JP4644438B2

JP4644438B2 - Brim lacrimal stent

Info

Publication number: JP4644438B2
Application number: JP2004141322A
Authority: JP
Inventors: 克昭栗橋
Original assignee: 有限会社エム・エル・シー
Priority date: 2004-05-11
Filing date: 2004-05-11
Publication date: 2011-03-02
Anticipated expiration: 2024-05-11
Also published as: JP2005319190A

Description

この発明は涙道閉塞やドライアイの治療に適した涙道ステントに関する。 The present invention relates to a lacrimal stent suitable for treatment of lacrimal passage obstruction and dry eye.

本発明者は涙道閉塞やドライアイの治療のために操作が簡単で患者に与える苦痛が少なく、しかも正確に素早く涙道内に挿入でき、従来のものに比較し効果的で、抜けにくく、装用感のよい涙道ステントを長年に渡り鋭意研究を続け、図２に示される細い部分（４０）とその両側につけられた太い部分（４２）からなるヌンチャク型シリコーンチューブ（以下ＮＳＴとする）や図３〜６に示されるブリムＮＳＴ、糸付き涙点プラグなどを発明した。図３に示されるようにブリムＮＳＴはＮＳＴを半切しツバ（２３）をつけた形をとっている。太いチューブ（４２）につけられた小さな切れ目（４９）よりプローブ（６１）を挿入し、涙点（１、２）から涙道内にＮＳＴやブリムＮＳＴを押し込む。涙点プラグはドライアイの診療に用いられるが、ブリムＮＳＴも涙点プラグの代わりとして有用である。図５〜６は従来のブリムＮＳＴの涙道内における留置された状態を示している。ＮＳＴやブリムＮＳＴはすでにカネカメディックス社で製造販売されて多くの医師により使用されている。例えば、米国特許Ｎｏ.ＵＳ６，３８３，１９２Ｂ１、米国特許Ｎｏ.ＵＳ６，２３８，３６３Ｂ１、米国特許Ｎｏ.ＵＳ５，４３７，６２５、栗橋克昭著「ダクリオロジー―臨床涙液学―」メディカル葵出版１９９８年、栗橋克昭「涙道手術とドライアイ（ビデオ）」製作：インターメディカ企画：日本眼科医会、協賛：万有製薬株式会社、２００３、特願２００３−１５４３２８参照。 The present inventor is easy to operate for treatment of lacrimal passage obstruction and dry eye, has little pain to the patient, and can be inserted into the lacrimal passage accurately and quickly, and is more effective and less difficult to remove than conventional ones. We have been studying a good lacrimal stent for many years. Nunchaku-type silicone tube (hereinafter referred to as NST) consisting of a thin part (40) and a thick part (42) attached to both sides shown in FIG. Invented brim NST, punctal plug with thread, etc. shown in 3-6. As shown in FIG. 3, the brim NST has a shape in which NST is cut in half and attached with a brim (23). The probe (61) is inserted through the small cut (49) formed in the thick tube (42), and NST or brim NST is pushed into the lacrimal passage from the punctum (1, 2). The punctal plug is used for dry eye treatment, but Brim NST is also useful as an alternative to the punctal plug. 5 to 6 show a state where the conventional brim NST is placed in the lacrimal passage. NST and Brim NST are already manufactured and sold by Kaneka Medix and used by many doctors. For example, US Patent No. US6,383,192B1, US Patent No.US6,238,363B1, US Patent No.US5,437,625, Katsuaki Kurihashi, "Dacriology-Clinical Teatology-" Medical Saga Publishing 1998, Kuriaki Kurihashi “Lacrimal Surgery and Dry Eye (Video)” Production: Intermedica Planning: Japan Ophthalmologists Association, Sponsor: Banyu Pharmaceutical Co., Ltd., 2003, Japanese Patent Application 2003-154328.

