Source: https://patents.google.com/patent/JP5416379B2/en
Timestamp: 2019-10-17 11:08:03
Document Index: 579599274

Matched Legal Cases: ['art 25', 'art 26', 'art 27', 'art 25', 'art 25', 'art 26', 'art 27', 'art 22', 'art 63', 'art 102', 'art 6', 'art)\n8', 'art)\n56', 'art)\n61', 'art)\n88']

JP5416379B2 - Intraocular lens insertion device - Google Patents
JP5416379B2
JP5416379B2 JP2008227641A JP2008227641A JP5416379B2 JP 5416379 B2 JP5416379 B2 JP 5416379B2 JP 2008227641 A JP2008227641 A JP 2008227641A JP 2008227641 A JP2008227641 A JP 2008227641A JP 5416379 B2 JP5416379 B2 JP 5416379B2
JP2008227641A
JP2010057767A (en
2008-09-04 Application filed by Ｈｏｙａ株式会社 filed Critical Ｈｏｙａ株式会社
2008-09-04 Priority to JP2008227641A priority Critical patent/JP5416379B2/en
2010-03-18 Publication of JP2010057767A publication Critical patent/JP2010057767A/en
2014-02-12 Publication of JP5416379B2 publication Critical patent/JP5416379B2/en
The present invention relates to an intraocular lens insertion device used to insert an intraocular lens into an aphakic eye after cataract surgery or into a phakic eye in refractive surgery.
In recent years, with the spread of ultrasonic emulsification, etc., intraocular lenses that can be inserted through small incisions for the purpose of reducing postoperative astigmatism and surgical invasion, that is, foldable silicone, acrylic resin, hydrogel, etc. Intraocular lenses made of soft materials have been developed and widely used in clinical practice.
On the other hand, various intraocular lens insertion devices have been developed as intraocular lens insertion instruments for inserting these foldable intraocular lenses through a smaller incision in the eyeball. According to these intraocular lens insertion devices, the folded intraocular lens can be pushed out into the eye through the cylindrical insertion tube, so that it is much smaller than the case of insertion using a conventional insulator. An intraocular lens can be inserted into the eye through the incision.
The insertion method of the intraocular lens insertion device is roughly classified into a screw type (screw-in type) and a push type.
The push type resists resistance such as friction between the intraocular lens and the inner wall of the insertion tube, and the operator presses the operation part with a grip force sensibly and transmits the pressure to the intraocular lens to push the intraocular lens forward Intraocular lens insertion device (for example, Patent Documents 1, 2, and 3). According to these push-type intraocular lens insertion devices, the insertion operation of the intraocular lens is simple and can be operated with one hand, so that the operator can perform other operations with an open hand even during the insertion operation. However, it is necessary to advance the intraocular lens while balancing the frictional resistance between the intraocular lens and the inner wall of the insertion tube and the operating pressure of the operating unit. There is also a drawback that it is relatively difficult to control. In addition, the nozzle provided at the tip of the intraocular lens insertion device is usually the thinnest in the insertion cylinder through which the intraocular lens passes. If the inner diameter of the nozzle is reduced to accommodate the wound, the load when the intraocular lens passes through the nozzle increases, causing the intraocular lens to suddenly be released into the eye and damaging the ocular tissue. There is also a possibility that.
On the other hand, the screw type has a male-female relationship between the plunger and the main body. By turning the operation part at the end of the plunger, the plunger or the rod that pushes out the intraocular lens is moved in the lens advancing direction. This is an intraocular lens insertion device (for example, Patent Document 4) that advances and thereby pushes the intraocular lens. According to these screw-type intraocular lens insertion devices, the movement amount of the plunger or rod is easy to control, so that the intraocular lens can be used when releasing a thick intraocular lens, or when reducing the inner diameter of the nozzle. Even if the load when passing through the nozzle increases, there is an advantage that the risk of suddenly releasing the intraocular lens into the eye can be reduced, but the insertion operation must be performed with both hands There is a concern that the operation is somewhat complicated compared to the push type.
JP 2000-516487 JP 2003-144480 A JP 2004-351196 A Japanese National Patent Publication No. 11-506357
As a method of reducing the “sudden release of intraocular lenses into the eye”, which is a problem with push-type intraocular lens insertion devices, a slit is provided at the tip of the insertion tube, or a lens is used by using a spring or the like. There is a method of applying a force in the direction opposite to the pushing direction to the plunger (for example, Japanese Patent Publication No. 11-510711), but neither method is sufficient as a method for preventing sudden discharge.
In view of the above-described problems, an object of the present invention is to provide an intraocular lens insertion device that can control the release of an intraocular lens more reliably in the eye.
The invention according to claim 1 of the present invention is an intraocular lens insertion device that pushes the operation portion to push the intraocular lens, a lens contact portion that pushes the intraocular lens, and an external force applied to the operation portion. Transmitting to the lens contact portion, an insertion tube for releasing the intraocular lens pushed out by the lens contact portion to the outside, and when the intraocular lens passes near the distal end portion of the insertion tube and a stopping means for temporarily stopping said lens contact portion, the operation portion includes a plurality of operation unit of the first operating unit, a second operating portion disposed in the rear of the first operating unit, step And a main body for extruding the intraocular lens and fixing the insertion cylinder forward, at least one of the operation portions being provided at the rear of the main body, and the stopping means from the distal end of the insertion cylinder At a position within 10 mm, the intraocular lens When the lens passes through the nozzle portion provided at the tip of the insertion tube, the operator's finger pressing the first operation portion comes into contact with the stop means to temporarily stop the lens contact portion, and thereafter The lens contact portion is configured to discharge the intraocular lens from the nozzle portion to the outside by applying an external force in the traveling direction of the intraocular lens to the second operation portion.
The invention according to claim 2 of the present invention is an intraocular lens insertion device that pushes the operation portion to push out the intraocular lens, and a lens contact portion that pushes out the intraocular lens, and an external force applied to the operation portion. Transmitting to the lens contact portion, an insertion tube for releasing the intraocular lens pushed out by the lens contact portion to the outside, and when the intraocular lens passes near the distal end portion of the insertion tube Stop means for temporarily stopping the lens contact portion, the transmission portion comprises a first plunger and a second plunger connected to the lens contact portion,
The second plunger moves forward as the first plunger moves forward, and moves to the first plunger independently from the first plunger so as to move forward independently. Slidably provided,
The operation unit includes a first operation unit provided with the first plunger and a second operation unit provided with the second plunger.
