Intraocular lens insertion device
Technical field

　The present invention relates to an intraocular lens insertion device that inserts an intraocular lens into the eye through an incision made in the eyeball.
Background technology

　In the cataract treatment, an intraocular lens that is inserted as a substitute for a lens to replace a human opaque lens and correct refraction has been put into practical use. In intraocular lens insertion surgery for the treatment of cataracts, for example, a few millimeter incision wound (incision) is made on the edge of the cornea, sclera, etc., and the lens is crushed by ultrasonic emulsification and suction to remove it from the incision. Then, the intraocular lens is inserted and fixed by the intraocular lens insertion device.

　Further, it is considered that the smaller the incision of the incision, the smaller the burden on the eye tissue. Therefore, various intraocular lens insertion devices for inserting the intraocular lens with good operability without damaging the incision have been proposed (Patent Document 1).
Advanced technical literature
Patent literature

Patent Document 1: Japanese Patent Publication No. 2001-517976
Summary of the invention
Problems to be Solved by the Invention

　However, even if the above technique is used, the shape of the tip of the intraocular lens insertion device may be different before and after the intraocular lens is inserted into the eye. For example, the hinge provided at the tip of the intraocular lens insertion device disclosed in the above document may have a valley fold before the insertion of the intraocular lens, but may become a mountain fold after the insertion of the intraocular lens. In this case, the hinge may damage the eye tissue at the incision when the intraocular lens insertion device is removed from the incision.
　The technology of 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 performing stable insertion of an intraocular lens while reducing the burden on the eye tissue. Is to provide.
Means for solving the problems

　The intraocular lens insertion device of the present disclosure includes a substantially cylindrical insertion member to be inserted into the eye, an opening provided at the tip of the insertion member for ejecting the intraocular lens into the eye, and the intraocular lens. And an intraocular lens pushing member that pushes the lens to move inside the insertion member and ejects the intraocular lens into the eye from the opening, and the opening direction of the opening is inclined with respect to the extending direction of the insertion member. And, on the insertion member rear end side of the opening, a concave portion having a predetermined depth extending in the extending direction is provided on the outer peripheral surface of the insertion member, and the concave portion is formed when the insertion member is inserted into the eye and When the intraocular lens moves in the insertion member, the opening is expanded and contracted by elastic deformation. Thereby, when the operator inserts the intraocular lens into the eye by the intraocular lens insertion device, the insertion member of the intraocular lens insertion device is easily inserted into the incision created in the eye, and the insertion member The movement of the intraocular lens in the inside becomes smoother.

　Further, a curved surface portion may be provided that connects the concave portion and the outer peripheral surface of the insertion member. Further, the curvature radius of the curved surface portion may be 0.5 mm or less on a plane orthogonal to the extending direction of the insertion member. Further, the recess of the insertion member may not be in contact with the inner peripheral surface of the insertion member, and the length of the recess in the extending direction of the insertion member may be 0.5 mm or more. Further, in the plane orthogonal to the extending direction of the insertion member, the depth of the recess may be such that the recess does not exceed the substantial center of the cross section of the insertion member. Further, the recess may be formed by secondary processing performed after molding the insertion member and the opening.
Effect of the invention

　According to the technique of the present disclosure, it is possible to provide an intraocular lens insertion device that can reduce the burden on the eye tissue and stably insert the intraocular lens.
Brief description of the drawings

FIG. 1(a) and FIG. 1(b) are diagrams showing an example of a configuration of an intraocular lens insertion instrument in one embodiment.
FIG. 2(a) and FIG. 2(b) are diagrams showing an example of the configuration of the intraocular lens in one embodiment.
FIG. 3 is a diagram showing an example of a configuration of a nozzle body in one embodiment.
FIG. 4( a) and FIG. 4( b) are diagrams showing an example of the configuration of a positioning member in one embodiment.
FIG. 5(a) and FIG. 5(b) are diagrams showing an example of the configuration of the plunger according to the embodiment.
FIG. 6(a) to FIG. 6(c) are diagrams showing an example of the configuration of the tip portion of the nozzle body in the embodiment.
[FIG. 7] FIG. 7(a) is a perspective view of a tip portion before secondary processing is performed, and FIG. 7(b) is a perspective view of a tip portion after secondary processing is schematically illustrated. FIG.
FIG. 8 is a view showing a cross section of the tip portion taken along the line AA′ of FIG. 6(c).
FIG. 9(a) to FIG. 9(c) are diagrams showing an example of modification of the tip end portion in the embodiment.
FIG. 10 is a diagram showing an example of a configuration of a tip end portion in a modified example.
MODE FOR CARRYING OUT THE INVENTION

　Embodiments of the present invention will be described below with reference to the drawings.