図１に示すように、涙液は涙腺（１４）から分泌され、角膜（１５）や結膜（１６）が存在する眼球表面（１７）を潤した後に、涙道を通って下鼻道（１８）に排出される。涙道は、上涙点（１）、下涙点（２）、上涙小管垂直部（３）、下涙小管垂直部（４）、上涙小管垂直部と水平部の境界部（５）、下涙小管垂直部と水平部の境界部（６）、上涙小管水平部（７）、下涙小管水平部（８）、総涙小管（９）、内総涙点（１０）、涙嚢（１１）、鼻涙管（１２）からなる。鼻涙管（１２）の下端（１３）は下鼻道（１８）に開いている。涙点から計測した涙小管の長さは約１０ｍｍである。涙点と涙小管垂直部の合計の長さは平均２．４ｍｍで涙小管水平部と総涙小管の合計の長さは平均７．６ｍｍである。例えば栗橋克昭著：ダクリオロジー―臨床涙液学―．メディカル葵出版，東京，1998．参照。
特開２０００−７０２９６号公報米国特許Ｎｏ．ＵＳ６，３８３，１９２Ｂ１米国特許Ｎｏ.ＵＳ６，２３８，３６３Ｂ１米国特許Ｎｏ.ＵＳ５，４３７，６２５特願２００３−１５４３２８特願２００３−１９８７７９特表２００２−５２９１４４特願２００３−２９５６６４特願２００３−３１１８８６特開平１０−３３５８４特願平１１−１２２９２７栗橋克昭著「ダクリオロジー―臨床涙液学―」メディカル葵出版１９９８年 Carter KD et al: Size variation of the lacrimal punctum in adults.Ophthalmic Plast Reconstr Surg 4: 231, 1988 鈴木志賀子「眼疾患に対する細隙灯検査法の研究、第２段，涙点に関する研究」臨床眼科１０：１１４１９５６年 Fayet B，et al:Canalicular stenoses complicating the insertion oflacrimal plugs．Incidence and mechanisms．J Fr Ophthalmol 15:25-33，1992 栗橋克昭「涙道手術とドライアイ（ビデオ）」製作：インターメディカ企画：日本眼科医会協賛：万有製薬株式会社２００３栗橋克昭「目と健康シリーズＮｏ．２２―特集：涙道や涙腺の病気―」監修：堀貞夫企画・製作：株式会社創新社 As shown in FIG. 1, lacrimal fluid is secreted from the lacrimal gland (14), moisturizes the surface of the eyeball (17) where the cornea (15) and conjunctiva (16) are present, and then passes through the lacrimal passage (18). ). The lacrimal passage consists of the upper punctum (1), the lower punctum (2), the upper lacrimal tubule vertical part (3), the lower lacrimal tubule vertical part (4), and the boundary between the upper lacrimal tubule vertical part and the horizontal part (5) , The border between the vertical part and the horizontal part of the lower lacrimal canal (6), the horizontal part of the upper lacrimal duct (7), the horizontal part of the lower lacrimal duct (8), the total lacrimal duct (9), the inner total punctum (10), the tears It consists of a sac (11) and a nasolacrimal duct (12). The lower end (13) of the nasolacrimal duct (12) is open to the lower nasal passage (18). The length of the canalicular tubule measured from the punctum is about 10 mm. The total length of the punctum and the vertical portion of the lacrimal canal is 2.4 mm on average, and the total length of the horizontal portion of the lacrimal canal and the total lacrimal tube is 7.6 mm on average. For example, Katsuaki Kurihashi: Dacology-Clinical tears-. Medical Samurai Publishing, Tokyo, 1998. reference.
JP 2000-70296 A U.S. Pat. US 6,383,192B1 US Patent No. US 6,238,363 B1 US Patent No. US5,437,625 Japanese Patent Application No. 2003-154328 Japanese Patent Application No. 2003-198779 Special Table 2002-529144 Japanese Patent Application No. 2003-295664 Japanese Patent Application No. 2003-311886 JP 10-33584 A Japanese Patent Application No.11-122927 Kuriaki Kuriaki, “Dacriology-Clinical Lacrimation-” Medical Tatsu Publishing 1998 Carter KD et al: Size variation of the lacrimal punctum in adults. Ophthalmic Plast Reconstr Surg 4: 231, 1988 Shikako Suzuki “Study on slit lamp test for eye disease, 2nd stage, Study on punctum” Clinical Ophthalmology 10: 114 1956 Fayet B, et al: Canalicular stenoses complicating the insertion of lacrimal plugs. Incidence and mechanisms. J Fr Ophthalmol 15: 25-33, 1992 Katsuaki Kurihashi “Lacrimal Surgery and Dry Eye (Video)” Production: Intermedica Planning: Japan Ophthalmologists Association Sponsor: Banyu Pharmaceutical Co., Ltd. 2003 Katsuaki Kurihashi “Eye and Health Series No. 22—Special Feature: Diseases of the Lacrimal Path and Lacrimal Gland” Supervision: Sadao Hori Planning and Production: Soshinsha Co., Ltd.

