Intraocular lens insertion tool

Abstract

The purpose of the present disclosure is to provide an intraocular lens insertion tool making it possible to reduce the load applied to an intraocular lens when the intraocular lens is being pushed out. The intraocular lens insertion tool comprises: an implement body including a stowage part for stowing an intraocular lens in a space formed by a top section and a bottom section, and a nozzle part that is arranged further to a distal end side than the stowage part and communicates with the stowage part and has on the distal end size an insertion barrel that is inserted into an incision wound; and an extrusion member for causing the intraocular lens stowed in the stowage part to move to the distal end side. The extrusion member comprises a support section abutment surface (31f) that is oriented toward the distal end side and abuts against part of a support section, and an upper cutout having a bottom surface (310g) facing upward and formed on a proximal end side from the support section abutment surface. The upper cutout is formed at a location at which the bottom surface creates a gap between the nozzle part and bottom surface, the gap being greater than the thickness of a junction of the intraocular lens.

Description

Intraocular lens insertion device

[0001] The present invention relates to an intraocular lens insertion instrument for inserting an intraocular lens into the eye.

[0002] Intraocular lenses are used in cataract treatment to replace the opacified human crystalline lens and correct refraction. In intraocular lens insertion surgery, an incision of several millimeters is made at the edge of the cornea or corneosclera, for example, and the crystalline lens is crushed and removed through the incision using phacoemulsification or other techniques. The intraocular lens is then inserted through the incision using an intraocular lens insertion device.

[0003] The intraocular lens is inserted into the eye through an incision using an intraocular insertion device. Patent Document 1 describes an intraocular lens insertion device.

[0004] Japanese Patent Application Laid-Open No. 2020-137894

[0005] If a load is applied to the intraocular lens when the intraocular lens insertion tool pushes out the intraocular lens, the intraocular lens may be scratched or its behavior may become unstable.

[0006] The technology disclosed herein aims to provide an intraocular lens insertion device that can properly fold an intraocular lens and stabilize the behavior of the intraocular lens.

[0007] The intraocular lens insertion device disclosed herein is an intraocular lens insertion device that inserts an intraocular lens through an incision made in the eye, and comprises: an instrument body including: a storage section that stores the intraocular lens in a space formed by a top surface and a bottom surface; a nozzle section that is disposed distally of the storage section and communicates with the storage section, and has an insertion tube section at the distal end that is inserted into the incision; and a pusher member that moves the intraocular lens stored in the storage section toward the distal end, wherein the intraocular lens has an optical section, a support section that is disposed proximal to the optical section when the intraocular lens is stored in the storage section, and a joint section that joins the optical section and the support section, and the pusher member has a support section abutting surface that faces the distal end and abuts against a part of the support section, and an upper notch that has a bottom surface that faces upward and is formed proximal to the support section abutting surface, and the upper notch is formed at a position where a gap larger than the thickness of the joint section of the intraocular lens is provided between the bottom surface and the nozzle section. This allows the intraocular lens insertion device to reduce the load on the intraocular lens by preventing the support portion of the intraocular lens from being pinched between the pusher member and the device body.

[0008] In the intraocular lens insertion device, the upper notch may be formed at a position where a gap larger than the thickness of the joint portion of the intraocular lens is provided between the bottom surface and the insertion tube portion.

[0009] In the intraocular lens insertion device, the pusher member may have an optical unit abutment surface facing the tip side and abutting against the rear end of the optical unit when moving the intraocular lens, and the optical unit abutment surface may be formed with an uneven surface in which the unevenness changes at intervals smaller than the edge thickness of the optical unit.

[0010] In the intraocular lens insertion device, the uneven surface of the pusher member may have grooves and protrusions extending with a width smaller than the edge thickness of the optical portion, and the grooves and protrusions may extend in the front-rear direction connecting the tip side and the base end side and in a direction perpendicular to the optical axis of the optical portion.

[0011] In the intraocular lens insertion device, the pusher member may have an optical unit abutment surface facing the tip side and abutting the rear end of the optical unit when moving the intraocular lens, and an upper protrusion formed between the optical unit abutment surface and the support unit abutment surface and protruding toward the tip side beyond the optical unit abutment surface and the support unit abutment surface.

[0012] In the intraocular lens insertion device, the upper protrusion of the pusher member may press the optical part toward the inner surface of the insertion tube part by means of a tip end portion arranged closest to the tip end.

[0013] In the intraocular lens insertion device, the upper protrusion may have an upper surface on which the support portion can be placed, and the upper surface may be inclined upward from the base end side toward the tip end side.

[0014] In the intraocular lens insertion device, the upper protrusion may be formed at a position where a gap is provided between the upper surface and the insertion tube portion that is larger than the thickness of the joint portion of the intraocular lens.