　FIG. 1 shows a schematic configuration of an intraocular lens insertion instrument 1 used for inserting the intraocular lens of the present embodiment into the eye. 1A is a plan view of the intraocular lens insertion instrument 1 when the stage lid 13 is opened, and FIG. 1B is a side view of the intraocular lens insertion instrument 1 when the stage lid 13 is closed. The figure is shown. The nozzle body 10 of the intraocular lens insertion device 1 is a tubular member having a substantially rectangular cross section, and has a rear end portion 10b that is largely open at one end portion and a nozzle portion that is narrowed to the other end portion. 15 and the tip portion 10a. As shown in FIG. 1B, the tip portion 10a has a thin cylindrical shape, and the end portion of the tip portion 10a opens obliquely to the extending direction of the nozzle body 10. The plunger 30 is inserted into the nozzle body 10 and can reciprocate. The tip portion 10a is an example of a substantially tubular insertion member that is inserted into the eye. The plunger 30 is an example of an intraocular lens pushing member.
　In the following description, the direction from the rear end portion 10b of the nozzle body 10 to the front end portion 10a is the front direction, the opposite direction is the rear direction, the front side of the paper surface is the upward direction, and the opposite direction is the downward direction in FIG. In FIG. 1B, the front side of the drawing is the left direction and the opposite direction is the right direction. In this case, the upper side is on the front side of the optical axis of the lens body 2a, the lower side is on the rear side of the optical axis of the lens body 2a, the front side is on the front side in the pressing direction by the plunger 30, and the rear side is on the pressing side by the plunger 30. The direction corresponds to the rear side.

　A holding portion 11 is integrally provided near the rear end portion 10b of the nozzle body 10 so as to project in a plate shape and to which a surgeon can put his/her finger when pushing the plunger 30 into the tip end side of the nozzle body 10. Has been. A stage 12 for setting the intraocular lens 2 is provided behind the nozzle 15 of the nozzle body 10. The stage portion 12 is configured such that the upper side of the nozzle body 10 is opened by opening the stage lid portion 13. A positioning member 50 is attached to the stage portion 12 from the lower side of the nozzle body 10. By the positioning member 50, the intraocular lens 2 is stably held in the stage portion 12 even before use (during transportation).

　That is, in the intraocular lens insertion device 1, the intraocular lens 2 is attached to the stage unit 12 before the optical axis while the stage lid unit 13 is opened and the positioning member 50 is attached to the stage unit 12 during manufacturing. The sides are set up. Then, the stage cover 13 is closed and then shipped and sold. Then, the user wets the lens with the viscoelastic substance or the perfusate with the stage lid 13 closed, removes the positioning member 50, and then pushes the plunger 30 into the tip side of the nozzle body 10.

　As a result, the intraocular lens 2 is pressed by the plunger 30 and moved to the nozzle portion 15, and then the intraocular lens 2 is released into the eye from the tip portion 10a. The nozzle body 10, the plunger 30, and the positioning member 50 in the intraocular lens insertion device 1 are made of a resin material such as polypropylene. Polypropylene has a proven track record in medical equipment and is a highly reliable material such as chemical resistance. Further, the intraocular lens insertion instrument 1 according to the present embodiment is a preset type in which the intraocular lens 2 is preset in the intraocular lens insertion instrument 1 before shipment, but the operator himself needs to perform the intraocular lens 2 before the operation. It may be a so-called separate type in which is set in the intraocular lens insertion device 1.
　Further, a confirmation window portion 17 is formed in a part of the stage lid portion 13 by making it a thin portion. It should be noted that how thin the confirmation window portion 17 in the stage lid portion 13 should be appropriately determined based on the material forming the stage lid portion 13 and the visibility of the intraocular lens through the confirmation window portion 17. Good. Further, by forming the confirmation window portion 17, an effect of reducing sink marks during molding of the stage lid portion 13 can be expected. Further, the stage lid 13 is provided with a lubricant supply hole 18 for injecting a viscoelastic substance as a lubricant into the stage 12 before the work of inserting the intraocular lens 2 into the eyeball. The lubricant supply hole 18 is a hole that connects the outside of the stage unit 12 and the intraocular lens 2 housed in the stage unit 12 when the stage cover 13 is closed.