図４〜６に示される従来のブリムＮＳＴにおいては細いロッド（４０）は全長にわたり同じ太さと硬さを有し柔軟性に欠けるため、涙小管垂直部と涙小管水平部の間の屈曲部に一致して細いロッド（４０）が十分に曲がらない。そのため、図５〜６に示されるように涙点開口部に対してツバ（２３）が斜めになる。そのためツバ（２３）の縁が涙点の耳側の組織の中に入り、肉芽が発生することがある。 In the conventional brim NST shown in FIGS. 4 to 6, the thin rod (40) has the same thickness and hardness over its entire length and lacks flexibility, and therefore, at the bent portion between the lacrimal tubule vertical portion and the lacrimal tubule horizontal portion. The thin rod (40) that coincides does not bend sufficiently. Therefore, as shown in FIGS. 5 to 6, the collar (23) is inclined with respect to the punctal opening. Therefore, the edge of the brim (23) may enter into the tissue on the ear side of the punctum, and granulation may occur.

本発明の解決手段は、図７〜２１に示されるように細い部分（４０）すなわち細いロッド（又はチューブ）（４０）が涙小管垂直部と水平部の間の屈曲部に一致して十分に曲がるように細い部分（４０）の一部を柔らかくする目的で細いロッド（又はチューブ）の間に薄肉のチューブ部分（２８）を設けることである。 As shown in FIGS. 7 to 21, the solution of the present invention has a thin portion (40), that is, a thin rod (or tube) (40), which is sufficiently aligned with the bend between the vertical portion of the lacrimal canal and the horizontal portion. The thin tube portion (28) is provided between the thin rods (or tubes) for the purpose of softening a part of the thin portion (40) to bend.

図７〜２１に示されるようにツバ（２３）の近くの細いロッド（又はチューブ）（４０）を薄肉のチューブにすることにより柔軟になり図１６〜１８に示されるように涙小管垂直部（３、４）と水平部（７、８）の間の屈曲部に一致して細いロッド（又はチューブ）（４０）が十分に曲がるようになる。その結果、ツバ（２３）が涙点の開口部に対して斜めにならなくなる。 The thin rod (or tube) (40) near the brim (23) as shown in FIGS. 7-21 becomes flexible by making it a thin-walled tube, and as shown in FIGS. 3, 4) and the thin rod (or tube) (40) bend sufficiently to coincide with the bent portion between the horizontal portions (7, 8). As a result, the collar (23) does not become oblique with respect to the opening of the punctum.

本発明の実施形態においては細いロッド（又はチューブ）（４０）の一端に太いチューブ（４２）が連結し、他端にツバ（２３）がついている。図７〜２１に示されるように細い部分（４０）すなわち細いロッド（又はチューブ）（４０）が涙小管垂直部（３、４）と水平部（７、８）の間の屈曲部に一致して十分に曲がるようにツバ（２３）から０．８〜１．２ｍｍ離れた部分から１．５〜３．０ｍｍにわたり薄肉のチューブが細い部分（４０）の間に設けられている。本発明の涙道内の安定性を保つために、細い部分（４０）が部分的に一層しなやかで涙小管の長さより長いこと、太い部分（４２）が重いことが重要である。すなわち涙点から挿入されたしなやかな細い部分（４０）が涙小管の中の屈曲部を通過し涙嚢（１１）に出て、それに結合している重い太い部分（４２）により重力で下方に引っ張られることにより本発明が安定性を保っているのである。 In the embodiment of the present invention, a thick tube (42) is connected to one end of a thin rod (or tube) (40), and a brim (23) is attached to the other end. As shown in FIGS. 7-21, the thin part (40), that is, the thin rod (or tube) (40) coincides with the bent part between the lacrimal canal vertical part (3, 4) and the horizontal part (7, 8). A thin tube is provided between the thin part (40) from 1.5 to 3.0 mm from a part 0.8 to 1.2 mm away from the collar (23) so that it can be bent sufficiently. In order to maintain the stability in the lacrimal passage of the present invention, it is important that the thin portion (40) is partially more supple and longer than the length of the lacrimal canal, and the thick portion (42) is heavy. That is, the supple thin part (40) inserted from the punctum passes through the bent part in the lacrimal tubule and exits to the lacrimal sac (11), and is lowered downward by gravity by the heavy thick part (42) connected thereto. The present invention maintains stability by being pulled.