[0015] In the intraocular lens insertion device, the pusher member may have a lateral notch formed by cutting out a side surface from which the support portion of the intraocular lens extends, and the lateral notch may be formed at a position that forms a space between the pusher member and the nozzle portion that can accommodate the support portion of the intraocular lens.

[0016] According to the technique disclosed herein, it is possible to reduce the load on the intraocular lens when the intraocular lens is pushed out.

[0017] FIG. 1 is a perspective view of an intraocular lens insertion device according to an embodiment. FIG. 2( a) is a plan view of a nozzle body of the intraocular lens insertion device according to an embodiment, as viewed from above, and FIG. 2( b) is a left side view of the nozzle body of the intraocular lens insertion device according to an embodiment, as viewed from the left side. FIG. 3( a) is a plan view of a plunger of the intraocular lens insertion device according to an embodiment, as viewed from above, and FIG. 3( b) is a left side view of the plunger of the intraocular lens insertion device according to an embodiment, as viewed from the left side. FIG. 4( a) is a plan view of an intraocular lens as viewed from the optical axis side, and FIG. 4( b) is a side view of the intraocular lens as viewed from the lateral side. FIG. 5 is a plan view of a holding member of the intraocular lens insertion device according to an embodiment, as viewed from above. FIG. 6( a) is a perspective view of the holding member of the intraocular lens insertion device according to an embodiment, as viewed obliquely from above, and FIG. 6( b) is a cross-sectional view of the holding member when cut along line AA in FIG. 6( a). FIG. 7 is an enlarged perspective view of a stage portion of the intraocular lens insertion device according to an embodiment. FIG. 8 is a top view of a nozzle body showing a state in which an intraocular lens is placed on a stage section of an intraocular lens insertion device according to an embodiment. FIG. 9 is a view showing the inside of a stage section of an intraocular lens insertion device according to an embodiment in which an intraocular lens is stored. FIG. 10 is a plan view of the stage section from above in a state in which a holding member has been removed from the intraocular lens insertion device according to an embodiment. FIG. 11(a) is a perspective view of the tip side of a plunger of an intraocular lens insertion device according to an embodiment, seen from the upper left. FIG. 11(b) is a perspective view of the tip side of a plunger of an intraocular lens insertion device according to an embodiment, seen from the upper right. FIG. 12(a) is a left side view of the tip side of a plunger of an intraocular lens insertion device according to an embodiment, seen from the left. FIG. 12(b) is a top view of the tip side of a plunger of an intraocular lens insertion device according to an embodiment, seen from above. FIG. 13(a) is an enlarged perspective view of the tip side of an intraocular lens insertion device according to an embodiment. FIG. 13(b) is a front view of the tip portion of an intraocular lens insertion device according to an embodiment, seen from the opening side. 14 and 15 are bottom and top views, respectively, of an orthographic projection of a plunger of an intraocular lens insertion device according to an embodiment.FIG. 16 is an orthographic front view of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 17 is an orthographic back view of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 18 is an orthographic left side view of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 19 is an orthographic right side view of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 20 is an enlarged view of a portion A-A' of FIG. 16. FIG. 21 is an enlarged view of a portion B-B' of FIG. 17. FIG. 22 is an enlarged view of a portion C-C' of FIG. 18. FIG. 23 is an enlarged view of a portion D-D' of FIG. 19. FIG. 24 is a perspective view 1 of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 25 is a perspective view 2 of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 26 is a perspective view 3 of a plunger of an intraocular lens insertion device according to an embodiment. FIG. 27 is a perspective view 4 of a plunger of an intraocular lens insertion device according to an embodiment. Fig. 28 is an enlarged perspective view 1 of a plunger of an intraocular lens insertion device according to an embodiment. Fig. 29 is an enlarged perspective view 2 of a plunger of an intraocular lens insertion device according to an embodiment. Fig. 30 is an enlarged perspective view 3 of a plunger of an intraocular lens insertion device according to an embodiment. Fig. 31 is an enlarged perspective view 4 of a plunger of an intraocular lens insertion device according to an embodiment.

[0018] Hereinafter, an intraocular lens insertion device according to an embodiment of the present disclosure will be described with reference to the drawings. Note that the configurations of the following embodiments are examples, and the present invention is not limited to the configurations of these embodiments.

[0019] 1 is a perspective view of an intraocular lens insertion device 1 according to this embodiment, viewed obliquely from above. The intraocular lens insertion device 1 includes a nozzle body 10 (an example of an "instrument body") and a plunger 30 (an example of an "extrusion member") inserted into the nozzle body 10. The nozzle body 10 has a cylindrical shape with a substantially rectangular cross section, and includes a rear end portion 10d at one end that is open on the entire surface, and a tip portion 10a (an example of an "insertion tube portion") at the other end that is tapered to a narrow nozzle portion 15 and has an opening 10b at its tip.

