Abstract:
The present invention is provided with: an approximately cylindrical nozzle body; a stage part which is provided in the nozzle body and houses an intraocular lens; a plunger which presses the intraocular lens housed in the stage part by the forward end thereof to discharge the intraocular lens into an eyeball; and a positioning member which restricts the initial position and posture of the intraocular lens by being mounted to the stage part from the outside. Rib sections are formed so as to extend in the front-back direction of the nozzle body at the outer periphery of the stage part, and side wall parts and rotation prevention wall parts are formed in the positioning member so as to sandwich the rib sections from both sides, thereby restricting the rotation of the positioning member with respect to the stage part.

Description:
TECHNICAL FIELD 
       [0001]    The present invention relates to an intraocular lens insertion tool for inserting an intraocular lens into an eyeball of a patient, and a positioning member provided in the intraocular lens insertion tool. 
       BACKGROUND ART 
       [0002]    Conventionally, in a surgery such as a cataract, a treatment has been performed in which an incision is provided in an ocular tissue such as a cornea (sclera) in the eyeball and a crystalline lens anterior capsule portion, an intracapsular crystalline lens is extracted and removed via the incision, and thereafter, an intraocular lens substituting the crystalline lens is inserted into the eye and disposed in the capsule from the incision. 
         [0003]    Especially, in recent years, when inserting the intraocular lens into the eyeball from the incision, in many cases, an insertion tool as illustrated below is used. That is, a leading end opening of an insertion cylindrical portion provided at a leading end portion of a tool main body is inserted into the eyeball through the incision, and the intraocular lens is extruded from the leading end opening of the insertion cylindrical portion by a rod-shaped plunger in a state of being slightly deformed in the tool main body, thereby inserting the intraocular lens into the eyeball. By using such an insertion tool, since it is possible to simply insert the intraocular lens into the eyeball by the use of the incision formed for extraction and removal of the crystalline lens, it is possible to simplify the surgery, and it is possible to suppress an occurrence of astigmatism and an occurrence of infectious disease after surgery. 
         [0004]    Incidentally, some above-described intraocular lens insertion tools have a positioning member that holds the position and posture of the intraocular lens in the insertion tools while restricting them, and hold the intraocular lens using the positioning member in the state before use. In this type of intraocular lens insertion tool, the restrictions on the position and posture of the intraocular lens are released by removing the positioning member during use, and the intraocular lens is set to an extrudable state by the plunger (for example, see Patent Literature 1). In this case, depending on a method of removing the positioning member, an inconvenience has occurred in which a lens main body or a support portion of the intraocular lens are interposed by some parts of the positioning member, in some cases, it is not possible to normally release the restrictions on the position and posture of the intraocular lens, and it is difficult to smoothly perform the inserting operation of the intraocular lens. 
       CITATION LIST 
     Patent Literature  
       [0005]    Patent Literature 1: JP 2008-61677 A 
         [0006]    Patent Literature 2: JP 2010-273986 A 
       SUMMARY OF INVENTION 
     Technical Problem  
       [0007]    The present invention has been made in view of the above-described conventional problems, and an object thereof is to provide a technique capable of smoothly releasing the restrictions on the position and posture of the intraocular lens without affecting the intraocular lens or the insertion tool itself, when detaching the positioning member from the intraocular lens insertion tool. 
       Solution to Problem  
       [0008]    According to the present invention for solving the above-described problems, there is provided an intraocular lens insertion tool that includes a substantially cylindrical tool main body; a housing portion that is provided in the tool main body to house the intraocular lens; a plunger that discharges the intraocular lens into the eyeball from an insertion cylindrical portion, by pressing the intraocular lens housed in the housing portion by a leading end; and a positioning member that restricts an initial position and posture of the intraocular lens by being mounted to the housing portion from the outside, the intraocular lens insertion tool being a type of being used after detaching the positioning member from the housing portion, wherein in one of an outer circumference of the housing portion or the positioning member, a flat plate portion as a flat plate-shaped wall portion extending in a front and rear direction of the tool main body is formed, and in the other of the outer circumference of the housing portion or the positioning member, a wall surface disposed to interpose the flat plate portion in parallel from both sides is formed, thereby suppressing the rotation of the positioning member around a longitudinal axis with respect to the housing portion. 
         [0009]    More particularly, there is provided an intraocular lens insertion tool that includes a tool main body formed in a substantially cylindrical shape that has an insertion cylindrical portion to be inserted into an incision formed in an ocular tissue and a housing portion capable of housing and disposing the intraocular lens; a plunger that moves the intraocular lens inside the tool main body to discharge the intraocular lens into the eyeball from the insertion cylindrical portion, by pressing the intraocular lens housed in the housing portion with a leading end, by being pushed into the tool main body; and a positioning member that restricts an initial position and posture of the intraocular lens within the tool main body by being mounted to the housing portion from the outside, the intraocular lens insertion tool permitting the movement of the intraocular lens and discharging into the eyeball by the plunger, by detaching the positioning member from the housing portion to release the restrictions on the position and posture of the intraocular lens within the tool main body during use, wherein in one of the outer circumference of the housing portion or the positioning member, a flat plate portion as a flat plate-shaped wall portion formed parallel to a direction of movement of the intraocular lens is provided, and in the other of the outer circumference of the housing portion or the positioning member, a rotation suppressing unit for suppressing the rotation of the positioning member with respect to the housing portion by causing two wall surfaces formed parallel to the flat plate portion to face the flat plate portion from both sides is provided. 
