JP7631971B2 - Intraocular lens insertion device - Google Patents

Description

This disclosure relates to an intraocular lens insertion device for inserting an intraocular lens into the eye.

Traditionally, one of the most common surgical methods for cataracts is to insert a soft, foldable intraocular lens into the eye instead of the crystalline lens. In some cases, the intraocular lens is inserted in front of the crystalline lens to correct the refractive power of the eye. An intraocular lens insertion tool called an injector is sometimes used to insert the intraocular lens into the eye.

One such injector is an intraocular lens insertion device that pushes out an intraocular lens through a hollow portion in which a notch is formed at the tip and the inner diameter gradually decreases toward the tip, folding the intraocular lens small and ejecting it from the tip (see, for example, Patent Document 1). The intraocular lens insertion device of Patent Document 1 prevents poor tacking of the front support part by tilting the tip of the plunger, which moves straight along the extrusion axis, toward the inner wall surface. However, since the diopter of the patient's eye varies from person to person, intraocular lenses are used selectively (see, for example, Patent Document 2). In other words, it is common for a given model name of intraocular lens to be available in multiple intraocular lenses that differ only in the power (refractive power) of the optical part.

JP 2016-190023 A JP 2010-207279 A

Here, the lower the power of the intraocular lens to be mounted, the thinner the optical part becomes, and the lower the rigidity of the optical part tends to be. Therefore, in the intraocular lens insertion device of Cited Document 1, if the tip of the plunger is uniformly inclined toward the inner wall surface, there was a concern that unintended deformation of the optical part may easily occur while pushing out a low-power intraocular lens with a thin optical part and low rigidity.

Therefore, the present disclosure has been made to solve the above-mentioned problems, and aims to provide an intraocular lens insertion device that can suitably insert an intraocular lens into a patient's eye regardless of the power of the intraocular lens to be inserted into the patient's eye.

An intraocular lens insertion device provided by a typical embodiment of the present disclosure is an intraocular lens insertion device in which one intraocular lens is pre-loaded from among multiple types of intraocular lenses, the thickness of the optical portion of which differs depending on the power, and includes a cylindrical insertion device body in which the intraocular lens is pre-loaded, a plunger that pushes the intraocular lens placed inside the cylindrical interior of the insertion device body along an extrusion axis, and a change means that is selected in accordance with the multiple types of intraocular lenses and acts to change the progression trajectory of the plunger progressing through the cylindrical interior of the insertion device body, and the progression trajectory is determined by the change means in accordance with the power of the intraocular lens that is pre-loaded.

The intraocular lens insertion device disclosed herein can provide an intraocular lens insertion device that can appropriately insert an intraocular lens into a patient's eye regardless of the power of the intraocular lens to be inserted into the patient's eye.

FIG. 2 is a plan view of an intraocular lens insertion instrument. FIG. 2 is a side view of an intraocular lens insertion device. FIG. 2 is a plan view of an intraocular lens. FIG. 2 is a right side view of the intraocular lens. 1 is a cross-sectional view of the optic portion of a low-power intraocular lens. FIG. 2 is a cross-sectional view of the optic portion of a high-power intraocular lens. 3 is a cross-sectional view taken along line VII-VII of FIG. 2. 3 is a cross-sectional view taken along line VIII-VIII in FIG. 2. FIG. 11 is a cross-sectional view showing a schematic diagram of a guide mechanism for low power lenses. FIG. 13 is a cross-sectional view showing a schematic guide mechanism for altitude. 1 is a cross-sectional view showing an intraocular lens in a compact folded state. 1 is a cross-sectional view showing the state when the intraocular lens is rotated in the circumferential direction of the optical part by a guide mechanism for low power. 1 is a cross-sectional view showing the state when the intraocular lens is rotated in the circumferential direction of the optical portion by a guide mechanism for high power. 11A and 11B are plan and side views showing a schematic view of the movement of the intraocular lens immediately after the intraocular lens is folded and the front support portion is placed on the outer periphery.

