Title of invention: Intraocular lens insertion device
Technical field
[0001]
　The present invention relates to an intraocular lens insertion device.
Background technology
[0002]
　In the treatment of cataracts, an intraocular lens inserted as a substitute for the crystalline lens to replace the human opaque crystalline lens and correct the refraction has been put into practical use. In intraocular lens insertion surgery in cataract treatment, for example, an incision of several millimeters is made at the edge of the cornea, strong cornea, etc., and the crystalline lens is crushed by ultrasonic emulsification and suction to remove it from the incision. After that, the intraocular lens is inserted and fixed.
[0003]
　In recent years, when inserting an intraocular lens into the eye through an incision, an insertion device in which the intraocular lens is preloaded in a cartridge may be used. The surgeon inserts the tip opening of the insertion tube provided at the tip of the instrument body into the eye through the incision. In addition, the surgeon pushes the intraocular lens through the tip opening of the insertion tube portion by a rod-shaped plunger provided on the insertion instrument, and inserts the intraocular lens into the eye.
[0004]
　Generally, an intraocular lens has a lens body and a support portion connected to the lens body. When the intraocular lens is inserted into the eye using the above-mentioned insertion device, the intraocular lens is folded according to the shape of the inner wall of the insertion tube when the intraocular lens is moved by the plunger. At this time, if the intraocular lens is simply pushed out by the plunger, the posture of the intraocular lens may not be determined in the insertion tube portion, and the behavior of the intraocular lens may not be stable. Therefore, a technique has been proposed in which a configuration for stabilizing the behavior of the intraocular lens in the insertion tube is provided at the tip of the plunger (see Patent Documents 1 to 3).
Prior art literature
Patent documents
[0005]
Patent Document 1: Japanese Patent Application Laid-Open No. 2012-50713
Patent Document 2: Japanese Patent Application Laid-Open No. 5-103803
Patent Document 3: Japanese Patent Application Laid-Open No. 5570254
Outline of the invention
Problems to be solved by the invention
[0006]
　However, in the conventional intraocular lens insertion device, the position of the support portion of the intraocular lens may change when the intraocular lens moves in the insertion tube portion by the plunger. In this case, even if the above-mentioned intraocular lens insertion device is used, the intraocular lens may behave abnormally in the insertion tube portion.
[0007]
　The technique disclosed in the present disclosure has been made in view of the above circumstances, and an object thereof is to provide an intraocular lens insertion device capable of more stable behavior of the intraocular lens.
Means to solve problems
[0008]
　The intraocular lens insertion device disclosed in the present disclosure has an insertion tube portion at the tip, which is inserted into the eye in a folded state of an intraocular lens having a lens body and a long support portion connected to the lens body at one end. It has a substantially tubular instrument body, a storage portion for accommodating the intraocular lens, and an extrusion member that slides inside the instrument body and pushes the intraocular lens to move the inside of the insertion cylinder portion. In front view of the intraocular lens of the member in the extrusion direction, the extruded member has a tip portion having a first protruding portion protruding in one of the left-right directions and a second protruding portion protruding in the other in the left-right direction. When the intraocular lens moves in the insertion tube portion, the first protruding portion abuts on the proximal end portion of the support portion from the front side in the optical axis direction of the intraocular lens, so that the optical axis of the proximal end portion The movement to the front side in the direction is restricted, and the second protruding portion abuts on the end portion of the support portion closer to the end than the base end portion from the front side in the optical axis direction, so that the optical axis of the tip portion Regulate forward movement in the direction. Thereby, when the intraocular lens is discharged from the insertion device into the eye, the behavior of the intraocular lens can be stabilized by restricting the movement of the base end portion and the end portion of the support portion.
[0009]
　Further, in the above-mentioned intraocular lens insertion device, the extrusion member has a notch portion located on the front side in the optical axis direction with respect to the intraocular lens stored in the storage portion, and the intraocular lens is stored in the storage portion. In this state, the notch may be configured to support the intermediate portion between the end portion and the base end portion of the support portion from the rear side in the optical axis direction. Further, in the above-mentioned intraocular lens insertion device, in a state where the intraocular lens is housed in the storage portion, the base end portion of the support portion of the first protruding portion is between the first protruding portion and the instrument body. Is configured to be movable forward in the optical axis direction, and the second protruding portion is configured so that the end portion of the support portion can be moved forward in the optical axis direction between the second protruding portion and the instrument body. You may.
[0010]
　Further, in the above-mentioned intraocular lens insertion device, in a state where the tip end portion of the extrusion member is in the insertion tube portion of the instrument body, the base end portion of the support portion is provided between the first protruding portion and the insertion tube portion. A first gap that can be inserted is formed, and a second gap that allows the end of the support portion to be inserted is formed between the second protrusion and the insertion cylinder portion, and the intraocular lens is formed by the extrusion member. When moving from the storage portion to the insertion cylinder portion, the base end portion of the support portion may enter the first gap, and the end portion of the support portion may enter the second gap.