図１９は本発明の寸法を説明するための図である。 FIG. 19 is a diagram for explaining the dimensions of the present invention.

ツバ（２３）は円形でも楕円形でもよい。ツバ（２３）が円形のときはツバ（２３）の直径（ａ）は０．５〜３．５ｍｍ、望ましくは０．８〜３．０ｍｍ、最適には１．８〜２．５ｍｍである。図７〜２１に示されるようにツバ（２３）は中央に行くほど厚くなっているが、ツバ（２３）の中央の厚さ（ｂ）は０．２〜０．８ｍｍ、望ましくは０．３〜０．７ｍｍ、最適には０．３５〜０．４５ｍｍである。ツバ（２３）から薄肉のチューブの上端までの長さ（ｃ）は０．２〜１．８ｍｍ、望ましくは０．５〜１．５ｍｍ、最適には０．７〜１．２ｍｍである。薄肉のチューブ（２８）の長さ（ｄ）は１．０〜４．０ｍｍ、望ましくは１．５〜３．０ｍｍ、最適には１．８〜２．５ｍｍである。薄肉のチューブ（２８）の壁の肉厚（ｅ）は０．０１〜０．３０ｍｍ、望ましくは０．０５〜０．２５ｍｍ、最適には０．１５〜０．２０ｍｍである。薄肉のチューブ（２８）の腔の直径（ｆ）は０．１〜０．５ｍｍ、望ましくは０．２〜０．４ｍｍ、最適には０．２５〜０．３５ｍｍである。薄肉のチューブ（２８）の直径は細い部分（４０）の直径と同じである。細い部分（４０）の直径（ｇ）は０．２〜０．９ｍｍ、望ましくは０．４〜０．７ｍｍ、最適には０．５〜０．６ｍｍである。太い部分（４２）すなわち太いチューブ（４２）の直径（ｈ）は０．７〜１．５ｍｍ、望ましくは０．８〜１．２ｍｍ、最適には０．９〜１．１ｍｍである。図７、図１０、図１３、図１９〜２１に示されるブリムＮＳＴにおいては太いチューブ（４２）の壁の肉厚は全長にわたり同じであるが、太いチューブ（４２）の壁の肉厚（ｉ）は０．０５〜０．６ｍｍ、望ましくは０．１〜０．３ｍｍ、最適には０．１５〜０．２５ｍｍである。そして太いチューブ（４２）の腔の直径（ｊ）は０．１〜１．０ｍｍ、望ましくは０．３〜０．８ｍｍ、最適には０．４〜０．６ｍｍである。細い部分（４０）と太い部分（４２）の間のスロープ（ｋ）は０．５〜４．０ｍｍ、望ましくは１．０〜３．０ｍｍ、最適には１．５〜２．５ｍｍである。太い部分（４２）の長さ（ｌ）は１０〜６０ｍｍ、望ましくは２０〜５０ｍｍ、最適には３０〜４５ｍｍである。細い部分（４０）の長さ（ｍ）は１０〜２０ｍｍ、望ましくは１２〜１８ｍｍ、最適には１４〜１５ｍｍである。太い部分（４２）の腔（２５）の間の最短距離（ｎ）は０．３〜３．０ｍｍ、望ましくは０．５〜２．０ｍｍ、最適には０．８〜１．５ｍｍである。 The collar (23) may be circular or elliptical. When the collar (23) is circular, the diameter (a) of the collar (23) is 0.5 to 3.5 mm, desirably 0.8 to 3.0 mm, and optimally 1.8 to 2.5 mm. As shown in FIGS. 7 to 21, the collar (23) is thicker toward the center, but the thickness (b) of the center of the collar (23) is 0.2 to 0.8 mm, preferably 0.3. -0.7 mm, optimally 0.35-0.45 mm. The length (c) from the brim (23) to the upper end of the thin tube is 0.2 to 1.8 mm, preferably 0.5 to 1.5 mm, and most preferably 0.7 to 1.2 mm. The length (d) of the thin-walled tube (28) is 1.0 to 4.0 mm, desirably 1.5 to 3.0 mm, and optimally 1.8 to 2.5 mm. The wall thickness (e) of the thin tube (28) is 0.01 to 0.30 mm, preferably 0.05 to 0.25 mm, and most preferably 0.15 to 0.20 mm. The diameter (f) of the cavity of the thin-walled tube (28) is 0.1 to 0.5 mm, desirably 0.2 to 0.4 mm, and optimally 0.25 to 0.35 mm. The diameter of the thin tube (28) is the same as the diameter of the thin part (40). The diameter (g) of the thin part (40) is 0.2 to 0.9 mm, desirably 0.4 to 0.7 mm, and optimally 0.5 to 0.6 mm. The diameter (h) of the thick portion (42), that is, the thick tube (42) is 0.7 to 1.5 mm, desirably 0.8 to 1.2 mm, and optimally 0.9 to 1.1 mm. In the brim NST shown in FIGS. 7, 10, 13, and 19 to 21, the wall thickness of the thick tube (42) is the same over the entire length, but the wall thickness (i ) Is 0.05 to 0.6 mm, preferably 0.1 to 0.3 mm, and most preferably 0.15 to 0.25 mm. The diameter (j) of the cavity of the thick tube (42) is 0.1 to 1.0 mm, desirably 0.3 to 0.8 mm, and optimally 0.4 to 0.6 mm. The slope (k) between the thin portion (40) and the thick portion (42) is 0.5 to 4.0 mm, preferably 1.0 to 3.0 mm, and most preferably 1.5 to 2.5 mm. The length (l) of the thick part (42) is 10 to 60 mm, desirably 20 to 50 mm, and optimally 30 to 45 mm. The length (m) of the thin part (40) is 10-20 mm, desirably 12-18 mm, optimally 14-15 mm. The shortest distance (n) between the cavities (25) of the thick part (42) is 0.3-3.0 mm, preferably 0.5-2.0 mm, optimally 0.8-1.5 mm.

