JP7547719B2 - 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 surgical methods for cataract surgery is to insert a foldable soft intraocular lens into the eye in place of the extracted 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.

In some cases, the intraocular lens insertion device folds the intraocular lens in a state where the support part of the intraocular lens is deformed and positioned on the optical part (so-called "tacking" is performed). By performing tacking, the possibility of damage to the support part is reduced. For example, in the intraocular lens insertion device described in Patent Document 1, the surgeon pushes out the pushing member, and the rear support part of the intraocular lens is folded inward of the outer periphery of the optical part by the pushing member. When the pushing member is further pushed out and the intraocular lens moves toward the tip side of the nozzle, the front support part of the intraocular lens comes into contact with the inner wall surface of the nozzle, and the front support part is also folded inward of the outer periphery of the optical part. When the intraocular lens is further pushed out toward the tip side, the optical part is folded with the front support part and the rear support part placed on the ceiling surface side of the optical part. The intraocular lens is then inserted into the eye through a passage in the nozzle.

JP 2016-190023 A

If the support is not folded into the correct position on the optical part during the folding process, various problems may occur.

For example, the position of the support part in the folded state relative to the upper surface (surface facing the ceiling) of the optical part may end up being higher than the appropriate position. In this case, the upper space in the nozzle passage is narrowed by the support part being higher than the appropriate position. The edges of the optical part, etc., slide against the inner wall of the nozzle while being folded towards the ceiling. Therefore, if the space on the ceiling side inside the nozzle is narrow, the edges of the optical part, etc., sliding against the inner wall of the nozzle, are likely to get into the gap between the inner wall on the ceiling side of the nozzle and the extrusion member.

Furthermore, if the support is located above the appropriate position, it may become pinched between the two edges of the optical section as it is folded toward the ceiling. Also, the support may not be positioned properly inside the optical section as it is folded into a roll. In these cases, problems such as damage to the support are likely to occur. Furthermore, if the optical section is folded while the support is located above the appropriate position, the amount by which the optical section is bent may be inappropriate. If the optical section is not bent an appropriate amount, the load on the nozzle when pushing the intraocular lens forward inside the nozzle and the load required for pushing may increase.

A typical object of the present disclosure is to provide an intraocular lens insertion instrument capable of properly inserting an intraocular lens into the eye.

An intraocular lens insertion device provided by a typical embodiment of the present disclosure is an intraocular lens insertion device that inserts a deformable intraocular lens having a disk-shaped optical portion and one or more support portions extending outward from the optical portion into the eye from an insertion opening at a front end through an internal passage, the passage area narrowing toward the front, the device comprising: a nozzle having the insertion opening at a front end, and a rod-shaped pushing member that pushes the intraocular lens forward by moving forward within the passage along the axis of the passage, the pushing member pushing the intraocular lens forward within the passage of the nozzle, folding the optical portion into a roll shape with the support portions folded onto the optical portion, and positioning the support portions inside the folded optical portion. Both of the left and right side surfaces of the extrusion member are defined as a first side surface on which the base end of a rear support part, which is the support part extending rearward from the optical part, is located. The extrusion member is equipped with an upper rib protruding laterally from an upper part of the first side surface, and a pressing part which is an inclined surface formed on a downward-facing surface of the upper rib and inclined downward as it approaches the rear. When the extrusion member is pushed forward with the rear support part bent onto the optical part, the pressing part brings the rear support part into direct contact with the optical part and presses it downward, i.e., toward the optical part , thereby moving the intraocular lens forward within the passage of the nozzle, and folding the optical part so as to encase the support part inward, and inserting the intraocular lens into the eye through the insertion port .

The intraocular lens insertion device disclosed herein allows the intraocular lens to be properly inserted into the eye.

1 is a perspective view of an intraocular lens insertion device 10 as viewed from diagonally above to the right. FIG. 2 is a perspective view of the plunger 300 as viewed from diagonally above to the right. 1A is a plan view of an intraocular lens 1, and FIG. 1B is a right side view thereof. 13 is a perspective view of the push-out member 310 as viewed from diagonally below on the right side. FIG. FIG. 2 is a perspective view of the push-out member 310 as viewed from diagonally above on the left side. FIG. 13 is a right side view of the push-out member 310. FIG. 2 is a schematic explanatory diagram showing the movement and deformation state of the intraocular lens 1 when it is pushed out. FIG. FIG. 13 is a perspective view of a push-out member 410 not including a pressing portion 327, as viewed from diagonally below on the right side. 13 is a front cross-sectional view of the nozzle 180 at approximately the center in the front-to-rear direction when the intraocular lens insertion instrument does not include a pressing portion 327. FIG. 1 is a front cross-sectional view of a nozzle 180 of this embodiment taken at approximately the center in the front-rear direction.

