[0001]The present invention relates to toric intraocular lenses and intraocular lens insertion.
BACKGROUND
[0002]Intraocular lens to be inserted as a substitute for the lens for correcting the replacement or refraction of human turbid crystalline lens in cataract has been put to practical use. If a patient with corneal astigmatism undergo cataract surgery, there is a case where correction of astigmatism intraocular lenses, called toric intraocular lens is inserted. When inserting a toric intraocular lens into the eye of a patient, it is necessary to match the toric axis of the astigmatic axis and the intraocular lens of the patient's cornea.
[0003]
　Conventionally, a toric intraocular lens, markings indicating the toric axis is applied. Toric intraocular lens comprises a lens body having a predetermined refractive power, coupled to the lens body, the lens body and a support portion for retaining in the eye. Marking showing the toric axis is applied to the vicinity of the joint portion between the support portion in the lens body. Alternatively, the toric intraocular lens is assumed to extrude into the eye of the patient using the intraocular lens insertion device, during extrusion of the toric intraocular lens according to the intraocular lens insertion device, the weak extrusion direction and toric intraocular lens as principal meridian is parallel, the lens body and the supporting portion of the toric intraocular lens is configured (for example, Patent Document 1).
[0004]
　A lens body and the supporting portion of the toric intraocular lens is manufactured in the same material, in the case of so-called one-piece toric intraocular lens, in order to increase the strength of the support unit, the joint between the lens body and the support portion They tend to be thicker than the other portion. In this case, opening toric intraocular lens of the intraocular lens insertion instrument is emitted because a small diameter, thick joint is prevented disturb the movement of the toric intraocular lens in the lens insertion instrument eye There is a need. Therefore, as the position of the support portion with respect to the extrusion direction of the toric intraocular lens is in the proper position, it is necessary to determine the like relative position of the lens body and the support portion. Further, the cross-sectional area of ​​the optical axis of the lens body of toric intraocular lens is different between the weak principal meridian direction and Tsuyonushi meridian direction, of the lens body of a weak main meridian direction thickness of the strong principal meridian direction of the lens body It is thicker than the thickness. Therefore, so as not to disturb the movement of the toric intraocular lens in the intraocular lens insertion device, necessary to determine the relative position of the weak principal meridian direction and Tsuyonushi meridian direction of the lens body relative to the extrusion direction of the toric intraocular lens there is also.
CITATION
Patent Document
[0005]
Patent Document 1: Japanese Patent No. 5771907
Summary of the Invention
Problems that the Invention is to Solve
[0006]
　However, in the above toric intraocular lenses, applying a marking indicating the toric axis in the vicinity of the junction portion between the supporting portion of the lens body, and a weak principal meridian section of the joint and the lens body means connected . That is, since the thick joint and weak principal meridian moiety is linked, the balance of the thickness of the entire toric intraocular lens is deteriorated. Such a thick portion is the direction (in this case, the weak principal meridian direction) and toric intraocular lens configured biased, the tip of the toric intraocular lens pushing member of the intraocular lens insertion (plunger) , when extruding a toric intraocular lens, in order to behave like escaping into thin part of the toric intraocular lens, there is a possibility that extrusion stable toric intraocular lens is prevented.
[0007]
　Further, as the weak principal meridian direction of the lens body in the extrusion direction and toric intraocular lens toric intraocular lens according to the intraocular lens insertion device is parallel, the plunger tip of the lens body of toric intraocular lens even so as to abut against the thicker portion, the lens body other than the weak principal meridian direction becomes thinner with respect to the lens body of the weak principal meridian direction. Therefore, also in this case, the tip of the plunger, when extruding a toric intraocular lens, in order to behave like escape to the weak principal meridian direction other portions of the lens body, extrusion stable toric intraocular lens there is likely to be hampered.
[0008]
　Technology of the present disclosure has been made in view of the above circumstances, it is an object of providing a toric intraocular lens which can be further stabilized extrusion toric intraocular lens according to the intraocular lens insertion device It is to be.
Means for Solving the Problems
[0009]
　Toric intraocular lens of the present disclosure, the joint portion for joining the lens body having a weak main meridian and Tsuyonushi meridian, a pair of support portions for positioning the lens body in the eye, the lens body and the supporting part a toric intraocular lens with bets, toric intraocular lens has a substantially tubular shape the instrument body and toric intraocular lens insertion tube portion of which has a toric intraocular lens on the tip of the insertion tube portion for insertion into the eye housed intraocular lens insertion instrument having a plunger for moving the tip, each junction, across the center of the optical axis of the lens body is provided in a position facing each other, one end of the weak principal meridian of the lens body, the lens with respect to the position where the tip of the plunger abuts the outer circumference of the body, located on the opposite side of the axis connecting the joint through the center of the optical axis of the lens body, and a weak principal meridian of the lens body Acute angle with the extrusion axis of the toric intraocular lens flanger is less than or equal 0 ° larger than 90 °. Accordingly, by the tip of the plunger abuts against the thinner portion is the thickness of the lens body, it is possible to suppress axis deviation when the extrusion toric intraocular lens according to the plunger suitably.
[0010]
　Preferably, an acute angle is, when the tip of the plunger is in contact with the outer periphery of the lens body, be configured such line extended weak principal meridian is less than there 90 ° above an angle that does not intersect the plunger good. Alternatively, acute angle may be less than 80 ° configuration greater than 10 °. Alternatively, acute angle, may be configured substantially 45 °. Further, the lens body may have a structure that the marking is applied to both ends of the weak principal meridian. Furthermore, it may be configured such that the distal end of the supporting portion is positioned on the axis connecting the marking. More preferably, may the axis and weak principal meridian and angle formed connecting each joint as 45 ° ± 10 °. Further, the housing portion of the toric intraocular lens of the intraocular lens insertion, toric intraocular lens may be accommodated in advance.
Effect of the invention
[0011]
　According to the present disclosed technology, it is possible to provide a toric intraocular lens which can be further stabilized extrusion toric intraocular lens according to the intraocular lens insertion device.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012]
[1] Figure 1 (a), (b) is a diagram showing a schematic configuration of a toric intraocular lens in one embodiment.