[0011]
　Further, in the above-mentioned intraocular lens insertion device, the width of the portion provided with the first protrusion and the second protrusion in the left-right direction is substantially the same as the width in the left-right direction of at least a part of the insertion cylinder portion. It may be configured to be. Further, in the above-mentioned intraocular lens insertion device, the notch may be configured to be provided on the base end side of the device body with respect to the first protruding portion and the second protruding portion.
Effect of the invention
[0012]
　According to the technique disclosed in the present invention, it is possible to provide an intraocular lens insertion device capable of more stable behavior of the intraocular lens.
A brief description of the drawing
[0013]
1 (a) and 1 (b) are diagrams showing a schematic configuration of an intraocular lens according to an embodiment.
2 (a) and 2 (b) are diagrams showing a schematic configuration of an intraocular lens insertion device according to an embodiment.
FIG. 3 is a diagram showing a schematic configuration of a nozzle body according to an embodiment.
4 (a) and 4 (b) are diagrams showing a schematic configuration of a positioning member in one embodiment.
5 (a) and 5 (b) are diagrams showing a schematic configuration of a plunger in one embodiment.
6 (a) to 6 (f) are enlarged views of the action portion of the plunger in one embodiment.
FIG. 7 is a diagram showing a working portion of a plunger and an intraocular lens in one embodiment.
FIG. 8 is a diagram showing a working portion of a plunger and an intraocular lens in one embodiment.
FIG. 9 is a cross-sectional view showing the positional relationship between the tip end portion of the nozzle body, the plunger, and the support portion of the intraocular lens in one embodiment.
Mode for carrying out the invention
[0014]
　Hereinafter, embodiments of the present invention will be described with reference to the drawings.
　First, as a premise for explaining the intraocular lens insertion device 1 of the present embodiment, the intraocular lens 2 inserted into the eye of a patient by the intraocular lens insertion device 1 will be described.
　FIG. 1 is a diagram showing a schematic configuration of an intraocular lens 2 in the present embodiment. FIG. 1 (a) is a plan view, and FIG. 1 (b) is a side view.
[0015]
　As shown in FIG. 1, the intraocular lens 2 is connected to a lens body 2a having a predetermined refractive power and two long support portions for holding the lens body 2a in the eye. It is provided with 2b. As shown in FIG. 1, the intraocular lens 2 is a so-called three-piece type, and the lens body 2a and the support portion 2b are formed separately, and all of them are made of a flexible resin as a material. There is.
[0016]
　In the following description, among the sides of the intraocular lens 2 facing the optical axis direction, the side facing the cornea after intraocular insertion is referred to as the "anterior side in the optical axis direction", and the opposite side is referred to as the "back side in the optical axis direction". Further, a part of the support portion 2b is designated as "base end portion 2b1", and the other part closer to the end than the base end portion 2b1 is designated as "terminal portion 2b2", and between the base end portion 2b1 and the terminal portion 2b2. Let some other part be "intermediate part 2b3". In other words, the base end portion 2b1 is located closer to the lens body 2a than the end end portion 2b2. It should be noted that the base end portion 2b1 does not need to include the connection portion of the support portion 2b with the lens body 2a. Similarly, it should be noted that the end 2b2 does not need to include the end of the support 2b.
[0017]
　Next, a schematic configuration of the intraocular lens insertion device 1 will be described.
　FIG. 2 shows a schematic configuration of the intraocular lens insertion device 1 in the present embodiment. FIG. 2A is a plan view of the stage lid portion 13 described later in an open state, and FIG. 2B is a side view of the stage lid portion 13 in a closed state.
[0018]
　The intraocular lens insertion device 1 is configured to be slidable in a substantially tubular nozzle body 10, a storage portion 70 for accommodating the intraocular lens 2, and the inside of the nozzle body 10, and the intraocular lens 2 is slidable from the nozzle body 10. It has a plunger 30 to be extruded. The nozzle body 10 is an example of an instrument body, and the plunger 30 is an example of an extrusion member.
[0019]
　The nozzle body 10 of the intraocular lens insertion device 1 is a tubular member having a substantially rectangular cross section as a whole, and includes a front end portion 10a provided on the front end side, a rear end portion 10b provided on the rear end side, and the like. It has a nozzle portion 15 provided between the front end portion 10a and the rear end portion 10b. The tip portion 10a is an example of the insertion cylinder portion. As shown in FIG. 2B, the tip portion 10a has a substantially cylindrical shape having a small diameter that can be inserted into a small incision in the eyeball, and the end portion opens obliquely with respect to the extending direction of the nozzle body 10. doing. The rear end portion 10b is formed with a large opening into which the plunger 30 can be inserted. The nozzle portion 15 is in contact with the tip portion 10a and is formed in a tapered shape that gradually becomes thinner from the rear end portion 10b to the tip portion 10a.