＜Overview＞
The intraocular lens insertion device exemplified in the present disclosure is an intraocular lens insertion device in which one intraocular lens is preloaded from among a plurality of types of intraocular lenses, the only difference being the thickness of the optical portion depending on the power. The intraocular lens insertion device includes an insertion device body, a plunger, and a change means. The insertion device body is cylindrical and is preloaded with the intraocular lens. The plunger pushes out the intraocular lens placed inside the cylindrical insertion device body along the extrusion axis. The change means selectively changes the progression trajectory of the plunger moving inside the cylindrical insertion device body. The change means determines the progression trajectory depending on the power of the intraocular lens preloaded.

The intraocular lens insertion device disclosed herein is equipped with a change means for selectively changing the trajectory of the plunger as it advances through the cylindrical interior of the insertion device body. This change means determines the trajectory of the plunger according to the power of the intraocular lens preloaded. Even for low-power intraocular lenses with a thin optical portion and low rigidity, the plunger's trajectory is determined according to the lens rigidity, so that tacking failures and the like can be suppressed and the lenses can be folded appropriately. Therefore, it is possible to provide an intraocular lens insertion device that can appropriately insert an intraocular lens into a patient's eye regardless of the power of the intraocular lens to be inserted into the patient's eye.

The change means in the intraocular lens insertion device may be such that a deflection mechanism is disposed on the extrusion axis, which is the direction in which the plunger advances inside the cylindrical interior of the insertion device body, and the trajectory of the plunger's advancement may be changed by changing the deflection angle of the deflection mechanism. Since the trajectory of the plunger's advancement changes by changing the deflection angle of the deflection mechanism, the amount of deflection can be set finely. This makes it easy to set multiple types of deflection mechanisms, for example, for low power bands, medium power bands, and high power bands.

The change means of the intraocular lens insertion device may be one that changes the left-right trajectory of the plunger's movement, which is perpendicular to the optical axis of the intraocular lens. This allows the intraocular lens to be folded appropriately while preventing tacking problems, since the movement trajectory is determined taking into account the lens rigidity according to the power while the optical part is rotated in the circumferential direction.

In the intraocular lens insertion device, the intraocular lens has a different radius of curvature of the optical surface depending on the power, the radius of curvature being larger for low powers than for high powers, and the changing means may have the plunger extrusion position closer to the extrusion axis for low powers of the intraocular lens than for high powers. As a result, since the optical part of low power intraocular lenses tends to be thinner and less rigid, unintended deformation of the intraocular lens can be suppressed by moving the plunger extrusion position closer to the extrusion axis. Furthermore, even low power intraocular lenses with a thin optical part and low rigidity can be folded appropriately while suppressing tacking failures.

In the intraocular lens insertion device, the intraocular lens has a pair of front and rear support parts that extend radially outward from the outer periphery of the optical part, and the insertion device body is provided with a convex part that suppresses the tilt of the optical part when the pre-filled intraocular lens is pushed out by the plunger, and the convex part is disposed in front of the optical axis of the optical part, among the positions facing the outer periphery of the optical part, on the side where the front support part is not disposed as viewed from the pushing axis, and the convex part protrudes in an arch shape from the bottom surface of the insertion device body toward the ceiling surface and is close to the outer periphery part of the rear optical surface side of the optical part. The convex part can suppress the tilt of the optical part when the intraocular lens is pushed out by the plunger, and can suppress the occurrence of a so-called "back tacking state" in which the front support part of the intraocular lens is unintentionally tacked.

First Embodiment
Hereinafter, a first embodiment, which is one of typical embodiments of the present disclosure, will be described with reference to the drawings.