[2] Figure 2 (a), (b) is a diagram showing the schematic configuration of the intraocular lens insertion device according to one embodiment.
3 is a diagram showing the schematic configuration of the nozzle body in one embodiment.
[4] FIG. 4 (a), (b) is a diagram showing the schematic configuration of the positioning member in one embodiment.
[5] FIG. 5 (a), (b) is a diagram showing a schematic configuration of a plunger in one embodiment.
[6] FIG. 6 (a) ~ (d) are diagrams illustrating an outline configuration in a case that no the case of axial displacement of the plunger for toric intraocular lens in one embodiment occurs.
[7] FIG. 7 (a) ~ (d) are diagrams illustrating an outline configuration in a case that no the case of axial displacement of the plunger for toric intraocular lens in one embodiment occurs.
[8] FIG. 8 (a), when extruding the (b) is, FIG 6 (a) ~ (d) and FIG. 7 (a) ~ plunger toric intraocular lenses (d), the plunger it is a diagram illustrating a case where no and if the axis deviation occurs.
The table shown in the extrusion by [9] FIG. 6 (a) ~ (d) and FIG. 7 (a) ~ (d) plunger toric intraocular lenses, the result of verifying the presence of axial displacement of the plunger it is.
[10] FIG. 10 (a), (b) shows an example of a cross section passing through the optical axis of the toric intraocular lens in one embodiment.
[11] FIG. 11 (a), (b) shows an example of a cross section passing through the optical axis of the toric intraocular lens in one embodiment.
[Figure 12] shows an example of a cross section passing through the optical axis of the toric intraocular lens in one embodiment.
DESCRIPTION OF THE INVENTION
[0013]
　Hereinafter, with reference to the drawings will be described embodiments of the present invention.
[0014]
　Figure 1 is a diagram showing a schematic configuration of a toric intraocular lens 2 according to the present embodiment. 1 (a) is a plan view, FIG. 1 (b) shows a side view. In addition, between 1 (a) and FIG. 1 (b), the orientation of the toric intraocular lens 2 is not compatible. Toric intraocular lens 2 is a so-called one-piece supporting portion and the lens portion are integrally molded of the same material, the material of the lens is an acrylic material flexible. Toric intraocular lens 2, a lens body 2a having a predetermined refractive power, coupled to the lens body 2a, and a long plate-like two supporting portions 2b for holding the lens body 2a in the eye provided. Lens body 2a and the supporting portion 2b is formed of a flexible resin material. Also, the lens body 2a and the support portion 2b, and are connected to one another via a joint 2e.
[0015]
　As shown in FIG. 1 (b), joint portions 2e are formed to protrude from the lens outer peripheral surface tangentially provided in contact around the periphery and a predetermined range of the lens body 2a. Further, in the present embodiment, the vicinity of the outer edge of the lens body 2a, a pair of markings 2d that face each other across the optical axis O of the lens body 2a is applied. Imaginary line connecting the marking and 2d represents a weak principal meridian of the lens body 2a, a line perpendicular to the line of the imaginary in the optical axis O of the lens body 2a is, represents the steepest meridian. Thus, the operator, after a toric intraocular lens 2 is inserted into a patient's eye, so that the weak principal meridian direction indicated by the marking 2d of patient's cornea the strong principal meridian direction and the lens body 2a coincide, toric it is possible to adjust the position of the intraocular lens 2.
[0016]
　In the present embodiment, within the intraocular lens insertion device 1 to be described later, one of the support portion 2b of the two supporting portions 2b is a rear side of the lens body 2a, the front side of the other support portion 2b lens body 2a as arranged, toric intraocular lens 2 is set on the stage 12. Note that the front supporting portion supporting portion disposed on the front side of the lens body 2a, a supporting portion arranged on the rear side of the lens body 2a and the rear support portion.
[0017]
　Toric intraocular lens 2 in this embodiment, embossing is applied to the support portion 2b. Thus, when by the plunger 30 of the pressing movement of the toric intraocular lens 2, the orientation of the toric intraocular lens 2 can be stabilized. Specifically, for example, by the plunger 30 when the toric intraocular lens 2 is pressed and moved, toric intraocular lens by appropriate frictional force is generated between the inner wall surface of the support portion 2b and the nozzle body 10 2 There can be prevented so as not to rotate with the nozzle body 10.. In addition, by embossing it is applied to the support portion 2b, when a toric intraocular lens 2 is folded in the nozzle body 10, may be supporting portion 2b is prevented so as not stick to the lens body 2a . Further, in the present embodiment, as shown in FIG. 1 (b), the peripheral portion of the lens body 2a toric intraocular lens 2, that is, in connection portion between the lens body 2a and the supporting portion 2b, optical with lens body 2a is reduce the center thickness of the lens by providing a curvature smaller optical surface 2c so as to alleviate the tilt of the surface, the cross-sectional area of ​​the lens also reduced, thereby realizing a thin lens shape. Here, the optical surface 2c may be a flat shape.
[0018]
　In the range where the joint 2e is in contact with the outer periphery of the lens body 2a, the optical section diameter of the front, since the only slightly larger amount than processing Majin'n other ranges, the optical portion in front slightly oval has a shape (non-circular). Further, the rear optical unit is also in the range of joint 2e is in contact with the outer periphery of the lens body 2a, has become larger optic diameter about 10% compared to other ranges, i.e., the optical lens surface in the joint 2e there is a function to have part of the as. Thus widely effective range of the lens a little in a predetermined size to be defined for the lens body 2a. Generally, the optical portion diameter of the lens body 2a in the range not contacting the joint 2e is 7.0mm from 5.5 mm.
[0019]
　Figure 2 shows a schematic configuration of the intraocular lens insertion device 1 for use in insertion into the eye of the toric intraocular lens of the present embodiment. 2 (a) is a plan view of the IOL injection instrument 1 in the case where the lid opening stage lid 13, FIG. 2 (b) side of the intraocular lens insertion device 1 in the case of closing the stage cover portion 13 It shows a view. The nozzle body 10 of the intraocular lens insertion device 1 is a cylindrical member of the cross-section substantially rectangular, and the rear end portion 10b which is largely opened on one side of the end portion, the insertion tube which is narrowed in an end portion of the other side and a nozzle portion 15 and the tip portion 10a of the parts 100. As shown in FIG. 2 (b), the tip portion 10a is opened obliquely. Plunger 30 is inserted into the nozzle body 10 is reciprocable.