When the intraocular lens passes through a nozzle portion provided at the distal end of the insertion cylinder at a position within 10 mm from the distal end of the insertion cylinder, the stopping means is adapted to contact the first operating section with the stop means. The lens contact portion is temporarily stopped by contact, and then the lens contact portion releases the intraocular lens from the nozzle portion to the outside by applying an external force in the traveling direction of the intraocular lens to the second operation portion. It is characterized by being configured.
According to the intraocular lens insertion device of the present invention, the stopping means temporarily stops the lens contact portion when the intraocular lens passes in the vicinity of the distal end portion of the insertion tube, thereby resisting the reaction force of the operation portion. Even if a large external force is applied, the lens contact portion can be stopped before the intraocular lens is released, so that the intraocular lens can be prevented from being suddenly released into the eye. Therefore, since the intraocular lens insertion device can release the intraocular lens with a smaller external force, the release of the intraocular lens can be controlled more reliably.
According to the present invention, by temporarily stopping the lens contact portion near the distal end portion of the insertion tube, it is possible to reduce the possibility that the intraocular lens is suddenly released into the eye as compared with the case where the lens contact portion is not stopped. it can.
When many parts of the intraocular lens come into the eye from the tip of the insertion tube when the lens contact part is temporarily stopped, the tip of the insertion tube part can be removed without pressing the intraocular lens again. Due to elasticity, it may naturally go into the eye. In that case, in order to install the intraocular lens at a predetermined position in the eye, the possibility can be reduced by applying a small force to the operation unit again to advance the lens contact unit.
Even when many portions of the intraocular lens remain in the insertion tube, the intraocular lens is moved into the intraocular region by temporarily stopping the lens contact portion to stop the momentum of the lens contact portion from moving forward. It is possible to reduce the possibility of sudden release.
When setting the position to temporarily stop, the material of the insertion tube, the shape of the lumen of the insertion tube (non-object, ellipse, diamond, circle, etc.), the shape of the tip of the insertion tube (slit, notch, etc.), support It must be set in consideration of various factors such as the shape of the intraocular lens including the portion, the material and flexibility of the intraocular lens, and the sliding resistance between the intraocular lens and the insertion tube.
For example, in an intraocular lens insertion device in which a slit is provided in the distal end portion of the insertion tube, the temporary stop position of the lens contact portion may be set on the distal end side of the insertion tube as compared with the case where no slit is provided.
Further, it is considered that the optimal setting position is different between the intraocular lens having high elasticity and the intraocular lens having low elasticity.
As one guideline for the stop position, it can be considered that the position from which the pressing resistance of the operation portion reaches the maximum value is set to the distal end side of the insertion tube.
As another guide, setting based on the size of the optical part of the intraocular lens can be considered. For example, in the case of an intraocular lens with an optical part diameter of 6 mm, a temporary stop position is placed 6 mm from the tip of the insertion tube (the front edge in the case of a nozzle part with a notch) to the insertion tube side. It can be set.
As described above, the temporary stop position needs to be set in consideration of various factors.However, if the position is 10 mm inward from the tip of the insertion tube, the lens contact portion is temporarily Even if it is stopped, it is considered necessary to press the operating part with a force close to or greater than that before stopping when applying the force to the operating part again to advance the lens contact part. It cannot be expected to have a great effect as a jump-out control.
As the stopping means for temporarily stopping the lens contact portion, a method for forcibly stopping mechanically, a means for forcibly stopping by the interaction between the operating hand or finger and the intraocular lens insertion device, etc. are considered. It is done.
In the operation unit, the portion that is pressed until it is temporarily stopped and the portion that is pressed again after being temporarily stopped may be the same or different. On the other hand, the lens contact portion is preferably the same portion before and after stopping.
1. First Embodiment (1) Overall Configuration An intraocular lens insertion device 1 shown in FIG. 1 includes a main body 2, a cartridge 4 attached to the main body 2, and an operation unit 5. A plunger 6 as a transmission unit is connected to the operation unit 5. A rod 7 for pushing the intraocular lens 8 is provided at the tip of the plunger 6. The operation unit 5 is disposed on the one end 2 a side of the main body 2. Accordingly, the intraocular lens 8 installed in the cartridge 4 can be pushed out by the rod 7 when the operator presses the operation unit 5 as a whole. Note that an insertion cylinder that is used in a disposable manner and in which an intraocular lens 8 is installed by an operator or assistant during surgery is generally called a cartridge.
Further, in addition to the above-described configuration, the intraocular lens insertion device 1 according to the present embodiment includes a stop unit to be described later, and after the rod 7 starts to push out the intraocular lens 8, the intraocular lens 8 is removed from the cartridge 4 to the outside. The rod 7 can be temporarily stopped after the intraocular lens 8 is pushed out by a predetermined distance until the rod 7 is released.
In the following description, the lens traveling direction (extrusion direction) is “front”, and the opposite direction is “rear”.
Here, it is preferable that the main body 2, the plunger 6, and the rod 7 are formed of a synthetic resin that can be injection-molded. Thereby, since it can mass-produce cheaply, it can be used suitably also for a disposable (disposable) use.
The intraocular lens 8 is made of a foldable soft material such as silicon resin, acrylic resin, hydrogel, and the like, and is deployed when released into the eyeball. In addition, the intraocular lens 8 in this figure shows the folded state.
The main body 2 is formed of a cylindrical member, and is provided with a restraining portion 10 as a stopping means at one end 2a. The main body 2 includes a locking portion 11 for preventing the operation portion 5 from returning and a cartridge 4 provided on the other end side. An attachment groove portion 12 to be attached and a finger hook portion 13 are provided.
The operation unit 5 includes a first operation unit 15 and a second operation unit 16, and the first operation unit 15 and the second operation unit 16 are connected to the base ends of the interval holders 17. Thus, the lens is held at a predetermined interval in the lens traveling direction. The operation unit 5 is formed by bending a substantially rectangular member into a U shape, and is connected to the plunger 6 in the first operation unit 15. One side surface of the first operation unit 15 is referred to as a first operation surface 15a. The first operation unit 15 is provided with a latch receiver 18 at a tip which is not connected to the interval holder 17.