[0020]
　The storage portion 70 is provided between the nozzle portion 15 of the nozzle body 10 and the rear end portion 10b, and is integrally formed with the nozzle body 10. The storage portion 70 has a stage portion 12 for setting the intraocular lens 2 and a stage lid portion 13 for covering the stage portion 12. The accommodating portion 70 realizes stable holding of the intraocular lens 2 in the accommodating portion 70 in cooperation with the positioning member 50 described later.
[0021]
　The plunger 30 has an action portion 31 provided on the distal end side that comes into contact with the intraocular lens 2 and an insertion portion 32 provided on the posterior end side that is provided for operation by the operator. The plunger 30 is configured to be able to reciprocate in the nozzle body 10, and is used to push the intraocular lens 2 into the eye from the tip portion 10a.
[0022]
　The nozzle body 10, the storage portion 70, the plunger 30, and the positioning member 50 of the intraocular lens insertion device 1 are made of a resin such as polypropylene. Polypropylene has a proven track record in medical equipment and is a highly reliable material such as chemical resistance.
[0023]
　In the following description, the direction (side) from the rear end portion 10b of the nozzle body 10 toward the tip portion 10a is the "front direction (side)", and the opposite direction (side) is the "rear direction (side)". In a), the direction (side) toward the front of the paper is "upward (side)", the opposite direction (side) is "downward (side)", and in FIG. 1 (b), the direction (side) toward the front of the paper is The "left direction (side)" and the opposite direction (side) are referred to as the "right direction (side)". In this case, as will be described later, the intraocular lens 2 is set so that the front side in the optical axis direction faces upward and the rear side in the optical axis direction faces downward with respect to the stage portion 12, and is stored in the storage portion 70. Will be done. In that sense, it should be noted that the "front side in the optical axis direction" and the mere "front side" are different, and the "rear side in the optical axis direction" and the mere "rear side" are different. Further, the direction of the reciprocating motion of the plunger 30 is defined as the "extrusion direction". In this case, the plunger 30 reciprocates in the nozzle body 10 in the front-rear direction.
[0024]
　Next, the configuration of the nozzle body 10 and the storage unit 70 will be described.
　FIG. 3 is a diagram showing a schematic configuration of the nozzle body 10 in the present embodiment.
　Inside the nozzle body 10, a through hole 10c on the front end side and a through hole 10f on the rear end side whose cross-sectional shape changes according to a change in the outer shape of the nozzle body 10 are provided. The through hole 10c is a hole that becomes a part of the movement path when the intraocular lens 2 is pressed and moved, and the through hole 10f is a hole through which the plunger 30 is inserted. By the time it is released into the eye, the intraocular lens 2 is deformed and folded in response to a change in the cross-sectional shape of the through hole 10c, changed to a shape that easily enters the incision of the eyeball, and then released into the eye. Will be done.
[0025]
　The tip portion 10a of the nozzle body 10 has a shape that is obliquely cut so that the upper front end of the nozzle body 10 is in front of the lower front end. The tip portion 10a may be cut linearly and diagonally when viewed from the left-right direction, or may be cut diagonally so as to have a bulge on the outside, that is, to have a curved surface shape. The oblique cut of the tip 10a makes it easier for the operator to insert the tip 10a into the incision in the eyeball as compared to otherwise. Further, the nozzle body 10 has a hold portion 11 protruding like a plate near the rear end portion 10b. The hold portion 11 is used by the operator when the plunger 30 is pushed into the tip end side of the nozzle body 10 by hooking a finger.
[0026]
　On the other hand, as described above, the storage portion 70 stores the intraocular lens 2, and is provided integrally with the nozzle body 10 on the rear side of the nozzle portion 15 of the nozzle body 10. As described above, the storage portion 70 has a stage portion 12 for setting the intraocular lens 2 and a stage lid portion 13 for covering the stage portion 12. After the intraocular lens 2 is set in the stage portion 12, the stage lid portion 13 is closed, so that the intraocular lens 2 is housed in the storage portion 70.
[0027]
　The stage portion 12 of the storage portion 70 is formed with a stage groove 12a having a width slightly larger than the diameter of the lens body 2a of the intraocular lens 2. The dimension of the stage groove 12a in the front-rear direction is set to be larger than the maximum width dimension including the support portions 2b and 2b extending on both sides of the intraocular lens 2. Further, the set surface 12b is formed by the bottom surface of the stage groove 12a. The vertical position of the set surface 12b is set above the height position of the bottom surface of the through hole 10f of the nozzle body 10, and the set surface 12b and the bottom surface of the through hole 10f are connected by the bottom slope 10d. .. Further, the set surface 12b of the stage portion 12 is processed so that the positioning member 50 can be removed from the lower side thereof.
[0028]
　Here, the positioning member 50 will be described in detail.