[0020]
　In the following description, forward a direction from the rear end 10b to the distal end portion 10a of the nozzle body 10, the rear direction and the opposite direction, upward direction near side in FIG. 2 (a), the downward direction and the opposite direction , the vertically upward direction from the sheet surface left, the opposite direction to the right in FIG. 2 (b). In this case, the upper on the front side optical axis of the lens body 2a to be described later, the optical axis rear lower lens body 2a, the front side in the pressing direction forward by the plunger 30, the rear side pressing by the plunger 30 It corresponds to the direction the rear.
[0021]
　In the vicinity of the rear end portion 10b of the nozzle body 10, protruding in a plate shape, the user hold unit 11 for applying a finger when pressing the plunger 30 in the distal end side of the nozzle body 10 is provided integrally. Further, the rear side of the nozzle portion 15 of the nozzle body 10, a stage unit 12 to set the toric intraocular lens 2 is provided. The stage unit 12 is adapted to open to the upper side of the nozzle body 10 by lid opening stage lid 13. Further, the stage unit 12, the positioning member 50 is attached from the lower side of the nozzle body 10. This positioning member 50, toric intraocular lens 2 is positioned stably in the stage unit 12 before use (during transport).
[0022]
　That is, in the intraocular lens insertion device 1, at the time of manufacture, in a state where the stage cover portion 13 is the positioning member 50 is opened cover is attached to the stage 12, toric intraocular lens 2 on the stage 12, the optical axis the front side is set to be the top. Then, it shipped after being closed the stage cover portion 13, is sold. Furthermore, in use, the user, by inserting the stage portion 12 of the needle of a syringe which lubricant filled for toric intraocular lens from the needle hole 20a of the insertion portion 20 to inject the lubricant. Then, the user removes the positioning member 50 while still closing the stage cover portion 13, then pushing the plunger 30 on the distal end side of the nozzle body 10.
[0023]
　Thus, pressing the toric intraocular lens 2 by the plunger 30, after moving to the nozzle section 15, a toric intraocular lens 2 is released into the eye from the tip 10a. The nozzle body 10 in the intraocular lens insertion device 1, the plunger 30, the positioning member 50 is formed of a resin such as polypropylene material. Polypropylene has a proven track record in medical equipment, reliability such as chemical resistance is also high material.
[0024]
　Further, a part of the stage cover portion 13 is formed a confirmation window 17 by a thin portion. Incidentally, either the degree of the thin portion of the check window portion 17 at the stage the lid 13 be suitably determined based on the visibility of the toric intraocular lens material and the confirmation window 17 to form a stage cover portion 13 Bayoi. Further, by forming the check window portion 17, it can be expected the effect of reducing shrinkage during molding of the stage cover portion 13.
[0025]
　The Figure 3 shows a plan view of the nozzle body 10. In the nozzle body 10 as described above, toric intraocular lens 2 is set on the stage 12. The toric intraocular lens 2 is released from the pressed the tip portion 10a in this state by the plunger 30. Incidentally, inside the nozzle body 10 through holes 10c are provided to vary the cross-sectional shape in response to changes in the contour of the nozzle body 10. Then, when the toric intraocular lens 2 is released, the toric intraocular lens 2 is deformed in accordance with a change in the cross-sectional shape of the through hole 10c of the nozzle body 10, the incision formed in the patient's eye It is released after having deformed easily form enters.
[0026]
　The tip portion 10a, the upper region of the nozzle portion 15 is cut obliquely so that the front of the lower region, a so-called bevel cut shape. Although described later in detail of the tip of the nozzle portion 15 of this embodiment, the cut shape obliquely the tip section 10a, as viewed from the lateral direction may be linearly obliquely cut and, to have a bulge on the outside, i.e. may be cut obliquely so that the curved shape.
[0027]
　The stage 12, the stage groove 12a having a width slightly greater than the diameter of the lens body 2a toric intraocular lens 2 is formed. Longitudinal dimension of the stage groove 12a is set larger than the maximum width dimension including a support portion 2b extending on either side of the toric intraocular lens 2. Further, the bottom surface of the stage groove 12a, a mounting surface of the toric intraocular lens set surface 12b is formed. Vertical position of the set surface 12b, rather than the height position of the bottom surface of the through hole 10c of the nozzle body 10 is set upward, it is connected by a sloping bottom face 10d and the set surface 12b and bottom surface of the through hole 10c .
[0028]
　It is formed integrally with the stage 12 and the stage cover portion 13. Stage lid 13 has a longitudinal dimension equivalent to the stage portion 12. Stage lid 13, the side surface of the stage 12 are connected by a thin plate-like connecting part 14 formed extending to the stage cover portion 13 side. Connecting portion 14 is bendable formed at the central portion, the stage cover portion 13 can be closed overlap from above the stage unit 12 by bending the connecting portion 14.
[0029]
　In stage lid 13, the set surface 12b which faces when closing, and reinforce the stage cover portion 13, the rib 13a for stabilizing the position of the toric intraocular lens 2, and 13b, upper plunger 30 guide protrusions 13c of the guide is provided for. Further, the stage cover portion 13, the needle hole 20a of the toric intraocular lens 2 as an insertion hole for injecting a syringe hyaluronic acid in the stage 12 before the operation of inserting the intraocular provided. The needle hole 20a, when closed stage cover portion 13 is a hole for connecting the toric intraocular lens 2 housed in the outside stage portion 12 of the stage 12. The user inserts the syringe needle from the needle hole 20a before the operation of inserting the toric intraocular lens 2, and supplies the hyaluronic acid is a viscoelastic material to the desired location within the stage portion 12.