The plunger 6 is configured to transmit an external force applied to the operation unit 5 in the direction of the lens traveling axis A to the rod 7. The plunger 6 has a coil spring loading rod 20 having one end 20 a connected to the other surface 15 b of the first operating portion 15 and a floating rod 21 connected to the other end 20 b of the coil spring loading rod 20. The idler 21 is configured to move freely in the main body 2 so as to advance and retract in the direction of the lens advancing axis A. The floating rod 21 has one end 21 a connected to the other end 20 b of the coil spring loading rod 20 and the other end 21 b connected to the base end 7 a of the rod 7.
The rod 7 is configured such that the intraocular lens 8 can be pushed out by an external force transmitted from the plunger 6. A lens contact portion 22 is provided at the tip of the rod 7. As the shape of the lens contact portion 22 at the tip of the rod 7, a known shape can be adopted.
The coil spring 23 is loaded on the coil spring loading rod 20 so that one end is in contact with the one end 2a of the main body 2 and the other end is in contact with the other surface 15b of the first operating portion 15. Due to the biasing force of the coil spring 23, the operation unit 5 is biased rearward. Thereby, the floating rod 21 is held at a position in contact with the inner wall of the one end 2a of the main body 2. In the present embodiment, the state where the floating rod 21 is in contact with the inner wall of the one end 2a of the main body 2 is referred to as an origin for convenience of explanation.
The cartridge 4 is provided with a lens installation part 25, a transition part 26, and a nozzle part 27 in order along the lens advancing axis A, and the intraocular lens 8 installed in the lens installation part 25 is pushed out by the rod 7. Then, it is folded small by moving from the lens installation part 25 and passing through the transition part 26, so that it can be discharged to the outside in a state of being folded small from the nozzle part 27 whose inner diameter is substantially constant in the lens traveling axis A direction. It is configured.
Further, on both sides of the cartridge 4, wing portions 28 are provided so as to project in a direction perpendicular to the lens traveling axis A. The wing portion 28 is formed so as to be able to fit into a mounting groove portion 12 provided on the other end side of the main body 2. Normally, at the start of operation, before the cartridge 4 is attached to the main body 2, a liquid that can smoothly move the intraocular lens 8 such as a viscoelastic substance is injected into the cartridge 4.
The restraining portion 10 is formed so that the operator's finger pressing the first operating portion 5 is restrained at a predetermined position, and the first operating portion 5 can be immersed. As shown in FIG. 2, the restraining portion 10 has one end connected to one end 2a of the main body 2, and has an immersion groove 30 and a restraining surface 31 provided at the other end.
The stop surface 31 is configured by a surface orthogonal to the lens traveling axis A. The immersion groove 30 extends in a straight line in a direction perpendicular to the lens traveling axis A through the approximate center of the stop surface 31 and is formed from one end to the other end of the stop portion 10.
A locking projection 32 formed at one end of the locking portion 11 is disposed at an outer edge portion where the immersion groove 30 and the stop surface 31 intersect. The locking portion 11 is connected to the main body 2 at a connection piece 33 provided on the other end side, and the locking projection 32 can tilt in a direction perpendicular to the lens advancing axis A with the connection piece 33 as a rotation center. It is formed as follows.
(2) Operation and effect In the above configuration, after the nozzle portion 27 is inserted into the eye, the operation portion 5 is pressed with the finger from the state where the operation portion 5 is at the origin (FIG. 1 (a)). Apply a forward external force to 5. As shown in FIG. 3, the intraocular lens insertion device 1 includes a plunger 6 while contracting the coil spring 23 on the other side surface 15 b of the first operation portion 15 by a forward external force applied to the operation portion 5. Both the rod 7 and the rod 7 move forward.
Then, as shown in FIG. 4, the first operation unit 15 reaches the restraining unit 10 and is immersed in the immersion groove 30. Here, the operator's finger pressing the first operation surface 15a comes into contact with the stop surface 31 when the first operation surface 15a and the stop surface 31 are flush with each other. This makes it impossible for the surgeon to push the first operation surface 15a and push the operation unit 5 forward further. Thereby, the intraocular lens insertion device 1 temporarily stops the lens contact portion 22.
At the same time, the distal end of the first operating portion 15 abuts on the locking projection 32 of the locking portion 11, and the first operating portion 15 is further pushed to bring the locking projection 32 in a direction orthogonal to the lens advancing axis A. Deform. When the tip of the first operating portion 15 gets over the locking projection 32, the locking portion 11 returns elastically. Then, in the first operating portion 15, the locking receiver 18 engages with the locking protrusion 32. As a result, the operation unit 5 cannot move backward.
As a result of the first operation described above, the lens contact portion 22 at the tip of the rod 7 is brought into contact with the peripheral edge of the optical portion 8a of the intraocular lens 8 installed in the cartridge 4, and the intraocular lens 8 is moved forward. Extrude (Figure 3). In the present embodiment, when the first operation surface 15a and the stop surface 31 are flush with each other, even if the first operation surface 15a is pressed, it is impossible to push the operation unit 5 forward further. The inner lens insertion instrument 1 temporarily stops the lens contact portion 22 when the intraocular lens 8 passes through the nozzle portion 27. As a result, the intraocular lens 8 sequentially moves from the lens installation unit 25 to the transition unit 26 and the nozzle unit 27 and stops at a predetermined position. Here, the predetermined position means a position before the intraocular lens 8 is released from the nozzle portion 27 of the cartridge 4. Therefore, the intraocular lens 8 at a predetermined position is in a state where it can be completely released to the outside if a slight force is applied.
Next, as shown in FIG. 5, the surgeon presses the second operation portion 16 to apply a forward external force to the operation portion 5. Due to the forward external force applied to the operating portion 5, the first operating portion 15 moves forward in the immersion groove 30 (FIG. 6). As a result, the plunger 6 and the rod 7 further move forward while the coil spring 23 is contracted on the other surface of the first operating portion 15.
As described above, the lens contact portion 22 is moved by the second operation of pushing the operation portion 5 that has become impossible to push the first operation surface 15a into the main body 2 by pressing the second operation portion 16. The intraocular lens 8 is discharged from the nozzle portion 27 to the outside (FIG. 5). At this time, the lens contact portion 22 is projected from the nozzle portion 27, so that the positions of the support portion 8b and the optical portion 8a of the intraocular lens 8 released into the eye can be adjusted.
