Intraocular lens insertion apparatus

Abstract

An intraocular lens insertion instrument (1) for inserting an intraocular lens (4) having an optical portion (41) having an optical function and a support portion (42a, 42b) extending from the optical portion (41) into an eye, the intraocular lens insertion instrument (1) comprising: a protruding portion (20) that, when the intraocular lens (4) folded with an inner surface of the optical portion (41) on an inner side is released to an outside of a hollow body in which the intraocular lens (4) is disposed by advancing the intraocular lens (4) along an inner wall of the hollow body, is bent against a front support portion (42a) disposed in front as one of the support portions (42a, 42b), the protruding portion (20) having a holding portion that temporarily suppresses the progress of the bending of the front support portion (42a) by holding the front support portion (42a) when the intraocular lens (4) is folded.

Description

TECHNICAL FIELD

[0001] The present application relates to an intraocular lens insertion instrument. BACKGROUND

[0002] In cataract surgery, removal of a cloudy crystalline lens by phacoemulsification and implantation into the eye after the removal of the crystalline lens are widely performed. Currently, a soft intraocular lens made of a soft material such as a silicone elastomer is inserted into the eye using an intraocular lens insertion instrument.

[0003] When a soft intraocular lens is inserted into the eye, the intraocular lens can be folded, and the incision opening of the cornea can be reduced.

[0004] As a method of folding an intraocular lens, a method of folding in an intraocular lens insertion instrument is known (for example, the patent document 1 of the applicant). In the method described in the patent document 1, by providing a protrusion portion in a housing and fitting the intraocular lens insertion instrument with the housing, the protrusion portion of the housing protrudes from the protrusion insertion hole provided in the intraocular lens insertion instrument (paragraph 0038, Figures 3-6 and the like).

[0005] In this state, the intraocular lens having a substantially disc-shaped optical portion having an optical function and a pair of support portions extending from the optical portion is advanced toward the discharge hole of the nozzle portion. As the advancement, the tip of the front support portion of the intraocular lens abuts against the protrusion portion, and the intraocular lens can be folded back toward the rear (paragraph 0041, Figure 6 , Figure 7 and the like).

[0006] PRIOR ART DOCUMENTS

[0007] PATENT DOCUMENTS

[0008] Patent document 1: Japanese patent document No. 5254669 specification. SUMMARY

[0009] PROBLEMS TO BE SOLVED BY THE INVENTION

[0010] According to the method described in the patent document 1, the front support portion of the intraocular lens can be folded back toward the rear. On the other hand, it was found by the inventor of the present application that the following phenomenon can occur.

[0011] In the method described in the patent document 1, the optical portion of the intraocular lens is folded at the same time as the front support portion of the intraocular lens is folded back toward the rear by the advancement of the intraocular lens. Ideally, the front support portion is wrapped by the face (hereinafter referred to as the inner surface) on the inner side at the time of folding. Such an ideal folded state is also referred to as tacking.

[0012] On the other hand, as a result of the inventors' investigation, it was found that, when the intraocular lens advances, the front support portion can enter between the outer surface, which is the opposite surface of the inner surface of the optical portion, and the inner wall of the intraocular lens insertion instrument.

[0013] When the front support portion enters between the outer surface of the optical portion and the inner wall of the intraocular lens insertion instrument, the practitioner must restore the deformation and bending of the front support portion after the intraocular lens is released, that is, in the patient's eye. At this time, the practitioner's burden is increased.

[0014] The technical task of the present application is to provide an intraocular lens insertion instrument that improves positioning accuracy.

[0015] Means for solving the problem

[0016] The inventors have conducted intensive research on the above problem. At this time, the inventors focused on the operation when the front support portion abuts against the protruding portion described in Patent Literature 1. As a result, it was found that, if the protruding portion described in Patent Literature 1, when the entire intraocular lens moves forward, the front support portion continues to bend backward, and the timing at which the front end of the front support portion moves to the vicinity of the inner wall of the intraocular lens insertion instrument is very close to the timing at which the periphery of the optical portion in the folded intraocular lens advances, and the front end of the front support portion tends to move rapidly toward the inner wall.

[0017] Therefore, the inventors created the following technical idea in order to intentionally misalign the timing: when the entire intraocular lens advances, the bending of the front support portion is suppressed by temporarily holding the front end of the front support portion bent toward the rear, and the timing at which the front end moves to the vicinity of the inner wall of the intraocular lens insertion instrument is delayed.

[0018] Based on the above insight, the following structure is obtained.

[0019] The first aspect of the present application provides an intraocular lens insertion instrument for inserting an intraocular lens having an optical portion having an optical function and a support portion extending from the optical portion into an eye, the intraocular lens insertion instrument comprising:

[0020] a protruding portion that, when the intraocular lens is released after being folded with the inner surface of the optical portion on the inside by advancing the intraocular lens along the inner wall of a hollow body in which the intraocular lens is disposed, abuts against a front support portion, which is one of the support portions, disposed in the front, to bend the front support portion,

[0021] the protruding portion has a holding portion that temporarily suppresses the bending of the front support portion by holding the front support portion when the intraocular lens is folded.