[0030]
　Below the set surface 12b of the stage 12, the positioning member 50 is provided detachably. Figure 4 shows a schematic configuration of the positioning member 50. 4 (a) shows a plan view of the positioning member 50, FIG. 4 (b) shows a left side view of the positioning member 50. The positioning member 50 is configured separately from the nozzle body 10, there is a pair of side wall portions 51, 51 are connected by a connecting portion 52 structure. The lower end of each side wall portion 51, the holding portion 53, 53 extending extending outward is formed.
[0031]
　Then, the inside of the side wall portions 51, 51, the first mounting portion 54 of the pair of protruding upward is formed. Further, on the outer peripheral side of the upper end face of the first mounting portion 54 and 54, first positioning portions 55, 55 are formed to protrude. Separation length of the inner each other of the first positioning portion 55 is set slightly larger than the diameter of the lens body 2a toric intraocular lens 2.
[0032]
　In addition, the inside of the side wall portions 51 and 51, the second mounting portion 56, 56 of the pair of protruding upward is formed. The height of the upper surface of the second mounting portion 56 is made equal to the height of the upper surface of the first loading portion 54 and 54. Furthermore, the outer part on the upper surface of the second mounting portion 56, the second positioning portions 57 and 57 to further protrude upward throughout the lateral direction of the second mounting portion 56 is formed . Separation length of the inner each other of the second positioning portion 57 is set slightly larger than the diameter of the lens body 2a toric intraocular lens 2.
[0033]
　In addition, the inside of the side wall portions 51 and 51, the third placing part 58 in which a part of the front support portion of the support portion 2b of the toric intraocular lens 2 is placed is formed. Further, the third positioning portion 59 protrudes further upward from the third mounting portion 58 is formed. The third positioning portion 59 a part of the front support portion abuts. Then, the inside of the side wall portions 51 and 51, a fourth mounting portion 60 in which a part of the rear support portion of the support portion 2b of the toric intraocular lens 2 is placed is formed. The fourth positioning portion 61 which protrudes further upward from the fourth mounting portion 60 is formed. The fourth positioning portion 61 a part of the rear support portion abuts. Incidentally, as shown in FIG. 4 (b), the height of the upper surface of the fourth mounting portion 60 and the fourth positioning portion 61, than the height of the upper surface of the first to third mounting portion and the first to third positioning portion It is provided so as also low. On the other hand, on the outside of the side wall portions 51 and 51, is provided rotation prevention wall 62 for preventing unwanted rotation when removing the positioning member 50.
[0034]
　The above positioning member 50 is assembled from the lower side of the set surface 12b of the nozzle body 10. The set surface 12b of the nozzle body 10, set surface through hole 12c penetrating the set surface 12b in the thickness direction is formed. The outer shape of the set surface through hole 12c is slightly larger substantially similar shape to the shape viewed first to fourth mounting portion and the first to fourth positioning portion of the positioning member 50 from the upper side. Then, when the positioning member 50 is attached to the nozzle body 10, mounting portion and the first to fourth positioning portion first to 4, is inserted from the lower side of the set surface 12b on the set surface through holes 12c, set surface protruding above the 12b.
[0035]
　Then, when the toric intraocular lens 2 is set to the set surface 12b is the outer peripheral bottom face of the lens body 2a is placed on the upper surface of the first mounting portion 54 and the second mounting portion 56 It is. The lens body 2a is restricted in position with respect to the horizontal direction (horizontal direction in sets face 12b) by the first positioning portion 55 and the second positioning portions 57 and 57. Furthermore, two support portions 2b of the toric intraocular lens 2 and the third placing part 58, respectively, are mounted on the upper surface of the fourth mounting portion 60. Moreover, two supporting portions 2b, the third positioning portion 59, respectively, is restricted in position with respect to the horizontal direction by the fourth positioning portion 61.
[0036]
　It shows a schematic configuration of the plunger 30 in FIG. Plunger 30 has a slightly larger front-rear length than the nozzle body 10. Then, the working portion 31 of the base and the distal end side of the cylindrical shape and a rectangular rod-shaped and is formed from the base and the rear end side of the insertion portion 32.. The action part 31 is configured to include a cylindrical portion 31a which is a cylindrical shape and a thin plate-like flat portion 31b extending in the lateral direction of the cylindrical portion 31a. Figure 5 (a) shows the central axis CX of the working portion 31 of the plunger 30 (columnar portion 31a). Here, the tip of the plunger 30 is generally from 0.5 mm 2.0 mm width (thickness). This case from thin plunger strength becomes weak, it is impossible to stably extruded lens. If thicker than this, in turn increases the incision for inserting an intraocular lens into the eye, astigmatism called induced astigmatism is likely to adversely affect the generated visual function.
[0037]
　The tip portion of the working portion 31, the cutout portion 31c is formed. The notch 31c, as can be seen from FIG. 5 (b), are formed in a groove shape that penetrates in the lateral direction open in the downward direction of the action part 31. Moreover, as can be seen from FIG. 5 (b), the groove wall on the distal end side of the cutout portion 31c is formed in the inclined surface directed downward to take to go to the tip end of the working portion 31.
[0038]
　Further, in the longitudinal direction in the vicinity of middle and proximal of the left and right flat portions 31b, the slit 31d, 31f are formed. Slits 31d, 31f are formed to be substantially L-shape consisting of notches and extending into the notches and the longitudinal direction to stretch the flat portion 31 in the lateral direction. Also, the flat portion 31b, the movable piece 31e by slits 31d, 31f are formed, 31 g is formed. Movable piece 31e, 31 g, when the plunger 30 moves the nozzle body 10, so that the cylindrical portion 31a is located at the center in the lateral direction of the nozzle body 10, functions of the so-called axial deviation prevention. In this embodiment, two pairs of the movable piece 31e, but 31g are formed, may be formed only one pair or three pairs or more.
[0039]
　Insertion portion 32 is generally has a substantially H-shaped cross section, dimensions of the horizontal direction and the vertical direction is set slightly smaller than the through-hole 10c of the nozzle body 10. Further, the rear end of the insertion portion 32, a disc-shaped pressing plate portion 33 extending in the vertical and horizontal direction is formed.