　Further, the stage lid 13 is provided with a guide wall 19 for guiding an injection member such as a needle for injecting the viscoelastic substance into the space in which the intraocular lens 2 is accommodated, into the lubricant supply hole 18. ing. The guide wall 19 is provided so as to surround at least a part of the periphery of the lubricant supply hole 18, and the operator brings the tip of the injection member for injecting the viscoelastic substance into contact with the guide wall 19 and further The tip is moved to the lubricant supply hole 18. In this way, the guide wall 19 is used as a member for guiding the injection member for injecting the viscoelastic substance to the lubricant supply hole 18.

　FIG. 2 is a diagram showing a schematic configuration of the intraocular lens 2 according to the present embodiment. 2A shows a plan view and FIG. 2B shows a side view. Note that the orientation of the intraocular lens 2 does not correspond between FIG. 2( a) and FIG. 2( b ). The intraocular lens 2 is a so-called one-piece type in which the lens body and the supporting portion are integrally molded with the same material, and the lens material is a flexible resin material. The intraocular lens 2 includes a lens main body 2a having a predetermined refractive power, and two long flat plate-shaped support portions 2b connected to the lens main body 2a for holding the lens main body 2a in the eyeball. .. Further, the lens body 2a and the support portion 2b are connected to each other via a joint portion 2d. Although the intraocular lens 2 in the present embodiment is described as a one-piece type, it may be a three-piece type in which the lens body and the supporting portion are made of different materials.

　In the present embodiment, in the intraocular lens insertion device 1, one support portion 2b of the two support portions 2b is arranged on the rear side of the lens body 2a, and the other support portion 2b is arranged on the front side of the lens body 2a. Thus, the intraocular lens 2 is set on the stage unit 12. In addition, the support portion disposed on the front side of the lens body 2a is referred to as a front support portion, and the support portion disposed on the rear side of the lens body 2a is referred to as a rear support portion.

　In the intraocular lens 2 according to this embodiment, the support portion 2b is textured. Thereby, when the intraocular lens 2 is folded in the nozzle body 10, the supporting portion 2b can be prevented from sticking to the lens body 2a.

　FIG. 3 shows a plan view of the nozzle body 10. As described above, in the nozzle body 10, the intraocular lens 2 is set on the stage unit 12. Then, in this state, the intraocular lens 2 is pressed by the plunger 30 and is discharged from the tip portion 10a. Inside the nozzle body 10, there are provided a through hole 10c on the front end side and a through hole 10f on the rear end side, the cross-sectional shape of which changes according to the change of the outer shape of the nozzle body 10. The through hole 10c is a hole that is a part of a 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. Then, when the intraocular lens 2 is released, the intraocular lens 2 is deformed and folded according to the change in the cross-sectional shape of the through hole 10c in the nozzle body 10, and is formed on the eyeball of the patient. It is released after being transformed into a shape that can easily enter the incision.

　In addition, the tip portion 10a of the nozzle body 10 has a shape that is obliquely cut so that the upper region of the nozzle unit 15 is on the front side of the lower region. In addition, the obliquely cut shape of the tip portion 10a may be linearly obliquely cut when viewed from the left-right direction, or may be slanted so as to have an outward bulge, that is, a curved shape. It may be cut into. Since the tip portion 10a is obliquely cut, it becomes easier for the operator to insert the tip portion 10a into the incision created in the eyeball of the patient, as compared with the case where the tip portion 10a is not cut obliquely.

　A stage groove 12 a having a width slightly larger than the diameter of the lens body 2 a of the intraocular lens 2 is formed in the stage portion 12. 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, 2b extending on both sides of the intraocular lens 2. Further, a set surface 12b is formed by the bottom surface of the stage groove 12a. The vertical position of the set surface 12b is set higher than 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. ..

　The stage unit 12 and the stage lid unit 13 are integrally formed. The stage lid 13 has the same dimension in the front-back direction as the stage 12. The stage lid 13 is connected by a thin plate-shaped connecting portion 14 formed by extending the side surface of the stage 12 toward the stage lid 13 side. The connecting portion 14 is formed to be bendable at the central portion, and the stage lid portion 13 can be closed by overlapping the stage portion 12 from above by bending the connecting portion 14.

　Ribs 13a and 13b are provided on the surface of the stage lid 13 that faces the set surface 12b when the lid is closed to reinforce the stage lid 13 and stabilize the position of the intraocular lens 2. A guide protrusion 13c is provided as a guide on the upper side of the plunger 30.