         [0010]    According to this, it is possible to provide a flat plate portion in one of the outer circumference of the housing portion or the positioning member, and causing the two wall surfaces formed in the other of the outer circumference of the housing portion or the positioning member parallel to the flat plate portion to face the flat plate portion from both sides, thus it is possible to dispose the flat plate portion so as to be interposed between the two wall surfaces. Therefore, for example, it is possible to more reliably suppress the rotation of the positioning member with respect to the housing portion, compared to the case of suppressing the rotation by causing the one wall surface to face the flat plate portion from the one side. 
         [0011]    Furthermore, here, the case of causing the two wall surfaces formed parallel to the flat plate portion to face the plate portion from both sides includes the case of causing the two wall surfaces to face the flat plate portion from both sides while keeping a gap, and the case of causing the two wall surfaces to face the flat plate portion from both sides without a gap. The presence or absence of the gap or the dimension of the gap is defined by an angle of rotation allowed for the positioning member. In addition, the direction of rotation capable of being suppressed in this case is mainly the rotation around a direction of movement (an axial direction of the plunger or an axial direction of the tool main body) of the intraocular lens. In addition, the outer circumference of the housing portion in the present invention illustrates an outer surface of the housing portion of the tool main body, and, for example, it may be a surface in a direction in which the positioning member should be attached to the outer surface of the housing portion. 
         [0012]    Furthermore, in the present invention, the flat plate portion may be provided on the outer circumference of the housing portion, and the rotation suppressing unit may be provided in the positioning member. Originally, since a rib for securing strength of the housing portion is often provided on the outer circumference of the housing portion, according to the present invention, it is possible to utilize the rib originally provided in the housing portion as the flat plate portion as it is. 
         [0013]    Furthermore, in the present invention, the flat plate portion and the rotation suppressing unit may be provided on both sides with respect to the central axis of the direction of movement of the intraocular lens, when viewed from a direction of optical axis of the intraocular lens housed in the housing portion. In that case, it is possible to cause each of the two wall surfaces to face the flat plate portion provided at two positions around the axis in the direction of movement of the intraocular lens from both sides, and it is possible to more reliably suppress the rotation of the positioning member with respect to the housing portion. 
         [0014]    Furthermore, in the present invention, the positioning member may have a plurality of convex portions that performs the position restrictions on the intraocular lens, the plurality of convex portions may be inserted into a plurality of holes formed on a placing surface as a surface on which the intraocular lens is placed in the housing portion, and when a locking portion provided on a side surface of the convex portion engages with an end surface of the placing surface forming the hole, the positioning member may be mounted to the housing portion. 
         [0015]    In the intraocular lens insertion tool having such a type of the positioning member, since the positioning member rotates around the axis in the direction of movement of the intraocular lens, the convex portion easily interposes the lens main body or the support portion of the intraocular lens, or damages the housing portion. Therefore, by applying the present invention to the intraocular lens insertion tool having such a type of the positioning member, it is possible to make the effect of the invention more remarkable. 
         [0016]    Furthermore, in the present invention, the intraocular lens may include a lens main body, and a whisker-like support portion extending outward from the outer circumference of the lens main body, a part of the plurality of convex portions may have a groove portion for supporting the support portion, and the groove portion may be formed parallel to the direction of movement of the intraocular lens. 
         [0017]    In such a case, when the positioning member rotates around the axis in the direction of movement of the intraocular lens, in some cases, the groove portion for supporting the support portion is deformed by interference between the convex portion and the housing portion, and interposes the support portion of the intraocular lens. Therefore, by applying the present invention to the intraocular lens insertion tool having such a type of the positioning member, it is possible to suppress the interposition of the support portion of the intraocular lens into the groove portion, and it is possible to make the effect of the invention more remarkable. 
         [0018]    Furthermore, in the present invention, the positioning member may have a gripping portion for gripping when attaching or detaching the positioning member to and from the housing portion, and the gripping portion may be provided to be biased from the center in the direction of movement of the intraocular lens in the positioning member. 
         [0019]    According to this, when a user detaches the positioning member from the housing portion by gripping the gripping portion, structurally, the positioning member easily rotates around the axis in the direction vertical to the direction of movement of the intraocular lens, and by rotating the positioning member around such an axis, the positioning member can be easily detached from the housing portion. As a result, since there is no need for rotation around the axis in the direction of movement of the intraocular lens, it is possible to more reliably suppress the rotation of the positioning member around the axis in the direction of movement of the intraocular lens. 
         [0020]    Furthermore, according to this, when mounting the positioning member to the housing portion, it is possible to suppress mounting in an opposite direction with regard to the direction of movement of the intraocular lens. 
         [0021]    Furthermore, in the present invention, an erroneous mounting prevention portion may be formed in at least a part of the wall surface facing the flat plate portion in the rotation suppressing unit, and the erroneous mounting prevention portion prohibits the mounting by interfering with a predetermined portion of the housing portion, when the positioning member is mounted in an opposite direction with regard to the direction of movement of the intraocular lens. According to this, it is possible to more reliably suppress the mounting in the opposite direction with regard to the direction of movement of the intraocular lens when mounting the positioning member to the housing portion. 
         [0022]    In addition, the intraocular lens insertion tool of the present invention may be a preset type insertion tool in which the intraocular lens is housed and the positioning member is mounted in the housing portion in advance in the manufacturing process, and which is distributed in a state in which the intraocular lens is housed and the positioning member is mounted in the housing portion. By applying the above-described invention to such a case, it is possible to further improve the reliability of the preset type insertion tool. 
         [0023]    Furthermore, the present invention may be a positioning member provided in any one of the above-described intraocular lens insertion tools. 
         [0024]    In addition, it is possible to use the above-described means for solving the problems of the present invention in combination as much as possible. 
       Advantageous Effects of Invention  
       [0025]    According to the present invention, when detaching the positioning member from the intraocular lens insertion tool, it is possible to smoothly release the restrictions on the position and posture of the intraocular lens, without affecting the intraocular lens and the insertion tool itself. 