[0040]
　The front side of the portion from the center of the longitudinal direction of the insertion portion 32, toward the upper side of the insertion portion 32 protrudes elastically by vertically movable pawl portion 32a of the material of the plunger 30 is formed. Then, when the plunger 30 is inserted into the nozzle body 10, the locking hole 10e and the pawl portion 32a shown in FIG. 3 provided in the thickness direction in the upper surface of the nozzle body 10 is engaged by this the relative positions of the nozzle body 10 and the plunger 30 in the initial state are determined. The formation position of the claw portion 32a and the engaging hole 10e is in engagement, the tip of the working portion 31 is positioned on the rear side of the lens body 2a toric intraocular lens 2 is set on the stage 12, lens notch 31c of the support portion 2b of the rear side of the main body 2a is set to be positioned on the support in a location from below. Also in the insertion portion 32, the slits 31d, similarly to 31f, a slit of a substantially L-shape consisting of a notch extending into the notches and the longitudinal direction extending in the lateral direction may be formed. Thus slit formed in the insertion portion 32, perform the function of axial misalignment prevention of the plunger 30.
[0041]
　FIG 6 (a) ~ (d) and FIG. 7 (a) ~ (d), a toric intraocular lenses 110-180 prototyped in this embodiment is shown schematically. In FIG. 6 (a) ~ (d) and FIG. 7 (a) ~ (d), when the toric intraocular lenses 110-180 are set on the stage portion 12, the axis corresponding to the center axis CX of the plunger 30 the a axis AX. That is, in the intraocular lens insertion device 1, toric intraocular lenses 110-180 are pushed in the axial direction AX by the plunger 30. Further, the axis perpendicular to the axis AX in toric intraocular lenses 110-180 in the optical axis direction perpendicular to the plane (the plane parallel to the plane) and the axis BX. Further, through the center of the optical axis of the lens body and the axis DX of the axis connecting the pair of joint portions. Further, the outer circumference of the lens body the tip of the plunger 30 to a position P abuts. Furthermore, the weak principal meridian and the extrusion axis of the plunger 30 of the lens body the acute angle between (axis AX) and theta.
[0042]
　In the present embodiment, as shown in FIG. 6 (a) ~ (d) and FIG. 7 (a) ~ (d), similarly to the marking 2d toric intraocular lens 2, the lens of the toric intraocular lenses 110-180 the body 110a ~ 180a, the marking 110d ~ 180d for indicating a weak principal meridian direction is applied. Incidentally, the marking 110d ~ 180d are applied to the lens body 110a ~ 180a as a pair of marks provided at both ends near the weak principal meridian of the lens body 110a ~ 180a.
[0043]
　The thickness of the lens body 110a ~ 180a in a plane perpendicular to the optical axis of the lens body 110a ~ 180a is maximized in the weak principal meridian direction. Here, the thickness of the lens body means the thickness in the periphery of the lens body (edge ​​thickness). Then, the thickness of the lens body 110a ~ 180a in the other direction through the center of the lens body is thinner than the thickness of the weak principal meridian direction. More specifically, in a plane perpendicular to the optical axis of the lens body 110a ~ 180a, assuming a line passing through the center of the lens body overlapping the weak principal meridian, the line clockwise or counter-clockwise, the lens bodies 110a and rotated to overlap with the imaginary line DX connecting the pair of joint portions 110e ~ 180e of ~ 180a. The thickness of the lens body 110a ~ 180a in the direction indicated lines for rotating becomes thinner as the rotation angle from the weak principal meridian direction becomes large, once after taking a minimum value, the center of the lens body 110a ~ 180a direction through the becomes thick toward the direction indicated by the imaginary line DX connecting the pair of joint portions 110e ~ 180e of the lens body 110a ~ 180a.
[0044]
　In the present embodiment, the line DX virtual connecting the pair of joint portions 110e ~ 180e, the thickness of the lens body 2a is defined as a line indicating the direction to take the maximum value, passes through the center of the lens body 110a ~ 180a if a line connecting together a predetermined position of the joint portion 110e ~ 180e, is not limited to the line shown in FIG. 6 (a) ~ (d) and FIG. 7 (a) ~ (d).
[0045]
　Thus, the thickness of the lens body 110a toric intraocular lens 110 shown in FIG. 6 (a) For example, when rotating a line passing through the center of the lens body 110a which overlaps with the axis AX clockwise, axial direction AX takes the maximum value in, after taking a minimum value between the axis AX and the axis DX, takes the maximum value in the axial direction DX, after taking a minimum value between the axis DX and the shaft AX, the axial direction AX again it takes a maximum value in. That is, between the weak principal meridian and the axis DX of the lens body 110a, the thickness of the lens body 110a is changed to take the maximum value and the minimum value. Incidentally, it is likewise conceivable for the change in thickness of the other lens body 120a ~ 180a.
[0046]
　Next, when extruding the toric intraocular lenses 110-180 in this embodiment by an intraocular lens insertion instrument 1, FIG. 8, the positional relationship between the toric intraocular lens 110-180 and the plunger 30 in the nozzle body 10 ( a), it will be described with reference to (b). Incidentally, FIG. 8 (a), the in (b), shows the nozzle body 10 and the plunger 30 by a broken line shows a toric intraocular lens 110 and 120 in solid lines.
[0047]
　The FIG. 8 (a), the at insertion into the eye of the toric intraocular lens 120 by an intraocular lens insertion instrument 1, illustrating the positional relationship between the toric intraocular lens 120 and the plunger 30 in the nozzle body 10. to. Are as described above, the thickness of the lens body 120a toric intraocular lens 120 includes a direction indicated with the axis DX indicated by imaginary line connecting the pair of marking 120d (FIG. 6 (b) in coincident with the axis BX) It takes a maximum value. That is, in the nozzle body 10, a position P where the leading end of the plunger 30 comes into contact with the lens body 120a is a portion sandwiched between two parts in which the thickness of the lens body 120a takes a maximum value.