＜Overview＞
The intraocular lens insertion instrument exemplified in the present disclosure inserts an intraocular lens into the eye through an insertion port at the front end through an internal passage. The intraocular lens includes a disk-shaped optical section and one or more support sections extending outward from the optical section. The intraocular lens insertion instrument includes a nozzle and a push-out member. The nozzle has a passage area that narrows toward the front and has an insertion port at the front end. The push-out member is rod-shaped and moves forward within the passage along the axis of the passage to push the intraocular lens forward. In addition, the push-out member pushes the intraocular lens forward within the nozzle passage, folding the optical section into a roll shape with the support section folded over the optical section, and positioning the support section inside the folded optical section. The intraocular lens insertion instrument exemplified in the present disclosure includes a pressing section. The pressing section presses the rear support section, which is a support section extending rearward from the optical section, downward, which is the optical section side, with the rear support section folded over the optical section.

Here, in this disclosure, the side opposite to the side on which the center of the optical section folded into a roll is located when viewed from the axis of the passage of the intraocular lens insertion device is defined as the ceiling side (upper side) of the intraocular lens insertion device. In other words, the side on which the edges of the optical section approach each other in the process of folding the optical section into a roll, among the directions intersecting the axis of the passage, is the ceiling side. The side opposite the ceiling side is defined as the bottom side (lower side). However, the definition of the up-down direction in this disclosure does not define the up-down direction when the intraocular lens insertion device is actually used. Therefore, the intraocular lens insertion device may be used in a state in which the up-down direction defined in this disclosure is reversed.

In the intraocular lens insertion device exemplified in the present disclosure, the pressing part presses the rear support part, which is folded over the optical part, toward the optical part. As a result, the optical part is easily folded so as to envelop the support part when the support part is appropriately pressed toward the optical part. Therefore, it is easy to secure space on the ceiling side in the passage of the nozzle. When the space on the ceiling side is secured, even if the optical part is folded in a roll shape and the edge part of the optical part is located on the ceiling side of the passage, the edge part of the optical part is easily able to escape into the space secured by the pressing part. Therefore, it is difficult for the intraocular lens to get between the inner wall of the nozzle and the extrusion member. In addition, the possibility of the support part being caught between both edges of the folded optical part is also reduced. Furthermore, the possibility of the support part not being positioned inside the optical part folded in a roll shape is also reduced. Therefore, the intraocular lens is appropriately inserted into the eye.

The pushing member may have a lower protrusion that protrudes forward from the lower part of the front end face. In this case, when the intraocular lens is pushed forward by the pushing member, the lower protrusion prevents the intraocular lens from shifting downward from the front end face of the pushing member. Therefore, even if the entire intraocular lens is pressed downward by the pressing part, it is difficult for part of the intraocular lens to get caught between the bottom surface of the pushing member and the inner wall of the nozzle.

Of the left and right sides of the extrusion member, the side on which the base end of the rear support part of the intraocular lens is located is defined as the first side. The extrusion member may have an upper rib protruding laterally from the upper part of the first side. The pressing part may be formed on the downward surface of the upper rib, and may be an inclined surface that is inclined downward as it approaches the rear. In this case, the upper rib further prevents a part of the intraocular lens from entering the gap between the inner wall on the ceiling side (upper side) of the nozzle and the extrusion member. In addition, when the extrusion member is pushed forward, the rear support part wraps around below the upper rib, and the intraocular lens moves forward while the rear support part is pressed toward the optical part by the pressing part, which is an inclined surface. Therefore, by simply pushing the extrusion member forward, the intraocular lens moves forward appropriately with the optical part folded so as to envelop the support part.

A parallel surface extending from the front end of the upper rib in parallel to the axis of the passage may be formed on the downward surface of the upper rib. The pressing portion, which is an inclined surface, may be formed behind the parallel surface. In this case, the rear support portion is pressed toward the optical portion by the pressing portion, forming a space below the parallel surface. Therefore, when the optical portion is folded into a roll shape, a part of the intraocular lens is likely to escape into the space below the parallel surface. Therefore, a part of the intraocular lens is less likely to enter the gap between the inner wall of the nozzle and the extrusion member. In addition, by defining the positions of the parallel surface and the pressing portion, the timing at which the rear support portion is pressed toward the optical portion by the pressing portion is adjusted to an appropriate timing. For example, the rear support portion is pressed by the pressing portion before it moves sufficiently above the optical portion, and a problem such as at least a part of the rear support portion turning around below the optical portion is suppressed. Therefore, the intraocular lens is more appropriately inserted into the eye.

However, it is also possible to omit the parallel surfaces of the upper rib. In other words, the pressing portion, which is an inclined surface, may extend rearward from the front end of the upper rib. Even in this case, the rear support portion is appropriately pressed toward the optical portion, so that the optical portion is appropriately folded to envelop the support portion.

The pushing member may have an optical section contact portion and a support section contact portion. The optical section contact portion is formed on the front end side of the pushing member and contacts the optical section to push the optical section forward. The support section contact portion is formed on the front end side of the pushing member above the optical section contact portion and contacts the rear support section to move the rear support section in a direction approaching the optical section. The upper rib may extend rearward from the front end of the support section contact portion. In this case, the movement of the rear support section onto the optical section (i.e., tucking of the rear support section), pressing of the rear support section toward the optical section, and movement of the entire intraocular lens forward are all performed appropriately by simply pushing the pushing member forward.