　FIG. 4 is a diagram showing a schematic configuration of the positioning member 50 in the present embodiment. FIG. 4A is a plan view, and FIG. 4B is a left side view. It is assumed that all of the intraocular lenses 2 shown in the description here are stored in the storage unit 70. Further, in the following description, of the two support portions 2b and 2b of the intraocular lens 2, the support portion 2b that comes to the front side of the lens body 2a in the state of being housed in the storage portion 70 is referred to as a "front support portion". The support portion that comes to the rear side of the lens body 2a may be referred to as a "rear support portion".
[0029]
　The positioning member 50 is configured as a separate body from the nozzle body 10, and has a structure in which a pair of side wall portions 51, 51 are connected by a connecting portion 52. At the lower end of the side wall portion 51, a holding portion 53 extending outward is formed.
[0030]
　The first mounting portion 54 and the second mounting portion 63 projecting upward are formed inside the side wall portions 51 and 51. Further, a first positioning portion 55 is formed so as to project on the outer peripheral side of the upper end surface of the first mounting portion 54. Further, a pair of second positioning portions 64, 64 for positioning the lens body 2a and the support portion 2b of the intraocular lens 2 are formed so as to project on the upper end surface of the second mounting portion 63. The separation length between the first positioning portion 55 and the second positioning portions 64, 64 is set to be slightly larger than the diameter dimension of the lens body 2a of the intraocular lens 2.
[0031]
　Further, a pair of third mounting portions 56, 56 protruding upward are formed inside the side wall portions 51, 51. The heights of the upper surfaces of the first mounting portion 54, the second mounting portion 63, and the third mounting portions 56, 56 are the same, respectively. Further, on the outer portion of the upper surface of the third mounting portions 56, 56, third positioning portions 57, 57 are formed so as to further project upward over the entire left-right direction of the third mounting portions 56, 56. .. The separation length between the insides of the third positioning portions 57, 57 is set to be slightly larger than the diameter dimension of the lens body 2a of the intraocular lens 2.
[0032]
　Further, inside the side wall portions 51 and 51, a fourth mounting portion 58 on which a part of one support portion 2b of the intraocular lens 2 is mounted is formed. Further, a fourth positioning portion 59 is formed which further protrudes upward from the fourth mounting portion 58. A part of the front support portion 2b comes into contact with the fourth positioning portion 59. A fifth mounting portion 60 on which a part of the rear support portion 2b of the intraocular lens 2 is mounted is formed inside the side wall portions 51 and 51. Further, a fifth positioning portion 61 is formed which further protrudes upward from the fifth mounting portion 60. A part of the rear support portion 2b comes into contact with the fifth positioning portion 61.
[0033]
　As shown in FIG. 4B, the heights of the upper surfaces of the fifth mounting portion 60 and the fifth positioning portion 61 are the first to fourth mounting portions 54, 63, 56, 58 and the first to fourth. It is provided so as to be lower than the height of the upper surface of the positioning portions 55, 64, 57, 59. On the other hand, on the outside of the side wall portions 51, 51, a rotation prevention wall portion 62 is provided to prevent unnecessary rotation when the positioning member 50 is removed.
[0034]
　On the other hand, the set surface 12b of the nozzle body 10 is formed with a set surface through hole 12c that penetrates the set surface 12b in the thickness direction. As for the outer shape of the set surface through hole 12c, the first to fifth mounting portions 54, 63, 56, 58, 60 and the first to fifth positioning portions 55, 64, 57, 59, 61 of the positioning member 50 are viewed from above. It is a similar figure that is slightly larger than the shape.
[0035]
　In the positioning member 50 configured in this way, the first to fifth mounting portions 54, 63, 56, 58, 60 and the first to fifth positioning portions 55, 64, 57, 59, 61 are located above the set surface 12b. It can be attached to the nozzle body 10 by inserting it into the set surface through hole 12c from the lower side of the set surface 12b until it protrudes.
[0036]
　Then, the bottom surface of the outer peripheral portion of the lens body 2a of the intraocular lens 2 is placed on the upper surfaces of the first mounting portion 54, the second mounting portion 63, and the third mounting portions 56, 56, and the two support portions 2b Is placed on the upper surfaces of the fourth mounting portion 58 and the fifth mounting portion 60, respectively. By doing so, the lens body 2a is positioned in the horizontal direction (horizontal to the set surface 12b) by the first positioning unit 55, the second positioning units 64, 64, and the third positioning units 57, 57. The positions of the two support portions 2b are regulated in the horizontal direction by the fourth positioning portion 59 and the fifth positioning portion 61, respectively. In this way, the accommodating portion 70 realizes stable holding of the intraocular lens 2 in cooperation with the positioning member 50.
　The above is a detailed description of the positioning member 50.