In the intraocular lens insertion device 1 according to the present embodiment, the lens contact portion 22 that pushes out the intraocular lens 8 is temporarily stopped before the intraocular lens 8 is released from the nozzle portion 27. Accordingly, even when a large external force is applied against the reaction force of the operation unit 5 that increases as the intraocular lens 8 passes through the nozzle unit 27 from the transition unit 26, the lens contact is performed before the intraocular lens 8 is released. The part 22 can be stopped. This can prevent the intraocular lens 8 from being suddenly released into the eye. Therefore, since the intraocular lens insertion device 1 can release the intraocular lens 8 with a smaller external force in the second operation, the intraocular lens 8 can be easily inserted into the eye.
The position where the lens contact portion 22 is temporarily stopped can be variously selected as described above. For example, by temporarily stopping the lens contact portion 22 in the range from when the maximum value of the reaction force generated in the operation portion 5 is exceeded until the intraocular lens 8 is completely released, it is smaller in the second operation. The intraocular lens 8 can be released by an external force. Accordingly, the intraocular lens 8 can be more reliably prevented from being suddenly released, so that the intraocular lens 8 can be easily inserted into the eye.
Further, in the intraocular lens insertion device 1 according to the present embodiment, the operation unit 5 is prevented from returning backward by the locking unit 11 when the first operation surface 15a is flush with the stop surface 31. It was. Thereby, in the second operation, the lens can be reliably pushed out from the position pushed out in the first operation, so that the intraocular lens 8 can be more reliably captured by the lens contact portion 22.
In addition, by holding the operating portion 5 at the position where the locking portion 11 is pushed out in the first operation, the operation position of the intraocular lens insertion instrument 1 can be changed to smoothly move to the second operation. The intraocular lens 8 can be inserted into the eye more easily.
2. Second Embodiment (1) Overall Configuration In the first embodiment, the lens contact portion is temporarily stopped by bringing the operator's finger pressing the operating portion into contact with the stop means, whereas this embodiment The difference is that the lens contact portion is mechanically temporarily stopped by bringing the operating portion into contact with the stopping means. In addition, about the structure similar to the said structure, the same code | symbol is attached | subjected and description is abbreviate | omitted for simplicity.
An intraocular lens insertion device 41 shown in FIG. 7 includes a main body 42 and an operation unit 43, and an insertion tube portion 44 in which the intraocular lens 8 is previously installed is attached to the main body 42. Usually, the intraocular lens 8 is a preload type intraocular lens insertion device 41 which is fixed to a case (not shown) and packaged with the intraocular lens 8 incorporated therein and transported. In the present embodiment, the insertion tube portion corresponds to the insertion tube.
The main body 42 is formed of a cylindrical member, and one end is provided with a first operation portion receiving surface 45 as a stopping means on one side across the lens traveling axis A, and a second operation portion receiving surface 46 is provided on the other side. Is provided. The second operation portion receiving surface 46 is provided at a position away from the first operation portion receiving surface 45 by a predetermined distance in the forward direction.
The insertion tube portion 44 is provided with a lens installation portion 25, a transition portion 26, and a nozzle portion 27 in order along the lens advancing axis A, and is integrated with the main body 42 in a state where the intraocular lens 8 is previously installed. It has become. The insertion cylinder portion 44 is attached to and integrated with an attachment portion formed at the other end 42b of the main body 42 at the base end.
In addition to the above configuration, the operation unit 43 includes a first operation unit 50 and a second operation unit 55. The first operation unit 50 and the second operation unit 55 are provided so as to be relatively movable in the lens traveling axis A direction in a state of being halved in the lens traveling axis A direction. In the present embodiment, as will be described later, the plunger as the transmission unit includes a first plunger and a second plunger.
As shown in FIG. 8, the first operating portion 50 has a first operating surface 50a formed on one side surface and a first plunger 51 provided on the other side surface 50b. The first plunger 51 is provided with an engagement rib 52 on the half surface 47a with the lens traveling axis A direction as the longitudinal direction. An extrusion surface 53 that is substantially perpendicular to the lens traveling axis A is formed at the tip of the first plunger 51.
The second operation portion 55 has a second operation surface 55a formed on one surface thereof, and a second plunger 56 provided on the other surface 55b. The rod 7 is disposed at the tip of the second plunger 56. Is connected. An engagement groove portion 57 whose longitudinal direction is the direction of the lens traveling axis A is provided on the half surface 48a of the second operation portion 55. Further, a contact surface 58 with which the pushing surface 53 contacts is provided at the tip of the second plunger 56.
The first operation unit 50 and the second operation unit 55 configured as described above are engaged by inserting the tip end of the first plunger 51 forward along the lens traveling axis A toward the second operation surface 55a. The engagement rib 52 is engaged with the groove portion 57 so that the half-split surfaces 47a and 48a are integrated with each other facing each other, and the half-split surfaces 47a and 48a are slidable in the front-rear direction. . At this time, the first operation surface 50a and the second operation surface 55a are flush with each other in a state where the extrusion surface 53 is in contact with the contact surface 58.
(2) Operation and Effect In the above configuration, as shown in FIG. 9A, the surgeon first presses the first operation surface 50 a to apply a forward external force to the first operation unit 50. The first plunger 51 pushes the contact surface 58 of the second plunger 56 with the pushing surface 53 by the forward external force applied to the first operation portion 50, and the first operation portion 50 and the second operation portion 55 are pushed. And move forward at the same time.
Then, the other surface 50b of the first operation unit 50 comes into contact with the first operation unit receiving surface 45 of the main body 42. Thereby, even if the surgeon pushes the first operation surface 50a forward, it becomes impossible to move the first operation portion 50 further forward. At this time, the second operation surface 55a remains flush with the first operation surface 50a.
By the first operation described above, the rod 7 comes into contact with the peripheral edge of the optical portion 8a of the intraocular lens 8 installed in the insertion tube portion 44 so that the lens contact portion 22 at the tip of the rod 7 is brought into contact with the intraocular lens 8. Push forward. In the present embodiment, the intraocular lens insertion device 41 temporarily stops the lens contact portion 22 when the intraocular lens 8 passes through the nozzle portion 27. As a result, the intraocular lens 8 sequentially moves from the lens installation unit 25 to the transition unit 26 and the nozzle unit 27 and stops at a predetermined position.