The structure of the injector 1, which is an intraocular lens insertion device, will be described. As shown in FIG. 1 and FIG. 2, the injector 1 (intraocular lens insertion device) of this embodiment is composed of an insertion device body 10, a plunger 12, and the like. The insertion device body 10 includes an insertion section 20 and a mounting section 22. Such an injector 1 is formed, for example, by injection molding using a resin material (for example, polypropylene) or the like. The injector 1 may also be formed by cutting out a resin. The injector 1 may be a cartridge type in which the insertion section 20 is replaceable. The injector 1 of this embodiment is a so-called preload type, and is shipped in a state in which the intraocular lens 100 is pre-loaded. The injector 1 of this embodiment can be loaded with an intraocular lens of model name MDL, which covers a range of lens powers from 1D to 30D in increments of 0.5D. In other words, the injector 1 of this embodiment can accommodate a range of intraocular lens 100 powers from 1D to 30D, and the intraocular lenses 100 are available in increments of 0.5D.

<Intraocular lens 100>
With reference to Figs. 3 and 4, an example of an intraocular lens 100 to be inserted into the eye by an injector 1 (intraocular lens insertion device) will be described. As shown in Figs. 3 and 4, the intraocular lens 100 used in this embodiment is a one-piece type intraocular lens in which the optical part 110 and a pair of support parts, a front support part 112A and a rear support part 112B, are integrally molded with a flexible material. The intraocular lens 100 can employ various soft resin materials as the flexible material, such as simple substances such as BA (butyl acrylate) and HEMA (hydroxyethyl methacrylate), and composite materials of acrylic acid ester and methacrylic acid ester. Although the so-called one-piece type intraocular lens 100 is exemplified in the first embodiment, at least a part of the technology exemplified in this disclosure can also be applied to a so-called three-piece type intraocular lens in which the optical part 110 and a pair of support parts (the front support part 112A and the rear support part 112B) are formed of separate members.

The optical part 110 provides a predetermined refractive power to the patient's eye. The optical part 110 is formed in a disk shape. The optical axis L of the optical part 110 passes through the center of the optical part 110 and extends in the vertical direction (thickness direction of the optical part 110). The front support part 112A and the rear support part 112B extend from the outer peripheral part 110a (edge) of the optical part 110 in a curved manner radially outward (outside), and are formed in a position that is point symmetrical with respect to the optical axis L, which is the center of the optical part 110. The front support part 112A has a root part 116A connected to the outer peripheral part 110a of the optical part 110 via the connection part 114A, has a loop shape curved in the circumferential direction, and has an open tip part 118A. (That is, the tip part 118A is a free end). In addition, the rear support portion 112B has a base portion 116B connected to the outer peripheral portion 110a of the optical portion 110 via a connecting portion 114B, and has a loop shape curved in the circumferential direction, with the tip portion 118B open (i.e., the tip portion 118B is a free end). The optical portion 110 has, as an end surface in the optical axis L direction, a front optical surface 110c that faces the ceiling surface 22b of the mounting portion 22, and a rear optical surface 110b that is opposite the front optical surface 110c and faces the bottom surface 22c of the mounting portion 22, as described below.

In the intraocular lens 100 of this embodiment, only the thickness of the optical portion 110 varies depending on the power of the lens, but the contour shape of the optical portion 110 when viewed from the optical axis direction and the shapes of the front support portion 112A and the rear support portion 112B do not change. In other words, the radii of curvature of the front optical surface 110c and the rear optical surface 110b, and the thickness of the outer circumferential portion 110a (also called the edge) change depending on the power, and the thickness of the optical portion 110 changes.

Figure 5 shows a cross-sectional view of the optical section 110 of an intraocular lens 100 with a diopter of 1D. Figure 6 shows a cross-sectional view of the optical section 110 of an intraocular lens 100 with a diopter of 30D. Note that Figures 5 and 6 are cross-sectional views at the position of the optical axis L. The radius of curvature of the optical surfaces (front optical surface 110c, rear optical surface 110b) in the intraocular lens 100 is relatively larger at low diopters than at high diopters. In other words, when comparing an intraocular lens 100 with a diopter of 1D and an intraocular lens 100 with a diopter of 30D, the radii of curvature of the front optical surface 110c and rear optical surface 110b are different. Accordingly, the thickness T1 of the optical section 110 of the 1D intraocular lens 100 is thinner than the thickness T2 of the optical section 110 of the 30D intraocular lens 100.

