is formed by a lens portion 7a, a front support portion 7b, and a rear support portion 7c. The lens portion 7a, the front support portion 7b, and the rear support portion 7c are made of a material having flexibility, and are formed to be flexibly deformable. In the present embodiment, a single piece type in which the lens portion 7a, the front support portion 7b, and the rear support portion 7c are integrally formed will be described as an example.
　装置本体２は、前方に先端チップ３が係合される構成であり、前端の外面に術者が把持可能な環状拡大部２２と、後端の外面に術者が指を掛けて保持する鍔状の保持部２３とを有している。装置本体２は、耐衝撃性を有するポリカーボネート等の樹脂を用いて形成される。環状拡大部２２は、例えば、複数の環状突起で構成されている。 The device main body 2 has a configuration in which the distal end tip 3 is engaged with the front, an annular enlarged portion 22 that can be gripped by an operator on the outer surface of the front end, and a flange that the operator holds by holding a finger on the outer surface of the rear end. And a holding portion 23 in a shape of a circle. The apparatus main body 2 is formed using a resin such as polycarbonate having impact resistance. The annular enlarged portion 22 is formed of, for example, a plurality of annular protrusions.
　なお、環状拡大部２２及び保持部２３は、必要とされる機能を発揮できるものであれば、どのような形状であってもよい。例えば、保持部２３を鍔状ではなく指を掛けることが可能な突起等により構成してもよい。 The annular expanding portion 22 and the holding portion 23 may have any shape as long as they can perform required functions. For example, the holding portion 23 may be formed by a protrusion or the like that allows a finger to be hooked, instead of a flange shape.
　術者は、片方の手でプランジャ５を押し込みながら、もう片方の手で環状拡大部２２を把持して、眼内レンズ７を前方支持部７ｂ、レンズ部７ａ、後方支持部７ｃの順番で、患者の眼内に放出する。環状拡大部２２を設けることにより、術者が挿入器具１を把持し易くなり、挿入器具１の操作性を高めることができる。 While pushing the plunger 5 with one hand, the surgeon grasps the annular enlarged portion 22 with the other hand and holds the intraocular lens 7 in the order of the front support portion 7b, the lens portion 7a, and the rear support portion 7c. Release into the patient's eye. The provision of the annular enlarged portion 22 makes it easier for the surgeon to grasp the insertion instrument 1 and enhances the operability of the insertion instrument 1.
　先端チップ３は、眼内レンズ７が放出される放出部３１と、前方へ向かうに従い内径が徐々に小さくなるノズル部３２と、側面が開口された矩形の外周を有する矩形部３３と、を有している。矩形部３３を装置本体２に係合させることにより、先端チップ３は装置本体２に接続される。ノズル部３２は、内腔を構成する互いに対向する側壁間の間隔が前方へ向かうに従い小さくように構成されており、対向するテーパー側壁を有する。また、案内路６は、ノズル部３２および矩形部３３の上面には、案内路６が形成されている。案内路６は、案内スリット６１および案内溝６２とからなる。なお、先端チップ３と装置本体２とを係合する構成は、例えば、係止爪と係止穴とによる係合など、どのような構成であってもよい。また、先端チップ３は、耐薬品性や柔軟性のあるポリプロピレンやポリアミドなどの樹脂を用いて形成される。 The distal tip 3 has an emission portion 31 from which the intraocular lens 7 is emitted, a nozzle portion 32 whose inner diameter gradually decreases toward the front, and a rectangular portion 33 having a rectangular outer periphery with an open side surface. are doing. The distal tip 3 is connected to the device main body 2 by engaging the rectangular portion 33 with the device main body 2. The nozzle portion 32 is configured such that the distance between the mutually facing side walls forming the lumen becomes smaller toward the front, and has opposed tapered side walls. The guide path 6 is formed on the upper surfaces of the nozzle section 32 and the rectangular section 33. The guide path 6 includes a guide slit 61 and a guide groove 62. The configuration for engaging the tip 3 with the apparatus main body 2 may be any configuration such as, for example, engagement between a locking claw and a locking hole. The tip 3 is formed using a resin such as polypropylene or polyamide having chemical resistance and flexibility.
　挿入器具１は、眼内レンズ７を保持するレンズホルダ４を取り付け可能な構成である。本実施形態に係る挿入器具１は、レンズホルダ４が分離された形態であってもよいし、レンズホルダ４が取り付けられた形態であってもよい。挿入器具１の使用時には、術者は、矩形部３３の側面に形成された開口にレンズホルダ４を挿入する。矩形部３３は、レンズホルダ４を設置する設置部であるといえる。なお、レンズホルダ４は、挿入器具１の使用前に、予め矩形部３３の開口に挿入されていてもよいし、挿入器具１の使用時に矩形部３３の開口に挿入されてもよい。 The insertion device 1 has a configuration in which the lens holder 4 holding the intraocular lens 7 can be attached. The insertion device 1 according to the present embodiment may have a form in which the lens holder 4 is separated or a form in which the lens holder 4 is attached. When using the insertion device 1, the surgeon inserts the lens holder 4 into the opening formed on the side surface of the rectangular portion 33. The rectangular part 33 can be said to be an installation part on which the lens holder 4 is installed. Note that the lens holder 4 may be inserted into the opening of the rectangular portion 33 before use of the insertion device 1, or may be inserted into the opening of the rectangular portion 33 when the insertion device 1 is used.
　レンズホルダ４は、眼内レンズ７を収容する収容空間を構成する収容部４１と、収容部４１から側方へ突出して設けられた摘み部４２と、を有する。収容部４１には、前方側および後方側の両方に開口部が形成されている。そして、収容部４１の後方側に形成された開口部を介して収容部４１内部の空間とノズル部３２内の空間とが連通するようになっている。収容部４１に眼内レンズ７を収容した後、術者が摘み部４２を摘んで、レンズホルダ４を矩形部３３の側面に形成された開口に挿入することにより、眼内レンズ７が挿入器具１に装着される。レンズホルダ４は、耐薬品性のあるポリプロピレンなどの樹脂を用いて形成される。 The lens holder 4 has a housing part 41 that forms a housing space for housing the intraocular lens 7, and a knob part 42 provided to protrude laterally from the housing part 41. The accommodation section 41 has openings formed on both the front side and the rear side. The space inside the housing portion 41 and the space inside the nozzle portion 32 communicate with each other through an opening formed on the rear side of the housing portion 41. After accommodating the intraocular lens 7 in the accommodating portion 41, the operator grasps the knob 42 and inserts the lens holder 4 into an opening formed on the side surface of the rectangular portion 33, so that the intraocular lens 7 is inserted. 1 is attached. The lens holder 4 is formed using a resin such as polypropylene having chemical resistance.
　プランジャ５は、後方側軸部５１と、押圧部５２と、中軸部５３と、を有するプランジャ本体、およびレンズ当接部材５４（先端部）を備えている。後方側軸部５１は、プランジャ５の最も後方側に位置する。後方側軸部５１は、プランジャ５が装置本体２に挿入された初期位置にある状態では外部に露出している部分である。また、後方側軸部５１は、装置本体２の後端に設けられたストッパにより、後方への移動が制限されている。押圧部５２は、後方側軸部５１の後方側の周面に鍔状に形成される。術者は、この押圧部５２を装置本体２側に押し込むことにより、プランジャ５を先端側に移動させる。レンズ当接部材５４は、前記プランジャ本体から分離できるように構成されている。しかし、レンズ当接部材５４は、前記プランジャ本体と一体的に構成され、前記プランジャ本体から分離できない構成であってもよい。また、ここでいう「先端部」は、前記プランジャ本体から分離できるように構成されたレンズ当接部材５４、および前記プランジャ本体と一体的に構成されたレンズ当接部材５４の両方を包含する。 The plunger 5 includes a plunger body having a rear shaft portion 51, a pressing portion 52, and a center shaft portion 53, and a lens contact member 54 (tip portion). The rear side shaft portion 51 is located on the rearmost side of the plunger 5. The rear shaft portion 51 is a portion that is exposed to the outside when the plunger 5 is in the initial position where the plunger 5 is inserted into the apparatus main body 2. The rearward movement of the rear shaft 51 is restricted by a stopper provided at the rear end of the apparatus main body 2. The pressing portion 52 is formed in a flange shape on the peripheral surface on the rear side of the rear side shaft portion 51. The operator moves the plunger 5 toward the distal end by pushing the pressing portion 52 toward the apparatus main body 2. The lens contact member 54 is configured to be separable from the plunger body. However, the lens contact member 54 may be configured integrally with the plunger main body and cannot be separated from the plunger main body. The “tip portion” here includes both the lens contact member 54 configured to be separable from the plunger main body and the lens contact member 54 configured integrally with the plunger main body.