[0037]
　On the other hand, the stage lid portion 13 is formed with a confirmation window portion 17 which is a thin-walled portion. Here, how thin the confirmation window portion 17 is may be appropriately determined based on the material forming the stage lid portion 13 and the visibility of the intraocular lens 2 from the confirmation window portion 17. The formation of the confirmation window portion 17 can also be expected to have the effect of reducing sink marks during molding of the stage lid portion 13. A viscoelastic substance as a lubricant is injected into the stage lid 13 before the work of inserting the intraocular lens 2 into the eye (hereinafter, may be simply referred to as “preoperative”). A lubricant supply hole 18 for this purpose and a guide wall 19 for guiding an injection member such as a needle for injecting the viscoelastic substance to the lubricant supply hole 18 are provided. The lubricant supply hole 18 is a hole that communicates with the inside and outside of the storage portion 70 when the stage lid portion 13 is closed. The guide wall 19 is provided so as to surround at least a part of the periphery of the lubricant supply hole 18. The surgeon moves the tip of the injection member into which the viscoelastic substance is injected into the lubricant supply hole 18 while abutting the guide wall 19. In this way, the guide wall 19 facilitates the introduction of the injection member into the lubricant supply hole 18.
[0038]
　The stage lid portion 13 is integrally formed with the stage portion 12. The stage lid portion 13 has the same dimensions in the front-rear direction as the stage portion 12. The stage lid portion 13 is connected by a thin plate-shaped connecting portion 14 formed by extending the side surface of the stage portion 12 toward the stage lid portion 13. The connecting portion 14 is formed so as to be bendable at the central portion, and the stage lid portion 13 can be overlapped with the stage portion 12 from above and closed by bending the connecting portion 14. Further, the stage lid portion 13 is provided with ribs 13a and 13b for reinforcing the stage lid portion 13 and stabilizing the position of the intraocular lens 2 with respect to the surface facing the set surface 12b when the lid is closed. There is. In addition, a guide protrusion 13c that serves as a guide on the upper side of the plunger 30 is also provided.
[0039]
　Next, the configuration of the plunger 30 will be described.
　FIG. 5 is a diagram showing a schematic configuration of the plunger 30 in the present embodiment. FIG. 5A is a plan view, and FIG. 5B is a side view.
[0040]
　The plunger 30 has a length in the front-rear direction slightly larger than that of the nozzle body 10. Then, it is formed from an action portion 31 on the front end side based on a cylindrical shape and an insertion portion 32 on the rear end side based on a rectangular rod shape. The working portion 31 is an example of the tip portion of the extrusion member.
[0041]
　The working portion 31 has a cylindrical cylindrical portion 31a and a thin plate-shaped flat portion 31b extending in the left-right direction of the cylindrical portion 31a. Further, the flat portion 31b is provided with a pair of sliding portions 31m that can slide with the inner wall surface of the nozzle body 10 when the plunger 30 moves in the nozzle body 10. The sliding portion 31m slides on the inner wall surface of the nozzle body 10 to generate a frictional force that becomes a resistance force when operating the plunger 30. This allows the operator to perform a more stable extrusion operation of the plunger 30. Further, the flat portion 31b is also provided with a protrusion 31n capable of contacting the inner wall surface of the nozzle body 10. The protrusion 31n comes into contact with the inner wall surface of the nozzle body 10 to prevent the plunger 30 from moving forward in the nozzle body 10. This makes it possible to prevent the operator from pushing the plunger 30 too far forward in the nozzle body 10.
[0042]
　On the other hand, the insertion portion 32 has a substantially H-shaped cross section as a whole, and its horizontal and vertical dimensions are set to be slightly smaller than the through hole 10f of the nozzle body 10. Further, at the rear end of the insertion portion 32, a disc-shaped pressing plate portion 33 extending in the vertical and horizontal directions is formed. A claw portion 32a that protrudes toward the upper side of the insertion portion 32 and can move up and down due to the elasticity of the material of the plunger 30 is formed in a portion of the insertion portion 32 in front of the center in the front-rear direction. Then, when the plunger 30 is inserted into the nozzle body 10, the locking hole 10e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 engages with the claw portion 32a, whereby The relative position between the nozzle body 10 and the plunger 30 in the initial state is determined. The claw portion 32a and the locking hole 10e are formed so that the tip of the acting portion 31 is located behind the lens body 2a of the intraocular lens 2 set in the stage portion 12 in the engaged state, and the notch is formed. The portion 31c is set so that the rear support portion 2b of the intraocular lens 2 can be supported from the rear side in the optical axis direction of the intraocular lens 2.
[0043]
　Next, the configuration of the working portion 31 of the plunger 30 will be described in more detail.
　FIG. 6 is an enlarged view of the working portion 31 of the plunger 30 in the present embodiment. 6 (a) is a top view, FIG. 6 (b) is a left side view, FIG. 6 (c) is a bottom view, FIG. 6 (d) is a right side view, and FIG. 6 (e) is a front view and FIG. 6 (e). f) is a front view which is a further enlarged view of FIG. 6 (e).