However, it is also possible to perform tucking of the rear support part using a member other than the pushing member. In other words, after tucking of the rear support part is performed using a member other than the pushing member, the intraocular lens may be pushed forward by the pushing member.

The front end surface of the support contact portion may be located forward of the front end surface of the optical contact portion. In this case, the rear support portion is more easily pushed forward by the optical contact portion. Therefore, tacking of the rear support portion is more easily performed.

The pushing member may further include a recessed portion. The recessed portion is formed on the first side surface rearward of the front end portion, and recesses inward from the first side surface at the front end portion. If the rear support portion is pressed toward the optical portion by the pressing portion, the load on the rear support portion (particularly the base end portion of the rear support portion) may increase. However, by forming the recessed portion, the rear support portion pressed by the pressing portion can escape into the recessed portion. This further reduces the possibility of the intraocular lens getting into the gap between the inner wall of the nozzle and the pushing member.

<Embodiment>
Hereinafter, a typical embodiment of the present disclosure will be described with reference to the drawings. In the following description, the direction of the nozzle 180 side of the main body 100 (lower left side of the paper in FIG. 1) is the front of the intraocular lens insertion device 10, and the direction of the pressed part 370 of the plunger 300 (upper right side of the paper in FIG. 1) is the rear of the intraocular lens insertion device 10. In addition, the upper side of the paper in FIG. 1 is the ceiling side (upper side) of the intraocular lens insertion device 10, the lower side of the paper in FIG. 1 is the bottom side (lower side) of the intraocular lens insertion device 10, the lower right side of the paper in FIG. 1 is the right side of the intraocular lens insertion device 10, and the upper left side of the paper in FIG. 1 is the left side of the intraocular lens insertion device 10. As described above, the definition of the direction in this disclosure does not define the direction when the intraocular lens insertion device 10 is actually used, but is a definition made for convenience to facilitate the description of the technology in this disclosure. Therefore, for example, the intraocular lens insertion device 10 may be used in a state in which the up-down direction defined in this disclosure is reversed.

(Overall composition)
The overall configuration of an intraocular lens insertion instrument 10 of this embodiment will be described with reference to Fig. 1. The intraocular lens insertion instrument 10 is used to insert a deformable intraocular lens 1 (see Fig. 3, etc.) into the eye. The intraocular lens insertion instrument 10 includes a main body 100 and a plunger 300. The main body 100 is substantially cylindrical, and the intraocular lens 1 is inserted into the eye through a passage inside the main body 100. The plunger 300 is rod-shaped, and can move in the front-rear direction through the passage inside the main body 100. The plunger 300 moves forward along an extrusion axis (axis of the passage) A to push out the intraocular lens 1 filled inside the main body 100.

The main body 100 and plunger 300 of this embodiment are formed from a resin material. The intraocular lens insertion device 10 may be formed by molding, cutting by scraping out resin, or the like. By forming the intraocular lens insertion device 10 from a resin material, the user can easily dispose of the intraocular lens insertion device 10 after use.

In this embodiment, a lubricating coating is applied to the inner wall of the main body 100 in order to smoothly insert the adhesive soft intraocular lens 1 into the eye. In addition, the intraocular lens insertion device 10 of this embodiment is formed to be colorless transparent or colorless translucent. Therefore, the user can easily visually check the deformation state of the intraocular lens 1 filled inside the intraocular lens insertion device 10 from the outside of the intraocular lens insertion device 10.

(Main body)
The main body 100 will be described with reference to Fig. 1. The main body 100 includes a cylindrical main body portion 110, an installation portion 130, and a nozzle (insertion portion) 180.

The main body tube portion 110 is formed in a cylindrical shape that extends in the front-rear direction, and is located at the base end side (rear) of the main body portion 100. A protruding portion 111 that is gripped by the user is formed on the outer periphery of the main body tube portion 110 slightly forward of the rear end.

The installation section 130 is connected to the tip side of the main body tube section 110. The installation section 130 is filled with the intraocular lens 1. In detail, the installation section 130 includes a holding section 160 and a setting section 170. The holding section 160 holds the intraocular lens 1 when the intraocular lens insertion device 10 is in a stored state. The setting section 170 is provided so as to be rotatable around the axis of the tip section. When the setting section 170 is rotated, the intraocular lens 1 held in the holding section 160 is moved and positioned at a standby position where it can be pushed out by the plunger 300.

The nozzle 180 is connected to the tip side of the installation part 130. The passage area inside the nozzle 180 becomes narrower toward the front because the intraocular lens 1 is deformed small in the process of pushing the intraocular lens 1 forward. In other words, a tapered internal space is formed in the nozzle 180. At the tip of the nozzle 180, a cylindrical insertion part 182 with an obliquely cut tip is provided. The insertion part 182 is inserted into the eye. At the tip of the insertion part 182, an insertion port 183 is formed, which is an opening for discharging the intraocular lens 1 forward from the internal passage. The internal passage of the main body part 100 penetrates from the rear end of the main body tube part 110 to the insertion port 183 at the tip of the nozzle 180.

(Plunger)
2, a schematic configuration of the plunger 300 will be described. The plunger 300 of this embodiment includes a pushing member 310, a pushing rod 330, a shaft base portion 350, and a pressed portion 370.