<Regarding the insertion instrument body 10>
The details of the insertion instrument body 10 will be described with reference to Figures 7 and 8. The insertion instrument body 10 includes an insertion section 20 and a mounting section 22. The insertion section 20 and the mounting section 22 are formed in a hollow cylindrical shape. In addition, a guide mechanism 30 for guiding the forward movement of the plunger 12 is provided on the inner wall of the cylindrical insertion instrument body 10. In the injector 1 of this embodiment, the guide mechanism 30 is detachable from the instrument body, and one guide mechanism 30 can be selected and attached from a plurality of types of guide mechanisms 30 having different shapes.

As shown in Figures 7 and 8, the insertion section 20 has a passage 20b (front passage). The passage 20b narrows the space through which the intraocular lens 100 passes toward the tip 20a of the insertion section 20 in order to fold the intraocular lens 100. In other words, the passage area gradually decreases toward the tip 20a. The passage area is the cross-sectional area of the passage 20b in a cross section perpendicular to the extrusion direction of the intraocular lens 100 (leftward in Figure 7).

The tip 20a of the insertion section 20 is formed with a notch (bevel) for sending the intraocular lens 100 to the outside. The intraocular lens 100 that passes through the passage 20b is folded small along the inner wall surface 20c (front inner wall surface), sent out from the notch at the tip 20a, and inserted into the eye. The inner wall surfaces 20c (first inner wall surface 24a and second inner wall surface 24b) are formed on both sides in a direction perpendicular to the central axis Lt of the passage 20b and parallel to the radial direction of the optical section 110 when the intraocular lens 100 is placed in the passage 20b. The first inner wall surface 24a and the second inner wall surface 24b are formed in a shape (incline) symmetrical with respect to the central axis Lt of the passage 20b.

The ceiling surface 20d (see FIG. 7) and the bottom surface 20e (see FIG. 8) are formed on both sides in a direction perpendicular to the central axis Lt of the passage 20b and parallel to the central axis (optical axis) L of the optical part 110 when the intraocular lens 100 is placed in the passage 20b. The bottom surface 20e is curved concavely toward the outside of the passage 20b (the far side of the paper in FIG. 8). In other words, the bottom surface 20e is a surface facing the first rail 32, second rail 34, and deflection part 36 of the guide mechanism 30 described later, and is concave in the protruding direction of the guide mechanism 30.

As shown in Figures 7 and 8, the X-axis, Y-axis, and Z-axis are assumed to be mutually orthogonal, and the direction parallel to the extrusion direction of the intraocular lens 100 (the direction of the central axis Lt of the passage 20b and the passage 22a, the direction of the extrusion axis Lp) is defined as the X-axis direction. Then, the passage 20b is surrounded by two inner wall surfaces 20c (the first inner wall surface 24a and the second inner wall surface 24b) formed on both sides in the Y-axis direction, and a ceiling surface 20d (see Figure 7) and a bottom surface 20e (see Figure 8) formed on both sides in the Z-axis direction. The central axis Lt of the passage 20b coincides with the extrusion axis Lp.

As shown in Figs. 7 and 8, the mounting section 22 is formed at a position rearward of the insertion section 20 in the pushing direction of the plunger 12 (to the right in Figs. 7 and 8). The intraocular lens 100 before being pushed out by the plunger 12 is pre-filled (placed) in a passage 22a (rear passage) formed inside the mounting section 22 (see Fig. 8). The mounting section 22 includes a passage 22a, a ceiling surface 22b, a bottom surface 22c, etc.