[0020] In the following description, the direction from the rear end 10d of the nozzle body 10 to the tip end 10a is referred to as the "front," the opposite direction as the "rear," the top of the paper in Figure 1 is referred to as the "up" and the opposite direction as the "down," the left side as you face forward is referred to as the "left," and the opposite direction as the "right." The upper side corresponds to the front side of the optical axis of the lens body 2a (described later), the lower side corresponds to the rear side of the optical axis of the lens body 2a, and the front side corresponds to the extrusion direction of the plunger 30.

[0021] The tip portion 10a provided at the front end of the nozzle body 10 is internally connected to the nozzle portion 15 and has a cylindrical shape with a smaller diameter than the nozzle portion 15. A plate-like holding portion 11 protrudes upward and downward near the rear end 10d of the nozzle body 10 and is integrally provided with the nozzle body 10. The holding portion 11 is a plate-like holding portion that protrudes upward and downward and allows the surgeon to place his or her fingers when pushing the plunger 30 toward the tip of the nozzle body 10. The nozzle body 10 also has a stage portion 12 provided behind the nozzle portion 15 and that stores the intraocular lens 2. The nozzle portion 15 and the tip portion 10a are located distal to the stage portion 12 and are connected to the stage portion 12. The stage portion 12 is connected to a stage cover 13, the upper side of which can be opened and closed, via a connecting portion 14 (see FIG. 2 ). The stage portion 12 and the stage cover 13 in the closed state form a storage portion that serves as a space for storing the intraocular lens 2. The bottom side of the storage section serves as a stage section 12, and the top side of the storage section serves as a stage lid section 13. Furthermore, the space for storing the intraocular lens 2 can be opened by opening the stage lid section 13. Furthermore, a holding member 50 is attached to the stage section 12 from the underside of the nozzle body 10. This holding member 50 stably holds the intraocular lens 2 within the stage section 12 even before use (during transportation).

[0022] Furthermore, a confirmation window 17 is formed in a portion of the stage lid 13, which is thinner than the surrounding area and allows the inside of the stage lid 13 to be viewed. The degree to which the confirmation window 17 should be thinner than the surrounding area can be determined appropriately based on the material from which the stage lid 13 is made and the visibility of the intraocular lens 2 through the confirmation window 17. Furthermore, by forming the confirmation window 17, it is expected that there will be an effect of reducing molding defects when the stage lid 13 is molded.

[0023] The intraocular lens insertion device 1 according to this embodiment is a preset type in which the intraocular lens 2 is stored in advance in the stage portion 12 at the time of shipment. In the preset type intraocular lens insertion device 1, during manufacturing, the stage lid portion 13 is opened, the holding member 50 is attached to the stage portion 12, and the intraocular lens 2 is placed on the stage portion 12 with the front side of the optical axis facing up. Then, the intraocular lens insertion device 1 is shipped after the stage lid portion 13 is closed.

[0024] The stage lid 13 is also provided with an injection hole 18 for injecting a viscoelastic substance onto the stage 12 before moving the intraocular lens 2 forward. The viscoelastic substance functions as a lubricant that reduces friction that occurs when the intraocular lens 2 moves. The injection hole 18 is a hole that connects the inside and outside of the storage section when the stage lid 13 is closed. The surgeon can use a syringe to inject the viscoelastic substance onto the stage 12 through the injection hole 18.

[0025] The stage lid 13 is also provided with a guide wall 19 for guiding an injection needle for injecting a viscoelastic substance into the injection hole 18. The guide wall 19 is provided on the stage lid 13 so as to surround the injection hole 18 from the left side of the open end, passing through the front side of the open end, and continuously surrounding the right side of the open end. The surgeon abuts the injection needle of the syringe for injecting the viscoelastic substance against the guide wall 19 and then moves the tip of the injection needle into the injection hole 18. In this way, the guide wall 19 can guide the injection needle for injecting the viscoelastic substance into the injection hole 18. The surgeon then wets the intraocular lens 2 with the viscoelastic substance while keeping the stage lid 13 closed, and then removes the holding member 50. Next, the surgeon pushes the plunger 30 toward the tip end of the nozzle body 10. The tip end 10a is connected to the stage 12 via the nozzle 15, and the intraocular lens 2 pressed by the plunger 30 can pass through the nozzle 15 and move within the tip end 10a. With the tip 10a of the intraocular lens insertion device 1 inserted into an incision made in the eye, the plunger 30 presses the intraocular lens 2, releasing the intraocular lens 2 into the eye through the opening 10b. This allows the intraocular lens insertion device 1 to insert the intraocular lens 2 into the eye through the incision.