Next, as shown in FIG. 9B, the surgeon presses the second operation surface 55 a and applies a forward external force to the second operation unit 55. Since the second operation portion receiving surface 46 is provided at a position away from the first operation portion receiving surface 45 by a predetermined distance in the forward direction, the external force applied to the second operation portion 55 causes the first operation portion receiving surface 45 to The two operation units 55 move forward independently independently from the first operation unit 50.
In a state where the first operation unit 50 cannot be pushed in this way, the lens contact unit 22 pushes the intraocular lens 8 into the nozzle unit 27 by the second operation of pushing the second operation unit 55 further into the main body 42. To the outside. At this time, the lens contact portion 22 is projected from the nozzle portion 27, so that the positions of the support portion 8b and the optical portion 8a of the intraocular lens 8 released into the eye can be adjusted.
In the intraocular lens insertion device 41 according to the present embodiment, the lens contact portion 22 that pushes out the intraocular lens 8 is temporarily stopped before the intraocular lens 8 is released from the nozzle portion 27. The same effect as in the first embodiment can be obtained.
Further, the second operation surface 55a and the first operation surface 50a are configured to be flush with each other at the start of the second operation. As a result, the second operation can be started simply by shifting the finger pressing the first operation surface 50a to the second operation surface 55a.
Further, in the intraocular lens insertion device 41 according to the present embodiment, it is not necessary to load the intraocular lens 8 into the cartridge 4 or to attach the cartridge 4 to the main body 42 at the time of surgery. can do.
Furthermore, the intraocular lens insertion device 41 according to this embodiment provides a risk of infection by providing a disposable system in which the main body 42, the intraocular lens 8, and the insertion tube portion 44 are used only once. It can be greatly reduced.
Further, in the intraocular lens insertion device 41 according to the present embodiment, it is possible to prevent the operation unit 43 from being pushed in unintentionally during storage and transportation by being fixed and packaged in a case (not shown). .
(3) Modified Example The intraocular lens insertion device 41a shown in FIG. 10 is different from the second embodiment in that the stop means is an oval slide hole 59 parallel to the lens travel axis A provided in the main body 42. Different in. Further, the first plunger 51 is provided with a stop pin 60 protruding in a direction orthogonal to the lens traveling axis A. The first plunger 51 is inserted into the main body 42 with the stop pin 60 inserted into the slide hole 59, and the first plunger 51 is within a range in which the stop pin 60 can move in the slide hole 59 in the front-rear direction. Is configured to be capable of piston movement.
Also in the intraocular lens insertion device 41a according to the present modification, the stop pin 60 abuts the front end 59a of the slide hole 59 so that the lens contact portion 22 is released before the intraocular lens 8 is released from the nozzle portion 27. Since the structure is once stopped, the same effect as the first embodiment can be obtained.
3. Third Embodiment (1) Overall Configuration An intraocular lens insertion device according to this embodiment is different from the first embodiment in that a knock mechanism is provided. In addition, about the structure similar to the said structure, the same code | symbol is attached | subjected and description is abbreviate | omitted for simplicity.
An intraocular lens insertion device 61 shown in FIG. 11 is attached to a main body 62, an operation portion 63, a knock mechanism 64 that allows the operation portion 63 to advance and retreat relative to the main body 62, and the other end 62b of the main body 62. As a whole, the operation unit 63 is repeatedly advanced and retracted by the knock mechanism 64 so that the intraocular lens 8 installed in the cartridge 65 can be pushed out in stages.
The knock mechanism 64 is configured to push out the intraocular lens 8 by a predetermined distance by pushing the operation portion 63 forward, and to automatically move the operation portion 63 pushed forward in the backward direction. Yes. This knock mechanism 64 includes a plunger 70 as a transmission unit integrated with the operation unit 63, a rod 71, a coil spring 72 as a return means for urging the plunger 70 rearward in the retraction direction, and a main body And an engaging portion described later provided on the inner surface of 62.
Here, the main body 62, the plunger 70, and the rod 71 are preferably formed of a synthetic resin that can be injection-molded. Thereby, since it can mass-produce cheaply, it can be used suitably also for a disposable (disposable) use.
The plunger 70 limits the movement range of the operation unit 63 to a predetermined range, and transmits the external force applied to the operation unit 63 by the operator to the lens contact unit 82a at the tip of the pushing shaft 82 of the rod 71. It has a function as a transmission means. The plunger 70 has a shaft body 75 provided with an operating portion 63 at one end, and a pair of extruded pieces 76 and 76 formed at the other end of the shaft body 75. The operation portion 63 is formed in a disk shape by concentrically expanding one end of the shaft body 75 and integrated with the shaft body 75.
The shaft body 75 is configured so that the coil spring 72 is loaded and can be loosely inserted into the main body 62. The other end of the shaft body 75 is provided with a pair of extruded pieces 76 and 76 via a narrow connecting portion 77. The connecting portion 77 is provided with a stop pin 79 that protrudes in a direction orthogonal to the lens traveling axis A.
The pair of extruding pieces 76 and 76 are provided on both sides of the lens traveling axis A, and the connecting portion 77 has a bifurcated tip so as to be substantially parallel to the lens traveling axis A. The pair of extruding pieces 76 and 76 are provided so as to be elastically deformable in a direction perpendicular to the lens traveling axis A with the base ends 76a and 76a connected to the connecting portion 77 as rotation centers. Further, convex portions 78 projecting outward are formed at the tips 76b, 76b of the extruded pieces 76, respectively.
The rod 71 is configured as a separate body independent of the plunger 70, is not integrated with the plunger 70, and is configured so that the intraocular lens 8 can be pushed out by an external force transmitted from the plunger 70. Yes. The rod 71 has a sliding body 80, a pair of locking pieces 81, 81 provided at one end of the sliding body 80, and an extrusion shaft 82 provided at the other end of the sliding body 80.
The sliding body 80 is formed of a cylindrical member having an outer diameter that is loosely inserted into the main body 62, and is configured to hold the extrusion shaft 82 on the lens traveling axis A. The sliding body 80 has a substantially flat contact surface 83 orthogonal to the lens traveling axis A at one end.