The pressed portion 370 is formed at the base end of the plunger 300. The pressed portion 370 is a plate-shaped member extending in a direction perpendicular to the extrusion axis A. The pressed portion 370 comes into contact with the user's finger when the user pushes the plunger 300 forward.

The shaft base 350 is a rod-shaped member extending forward from the tip side of the pressed portion 370. In this embodiment, the shaft base 350 is formed so that the cross section perpendicular to the extrusion axis A has a substantially H-shape. By inserting the shaft base 350 into the main body tube portion 110, which has a substantially rectangular cross section perpendicular to the extrusion axis A, the circumferential rotation of the extrusion axis A of the plunger 300 relative to the main body portion 100 is suppressed. When the plunger 300 moves forward and reaches a position where the insertion of the intraocular lens 1 into the eye is completed, the inclined portion 353 formed at the lower tip of the shaft base 350 comes into contact with an inclined surface formed at a predetermined location on the main body portion 100. As a result, the tip of the plunger 300 is prevented from excessively protruding from the insertion port 183 (see FIG. 1).

The push rod 330 is a rod-shaped member that extends forward from the tip of the shaft base 350 along the axial direction of the push shaft A. The push rod 330 is formed so that the cross section perpendicular to the push shaft A has a substantially circular shape. The push rod 330 has a thickness that allows it to pass through the insertion port 183 of the main body 100. The push member 310 is connected to the tip of the push rod 330. The push member 310 moves forward along the push shaft A within the passage of the main body 100, thereby tucking the intraocular lens 1 and ejecting the intraocular lens 1 from the insertion port 183 into the eye. The detailed configuration of the push member 310 will be described later.

(intraocular lens)
An example of an intraocular lens 1 to be inserted into the eye by an intraocular lens insertion device 10 will be described with reference to Fig. 3. The intraocular lens 1 includes an optical part 2 and a support part 3. The intraocular lens 1 of this embodiment is a so-called one-piece type intraocular lens in which the optical part 2 and the support part 3 are integrally molded. As the material of the intraocular lens 1, various soft materials can be used, such as simple substances such as BA (butyl acrylate) and HEMA (hydroxyethyl methacrylate), and composite materials of acrylic acid ester and methacrylic acid ester.

The optical part 2 provides a predetermined refractive power to the patient's eye. The support part 3 supports the optical part 2 inside the eye. As an example, the intraocular lens 1 of this embodiment is provided with a pair of support parts 3. However, the number of support parts 3 is not limited to two. In this embodiment, when the intraocular lens 1 is installed in the installation part 130, the support part 3 extending from the optical part 2 toward the nozzle 180 (i.e., forward) is referred to as the forward support part 3A, and the support part 3 extending from the optical part 2 toward the plunger 300 (i.e., rearward) is referred to as the rear support part 3B.

The pair of support parts 3 extend outward from the periphery of the optical part 2. The support parts 3 are loop-shaped curved in the circumferential direction, and the tips of the support parts 3 are free ends. The pair of support parts 3 are symmetrical in shape with respect to the center of the optical part 2, and extend in the same circumferential direction. Therefore, the straight line connecting the base ends 4 of the pair of support parts 3 passes through the center of the optical part 2.

(Extrusion member)
The configuration of the pusher member 310 in the plunger 300 of this embodiment will be described in detail with reference to Figures 4 to 7. As shown in Figures 4 to 7, the pusher member 310 has a support portion contact portion 313, an optical portion contact portion 314, an upper protrusion portion 315, and a lower protrusion portion 316 provided at its front end portion.

The support part contact part 313 comes into contact with the rear support part 3B of the intraocular lens 1, thereby deforming and moving the rear support part 3B in a direction approaching the optical part 2 (i.e., forward). In other words, the rear support part 3B is tucked by the support part contact part 313. The support part contact part 313 is provided at the front end of the extrusion member 310, above the optical part contact part 314. Therefore, as will be described in detail later, when the rear support part 3B is pushed forward by the support part contact part 313, the rear support part 3B moves above the optical part 2. The support part contact part 313 is formed in a curved shape that is convex toward the front. Therefore, the rear support part 3B is less likely to be damaged.

The optical part contact part 314 comes into contact with the optical part 2 of the intraocular lens 1, thereby pushing the optical part 2 forward. The optical part contact part 314 is provided on the front end part of the pushing member 310, below the support part contact part 313. The optical part contact part 314, like the support part contact part 313, is formed in a curved shape that is convex toward the front. Therefore, the optical part 2 is less likely to be damaged.

As shown in FIG. 7, when the extrusion member 310 is viewed from the front along the extrusion axis A, both the support portion contact portion 313 and the optical portion contact portion 314 face forward. Therefore, simply by pushing the plunger 300 forward, both the rear support portion 3B is tucked and the optical portion 2 is pushed forward.