[0022] The second aspect of the present application is based on the intraocular lens insertion instrument described in the first aspect described above, and includes:

[0023] The hollow body is a main body of an insertion device;

[0024] The lens setting portion is provided inside the hollow body;

[0025] The advancing member advances the intraocular lens disposed in the lens setting portion;

[0026] The protruding portion is disposed in front of the lens setting portion and protrudes from the inner wall of the hollow body; and

[0027] The insertion tube is disposed in front of the front end portion of the hollow body,

[0028] The insertion tube has a hollow insertion tube main body and a tubular nozzle portion,

[0029] The protruding portion has a first abutting portion that bends the front support portion by abutting against the front support portion when the intraocular lens is advanced by the advancing member, and a holding portion disposed in front of the first abutting portion,

[0030] The holding portion has a support portion receiving portion that supports the front support portion after the front support portion is separated from the first abutting portion, and a second abutting portion disposed in front of the support portion receiving portion and abutting against the front support portion while being supported by the support portion receiving portion.

[0031] The third aspect of the present application further includes the following configuration based on the intraocular lens insertion device of the second aspect described above:

[0032] The first abutting portion and the holding portion are chamfered.

[0033] The fourth aspect of the present application provides an intraocular lens insertion device for inserting an intraocular lens having an optical portion and a support portion extending from the optical portion into an eye, the intraocular lens insertion device comprising:

[0034] A hollow body having a lens setting portion to place the intraocular lens with the optical axis direction of the intraocular lens as the up-down direction; and

[0035] A protruding portion protruding from the inner wall of the hollow body and having at least one step toward the upper direction when viewed from the lens setting portion toward the front, and a wall disposed in front of the step.

[0036] The fifth aspect of the present application further includes the following configuration based on the intraocular lens insertion device of the fourth aspect described above:

[0037] The protruding portion protrudes upward from below the inner wall of the hollow body and has two steps at least upward when viewed from the lens arrangement portion toward the front.

[0038] The sixth aspect of the present application further includes the following configuration in the intraocular lens inserter of any one of the above first to fifth aspects.

[0039] A slope is provided on the most rear side in the protruding portion.

[0040] The seventh aspect of the present application further includes the following configuration in the intraocular lens inserter of any one of the above first to sixth aspects.

[0041] Further includes a housing which is fitted to the hollow body,

[0042] The protruding portion is provided to the housing,

[0043] A hole which is fitted to the protruding portion is formed in the hollow body.

[0044] The eighth aspect of the present application further includes the following configuration in the intraocular lens inserter of any one of the above first to seventh aspects.

[0045] Further includes the intraocular lens,

[0046] The optical portion and the base end side of the supporting portion of the intraocular lens are made of a soft material,

[0047] The optical portion of the intraocular lens has an effective optical portion which performs an optical function, and a peripheral portion which is disposed around the effective optical portion and is a flat plate.

[0048] Effects of the Invention

[0049] According to the present application, an intraocular lens insertion tool which improves positioning accuracy can be provided. BRIEF DESCRIPTION OF DRAWINGS

[0050] Figure 1 is a perspective view showing the external configuration of the intraocular lens insertion tool of the embodiment of the present application;

[0051] Figure 2 is a perspective view showing the configuration and arrangement of the front end portion of the main body of the intraocular lens insertion tool of the embodiment of the present application;

[0052] Figure 3 is a perspective view showing the housing of the intraocular lens insertion tool of the embodiment of the present application;

[0053] Figure 4 is a perspective view showing the state in which the intraocular lens insertion tool of the embodiment of the present application is fitted to the housing;

[0054] Figure 5 is a perspective view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the embodiment of the present application;

[0055] Figure 6 is a side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the embodiment of the present application when viewed from the Y1 toward the Y2 direction;

[0056] Figure 7 is a schematic cross-sectional view showing the operation of the front support portion (cross-sectional view) with respect to the protruding portion in the intraocular lens insertion instrument of the embodiment of the present application;

[0057] Figure 8 is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the modification (one) of the present application when viewed from the Y1 toward the Y2 direction;

[0058] Figure 9 is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the modification (two) of the present application when viewed from the Y1 toward the Y2 direction;

[0059] Figure 10 is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the modification (three) of the present application when viewed from the Y1 toward the Y2 direction. DETAILED DESCRIPTION

[0060] Hereinafter, the embodiments of the present application will be described in detail with reference to the drawings. In the present specification, "~" means above and below a predetermined value.

[0061] In the present embodiment, when the relative positional relationship or the direction of the operation of each portion of the intraocular lens insertion instrument is described, one side of the X-axis direction is set as the XI direction, the other side of the X-axis is set as the X2 direction, one side of the Y-axis direction is set as the Yl direction, the other side of the Y-axis is set as the Y2 direction, one side of the Z-axis direction is set as the Zl direction, and the other side of the Z-axis is set as the Z2 direction. Also, the XI direction is defined as the front end side (front, direction in which the lens advances), the X2 direction is defined as the rear end side (rear), the Yl direction is defined as the left side (left), the Y2 direction is defined as the right side (right), the Zl direction is defined as the upper side (up, thickness direction and optical axis direction when the intraocular lens is disposed), and the Z2 direction is defined as the lower side (down). Among them, the XI direction and the X2 direction correspond to the length direction of the intraocular lens insertion instrument 1, the Yl direction and the Y2 direction correspond to the width direction of the intraocular lens insertion instrument, and the Zl direction and the Z2 direction correspond to the height direction of the intraocular lens insertion instrument 1.