　A positioning member 50 is detachably provided below the set surface 12b of the stage unit 12. FIG. 4 shows a schematic configuration of the positioning member 50. FIG. 4A shows a plan view of the positioning member 50, and FIG. 4B shows a left side view of the positioning member 50. The positioning member 50 is configured separately from the nozzle body 10, and has a structure in which a pair of side wall portions 51, 51 are connected by a connecting portion 52. A holding portion 53 is formed at the lower end of the side wall portion 51 so as to extend and spread outward.

　Then, inside the side wall portions 51, 51, a first placing portion 54 and a second placing portion 63 that project upward are formed. 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 on the upper end surface of the second mounting portion 63 so as to project. The distance between the first positioning portion 55 and the second positioning portions 64, 64 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2.

　Further, inside the side wall portions 51, 51, a pair of third mounting portions 56, 56 protruding upward are formed. The heights of the upper surfaces of the first placing portion 54, the second placing portion 63, and the third placing portions 56, 56 are equal to each other. Further, third positioning portions 57, 57 are formed on outer portions of the upper surfaces of the third mounting portions 56, 56 so as to project further upward in the entire lateral direction of the third mounting portions 56, 56. .. The distance between the inner sides of the third positioning portions 57, 57 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2.

　Further, inside the side wall portions 51, 51, a fourth mounting portion 58 on which a part of the front supporting portion of the supporting portion 2b of the intraocular lens 2 is mounted is formed. Further, a fourth positioning portion 59 is formed so as to project further upward from the fourth mounting portion 58. A part of the front support portion contacts the fourth positioning portion 59. Then, inside the side wall portions 51, 51, a fifth mounting portion 60 on which a part of the rear supporting portion of the supporting portion 2b of the intraocular lens 2 is mounted is formed. Furthermore, the 5th positioning part 61 which protrudes further upwards from the 5th mounting part 60 is formed. A part of the rear support portion contacts the fifth positioning portion 61.

　As shown in FIG. 4B, the heights of the upper surfaces of the fifth mounting portion 60 and the fifth positioning portion 61 are higher than the heights of the upper surfaces of the first to fourth mounting portions and the first to fourth positioning portions. Is also set to be low. On the other hand, outside the side wall portions 51, 51, a rotation preventing wall portion 62 is provided for preventing unnecessary rotation when the positioning member 50 is removed.

　The set surface 12b of the nozzle body 10 is provided with a set surface through hole 12c that penetrates the set surface 12b in the thickness direction. The outer shape of the set surface through hole 12c is substantially similar to the shape of the first to fifth mounting portions and the first to fifth positioning portions of the positioning member 50 as viewed from above. Then, when the positioning member 50 is attached to the nozzle body 10, the first to fifth mounting portions and the first to fifth positioning portions are inserted into the set surface through hole 12c from the lower side of the set surface 12b, It projects above 12b.

