JP2009028223A - Intraocular lens inserting instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intraocular lens inserting instrument which safely and credibly discharges an intraocular lens into the eye by making a credible engagement between the periphery of the intraocular lens and the distal part of a plunger even when the diameter of the distal part of a nozzle is small and sliding resistance between the nozzle and the intraocular lens is large. <P>SOLUTION: The intraocular lens inserting instrument is used for inserting a deformable intraocular lens 2 into the eyeball via an incision in the eyeball tissue. The intraocular lens inserting instrument comprises a cylindrical main unit 5, an intraocular lens receiving section 3 formed in one piece with or separately from the main unit 5, and the plunger 6 for pushing the intraocular lens 2 received within the receiving section 3 to discharge the intraocular lens into the eyeball. The intraocular lens inserting instrument 1 is characterized by that a vertical edge capturing section 7 and horizontal edge capturing sections 8a and 8b are arranged on the distal part of the plunger 6 in order to solve the problems. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an intraocular lens insertion device for implanting an intraocular lens in an eyeball instead of a lens removed by cataract surgery, and in particular, a distal end shape of a plunger for extruding the intraocular lens. About.

  In cataract surgery, the removal of a turbid lens by ultrasonic emulsification and aspiration (PEA) and the implantation of an intraocular lens in the eye after removal of the lens are widely performed. The intraocular lens includes a hard intraocular lens whose optical part is made of a hard material such as polymethyl methacrylate (PMMA), and a soft intraocular lens made of a soft material such as silicone elastomer or soft acrylic.

  When using a hard intraocular lens, an incision with a width approximately the same as the diameter of the optical part must be made in the cornea or sclera and the lens must be inserted, whereas a soft intraocular lens is used. In this case, there is an advantage that the lens can be inserted from an incision smaller than the diameter of the optical part by folding the optical part. Furthermore, in order to reduce corneal astigmatism and infection after surgery, it is preferable to insert an intraocular lens through a small incision, and at present, a soft intraocular lens tends to be preferred.

  In order to put the intraocular lens into the eye, a dedicated intraocular lens insertion device having a structure for introducing the intraocular lens into the eye through an elongated tube may be used. By using such an intraocular lens insertion device dedicated to an intraocular lens, it is possible to insert the lens into the eye from an incision wound smaller than 3 mm.

  Furthermore, in order to eliminate the possibility of contamination by bacteria during the handling of intraocular lenses and the possibility of operational errors that may occur during the handling of intraocular lenses, the lenses are set in advance in the intraocular lens insertion device, and packed and stored. Possible types of intraocular lens insertion devices have also been developed.

  When an intraocular lens is inserted into the eye using an intraocular lens insertion device, it is necessary that the plunger tip for pushing the intraocular lens in the insertion device and the intraocular lens are firmly engaged. If the engagement is insufficient, the positional relationship between the plunger and the intraocular lens is shifted, or the plunger rides on the intraocular lens or enters under the intraocular lens. The part or the support part may be scratched or damaged, or the plunger may pass through the intraocular lens, and the intraocular lens may not be inserted into the eye.

In order to solve this problem, a technique for preventing the plunger from riding on the intraocular lens by constantly pressing a plunger having a round tip portion offset from the cartridge central axis against the inner wall of the cartridge is disclosed. (For example, Patent Document 1). Further, when the intraocular lens is moved in the intraocular lens insertion device, the plunger tip and the intraocular lens are firmly engaged with each other, as shown in FIGS. And a plunger 6 for pressing and releasing the intraocular lens 2 housed in the housing part 3 into the eyeball, and a protrusion 50 is provided at the tip of the plunger 6. An provided intraocular lens implantation device has been proposed (see, for example, Patent Document 2).
JP-T-2002-516709 International Publication WO2006 / 070628 A1 Pamphlet

  In recent years, there has been an increasing demand for a small incision, and accordingly, an intraocular lens insertion instrument having a small nozzle diameter has been demanded. When the nozzle diameter is reduced and the sliding resistance of the intraocular lens in the intraocular lens insertion device is increased, it has been found that the plunger according to the above prior art is insufficiently engaged between the plunger and the intraocular lens. . In particular, in the case of a disposable injector that is used only once and then discarded, the plunger is manufactured from a resin molded product in order to reduce the manufacturing cost, and the bending rigidity of the plunger is low. Therefore, the smaller the diameter of the nozzle tip, the more the plunger is deformed in an arcuate shape, the tip is disengaged from the peripheral edge of the intraocular lens, and the plunger is likely to ride on the optical part of the intraocular lens.