The pair of locking pieces 81 and 81 are formed substantially parallel to the lens traveling axis A from the vicinity of the outer edge of the sliding body 80 on both sides of the lens traveling axis A. The locking pieces 81 and 81 are formed so as to taper from the distal end toward the base end 81a connected to the sliding body 80, and are orthogonal to the lens advancing axis A with the base end 81a as the center of rotation. It is provided so as to be elastically deformable in the direction in which it moves. Further, at the tip of each of the locking pieces 81, 81, a recess 84 is formed on the inside to engage the projection 78, and a projection 85 is formed on the outside.
The cartridge 65 is provided with wings 95 that can be elastically deformed in the direction perpendicular to the lens traveling axis A on both sides. Engagement protrusions 96 are formed inside the rear end of the wing portion 95, respectively. The cartridge 65 is configured such that when an external force is applied from the outside to the inside with respect to the tip of the wing portion 95, the rear end of the wing portion 95 can be elastically deformed outward.
As shown in FIG. 12, the main body 62 is formed of a cylindrical member, and an oblong slide hole 88 parallel to the lens advancing axis A as a stopping means is provided on the surface on the one end 62a side. Further, on the surface of the main body 62 on the side of the other end 62b, rectangular receiving holes 89 and 89 for engaging with the engaging protrusions 96 of the cartridge 65 are provided on both sides of the lens traveling axis A, respectively.
Further, the inner peripheral surface of the main body 62 is provided with a fixing concave portion 90 for fixing the rod 71 as an engaging portion described above and a regulating convex portion 91 for restricting the rod 71 from returning backward. It has been.
Next, the plunger 70 with the coil spring 72 inserted is inserted into the one end 62a of the main body 62 from the extruded piece 76. At this time, the plunger 70 is inserted into the main body 62 until the extruding piece 76 passes between the engaging piece 81 and the engaging piece 81 of the rod 71 and the tip 76b of the extruding piece 76 contacts the contact surface 83. (Fig. 13).
Further, the stop pin 79 provided in the connecting portion 77 of the plunger 70 is loosely inserted into the slide hole 88 of the main body 62. Accordingly, the plunger 70 can move rearward and forward within a range in which the stop pin 79 contacts the one end 88a and the other end 88b of the slide hole 88, whereby the operation unit 63 is parallel to the lens travel axis A. It becomes possible to advance and retreat
In the following description, the position of the operating portion 63 (plunger 70) when the stop pin 79 is in contact with one end 88a of the slide hole 88 is referred to as the origin, and the stop pin 79 is the other end 88b of the slide hole 88. The position of the operation part 63 (plunger 70) when it is in contact with is referred to as an extrusion point.
In addition, the coil spring 72 is loaded between the one end 62a of the main body 62 and the operation unit 63, biases the operation unit 63 backward, and operates the operation unit 63 when the operation unit 63 is moved forward. It can be returned to a possible position.
Here, the operable position is a position where the operation portion 63 can be pushed forward, and in this embodiment, the stop pin 79 is separated from the other end 88b of the slide hole 88 toward the one end 88a. Position. Therefore, the operable position is not limited to the position where the stop pin 79 is in contact with the one end 88a of the slide hole 88.
Thus, the cartridge 65 in which the intraocular lens 8 is installed is attached to the main body 62 in which the knock mechanism 64 is assembled. The cartridge 65 can be inserted into the other end 62b of the main body 62 because the rear end of the wing portion 95 is elastically deformed outward when an external force is applied to the tip end of the wing portion 95 from the outside to the inside. When the external force applied to the tip of the wing portion 95 is removed in this state, the wing portion 95 is elastically restored, and the engagement protrusion 96 engages with the receiving hole 89, whereby the cartridge 65 is attached and fixed to the main body 62 ( Figure 11).
In this way, the intraocular lens insertion instrument 61 is obtained, and the intraocular lens 8 can be pushed out by the knock mechanism 64 and released from the cartridge 65 in a small folded state.
(2) Operation and Effect In the above configuration, when the operating portion 63 is pushed into the main body 62 from the state where the operating portion 63 is at the origin (FIG. 11), the external force applied to the operating portion 63 causes the projection 85 and the main body 62 to move. The engagement with the fixed recess 90 is released. Then, as shown in FIG. 14A, both the plunger 70 and the rod 71 move forward while the coil spring 72 is contracted.
Here, in the plunger 70, the stop pin 79 moves in the slide hole 88 provided in the main body 62 from the one end 88a to the other end 88b. Therefore, the plunger 70 and the rod 71 can cause the stop pin 79 to freely perform piston movement by the length from the one end 88a to the other end 88b of the slide hole 88. Thus, when the stop pin 79 of the plunger 70 reaches the other end 88b of the slide hole 88 of the main body 62, the plunger 70 and the operating portion 63 are temporarily stopped mechanically at the pushing point. As a result, the plunger 70 and the operation unit 63 cannot move forward.
At this time, while the rod 71 moves forward, the locking pieces 81, 81 are elastically deformed inward toward the lens advancing axis A, and the protrusion 85 gets over the restricting convex portion 91 of the main body 62.
Next, when the external force applied to the operation unit 63 is removed, the plunger 70 moves rearward by the urging force of the coil spring 72 as shown in FIG. Again, in the plunger 70, the stop pin 79 moves in the slide hole 88 from the other end 88b (extrusion point) toward the one end 88a.
In this way, when the operation portion 63 moves from the pushing point toward the one end 88a, the pushing piece 76 moves rearward inside the locking pieces 81, 81. On the other hand, the rod 71 is held in a stopped state because the protrusion 85 of the locking pieces 81, 81 is engaged with the restricting convex portion 91 of the main body 62, so that the backward movement is restricted. Then, the protrusion 78 of the extruded piece 76 engages with the recess 84 of the locking pieces 81 and 81. In this way, the plunger 70 and the operation unit 63 are returned to the operable position.
By the first operation described above, the rod 71 is brought into contact with the peripheral edge of the optical portion 8a of the intraocular lens 8 installed in the cartridge 65 so that the lens contact portion 82a at the tip of the extrusion shaft 82 is in contact with the intraocular lens. Extrude 8 forward. In the present embodiment, the intraocular lens insertion instrument 61 temporarily stops the lens contact portion 82a when the intraocular lens 8 passes through the nozzle portion 27. As a result, the intraocular lens 8 sequentially moves from the lens installation unit 25 to the transition unit 26 and the nozzle unit 27 and stops at a predetermined position.