[0062] Furthermore, as described above, the main feature of this embodiment is the protrusion 21 described in Patent Document 1 (in the first embodiment of Patent Document 1). Figures 3-6 etc.), protrusion 52 (in the second embodiment of Patent Document 1) Figure 7 etc.), protrusion 80 (in the third embodiment of Patent Document 1) Figure 8 , Figure 10 The shape (Figure 11, etc.) is shown. Therefore, the part other than the protrusion of the front support in the device for inserting a bent intraocular lens will be described in a simplified manner.

[0063] For the portion other than the protrusion of the forward support, which is used for bending, a known structure of an intraocular lens insertion device may also be adopted. For example, the structure in the applicant's WO2018 / 003854 publication may be adopted. For contents not described below, a known structure of an intraocular lens insertion device (e.g., the structure in WO2018 / 003854 publication) shall be adopted, the contents of which are fully described in this specification.

[0064] <Structure of Intraocular Lens Insertion Device>

[0065] Figure 1 This is a perspective view showing the external configuration of an intraocular lens insertion device according to an embodiment of the present invention.

[0066] Figure 2 This is a perspective view showing the structure and configuration of the front end portion of the main body of the intraocular lens insertion device according to an embodiment of the present invention.

[0067] In addition, this application Figure 1 , Figure 2 With WO2018 / 003854 Figure 1 , Figure 6 The structure is similar except for the intraocular lens 4. Therefore, this application Figure 2 For symbols not described in this specification, refer to the description in WO2018 / 003854.

[0068] The intraocular lens insertion device 1 is used when inserting an intraocular lens into the eye. In this embodiment, as an example of an intraocular lens, a monolithic intraocular lens 4 (see reference) is made of a soft material such as silicone elastomer or flexible acrylic. Figure 2), including: an optical portion 41 having a circular effective optical portion 41a that performs an optical function and a peripheral portion 41b thereof, and two support portions 42a, 42b that are bent from two portions of the outer peripheral portion of the optical portion 41 and extend outward, and an intraocular lens insertion instrument 1 for handling an intraocular lens 4. Symbol 42a indicates a front support portion that is disposed in front when the lens setting portion 11 is disposed, and symbol 42b indicates a rear support portion that is disposed in the rear.

[0069] Examples show a case where the base end side of the optical portion 41 of the intraocular lens 4 and the support portions 42a, 42b connected to the optical portion 41 are composed of a soft material. According to this structure, folding of the intraocular lens 4 becomes easy. In addition, the tip side of the support portions 42a, 42b can also be composed of a soft material, or can be composed of a hard material (for example, polyethylene, PMMA (Polymethyl Methacrylat), or the like).

[0070] In addition, the effective optical portion 41a in the optical portion 41 has a shape that performs an optical function, and the peripheral portion 41b is formed in a circular ring shape around the effective optical portion 41a, and the circular ring is a flat plate. Of course, structures other than this can also be adopted. For example, the optical portion 41 can also be composed only of the effective optical portion 41a. In addition, the peripheral portion 41b can also be formed continuously with the effective optical portion 41a, that is, the peripheral portion 41b can also be smoothly connected to the effective optical portion 41a to form a continuous surface.

[0071] The configuration of the intraocular lens insertion instrument 1 includes: an insertion instrument main body 5, a slider 6, an insertion barrel 7, a rotation member 8, a plunger 9, and a rod (hidden in the inside of the intraocular lens insertion instrument 1 due to the configuration of Figure 1 These constituent elements are preferably each composed of a finished product of resin.

[0072] The insertion instrument main body 5 and the insertion barrel 7 each have a hollow structure, and constitute a hollow body by being connected to each other.

[0073] The slider 6 is mounted to the insertion instrument main body 5.

[0074] The insertion barrel 7 is disposed so as to communicate with the front end portion of the insertion instrument main body 5. The insertion barrel 7 can be integrally formed with the front end portion of the insertion instrument main body 5, or can be separately formed and mounted to the front end portion. The insertion barrel 7 has a hollow insertion barrel main body 7a and a tubular nozzle portion 7b. At this time, the lens setting portion 11 of the insertion instrument main body 5 is housed together with the intraocular lens 4 disposed therein in the insertion barrel main body 7a of the insertion barrel 7. An injection hole 7c is formed in the upper surface of the insertion barrel main body 7a. The injection hole 7c is used for injecting a viscoelastic substance (for example, sodium hyaluronate or the like). The viscoelastic substance injected from the injection hole 7c is supplied to the intraocular lens 4 disposed in the lens setting portion 11.

[0075] The rotating member 8 is rotatably coupled to the rear end portion of the insertion instrument main body 5.

[0076] The plunger 9 is coaxially disposed to the insertion instrument main body 5. A part of the plunger 9 is disposed inside the insertion instrument main body 5 through the rotating member 8, and the other part of the plunger 9 is disposed in a state of protruding rearward from the rotating member 8.