The guide mechanism 30 (changing means) is formed on the ceiling surface 20d and the ceiling surface 22b side, and is a part that guides the extrusion direction of the plunger 12. The guide mechanism 30 includes a pair of rail parts extending parallel to the central axis Lt, such as a first rail 32 (first guide protrusion), a second rail 34 (second guide protrusion), and a deflection part 36 formed on the tip side of the first rail 32.

The first rail 32 and the second rail 34 are formed parallel to the central axis Lt (which is also the extrusion axis Lp in the extrusion direction of the plunger 12). The first rail 32 constitutes one side (upper side of FIG. 7) of the wall surface of the guide mechanism 30, and protrudes from the ceiling surface 20d (see FIG. 7) and the ceiling surface 22b (see FIG. 7) toward the bottom surface 20e (see FIG. 8) and the bottom surface 22c (see FIG. 8) (the front side of the paper in FIG. 7). The second rail 34 constitutes the other side (lower side of FIG. 7) of the wall surface of the guide mechanism 30, and protrudes from the ceiling surface 22b (see FIG. 7) toward the bottom surface 22c (see FIG. 8) (the front side of the paper in FIG. 7).

As shown in FIG. 7, in this embodiment, the first rail 32 is provided with a deflection section 36 (deflection mechanism). The deflection section 36 is formed at a position on the first rail 32 on the tip 20a side of the insertion section 20. The deflection section 36 protrudes from the ceiling surface 20d (see FIG. 7) side toward the bottom surface 20e (see FIG. 8) side within the passage 20b (see FIG. 7) of the insertion section 20. The deflection section 36 also protrudes from the ceiling surface 22b (see FIG. 7) side toward the bottom surface 22c (see FIG. 8) side within the passage 22a (see FIG. 7) of the placement section 22.

The deflection section 36 has a guide surface 36a formed so that the first rail 32 is inclined toward the second rail 34 side more than the rail surface 32b where the first rail 32 faces the second rail 34. The deflection section 36 is formed in an inclined shape (tapered shape) so that the guide surface 36a gradually inclines toward the tip 20a side of the insertion section 20. That is, the inclination amount of the guide surface 36a of the deflection section 36 gradually increases toward the tip 20a side of the insertion section 20. Note that the guide surface 36a becomes a surface that deflects and guides the plunger 12, as described later. The deflection section 36 may also be formed separately (separately) from the first rail 32. In this embodiment, as shown in FIG. 7, the front end 34a on the tip 20a side of the insertion section 20 in the second rail 34 is formed at a position rearward in the extrusion direction of the intraocular lens 100 than the front end 32a on the tip 20a side of the insertion section 20 in the first rail 32.

In this embodiment, the selection and attachment of the guide mechanism 30 is performed during the manufacturing process of the injector 1, and the injector 1 is shipped with the guide mechanism 30 selected in advance in consideration of the power of the intraocular lens 100 to be filled attached to the main body. For example, when the power of the intraocular lens 100 to be filled is 1D or more and 9D or less (referred to as the low power band), the guide mechanism 30A (see FIG. 9) is used, and when the power is more than 9D and 30D or less (referred to as the high power band), the guide mechanism 30B (see FIG. 10) is used. The manufacturing method of the injector 1 may be, for example, a first step of determining the power of the intraocular lens to be filled, a second step of selecting a guide mechanism corresponding to the power determined in the first step from among a plurality of guide mechanisms having different shapes, and a third step of assembling the injector 1 using the intraocular lens with the power determined in the first step and the guide mechanism selected in the second step. In the second step, a worker in the manufacturing process may select the guide mechanism by referring to a table showing the relationship between the combination of the power of the intraocular lens and the type of guide mechanism. Guide mechanism 30A and guide mechanism 30B have different shapes of deflection portion 36. When plunger 12, which moves forward along central axis Lt, comes into contact with deflection portion 36, its tip is deflected in a direction away from central axis Lt and moves forward. In this embodiment, guide mechanism 30A and guide mechanism 30B have different amounts of deflection (i.e., the angle at which guide surface 36a is inclined relative to central axis Lt). In other words, the amount of deflection is greater in guide mechanism 30B than in guide mechanism 30A.