As shown in FIG. 6, in this embodiment, the front end surface of the support contact portion 313 protrudes further forward than the front end surface of the optical contact portion 314. In this case, tacking is performed with the rear support portion 3B extended far forward by the support contact portion 313, which protrudes further forward than the optical contact portion 314. This improves the accuracy of tacking. In addition, the connection surface 318 that connects the front end surface of the support contact portion 313 and the front end surface of the optical contact portion 314 is inclined so as to face diagonally forward. Therefore, the optical portion 2 that contacts the connection surface 318 is smoothly guided to the optical contact portion 314.

As shown in FIG. 7, the support contact portion 313 is biased toward the side (the right side in this embodiment) where the base end portion 4B (see FIG. 8(a)) of the rear support portion 3B of the intraocular lens 1 is located in the left-right direction centered on the extrusion axis A. The function of this will be described later.

As shown in Figs. 4 to 6, the upper protrusion 315 protrudes forward from the upper end of the front end surface of the support contact portion 313. The upper protrusion 315 suppresses the rear support portion 3B from shifting upward from the support contact portion 313. As a result, the rear support portion 3B is prevented from not contacting the support contact portion 313, and tacking is easily performed appropriately. The lower protrusion 316 protrudes forward from the lower end of the front end surface of the optical portion contact portion 314. The lower protrusion 316 suppresses the optical portion 2 from shifting downward from the optical portion contact portion 314. As a result, the optical portion 2 is prevented from being caught between the bottom surface of the extrusion member 310 and the inner wall of the nozzle 180. Note that the phrase "upper end of the front end surface of the support contact portion 313" does not limit the upper protrusion 315 to being strictly located at the upper end of the front end surface. In other words, the upper protrusion 315 may be disposed near the upper end of the support contact portion 313. Similarly, the lower protrusion 316 may be disposed near the lower end of the optical contact portion 314.

Next, the configuration of the right side of the pusher member 310 will be described. In the following description, the side on the left side and the right side of the pusher member 310 where the base end 4B (see FIG. 8(a)) of the rear support portion 3B of the intraocular lens 1 is located is referred to as the first side 320 (see FIGS. 4 and 6). In this embodiment, the first side 320 is the right side of the pusher member 301. Of the left side and the right side of the pusher member 310, the side opposite the first side 320 (the left side in this embodiment) is referred to as the second side 325 (see FIG. 5). As shown in FIG. 4, the right side of the pusher member 310 is provided with a first recess 321, an upper rib 322, and a lower rib 323.

The first recess 321 is formed on the first side (right side in this embodiment) 320 of the push-out member 310, rearward of the support contact portion 313 and the optical contact portion 314. The first recess 321 is a portion recessed inward (leftward in this embodiment) from the first side 320A of the support contact portion 313 and the optical contact portion 314. The first recess 321 is a space into which a part of the intraocular lens 1 (for example, the vicinity of the base end 4B of the rear support portion 3B in the tacked state) that has entered between the first side 320 and the inner wall of the nozzle 180 escapes. Therefore, the intraocular lens 1 is less likely to enter between the inner wall on the ceiling side of the nozzle 180 and the surface on the ceiling side of the push-out member 310. Therefore, the formation of the first recess 321 reduces the load on the intraocular lens 1, and the occurrence of damage to the intraocular lens 1 is suppressed.

As shown in FIG. 4, the first side 320A of the support contact portion 313 and the optical contact portion 314 and the side 321A of the part that is inwardly the most inward in the first recess 321 are smoothly connected by an inclined surface 321B that faces diagonally backward. Therefore, there is no abrupt step between the first side 320A of the support contact portion 313 and the optical contact portion 314 and the side 321A of the part that is inwardly the most inward in the first recess 321. Therefore, when a part of the intraocular lens 1 that has escaped into the first recess 321 returns forward, the intraocular lens 1 is prevented from being damaged by abrupt steps.

The upper rib 322 is a rib-like member that protrudes laterally (to the right in this embodiment) from the upper end of the first side surface (right side surface in this embodiment) 320 of the extrusion member 310. The upper rib 322 extends continuously from the front end of the support contact portion 313 to the first recessed portion 321. As will be described in detail later, the upper rib 322 prevents a part of the intraocular lens 1 from entering the gap between the upper surface of the extrusion member 310 and the inner wall on the ceiling side of the nozzle 180 from the first side surface 320 side. Note that the upper rib 322 does not need to be formed strictly at the upper end of the first side surface 320. In other words, the upper rib 322 only needs to be disposed near the upper end of the first side surface 320.

As shown in Figs. 4 and 6, the intraocular lens insertion device 10 includes a pressing portion 327. The pressing portion 327 presses the rear support portion 3B toward the optical portion 2 (i.e., downward) when the rear support portion 3B is folded onto the optical portion 2. The pressing portion 327 in this embodiment is formed on the downward-facing surface of the upper rib 322, and is an inclined surface that is inclined downward as it approaches the rear. In other words, the pressing portion 327, which is an inclined surface, is inclined so as to face diagonally forward on the bottom surface of the upper rib 322. The function of the pressing portion 327 will be described in detail later.

In addition, a parallel surface 328 is formed on the downward-facing surface of the upper rib 322. The parallel surface 328 extends from the front end of the upper rib 322 rearward in parallel with the axis of the pusher member 310, which is parallel to the axis of the passage. The pressing portion 327, which is an inclined surface, is formed rearward of the parallel surface 328. The function of the parallel surface 328 will be described in detail later.