　中軸部５３は、後方側軸部５１の前方側に接続され、後方側軸部５１よりも細い径の軸部である。中軸部５３の先端には、眼内レンズ７の後方支持部７ｃに当接するレンズ当接部材５４が取り付けられている。 The center shaft 53 is connected to the front side of the rear shaft 51 and is a shaft having a smaller diameter than the rear shaft 51. A lens contact member 54 that contacts the rear support portion 7c of the intraocular lens 7 is attached to the distal end of the center shaft portion 53.
　また、中軸部５３の外周面に沿ってスプリング８が設けられている。これにより、プランジャ５の押込み時にスプリング８から反力を受け、眼内レンズ７がプランジャ５のレンズ当接部材５４から勢いよく飛び出すことを防止できる。スプリング８の位置は特に限定されず、例えばプランジャ５の押圧部５２と装置本体２の後端との間に配置してもよく、プランジャ５の押込み時に弾性部材から反力を受ける構成であればよい。 ス プ リ ン グ Further, a spring 8 is provided along the outer peripheral surface of the center shaft portion 53. Accordingly, the reaction force is received from the spring 8 when the plunger 5 is pushed, and the intraocular lens 7 can be prevented from vigorously jumping out of the lens contact member 54 of the plunger 5. The position of the spring 8 is not particularly limited. For example, the spring 8 may be disposed between the pressing portion 52 of the plunger 5 and the rear end of the apparatus main body 2, provided that the spring 8 receives a reaction force from the elastic member when the plunger 5 is pressed. Good.
　プランジャ５が初期位置にある状態で、術者によってプランジャ５が初期位置から前後方向の先端側に押し込まれると、プランジャ５は、収容部４１の後方側に形成された開口部を通過する。そして、プランジャ５の先端にあるレンズ当接部材５４が眼内レンズ７の後方支持部７ｃに当接した状態となる。そして、プランジャ５が更に先端側に進み、収容部４１の前方側に形成された開口部を通過し先端チップ３内へ進む。このとき、眼内レンズ７は先端チップ３のノズル部３２を通過しながら凹状に折り畳まれる。次いで、眼内レンズ７が折り畳まれた状態で、眼内レンズ７が放出部３１に到達する。放出部３１に到達した眼内レンズ７は、前方支持部７ｂ、レンズ部７ａ、後方支持部７ｃの順番で放出部３１のカットされている側から眼内に挿入される。 When the plunger 5 is pushed from the initial position to the front-back direction from the initial position in a state where the plunger 5 is at the initial position, the plunger 5 passes through the opening formed on the rear side of the housing portion 41. Then, the lens contact member 54 at the tip of the plunger 5 comes into contact with the rear support portion 7c of the intraocular lens 7. Then, the plunger 5 further advances to the distal end side, passes through an opening formed in the front side of the housing section 41, and advances into the distal end tip 3. At this time, the intraocular lens 7 is folded in a concave shape while passing through the nozzle portion 32 of the tip 3. Next, the intraocular lens 7 reaches the emission unit 31 in a state where the intraocular lens 7 is folded. The intraocular lens 7 that has reached the emission unit 31 is inserted into the eye from the cut side of the emission unit 31 in the order of the front support unit 7b, the lens unit 7a, and the rear support unit 7c.
　ところで、例えば特許文献１～３に開示された従来の眼内レンズ挿入器具に搭載される眼内レンズは、前方支持部及び後方支持部が、レンズ部側面から曲線状に延び出るように形成されたループ形状を有している。上述したプレート型眼内レンズである眼内レンズ７は、前記ループ形状の前方支持部及び後方支持部を有する眼内レンズと比較して、柔軟性を有する素材で構成されている。それゆえ、従来の眼内レンズを搭載する眼内レンズ挿入器具を使用してプレート型の眼内レンズ７を眼内で挿入した場合、眼内レンズ７が破損するおそれがある。本実施形態に係る挿入器具１は、プレート型の眼内レンズ７を破損することなく、適切に眼内に挿入することを課題としている。 By the way, in an intraocular lens mounted on conventional intraocular lens insertion devices disclosed in Patent Documents 1 to 3, for example, a front support portion and a rear support portion are formed so as to extend in a curved manner from the side surface of the lens portion. It has a loop shape. The intraocular lens 7, which is the above-mentioned plate-type intraocular lens, is made of a material having flexibility as compared with the intraocular lens having the loop-shaped front support portion and the rear support portion. Therefore, when a plate-type intraocular lens 7 is inserted into the eye using a conventional intraocular lens insertion device equipped with an intraocular lens, the intraocular lens 7 may be damaged. The object of the insertion device 1 according to the present embodiment is to properly insert the plate-type intraocular lens 7 into the eye without damaging it.
　プレート型の眼内レンズ７を破損することなく放出する観点では、プランジャ５における眼内レンズ７との当接面積は大きいことが好ましい。それゆえ、プランジャ５のレンズ当接部材５４の寸法は大きいことが望ましい。また、プランジャ５の押圧力を損失なく眼内レンズ７へ伝達する観点では、レンズ当接部材５４の材質は、ある程度の剛性があることが望ましい。 From the viewpoint of releasing the plate-type intraocular lens 7 without damage, it is preferable that the contact area of the plunger 5 with the intraocular lens 7 is large. Therefore, it is desirable that the dimension of the lens contact member 54 of the plunger 5 is large. Further, from the viewpoint of transmitting the pressing force of the plunger 5 to the intraocular lens 7 without loss, it is desirable that the material of the lens contact member 54 has some rigidity.
　また、プランジャ５の押込み時に、レンズ当接部材５４は、先端チップ３の矩形部３３、ノズル部３２、および放出部３１といった、構成する壁の寸法が異なる内腔を通過する。このため、プランジャ５の押込み時に、プランジャ５が矩形部３３、ノズル部３２、および放出部３１全ての内腔をスムーズに通過するように、レンズ当接部材５４が構成されていることが好ましい。 (4) When the plunger 5 is pushed in, the lens contact member 54 passes through lumens having different wall dimensions, such as the rectangular portion 33, the nozzle portion 32, and the discharge portion 31, of the distal end tip 3. For this reason, it is preferable that the lens contact member 54 be configured so that when the plunger 5 is pushed in, the plunger 5 smoothly passes through all the lumens of the rectangular portion 33, the nozzle portion 32, and the discharge portion 31.
　本実施形態に係る挿入器具１では、先端チップ３およびレンズ当接部材５４の構成により、レンズ当接部材５４の寸法を大きくしプランジャ５における眼内レンズ７との当接面積は大きくでき、かつ、プランジャ５の押込み時にレンズ当接部材５４が先端チップ３の内腔をスムーズに通過し得る。図３は、先端チップ３の概略構成を示し、図３の３００１は、上面図であり、図３の３００２は、後方から見た背面図である。また、図４は、レンズ当接部材５４の構成を示し、図４の４００１は、斜視図であり、図４の４００２は、上方から見た上面図である。 In the insertion device 1 according to the present embodiment, with the configuration of the distal end tip 3 and the lens contact member 54, the dimension of the lens contact member 54 can be increased, and the contact area of the plunger 5 with the intraocular lens 7 can be increased. When the plunger 5 is pushed in, the lens contact member 54 can smoothly pass through the lumen of the tip 3. FIG. 3 shows a schematic configuration of the tip 3, where 3001 in FIG. 3 is a top view and 3002 in FIG. 3 is a rear view as viewed from the rear. 4 shows a configuration of the lens contact member 54, where 4001 in FIG. 4 is a perspective view, and 4002 in FIG. 4 is a top view as viewed from above.
　図３の３００１および３００２に示されるように、先端チップ３に設けられた案内路６は、案内スリット６１と案内溝６２とからなっている。案内スリット６１は、ノズル部３２の上面を貫通するように設けられている。また、案内溝６２は、矩形部３３におけるレンズホルダ４と対向する上面に設けられている。案内スリット６１および案内溝６２の両方は、ノズル部３２の軸線Ｘに平行に形成されている。より具体的には、案内スリット６１および案内溝６２は、ノズル部３２の軸線Ｘに沿って設けられている。 案 内 As shown by 3001 and 3002 in FIG. 3, the guide path 6 provided in the tip 3 is composed of a guide slit 61 and a guide groove 62. The guide slit 61 is provided so as to penetrate the upper surface of the nozzle portion 32. The guide groove 62 is provided on the upper surface of the rectangular portion 33 facing the lens holder 4. Both the guide slit 61 and the guide groove 62 are formed parallel to the axis X of the nozzle part 32. More specifically, the guide slit 61 and the guide groove 62 are provided along the axis X of the nozzle part 32.