     
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         [0026]      FIG. 1A  and  FIG. 1B  are diagrams illustrating a schematic configuration of a conventional intraocular lens insertion tool. 
           [0027]      FIG. 2A  and  FIG. 2B  are diagrams illustrating a schematic configuration of an intraocular lens. 
           [0028]      FIG. 3  is a diagram illustrating a schematic configuration of a nozzle body. 
           [0029]      FIG. 4A  and  FIG. 4B  are diagrams illustrating a schematic configuration of a conventional positioning member. 
           [0030]      FIG. 5A  and  FIG. 5B  are diagrams illustrating a schematic configuration of a plunger. 
           [0031]      FIG. 6A  and  FIG. 6B  are diagrams illustrating a schematic configuration of the positioning member in a first example of the present invention. 
           [0032]      FIG. 7A  and  FIG. 7B  are diagrams illustrating a schematic configuration of an intraocular lens insertion tool in the first example of the invention. 
           [0033]      FIG. 8A  and  FIG. 8B  are diagrams illustrating the vicinity of a positioning member in the intraocular lens insertion tool in the first example of the invention. 
           [0034]      FIG. 9A  and  FIG. 9B  are diagrams illustrating the vicinity of a positioning member in an intraocular lens insertion tool in a second example of the invention. 
           [0035]      FIG. 10A  and  FIG. 10B  are diagrams illustrating a schematic configuration of a positioning member in a third example of the invention. 
           [0036]      FIG. 11A  and  FIG. 11B  are perspective views of the positioning member in the third example of the invention. 
           [0037]      FIG. 12A  and  FIG. 12B  are diagrams illustrating a schematic configuration of the intraocular lens insertion tool in the third example of the invention. 
           [0038]      FIG. 13A  to  FIG. 13G  are external views of the positioning member in the third example of the invention. 
           [0039]      FIG. 14A  to  FIG. 14G  are external views of the positioning member in the third example of the invention. 
       
    
    
     DESCRIPTION OF EMBODIMENTS 
       [0040]    Hereinafter, embodiments of the invention will be described by referring to the drawings. 
       First Example 
       [0041]      FIG. 1A  and  FIG. 1B  illustrate schematic configurations of a conventional intraocular lens insertion tool  1  (hereinafter, simply referred to as the insertion tool  1 ).  FIG. 1A  illustrates a plan view, and  FIG. 1B  illustrates a side view. The insertion tool  1  has a nozzle body  10  as a tool main body, and a plunger  30  which is inserted into the nozzle body  10  so as to be able to reciprocate. In the nozzle body  10 , one side formed in a cylindrical shape with a substantially rectangular cross-section (hereinafter, a largely open side is referred to as a rear end portion  10   b ) is largely open, and at an end portion on the other side, a nozzle portion  15  as a thinly narrowed insertion cylindrical portion, and an obliquely open leading end portion  10   a  are included. In addition, hereinafter, a direction from the leading end portion  10   a  toward the rear end portion  10   b  of the nozzle body  10  or its opposite direction (a direction parallel to the direction of movement of the intraocular lens) is set to a front and rear direction, a direction perpendicular to a sheet surface in  FIG. 1A  is set to a upward and downward direction, and a direction perpendicular to the sheet surface in  FIG. 1B  is set to a leftward and rightward direction. 
         [0042]    In the vicinity of the rear end portion  10   b  of the nozzle body  10 , a hold portion  11  is integrally provided which protrudes in a plate shape and is caught by a finger when a user pushes the plunger  30  to the leading end side of the nozzle body  10 . In addition, on the rear end side of the nozzle portion  15  of the nozzle body  10 , a stage portion  12  as a housing portion for setting an intraocular lens  2  is provided. The stage portion  12  is configured so that the upper side (a vertical front side of the sheet surface in  FIG. 1A )) of the nozzle body  10  is open by opening a stage lid portion  13 . Furthermore, a positioning member  50  is mounted to the stage portion  12  from the lower side (a vertical back side of the sheet surface in  FIG. 1A ) of the nozzle body  10 . By this positioning member  50 , the position and posture of the intraocular lens  2  are restricted within the stage portion  12  before use (during transport), and the intraocular lens  2  is stably held. 
         [0043]    That is, in the insertion tool  1 , during manufacture, in a state in which the stage lid portion  13  opens and the positioning member  50  is attached to the stage portion  12 , the intraocular lens  2  is set to the stage portion  12 . Moreover, after closing the stage lid portion  13 , the insertion tool is shipped and sold. Furthermore, during use, the user detaches the positioning members  50  while closing the stage lid portion  13 , and then, pushes the plunger  30  to the leading end side of the nozzle body  10 . Thus, the intraocular lens  2  is pressed by the plunger  30 , and the intraocular lens  2  is extruded from the leading end portion  10   a . In addition, the nozzle body  10 , the plunger  30 , and the positioning member  50  in the insertion tool  1  are formed of a resin material such as polypropylene. Polypropylene is a material that has a proven track record in a medical device and has high reliability such as chemical resistance. 
         [0044]      FIG. 2A  and  FIG. 2B  are diagrams illustrating a schematic configuration of the intraocular lens  2 .  FIG. 2A  illustrates a plan view, and  FIG. 2A  illustrates a side view. The intraocular lens  2  is formed to have a lens main body  2   a  having a predetermined refractive power, and two whisker-like support portions  2   b  and  2   b  that are provided in the lens main body  2   a  to hold the lens main body  2   a  within the eyeball. The support portions  2   b  and  2   b  correspond to a lens holding portion in this embodiment. The lens main body  2   a  is formed from a flexible resin material. 