[0048]
　As a result, during the extrusion of the toric intraocular lens 120 by the plunger 30, the position deviation of the tip of the plunger 30 the thickness of the lens body 120a on both sides of the front end of the plunger 30 becomes thicker is suppressed result, plunger 30 state and the central axis CX and the extrusion direction (axial direction AX) matches the can be suitably maintained.
[0049]
　Further, in FIG. 8 (b), upon insertion of by the intraocular lens insertion device 1 into the eye of the toric intraocular lens 110, the positional relationship between the toric intraocular lens 110 and the plunger 30 in the nozzle body 10. exemplified. Are as described above, the thickness of the lens body 110a toric intraocular lens 110 includes a direction indicated with the axis DX indicated by imaginary line connecting the pair of marking 110d (FIGS. 6 (a) in coincident with the axis AX) It takes a maximum value. That is, in the nozzle body 10, a position P where the leading end of the plunger 30 comes into contact with the lens body 120a, the thickness of the lens body 120a becomes part takes a maximum value.
[0050]
　As a result, during the extrusion of the toric intraocular lens 110 by the plunger 30, as a result of thickness is thinner in lens body 110a on both sides of the front end of the plunger 30, the tip of the plunger 30 is, the thickness of the lens body 120a is It tends to shift to either side from the portion that takes a maximum value. In this case, as illustrated in FIG. 8 (b), a result of the tip is displaced plunger 30, a state where the center axis CX and the extrusion direction of the plunger 30 (the axial direction AX) does not match. With such the tip of the plunger 30 is displaced, the extrusion operation toric intraocular lens 110 by the plunger 30 is not stable, which may hinder the practitioner by the operator.
[0051]
　9 shows, the weak main-intraocular lens 110 of each pattern of meridian 180 shown in FIG. 6 (a) ~ (d) and FIG. 7 (a) ~ (d), during extrusion by a plunger 30, the It shows the result of verifying whether the tip of the plunger 30 is displaced so. Each digit of the "lens" in the figure refers to the sign of said toric intraocular lenses. Further, "none" in Figure "axis deviation", as illustrated in FIG. 8 (a), by the plunger 30 in a state where the center axis CX and extrusion direction (axial direction AX) matches the plunger 30 meaning that it was possible to perform extrusion of toric intraocular lenses. "Yes" in the figure "axis deviation", as illustrated in FIG. 8 (b), during extrusion of the toric intraocular lens according to the plunger 30, the plunger 30 the central axis CX and the extrusion direction (axial direction AX) It means that the door is in a state that does not match.
[0052]
　In toric intraocular lenses 120,130,160,180 9, axial displacement of the plunger 30 does not occur. That is, during extrusion of the toric intraocular lens 120,130,160,180 by the plunger 30, the positional relationship between the toric intraocular lens 120,130,160,180 and the plunger 30 in the nozzle body 10, FIG. 8 the central axis CX and the axis AX of the plunger 30 is coincident as illustrated in (a). Here, FIG. 6 (b), (c) and 7 (b), referring to (d), one of the pair of markings indicating the weak principal meridian of the lens body of toric intraocular lenses (figure EX), that end of the weak principal meridian is, the position where the tip of the plunger 30 abuts the outer circumference of the lens body relative (in the figure P), the axis connecting the pair of joint portions through the center of the optical axis of the lens body (axial DX ) located on the opposite side of the, and, when the weak principal meridian and the extrusion axis of the plunger 30 of the lens body (axis AX) and acute forms of (in the figure theta) is less than or equal to 0 ° greater than 90 ° , it can be said that the axial misalignment of the plunger 30 does not occur. The thickness of the outer periphery of the lens body, the front end of the plunger in the outer periphery of the lens body is configured to take a minimum value at a position where the abutment, the lens body the plunger 30 in the thinner portion than around abut in believed to axial deviation it can be suppressed more suitably.
[0053]
　Further, toric intraocular lenses, immediately after insertion into the eye, it is necessary to align the position of the main meridian in the eye (direction), in toric intraocular lens such embodiments are toric in alignment fewer angle to rotate the intraocular lens can be more easily surgery. The reason is that, because in actual surgery can reduce the corneal astigmatism by incision and dissected steepest meridian side of the cornea, often inserting a toric intraocular lens. In this case, strong principal meridian direction of the direction and astigmatism inserting a toric intraocular lens coincides. Furthermore, when the axis of the weak principal meridian of the toric intraocular lens aligned with the astigmatic axis to rotate the toric intraocular lens clockwise has become customary. Therefore, when acute form of the weak principal meridian and the extrusion axis of the plunger 30 of the lens body as shown in the embodiment (axis AX) (in the figure theta) is less than or equal to 0 ° greater than 90 °, the immediately after the toric intraocular lens inserted into the astigmatic patients, the rotational direction for alignment are oriented to rotate the toric intraocular lens clockwise, the rotation angle of an acute angle.
[0054]
　If the contrary weak principal meridian axis at the junction of the support portion is aligned want direction and toric marks indicate the axis (weak principal meridian axis) because an obtuse angle, alignment than in the case of acute rotation amount for becomes many. In the case where to match the axis of the extrusion axis and the weak principal meridian, the rotation amount is considered to be ideally minimized, in practice, when working to adjust the removal and intraocular stability of the viscoelastic material toric intraocular lens from the ideal position is assumed that ends up turning more than necessary in a clockwise direction. To return to the ideal position toric intraocular lens in the case, it is necessary to rotate near 180 °, since most risk that the rotation amount becomes more is concerned, actually is better not to match the preferred embodiments.
[0055]
　In the toric intraocular lenses 110,140,150,170 9, axial displacement of the plunger 30 is caused. That is, during extrusion of the toric intraocular lens 110,140,150,170 by the plunger 30, the positional relationship between the toric intraocular lens 110,140,150,170 and the plunger 30 in the nozzle body 10, FIG. 8 the central axis CX of the plunger 30 as illustrated in (b) is being shifted from the axis AX. Here, FIG. 6 (a), (d) and FIG. 7 (a), when referring to (c), one of the pair of markings indicating the weak principal meridian of the lens body of toric intraocular lenses (figure EX), that end of the weak principal meridian is, the position where the tip of the plunger 30 abuts the outer circumference of the lens body relative (in the figure P), the axis connecting the pair of joint portions through the center of the optical axis of the lens body (axial DX ) located at a position overlapping the extrusion axis on the opposite side or plunger 30 (axis AX) and, and the weak principal meridian and acute forms of the axis AX of the lens body (in the figure theta) is greater than 90 ° 180 ° when the less, it can be said that the axial displacement of the plunger 30 is caused.