　また、図４の４００１および４００２に示されるように、レンズ当接部材５４は、基端部５５と、第１当接部５６と、第２当接部５７と、凹部５８と、を有する。第１当接部５６および第２当接部５７は、基端部５５から前方へ延びて設けられている。また、凹部５８は、基端部５５の外面５５ａから突出して設けられておらず、外面５５ａよりも凹んで形成されている。 4, as shown by 4001 and 4002 in FIG. 4, the lens contact member 54 has a base end portion 55, a first contact portion 56, a second contact portion 57, and a concave portion 58. The first contact portion 56 and the second contact portion 57 are provided to extend forward from the base end portion 55. Further, the recess 58 is not provided so as to protrude from the outer surface 55a of the base end portion 55, and is formed to be recessed from the outer surface 55a.
　第１当接部５６は、眼内レンズ７の後方支持部７ｃに当接する部分であり、基端部５５から前方に伸長する２つの伸長部５６ａ（第１の伸長部）を有する。２つの伸長部５６ａは、左右方向において、互いの距離が変化するように変形可能な構成である。ここで、左右方向は、ノズル部３２の内腔を構成するテーパー側壁の対向方向であるともいえる。 The first contact portion 56 is a portion that contacts the rear support portion 7c of the intraocular lens 7, and has two extension portions 56a (first extension portions) that extend forward from the base end portion 55. The two extending portions 56a have a configuration that can be deformed so that the distance between the two extending portions 56a changes in the left-right direction. Here, it can be said that the left-right direction is the direction in which the tapered side walls forming the lumen of the nozzle portion 32 face each other.
　また、伸長部５６ａの前方側の端部は、眼内レンズ７の後方支持部７ｃに対して、より広い面積で当接できるように、前後方向に対し垂直な当接平面５６ｂが形成されている。伸長部５６ａは、当接平面５６ｂから基端部５５へ向かうに従い、左右方向のサイズが小さくなるように形成されており、基端部５５へ向かって先細形状となっている。このような形状により、２つの伸長部５６ａが左右方向において変形可能な構造となる。なお、第１当接部５６は、伸長部５６ａが左右方向において変更可能な構造であれば、伸長部５６ａの数は複数あればよく、２つに限定されない。 The front end of the extension 56a has a contact plane 56b perpendicular to the front-rear direction so that the front end of the extension 56a can contact the rear support 7c of the intraocular lens 7 with a larger area. I have. The extension portion 56a is formed such that the size in the left-right direction decreases from the contact plane 56b toward the base end portion 55, and is tapered toward the base end portion 55. With such a shape, the two extending portions 56a have a structure that can be deformed in the left-right direction. The first contact portion 56 may have a plurality of extending portions 56a as long as the extending portions 56a can be changed in the left-right direction, and are not limited to two.
　第２当接部５７は、第１当接部５６よりも上方側に配されている。また、第２当接部５７は、基端部５５から前方へ伸長する伸長部５７ａ（第２の伸長部）を有する。伸長部５７ａは、基端部５５よりも上方に突出して設けられている。ここで、眼内レンズ７は、初期位置では、ノズル部３２の入口よりと等しい開口又は小さな開口を前後方向に有するレンズホルダ４に格納されている。このレンズホルダ４は、ノズル部３２ほどのテーパー側壁を有する構造ではなく、筒状の構造である。それゆえ、レンズホルダ４内で眼内レンズ７におけるレンズ当接部材５４の当接ポイントがずれると、プランジャ５による押圧操作により眼内レンズ７をノズル部３２の入口まで到達させることができなくなるというミスが生じ得る。そこで、本実施形態に係る挿入器具１では、第２当接部５７が基端部５５よりも上方に突出した形状であることによって、レンズホルダ４内の初期位置での眼内レンズ７に対するレンズ当接部材５４の当接ポイントを広くしている。このため、眼内レンズ７におけるレンズ当接部材５４の当接ポイントのずれを少なくし、ミスなく確実に眼内レンズ７をノズル部３２の入口まで到達させることができる。 The second contact portion 57 is disposed above the first contact portion 56. Further, the second contact portion 57 has an extension portion 57a (second extension portion) extending forward from the base end portion 55. The extension portion 57a is provided so as to protrude above the base end portion 55. Here, at the initial position, the intraocular lens 7 is stored in the lens holder 4 having an opening equal to or smaller than the entrance of the nozzle unit 32 in the front-rear direction. The lens holder 4 has a cylindrical structure, not a structure having a tapered side wall as large as the nozzle portion 32. Therefore, if the contact point of the lens contact member 54 of the intraocular lens 7 is shifted in the lens holder 4, the intraocular lens 7 cannot reach the entrance of the nozzle unit 32 by the pressing operation by the plunger 5. Mistakes can occur. Therefore, in the insertion device 1 according to the present embodiment, the second abutment portion 57 has a shape protruding above the base end portion 55, so that the lens with respect to the intraocular lens 7 at the initial position in the lens holder 4. The contact point of the contact member 54 is widened. For this reason, the displacement of the contact point of the lens contact member 54 in the intraocular lens 7 can be reduced, and the intraocular lens 7 can reliably reach the inlet of the nozzle unit 32 without mistake.
　また、上方側から見て、第２当接部５７は、第１当接部５６における２つの伸長部５６ａの間に配されている。また、第２当接部５７は、後方側の外力が当接傾斜面５７ｂにかかると、後方側へ折れ曲がり変形するように構成されている。ここで、当接傾斜面５７ｂは、前後方向において、前方側へ上向きに傾斜した面である。当接傾斜面５７ｂをこのような傾斜面とすることにより、第２当接部５７は、後方側へスムーズに折れ曲がる。 {Circle around (2)} When viewed from above, the second contact portion 57 is disposed between the two extending portions 56a of the first contact portion 56. The second contact portion 57 is configured to bend and deform rearward when an external force on the rear side is applied to the contact inclined surface 57b. Here, the contact inclined surface 57b is a surface that is inclined upward and forward in the front-rear direction. By making the contact inclined surface 57b such an inclined surface, the second contact portion 57 is smoothly bent rearward.
　眼内レンズ７は、後方支持部７ｃが第１当接部５６によって当接された状態で押圧されると、後方支持部７ｃが上方に凸に折れ曲がる等といった、上方への変形が生じることがある。第２当接部５７は、このような眼内レンズ７の上方への変形部分に当接する。上述のように第２当接部５７が基端部５５よりも上方に突出した形状であり、かつ当接傾斜面５７ｂが前後方向において前側へ上向きに傾斜した面である。それゆえ、第２当接部５７の前方側の端部は、このような眼内レンズ７の変形部分に対して、より広い面積で当接する。 When the intraocular lens 7 is pressed in a state where the rear support portion 7c is in contact with the first contact portion 56, the rear support portion 7c may be deformed upward, such as being bent upward. is there. The second contact portion 57 contacts such an upwardly deformed portion of the intraocular lens 7. As described above, the second contact portion 57 has a shape protruding above the base end portion 55, and the contact inclined surface 57b is a surface inclined forward and upward in the front-rear direction. Therefore, the front end of the second contact portion 57 contacts a deformed portion of the intraocular lens 7 with a larger area.
　第２当接部５７の伸長部５７ａは、当接傾斜面５７ｂから基端部５５へ向かうに従い、上下方向のサイズが小さくなるように形成されており、基端部５５へ向かって先細形状となっている。第２当接部５７における基端部５５との連結部分５７ｃは、上下方向のサイズが最も小さくなっている。このような形状により、第２当接部５７は、後方側の外力が当接傾斜面５７ｂにかかると、連結部分５７ｃで後方側へ折れ曲がり変形するような構造となる。 The extension portion 57a of the second contact portion 57 is formed such that the size in the vertical direction decreases from the contact inclined surface 57b toward the base end portion 55, and has a tapered shape toward the base end portion 55. Has become. The connecting portion 57c of the second contact portion 57 with the base end portion 55 has the smallest vertical size. With such a shape, the second contact portion 57 is configured to bend and deform rearward at the connecting portion 57c when an external force on the rear side is applied to the contact inclined surface 57b.
　また、第２当接部５７は、第１当接部５６よりも前方に突出して設けられている。これにより、第１当接部５６と眼内レンズ７の後方支持部７ｃとの当接部分よりも前方側で、眼内レンズ７の上方への変形部分が第２当接部５７により係止される。このため、眼内レンズ７の上方への変形部分が第１当接部５６と後方支持部７ｃとの当接部分に干渉することが防止される。 The second contact portion 57 is provided so as to protrude forward from the first contact portion 56. As a result, the upwardly deformed portion of the intraocular lens 7 is locked by the second contact portion 57 in front of the contact portion between the first contact portion 56 and the rear support portion 7c of the intraocular lens 7. Is done. Therefore, the upwardly deformed portion of the intraocular lens 7 is prevented from interfering with the contact portion between the first contact portion 56 and the rear support portion 7c.