[0077] The rod is disposed inside the hollow body including the insertion instrument main body 5 and the insertion barrel 7. The rod is coupled to the plunger 9, and functions to advance the intraocular lens 4.

[0078] As shown in Figure 2 The lens setting portion 11 includes a bottom surface portion 11a, a lens receiving portion 11b, and a lens guide portion 11c. The lens receiving portion 11b receives and supports the intraocular lens 4 from below. The intraocular lens 4 is set to the lens setting portion 11 in a state that a front support portion 42a is disposed in the front (X1 direction) and the other rear support portion 42b is disposed in the rear (X2 direction) as their names suggest. The intraocular lens insertion instrument 1 is of a pre-loaded type in which the intraocular lens 4 is set to the lens setting portion 11 of the insertion instrument main body 5 in advance. Therefore, the intraocular lens 4 is one of the constituent elements of the intraocular lens insertion instrument 1. However, it is not necessarily required to be of the pre-loaded type when the present application is implemented.

[0079] If the structure of the intraocular lens insertion instrument 1 is expressed except for the protrusion portion 20 described later, it is as follows.

[0080] "An intraocular lens insertion instrument 1, comprising: the hollow body, which is an insertion instrument main body 5;

[0081] a lens setting portion 11, which is set inside the hollow body;

[0082] an advancing member (a rod coupled to the slider 6 or the plunger 9), which advances the intraocular lens 4 disposed to the lens setting portion 11;

[0083] the protrusion portion 20, which is disposed in front of the lens setting portion 11 and protrudes from the inner wall of the hollow body; and

[0084] an insertion barrel 7, which is disposed to the front end portion of the hollow body;

[0085] the insertion barrel 7 has a hollow insertion barrel main body 7a and a tubular nozzle portion 7b."

[0086] Structure of the housing

[0087] As the structure of the case, for example, the structure of Patent Document 1 of the applicant can be adopted. As for the structure of the case, the following contents not described in the present specification are adopted in the structure of Patent Document 1, the contents of Patent Document 1 are entirely described in the present specification.

[0088] In addition, in the case where the contents described in the above-mentioned WO2018 / 003854 and the contents described in Patent Document 1 are inconsistent, the contents described in the above-mentioned WO2018 / 003854 are given priority. For example, in Patent Document 1, it is described that the intraocular lens 4 is disposed to the lens disposing portion in a state where the front supporting portion is bent by the protruding portion 80, but in the present embodiment, as described in WO2018 / 003854, the portion where the intraocular lens 4 is placed in the state before being bent is used as the lens disposing portion 11.

[0089] Figure 3 is a perspective view of a case of an intraocular lens insertion instrument according to an embodiment of the present application.

[0090] Figure 4 is a perspective view showing a state where the intraocular lens insertion instrument according to an embodiment of the present application is housed in the case.

[0091] The intraocular lens insertion instrument 1 of the present embodiment is, for example, detachably mounted to the case 62 which is integrally formed of a synthetic resin material. As in Patent Document 1 of the applicant Figure 10 (as in the present application Figure 3 ), a U-shaped wall portion 76 is provided upright on a bottom plate portion 75 of the case 62 in a manner of surrounding the intraocular lens insertion instrument 1, and a protruding portion 20 is provided upright at a prescribed position of the bottom plate portion 75.

[0092] The protruding portion 20 is configured to be inserted into the protruding insertion hole 73 of the intraocular lens insertion instrument 1 by the intraocular lens insertion instrument 1 being mounted to the case 62, as shown in Fig. 11 of Patent Document 1 (as in the present application Figure 4 ). Thereby, in the intraocular lens insertion instrument 1, the protruding portion 20 of the case 62 can be disposed in the central region of the movement space of the front end member 71.

[0093] As shown in Fig. 1 (as in the present application Figure 4 ), in a state where the intraocular lens insertion instrument 1 is mounted to the case 62, the intraocular lens 4 placed on the lens disposing portion 11 is advanced toward the discharge hole of the nozzle portion 7b by the slider 6. In addition, in the case where a structure in which the slider 6 is not provided is adopted, the advancement can also be performed by the plunger 9 (a rod directly linked to the plunger 9). Therefore, the rod linked to the slider 6 or the plunger 9 is also referred to as an advancement member.

[0094] By this advance, the front support portion 42a of the intraocular lens 4 comes into abutment with the protruding portion 20, the front end of the front support portion 42a is folded back toward the rear (X2 direction) in the direction opposite to the advancing direction of the lens (front, X1 direction), and is bent into a substantially U shape.

[0095] In addition, the intraocular lens insertion instrument 1 is detached from the case 62 in this state, the intraocular lens 4 is pushed out by the plunger 9 in the front direction (X1 direction) in the state where the front support portion 42a is bent, and the intraocular lens 4 can be released from the nozzle portion 7b toward the intraocular lens.

[0096] <Detail explanation of protruding portion in this embodiment>

[0097] On the other hand, when the intraocular lens 4 is released, the front end of the front support portion 42a enters between the inner wall of the hollow body and the outer surface of the optical portion 41 as described above, and the following problem occurs. In order to solve this problem, in this embodiment, the intraocular lens insertion instrument 1 is used in which the protruding portion 20 is in the following form.