図２０は細い部分（４０）がロッドのときロッドの間に腔（２７）を有する薄肉のチューブ部分（２８）を介在させたときの代表的な例である。図７〜９、図１６、図２０に示されるように細いロッド（４２）の間に薄肉のチューブを配置してその部分を柔軟にする。図２０に示されるように薄肉のチューブ部分（２８）はツバ（２３）から１ｍｍ離れた点から始まり長さは２ｍｍで、その腔の直径は０．３ｍｍである。また細いロッド（４２）の直径は０．６ｍｍで腔のある部分の壁の肉厚（ｅ）は０．１５ｍｍである。 FIG. 20 is a typical example when a thin tube portion (28) having a cavity (27) is interposed between rods when the thin portion (40) is a rod. As shown in FIGS. 7 to 9, 16, and 20, a thin tube is disposed between the thin rods (42) to make the portion flexible. As shown in FIG. 20, the thin tube portion (28) starts at a point 1 mm away from the brim (23), has a length of 2 mm, and has a cavity diameter of 0.3 mm. The thin rod (42) has a diameter of 0.6 mm, and the wall thickness (e) of the cavity portion is 0.15 mm.

図２１は、細い部分（４０）がチューブのときの代表的な一例である。図１７、図１８、図２１に示されるように細い部分がチューブのときはその一部を柔らかくするために壁の肉厚をさらに小さくした薄肉のチューブ部分（２８）を細いチューブ（４０）の間に介在させてある。さらに、図１３〜１５、図２１に示されるように、洗浄できるようにツバ（２３）の中央に孔を設け、太い部分（４２）の先端にも孔を設け、ツバ（２３）の中央の孔から洗浄液を注入して先端の孔から洗浄水が出るように全長にわたり腔を設けてある。 FIG. 21 is a typical example when the thin portion (40) is a tube. When the thin portion is a tube as shown in FIGS. 17, 18 and 21, the thin tube portion (28) whose wall thickness is further reduced to soften a portion of the thin portion is a tube (40). It is interposed between them. Furthermore, as shown in FIGS. 13 to 15 and FIG. 21, a hole is provided in the center of the collar (23) so that it can be washed, a hole is also provided in the tip of the thick part (42), and the center of the collar (23) is provided. A cavity is provided over the entire length so that the cleaning liquid is injected from the hole and the cleaning water comes out from the hole at the tip.