　また、挿入器具１において、第２当接部５７は、上方側から見て、ノズル部３２の軸線Ｘに沿って設けられている。プランジャ５の押込み動作中、プランジャ５は、レンズ当接部材５４の第２当接部５７が案内溝６２に挿入された状態で矩形部３３を通過する。そして、ノズル部３２では、第２当接部５７が案内スリット６１に挿入された状態で通過する。また、プランジャ５は、さらに前方へ押し込まれることにより、第２当接部５７が案内スリット６１の前方端部に当接するように配されている。第２当接部５７は、案内スリット６１の前方端部に当接すると、連結部分５７ｃで、後方側に折れ曲がり変形する。折れ曲がり変形した第２当接部５７は、凹部５８に収容される。それゆえ、凹部５８の寸法は、第２当接部５７の寸法よりも大きいか、あるいは同じであることが好ましい。さらに、凹部５８は、前方側が開口した構成であり、基端部５５と第２当接部５７との連結部分５７ｃの真後ろに設けられていることが好ましい。 In addition, in the insertion device 1, the second contact portion 57 is provided along the axis X of the nozzle portion 32 when viewed from above. During the pushing operation of the plunger 5, the plunger 5 passes through the rectangular portion 33 with the second contact portion 57 of the lens contact member 54 inserted into the guide groove 62. Then, in the nozzle portion 32, the second contact portion 57 passes while being inserted into the guide slit 61. Further, the plunger 5 is arranged such that the second contact portion 57 contacts the front end of the guide slit 61 by being pushed further forward. When the second contact portion 57 contacts the front end of the guide slit 61, the second contact portion 57 bends and deforms rearward at the connecting portion 57c. The bent and deformed second contact portion 57 is accommodated in the concave portion 58. Therefore, it is preferable that the size of the concave portion 58 is larger than or the same as the size of the second contact portion 57. Further, it is preferable that the concave portion 58 has a configuration in which the front side is opened, and is provided directly behind the connecting portion 57c between the base end portion 55 and the second contact portion 57.
　本実施形態に係る挿入器具１では、レンズ当接部材５４が第１当接部５６および第２当接部５７を有することにより、レンズホルダ４に格納されている眼内レンズ７の初期位置では、レンズ当接部材５４の寸法を大きくしプランジャ５における眼内レンズ７との当接面積を大きくできる。これによって、眼内レンズ７におけるレンズ当接部材５４の当接ポイントのずれが少なくなり、プランジャ５の押込み動作により、レンズホルダ４からノズル部３２の入口まで確実に眼内レンズ７を到達させることができる。また、上方に突出した第２当接部５７が案内スリット６１の前方端部との当接により凹部５８に収容されるので、プランジャ５がノズル部３２を通過中、レンズ当接部材５４の眼内レンズ７との当接面の寸法を小さく変更させることができる。 In the insertion device 1 according to the present embodiment, the lens contact member 54 has the first contact portion 56 and the second contact portion 57, so that the initial position of the intraocular lens 7 stored in the lens holder 4 is The size of the lens contact member 54 can be increased, and the contact area of the plunger 5 with the intraocular lens 7 can be increased. Accordingly, the displacement of the contact point of the lens contact member 54 in the intraocular lens 7 is reduced, and the pushing operation of the plunger 5 ensures that the intraocular lens 7 reaches from the lens holder 4 to the entrance of the nozzle portion 32. Can be. Further, since the second contact portion 57 protruding upward is accommodated in the concave portion 58 by contact with the front end portion of the guide slit 61, the eye of the lens contact member 54 while the plunger 5 passes through the nozzle portion 32. The dimension of the contact surface with the inner lens 7 can be reduced.
　このように、レンズ当接部材５４は、プランジャ５の押込み動作中、前後方向の開口が比較的大きいレンズホルダ４内では、眼内レンズ７との当接面積を大きくし、眼内レンズ７を確実に捉えてノズル部３２まで押出す。そして、眼内レンズ７との当接面積が小さくなる形状に変形しながら（上下方向に収縮して）ノズル部３２を通過する。このようにレンズ当接部材５４が変形しながら前後方向に押出される構造であるので、押し出し方向と反対方向の抵抗力が上昇することなくプランジャ５をスムーズに前方へ押し進めることができる。 As described above, the lens contact member 54 increases the contact area with the intraocular lens 7 in the lens holder 4 having a relatively large opening in the front-rear direction during the pushing operation of the plunger 5, and Caught securely and extruded to the nozzle part 32. Then, it passes through the nozzle part 32 while deforming (shrinking in the vertical direction) into a shape in which the contact area with the intraocular lens 7 becomes small. Since the lens abutting member 54 is structured to be pushed out in the front-rear direction while being deformed, the plunger 5 can be pushed forward smoothly without increasing the resistance in the direction opposite to the pushing-out direction.
　図５は、プランジャ５がノズル部３２を通過したときのレンズ当接部材５４の様子を示す平面図である。図５の５００１は第２当接部５７がノズル部３２の案内スリット６１を通過しているときの様子を示す。また、図５の５００２は第２当接部５７がノズル部３２の案内スリット６１の前方端部に当接したときの様子を示す。また、図５の５００３は第２当接部５７がノズル部３２の案内スリット６１の前方端部に当接した後の様子を示す。 FIG. 5 is a plan view showing a state of the lens contact member 54 when the plunger 5 passes through the nozzle portion 32. FIG. Reference numeral 5001 in FIG. 5 shows a state in which the second contact portion 57 passes through the guide slit 61 of the nozzle portion 32. Also, reference numeral 5002 in FIG. 5 shows a state where the second contact portion 57 contacts the front end of the guide slit 61 of the nozzle portion 32. Further, reference numeral 5003 in FIG. 5 shows a state after the second contact portion 57 has contacted the front end of the guide slit 61 of the nozzle portion 32.
　図５の５００１に示されるように、プランジャ５は、第１当接部５６が眼内レンズ７の後方支持部７ｃに当接している。また、第２当接部５７は、眼内レンズ７の上方への変形部分に当接している。また、第２当接部５７は、ノズル部３２の案内スリット６１に挿入された状態になっている。 ５００As shown by 5001 in FIG. 5, the plunger 5 has the first contact portion 56 in contact with the rear support portion 7c of the intraocular lens 7. The second contact portion 57 contacts an upwardly deformed portion of the intraocular lens 7. Further, the second contact portion 57 is in a state of being inserted into the guide slit 61 of the nozzle portion 32.
　そして、図５の５００１に示される状態からプランジャ５がさらに押し込まれると、図５の５００２に示されるように、プランジャ５は、第１当接部５６が眼内レンズ７の後方支持部７ｃに当接するとともに、第２当接部５７が案内スリット６１の前方端部に当接した状態になる。この状態でさらにプランジャ５が押し込まれると、図５の５００３に示されるように、プランジャ５は、第２当接部５７が後方側へ折れ曲がり変形し凹部５８に収容された状態になる。このとき、第２当接部５７は、眼内レンズ７に当接していない。 Then, when the plunger 5 is further pushed in from the state shown by 5001 in FIG. 5, as shown by 5002 in FIG. 5, the first contact portion 56 is moved to the rear support portion 7c of the intraocular lens 7 as shown in FIG. At the same time, the second contact portion 57 comes into contact with the front end of the guide slit 61. In this state, when the plunger 5 is further pushed in, the plunger 5 is in a state in which the second contact portion 57 is bent rearward and deformed and accommodated in the recess 58 as shown by 5003 in FIG. At this time, the second contact portion 57 is not in contact with the intraocular lens 7.
　このように第１当接部５６が眼内レンズ７の後方支持部７ｃに当接した状態で、プランジャ５がさらに押し込まれると、眼内レンズ７は、ノズル部３２により折り畳まれた状態で放出部３１を通過し、挿入器具１から外部へ放出される。 When the plunger 5 is further pushed in a state in which the first contact portion 56 is in contact with the rear support portion 7c of the intraocular lens 7, the intraocular lens 7 is released in a state of being folded by the nozzle portion 32. It passes through the part 31 and is released from the insertion device 1 to the outside.
　ここで、ノズル部３２の内腔の容積は後方側へ向かうに従い大きくなっている。それゆえ、ノズル部３２において、眼内レンズ７は、ノズル部３２の入口近傍では、内腔の容積が大きいため、プランジャ５の押込み動作により軸線Ｘからずれて谷折りされやすくなるとともに上方へ変形しやすくなる。そして、前方側へ向かって移動するに従って、上方へ変形しにくくなり軸線Ｘに対称に安定して折り畳まれる。それゆえ、プランジャ５の押込み動作中、レンズ当接部材５４は、ノズル部３２の入口近傍では、眼内レンズ７の上方への変形部分および後方支持部７ｃに当接させて眼内レンズ７との当接面積を大きくし、ノズル部３２の出口近傍では、後方支持部７ｃのみに当接させて眼内レンズ７との当接面積を小さくするようにスムーズに変形されることが好ましい。 Here, the volume of the lumen of the nozzle portion 32 increases toward the rear side. Therefore, in the nozzle portion 32, the intraocular lens 7 has a large lumen volume near the entrance of the nozzle portion 32, so that the plunger 5 pushes the intraocular lens 7 out of the axis X and is easily valley-folded and deformed upward. Easier to do. Then, as it moves toward the front side, it is difficult to be deformed upward, and it is stably folded symmetrically about the axis X. Therefore, during the pushing operation of the plunger 5, the lens contact member 54 is brought into contact with the upwardly deformed portion of the intraocular lens 7 and the rear support portion 7c in the vicinity of the entrance of the nozzle portion 32 so as to contact the intraocular lens 7. It is preferable that the contact area of the nozzle portion 32 is increased and the contact area with the intraocular lens 7 is reduced smoothly by bringing the contact section only into contact with the rear support section 7c near the exit of the nozzle section 32.