Next, as shown in FIG. 14 (c), when the operating portion 63 returned to the operable position is pushed into the main body 62 again, the convex portion 78 of the extruded piece 76 is engaged with the concave portion 84 of the locking pieces 81, 81. Therefore, both the plunger 70 and the rod 71 move forward.
Also in this case, in the plunger 70, the stop pin 79 moves in the slide hole 88 provided in the main body 62 from the operable position toward the other end 88b. Accordingly, when the stop pin 79 reaches the other end 88b of the slide hole 88, the plunger 70 is mechanically stopped at the pushing point.
In this way, the push-out shaft 82 releases the intraocular lens 8 from the nozzle portion 27 to the outside by the second operation of pushing the operation portion 63 returned to the operable position into the main body 62 again. At this time, the lens contact portion 82a of the extrusion shaft 82 is protruded from the nozzle portion 27, thereby adjusting the positions of the support portions 8b and 8b of the intraocular lens 8 released into the eye and the intraocular lens 8. You can also.
In the intraocular lens insertion instrument 61 according to the present embodiment, the operation unit 63 that performs the operation of pushing out the intraocular lens 8 is provided with a knock mechanism 64 that automatically returns to the operable position. As a result, when the operator performs the operation of pushing out the intraocular lens 8, it is not necessary to push in a long stroke from the installation position of the intraocular lens 8 until it is released into the eye at a time. The pressure can be easily controlled. Also, when operating with one hand, the stroke of one extrusion operation can be shortened, so that one-handed operation is easy.
In the present embodiment, the intraocular lens insertion instrument 61 is configured to release the intraocular lens 8 to the outside by an operation of pushing the operation unit 63 forward twice. As a result, the amount of movement of the operation unit 63 can be reduced as compared with the conventional case in which the intraocular lens 8 is released to the outside with a single operation, so that the operator can easily adjust the amount of movement of the intraocular lens 8. can do.
Furthermore, since the intraocular lens insertion instrument 61 is configured to mechanically stop the intraocular lens 8 at a position before being discharged from the nozzle portion 27 of the cartridge 65 in the first operation, skill is required. Without it, it is possible to prevent the intraocular lens 8 from being suddenly released into the eye. In particular, when the intraocular lens 8 passes through the nozzle portion 27, the intraocular lens 8 is folded small. Therefore, in order to push out the intraocular lens 8, it is necessary to push the operation unit 63 strongly forward. In the second operation, since the lens contact portion 82a is mechanically temporarily stopped at a position before the intraocular lens 8 is discharged from the nozzle portion 27, the force for pushing the operation portion 63 is strong. Also, it is possible to prevent the intraocular lens 8 from being released suddenly and to release it more safely.
In addition, even during the second operation in which the operation unit 63 needs to be pushed out strongly, the intraocular lens insertion device 61 is configured so that the operation unit 63 is automatically returned to the operable position. Since the operation unit 63 can be operated at the same operable position as the first time, the intraocular lens 8 can be inserted into the eye more easily.
In the present embodiment, since the operation unit 63 is provided behind the main body 62, the insertion operation of the intraocular lens 8 is easy and can be performed with one hand. You can do other operations with.
In the present embodiment, since the operation unit 63 is biased in the retraction direction by the coil spring 72, the operation unit 63 can be more reliably returned to the operable position.
In the above embodiment, as the knock mechanism 64, the plunger 70 integrated with the operation unit 63, the rod 71, the coil spring 72 as a biasing means for biasing the plunger 70 rearward in the retreat direction, Although an example having an engaging portion provided on the inner surface of the main body 62 has been described, the present invention is not limited to this, and it is sufficient that the operating portion can be automatically returned to the operable position, such as a so-called mechanical pencil. A knock mechanism can also be used. The return means is not limited to a coil spring, and may be a leaf spring, elastic rubber, or the like.
In the above-described embodiment, the example in which the intraocular lens is released to the outside by performing the operation of pushing the operation unit into the main body twice has been described. However, the present invention is not limited thereto, and the operation unit is automatically operated. It is sufficient if the position can be returned to the possible position, and the above operation may be performed three times, four times, or more.
(3) Modification An intraocular lens insertion device 100 shown in FIG. 15 includes a main body 101, an operation unit 63, and a knock mechanism 64, and the main body 101 has an insertion tube in which the intraocular lens 8 is previously installed. Part 102 is attached. This intraocular lens insertion device 100 is a preload type intraocular lens insertion device that is fixed to the case 103 and packaged with the intraocular lens 8 incorporated therein and then transported. The main body 101 is provided with a mounting portion 104 for attaching the insertion tube portion 102 at the tip thereof instead of a rectangular receiving hole for mounting the cartridge.
In the above configuration, the intraocular lens 8 can be released to the outside by two operations, as in the present embodiment. Further, during operation, the operation unit 63 can automatically return to the operable position by the knock mechanism 64.
The intraocular lens insertion device 100 according to the present embodiment includes the knock mechanism 64 that automatically returns the operation unit 63 that performs the operation of pushing out the intraocular lens 8 to the operable position. The same effect as that of the first embodiment can be obtained.
In addition, in the intraocular lens insertion device 100 according to the present embodiment, the plunger 70 can be prevented from being pushed forward unintentionally during storage and transportation by being fixed to the case 103 and packaged.
4). Other Embodiments In the above-described embodiments, the case where the lens contact portion protrudes from the nozzle portion when the intraocular lens is released to the outside has been described. However, the present invention is not limited to this, and the lens contact portion. Even after the forward movement of the lens contact portion stops, the lens can be slowly brought into the eye with its own shape recovery ability due to the elasticity of the intraocular lens. It may be configured to release.
In the above-described embodiment, the operation unit is described as being provided so as to be able to advance and retract in parallel with the lens traveling axis. Also good. In this case, the operation unit is provided on the side surface of the main body, for example, and has an extrusion point in the inner direction (traveling direction) of the main body and has an origin in the outer direction (regression direction) of the main body.