         [0045]      FIG. 3  illustrates a plan view of the nozzle body  10 . In the nozzle body  10  as described above, the intraocular lens  2  is set to the stage portion  12 . Moreover, the intraocular lens  2  is pressed by the plunger  30  in that state and extruded from the leading end portion  10   a . In addition, a through hole  10   c , in which the cross-sectional shape varies in response to changes in the external form of the nozzle body  10 , is provided inside the nozzle body  10 . Moreover, when the intraocular lens  2  is extruded, the intraocular lens  2  is deformed in response to changes in the cross-sectional shape of the through hole  10   c  in the nozzle body  10 , is deformed into a shape which easily enters the incision formed in the patient&#39;s eyeball, and then is extruded. 
         [0046]    The stage portion  12  is formed with a stage groove  12   a  having a width that is slightly larger than the diameter of the lens main body  2   a  of the intraocular lens  2 . A dimension in the front and rear direction of the stage groove  12   a  is set to be larger than the maximum width dimension including the support portions  2   b  and  2   b  which extend to either side of the intraocular lens  2 . Furthermore, a set surface  12   b  is formed by the bottom surface of the stage groove  12   a . A vertical position (a position in a direction perpendicular to the sheet surface of  FIG. 3 ) of the set surface  12   b  is set above the height position of the bottom surface of the through hole  10   c  of the nozzle body  10  (front side in the direction perpendicular to the sheet surface of  FIG. 3 ), and the set surface  12   b  and the bottom surface of the through hole  10   c  are connected by a bottom inclined surface  10   d . In addition, on the set surface  12   b , two guide portions  10   f  and  10   f  for guiding a cylindrical portion  31   a  to be described below in the plunger  30  are provided. 
         [0047]    The stage portion  12  and the stage lid portion  13  are integrally formed. The stage lid portion  13  has a dimension in the front and rear direction that is equivalent to the stage portion  12 . The stage lid portion  13  is connected by a thin plate-shaped connecting portion  14  that is formed by extending the side surface of the stage portion  12  to the stage lid portion  13  side. The connecting portion  14  is flexibly formed in a central portion, and the stage lid portion  13  is adapted to be able to overlap and close the stage portion  12  from the upper side, by bending the connecting portion  14 . 
         [0048]    In the stage lid portion  13 , on a surface facing the set surface  12   b  during closing, ribs  13   a  and  13   b  are provided to reinforce the stage lid portion  13  and stabilize the position of the intraocular lens  2 . In addition, a guide projection  13   c  is provided as an upper guide of the plunger  30 . 
         [0049]    Below the set surface  12   b  of the stage portion  12 , the positioning member  50  is detachably provided.  FIG. 4A  and  FIG. 4B  illustrate schematic configurations of the positioning member  50 .  FIG. 4A  illustrates a plan view, and  FIG. 4B  illustrates a side view. The positioning member  50  is configured separately from the nozzle body  10 , and has a structure in which a pair of side wall portions  51  and  51  is provided perpendicular to a connecting portion  52  on both right and left sides of the plate-shaped connecting portion  52 . From the lower end of each side wall portion  51 , holding portions  53  and  53  as gripping portions are provided to extend outward and spread. 
         [0050]    Moreover, at the diagonal positions in the central portion of the connecting portion  52 , a pair of first placing portions  54  and  54  protruding upward is formed. Furthermore, in a portion of the outer circumferential side of the first placing portion  54 , first positioning portions  55  and  55  are formed to protrude further upward. An inner wall of the first positioning portion  55  has a circular arc shape, a distance between the inner walls is set to be slightly larger than the diameter dimension of the lens main body  2   a  of the intraocular lens  1 . Also, the first positioning portions  55  and  55  are formed with support portion grooves  55   a  and  55   a  as groove portions for receiving the support portions  2   b  and  2   b  when placing the intraocular lens  2 . 
         [0051]    Furthermore, at the diagonal positions opposite to the first placing portions  54  and  54  of the connecting portion  52 , a pair of second placing portions  56  and  56  is formed. The height of the top surface of the second placing portion  56  is equal to the height of the top surface of the first placing portion  54 . In addition, on the outer portions of the top surfaces of the second placing portions  56  and  56 , second positioning portions  57  and  57  are formed to further protrude upward. The inner wall of the second positioning portion  57  also has a circular arc shape, and a distance between the inner walls is set to be slightly larger than the diameter of the lens main body  2   a  of the intraocular lens  2 . In addition, at the end portion of the central side of the connecting portion  52  in the second placing portions  56  and  56 , locking claws  58  and  58  are formed to slightly protrude. 
         [0052]    In this example, the positioning member  50  is assembled from the lower side of the set surface  12   b  of the nozzle body  10 . On the set surface  12   b  of the nozzle body  10 , a set surface through hole  12   c  penetrating through the set surface  12   b  in the thickness direction is formed. The external form of the set surface through hole  12   c  has an approximately similar shape that is slightly larger than a shape when the first placing portion  54  and the second placing portion  56  of the positioning member  50  are viewed from the top. Moreover, when the positioning member  50  is attached to the nozzle body  10 , the first placing portions  54  and  54  and the second placing portions  56  and  56  are inserted into the set surface through hole  12   c  from the lower side of the set surface  12   b , and protrude to the upper side of the set surface  12   b.    