[0098] <Detail explanation of protruding portion in this embodiment>

[0099] <Detail explanation of protruding portion in this embodiment>

[0100] <Detail explanation of protruding portion in this embodiment>

[0101] The form of the protruding portion 20 in this embodiment is described in detail. In chronological order, starting from the state where the intraocular lens 4 is placed on the lens placement portion 11, the action of the front support portion 42a when the intraocular lens 4 is advanced by the slide 6 is described.

[0102] Figure 5 <Detail explanation of protruding portion in this embodiment>

[0103] Figure 6 <Detail explanation of protruding portion in this embodiment>

[0104] <Detail explanation of protruding portion in this embodiment> Figure 7 <Detail explanation of protruding portion in this embodiment>

[0105] When the intraocular lens 4 starts to advance, the front support portion 42a comes into contact with the upright portion 22a of the step 22 in the protrusion portion 20. As shown, the step 22 is a step toward the upper side, that is, an up-step-shaped step. When the intraocular lens 4 continues to advance, the front support portion 42a is folded back toward the rear side by the contact with the step 22, and the front support portion 42a slides up the step 22 by the advance of the optical portion 41 (a)→(b)→(c). Figure 6 Figure 7 Further, when the intraocular lens 4 continues to advance, the front support portion 42a completely climbs up the top 22b of the step 22. When the front support portion 42a completely climbs up the top 22b of the step 22, the front support portion 42a starts to advance again toward the wall portion 23a of the step 22 in front while moving along the top of the step 22 (c)→(d). When the series of actions of moving along the top 22b of the step 22 and advancing again is performed, the folding of the front support portion 42a is temporarily suppressed compared with the time of the slide-up of the step 22.

[0106] Further, when the intraocular lens 4 continues to advance, the front support portion 42a completely climbs up the top 22b of the step 22. When the front support portion 42a completely climbs up the top 22b of the step 22, the front support portion 42a starts to advance again toward the wall portion 23a of the step 22 in front while moving along the top of the step 22 (c)→(d). When the series of actions of moving along the top 22b of the step 22 and advancing again is performed, the folding of the front support portion 42a is temporarily suppressed compared with the time of the slide-up of the step 22. Figure 7 Further, when the intraocular lens 4 continues to advance, the front support portion 42a completely climbs up the top 22b of the step 22. When the front support portion 42a completely climbs up the top 22b of the step 22, the front support portion 42a starts to advance again toward the wall portion 23a of the step 22 in front while moving along the top of the step 22 (c)→(d). When the series of actions of moving along the top 22b of the step 22 and advancing again is performed, the folding of the front support portion 42a is temporarily suppressed compared with the time of the slide-up of the step 22.

[0107] Figure 7 Further, when the intraocular lens 4 continues to advance, the front support portion 42a completely climbs up the top 22b of the step 22. When the front support portion 42a completely climbs up the top 22b of the step 22, the front support portion 42a starts to advance again toward the wall portion 23a of the step 22 in front while moving along the top of the step 22 (c)→(d). When the series of actions of moving along the top 22b of the step 22 and advancing again is performed, the folding of the front support portion 42a is temporarily suppressed compared with the time of the slide-up of the step 22.

[0108] Thus, the timing of the movement of the front end of the front support portion 42a to the vicinity of the inner wall of the hollow body can be delayed with respect to the timing of the advance of the folded peripheral portion 41b of the optical portion 41 of the intraocular lens 4. As a result, the accuracy of the positioning can be improved.

[0109] Further, the protrusion portion 21 of the patent document 1, which is a protrusion portion that folds the front support portion, is a simple pin-shaped protrusion. Even if the pin-shaped protrusion is regarded as a step, there is no wall 23a in front of the protrusion portion 20 of the present embodiment. Further, the other protrusion portions 52, 80 of the patent document 1, although curved in a concave shape when viewed from the lens setting portion toward the front, have only one step when viewed from the lens setting portion toward the front, and there is no wall 23a in front of the protrusion portion 20 of the present embodiment.

[0110] As a specific form of the protrusion portion 20, there is no particular limitation as long as the above-described structure (protrusion from the inner wall of the hollow body, step, wall) is satisfied. For example, the protrusion portion 20 can protrude from the lower side of the inner wall of the hollow body toward the upper side, and have at least two steps toward the upper side when viewed from the above-described lens setting portion 11 toward the front. ​​

[0111] As Figure 5 , Figure 6 shown, the number of steps toward the upper side when the protruding portion 20 protrudes from the lower side toward the upper side is not particularly limited as long as it is two or more, and preferably, if it is 2 to 4, the above timing can be effectively staggered and the manufacture of the intraocular lens insertion instrument 1 becomes easy. Of course, even if more steps are provided (in other words, even if the distance in the vertical direction of the upright portion 22a of one step 22 is small), compared with the protruding portion described in Patent Document 1, the timing of advancing the folded peripheral portion 41b of the optical portion 41 of the intraocular lens 4 and the timing of moving the front end of the front support portion 42a to the vicinity of the inner wall of the hollow body are not changed.