[0056]
　Incidentally, were evaluated for the extrusion load at the time of extruding the toric intraocular lenses 110-180 in the plunger 30 with the intraocular lens insertion device 1, the cross-sectional area of ​​the cross-sectional shape of toric intraocular lens 2 is extrusion load is folded there is large tends correlated, but the difference between the load value is not greater. For example, in toric intraocular lens of cylindrical power is + 6.00 D, the difference in the extrusion force is large even about 1N, it was not different enough to affect the surgery. In addition, actually where the actual results of the intraocular lens insertion surgery was evaluated extrusion sense of the plunger 30 to target a sufficiently certain clinicians, obtained evaluation results that can be extruded in the same way regardless of the orientation of the weak main meridian obtained. That is, in this embodiment, be configured to the weak principal meridian of the toric intraocular lenses 110-180 axial displacement of the plunger 30 does not occur, the larger the extrusion load by the plunger 30 will affect the operation concerns it can be said that there is no.
[0057]
　Above is the description of the present embodiment, the configuration such as the above-mentioned lens and the insertion portion is not limited to the above embodiments, and various within a range that does not lose the technical idea and the identity of the present invention it is possible to change. For example, more preferably, above the acute angle theta, when the outer circumference of the lens body the tip of the plunger 30 abuts, line extended weak principal meridian of the lens body has at least an angle that does not intersect the plunger 30 is less than 90 °. Further, in the present embodiment, the thickness in the periphery of the lens body of a change in (edge ​​thickness) is maximized with respect to angle around the optical axis, the weak principal meridian direction and Tsuyonushi meridian direction of the intermediate, i.e. θ is It was found to be at most 45 °. In this case, contact with the edge thickness tip of the plunger 30 is not only a local minimum, the positional deviation of the the difference in minimum value and the edge thickness Metropolitan on either side of the plunger 30 becomes maximum, the plunger 30 tip it is possible to suppress efficiently. Further, the marking indicating the weak principal meridian direction in the production of toric intraocular lenses, due to a manufacturing error, there is likely to be subjected to displacement ± 5 ° with respect to the weak principal meridian direction. Given these points, the above acute angle, although 45 ° is the best, preferably not more than 10 ° less than 80 °, more preferably substantially 45 °, i.e. the range of the 45 ° ± 5 ° it is the angle.
[0058]
　Further, in another embodiment, the angle between Yowanushi meridian and the axis (DX) connecting the pair of joint portions may be 45 degrees. In this case, the cross-sectional shape of the toric intraocular lens to be bonded to the pair of joints becomes a shape similar to the cross-sectional shape of the monofocal intraocular lens having the same power as the spherical equivalent power of the toric intraocular lens. Therefore, it is possible to make the mechanical properties of the toric intraocular lens equivalent to the mechanical properties of the monofocal intraocular lens. That can be made equal mechanical properties means that stability in the eye are equivalent, it is possible to obtain a stable operation result.
[0059]
　Figure 10 (a), (b), FIG. 11 (a), (b), FIG. 12 shows a cross section through the optical axis of the toric intraocular lens. In this figure, 35 ° direction, 45 ° direction, 55 ° direction as 0 ° direction weak main meridian direction is a direction corresponding to the angle at which the strong principal meridian direction and 90 ° direction. Figure 10 (a), (b), FIG. 11 (a), (b), FIG. 12 is a intraocular principal point refractive power is illustrates a cross-sectional shape of the toric intraocular lens of + 20.0D. In the figure, the horizontal axis represents the distance from the optical axis r (mm), the distance from the vertical axis lens rear surface vertex Z (mm), the upper surface is non-spherical shape on the front (FC), the lower surface of the single focus lens in the rear surface It shows the rear surface BC and the toric surface. Cross-sectional shape of the toric surface is Toric from the larger cylinder power (Large), Toric (Middle), is shown as Toric (Small). As can be seen, although the strong principal meridian direction and a weak principal meridian direction different shapes monofocal intraocular lens and toric intraocular lens, for the 45 ° direction, the difference as to affect the mechanical properties no. The axial DX is axis connecting the arc midpoints shaft or the supporting portion 2b, is connected to 2e connecting the midpoints of the arcs joining portion 2e and the lens body 2a is in contact is desirable.
[0060]
　Also, the junction of toric intraocular lens is provided in contact around the periphery and a predetermined range of the lens body may be joined without mechanical properties as long as the predetermined range is changed. As an example, if the outer periphery of the junction and the lens body of toric intraocular lens is in contact with a range of 45 ° ± 10 °, 35 ° direction and 55 ° Comparing the direction of the cross-sectional shape, monofocal intraocular lens and the toric eye the cross-sectional shape of the inner lens can be confirmed that there is no difference as to affect the mechanical properties similar to the 45 ° direction. Here, the optical shape of the optic in contact with the joint portion may be difference occurs. Further, an axis connecting the pair of joint portions (DX) may be set arbitrarily within a predetermined range.
[0061]
　Here, the orientation of the folding of the lens body of toric intraocular lens in an intraocular lens insertion device, in Japanese Patent 5603326, the edges of the 45 ° direction mentioned above toric intraocular lens (45 ° direction from the weak main meridian) the thickness was consistent with the edge thickness of the 45 ° direction monofocal intraocular lens, by performing an operation folding in the direction of 45 ° (45 ° direction from the weak main meridian), single which is the base of toric intraocular lens folding manipulated like intraocular lens is that the it is possible to think that the disclosed. Meanwhile, in the present embodiment, as described above, the extrusion load, since more or less correlated to the cross-sectional area of ​​the cross section of the lens body to be folded, relatively small cross-sectional area direction, i.e. the steepest meridian Collapse (weak principal meridian folded around a) If that is extruded at a smaller extrusion load, lenses and it is possible to reduce the damage risk of the insertion portion, the plunger during the extrusion operation as in this embodiment it is possible to axial misalignment of to prevent the occurrence, it is possible to provide a more secure stable extrusion.