         [0053]    At that time, the locking claws  58  and  58  provided in the second positioning portions  57  and  57  protrude to the set surface  12   b  via the set surface through hole  12   c , and are locked to the top surface of the set surface  12   b . Therefore, the positioning member  50  is assembled from the lower side of the nozzle body  10 , the first placing portions  54  and  54  and the second placing portions  56  and  56  are fixed in a state of protruding from the set surface  12   b . Moreover, when the intraocular lens  2  is set to the set surface  12   b , the outer circumference bottom surface of the lens main body  2   a  is placed on the top surfaces of the first placing portions  54  and  54  and the second placing portion  56  and  56 . In addition, the position of the lens main body  2   a  is restricted with respect to the horizontal direction, by the first positioning portions  55  and  55  and the second positioning portions  57  and  57 . Furthermore, at that time, the vicinity of the base of the support portions  2   b  and  2   b  is supported so as to pass through the support portion grooves  55   a  and  55   a , and the rotation around the optical axis of the intraocular lens  2  is restricted. In addition, the first placing portion  54 , the second placing portion  56 , the first positioning portion  55  and the second positioning portion  57  in this example correspond to the convex portions. 
         [0054]      FIG. 5A  and  FIG. 5B  illustrate schematic configurations of the plunger  30 . The plunger  30  has a length in the front and rear direction that is slightly larger than the nozzle body  10 . Moreover, the plunger is formed from an acting portion  31  of the leading end side based on a cylindrical shape, and an insertion portion  32  of the rear end side based on a rectangular rod shape. Moreover, the acting portion  31  is configured to include a cylindrical portion  31   a  having a cylindrical shape, and a thin plate-shaped flat portion  31   b  extending in the leftward and rightward direction of the cylindrical portion  31   a.    
         [0055]    At the leading end portion of the acting portion  31 , a notch portion  31   c  is formed. As can be seen from  FIG. 5A  and  FIG. 5B , the notch portion  31   c  is formed in a groove shape that opens in the upward direction and passes in the leftward and rightward direction of the acting portion  31 . Also, as can be seen from  FIG. 5B , the groove wall of the leading end side of the notch portion  31   c  is formed by the inclined surface toward the upper part as it goes to the leading end side of the acting portion  31 . 
         [0056]    Meanwhile, the insertion portion  32  has a generally H-shaped cross-section as a whole, the dimensions thereof in the upward and downward direction and the leftward and rightward direction are set to be slightly smaller than the through hole  10   c  of the nozzle body  10 . In addition, at the rear end of the insertion portion  32 , a disk-shaped pressing plate portion  33  extending in the upward, downward, leftward and rightward direction the vertical and horizontal directions is formed. 
         [0057]    In a portion of the leading end side from the center in the front and rear direction of the insertion portion  32 , a claw portion  32   a  is formed which protrudes toward the upper side of the insertion portion and is vertically movable by elasticity of the material of the plunger  30 . Moreover, when the plunger  30  is inserted into the nozzle body  10 , a locking hole  10   e  illustrated in  FIG. 3  provided in the thickness direction on the top surface of the nozzle body  10  engages with the claw portion  32   a , and thus, the relative position between the nozzle body  10  and the plunger  30  in the initial state is determined. In addition, the formation positions of the claw portion  32   a  and the locking hole  10   e  are set so that, in the engaged state, the leading end of the acting portion  31  is positioned behind the lens main body  2   a  of the intraocular lens  2  set on the stage portion  12 , and is positioned at a location where the notch portion  31   c  can support the rear support portion  2   b  of the lens main body  2   a  from the lower side. 
         [0058]    Prior to use of the insertion tool  1  configured as described above, the plunger  30  is inserted into the nozzle body  10  and disposed at the initial position. Furthermore, as described above, the positioning member  50  is attached to the nozzle body  10  from the lower side of the set surface  12   b . Thus, the first placing portion  54  and the second placing portion  56  of the positioning member  50  are held in a state that protrudes from the set surface  12   b.    
         [0059]    Next, the lens main body  2   a  of the intraocular lens  2  is placed and positioned on the top surfaces of the first placing portion  54  and the second placing portion  56  in the state of causing the support portions  2   b  and  2   b  to face in the front and rear direction of the nozzle body  10 . In this state, since the outer circumferential portion of the lens main body  2   a  in the intraocular lens  2  comes into contact with the first placing portion  54  and the second placing portion  56 , the central portion is supported in a non-load state. Also, in this state, the support portion  2   b  of the intraocular lens  2  is also supported by the bottom surface of the notch portion  31   c  of the plunger  30 , other than the support portion grooves  55   a  and  55   a.    
         [0060]    When the intraocular lens  2  is inserted into the eyeball using the insertion tool  1 , first, the positioning member  50  is detached from the nozzle body  10 . Thus, the first placing portion  54  and the second placing portion  56  supporting the lens main body  2   a  of the intraocular lens  2  are retracted from the set surface  12   b , the intraocular lens  2  is movably placed on the set surface  12   b , and the restrictions on the position and posture of the intraocular lens  2  are released. 
         [0061]    Subsequently, the leading end portion  10   a  of the nozzle portion  15  of the nozzle body  10  is inserted into the incision provided in the eye tissue. Here, since the leading end portion  10   a  has an oblique opening shape, it is possible to easily perform the insertion into the incision. Moreover, after inserting the nozzle portion  15  into the incision, in that state, the pressing plate portion  33  of the plunger  30  is pushed to the leading end side of the nozzle body  10 . Thus, the leading end of the acting portion  31  of the plunger  30  abuts against the outer circumference of the lens main body  2   a  of the intraocular lens  2  set on the set surface  12   a , and the intraocular lens  2  moves toward the leading end portion  10   a  along with the advancement of the plunger  30 . 
         [0062]    Moreover, when the intraocular lens  2  is pressed by the plunger  30  and the nozzle body  10  moves forward, the intraocular lens  2  is deformed in response to changes in the cross-sectional shape of the through hole  10   c , the intraocular lens  2  is extruded into the eyeball from the leading end portion  10   a  of the nozzle body  10  in the deformed state. 