　Then, when the intraocular lens 2 is set on the setting surface 12b, the bottom surface of the outer peripheral portion of the lens main body 2a is the first mounting portion 54, the second mounting portion 63, and the third mounting portions 56, 56. Placed on the top surface. The position of the lens body 2a is regulated in the horizontal direction (the direction horizontal to the setting surface 12b) by the first positioning portion 55, the second positioning portions 64, 64, and the third positioning portions 57, 57. Further, the two supporting portions 2b of the intraocular lens 2 are placed on the upper surfaces of the fourth placing portion 58 and the fifth placing portion 60, respectively. 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.
　Next, FIGS. 5A and 5B show a schematic configuration of the plunger 30 in the present embodiment. 5A is a plan view of the plunger 30, and FIG. 5B is a side view of the plunger 30.
　The plunger 30 has a length in the front-rear direction slightly larger than that of the nozzle body 10. Further, it is formed of a leading end side action portion 31 based on a columnar shape and a rear end side insertion portion 32 based on a rectangular rod shape. The acting portion 31 is configured to include a columnar portion 31a having a columnar shape and a thin plate-shaped flat portion 31b extending in the left-right direction of the columnar portion 31a.
　A notch 31c is formed at the tip of the action portion 31. As shown in FIGS. 5A and 5B, the cutout portion 31c is formed in a groove shape that opens downward in the action portion 31 and penetrates leftward and rightward. Further, as shown in FIG. 5B, the groove wall on the tip end side of the cutout portion 31 c is formed by an inclined surface that is downward as it goes to the tip end side of the action portion 31. On the other hand, the insertion portion 32 has a generally H-shaped cross section as a whole, and its horizontal and vertical dimensions are set to be slightly smaller than the through holes 10 f of the nozzle body 10. At the rear end of the insertion portion 32, a disc-shaped pressing plate portion 33 that spreads in the vertical and horizontal directions is formed.
　A claw portion 32a that projects toward the upper side of the insertion portion 32 and that can move up and down due to the elasticity of the material of the plunger 30 is formed at a portion of the insertion portion 32 that is located forward of the center in the front-rear direction. Then, when the plunger 30 is inserted into the nozzle body 10, the engaging hole 10e shown in FIG. 3 provided in the thickness direction on the upper surface of the nozzle body 10 and the claw portion 32a engage with each other. The relative position between the nozzle body 10 and the plunger 30 in the initial state is determined. In addition, regarding the formation positions of the claw portion 32a and the locking hole 10e, in the engaged state, the tip of the action portion 31 is located on the rear side of the lens body 2a of the intraocular lens 2 set on the stage portion 12, The support portion 2b on the rear side of the main body 2a is set so that the notch portion 31c can be supported from above.
　Next, FIGS. 6A to 6C show the tip portion 10a of the nozzle body 10 and the nozzle portion 15. 6(a) is a plan view of the tip portion 10a and the nozzle portion 15, and FIG. 6(b) is a cross-sectional view of the nozzle body 10 taken along the line AA′ of FIG. 6(c). FIG. 7C is a side view of the tip portion 10 a and the nozzle portion 15. Note that, in FIG. 6B, the nozzle portion 15 is shown by a dotted line when the nozzle body 10 is viewed from the front end portion 10a to the rear end portion 10b. Further, as shown in the front views of the nozzle body 10 in FIGS. 6A and 6C, the central axis of the cylindrical nozzle portion 15 extending in the front-back direction of the nozzle body 10 is defined by AX (two in the drawings). The dotted line). The extending direction of the central axis AX is the extending direction of the distal end portion 10a that is the insertion member, and is the extending direction of the extrusion shaft of the plunger 30.
　As shown in FIGS. 6(a) to 6(c), an edge portion 10h on the rear end portion 10b side of the central axis AX in the opening portion 10g of the distal end portion 10a is recessed toward the central axis AX. As shown in FIG. 6A, in the present embodiment, the length of the recess 10i in the extending direction of the central axis AX is L1. Further, as shown in FIGS. 6B and 6C, a recess 10i extending in the extending direction of the central axis AX is formed on the outer peripheral surface of the tip 10a. Further, as shown in FIG. 6(b), the recess 10i has the shortest distance from the portion of the edge 10h overlapping the central axis AX to the central axis AX in the plan view of FIG. 6(a). It is provided.
　As a method of forming the recess 10i, secondary processing is performed after the opening 10g is formed in the cylindrical member that is the base of the tip 10a by injection molding or the like, that is, after the insertion member and the opening are formed. By the subsequent processing, the edge 10h of the opening 10g is deformed toward the central axis AX, and the recess 10i shown in FIGS. 6A to 6C is provided. As an example of the secondary processing, deformation due to heat press fitting can be mentioned.
　FIG. 7A is a perspective view of the tip portion 100a of the nozzle body 100 before the above-mentioned secondary processing, and FIG. 7B shows the tip portion after the nozzle body 100 is subjected to the secondary processing. The perspective view of 10a is each shown typically. The nozzle body 100 is molded by injection molding before the above-mentioned secondary processing is performed. As shown in FIG. 7A, although the opening 100g is provided in the tip portion 100a before the secondary processing, the recess 10i is not formed. Then, the tip portion 100a is subjected to secondary processing such as heat press fitting using a die, for example, to form the recess 10i as shown in FIG. 7B.
　By molding the recess 10i by the above-described secondary processing, as compared with the case of molding the recess 10i by injection molding or the like without performing the secondary processing, it is possible to secure strength that is unlikely to break even if the thickness of the recess 10i is thin. At the same time, it can be said that it is possible to secure the flexibility to restore when the concave portion 10i is deformed when the intraocular lens 2 is ejected from the opening 10g.
　FIG. 8 shows an enlarged view of the tip portion 10a of FIG. 6(b). As shown in FIG. 8, the concave portion 10i is provided with a curved surface portion 10j that curves toward the central axis AX. Further, the tip portion 10a is provided with curved surface portions 10m and 10n which connect the concave portion 10i and the outer peripheral surface of the tip portion 10a. The curved surface portions 10m and 10n are curved toward the side opposite to the central axis AX (downward in the drawing).
　As shown in FIG. 8, the radii of curvature of the curved surface portions 10j, 10m, and 10n on the plane orthogonal to the central axis AX are R1, R2, and R3, respectively. At this time, the possible values of R1, R2, and R3 may be in the range of 0.1 mm to 0.5 mm. The combination of R1, R2 and R3 can be appropriately determined. For example, in FIG. 7, it is assumed that R1, R2, and R3 satisfy R1>R2=R3, but the magnitude relationship of R1, R2, and R3 is not limited to this.
Further, as shown in FIG. 8, the depth D1 of the recess 10i on the plane orthogonal to the central axis AX is preferably set so that the recess 10i does not contact the inner peripheral surface of the tip 10a. The length L1 of the recess 10i is preferably 0.5 mm or more in the extending direction of the central axis AX. More preferably, the depth D1 should be a depth that does not exceed the central axis AX of the recess 10i, that is, a depth that does not exceed the substantial center of the cross section of the insertion member. By setting the depth D1 and the length L1 of the concave portion 10i in this manner, the distal end portion 10a can be set when the distal end portion 10a is inserted into an incision or when the intraocular lens 2 is ejected into the eye from the opening portion 10g. It can be expected to be suitably deformed. Note that the depth D1 is an example of the predetermined depth of the recess 10i, and by changing the depth D1, the state of deformation of the tip 10a when the tip 10a is inserted into an incision and the intraocular lens 2 The state of movement within the tip portion 10a of the is changed.