  The present invention has been made in order to solve the above-described problems of the prior art, more reliably engages the peripheral portion of the intraocular lens and the tip of the plunger, and slides the nozzle tip at a small diameter. It is an object of the present invention to provide an intraocular lens insertion device capable of safely and reliably releasing an intraocular lens into the eye even when the resistance is large.

  The invention according to claim 1 is an intraocular lens insertion device for inserting a deformable intraocular lens into an eyeball from an incision wound of eyeball tissue, and is a cylindrical main body and an integral or separate body with the main body. And a plunger for pressing and releasing the intraocular lens housed in the housing part into the eyeball, and a vertical edge capturing part and a horizontal part at the tip of the plunger. An edge capturing unit is provided.

  According to a second aspect of the present invention, in the intraocular lens insertion device according to the first aspect, an abutting portion is provided in the vertical edge capturing portion.

  According to a third aspect of the present invention, in the intraocular lens insertion device according to the first or second aspect, the tip surface of the horizontal edge capturing portion is provided with an inclination.

  According to the intraocular lens insertion device of claim 1, even if there is a large sliding resistance when the intraocular lens is inserted into the eye, the intraocular lens can be reliably captured at the distal end portion of the plunger. It is possible to prevent the plunger from riding on the optical part of the intraocular lens.

  According to the intraocular lens insertion device of the second aspect, since the deformation amount of the intraocular lens can be limited by the abutting portion against the vertical edge capturing portion, it is possible to prevent excessive deformation of the intraocular lens. .

  According to the intraocular lens insertion device of the third aspect, the distal end of the plunger can capture the peripheral edge of the intraocular lens more reliably by the inclination provided on the distal end surface of the horizontal edge capturing portion.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is an external perspective view of an intraocular lens insertion device according to the present invention, and FIG. 2 is a cross-sectional view thereof. FIG. 3 is an exploded view of components of the intraocular lens insertion device.

  First, an intraocular lens insertion device 1 to which the present invention is applied will be described. The schematic configuration of an intraocular lens insertion device 1 to which the present invention is applied includes a cartridge 3 which is an intraocular lens storage portion, and a cylinder which is a main body in which the cartridge 3 is locked at one end and a gripping flange 4 is fixed at the other end. And a plunger 6 that is inserted through the handpiece 5 and integrated with the push rod 13. The distal end of the plunger 6 is provided with a vertical edge capturing part 7 and a horizontal edge capturing part 8 for capturing the peripheral edge of the intraocular lens.

  The cartridge 3 accommodates an intraocular lens therein, and inserts the tip of the intraocular lens into the eyeball through the incision wound of the eyeball tissue to release the lens into the eyeball. The cartridge 3 has a substantially hollow cylindrical shape. And is formed to be tapered. Then, the end of the cartridge 3 on the operator side is provided for the intraocular lens insertion port 3a, and the other end on the distal end side is provided for the intraocular lens discharge port 3b. The insertion port 3a is for folding an intraocular lens and loading it into the cartridge 3, and an insertion groove 3c is provided in the cylindrical portion. Due to the presence of the insertion groove 3c, the intraocular lens can be easily loaded into the cartridge 3 using an insertion instrument (not shown). Further, the discharge port 3b located at the tip of the cartridge 3 is formed obliquely so that the eyeball tissue can be easily inserted into the incision wound. Further, the side surface of the cartridge 3 is provided with two wing portions 3d for locking the cartridge 3 to the handpiece 5.

  In this embodiment, the cartridge 3 serving as the storage unit for the intraocular lens and the hand piece 5 serving as the main body are configured separately, but the cartridge 3 and the hand piece 5 may be configured integrally.