As shown in Fig. 8, the bottom surface 22c of the passage 22a formed inside the mounting portion 22 is provided with a convex portion 22f that suppresses the inclination of the optical portion 110 when the intraocular lens 100 is pushed toward the tip 20a of the insertion portion 20 by the plunger 12 and moves. The convex portion 22f is disposed in a position facing the outer peripheral portion 110a, which is the edge of the optical portion 110 of the intraocular lens 100, at the following location. The convex portion 22f is disposed on the forward (tip 20a of the insertion portion 20) side (leftward in Fig. 8) of the optical axis L of the optical portion 110 of the intraocular lens 100, and on the side where the front support portion 112A of the intraocular lens 100 is not disposed as viewed from the central axis Lt (which is also the extrusion axis Lp in the extrusion direction of the plunger 12) (lower side of the central axis Lt in Fig. 8). The convex portion 22f protrudes from the bottom surface 22c toward the ceiling surface 22b in an arched shape and is close to the outer peripheral portion 110a of the optical portion 110 on the side of the posterior optical surface 110b. The convex portion 22f is tapered in the protruding direction and has a rounded filleted tip. This convex portion 22f can suppress the inclination of the optical portion 110 when the intraocular lens 100 is pushed out by the plunger 12, and can suppress the occurrence of a so-called "back tacking state" in which the front support portion 112A of the intraocular lens 100 is unintentionally tacked toward the posterior optical surface 110b.

Note that the names "ceiling surface 20d", "bottom surface 20e", "ceiling surface 22b", "bottom surface 22c", etc. are for convenience and do not strictly define the up-down direction of the injector 1. For example, the bottom surface 20e is not always located below the intraocular lens 100. In other words, the up-down direction of the injector 1 can change during transportation, when the injector 1 is filled with a viscoelastic substance, when the intraocular lens 100 is inserted into the eye, etc.

The method of using the injector 1 (intraocular lens insertion device) of this embodiment will be described. In explaining the method of use, the injector 1 will be described as being filled with a low-power intraocular lens 100 and equipped with a guide mechanism 30A. When the user pushes the pusher portion formed at the base end of the plunger 12 to move the entire plunger 12 forward, the intraocular lens 100 with the rear support portion 112B tacked thereto is pushed out along the central axis Lt (which is also the push-out axis Lp in the pushing direction of the plunger 12).

As shown in FIG. 11, when the plunger 12 is further pushed out, the front support portion 112A also tacks onto the front optical surface 110c of the optical portion 110, and then the entire optical portion 110 is deformed into a roll shape and the intraocular lens 100 is ejected from the insertion port.

Figure 12 shows the deformed state of the optical section 110 when the guide mechanism 30A is used. As shown in Figure 12, when the front support section 112A is tacked onto the optical section 110, the tip 12a of the plunger 12 (see Figures 7 and 8) comes into contact with the guide surface 36a of the deflection section 36, and the tip 12a of the plunger 12 advances while moving away from the central axis Lt. As the tip 12a of the plunger 12 advances and moves away from the central axis Lt, a circumferential rotation is imparted to the optical section 110, and the tip of the front support section 112A becomes easier to reach near the center of the optical section 110 (see also JP 2016-190023 A).