[0112] As for the details of the steps 22 toward the upper side, for example, preferably, the upright portion 22a of the last step in the steps is arranged obliquely at 45° to 95° with respect to the advancing direction of the intraocular lens 4, with the upper side being taken as positive and the lower side being taken as negative, the inclination of the top 22b in the step 22 is set in the range of -30° to 30° with respect to the advancing direction of the intraocular lens 4, the above timing is effectively staggered, and the accuracy of positioning is easily further improved. Also, similarly preferably, the wall 23a (upright portion in the second layer of steps 23) arranged in front of the step 22 is arranged obliquely at 60° to 100° with respect to the advancing direction of the intraocular lens 4. In addition, as for the inclination of the top 23b in the second layer of steps 23, there is no particular limitation, and it can be the same as the top 22b in the first layer of steps 22, set in the range of -30° to 30° with respect to the advancing direction of the intraocular lens 4. Hereinafter, unless otherwise specified, the steps refer to the first layer of steps 22.

[0113] The distance in the vertical direction of the upright portion 22a of the last step in the steps 22 can be, for example, 0.3 to 1.5 mm, the distance in the front-rear direction of the top 22b of the step 22 can be 0.2 to 1.5 mm, and the distance in the vertical direction of the wall 23a can also be, for example, 0.3 to 1.5 mm. When there are a plurality of steps, the distance in the vertical direction of the upright portion of each step can all be 0.3 to 1.5 mm. According to these conditions, the above timing can be effectively staggered and the improvement in the accuracy of positioning becomes easy.

[0114] In addition, in view of the use of the intraocular lens insertion instrument 1, it is preferable that the distance in the vertical direction of the entire protruding portion 20 be 1.5 to 3.0 mm.

[0115] As Figures 5-7As shown, an uplink slope (inclination) 21 can also be provided behind the step 22. By providing the slope 21, when the intraocular lens 4 starts to advance, the front support portion 42a can be guided to the upright portion 22a of the step 22 against which the front support portion 42a should abut. Note that the angle of the slope 21 is not particularly limited, but is ultimately a slope 21, and thus, preferably, exceeds 0° and is below 45° with respect to the advancing direction of the intraocular lens.

[0116] Note that the slope 21 is preferably a continuous surface with respect to the lower portion of the inner wall of the hollow body, but can also be a plurality of steps (e.g., 0.1 mm or less in the up-down direction). If the distance is 0.1 mm or more, it can also be considered to be a step 22. In the present specification, the expression of at least two steps is used in consideration of such a case.

[0117] Figure 8 is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument of the modification example (one) of the present application as viewed from Y1 toward Y2.

[0118] In addition, in the present embodiment, a case in which the step 22 is integrally formed with the wall 23a is exemplified, but as shown, the step 22 and the wall 23a can also be formed separately from each other. Figure 8 However, if the separation width is too large, there is a possibility that the front support portion 42a is inserted and affects the positioning. Thus, even if separated, it is preferable that the separation width is smaller than the minimum width of the cross section of the front support portion 42a.

[0119] Although the protruding portion 20 is in a state of protruding from the inner wall of the hollow body, in the present embodiment, a case such as described in Patent Document 1 is exemplified, in which the protruding portion 20 is provided to the housing 62 and the protruding insertion hole 73 is provided to the intraocular lens insertion instrument 1.

[0120] That is, in the present embodiment, an “intraocular lens insertion instrument 1, further comprising a housing 62 that is fitted to the hollow body, the protruding portion 20 is provided to the housing 62,

[0121] a hole 73 that can be fitted to the protruding portion 20 is formed in the hollow body.”

[0122] On the other hand, with respect to the inner wall of the hollow body of the intraocular lens insertion instrument 1, of course, the protruding portion 20 or a portion of the protruding portion 20 can also be provided.

[0123] In addition, in the present embodiment, a case in which the protruding portion 20 protrudes from the lower portion toward the upper portion is exemplified. Although the above case is preferable, the present application is not limited to the above case.

[0124] Figure 9is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument according to the modification (Example 2) of the present application when viewed from Yl toward Y2 direction.

[0125] For example, as shown in Figure 9 , when the protruding portion 20 protrudes from above the inner wall of the hollow body toward the lower side, the step 22 toward the above and the wall 23a can be arranged so as to overhang from above the inner wall of the hollow body, when viewed from the lens setting portion 11 toward the front. Similarly, the protruding portion 20 can be made to protrude from the side of the inner wall of the hollow body.

[0126] It has been found by the present inventor that the accuracy of positioning can be further improved by chamfering the portion of the step 22 between the rearmost upright portion 22a and the top portion 22b, that is, the corner of the step. The manner of chamfering is not particularly limited, and can be planarized by cutting the corner as in Figure 5 , Figure 6 or can be rounded.

[0127] Further, the chamfering in the above paragraph can be performed on all the corner portions involved by the steps 22 and 23.

[0128] Figure 10 is a schematic side view showing the state of the vicinity of the protruding portion in the intraocular lens insertion instrument according to the modification (third modification) of the present application when viewed from Yl toward Y2 direction.

[0129] Figure 10 In the case where the tangent of the curved surface in the portion of the upright portion 22a and the portion of the wall 23a is inclined at 60° to 100° with respect to the advancing direction of the intraocular lens 4, for example, the bending and sliding upward of the front support portion 42a is effectively generated. Further, in the case where the inclination of the tangent of the portion of the step 22 corresponding to the top portion 22b is -30° to 30° with respect to the advancing direction of the intraocular lens 4, for example, the front support portion 42a rides over the portion 22b, and the bending is temporarily suppressed.