　本実施形態に係る挿入器具１によれば、ノズル部３２の入口近傍では、レンズ当接部材５４は、第１当接部５６および第２当接部５７それぞれにより、後方支持部７ｃおよび眼内レンズ７の上方への変形部分に当接した構成となっており、眼内レンズ７との当接面積が大きくなっている。一方、ノズル部３２の出口近傍では、レンズ当接部材５４は、第１当接部５６により後方支持部７ｃのみが当接した構成となっており、眼内レンズ７との当接面積が小さくなっている。それゆえ、レンズ当接部材５４と眼内レンズ７との当接面積が、ノズル部３２の入口近傍にて大きくなり、ノズル部３２の出口近傍にて小さくなるようにレンズ当接部材５４が変形するので、眼内レンズ７の安定した折り畳みを実現できる。 According to the insertion device 1 according to the present embodiment, in the vicinity of the entrance of the nozzle portion 32, the lens contact member 54 is moved by the first contact portion 56 and the second contact portion 57 to the rear support portion 7c and the intraocular. The configuration is such that it contacts the upwardly deformed portion of the lens 7, and the contact area with the intraocular lens 7 is large. On the other hand, near the outlet of the nozzle portion 32, the lens contact member 54 has a configuration in which only the rear support portion 7c is in contact with the first contact portion 56, and the contact area with the intraocular lens 7 is small. Has become. Therefore, the lens contact member 54 is deformed such that the contact area between the lens contact member 54 and the intraocular lens 7 increases near the entrance of the nozzle portion 32 and decreases near the exit of the nozzle portion 32. Therefore, stable folding of the intraocular lens 7 can be realized.
　さらに、プランジャ５の押込み動作中、第２当接部５７が案内スリット６１の前方端部と当接することより折れ曲がり変形して凹部５８に収容されて、プランジャ５と眼内レンズ７との当接面積が小さくなる。それゆえ、挿入器具１の構成によれば、プランジャ５の押込み動作を邪魔することなく、スムーズにレンズ当接部材５４を変形することが可能である。また、第１当接部５６は、２つの伸長部５６ａが左右方向において変形可能な構造となっている。このため、プランジャ５の押込み動作中、ノズル部３２のテーパー面との当接により、２つの伸長部５６ａが左右方向の距離が小さくなるように変形することで、レンズ当接部材５４は、スムーズに放出部３１に挿入される。 Further, during the pushing operation of the plunger 5, the second contact portion 57 is bent and deformed by being in contact with the front end of the guide slit 61 and is accommodated in the concave portion 58, and the contact between the plunger 5 and the intraocular lens 7 is made. The area becomes smaller. Therefore, according to the configuration of the insertion device 1, the lens contact member 54 can be smoothly deformed without hindering the pushing operation of the plunger 5. Further, the first contact portion 56 has a structure in which the two extending portions 56a can be deformed in the left-right direction. Therefore, during the pushing operation of the plunger 5, the two extending portions 56a are deformed by the contact with the tapered surface of the nozzle portion 32 so that the distance in the left-right direction is reduced, so that the lens contact member 54 is smoothly moved. Is inserted into the discharge part 31.
　以上のことから、本実施形態に係る挿入器具１によれば、レンズ当接部材５４の寸法を大きくしプランジャ５における眼内レンズ７との当接面積は大きくでき、かつ、プランジャ５の押込み時にレンズ当接部材５４が先端チップ３の内腔をスムーズに通過し得る。したがって、柔軟性素材で構成されたプレート型の眼内レンズ７を破損することなく、適切に眼内に挿入することが可能な挿入器具１を実現できる。 From the above, according to the insertion device 1 according to the present embodiment, the dimension of the lens contact member 54 can be increased, the contact area of the plunger 5 with the intraocular lens 7 can be increased, and when the plunger 5 is pushed in. The lens contact member 54 can smoothly pass through the lumen of the tip 3. Therefore, it is possible to realize the insertion device 1 that can be appropriately inserted into the eye without damaging the plate-type intraocular lens 7 made of a flexible material.
　また、プランジャ５は、レンズ当接部材５４の第２当接部５７がノズル部３２の案内スリット６１に挿入された状態で前方へ移動する。また、図示していないが、プランジャ５は、矩形部３３内では、第２当接部５７が矩形部３３の案内溝６２に摺動した状態で前方へ移動している。このように、プランジャ５は、矩形部３３およびノズル部３２を通過中、レンズ当接部材５４の第２当接部５７が軸線Ｘに沿った案内溝６２および案内スリット６１内を移動する。それゆえ、押込み動作中、プランジャ５の左右方向のガタツキまたはズレが防止される。すなわち、第２当接部５７および案内路６を組み合わせた構成は、プランジャ５の押込み動作中のプランジャ５のセンタリング機能にも寄与する。 プ ラ ン Further, the plunger 5 moves forward with the second contact portion 57 of the lens contact member 54 inserted into the guide slit 61 of the nozzle portion 32. Although not shown, the plunger 5 moves forward in the rectangular portion 33 with the second contact portion 57 sliding in the guide groove 62 of the rectangular portion 33. As described above, while the plunger 5 passes through the rectangular portion 33 and the nozzle portion 32, the second contact portion 57 of the lens contact member 54 moves in the guide groove 62 and the guide slit 61 along the axis X. Therefore, rattling or displacement of the plunger 5 in the left-right direction is prevented during the pushing operation. That is, the configuration in which the second contact portion 57 and the guide path 6 are combined also contributes to the centering function of the plunger 5 during the pushing operation of the plunger 5.
　なお、案内スリット６１および案内溝６２は、上方側から見て、ノズル部３２の軸線Ｘに沿って設けられていた。換言すれば、案内スリット６１および案内溝６２は、上側から見て、軸線Ｘと重複するように配されていた。しかし、案内スリット６１および案内溝６２は、プランジャ５の押込み動作中、プランジャ５の軸とノズル部３２の軸線Ｘとがずれないように維持できる配置であればよい。すなわち、案内スリット６１および案内溝６２は、軸線Ｘと平行に配されていればよく、軸線Ｘからずれていてもよい。 The guide slit 61 and the guide groove 62 are provided along the axis X of the nozzle 32 when viewed from above. In other words, the guide slit 61 and the guide groove 62 are arranged so as to overlap with the axis X when viewed from above. However, the guide slit 61 and the guide groove 62 only need to be arranged so that the axis of the plunger 5 and the axis X of the nozzle portion 32 can be maintained during the pushing operation of the plunger 5. That is, the guide slit 61 and the guide groove 62 may be arranged in parallel with the axis X, and may be shifted from the axis X.
　また、図３及び図４に示された挿入器具１では、ノズル部３２の軸線Ｘと平行な、プランジャ５のレンズ当接部材５４を案内する案内路は、案内スリット６１であった。しかし、本実施形態に係る挿入器具１における案内路は、レンズ当接部材５４を案内可能な構造であればよく、貫通溝である案内スリット６１に限定されない。例えば、第２当接部５７が後方側へ折れ曲がり変形するに際し、ノズル部３２の上部に第２当接部５７が干渉しないだけの空間が確保されていれば、案内路は、有底溝であってもよい。 In addition, in the insertion device 1 shown in FIGS. 3 and 4, the guide path that guides the lens contact member 54 of the plunger 5 and is parallel to the axis X of the nozzle portion 32 is the guide slit 61. However, the guide path in the insertion device 1 according to the present embodiment may be any structure that can guide the lens contact member 54, and is not limited to the guide slit 61 that is a through groove. For example, when the second contact portion 57 is bent rearward and deformed, if a space is secured above the nozzle portion 32 so that the second contact portion 57 does not interfere, the guide path is formed with a bottomed groove. There may be.