         [0063]    Here, in the above-described inserting operation of the intraocular lens  2 , when the positioning member  50  is detached from the nozzle body  10 , in a case where the positioning member  50  is detached straight in the direction of the optical axis of the intraocular lens  2 , in particular, no problems occur. However, for example, when it is detached by twisting so as to rotate around the axis in the front and rear direction (the axis in the direction of movement of the intraocular lens  2 ) of the insertion tool  1 , there is a risk of damage to the nozzle body  10  or the positioning member  50  by interference of the first placing portion  54  and the second placing portion  56  with the end surface of the set surface through hole  12   c . In addition, there is a fear that the first placing portion  54  and the second placing portion  56  interpose the lens main body  2   a  or the support portion  2   b  of the intraocular lens  2 . 
         [0064]    In particular, in a case where the right and left outer walls of the first positioning portions  55  and  55  of the first placing portions  54  and  54  are deformed by interference with the end surface of the set surface through hole  12   c , in some cases, the support portion grooves  55   a  and  55   a  are crushed and the opening portion is closed, and the support portions  2   b  and  2   b  are interposed between the support portion grooves  55   a  and  55   a . Then, when the positioning member  50  is detached from the stage portion  12 , a situation occurs in which the support portions  2   b  and  2   b  of the intraocular lens  2  protrude outside of the set surface through holes  12   c , and in some cases, the intraocular lens  2  is damaged, and the insertion intraocular lens  2  becomes impossible. 
         [0065]    In contrast, in this example, the positioning member  50  is provided with an anti-rotation wall portion that suppresses the rotation around the axis in the direction of movement of the intraocular lens  2  at the time of detachment.  FIG. 6A  and  FIG. 6B  illustrate a positioning member  60  in this example. The positioning member  60  differs from the positioning member  50  illustrated in  FIG. 4A  and  FIG. 4B  in that anti-rotation wall portions  59  and  59  are provided on the outside of the respective side wall portions  51  and  51 . The anti-rotation wall portions  59  and  59  are provided for the entire area in the front and rear direction of the positioning member  60  to be parallel to the side wall portions  51  and  51 . Moreover, rib groove portions  61  and  61  configured to house a rib portion  12   g  of the stage portion  12  of the nozzle body  10  are formed between the side wall portion  51  and the anti-rotation wall portion  59  as described below. 
         [0066]      FIG. 7A  and  FIG. 7B  illustrate diagrams of the case of applying the positioning member  60  of this example to the intraocular lens insertion tool  1 . Unlike  FIG. 1A  and  FIG. 1B , it is understood that the anti-rotation wall portion  59  is disposed to be exposed to the outside of the right and left sides of the stage portion  12 . Furthermore,  FIG. 8A  and  FIG. 8B  illustrate diagrams of the vicinity of the positioning member  60  in the case of applying the positioning member  60  in this example to the intraocular lens insertion tool  1 .  FIG. 8A  illustrates the side view, and  FIG. 8B  illustrates an A-A cross-section thereof. 
         [0067]    As can be seen from  FIG. 8B , on the right and left lower sides of the set surface  12   b  in the stage portion  12  of the nozzle body  10 , the rib portions  12   g  and  12   g  as the flat plate portions are provided. When the rib portion  12   g  is viewed from the side surface, as illustrated in  FIG. 8A , the height of the leading end side thereof increases like a taper, and the rear side thereof has a constant height. 
         [0068]    The positioning member  60  in this example is fixed in the state of housing the respective rib portions  12   g  between the respective side wall portions  51  and  51  and the respective anti-rotation wall portions  59  and  59 , when it is mounted to the stage portion  12  from the lower side. In this example, the distance between the respective side wall portions  51  and  51  and the respective anti-rotation wall portions  59  and  59  is set to be slightly larger than the thickness of the respective rib portions  12   g  and  12   g.    
         [0069]    According to this, as indicated by the arrow in  FIG. 8B , in a case where the user of the intraocular lens insertion tool  1  detaches the positioning member  60  from the nozzle body  10 , even when trying to rotate the positioning member  60  around the axis in the front and rear direction (the axis in the direction of movement of the intraocular lens  2 ) of the nozzle body  10 , it is possible to suppress the positioning member  60  from rotating too much. In addition, the operation of housing the rib portion  12   g  in the rib groove portion  61  between the side wall portion  51  and the anti-rotation wall portion  59  corresponds to the operation of suppressing the rotation of the positioning member, by causing the two wall surfaces formed parallel to the flat plate portion to face the flat plate portion from both sides in this example. 
         [0070]    According to this, it is possible to suppress the damage of the nozzle body  10  or the positioning member  60  due to interference of the first placing portion  54  and the second placing portion  56  with the end surface of the set surface through hole  12   c . Furthermore, it is possible to suppress the first placing portion  54  and the second placing portion  56  from interposing the lens main body  2   a  or the support portion  2   b  of the intraocular lens  2 . Thus, it is possible to more smoothly or reliably perform the inserting operation of the intraocular lens. 
         [0071]    In addition, it is possible to prevent a situation in which the right and left outer walls of the first positioning portions  55  and  55  of the first placing portions  54  and  54  are deformed by interference with the end surface of the set surface through hole  12   c , the support portion grooves  55   a  and  55   a  collapse to close the opening portion, and the support portions  2   b  and  2   b  of the intraocular lens  2  are interposed. As a result, it is possible to prevent a situation in which the support portions  2   b  and  2   b  of the intraocular lens  2  protrude from the set surface through hole  12   c , when detaching the positioning member  50 . 
         [0072]    In addition, the rotation suppressing unit in this example is configured to include the side wall portions  51  and  51 , the anti-rotation wall portions  59  and  59 , and the rib groove portions  61  and  61 . Furthermore, in this example, the side wall portions  51  and  51 , the anti-rotation wall portions  59  and  59 , and the rib groove portions  61  and  61  are disposed on both sides of the intraocular lens center. Thus, the rotation suppressing unit in this example are provided on both sides with respect to the central axis in the direction of movement of the intraocular lens, when viewed from the direction of optical axis of the intraocular lens. 