　Next, the shape of the recess 10i of the tip portion 10a of the nozzle body 10 when the operator inserts the intraocular lens 2 into the patient's eye using the intraocular lens insertion tool 1 will be described. First, before the intraocular lens 2 is housed in the intraocular lens insertion device 1, the plunger 30 is inserted into the nozzle body 10 and arranged at the initial position. Further, as described above, the positioning member 50 is attached to the nozzle body 10 from below the setting surface 12b. Thereby, the 1st mounting part 54, the 2nd mounting part 63, and the 3rd mounting parts 56, 56 of the positioning member 50 are hold|maintained in the state which protruded to the setting surface 12b. Then, with the lens body 2a of the intraocular lens 2 with the support portion 2b facing the front-back direction of the nozzle body 10, the upper surfaces of the first mounting portion 54, the second mounting portion 63, and the third mounting portions 56, 56. It is placed and positioned on. In this state, a part of the support portion 2b on the rear side of the intraocular lens 2 is sandwiched and supported by the cutout portion 31c of the plunger 30.
　
Next, the operator removes the positioning member 50 from the stage unit 12. As a result, the intraocular lens 2 is set on the stage unit 12. Before the distal end portion 10a of the nozzle body 10 is inserted into the incision, the concave portion 10i is separated from the curved surface portion 10m and the curved surface portion 10n on a plane orthogonal to the central axis AX as shown in FIG. 9A. It will be in a state of being.
　
Next, the operator inserts the tip portion 10a of the nozzle body 10 into the incision created in the eye tissue. Here, since the tip portion 10a has an oblique opening shape, it can be easily inserted into the incision. At this time, as a result of the tip 10a being pushed by the incision, the tip 10a contracts in the left-right direction due to elastic deformation of the recess 10i in the plane orthogonal to the central axis AX, as shown in FIG. 9B. The curved surface portion 10m and the curved surface portion 10n come into contact with each other to reduce the opening 10g. As a result, the outer diameter of the distal end portion 10a becomes smaller than that before the distal end portion 10a is inserted into the incision, so that the outer diameter of the distal end portion does not change before and after insertion into the incisional wound. It becomes easy to insert 10a into the incision. Further, the curved surface portion 10j moves toward the central axis AX on the plane orthogonal to the central axis AX. That is, since the curved surface portion 10j does not project toward the outer peripheral side of the distal end portion 10a and the curved surface portion 10j does not touch the incision when the distal end portion 10a is inserted into the incisional wound, the incisional wound due to the deformation of the distal end portion 10a. There is little concern that the organization will be burdened. It should be noted that while the tip portion 10a is being inserted into the incision, the tip portion 10a is maintained in a state in which the outer diameter is reduced as shown in FIG. 9B.