The lower rib 323 protrudes laterally (to the right in this embodiment) from the lower end of the first recess 321 in the first side surface (right side surface in this embodiment) 320 of the pushing member 310. The lower rib 323 prevents a part of the intraocular lens 1 from entering the gap formed by the bottom surface of the pushing member 310 and the inner wall of the nozzle 180 from the first side surface 320 side. Note that, like the upper rib 322, the lower rib 323 does not have to be formed strictly at the lower end of the first side surface 320.

Next, the configuration of the left side of the pusher member 310 will be described. As shown in FIG. 5, a second recess 326 that recesses inward is formed on the second side (left side in this embodiment) 325 of the pusher member 310 to the left of the support portion contact portion 313. The second recess 326 becomes a space into which a part of the deformed intraocular lens 1 escapes. Therefore, by providing the second recess 326, it becomes difficult for a load to be applied to the part of the intraocular lens 1 that enters the left side of the pusher member 310.

(Migration and deformation of intraocular lens)
Referring to FIG. 8, the movement and deformation of the intraocular lens 1 from the setting portion 130 to the nozzle 180 when the intraocular lens 1 is inserted into the eye by the intraocular lens insertion device 10 of this embodiment will be described.

First, the operator rotates the setting unit 170 (see FIG. 1) to move the intraocular lens 1 held by the holding unit 160 (see FIG. 1) of the installation unit 130 to a standby position where it can be pushed out by the plunger 300. Here, as shown in FIG. 8(a), the base end 4B of the rear support portion 3B in the intraocular lens 1 held by the holding unit 160 is shifted in either the left or right direction with respect to the pushing axis A. As an example, in this embodiment, the base end 4B of the rear support portion 3B is located on the right side (lower side in FIG. 8) with respect to the pushing axis A. Therefore, in this embodiment, the right direction of the intraocular lens insertion instrument 10 is the direction of the first side surface 320 described above, and the left direction is the direction of the second side surface 325 described above. Note that the direction in which the support portion 3 of the intraocular lens 1 extends may be the opposite direction to this embodiment. In this case, the direction of the first side surface 320 described above is the left direction of the intraocular lens insertion instrument 10.

When the setting unit 170 (see FIG. 1) is rotated and the intraocular lens 1 is moved to the standby position, the positioning unit 171 (see FIG. 8(a)) of the setting unit 170 positions the rear support unit 3B in a state where it is moved to the ceiling side (higher) than the optical unit 2. As a result, when the rear support unit 3B is tacked as described below, the rear support unit 3B moves to above the optical unit 2, which is the desired position. Note that it is also possible to change the configuration for positioning the rear support unit 3B on the ceiling side of the optical unit 2.

Next, the operator uses a syringe or the like to inject lubricant (viscoelastic material) into the installation portion 130, and starts moving the plunger 300 forward. As a result, as shown in FIG. 8(a), the support portion contact portion 313 (see FIGS. 4 to 7) of the pushing member 310 comes into contact with the rear support portion 3B of the intraocular lens 1.

When the plunger 300 is pushed further forward, the rear support part 3B is moved (bent) by the pushing member 310 in a direction approaching the optical part 2, as shown in FIG. 8(b). As described above, the support part contact part 313 is provided above the optical part contact part 314. Furthermore, the rear support part 3B is positioned on the ceiling side (above) of the optical part 2 in the standby position. Therefore, the rear support part 3B deforms and moves above the optical part 2, and the tip of the rear support part 3B faces forward. As a result, tucking of the rear support part 3B is performed.

As described above, the support contact portion 313 is biased toward the side (the right side in this embodiment) where the base end 4B (see FIG. 8(a)) of the rear support portion 3B of the intraocular lens 1 is located in the left-right direction centered on the extrusion axis A. In this case, the support contact portion 313 pushes forward a position of the rear support portion 3B close to the base end 4B. Therefore, compared to when the tip side of the rear support portion 3B is pushed, the deformation and movement of the rear support portion 3B is more stable, and the amount of movement is easily ensured.

When the plunger 300 is pushed further forward, the optical section contact portion 314 (see Figures 4 to 7) of the pushing member 310 comes into contact with the optical section 2, and the entire intraocular lens 1 moves forward. As shown in Figure 8 (c), when the intraocular lens 1 reaches the nozzle 180, the front support portion 3A comes into contact with the tapered inner wall of the nozzle 180. As a result, the front support portion 3A deforms and moves upwards in the optical section 2, and the tip of the front support portion 3A faces backwards. In other words, tacking of the front support portion 3A is performed.

When the plunger 300 is further pushed forward, the optical part 2 of the intraocular lens 1 also comes into contact with the tapered inner wall of the nozzle 180. As a result, as shown in FIG. 8(d), the intraocular lens 1 is folded small with the front support part 3A and the rear support part 3B tucked. Here, the front support part 3A and the rear support part 3B are tucked to the ceiling side (upper side) of the optical part 2. Furthermore, the optical part 2 is folded while contacting the bottom surface of the tapered nozzle 180. Therefore, the left and right edges (upper and lower sides in FIG. 8(d)) of the optical part 2 are gradually folded upward from the center of the optical part 2 so as to sandwich the tucked front support part 3A and the rear support part 3B inside. In other words, the optical part 2 is folded in a valley fold toward the bottom side (the back side in FIG. 8(d)).