       Second Example 
       [0073]    Next, a second example will be described with reference to  FIG. 9A  and  FIG. 9B . In the first example, the rib portions  12   g  and  12   g  are provided on the right and left lower sides of the set surface  12   b  in the stage portion  12  of the nozzle body  10 , and the positioning member  60  is provided with the anti-rotation wall portions  59  and  59  on the outer side of the respective side wall portions  51  and  51 . Moreover, the positioning member  60  is fixed in the state in which the respective rib portions  12   g  and  12   g  are housed between the respective side wall portions  51  and  51  and the respective anti-rotation wall portions  59  and  59 , when it is attached to the stage portion  12  from the lower side. 
         [0074]    In contrast, in this example, on the right and left lower sides of the set surface  12   b  in the stage portion  12  of the nozzle body  10 , in addition to the rib portions  12   g  and  12   g , anti-rotation rib portions  12   h  and  12   h  are provided inside the rib portions  12   g  and  12   g . In addition, a positioning member  65  is not provided with the anti-rotation wall portion. Moreover, when the positioning member  65  is attached to the stage portion  12  from the lower side, it is fixed in a state in which the respective side wall portions  51  and  51  are housed in side wall groove portions  12   k  and  12   k  between the respective rib portions  12   g  and  12   g  and the respective anti-rotation rib portions  12   h  and  12   h.    
         [0075]    With this configuration, in a case where the user of the intraocular lens insertion tool  1  detaches the positioning member  65  from the nozzle body  10 , as indicated by the arrow in  FIG. 9B , even when trying to rotate the positioning member  65  around the axis in the front and rear direction (the axis in the direction of movement of the intraocular lens  2 ) of the nozzle body  10 , it is possible to suppress the positioning member  65  from rotating too much. In addition, the operation of housing the side wall portion  51  in the side wall groove portion  12   k  between the rib portion  12   g  and the anti-rotation rib portion  12   h  corresponds to the operation of suppressing the rotation of the positioning member, by causing the two wall surfaces formed parallel to the flat plate portion to face the flat plate portion from both sides in this example. 
         [0076]    Furthermore, with this configuration, it is also possible to suppress the damage of the nozzle body  10  or the positioning member  65  due to interference of the first placing portion  54  and the second placing portion  56  with the end surface of the set surface through hole  12   c . Furthermore, it is possible to suppress the first placing portion  54  and the second placing portion  56  from interposing the lens main body  2   a  and the support portion  2   b  of the intraocular lens  2 . Thus, it is possible to more smoothly or reliably perform the inserting operation of the intraocular lens. 
         [0077]    In addition, it is possible to prevent the situation in which the right and left outer walls of the first positioning portions  55  and  55  of the first placing portions  54  and  54  are deformed by interference with the end surface of the set surface through holes  12   c , the support portion grooves  55   a  and  55   a  collapse to close the opening portion, and the support portions  2   b  and  2   b  of the intraocular lens  2  are interposed. As a result, it is possible to prevent a situation in which the support portions  2   b  and  2   b  of the intraocular lens  2  protrude from the set surface through hole  12   c , when detaching the positioning member  65 . 
         [0078]    In addition, the rotation suppressing unit in this example is configured to include the rib portions  12   g  and  12   g , the anti-rotation rib portions  12   h  and  12   h , and the side wall groove portions  12   k  and  12   k.    
       Third Example 
       [0079]    Next, a third example of the invention will be described. In this example, an example will be described in which, by disposing the holding portion of the positioning member on the rear side of the center in the front and rear direction of the member, while preventing the rotation about the axis in the front and rear direction of the nozzle body  10  (the direction of movement of the intraocular lens), the rotation about the axis in the leftward and rightward direction of the nozzle body  10  is allowed, and the positioning member can be more easily detached. 
         [0080]      FIG. 10A  and  FIG. 10B  illustrate a schematic configuration of a positioning member  70  in this example.  FIG. 10A  illustrates a plan view, and  FIG. 10B  illustrates a side view. Furthermore,  FIG. 11A  and  FIG. 11B  illustrate perspective views of the positioning member  70 .  FIG. 11A  is a perspective view when viewed from the upper rear side, and  FIG. 11B  is a perspective view when viewed from the lower front side thereof. The positioning member  70  differs from the positioning member  60  described in  FIG. 6A  and  FIG. 6B  in that, in the positioning member  70 , holding portions  63  and  63  as the gripping portions are provided so as to be biased to the rear side from the center in the front and rear direction of the positioning member  70 . 
         [0081]      FIG. 12A  and  FIG. 12B  illustrate overall views of the case of applying the positioning member  70  of this example to the intraocular lens insertion tool  1 . The locking claws  58  and  58  provided on the second positioning portions  57  and  57  as described above are locked to the top surface of the set surface  12   b , and thus, the positioning member  70  is mounted to the nozzle body  10 . In this example, therefore, the holding portion  63  is provided so as to be biased to the rear side from the junction of the positioning member  70  with the nozzle body  10 . As a result, by simply holding and pulling the holding portion  63  downward by the user, it is possible to detach the positioning member  70  while rotating it in the direction illustrated by the arrow in  FIG. 12B  (around the axis in the leftward and rightward direction of the nozzle body  10 ), and it is possible to more easily detach the positioning member  70 . 