[0044]
　As shown in FIGS. 6A and 6B, the cylindrical portion 31a of the working portion 31 is formed with a groove-shaped notch 31c that opens upward and penetrates in the left-right direction of the acting portion 31. There is. The cutout portion 31c is provided so as to be located on the front side in the optical axis direction with respect to the intraocular lens 2 set in the stage portion 12. Further, as shown in FIG. 6B, the groove wall 31d on the tip end side of the notch portion 31c is formed by an inclined surface that goes upward toward the tip end side of the action portion 31.
[0045]
　Further, as shown in FIG. 6 (f), the acting portion 31 protrudes from the cylindrical portion 31a in the left-right direction in the front view of the plunger 30 in the extrusion direction of the plunger 30 (extending direction of the central axis O). Protruding portions 31e and 31f are provided, respectively. These protruding portions 31e and 31f are portions that are locally raised in the direction away from the central axis O with respect to the outer peripheral surface of the cylindrical portion 31a. The protruding portion 31e is an example of the first protruding portion, and the protruding portion 31f is an example of the second protruding portion. With these protrusions 31e and 31f, gaps 31j and 31k are formed below the protrusions 31e and 31f and between the protrusions 31e and 31f and the nozzle body 10. Then, as shown in FIGS. 6 (b) and 6 (d), these gaps 31j and 31k extend from the tip surface of the acting portion 31 to the notch 31c along the side surface of the acting portion 31 of the plunger 30. ing.
[0046]
　Further, the lower side surfaces of the protruding portions 31e and 31f are contact surfaces 31s and 31t that come into contact with the supporting portion 2b in the tip portion 10a of the nozzle body 10. As shown in FIG. 6 (f), the protruding portions 31e and 31f may be formed so that the shapes of the acting portions 31 in the front view are substantially symmetrical. Further, the gap 31j is an example of the first gap, and the gap 31k is an example of the second gap.
[0047]
　Here, in the present embodiment, it is necessary to set the width of the portion of the working portion 31 where the protruding portions 31e and 31f are provided in the left-right direction while paying attention to the following points.
　That is, when the protrusions 31e and 31f are located at the storage portion 70, the space between the protrusions 31e and the stage groove 12a is such that the base end portion 2b1 of the rear support portion 2b can move forward in the optical axis direction. Make it free. Similarly, a space is provided between the protrusion 31f and the stage groove 12a so that the end portion 2b2 of the rear support portion 2b can move forward in the optical axis direction.
[0048]
　When the protrusions 31e and 31f are located at the tip portion 10a, the base end portion 2b1 of the rear support portion 2b moves forward in the optical axis direction between the protrusion portion 31e and the inner wall surface of the tip portion 10a. Make it impossible. Similarly, between the protruding portion 31f and the inner wall surface of the tip portion 10a, the end portion 2b2 of the rear support portion 2b is prevented from moving forward in the optical axis direction. Therefore, the protrusions 31e and 31f are configured so that the width of the portion provided with the protrusions 31e and 31f in the left-right direction is substantially the same as the width in the left-right direction of at least a part of the tip portion 10a.
[0049]
　Next, the behavior of the intraocular lens 2 when the intraocular lens insertion device 1 is used will be described.
　7 and 8 are views showing the state of the working portion 31 of the plunger 30 and the intraocular lens 2 in the present embodiment. Further, FIG. 9 is a cross-sectional view showing the positional relationship between the tip portion 10a of the nozzle body 10, the plunger 30, and the support portion 2b of the intraocular lens 2 in the present embodiment. These figures explain the state when the intraocular lens 2 is moving in the tip portion 10a, and FIG. 7 and FIG. 8 are omitted from the illustration of the nozzle body 10 for easy understanding. ..
[0050]
　The intraocular lens insertion device 1 of the present embodiment is a so-called preset type.
　That is, in the intraocular lens insertion device 1, the intraocular lens 2 has an optical axis with respect to the stage portion 12 in a state where the stage lid portion 13 is opened and the positioning member 50 is attached to the stage portion 12 at the time of manufacture. It is set so that the front side in the direction is on the upper side. Then, after the stage lid portion 13 is closed, the intraocular lens insertion device 1 is shipped and sold.
[0051]
　When the intraocular lens 2 is housed in the storage part 70, the intermediate part 2b3 of the rear support part 2b is supported by the notch 31c. At this time, the base end portion 2b1 and the end portion 2b2 of the rear support portion 2b are in a state in which the intraocular lens 2 can be moved to the front side in the optical axis direction without being restricted by the positions of the protrusions 31e and 31f. ..
[0052]
　Subsequently, the operator using the intraocular lens insertion device 1 wets the intraocular lens 2 with a viscoelastic substance, a perfusate, or the like while keeping the stage lid 13 closed, and then removes the positioning member 50. As a result, the horizontal position regulation of the storage portion 70 with respect to the intraocular lens 2 is released.