As shown in FIG. 8(e), the intraocular lens 1 is folded smaller as it is pushed forward. The vicinity of the base end 4B of the rear support portion 3B and the vicinity of the rear end of the optical portion 2 enter between the first side surface 320 of the pushing member 310 and the inner wall of the nozzle 180. When the pushing member 310 is pushed further forward, the intraocular lens 1 is inserted into the eye through the insertion port 183.

Now, referring to Figures 9 and 10, the configuration of the pusher member 410 and the state of movement and deformation of the intraocular lens 1 when the intraocular lens 10 does not have a pressing portion 327 (see Figures 4, 6, and 7) will be described. Note that the only difference between the pusher member 410 illustrated in Figures 9 and 10 and the pusher member 310 illustrated in Figures 4 to 7 is the presence or absence of a pressing portion 327 on the downward surface of the upper rib 422; all other configurations are the same. Therefore, in Figures 9 and 10, for members that can adopt the same configuration as the pusher member 310 illustrated in Figures 4 to 7, the same reference numerals as those used in Figures 4 to 7 are used, and their description will be omitted or simplified.

The pusher member 410 shown in FIG. 9, like the pusher member 310 illustrated in FIGS. 4 to 7, has an upper rib 422 that protrudes laterally (to the right in this embodiment) from the upper end of the first side surface 320. However, the downward-facing surface of the upper rib 422 shown in FIG. 9 is parallel to the axis of the pusher member 410 from the tip to the rear end. In other words, in the pusher member 410 shown in FIG. 9, the downward-facing surface of the upper rib 422 does not have a pressing portion 327, which is an inclined surface, formed thereon.

As shown in FIG. 10, when an intraocular lens insertion device that does not have a pressing portion 327 is used, the position of the support portion 3 (e.g., rear support portion 3B) in the folded state (i.e., tucked state) relative to the upper surface (ceiling side surface) of the optical portion 2 may be higher than the appropriate position. In the state shown in FIG. 10, the ceiling side space in the passage of the nozzle 180 is narrowed by the rear support portion 3B, which is higher than the appropriate position. The edges 2R, 2L, etc. of the optical portion 2 are folded toward the ceiling side while sliding against the inner wall of the nozzle 180. Therefore, if the space on the ceiling side inside the nozzle 180 is narrow, the edges 2R, 2L, etc. of the optical portion 2 sliding against the inner wall of the nozzle 180 are likely to enter the gap 200 between the inner wall on the ceiling side of the nozzle 180 and the extrusion member 410. As a result, problems such as damage to the intraocular lens 1 may occur.

Furthermore, if the support part 3 (e.g., the rear support part 3B) is located above the appropriate position, the support part 3 may be pinched between one edge part 2R and the other edge part 2L of the optical part 2 as it is folded toward the ceiling. Also, the support part 3 may not be positioned appropriately inside the optical part 2 that is folded into a roll. In these cases, problems such as damage to the support part 3 are likely to occur. Furthermore, the optical part 2 may not be folded an appropriate amount due to the support part 3 being located above the appropriate position. In this case, the load on the nozzle 180 when pushing the intraocular lens 1 forward within the nozzle 180 and the load required for pushing may increase.

With reference to FIG. 11 and the like, the movement and deformation state of the intraocular lens 1 when the intraocular lens insertion device 10 of this embodiment is used will be described in more detail. As shown in FIG. 11, in this embodiment, the rear support part 3B folded over the optical part 2 is pressed toward the optical part 2 by the pressing part 327. As a result, as shown in FIG. 8(e), the optical part 2 is easily folded so as to enclose the rear support part 3B inside. Therefore, it is easy to secure space on the ceiling side (upper part) in the passage of the nozzle 180. When the space on the ceiling side is secured, even if the edges 2R, 2L, etc. of the optical part 2 are located on the ceiling side of the passage, the edges 2R, 2L, etc. are easily escaped into the space secured by the pressing part 327. Therefore, the intraocular lens 1 is less likely to get in between the inner wall on the ceiling side of the nozzle 180 and the surface on the ceiling side of the extrusion member 310. In addition, the possibility of the support part 3 being pinched between the edges 2R, 2L of the folded optical part is also reduced. Furthermore, the possibility that the support part 3 will not be positioned inside the optical part 2 that is folded into a roll is reduced. Therefore, the intraocular lens 1 can be properly inserted into the eye.

In addition, the pressing portion 327 in this embodiment is an inclined surface formed on the downward-facing surface of the upper rib 322. Therefore, when the pushing member 310 is pushed forward, the rear support portion 3B wraps around below the upper rib 322, and the intraocular lens 1 moves forward while the rear support portion 3B is pressed toward the optical portion 2 by the pressing portion 327, which is an inclined surface. Therefore, by simply pushing the pushing member 310 forward, the intraocular lens 1 moves forward with the optical portion 2 properly folded so as to encase the support portion 3.