　本実施形態に係る挿入器具１では、レンズ当接部材５４は、プランジャ５の押圧力を損失なく眼内レンズ７へ伝達する観点である程度の剛性がある材料であることが好ましい。また、変形時に欠損することを防止する観点で、靱性があり、かつ、眼内レンズ７への傷付きを低減する観点で表面強度が硬すぎない材料であることが好ましい。レンズ当接部材５４の好適な材料としては、ポリプロピレン（ＰＰ）、ポリアミド、ポリウレタンといった比較的柔軟性があるプラスチック材料、熱可塑性エラストマー、ゴム系樹脂等が挙げられる。 In the insertion device 1 according to the present embodiment, the lens contact member 54 is preferably made of a material having a certain degree of rigidity from the viewpoint of transmitting the pressing force of the plunger 5 to the intraocular lens 7 without loss. Further, it is preferable that the material has toughness from the viewpoint of preventing loss during deformation and has a surface strength not too hard from the viewpoint of reducing damage to the intraocular lens 7. Suitable materials for the lens contact member 54 include relatively flexible plastic materials such as polypropylene (PP), polyamide, and polyurethane, thermoplastic elastomers, and rubber-based resins.
　（ノズル部３２の内腔形状）
　挿入器具１は、ノズル部３２内において眼内レンズ７が線対称に谷折して折り畳まれているために、ノズル部３２の内腔を構成するテーパー内壁面の形状に特徴を有している。図６の６００１～６００５はそれぞれ、ノズル部３２の内腔３４を構成するテーパー内壁面３５の断面形状を示す図である。図７の７００１～７００５はそれぞれ、ノズル部３２の内腔３４を構成するテーパー内壁面３５の別の断面形状を示す図である。図６および図７では、前後方向に垂直な断面形状として、後方側から前方側へ向けて順番に、Ｉ－Ｉ線断面形状、ＩＩ－ＩＩ線断面形状、ＩＩＩ－ＩＩＩ線断面形状、ＩＶ－ＩＶ線断面形状、Ｖ－Ｖ線断面形状がそれぞれ、断面形状６００１および７００１～６００５および７００５に対応する。 (Internal cavity shape of nozzle part 32)
The insertion device 1 is characterized by the shape of the tapered inner wall surface that forms the lumen of the nozzle part 32 because the intraocular lens 7 is folded line-symmetrically and folded in the nozzle part 32. . 6, 6001 to 6005 are views each showing a cross-sectional shape of the tapered inner wall surface 35 constituting the inner cavity 34 of the nozzle portion 32. Each of 7001 to 7005 in FIG. 7 is a diagram showing another cross-sectional shape of the tapered inner wall surface 35 that forms the lumen 34 of the nozzle portion 32. 6 and 7, as the cross-sectional shape perpendicular to the front-rear direction, the cross-sectional shape along line II, the cross-sectional shape along line II-II, the cross-sectional shape along line III-III, the cross-sectional shape along line IV- The IV line cross-sectional shape and the VV line cross-sectional shape correspond to the cross-sectional shapes 6001 and 7001 to 6005 and 7005, respectively.
　図６に示す断面形状６００１～６００５からわかるように、ノズル部３２は、内腔３４と、内腔３４を構成するテーパー内壁面３５と、凸条部３６と、を備えている。凸条部３６は、上方側のテーパー内壁面３５に設けられており、下方側へ向かって突出している。また、凸条部３６は、ノズル部３２の上下方向の対称軸を挟んで２つ設けられている。これら２つの凸条部３６は、ノズル部３２の対称軸に対して線対称になるように配置されている。また、図６に示す断面形状６００４および６００５からわかるように、凸条部３６は、少なくともノズル部３２の先端部を避けて設けられている。 わ か る As can be seen from the cross-sectional shapes 6001 to 6005 shown in FIG. 6, the nozzle portion 32 includes a lumen 34, a tapered inner wall surface 35 constituting the lumen 34, and a ridge 36. The ridge 36 is provided on the tapered inner wall surface 35 on the upper side, and protrudes downward. Further, two convex ridges 36 are provided with a vertical axis of symmetry of the nozzle 32 interposed therebetween. These two ridges 36 are arranged to be line-symmetric with respect to the axis of symmetry of the nozzle 32. Further, as can be seen from the cross-sectional shapes 6004 and 6005 shown in FIG. 6, the protruding ridge portion 36 is provided so as to avoid at least the tip end portion of the nozzle portion 32.
　プランジャ５の押込み動作によりノズル部３２に移動した眼内レンズ７は、ノズル部３２の位置口近傍の案内スリット６１により谷折りされて前方側へ移動する。そして、谷折りされた眼内レンズ７は、テーパー内壁面３５の作用により折り畳まれつつ、前方側へ移動する。ここで、谷折りされた眼内レンズ７は、テーパー内壁面３５上を移動するに際し、眼内レンズ７の進行軸がずれる場合がある。このように進行軸がずれた眼内レンズ７は、テーパー内壁面３５に沿って回転移動してしまう。その結果、眼内レンズ７が線対称に谷折して折り畳まれなくなるおそれがある。 内 The intraocular lens 7 moved to the nozzle part 32 by the pushing operation of the plunger 5 is folded valley by the guide slit 61 near the position opening of the nozzle part 32 and moves forward. Then, the valley-folded intraocular lens 7 moves forward while being folded by the action of the tapered inner wall surface 35. Here, when the valley-folded intraocular lens 7 moves on the tapered inner wall surface 35, the traveling axis of the intraocular lens 7 may be shifted. The intraocular lens 7 whose traveling axis is displaced in this way rotates and moves along the tapered inner wall surface 35. As a result, there is a possibility that the intraocular lens 7 will not be folded due to the line-symmetric valley fold.
　そこで、挿入器具１では、ノズル部３２に凸条部３６が設けられていることにより、眼内レンズ７のテーパー内壁面３５に沿った回転移動が規制されている。図６に示す断面形状６００２および６００３からわかるように、谷折りされた眼内レンズ７がプランジャ５により前方側へ移動したとき、眼内レンズ７の左右方向の端部は、テーパー内壁面３５に沿った移動が、凸条部３６により係止される。そして、凸条部３６による眼内レンズ７の端部の係止は、凸条部３６が設けられていないノズル部３２の先端部近傍にて解除される。その結果、ノズル部３２内において眼内レンズ７が線対称に谷折して折り畳まれている。なお、谷折り直後の眼内レンズ７のテーパー内壁面３５に沿った回転移動を規制するという観点では、凸条部３６は、案内スリット６１の前方側の先端よりも後方側に設けられていることが好ましい。また、ノズル部３２の入口近傍では、凸条部３６は、必ずしも案内スリット６１よりも後方側に設けられる必要はない。その理由は、ノズル部３２の入口近傍では、眼内レンズ７の左右方向の端部がテーパー内壁面３５の凸条部３６の位置に到達しないためである。 Therefore, in the insertion device 1, the rotational movement of the intraocular lens 7 along the tapered inner wall surface 35 is restricted by the provision of the ridge 36 on the nozzle 32. As can be seen from the cross-sectional shapes 6002 and 6003 shown in FIG. 6, when the valley-folded intraocular lens 7 is moved forward by the plunger 5, the left-right end of the intraocular lens 7 is formed on the tapered inner wall surface 35. The movement along is locked by the ridge 36. Then, the locking of the end portion of the intraocular lens 7 by the convex ridge portion 36 is released in the vicinity of the tip end of the nozzle portion 32 where the convex ridge portion 36 is not provided. As a result, the intraocular lens 7 is folded line-symmetrically and valley-folded in the nozzle portion 32. In addition, from the viewpoint of restricting the rotational movement along the tapered inner wall surface 35 of the intraocular lens 7 immediately after the valley folding, the protruding ridge portion 36 is provided behind the front end of the guide slit 61. Is preferred. In the vicinity of the inlet of the nozzle portion 32, the ridge portion 36 does not necessarily need to be provided on the rear side of the guide slit 61. The reason is that the left and right ends of the intraocular lens 7 do not reach the position of the convex portion 36 of the tapered inner wall surface 35 near the entrance of the nozzle portion 32.
　なお、図６に示される構成では、ノズル部３２の内腔３４を構成するテーパー内壁面３５の前後方向に垂直な断面形状６００１～６００５は、上下方向に縦長の形状であった。しかし、テーパー内壁面３５の断面形状は、眼内レンズ７の寸法、折り畳みの挙動等に応じて適宜設定可能であり、図６に示された断面形状６００１～６００５に限定されない。例えば、テーパー内壁面３５の断面形状は、図７に示されるような、左右方向に横長な断面形状７００１～７００５であってもよい。 In the configuration shown in FIG. 6, the cross-sectional shapes 6001 to 6005 of the tapered inner wall surface 35 forming the inner cavity 34 of the nozzle portion 32, which are perpendicular to the front-rear direction, are vertically long in the vertical direction. However, the cross-sectional shape of the tapered inner wall surface 35 can be appropriately set in accordance with the dimensions of the intraocular lens 7, folding behavior, and the like, and is not limited to the cross-sectional shapes 6001 to 6005 shown in FIG. For example, the cross-sectional shape of the tapered inner wall surface 35 may be cross-sectional shapes 7001 to 7005 horizontally long in the left-right direction as shown in FIG.