[0130] Further, it has been found by the present inventor that the possibility of the front support portion 42a entering between the outer surface of the optical portion 41 and the inner wall of the intraocular lens insertion instrument 1 varies depending on the surgical conditions (particularly, the flexibility of the peripheral portion 41b of the intraocular lens 4). The structure reflecting this insight is as follows:

[0131] "An intraocular lens insertion instrument, wherein the intraocular lens 4,

[0132] the base end side of the optical portion 41 and the support portions 42a, 42b of the intraocular lens 4 are composed of a soft material,

[0133] The optical portion 41 of the intraocular lens 4 has an effective optical portion 41a that performs an optical function, and a peripheral portion 41b that is disposed around the effective optical portion 41a and is flat.

[0134] The shape of the protruding portion 20 of the present embodiment is specifically determined as above. On the other hand, the technical idea of the present application is that the timing of moving the front end of the front support portion 42a to the vicinity of the inner wall of the intraocular lens insertion instrument 1 is delayed with respect to the timing of advancing the folded peripheral portion 41b of the optical portion 41 of the intraocular lens 4. If the present application is expressed as a technical idea, it becomes the following structure.

[0135] "An intraocular lens insertion instrument 1 for inserting an intraocular lens 4 having an optical portion 41 that has an optical function and a support portion 42a, 42b that extends from the optical portion 41 into an eye, comprising:

[0136] A protruding portion 20 that, when the intraocular lens 4 folded by making the inner surface of the optical portion 41 an inner side by advancing the intraocular lens 4 along the inner wall of a hollow body in which the intraocular lens 4 is disposed is released to the outside of the hollow body, bends a front support portion 42a that is one of the support portions 42a, 42b and is disposed in front, by abutting against the front support portion 42a,

[0137] The protruding portion 20 has a holding portion that temporarily suppresses the progress of bending of the front support portion 42a by holding the front support portion 42a when the intraocular lens 4 is folded."

[0138] In addition, the preferred examples of the shape of the protruding portion 20 of the present embodiment described thus far can also be applied to the above structure.

[0139] The protruding portion 20 in the above paragraph corresponds to the step 22 and the wall 23a described thus far. Also, the holding portion that the protruding portion 20 has corresponds to the top 22b of the step 22 and the wall 23a described thus far. That is, the front support portion 42a is temporarily held by being temporarily accommodated between the top 22b and the wall 23a of the step 22. However, this holding is ultimately temporary, and when the intraocular lens 4 further advances, the same phenomenon as the first layer of the step 22 occurs, that is, the front support portion 42a slides up with respect to the wall 23a, and the degree of bending of the front support portion 42a increases again. In addition, in the above expression of the present application, the protruding portion 20 is not limited to the step 22, 23. Similarly, the holding portion is not limited to the top 22b of the step 22 and the wall 23a located in front thereof.

[0140] More preferably, the present application is expressed as a technical idea, and it becomes the following structure.

[0141] The protruding portion 20 has a first abutting portion that bends the front support portion 42a by abutting against the front support portion 42a when the intraocular lens 4 advances by the advancing member, and a holding portion disposed in front of the first abutting portion,

[0142] The holding portion has a support portion receiving portion that supports the front support portion 42a after the front support portion 42a departs from the first abutting portion, and a second abutting portion disposed in front of the support portion receiving portion and abutting against the front support portion 42a while being supported by the support portion receiving portion.

[0143] The respective relationships of the first abutting portion, the support portion receiving portion, and the second abutting portion are arranged as follows.

[0144] As the first abutting portion, the upright portion 22a of the step 22 in Figures 5-10 corresponds.

[0145] As the support portion receiving portion, the top portion 22b of the step 22 in Figures 5-10 corresponds.

[0146] As the second abutting portion, the wall 23a disposed in front of the step 22 in Figures 5-10 corresponds.

[0147] In addition, the intention of using the expression "the holding portion temporarily suppresses the progress of bending" is as follows.

[0148] The protruding portion described in Patent Document 1 is only one step when viewed in the advancing direction of the intraocular lens. In the case where the front support portion 42a abuts against the upright portion of the step, the bending progresses continuously. Furthermore, the present inventors found that, assuming that the front support portion 42a completely rides up the step, the progress of bending is suppressed at the instant of complete riding up, but at this time, there is a possibility that the front end of the front support portion 42a has already reached the inner wall of the hollow body before the peripheral portion 41b of the optical portion 40 of the intraocular lens 4. At this time, the front support portion 42a enters between the opposite surface, i.e., the outer surface, of the inner surface of the optical portion 40 and the inner wall of the intraocular lens insertion instrument.

[0149] On the other hand, in the present embodiment, since the second abutting portion exists in front of the step, the front support portion 42a advances while being supported by the support portion receiving portion and abuts against the second abutting portion, and the degree of bending of the front support portion 42a is increased again. In this way, in order to express the process of the increase, decrease, and increase of the degree of bending of the front support portion 42a, the expression "the holding portion temporarily suppresses the progress of bending" is used in the above-described structure. This means that at least two discontinuous changes occur as the degree of bending decreases.