As shown in FIG. 6, the pressing portion 327 in this embodiment is formed behind the parallel surface 328. Therefore, the rear support portion 3B is pressed downward by the pressing portion 327, which makes it easier to secure a space ("S" in FIG. 6) at the bottom near the parallel surface 328. As a result, when the optical portion 2 is folded into a roll, the intraocular lens 1 (e.g., the optical portion 2) is more likely to escape into the space S. Therefore, it becomes even more difficult for a part of the intraocular lens 1 to get between the inner wall on the ceiling side of the nozzle 180 and the surface on the ceiling side of the extrusion member 310. In addition, by defining the positions of the parallel surface 328 and the pressing portion 327, the timing at which the rear support portion 3B is pressed toward the optical portion 2 by the pressing portion 327 is adjusted to an appropriate timing.

The pushing member 310 also has a first recess 321. Therefore, the vicinity of the rear end of the rear support part 3B pressed by the pressing part 327 can escape to the first recess 321. Therefore, even if the intraocular lens 1 is folded small and the load on the intraocular lens 1 increases, the intraocular lens 1 becomes even less likely to get between the inner wall on the ceiling side of the nozzle 180 and the surface on the ceiling side of the pushing member 310.

The technology disclosed in the above embodiment is merely an example. Therefore, it is possible to modify the technology exemplified in the above embodiment. For example, the intraocular lens insertion device 10 of the above embodiment has multiple configurations in order to properly insert the intraocular lens 1 into the eye. However, it is also possible to adopt only some of these configurations rather than all of them. For example, the pushing member 310 may have a pressing portion 327 without having a first recessed portion 321.

In the above embodiment, the pressing portion 327 that presses the tacked rear support portion 3B toward the optical portion 2 is an inclined surface formed on the downward surface of the upper rib 322. However, it is also possible to change the configuration of the pressing portion. For example, instead of an inclined surface, a protrusion or the like may be formed on the extrusion member as the pressing portion. Also, the pressing portion may be provided on a member other than the extrusion member. For example, the pressing portion may be a button or the like that is operated downward by the user.

REFERENCE SIGNS LIST 1 intraocular lens 2 optical part 3 support part 3B rear support part 10 intraocular lens insertion tool 180 nozzle 183 insertion port 310 pusher member 313 support part contact part 314 optical part contact part 315 upper protrusion part 316 lower protrusion part 320 first side surface 321 first recessed part 322 upper rib 327 pressing part 328 parallel surface

Claims (4)

An intraocular lens insertion device for inserting a deformable intraocular lens having a disk-shaped optical portion and one or more support portions extending outward from the optical portion into an eye from an insertion port at a front end portion through an internal passage,
A nozzle having a passage area narrowing toward the front and having the insertion port at a front end thereof;
a rod-shaped pushing member that moves forward within the passage along an axis of the passage to push the intraocular lens forward;
Equipped with
The extrusion member is
The intraocular lens is pushed forward within the passage of the nozzle, whereby the optical portion is folded into a roll shape with the support portion folded onto the optical portion, and the support portion is positioned inside the folded optical portion;
When the side surface on the left side surface and the right side surface of the extrusion member on which a base end of a rear support portion, which is the support portion extending rearward from the optical portion , is located is defined as a first side surface, an upper rib protruding laterally from an upper portion of the first side surface;
A pressing portion is formed on a downward surface of the upper rib, the pressing portion being an inclined surface that is inclined downward toward the rear;
Equipped with
The extrusion member is pushed forward with the rear support portion bent onto the optical portion, thereby moving the intraocular lens forward within the passage of the nozzle while causing the rear support portion to come into direct contact with the optical portion and press it downward toward the optical portion using the pressing portion , thereby folding the optical portion so as to encase the support portion inward, and inserting the intraocular lens into the eye through the insertion port . 2. The intraocular lens insertion device according to claim 1,
A parallel surface is formed on the downwardly facing surface of the upper rib, the parallel surface extending rearward from the front end of the upper rib parallel to the axis of the passage,
An intraocular lens insertion device, characterized in that the pressing portion, which is the inclined surface, is formed behind the parallel surface. 3. The intraocular lens insertion device according to claim 1,
The extrusion member is
an optical portion contact portion formed on a front end side of the pushing member and contacting the optical portion to push the optical portion forward;
a support portion contact portion that is formed on a front end side of the extrusion member above the optical portion contact portion and that comes into contact with the rear support portion to move the rear support portion in a direction approaching the optical portion;
Equipped with
An intraocular lens insertion tool, characterized in that the upper rib extends rearward from a front end of the support portion contact portion. 4. The intraocular lens insertion device according to claim 1,
The extrusion member is
an intraocular lens insertion device further comprising a recess formed on the first side surface rearward of a front end portion of the first side surface, the recess being recessed inward relative to the first side surface at the front end portion, when the side surface on which the base end of the rear support portion of the intraocular lens is located is defined as a first side surface, the left side surface and the right side surface of the push-out member being defined as a first side surface.

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