In the above-described embodiment, the case where the transmission unit is a plunger has been described. However, the present invention is not limited to this, and a link mechanism, a cam mechanism, or the like may be used. It is good also as transmitting to a part.
In the above-described embodiment, the case where the insertion tube portion includes the lens installation portion has been described. However, the present invention is not limited thereto, and the insertion tube portion only needs to include the transition portion and the nozzle portion. In addition, a lens installation portion may be provided in the main body.
The present invention relates to an intraocular lens insertion device according to various forms, for example, Japanese Patent Publication No. 2008-521535, Japanese Patent Publication No. 2001-502563, German Patent Invention No. 4110278, Japanese Patent Application Laid-Open No. 4-212350. The present invention can also be applied to various types of intraocular lens insertion devices such as the intraocular lens insertion device according to Japanese Patent Laid-Open No. 63-197453.
It is sectional drawing which shows the structure of the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention, (a) Whole structure, (b) It is a figure which shows the state which removed the cartridge. It is a perspective view which shows the structure of the operation part in the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention. It is sectional drawing which shows the use condition (1) in the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention. It is a perspective view which shows the use condition (1) in the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention. It is sectional drawing which shows the use condition (2) in the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention. It is a perspective view which shows the use condition (2) in the intraocular lens insertion instrument which concerns on 1st Embodiment of this invention. It is sectional drawing which shows the whole structure of the intraocular lens insertion instrument which concerns on 2nd Embodiment of this invention. It is a front view which shows the structure of the operation part in the intraocular lens insertion instrument which concerns on 2nd Embodiment of this invention. It is sectional drawing which shows the use condition in the intraocular lens insertion instrument which concerns on 2nd Embodiment of this invention in steps, (a) Use condition (1), (b) It is a figure which shows use condition (2). It is sectional drawing which shows the modification in the intraocular lens insertion instrument which concerns on 2nd Embodiment of this invention, (a) Component block diagram, (b) Use condition (1), (c) Use condition (2) is shown. FIG. It is sectional drawing which shows the whole structure of the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention. It is sectional drawing which shows the structure of the main body in the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention. It is sectional drawing which shows the state which assembled | attached the knock mechanism to the main body in the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention. It is a figure which shows the use condition in the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention in steps, (a) 1st pushing operation | movement, (b) Return to an operable position, (c) 2nd time It is sectional drawing which shows the extrusion operation | movement of. It is sectional drawing which shows the modification in the intraocular lens insertion instrument which concerns on 3rd Embodiment of this invention.
1 Intraocular lens insertion device 2 Body 4 Cartridge (insertion tube)
5 Operation part 6 Plunger (transmission part)
8 Intraocular lenses
10 Stopping part (stopping means)
22 Lens contact area
41 Intraocular lens insertion device
43 Control section
44 Insertion tube (insertion tube)
45 First operation part receiving surface (stopping means)
51 First plunger (transmission part)
56 Second plunger (transmission part)
61 Intraocular lens insertion device
63 Control section
65 cartridge (insertion tube)
70 Plunger (Transmission part)
88 Slide hole (stop)
In an intraocular lens insertion device that pushes the operating part to push out the intraocular lens,
A lens contact portion for extruding the intraocular lens;
A transmission unit for transmitting an external force applied to the operation unit to the lens contact unit;
An insertion tube for releasing the intraocular lens extruded by the lens contact portion to the outside;
Stop means for temporarily stopping the lens contact portion when the intraocular lens passes in the vicinity of the distal end portion of the insertion tube;
The operation unit includes a first operation portion, extruding the first consists of a plurality of operating portions and the second operation portion which is disposed behind the operating portion, stepwise the intraocular lens,
A main body for fixing the insertion tube forward;
At least one of the operation units is provided behind the main body,
The stop means presses the first operating portion against the stop means when the intraocular lens passes through a nozzle portion provided at the distal end of the insertion cylinder at a position within 10 mm from the distal end of the insertion cylinder. The lens contact portion is temporarily stopped by the contact of the operator's finger , and then the lens contact portion pushes the intraocular lens into the nozzle by applying an external force in the traveling direction of the intraocular lens to the second operation portion. An intraocular lens insertion device configured to be discharged from a portion to the outside.
The transmission unit includes a first plunger and a second plunger to which the lens contact unit is connected.
When the intraocular lens passes through a nozzle portion provided at the distal end of the insertion cylinder at a position within 10 mm from the distal end of the insertion cylinder, the stopping means is adapted to contact the first operating section with the stop means. The lens contact portion is temporarily stopped by contact, and then the lens contact portion releases the intraocular lens from the nozzle portion to the outside by applying an external force in the traveling direction of the intraocular lens to the second operation portion. An intraocular lens insertion device characterized by comprising the following.
JP2008227641A 2008-09-04 2008-09-04 Intraocular lens insertion device Active JP5416379B2 (en)
JP2008227641A JP5416379B2 (en) 2008-09-04 2008-09-04 Intraocular lens insertion device
US13/061,143 US8470032B2 (en) 2008-09-04 2009-08-27 Intraocular lens insertion device
EP09811445.7A EP2332501A4 (en) 2008-09-04 2009-08-27 Intraocular lens inserting instrument
JP2010057767A JP2010057767A (en) 2010-03-18
JP5416379B2 true JP5416379B2 (en) 2014-02-12
JP2008227641A Active JP5416379B2 (en) 2008-09-04 2008-09-04 Intraocular lens insertion device
JP5570265B2 (en) * 2010-03-26 2014-08-13 株式会社ニデック Intraocular lens insertion device
AU712574B2 (en) 1995-05-24 1999-11-11 Staar Surgical Company, Inc. Injection system and method for use with a deformable intraocular lens
2008-09-04 JP JP2008227641A patent/JP5416379B2/en active Active
2009-08-27 US US13/061,143 patent/US8470032B2/en active Active
2009-08-27 WO PCT/JP2009/064976 patent/WO2010026919A1/en active Application Filing
2009-08-27 EP EP09811445.7A patent/EP2332501A4/en active Pending
EP2332501A1 (en) 2011-06-15
US8470032B2 (en) 2013-06-25
EP2332501A4 (en) 2017-11-29
US20110264101A1 (en) 2011-10-27
JP2010057767A (en) 2010-03-18
WO2010026919A1 (en) 2010-03-11
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