図８、図１１、図１４に示されるように太いチューブ（４２）の腔（２５）に段（ｓ）を配置すると、プローブ（６１）でチューブを涙道内に押し込むのが容易となる（米国特許Ｎｏ．ＵＳ６，３８３，１９２Ｂ１、特願平１１−１２２９２７参照）。また、図９、図１２、図１５に示されるように太いチューブ（４２）の腔の形を先端に行くほど小さくなった円錐台形にしてもチューブを涙道内に押し込むのが容易となる（米国特許Ｎｏ．ＵＳ６，３８３，１９２Ｂ１、特願平１１−１２２９２７参照）。 When the step (s) is placed in the cavity (25) of the thick tube (42) as shown in FIGS. 8, 11, and 14, it is easy to push the tube into the lacrimal passage with the probe (61) (US) Patent No. US 6,383,192B1, Japanese Patent Application No. 11-122927). In addition, as shown in FIGS. 9, 12, and 15, even if the shape of the cavity of the thick tube (42) becomes a truncated cone shape that becomes smaller toward the tip, the tube can be easily pushed into the lacrimal passage (US). Patent No. US 6,383,192B1, Japanese Patent Application No. 11-122927).

ツバ近くの細い部分（４０）の一部を薄肉のチューブにすることにより涙道内の安定性が良くなり涙点の開口部を十分に塞ぐことができるので、涙道閉塞のための涙道ステントとしてだけでなくドライアイの治療用具として役立つ。 By making a thin tube (40) near the brim into a thin tube, the lacrimal passage becomes more stable and can sufficiently close the opening of the punctum. As well as serving as a dry eye treatment tool.

涙道を示す概略図Schematic showing the lacrimal passage 従来のヌンチャク型シリコーンチューブ（ＮＳＴ）を示す概略図Schematic showing a conventional nunchaku type silicone tube (NST) 従来のブリムＮＳＴを示す概略図Schematic showing a conventional brim NST 従来のブリムＮＳＴを示す中央断面図Central sectional view showing a conventional brim NST 従来のブリムＮＳＴの実施法を説明するための概略図Schematic for explaining the implementation method of the conventional brim NST 従来のブリムＮＳＴを実施したときの問題点を示す概略図Schematic showing the problems when implementing the conventional brim NST 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention 本発明の一例を示す中央断面図Central sectional view showing an example of the present invention （Ａ）は本発明の一例の一方の端部を示す端面図、（Ｂ）は本発明の一例を示す中央断面図、（Ｃ）は本発明の一例の一方の端部を示す端面図 (A) is an end view showing one end of an example of the present invention, (B) is a central sectional view showing an example of the present invention , and (C) is an end view showing one end of an example of the present invention. （Ａ）は本発明の一例の一方の端部を示す端面図、（Ｂ）は本発明の一例を示す中央断面図、（Ｃ）は本発明の一例の一方の端部を示す端面図 (A) is an end view showing one end of an example of the present invention, (B) is a central sectional view showing an example of the present invention , and (C) is an end view showing one end of an example of the present invention. （Ａ）は本発明の一例の一方の端部を示す端面図、（Ｂ）は本発明の一例を示す中央断面図、（Ｃ）は本発明の一例の一方の端部を示す端面図 (A) is an end view showing one end of an example of the present invention, (B) is a central sectional view showing an example of the present invention , and (C) is an end view showing one end of an example of the present invention. 本発明の一例を実施したときの利点を示す概略図Schematic showing the advantages of implementing an example of the invention 本発明の一例を実施したときの利点を示す概略図Schematic showing the advantages of implementing an example of the invention 本発明の一例を実施したときの利点を示す概略図Schematic showing the advantages of implementing an example of the invention 本発明の一例の寸法を示す中央断面図Central sectional view showing dimensions of an example of the present invention 本発明の代表的な一例の寸法を示す中央断面図Central sectional view showing dimensions of a typical example of the present invention 本発明の代表的な一例の寸法を示す中央断面図Central sectional view showing dimensions of a typical example of the present invention