Here, a comparative injector 1 will be described in which guide mechanism 30B is attached instead of guide mechanism 30A. FIG. 13 shows the deformation state of the optical section 110 when comparative guide mechanism 30B is used. In the comparative injector 1, the deflection amount by guide mechanism 30A is larger than that by guide mechanism 30A, so the deformation of the optical section 110 is likely to be large when pushing out the low-power intraocular lens 100. In other words, the lower the power of the intraocular lens 100, the thinner the optical section 110 becomes, and the stiffness of the optical section 110 tends to be low. Therefore, the further the tip 12a of the plunger 12 is moved from the central axis Lt, the more the optical section 110 is pushed at a location with low stiffness, and the more likely it is that unintended large deformation will occur in the optical section 110.

Here, the inventors conducted repeated experiments and discovered a correlation between the fact that low-power intraocular lenses 100 are prone to large unintended deformation, while the optical portion 110 is thin and therefore the front support portion 112A is easy to tuck. Based on this insight, the inventors arrived at a technical idea that allows the front support portion 112A to be suitably tucked even if the amount of deflection by the guide mechanism 30A is reduced for low-power intraocular lenses 100.

In other words, as shown in Fig. 14, even if the tip portion 118A of the forward support portion 112A of the high-power intraocular lens 100 is placed on the outer peripheral portion 110a, which is the edge of the optical portion 110, the center portion of the optical portion 110 is higher than the center portion of the low-power intraocular lens 100 (see Fig. 5), so the tip portion 118A of the forward support portion 112A is unlikely to move from the outer peripheral portion 110a, which is the edge, to the center portion (see Fig. 6). Therefore, since the tacking of the forward support portion 112A is likely to occur shallowly, the tacking property of the forward support portion 112A is improved by rotating the optical portion 110 in the circumferential direction. On the other hand, since the center of the optical portion 110 of the low-power intraocular lens 100 is not raised higher (see FIG. 5) than the center of the high-power intraocular lens 100 (see FIG. 6), when the tip portion 118A of the forward support portion 112A is placed on the outer peripheral portion 110a, which is the edge of the optical portion 110, the tip portion 118A is likely to move from the outer peripheral portion 110a to the center. Therefore, even if the circumferential rotation of the optical portion 110 is reduced, the tucking of the forward support portion 112A is unlikely to become shallow.

In this way, the injector 1 of this embodiment focuses on the relationship between the power and the thickness of the optical portion 110, and by changing the amount of deflection according to the power, the forward support portion 112A can be appropriately tucked from low power to high power. Note that this embodiment is just one example, and for example, the selectable types of guide mechanism 30 may be three types for the low power range, the medium power range, and the high power range, and the deflection angle may be selectable from three types.

Thus, according to the injector 1 (intraocular lens insertion device) according to the first embodiment of the present disclosure, the plunger 12 is provided with a guide mechanism 30 (changing means) that selectively changes the trajectory of the plunger 12 moving through the cylindrical interior of the insertion device body 10. The trajectory of the plunger 12 is determined according to the power of the intraocular lens 100 that is pre-loaded by the guide mechanism 30. Even if the intraocular lens 100 has a low power and a thin optical portion 110 with low rigidity, the trajectory of the plunger 12 is determined according to the lens rigidity, so that tacking failures and the like can be suppressed and the lens can be folded appropriately. Therefore, it is possible to provide an injector 1 (intraocular lens insertion device) that can appropriately insert the intraocular lens 100 into the patient's eye regardless of the power of the intraocular lens 100 to be inserted into the patient's eye.

In addition, by changing the deflection angle of the deflection unit 36 (deflection mechanism), the trajectory of the plunger 12 changes, so the amount of deflection can be set precisely. This makes it easy to set multiple types of deflection unit 36, such as for low power ranges, medium power ranges, and high power ranges.

In addition, the intraocular lens 100 is rotated in the circumferential direction at its optical portion 110, and the advancement angle is determined taking into account the lens rigidity according to the diopter, so that tacking problems can be suppressed and the lens can be folded appropriately.