　Next, the operator operates the plunger 30 to move the intraocular lens 2 set on the stage unit 12 to the distal end portion 10a side. At this time, in the plane orthogonal to the central axis AX of the distal end portion 10a, the curved surface portion 10j is pushed in the direction away from the central axis AX by the lens body 2a of the intraocular lens 2, so that the distal end portion 10a is shown in FIG. Deformation starts from the state shown, and the recess 10i stretches in the left-right direction by elastic deformation. At this time, along with the movement of the curved surface portion 10j away from the central axis AX, the curved surface portions 10m and 10n move in the direction away from each other (left and right direction in the drawing), and the opening 10g expands. As a result, as shown in FIG. 9C, the tip portion 10a is deformed so that the curved surface portions 10j, 10m, and 10n become part of the cylindrical shape. Further, the outer diameter of the distal end portion 10a when deformed as shown in FIG. 9(c) is larger than the outer diameter of the distal end portion 10a before the distal end portion 10a is inserted into the incision, so that the intraocular lens 2 is It is possible to secure a larger space for the intraocular lens 2 to pass through and to ensure a more stable movement of the intraocular lens 2 as compared with the case where the outer diameter of the front end does not change when ejected from the tip into the eye. realizable. As described above, according to the present embodiment, when the distal end portion 10a is inserted into an incision in the eye and when the intraocular lens 2 moves within the distal end portion 10a, the concave portion 10i provided in the distal end portion 10a. By elastically expanding and contracting to expand and contract the opening 10g, the burden on the eye tissue of the incision can be reduced, and stable insertion of the intraocular lens can be performed.
　
Further, when the recess 10i is deformed as shown in FIG. 9C, the tip 10a is pressed by the incision, so that the recess 10i has a restoring force for returning to the shape shown in FIG. 9B. work. On the other hand, when the intraocular lens 2 moves in the tip portion 10a, the lens body 2a is curved in the tip portion 10a as shown in FIG. As shown in b), a restoring force that tries to return to a flat plate shape acts. That is, when the intraocular lens 2 moves in the distal end portion 10a, the restoring force of the recess 10i acts against the restoring force of the lens body 2a of the intraocular lens 2 and acts on the lens body 2a.

　On the other hand, due to the presence of the recess 10i, a restoring force that acts to restore the tip 10a from the shape shown in FIG. 9B to the shape shown in FIG. 9A acts. In other words, this restoring force acts so as to secure a wider inner diameter cross-sectional area of the nozzle through which the lens passes. As a result, the cross-sectional area of the area through which the lens passes becomes wider, and the unevenness of extrusion resistance is reduced. Further, since the plunger collides with the concave portion, it becomes a resistance, and it is assumed that the pushing load change is unlikely to occur. From these results, it is considered that the possibility that the so-called rocket launch, which is a phenomenon in which the lens body 2a vigorously jumps out of the opening 10g of the tip 10a at a speed not intended by the operator, is reduced. Further, as a result, when the intraocular lens 2 moves in the distal end portion 10a, the risk that the distal end portion 10a is vigorously deformed into a shape as shown in FIG. There is also less concern that the organization of the wound will be overburdened.
　
Further, it can be said that when the concave portion 10i is deformed as described above, the restoring force of the concave portion 10i is stronger than the restoring force of the tip portion 10a other than the concave portion 10i. Therefore, for example, as shown in FIG. 9C, even if the concave portion 10i is deformed so that the curved surface portions 10j, 10m, and 10n become part of the cylindrical shape, the concave portion 10i still has the nozzle shown in FIG. 9B. Returns to the shape it had when it was inserted into the eye. Further, when the recess 10i is deformed as described above, the stress acting on the tip 10a is not concentrated on the recess 10i, and the tip 10a is entirely deformed. Therefore, it can be said that there is little concern that the stress exceeds the elastic limit of the elastic deformation of the recess 10i and the recess 10i is plastically deformed.

　Further, when the distal end portion 10a is deformed as shown in FIG. 9C, the resistance of the lens due to the restoring force of the distal end portion 10a is transmitted from the lens body 2a to the plunger 30, so that the surgeon is required to operate the plunger 30. Thus, when the lens body 2a is moved to the tip portion 10a, the restoring force of the tip portion 10a can be sensed via the plunger 30. Therefore, the restoring force of the tip portion 10a can also be used as an opportunity to notify the operator who operates the plunger 30 that the lens body 2a has moved to the tip portion 10a.

　Then, when the intraocular lens 2 is ejected into the eye from the opening 10g of the distal end portion 10a, the distal end portion 10a is pushed by the incision, so that the shape shown in FIG. Return to the shape shown in. Next, when the operator removes the tip portion 10a from the incision, the tip portion 10a returns from the shape shown in FIG. 9(b) to the shape shown in FIG. 9(a). At this time, since the distal end portion 10a is deformed according to the size of the wound opening of the incision, there is little concern that the deformation of the distal end portion 10a will cause a burden on the tissue of the incision wound, such as the opening of the wound wound.