　また、図６に示す断面形状６００１～６００５では、凸条部３６は、２つ配置されていた。しかし、本実施形態に係る挿入器具１においては、凸条部３６の数は、ノズル部３２の対称軸に対して線対称に配置される構成であれば、特に限定されない。 Also, in the cross-sectional shapes 6001 to 6005 shown in FIG. 6, two ridges 36 were arranged. However, in the insertion device 1 according to the present embodiment, the number of the ridges 36 is not particularly limited as long as the number is arranged symmetrically with respect to the axis of symmetry of the nozzle 32.
　例えば、図８に示す断面形状８００１～８００５のように、１つの凸条部３６ａを備えた構成であってもよい。凸条部３６ａは、ノズル部３２の対称軸に対して線対称な形状であり、少なくともノズル部３２の先端部を避けて設けられている。また、ノズル部３６ａは、ノズル部３２の先端部側へ向かうに従い、左右方向の幅が小さくなるような形状になっている。図８に示す断面形状８００１～８００５であっても、ノズル部３２内において眼内レンズ７が線対称に谷折して折り畳まれる。 For example, a configuration provided with a single protruding portion 36a may be used as in the cross-sectional shapes 8001 to 8005 shown in FIG. The protruding ridge portion 36 a has a shape symmetrical with respect to the axis of symmetry of the nozzle portion 32, and is provided so as to avoid at least the tip portion of the nozzle portion 32. The nozzle portion 36a has a shape such that the width in the left-right direction decreases toward the tip end side of the nozzle portion 32. Even in the cross-sectional shapes 8001 to 8005 shown in FIG. 8, the intraocular lens 7 is folded line-symmetrically in the nozzle portion 32.
　（センタリング部材９）
　ノズル部３２内において眼内レンズ７が線対称に谷折して折り畳まれているためには、レンズホルダ４内にて、眼内レンズ７におけるプランジャ５の当接位置が、眼内レンズ７の進行軸からずれないことが重要である。プランジャ５の中軸部５３は、後方側軸部５１に比べて細くなるように形成されている。このため、プランジャ５に力が加わったとき、中軸部５３の撓みによりガタツキが生じる。その結果、眼内レンズ７におけるプランジャ５の当接位置が、眼内レンズ７の進行軸からずれるおそれがある。センタリング部材９は、このようなプランジャ５のガタツキを規制する部材である。 (Centering member 9)
In order for the intraocular lens 7 to be folded line-symmetrically and valley in the nozzle portion 32, the contact position of the plunger 5 in the intraocular lens 7 in the lens holder 4 It is important not to deviate from the axis of travel. The central shaft portion 53 of the plunger 5 is formed to be thinner than the rear shaft portion 51. For this reason, when a force is applied to the plunger 5, rattling occurs due to the bending of the center shaft portion 53. As a result, the contact position of the plunger 5 in the intraocular lens 7 may be shifted from the axis of advance of the intraocular lens 7. The centering member 9 is a member that regulates such rattling of the plunger 5.
　図９は、環状拡大部２２に取り付けられたセンタリング部材９の構成を示し、図９の９００１は、斜視図であり、図９の９００２は、断面図である。また、図１０の１０００１は、センタリング部材９の構成を示す前方側から見た正面図であり、図１０の１０００２は、環状拡大部２２に取り付けられたセンタリング部材９の構成を示す前後方向に垂直な断面図である。 FIG. 9 shows a configuration of the centering member 9 attached to the annular enlarged portion 22, 9001 in FIG. 9 is a perspective view, and 9002 in FIG. 9 is a cross-sectional view. Also, 10001 in FIG. 10 is a front view showing the configuration of the centering member 9 as viewed from the front side, and 10002 in FIG. 10 shows the configuration of the centering member 9 attached to the annular enlarged portion 22 in the vertical direction. FIG.
　図９の９００１に示されるように、センタリング部材９は、装置本体２の環状拡大部２２に設けられている。装置本体２におけるセンタリング部材９の位置は、環状拡大部２２に限定されない。また、プランジャ５は、センタリング部材９に対して、レンズ当接部材５４が前方側に位置するように取り付けられている。また、スプリング８は、センタリング部材９の後方側に配置されている。このような構成により、プランジャ５のレンズ当接部材５４は、センタリング部材９よりも前方側にのみ移動し、後方側には移動しない。例えば、環状拡大部２２が複数の環状突起から構成されている場合、図９の９００２に示されるように、センタリング部材９は、環状突起間に挟まれて設けられている。 セ ン タ As shown by 9001 in FIG. 9, the centering member 9 is provided on the annular enlarged portion 22 of the apparatus main body 2. The position of the centering member 9 in the apparatus main body 2 is not limited to the annular enlarged portion 22. The plunger 5 is attached to the centering member 9 such that the lens contact member 54 is located on the front side. Further, the spring 8 is arranged on the rear side of the centering member 9. With such a configuration, the lens contact member 54 of the plunger 5 moves only forward of the centering member 9 and does not move rearward. For example, when the annular enlarged portion 22 includes a plurality of annular protrusions, the centering member 9 is provided between the annular protrusions, as shown by 9002 in FIG.
　図９の９００１に示されるように、センタリング部材９は、２つの下側係止爪９１と、プランジャ挿入部９２と、上側係止片９３と、を有している。プランジャ挿入部９２は、下側係止爪９１と上側係止片９３との間に設けられており、プランジャ５の中軸部５３が挿入されている。環状拡大部２２の上側には、プランジャ挿入部９２が上下方向に貫通可能な貫通孔が設けられている。また、環状拡大部２２の下側には、下側係止爪９１が貫通可能な２つの貫通孔が設けられている。 As shown by 9001 in FIG. 9, the centering member 9 has two lower locking claws 91, a plunger insertion portion 92, and an upper locking piece 93. The plunger insertion portion 92 is provided between the lower locking claw 91 and the upper locking piece 93, and the center shaft portion 53 of the plunger 5 is inserted. A through hole is provided above the annular enlarged portion 22 so that the plunger insertion portion 92 can penetrate vertically. Further, two through holes through which the lower locking claw 91 can pass are provided below the annular enlarged portion 22.
　下側係止爪９１は、環状拡大部２２の下側に設けられた２つの貫通孔を貫通して、環状拡大部２２の外側から貫通孔に引掛かることにより係止されている。また、上側係止片９３は、プランジャ挿入部９２が貫通する環状拡大部２２の上側の貫通孔の縁部に外側から当接して係止されている。このように下側係止爪９１および上側係止片９３が環状拡大部２２に係止されることにより、プランジャ挿入部９２は、プランジャ５の進行軸に位置合わせされる。それゆえ、プランジャ５は、プランジャ挿入部９２に挿入されることで、力が掛かっても、左右方向および上下方向のガタツキが規制される。その結果、挿入器具１によれば、眼内レンズ７におけるプランジャ５の当接位置が、眼内レンズ７の進行軸からずれることがない。 The lower locking claw 91 is locked by penetrating two through holes provided below the annular enlarged portion 22 and hooking the through hole from outside the annular enlarged portion 22. The upper locking piece 93 is locked by contacting from the outside with the edge of the upper through hole of the annular enlarged portion 22 through which the plunger insertion portion 92 penetrates. By locking the lower locking claw 91 and the upper locking piece 93 on the annular enlarged portion 22 in this manner, the plunger insertion portion 92 is aligned with the advancing axis of the plunger 5. Therefore, when the plunger 5 is inserted into the plunger insertion portion 92, rattling in the left-right direction and the up-down direction is regulated even when a force is applied. As a result, according to the insertion device 1, the contact position of the plunger 5 in the intraocular lens 7 does not deviate from the advancing axis of the intraocular lens 7.
　また、このセンタリング部材９は、装置本体２とは別体であってもよいし、装置本体２に一体的に形成されていてもよい。 The centering member 9 may be separate from the apparatus main body 2 or may be formed integrally with the apparatus main body 2.