In addition, since the optical section 110 of the low-power intraocular lens 100 tends to be thinner and less rigid, unintended deformation of the intraocular lens 100 can be suppressed by positioning the plunger 12 extrusion position closer to the extrusion axis. In addition, even with a low-power intraocular lens 100 with a thin optical section 110 and low rigidity, tacking failures and the like can be suppressed and the lens can be folded appropriately.

In addition, the convex portion 22f can suppress the inclination of the optical portion 110 when the intraocular lens 100 is pushed out by the plunger 12, and can suppress the occurrence of a so-called "reverse tacking state" in which the front support portion 112A of the intraocular lens 100 is unintentionally tacked.

Although the embodiments of the present disclosure have been described above, the intraocular lens insertion device of the present disclosure is not limited to the above embodiments and can be implemented in various other forms.

1. Injector (intraocular lens insertion device)
10 Insertion instrument body 12 Plunger 12a Tip 20 Insertion section 20a Tip 20b Passage 20c Inner wall surface 20d Ceiling surface 20e Bottom surface 24a First inner wall surface 24b Second inner wall surface 22 Placement section 22b Ceiling surface 22c Bottom surface 22f Convex portion 30 Guide mechanism (modification means)
30A Guide mechanism 30B Guide mechanism 32 First rail (first guide protrusion)
32a: front end portion 32b: rail surface 34: second rail (second guide protrusion)
34a Front end 36 Deflection part (deflection mechanism)
36a Guide surface 100 Intraocular lens 110 Optical part 110a Outer peripheral part 110b Posterior optical surface 110c Front optical surface 112A Anterior support part 112B Rear support part 114A Connection part 116A Root part 118A Tip part 114B Connection part 116B Root part 118B Tip part L Optical axis Lp Extrusion axis Lt central axis

Claims (5)

An intraocular lens insertion device in which one intraocular lens is preloaded from among a plurality of types of intraocular lenses whose optical portion only has a different thickness depending on the power,
A cylindrical insertion device body in which the intraocular lens is preloaded;
A plunger that pushes out the intraocular lens disposed inside the cylindrical portion of the insertion instrument body along a push-out axis;
a change means for changing a trajectory of the plunger moving through a cylindrical interior of the insertion instrument body, the change means being selected according to the plurality of types of intraocular lenses,
An intraocular lens insertion tool, the moving trajectory of which is determined by the changing means in accordance with the power of the intraocular lens pre-filled. 2. The intraocular lens insertion device according to claim 1,
The change means is
A deflection mechanism is disposed on an extrusion axis which is a direction in which the plunger advances inside the cylindrical interior of the insertion instrument body,
An intraocular lens insertion device in which the moving trajectory changes as the deflection angle by the deflection mechanism changes. The intraocular lens insertion device according to claim 1 or 2,
The change means is an intraocular lens insertion device that changes a lateral movement trajectory of the plunger perpendicular to the optical axis of the intraocular lens. The intraocular lens insertion device according to any one of claims 1 to 3,
The intraocular lens has a radius of curvature of an optical surface that varies depending on the power, and the radius of curvature is larger for low power than for high power,
The change means is an intraocular lens insertion device in which the pushing position of the plunger is closer to the pushing axis when the power of the intraocular lens is lower than that of the high power. The intraocular lens insertion device according to any one of claims 1 to 4,
The intraocular lens includes a pair of front support portions and a rear support portion extending radially outward from an outer circumferential portion of the optical portion,
The insertion instrument body is provided with a convex portion that suppresses the inclination of the optical portion when the pre-loaded intraocular lens is pushed out by the plunger,
the convex portion is disposed on a side of the optical axis of the optical portion, which is located forward of the optical axis of the optical portion and on a side where the front support portion is not disposed as viewed from the extrusion shaft, among positions facing an outer circumferential portion of the optical portion,
The convex portion protrudes in an arched shape from a bottom surface of the insertion device body toward a ceiling surface and is close to an outer circumferential portion of the optical portion on the side of the posterior optical surface.

Images