[0150] With the above, whether in the specific manner or the structure that embodies the technical idea of the present application, the timing at which the leading end of the front support portion 42a is moved to the vicinity of the inner wall of the hollow body is delayed relative to the timing at which the peripheral portion 41b of the folded intraocular lens advances. As a result, the accuracy of the positioning can be improved.

[0151] Symbol explanation

[0152] 1: Intraocular lens insertion device

[0153] 5: Insertion device main body

[0154] 6: Slider

[0155] 7: Insertion barrel

[0156] 7a: Insertion barrel main body

[0157] 7b: Nozzle portion

[0158] 7c: Injection hole

[0159] 8: Rotating member

[0160] 9: Plunger

[0161] 11: Lens setting portion

[0162] 11a: Bottom surface portion

[0163] 11b: Lens receiving portion

[0164] 11c: Lens guide portion

[0165] 73: Protrusion insertion hole

[0166] 62: Housing

[0167] 20: Protrusion portion

[0168] 21: Slope

[0169] 22: (First layer) step

[0170] 22a: Upright portion of (first layer) step

[0171] 22b: Top portion of (first layer) step

[0172] 23: (Second layer) step

[0173] 23a: (Second layer) wall

[0174] 23b: Top portion of (second layer) step

[0175] 75: bottom plate portion;

[0176] 76: U-shaped wall portion;

[0177] 4: intraocular lens;

[0178] 41: optical portion;

[0179] 41a: effective optical portion;

[0180] 41b: peripheral portion;

[0181] 42a: front support portion;

[0182] 42b: rear support portion.

Claims

1. An intraocular lens insertion instrument for inserting an intraocular lens into an eye, the intraocular lens including an optical portion having an optical function and a support portion extending from the optical portion, the intraocular lens insertion instrument comprising: a hollow body including an inner wall and a lens setting portion, and defining a lens advancing direction; a protruding portion that, when the intraocular lens folded with an inner surface of the optical portion inside after being advanced along the inner wall of the hollow body on which the intraocular lens is set, is bent by abutting against the support portion, which is one of the support portions, disposed in front of the intraocular lens in the lens advancing direction, wherein the protruding portion includes an inclined surface extending upward and along the lens advancing direction, defining a first slope, and located at a rearmost side of the protruding portion, a step including an upright portion, a flat top portion, and a chamfered portion between the upright portion and the flat top portion, the upright portion extending upward and along the lens advancing direction, and defining a second slope greater than the first slope, and an upwardly extending wall located in front of the flat top portion of the step.

2. The intraocular lens insertion instrument according to claim 1, wherein the hollow body includes a main body of the insertion instrument; an advancing member for advancing the intraocular lens is disposed at the lens setting portion; the protruding portion protrudes from the inner wall of the hollow body; and an insertion barrel having a hollow insertion barrel main body and a tubular nozzle portion is disposed at a front end portion of the hollow body.

3. The intraocular lens insertion instrument according to claim 1 or 2, further comprising: a housing that cooperates with the hollow body, wherein the protruding portion is provided at the housing, and a hole is formed in the hollow body so that the protruding portion and the hole can cooperate with each other.

4. The intraocular lens insertion instrument according to claim 1 or 2, further comprising the intraocular lens, wherein the optical portion and a base end of the support portion of the intraocular lens are composed of a soft material, and wherein the optical portion of the intraocular lens has an effective optical portion that performs an optical function, and a peripheral portion that is disposed around the effective optical portion and is a flat plate.

5. An intraocular lens insertion instrument for inserting an intraocular lens into an eye, the intraocular lens having an optical portion and a support portion extending from the optical portion, the intraocular lens insertion instrument comprising: a hollow body having an inner wall, a lens setting portion in the hollow body, a lens advancing direction, and a protruding hole extending through the inner wall and located in front of the lens setting portion, the lens setting portion placing the intraocular lens with an optical axis direction of the intraocular lens as an up-down direction, and a housing that cooperates with the hollow body. a housing configured to partially surround the hollow body and fastened to the hollow body, the housing including a protrusion portion including an inclined surface extending upward and in the lens advancing direction, defining a first slope and located at a rearmost side of the protrusion portion, a step including an upright portion, a flat top portion, and a chamfered portion between the upright portion and the flat top portion, the upright portion extending upward and in the lens advancing direction and defining a second slope greater than the first slope, and an upwardly extending wall disposed forward of the flat top portion of the step; wherein the hollow body and the housing are respectively configured such that the protrusion portion extends through the protrusion hole when the housing is fastened to the hollow body and the intraocular lens insertion instrument is in the housing.

6. The intraocular lens insertion instrument according to claim 5, wherein the protrusion portion projects upward from below an inner wall of the hollow body and has two steps at least upward when viewed from the lens disposing portion toward the front.

7. The intraocular lens insertion instrument according to claim 5 or 6, further comprising the intraocular lens, wherein, the optical portion and the base end of the support portion of the intraocular lens are composed of a soft material, and wherein the optical portion of the intraocular lens has an effective optical portion performing an optical function and a peripheral portion disposed around the effective optical portion and being a flat plate shape.

Images