[0053]
　Subsequently, the operator pushes the plunger 30 toward the tip end side of the nozzle body 10. As a result, the front end surface of the working portion 31 of the plunger 30 comes into contact with the rear side of the outer circumference of the intraocular lens 2, and the intraocular lens 2 moves from the accommodating portion 70 to the nozzle portion 15. Further, the intraocular lens 2 moves in the nozzle portion 15, and in the process, the lens body 2a is folded so as to be gradually valley-folded according to the shape of the inner wall of the nozzle portion 15. At this time, the portion of the rear support portion 2b of the intraocular lens 2 that is closer to the lens body 2a moves to the vicinity of the lower end of the front end surface of the action portion 31. Here, the lower end of the front end surface of the action portion 31 is the end portion of the front end surface located on the rear side in the optical axis direction of the intraocular lens 2 housed in the storage portion 70.
[0054]
　Subsequently, when the operator pushes the plunger 30 further, as shown in FIG. 7, the proximal end portion 2b1 of the rear support portion 2b of the intraocular lens 2 enters the gap 31j. Then, when the base end portion 2b1 enters the gap 31j, the portion of the rear support portion 2b on the terminal side of the portion held in the gap 31j extends to the notch portion 31c. Then, as shown in FIG. 8, the rear support portion 2b extending to the notch portion 31c is curved by the wall portion 31i and the convex portion 31h so as not to advance in the rear direction of the cylindrical portion 31a. When the rear support portion 2b is curved by the wall portion 31i and the convex portion 31h, the tip of the rear support portion 2b faces the gap 31k. In this state, the rear support portion 2b further extends to the notch portion 31c, and the end portion 2b2 of the rear support portion 2b, that is, the portion of the rear support portion 2b far from the lens body 2a has a gap from the notch portion 31c. Enter 31k.
[0055]
　In the process of pushing the plunger 30, the gap between the protruding portions 31e and 31f and the inner wall surface of the nozzle body 10 gradually narrows in the nozzle portion 15, and the rear support portion 2b protrudes in the tip portion 10a. The gap between the protruding portions 31e and 31f and the inner wall surface of the nozzle body 10 (inner wall surface 10a1 of the tip portion 10a) is narrowed to the extent that it cannot pass through the sides of the portions 31e and 31f and escape from the gaps 31k and 31j. As a result, the base end portion 2b1 of the rear support portion 2b in the gap 31j comes into contact with the contact surface 31s of the protruding portion 31e and the inner wall surface 10a1 of the tip portion 10a, and the movement to the front side in the optical axis direction is restricted. It will be. Similarly, the end portion 2b2 of the rear support portion 2b in the gap 31j abuts on the contact surface 31s of the protrusion 31e and the inner wall surface 10a1 of the tip portion 10a, and the movement to the front side in the optical axis direction is restricted. become.
[0056]
　Subsequently, when the operator further pushes the plunger 30, the lens body 2a (and the front support 2b) is discharged to the outside of the instrument through the opening of the tip portion 10a of the nozzle body 10. At this time, the rear support portion 2b is still regulated by the protruding portions 31e and 31f. Then, when the operator pushes the plunger 30 further, the restriction on the rear support portion 2b is released, and the entire intraocular lens 2 is discharged into the eye through the opening of the tip portion 10a of the nozzle body 10.
　The above is a description of the behavior of the intraocular lens 2 when the intraocular lens insertion device 1 is used.
[0057]
　Next, the effect of the intraocular lens insertion device 1 of the present embodiment will be described.
　If there are no protrusions 31e and 31f, the base end portion 2b1 and the end portion 2b2 of the rear support portion 2b show abnormal behavior, and the outer peripheral surface of the action portion 31 of the plunger 30 and the inner wall surface 10a1 of the tip portion 10a There is a risk of being caught between them. In this case, there is a possibility that the intraocular lens 2 is damaged or the intraocular lens 2 cannot be released into the eye.
　On the other hand, in the present embodiment, the posture of the rear support portion 2b is stabilized by providing the protruding portions 31e and 31f. Further, since the movement of the lens body 2a in the rotation direction N (see FIG. 1) about the base end portion 2b1 of the rear support portion 2b is restricted, the behavior of the lens body 2a is also stable. Further, by providing the protruding portions 31e and 31f, the effect of preventing the end portion 2b2 of the rear support portion 2b from being sandwiched between the outer peripheral surface of the working portion 31 of the plunger 30 and the inner wall surface 10a1 of the tip portion 10a. Can also be expected.
[0058]
　Further, since the plunger 30 has the protrusions 31e and 31f, when the plunger 30 moves into the tip portion 10a of the nozzle body 10, the protrusions 31e and 31f come into contact with the inner wall surface 10a1 of the tip portion 10a. The movement of the plunger 30 is stable.
[0059]
　Further, even if the lens body 2a (and the front support 2b) comes out of the instrument through the opening of the tip 10a of the nozzle body 10 by pushing the plunger 30, the inner wall surface 10a1 of the tip 10a and the plunger 30 The movements of the base end portion 2b1, the intermediate portion 2b3, and the end portion 2b2 of the rear support portion 2b are regulated (supported) by the protrusions 31e and 31f and the gaps 31j and 31k. As a result, the intraocular lens 2 can be released into the eye with stable behavior.