  The hand piece 5 is formed with a semicircular arc-shaped guide portion 5a having a guide path for guiding the wing portion 3d of the cartridge 3 on the side surface close to the tip end side. A locking portion 5b that can lock the wing portion 3d is provided. A ball bush 9 is attached to the other end of the handpiece 5 between the outer peripheral surface of the push bar 13 and the inner peripheral surface of the handpiece 5. Furthermore, a cap 11 is fixed to the other end of the handpiece 5, and a grip flange 4 is fixed to the cap 11 for facilitating the operator's grip.

  A push bar 13 is integrated with the plunger 6 by a fastener 12 and is inserted into the handpiece 5, the ball bush 9 and the gripping flange 4 described above. An end plate 14 for facilitating pushing and pulling of the push rod 13 is fixed to the operator side of the push rod 13.

  Next, the shape of the tip of the plunger 6 which is a characteristic part of the present invention will be described with reference to FIGS. The distal end portion of the plunger 6 includes a vertical edge capturing portion 7 and horizontal edge capturing portions 8a and 8b. FIG. 4 shows a state immediately before the peripheral edge 2 a of the intraocular lens 2 housed in the cartridge 3 is captured by the distal end portion of the plunger 6. FIG. 5 is an enlarged side view of the plunger, and FIG. 6 is an enlarged front view of the plunger. Further, FIG. 7 is a side view showing a state in which the distal end portion of the plunger 6 has captured the peripheral edge 2a of the intraocular lens. The distal end portion of the plunger 6 is provided at a position slightly offset downward with respect to the axis of the root portion. By doing in this way, the peripheral edge 2a position of the optical part of the intraocular lens 2 folded concavely in the cartridge 3 and the tip end position of the plunger can be made substantially coincident. A groove 3e that is slightly wider than the width of the plunger tip is provided on the lower surface of the lens housing portion of the cartridge 3 with an inclination.

  Here, the tip of the plunger 6 is provided with horizontal edge capturing portions 8a and 8b at two locations, an upper portion and a lower portion, and the central portion is connected to connect these two horizontal edge capturing portions 8a and 8b. A vertical edge capture 7 is provided. The front end surfaces of these two horizontal edge capturing portions 8a and 8b and the front end surface of the vertical edge capturing portion 7 are formed to be on the same plane. Therefore, when the front end portion of the plunger 6 is viewed from the front, it has a substantially “I” shape as shown in FIG. 6.

  Specific examples of dimensions of the plunger tip shown in FIGS. 6 and 7 are as follows. An intraocular lens having an outer diameter of 6 mm and an edge thickness of 0.3 mm is inserted into the eye using a cartridge having a nozzle inner diameter of 1.8 mm. When inserted, W1 = 0.6 mm, W2 = 0.8 mm, H = 0.2 mm, and D = 0.5 mm are appropriate values.

  Next, an operation when the plunger 6 having such a tip shape abuts on the peripheral edge 2a of the intraocular lens will be described. When the plunger 6 is pushed forward, the vertical edge capturing portion 7 of the plunger first comes into contact with the peripheral edge 2a of the intraocular lens. At this stage, the contact area between the vertical edge capturing portion 7 and the peripheral edge 2a of the intraocular lens is small, and the contact portion of the peripheral edge 2a of the intraocular lens is elastically deformed toward the center of the lens by the pressure received from the vertical edge capturing portion 7. Will do. On the other hand, a portion of the peripheral edge 2a of the intraocular lens that is not in contact with the vertical edge capturing portion 7 is hardly elastically deformed because it receives no external force. As a result, the vertical edge capturing portion 7 of the plunger 6 bites into the contact portion with the peripheral edge 2a of the intraocular lens, and can reliably capture the peripheral edge 2a of the intraocular lens. A so-called anchor effect is exhibited. Here, the horizontal edge capturing portions 8a and 8b provided at the upper and lower portions of the tip of the plunger 6 do not directly bite into the peripheral edge 2a of the intraocular lens, but the vertical edge capturing portion 7 A function of guiding the vertical direction when starting to capture the peripheral edge 2a of the intraocular lens and a function of restraining the intraocular lens 2 in the vertical direction after the vertical edge capturing unit 7 bites into the peripheral edge 2a of the intraocular lens. Will also be fulfilled. Thus, according to the intraocular lens insertion device 1 according to the present embodiment, the peripheral edge 2a of the intraocular lens can be reliably captured at the distal end portion of the plunger 6.