         [0082]    Moreover, it is possible to urge the user to rotate and detach the holding portion  63  around the axis in the leftward and rightward direction of the nozzle body  10 , and it is possible to suppress the positioning member  70  from being rotated and detached around the axis in the front and rear direction of the nozzle body  10 . When rotating and detaching the positioning member  70  around the axis in the horizontal direction of the nozzle body  10 , since the support portion groove  55   a  rotates in the longitudinal direction, a risk that the support portion groove  55   a  collapses to interpose the support portion  2   b  is significantly lowered. Therefore, in this example, it is possible to more reliably or smoothly perform the inserting operation of the intraocular lens  2 . 
         [0083]    In addition, in the anti-rotation wall portions  59  and  59  of the positioning member  70  of this example, concave portions  59   a  and  59   b  are provided, respectively. Moreover, the length in the front and rear direction of the concave portion  59   a  is formed to be longer than the length in the front and rear direction of the concave portion  59   b . This is configured so that a nozzle snap fit  13   e  of the lid portion  13  as illustrated in  FIG. 12A  and  FIG. 12B  can escape from the concave portion  59   a  but does not escape from the concave portion  59   b.    
         [0084]    According to this configuration, as illustrated in  FIG. 12B , when trying to mount the positioning member  70  in a correct direction, it is possible to mount the positioning member  70  without interference between the anti-rotation wall portion  59  and the nozzle snap fit  13   e . Meanwhile, when trying to mount the positioning member  70  in an incorrect direction, the anti-rotation wall portion  59  and the nozzle snap fit  13   e  interfere with each other and the mounting is prohibited. Thus, in the assembling process of the intraocular lens insertion tool  1 , it is possible to prevent the erroneous mounting of the positioning member  70 . In addition, in this example, the concave portions  59   a  and  59   b  correspond to the erroneous mounting preventing portions. 
         [0085]    In addition, in this example, since the holding portion  63  is positioned so as to be biased to the rear side from the center in the front and rear direction of the positioning member  70 , by viewing the position of the holding portion  63 , it is also possible to more easily prevent the erroneous mounting of the positioning member  70 . 
         [0086]      FIG. 13A  to  FIG. 13G  are six-sided views of the positioning member  70  in this example:  FIG. 13A  is a plan view;  FIG. 13B  is a bottom view;  FIG. 13C  is a front view;  FIG. 13D  is a rear view;  FIG. 13E  is a left side view;  FIG. 13F  is a right side view; and  FIG. 13G  illustrates a perspective view. 
         [0087]    In addition,  FIG. 14A  to  FIG. 14G  illustrate characteristic portions (partial design) of an external diagram of the positioning member  70  by a solid line, and illustrates other portions by a broken line. Of course, the entire shape constituted by the characteristic portions and the broken line is also a new part, but it is to clarity the description. In  FIG. 14A  to  FIG. 14G ,  FIG. 14A  is a plan view;  FIG. 14B  is a bottom view;  FIG. 14C  is a front view;  FIG. 14D  is a rear view;  FIG. 14E  is a left side view;  FIG. 14F  is a right side view; and  FIG. 14G  illustrates a perspective view. 
         [0088]    In addition, in this example, the rotation suppressing unit is configured to include the side wall portions  51  and  51 , the anti-rotation wall portions  59  and  59 , and the rib groove portions  61  and  61 . Furthermore, in this example, the side wall portions  51  and  51 , the anti-rotation wall portions  59  and  59 , and the rib groove portions  61  and  61  are disposed on both sides of center of the intraocular lens. Thus, the rotation suppressing unit in this example are provided on both sides with respect to the central axis in the direction of movement of the intraocular lens, when viewed from the optical axis of the intraocular lens. 
         [0089]    In each of the above-described examples, as the intraocular lens to be inserted, an example of using a so-called three-piece type in which the lens main body (optical portion) and the support portion are made of different materials has been described. However, it is also possible to apply the invention to an insertion tool for inserting a so-called one-piece intraocular lens in which the lens main body (optical portion) and the support portion are integrally formed. Furthermore, the shape of the positioning member is not intended to be limited to the shape of the above-described examples, unless it departs from the spirit of the invention. As long as the rotation of the positioning member is suppressed, by causing the flat plate portion formed on one of the outer circumference of the housing portion or the positioning member to be faced by the two wall surfaces formed on the other of the outer circumference of the housing portion or the positioning member from both sides, other shapes may be selected. 
         [0090]    For example, an aspect may be adopted in which the length in the front and rear direction of the anti-rotation wall portion does not extend throughout the entire region of the positioning member, or only one anti-rotation wall portion is provided. In addition, an aspect may be adopted in which the gap between the anti-rotation wall portion and the side wall portion is smaller than the rib thickness, and the rib portion is interposed between the two wall surfaces without a gap. 
         [0091]    In addition, the length in the front and rear direction of the anti-rotation rib portion may be equal to or different from the rib portion. Furthermore, the anti-rotation rib portion may be provided so as to be divided in the front and rear direction. In addition, only one anti-rotation rib portion may be provided. In addition, an aspect may be adopted in which the gap between the anti-rotation rib portion and the rib portion is smaller than the thickness of the side wall portion, and the side wall portion is interposed between the two wall surfaces without a gap. 
       REFERENCE SIGNS LIST 
       [0000]    
       
           1  insertion tool 
           2  intraocular lens 
           10  nozzle body 
           10   a  leading end portion 
           10   b  rear end portion 
           10   f  guide portion 
           10   g  contact portion 
           12  stage portion 
           12   b  set surface 
           12   g  rib portion 
           12   h  anti-rotation rib portion 
           12   k  side wall groove portion 
           13  stage lid portion 
           13   a  rib 
           13   b  rib 
           13   c  guide projection 
           15  insertion cylindrical portion 
           30  plunger 
           31  acting portion 
           31   a  cylindrical portion 
           31   b  flat portion 
           50 ,  60 ,  70  positioning member 
           51  side wall portion 
           53 ,  63  holding portion 
           59  anti-rotation wall portion 
           61  rib groove portion