　〔まとめ〕
　本発明の態様１に係る眼内レンズ挿入器具は、眼内レンズを保持するレンズホルダを取り付け可能な眼内レンズ挿入器具であって、前記眼内レンズに当接する先端部を前方に備え、前記眼内レンズを押出すプランジャと、前記プランジャにより押出された眼内レンズを折り畳みつつ外部へ放出するノズル部と、を備え、前記ノズル部は、当該ノズル部の軸線と平行な案内路を有し、前記先端部は、基端部と、前記基端部から前方へ延びた第１および第２の当接部と、を有し、前記第２の当接部は、前記案内路へ挿入されるとともに、前記案内路の前方端部との当接により後方へ折れ曲がり変形し、前記基端部は、後方へ折れ曲がり変形した前記第２の当接部が収容される凹部を有する構成である。 [Summary]
An intraocular lens insertion device according to aspect 1 of the present invention is an intraocular lens insertion device to which a lens holder for holding an intraocular lens can be attached, the device having a front end portion abutting on the intraocular lens, A plunger for pushing out the intraocular lens, and a nozzle portion for discharging the intraocular lens pushed out by the plunger to the outside while being folded, wherein the nozzle portion has a guide path parallel to the axis of the nozzle portion. The distal end portion has a proximal end portion, and first and second contact portions extending forward from the proximal end portion, and the second contact portion is inserted into the guide path. In addition, the guide path is bent rearward by contact with a front end of the guide path, and the base end has a recess in which the second contact part bent rearward is deformed.
　また、本発明の態様２に係る眼内レンズ挿入器具は、態様１において、前記ノズル部は、互いに対向するテーパー側壁を有しており、前記第１の当接部は、前記基端部から前方へ伸長する複数の第１の伸長部を有し、当該第１の伸長部は、前記テーパー側壁の対向方向において、互いの距離が変化するように変形可能である構成であってもよい。 In addition, in the intraocular lens insertion device according to aspect 2 of the present invention, in aspect 1, the nozzle portion has tapered side walls facing each other, and the first abutment portion extends from the base end portion. It may be configured to have a plurality of first extension portions extending forward, and the first extension portions can be deformed such that a distance between the first extension portions changes in a direction facing the tapered side wall.
　また、本発明の態様３に係る眼内レンズ挿入器具は、態様１または２において、前記第２の当接部は、前記基端部から前方へ伸長する第２の伸長部を有し、前記第２の伸長部と前記基端部との連結部分で折れ曲がるように構成されていることが好ましい。 Further, in the intraocular lens insertion device according to aspect 3 of the present invention, in the aspect 1 or 2, the second contact portion has a second extension portion extending forward from the base end portion, It is preferable that the connecting portion between the second extending portion and the base end be bent.
　また、本発明の態様４に係る眼内レンズ挿入器具は、態様１～３において、前記２の当接部は、前記第１の当接部よりも上方に配されており、前記案内路は、前記ノズル部の上面に、前記ノズル部の軸線に沿って形成されている構成であることが好ましい。 Also, in the intraocular lens insertion device according to aspect 4 of the present invention, in the aspects 1 to 3, the second contact portion is disposed above the first contact portion, and the guide path is It is preferable that the nozzle is formed on the upper surface of the nozzle along the axis of the nozzle.
　また、本発明の態様５に係る眼内レンズ挿入器具は、態様１～４において、前記第２の当接部は、前記第１の当接部よりも前方に突出して設けられている構成であることが好ましい。 An intraocular lens insertion device according to a fifth aspect of the present invention is the intraocular lens insertion device according to the first to fourth aspects, wherein the second contact portion is provided so as to protrude forward from the first contact portion. Preferably, there is.
　また、本発明の態様６に係る眼内レンズ挿入器具は、態様１～５において、前記案内路は、前記ノズル部の上面に、前記軸線に沿って形成されている構成であることが好ましい。 In addition, the intraocular lens insertion device according to aspect 6 of the present invention is preferably configured such that, in aspects 1 to 5, the guide path is formed on the upper surface of the nozzle portion along the axis.
　本発明は上述した実施形態に限定されるものではなく、請求項に示した範囲で種々の変更が可能であり、実施形態に開示された技術的手段を適宜組み合わせて得られる実施形態についても本発明の技術的範囲に含まれる。 The present invention is not limited to the above-described embodiments, and various changes can be made within the scope shown in the claims, and the embodiments obtained by appropriately combining the technical means disclosed in the embodiments are also described. Included in the technical scope of the invention.
　１　　挿入器具（眼内レンズ挿入器具）
　２　　装置本体
　３　　先端チップ
　４　　レンズホルダ
　５　　プランジャ
　６　　案内路
　７　　眼内レンズ
３２　　ノズル部
５４　　レンズ当接部材（先端部）
５５　　基端部
５５ａ　外面
５６　　第１当接部
５６ａ　伸長部（第１の伸長部）
５７　　第２当接部
５７ａ　伸長部（第２の伸長部）
５７ｃ　連結部分
５８　　凹部
６１　　案内スリット（案内路）
６２　　案内溝
　Ｘ　　軸線
  1 insertion device (intraocular lens insertion device)
2 Device body 3 Tip 4 Lens holder 5 Plunger 6 Guide path 7 Intraocular lens 32 Nozzle 54 Lens contact member (tip)
55 Base end portion 55a Outer surface 56 First contact portion 56a Extension portion (first extension portion)
57 Second contact part 57a Extension part (second extension part)
57c Connecting part 58 Recess 61 Guide slit (guide path)
62 Guide groove X axis

Claims (5)

  1. 　眼内レンズを保持するレンズホルダを取り付け可能な眼内レンズ挿入器具であって、
    　前記眼内レンズに当接する先端部を前方に備え、前記眼内レンズを押出すプランジャと、
    　前記プランジャにより押出された眼内レンズを折り畳みつつ外部へ放出するノズル部と、を備え、
    　前記ノズル部は、当該ノズル部の軸線と平行な案内路を有し、
    　前記先端部は、
    　基端部と、
    　前記基端部から前方へ延びた第１および第２の当接部と、を有し、
    　前記第２の当接部は、前記案内路へ挿入されるとともに、前記案内路の前方端部との当接により後方へ折れ曲がり変形し、
    　前記基端部は、後方へ折れ曲がり変形した前記第２の当接部が収容される凹部を有することを特徴とする眼内レンズ挿入器具。     An intraocular lens insertion device to which a lens holder holding an intraocular lens can be attached,
    A plunger for extruding the intraocular lens, comprising a front end portion in contact with the intraocular lens,
    A nozzle unit that discharges the intraocular lens extruded by the plunger to the outside while folding the intraocular lens,
    The nozzle unit has a guide path parallel to the axis of the nozzle unit,
    The tip is
    A proximal end,
    First and second contact portions extending forward from the base end portion,
    The second contact portion is inserted into the guide path, and is bent and deformed rearward by contact with a front end of the guide path,
    The intraocular lens insertion device, wherein the base end has a concave portion in which the second contact portion bent and deformed rearward is accommodated.
  2. 　前記ノズル部は、互いに対向するテーパー側壁を有しており、
    　前記第１の当接部は、前記基端部から前方へ伸長する複数の第１の伸長部を有し、当該第１の伸長部は、前記テーパー側壁の対向方向において、互いの距離が変化するように変形可能であ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。     The nozzle portion has tapered side walls facing each other,
    The first contact portion has a plurality of first extension portions extending forward from the base end portion, and the first extension portions change in distance from each other in a direction facing the tapered side wall. The intraocular lens insertion device according to claim 1, wherein the intraocular lens insertion device is deformable.
  3. 　前記第２の当接部は、前記基端部から前方へ伸長する第２の伸長部を有し、前記第２の伸長部と前記基端部との連結部分で折れ曲がるように構成されていることを特徴とする請求項１または２に記載の眼内レンズ挿入器具。 The second contact portion has a second extension portion extending forward from the base end portion, and is configured to bend at a connection portion between the second extension portion and the base end portion. The intraocular lens insertion device according to claim 1 or 2, wherein:
  4. 　前記第２の当接部は、前記第１の当接部よりも上方に配されており、
    　前記案内路は、前記ノズル部の上面に、前記ノズル部の軸線に沿って形成されていることを特徴とする請求項１～３の何れか１項に記載の眼内レンズ挿入器具。     The second contact portion is disposed above the first contact portion,
    The intraocular lens insertion device according to any one of claims 1 to 3, wherein the guide path is formed on an upper surface of the nozzle portion along an axis of the nozzle portion.
  5. 　前記第２の当接部は、前記第１の当接部よりも前方に突出して設けられていることを特徴とする請求項１～４の何れか１項に記載の眼内レンズ挿入器具。
     
          The intraocular lens insertion device according to any one of claims 1 to 4, wherein the second contact portion is provided to protrude forward from the first contact portion.

PCT/JP2019/030898 2018-08-07 2019-08-06 Intraocular lens insertion implement WO2020032024A1 (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010079780A1 (en) * 2009-01-07 2010-07-15 Hoya株式会社 Intraocular lens insertion device
JP5236638B2 (en) * 2007-05-30 2013-07-17 Ｈｏｙａ株式会社 Intraocular lens insertion device

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5236638B2 (en) * 2007-05-30 2013-07-17 Ｈｏｙａ株式会社 Intraocular lens insertion device
WO2010079780A1 (en) * 2009-01-07 2010-07-15 Hoya株式会社 Intraocular lens insertion device

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