Explanation of symbols

１上涙点
２下涙点
３上涙小管垂直部
４下涙小管垂直部
５上涙小管垂直部と水平部の境界部
６下涙小管垂直部と水平部の境界部
７上涙小管水平部
８下涙小管水平部
９総涙小管
１０内総涙点
１１涙嚢
１２鼻涙管
１３鼻涙管の下端
１４涙腺
１５角膜
１６結膜
１７眼球表面
１８下鼻道
２３ツバ
２５太い部分（４２）の腔
２７薄肉のチューブ部分（２８）の腔
２８薄肉のチューブ、薄肉のチューブ部分
４０細いロッド（またはチューブ）、細い部分
４２太いチューブ、太い部分
４９小さな切れ目
６１プローブ
ａツバ（２３）の直径
ｂツバ（２３）の中央の厚さ
ｃツバ（２３）から薄肉のチューブ（２８）の上端までの長さ
ｄ薄肉のチューブ（２８）の長さ
ｅ薄肉のチューブ（２８）の壁の肉厚
ｆ薄肉のチューブ（２８）の腔（２７）の直径
ｇ細い部分（４０）の直径
ｈ太いチューブ（４２）の直径
ｉ太いチューブ（４２）の壁の肉厚
ｊ太いチューブ（４２）の腔（２５）の直径
ｋ細い部分（４０）と太い部分（４２）の間のスロープ
ｌ太い部分（４２）の長さ
ｍ細い部分（４０）の長さ
ｎ太い部分（４２）の先端と腔（２５）の間の最短距離
ｓ太いチューブ（４２）の腔（２５）につけられた段 DESCRIPTION OF SYMBOLS 1 Upper punctum 2 Lower punctum 3 Upper lacrimal tubule vertical part 4 Lower lacrimal tubule vertical part 5 Upper lacrimal tubule vertical part and horizontal part boundary 6 Lower lacrimal tubule vertical part and horizontal part boundary 7 Upper lacrimal tubule horizontal part 8 Lacrimal canal horizontal part 9 Total lacrimal duct 10 Inner total punctum 11 Lacrimal sac 12 Nasal lacrimal duct 13 Lower end of nasolacrimal duct 14 Lacrimal gland 15 Cornea 16 Conjunctiva 17 Eyeball surface 18 Lower nasal passage 23 Head 25 Thick part (42) Cavity 27 Cavity of thin tube portion (28) 28 Thin tube, thin tube portion 40 Thin rod (or tube), thin portion 42 Thick tube, thick portion 49 Small cut 61 Probe a Diameter of brim (23) b (23) Center thickness c Length from brim (23) to upper end of thin tube (28) d Length of thin tube (28) e Wall thickness of thin tube (28) f Thin wall The Chu The diameter of the cavity (27) of the tube (28) g The diameter of the thin part (40) h The diameter of the thick tube (42) i The wall thickness of the thick tube (42) j The thickness of the cavity (25) of the thick tube (42) Diameter k Slope between thin part (40) and thick part (42) l Length of thick part (42) m Length of thin part (40) n Between tip of thick part (42) and cavity (25) The shortest distance s of the step attached to the cavity (25) of the thick tube (42)

Claims

In a lacrimal stent having a thick tube (42) connected to one end of the thin portion (40) and a collar (23) on the other end of the thin portion (40), the lacrimal duct vertical portion (3, 4) a horizontal section (as thin portions corresponding to the bent portion between 7,8) (40) bends sufficiently, have cavities (27) into the narrow part of the solid (40) is formed A lacrimal stent characterized in that the cavity (27) is in the form of a thin tube (28).

The length (c) from the brim (23) to the upper end of the thin tube (28) is 0.5 to 1.5 mm, and the length (d) of the thin tube (28) is 1.5 to 3.0 mm. The wall thickness (e) of the thin tube (28) is 0.05 to 0.25 mm, and the diameter of the thin tube (28) is the same as the diameter (g) of the thin portion (40). The lacrimal stent according to claim 1.

In a lacrimal stent having a thick tube (42) connected to one end of the thin portion (40) and a collar (23) on the other end of the thin portion (40), the lacrimal duct vertical portion (3, 4) and a cavity (27) is formed in the thin portion (40) so that the thin portion (40) is sufficiently bent corresponding to the bent portion between the horizontal portion (7, 8), The cavity (27) is in the form of a thin tube (28), and there is a hole in the middle of the collar (23), and there is a hole at the tip of the thick tube (42). A lacrimal stent , characterized in that the cavity penetrates the entire length of the lacrimal stent so that the lavage fluid injected from the middle hole can exit the hole at the tip of the thick tube (42).