[0062]
　Furthermore, the junction of toric intraocular lens, if provided in contact around the periphery and a predetermined range of the lens body, while suitably maintaining the mechanical properties, the outer periphery of the junction and the lens body are in contact with each other range it is possible to adjust the position of the weak principal meridian within.
[0063]
　As a modification of the above embodiment, the edge portion of the 45 ° direction in the lens body Given that it is part overlapping the joint portion of the support portion, the edge thickness of the 45 ° direction from the weak principal meridian of the toric intraocular lens It may be configured not to coincide with the edge thickness of the monofocal intraocular lens. Further, a toric as disclosed in WO 2015/136997, the change of the optical axis of the edge of the lens body is changed so as not sinusoidal, the edge thickness of the 45 ° direction from the weak main meridian by so different from the edge thickness of the monofocal intraocular lens which is a base shape of the intraocular lens, or additional optical features may or improve handling properties. Incidentally, the edge of the lens body has a mechanical edge is an end of the shape itself of the lens body, optical corresponding to the outer edge of the effective functioning portion as the optical part and the boundary of the non-optical portion, i.e. the lens Although edge and can be considered, it is assumed optical edge to the lens body of the edges in this embodiment.
[0064]
　Further, as a modification of the above embodiment, in a state where the intraocular lens is compressed into .phi.9 ~ 11 mm in the eye, as there is a weak main radial line on a line connecting the respective tips of the pair of support portions it may be. Since generally intraocular lens is fixed to the retina side of the pupil, in the inserted state into the eye, only a small area than the size of the pupil diameter operator can not be observed. Therefore, it is difficult to operator to grasp the position of the support tip. Meanwhile, in the present embodiment, there is a pair of marks indicating weak main meridian in the smaller area than the pupil diameter, since there is a supporting tip on its extension, the operator clearly the position of the support tip it is possible to grasp.
[0065]
　For example, when there is a case that wrinkles posterior capsule occurs when inserting the intraocular lens, the surgeon can only guess the position of the support tip from the position of the support part base in the conventional lens, the support portion cause investigation for but not able to identify the range present are difficult. However, in the present embodiment, the operator since it is possible to clearly grasp the extent to which the support unit is present, it is possible to investigate the relationship between posture and wrinkles of the intraocular lens. Also, if you've cracked part of the capsular bag to fix the intraocular lens, the surgeon can easily be the tip of the support portion is adjusted so as not located in the direction of the crack. In addition, in the case of one-piece lens, the lens in the eye that axes of the mark connecting the supporting portion tip end of the pair from the support tip is in contact with the lens capsule are coincident when rotated in the eye It sought to be enhanced stability behavior.
[0066]
　Furthermore, when manufacturing such intraocular lenses, intraocular lens of the same size produced previously, by placing the holder such that the inner diameter is in the .phi.9 ~ 11 mm, intraocular lens within the eye in the positional relationship of the supporting portion and the mark in the compressed state is known, it can be prepared based on the information. In the case deformation of the support portion by compression in the eye is not so large, as shown in FIG. 7 (d), in the initial shape of the intraocular lens (uncompressed), a pair of support tip it may be prepared as is weak mainly radial line on a line connecting.
DESCRIPTION OF SYMBOLS
[0067]
1 intraocular lens insertion
2,110,120,130,140,150,160,170,180 toric intraocular lens
2a, 110a, 120a, 130a, 140a, 150a, 160a, 170a, 180a lens body
2b, 110b, 120b, 130b, 140b, 150b, 160b, 170b, 180b support portion
2d, 110d, 120d, 130d, 140d, 150d, 160d, 170d, 180d marking
2e, 110e, 120e, 130e, 140e, 150e, 160e, 170e, 180e junction
10 the nozzle body
100 insertion tube

WE CLAIM

Toric has a lens body having a weak main meridian and Tsuyonushi meridian, a pair of support portions for positioning of the lens body in the eye, and a joint portion for joining said lens body and the support portion intraocular a lens,
　said toric intraocular lens has a substantially cylindrical distal end of the instrument body and the toric intraocular lens wherein the insertion tube having an insertion cylinder portion to the tip inserting the toric intraocular lens in the eye housed intraocular lens insertion instrument having a plunger that moves on,
　each junction, across the optical axis center of the lens body is provided in a position facing each other,
　one end of the weak principal meridian of said lens body but with respect to the position where the tip of the plunger abuts the outer periphery of the lens body, on the opposite side of the axis connecting the respective junction through the optical axis center of the lens body Location, and
　forms an acute angle with the extrusion axis of the toric intraocular lens of the weak principal meridian and the plunger of the lens body is not more than 0 ° greater than 90 °
toric intraocular lens, characterized in that.
[Requested item 2]
　Said acute angle, wherein the tip of said plunger when in contact with the outer periphery of the lens body, line extended to the weak principal meridian is less than there 90 ° in angle or more disjoint with the plunger, it toric intraocular lens according to claim 1,.
[Requested item 3]
　It said acute angle is greater than 10 ° 80 ° smaller than toric intraocular lens according to claim 1, characterized in that.
[Requested item 4]
　Said acute angle is substantially 45 °, toric intraocular lens according to claim 1, characterized in that.
[Requested item 5]
　Wherein the lens body, marking both ends of the weak principal meridian is applied, toric intraocular lens according to claim 1, any one of 4, characterized in that.
[Requested item 6]
　Toric intraocular lens according to claim 5 in which the distal end of the supporting portion on the axis connecting the marking is located.
[Requested item 7]
　The toric intraocular lens according to any one of claims 1 6 acute angle of the axis and the weak principal meridian connecting the joint is 45 ° ± 10 °.
[Requested item 8]
　Toric intraocular lens according to any one of claims 1 7, wherein the intraocular lens insertion device is previously held in the holding section of the toric intraocular lenses, intraocular lens insertion, characterized in that instrument.