[0060]
　The above is the description of the present embodiment, but the configuration of the intraocular lens insertion device and the like of the present embodiment is not limited to the contents of the above description, and the same as the technical idea of ​​the present invention is not lost. Various changes can be made within. For example, the shapes and sizes of the protrusions 31e and 31f and the gaps 31j and 31k can be appropriately changed according to the configurations of the support portion 2b of the intraocular lens 2 and the nozzle portion 15 and the tip portion 10a of the nozzle body 10. ..
[0061]
　Further, although the above embodiment has been described using the three-piece type intraocular lens 2, a one-piece type intraocular lens in which the lens body and the support portion are integrally formed may be used instead. In this case, the position where the gaps 31j and 31k are provided in the working portion 31 of the plunger 30 and the extending direction to the notch portion 31c may be appropriately changed. Further, in the above embodiment, it is assumed that the intraocular lens 2 is in a valley-folded state at the tip portion 10a, but the folded state may be a mountain-folded state. This point is the same even if the intraocular lens is a one-piece type. That is, this embodiment can be applied not only to a three-piece type intraocular lens but also to a one-piece type intraocular lens, and further, it can be applied not only to a valley-folded state but also to a mountain-folded state for insertion into the eye. is there. Further, although the above embodiment has been described using the preset type intraocular lens insertion instrument 1, it is a so-called separate type intraocular lens insertion instrument in which the operator himself sets the intraocular lens on the instrument before the operation. May be good.
Code description
[0062]
1 Insertion device
2 Intraocular lens
2a Lens body
2b Support part
10 Nozzle body
10a Tip part
15 Nozzle part
30 Plunger
31 Acting part
31c Notch
31e, 31f Protruding part
31j, 31k Gap
The scope of the claims
[Claim 1]
　An intraocular lens having an intraocular lens having a lens body and a long support portion connected to the lens body at one end, and a substantially tubular instrument body having an insertion tube portion at the tip to be inserted into the eye in a folded state, and the
　above. a housing part for housing the intraocular lens,
　slides the instrument body, a pushing member for moving the insertion cylindrical portion by pushing the intraocular lens,
has,
　the extrusion member, wherein the pushing member In front view in the extrusion direction of the intraocular lens, the
　extruding member has a tip portion having a first protruding portion protruding in one of the left-right directions and a second protruding portion protruding in the other in the left-right direction . When the intraocular lens moves in the insertion tube
　　portion, the first protruding portion abuts on the base end portion of the support portion from the front side in the optical axis direction of the intraocular lens, thereby causing the intraocular lens. The movement of the base end portion toward the front side in the optical axis direction is restricted, and
　　the second protruding portion is the front side in the optical axis direction with respect to the end portion of the support portion closer to the end than the base end portion.
An intraocular lens insertion device, characterized in that the movement of the terminal portion to the front side in the optical axis direction is restricted by abutting from the lens.
[Claim 2]
　The extruded member has a notch located on the front side in the optical axis direction of the
　intraocular lens housed in the storage part, and the intraocular lens is housed in the storage part.
The intraocular lens insertion device according to claim 1 , wherein the notch portion supports an intermediate portion between the end portion and the base end portion of the support portion from the rear side in the optical axis direction. ..
[Claim 3]
　In a state where the intraocular lens is housed in the storage portion,
　　the first protruding portion has an optical axis in which the base end portion of the support portion is between the first protruding portion and the instrument main body.
　　The second protrusion is configured to be movable forward in the direction, and the end portion of the support portion moves forward in the optical axis direction between the second protrusion and the instrument body.
The intraocular lens insertion device according to claim 1 or 2, wherein the intraocular lens insertion device is configured to be possible .
[Claim 4]
　In a state where the tip end portion of the extrusion member is in the insertion cylinder portion of the instrument body, the
　　base end portion of the support portion can be inserted between the first protruding portion and the insertion cylinder portion. A gap of 1 is formed,
　　and a second gap through which the end portion of the support portion can be inserted is formed between the second protruding portion and the insertion cylinder portion, and the
　extruding member forms the intraocular lens. when the lens is moved to the insertion tube from the housing portion, wherein the proximal end portion of the support portion enters said first gap, said distal end of said support portion enters the second gap
that The intraocular lens insertion device according to any one of claims 1 to 3, wherein the intraocular lens insertion device is characterized.
[Claim 5]
　The width of the first protruding portion and the portion provided with the second protruding portion in the left-right direction is substantially the same as the width in the left-right direction of at least a part of the insertion cylinder portion. The intraocular lens insertion device according to any one of claims 1 to 4.
[Claim 6]
　Any one of claims 1 to 5, wherein the notch portion of the extruded member is provided on the proximal end side of the instrument main body with respect to the first protruding portion and the second protruding portion. The intraocular lens insertion device described in the section.