  FIG. 8 is a side view of the distal end portion of the plunger 6 showing the second embodiment of the present invention. The basic configuration of this embodiment is the same as that of the first embodiment. However, in the first embodiment, the two horizontal edge capturing portions 8a and 8b and the front end surface of the vertical edge capturing portion 7 are formed to be on the same plane, but in the second embodiment, the horizontal edge capturing portion is formed. The difference is that an inward slope is provided on the tip surfaces of 8a and 8b. In this way, the vertical edge position of the peripheral edge 2a of the intraocular lens is slightly deviated from the vertical position of the vertical edge capturing part 7 by providing an inclination to the tip surfaces of the horizontal edge capturing parts 8a and 8b. However, when the vertical edge capturing unit 7 starts capturing the peripheral edge 2a of the intraocular lens, the inclined surfaces of the horizontal edge capturing units 8a and 8b perform a vertical guiding function. Therefore, the peripheral edge 2a of the intraocular lens can be captured more reliably at the distal end portion of the plunger 6.

  FIG. 9 is a perspective view of a plunger tip portion showing a third embodiment of the present invention, and FIG. 10 is a plan view thereof. The plunger 6 according to this embodiment is provided with abutting portions 19 on both sides of the vertical edge capturing portion 7. That is, the abutting portions 19 are provided on both side portions of the vertical edge capturing portion 7 and slightly rearward (operator side) from the distal end surface of the plunger. By providing the abutting portion 19 in this way, it is possible to limit the amount that the vertical edge capturing portion 7 bites into the peripheral edge 2a of the intraocular lens. Therefore, excessive deformation of the intraocular lens 2 can be prevented.

  As mentioned above, although this invention was demonstrated based on the Example, this invention is not limited to the said Example, A various deformation | transformation implementation is possible. For example, in the above embodiment, one vertical edge capturing unit 7 is provided between the pair of upper and lower horizontal edge capturing units 8a and 8b, but a plurality of vertical edge capturing units may be provided.

1 is an external perspective view of an intraocular lens insertion device according to the present invention. It is sectional drawing of an intraocular lens insertion instrument. It is a component exploded view of an intraocular lens insertion instrument. 4 is a cross-sectional view showing a state immediately before the periphery of the intraocular lens 2 is captured by the distal end portion of the plunger 6. FIG. It is a front-end | tip enlarged side view of a plunger. It is a front-end | tip enlarged front view of a plunger. It is a side view which shows the state which the plunger front-end | tip part captured the periphery of the intraocular lens. It is a side view of the plunger front-end | tip part which shows 2nd Example. It is a perspective view of the plunger front-end | tip part which shows 3rd Example. It is a top view of 3rd Example. It is a perspective view which shows the plunger front-end | tip of the transplant apparatus by a prior art. It is sectional drawing which shows the state which the plunger front-end | tip of the transplanting device by a prior art pressed the lens. It is an AA arrow line view of FIG.

Explanation of symbols

1 Intraocular lens insertion device 2 Intraocular lens 3 Storage part (cartridge)
5 Body (handpiece)
6 Plunger 7 Vertical edge capture part
8a, 8b Horizontal edge capture unit
19 Butting part

Claims (3)

An intraocular lens insertion device for inserting a deformable intraocular lens into an eyeball from an incision wound of an eyeball tissue, and a cylindrical main body, and a storage portion for an intraocular lens that is integral with or separate from the main body. A plunger for pressing and releasing the intraocular lens housed in the housing section into the eyeball, and a vertical edge capturing section and a horizontal edge capturing section are provided at the tip of the plunger. An intraocular lens insertion device. The intraocular lens insertion device according to claim 1, wherein an abutting portion is provided on the vertical edge capturing portion. The intraocular lens insertion device according to claim 1, wherein an inclination is provided on a distal end surface of the horizontal edge capturing unit.

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