　The above is the description of the present embodiment, but the configuration of the distal end portion and the like of the intraocular lens insertion instrument is not limited to the above embodiment, and does not lose the same identity as the technical idea of the present invention. Various changes can be made within the range. For example, in FIG. 8, one of the radii of curvature R2, R3 of the curved surface portions 10m, 10n through which the rear support portion of the intraocular lens 2 passes can be set to be small. As a result, there is a difference in the size of the space in the left-right direction of the distal end portion 10a, and when the intraocular lens 2 is inserted into the eye, the lens body 2a passes through the wider space and the pressure received is reduced. The increase or decrease in the extrusion resistance is further suppressed, and the rear support passes through the narrower space, whereby the posture of the intraocular lens 2 can be controlled until the insertion of the intraocular lens 2 is completed. Further, instead of the above-mentioned tip portion 10a having the shape shown in FIG. 9(a), a tip portion 200a having a concave portion 200i (a portion extending from 10m to 10n in the figure through 10i in the figure) having the shape shown in FIG. May be adopted. The concave portion 200i has a curved portion of the tip portion 10a, and 200h as a bent portion of a portion corresponding to the portion of 10j in FIG. Even when such a concave portion 200i is adopted, the concave portion 200i is deformed when the distal end portion 200a is inserted into the incision and when the intraocular lens 2 moves inside the distal end portion 200a, as in the above embodiment. It is possible to smoothly insert the intraocular lens 2 into the eye by the plunger 30 while reducing the concern that the tissue of the incision will be burdened.

　Further, the intraocular lens insertion device utilizing the present invention is not limited to the above-mentioned embodiment, and for example, the intraocular lens and intraocular lens disclosed in Japanese Unexamined Patent Publication No. 2017-445 can be used. It can also be applied to a lens insertion device. That is, the intraocular lens is not limited to the one-piece type lens shown in FIG. 2, and may be a three-piece type lens disclosed in Japanese Patent Laid-Open No. 2017-445. Also, the plunger is not limited to the shape shown in FIG. 3, and a plunger having a shape as disclosed in Japanese Patent Laid-Open No. 2017-445 can be adopted. In addition, the deformed shape of the lens at the time of insertion is not the so-called valley fold that is rolled up from the mode in which the upper side is open as shown in FIG. There is no problem even if it is rolled up, so-called mountain fold shape.
Explanation of symbols
1 Intraocular lens insertion instrument
10a, 200a Tip part
10g Opening part
10i, 200i Recessed part
10j, 10m, 10n Curved surface part

claims
[Request item 1]
　A substantially cylindrical insertion member to be inserted into
　the eye, an opening provided at the tip of the insertion member for ejecting the intraocular lens into the eye, and the
　insertion by pressing the intraocular lens. moving the member, the intraocular lens and intraocular lens push member to emit into said eye from said opening
having a
　opening direction of the opening is inclined with respect to the extending direction of the insertion member On the
　rear end side of the insertion member of the opening , a concave portion having a predetermined depth extending in the extending direction is provided on the outer peripheral surface of the insertion member, and the
　concave portion includes the insertion member inside the eye.
An intraocular lens insertion device, wherein the intraocular lens is expanded and contracted by elastic deformation when the intraocular lens is moved into the insertion member and when the intraocular lens is moved into the insertion member .
[Request item 2]
　The intraocular lens insertion device according to claim 1, wherein a curved surface portion that connects the concave portion and the outer peripheral surface of the insertion member is provided.
[Request item 3]
　The intraocular lens insertion device according to claim 2, wherein a radius of curvature of the curved surface portion is 0.5 mm or less on a plane orthogonal to the extending direction of the insertion member.
[Request item 4]
　The eye according to claim 3, wherein the recess of the insertion member does not abut the inner peripheral surface of the insertion member, and the length of the recess in the extending direction is 0.5 mm or more. Inner lens insertion tool.
[Request 5]
　The eye according to claim 4, wherein, in a plane orthogonal to the extending direction of the insertion member, the depth of the recess is such that the recess does not exceed the substantial center of the cross section of the insertion member. Inner lens insertion tool.
[Request 6]
　The intraocular lens insertion device according to any one of claims 1 to 5, wherein the recess is formed by a secondary process performed after the insertion member and the opening are molded.