[0026] The plunger 30 is inserted into the nozzle body 10 from the rear end 10d and is movable back and forth. By moving the plunger 30 forward, the intraocular lens insertion device 1 ejects the intraocular lens 2 from the nozzle portion 15 and the tip portion 10a through the opening 10b into the eye.

[0027] The nozzle body 10, plunger 30, and holding member 50 of the intraocular lens insertion device 1 are made of resin such as polypropylene. Polypropylene has a proven track record as a material for medical devices and is a highly reliable material with excellent chemical resistance.

[0028] 2(a) and (b) are views showing the nozzle body 10 extracted from the intraocular lens insertion device 1. Fig. 2(a) is a plan view of the nozzle body 10 seen from above, and Fig. 2(b) is a left side view of the nozzle body 10 seen from the left side. Fig. 2(a) shows a state in which the stage lid part 13 is open, and Fig. 2(b) shows a state in which the stage lid part 13 is closed.

[0029] The nozzle body 10 is provided with a front through-hole 10c and a rear through-hole 10g, whose cross-sectional shapes change in response to changes in the external shape of the nozzle body 10. The through-hole 10c is located in front of the stage portion 12, and the through-hole 10g is located behind the stage portion 12. The through-hole 10c is a hole that serves as a path along which the intraocular lens 2 moves when pressed by the plunger 30, and the through-hole 10g is a hole through which the plunger 30 is inserted. The intraocular lens 2 is folded while passing through the through-hole 10c and is released into the patient's eyeball through the opening 10b in the distal end portion 10a. The intraocular lens 2 is folded in a valley fold when viewed from above. The opening edge of the opening 10b is formed obliquely with respect to the extension direction of the distal end portion 10a. Specifically, as shown in FIG. 2(b), the opening edge of the opening 10b is formed so that it slopes upward from the rear side to the front side.

[0030] The stage portion 12 is formed with a stage groove 12a having a width slightly larger than the diameter of the lens body of the intraocular lens 2 (lens body 2a shown in FIGS. 4(a) and 4(b)). The dimension of the stage groove 12a in the front-to-rear direction is set larger than the maximum width dimension including the support portions 2b, 2c (see FIGS. 4(a) and 4(c)) extending on both the front and rear sides of the intraocular lens 2. The stage portion 12 stores the intraocular lens 2 in a space formed by a bottom surface 12b of the stage groove 12a and a top surface 13a located inside the storage portion when the stage lid portion 13 is closed. When the stage lid portion 13 is in the closed state, the bottom surface 12b and the top surface 13a form a space for storing the intraocular lens 2. As shown in Figure 2(b), the vertical position of the bottom surface portion 12b is set higher than the height position of the bottom surface of the through hole 10g of the nozzle body 10, and the bottom surface portion 12b and the bottom surface of the through hole 10g are connected by a bottom slope 10e.

[0031] The stage section 12 and the stage lid section 13 are integrally formed. The stage lid section 13 has the same front-to-rear dimension as the stage section 12. The stage lid section 13 is connected to the stage section 12 by a thin plate-like connecting section 14 formed by extending outward from the right side surface of the stage section 12. The connecting section 14 is formed to be bendable at its center, and the stage lid section 13 can be opened and closed around the center of the connecting section 14 by bending the connecting section 14. The stage lid section 13 overlaps the stage section 12 from above, allowing the stage section 12 to be in a closed state in which it is isolated from the outside.

[0032] The top surface 13a of the stage lid 13 is formed with ribs 13b for reinforcing the stage lid 13 and stabilizing the position of the intraocular lens 2. The top surface 13a of the stage lid 13 also has a guide groove 13c formed in the center of the rib 13b, extending forward and backward, for guiding the reciprocating movement of the plunger 30. The top surface 13a further has upper positioning portions 13d formed thereon, each having a columnar shape protruding from the top surface 13a, for fixing the lens body 2a and rear support portion 2c of the intraocular lens 2 together with a pair of second positioning portions 67 of the holding member 50, which will be described later.

[0033] As shown in FIG. 2A, the nozzle body 10 has an upper surface formed with a locking hole 10f that can be engaged with a claw 32a of a plunger 30, which will be described later.

[0034] 3(a) and 3(b) are views showing the plunger 30 extracted from the intraocular lens insertion device 1. FIG. 3(a) is a plan view of the plunger 30 seen from above, and FIG. 3(b) is a left side view of the plunger 30 seen from the left side. By moving the plunger 30 forward, it is possible to move the intraocular lens 2 housed in the stage unit 12 toward the tip unit 10a. The plunger 30 is slightly longer in the front-to-rear direction than the nozzle body 10. The plunger 30 has a front action portion 31 that presses the intraocular lens 2 and a rear insertion portion 32 having a rectangular rod shape. The action portion 31 has a cylindrical columnar portion 31a extending in the front-to-rear direction and a thin, flat portion 31b extending in the left-to-right direction of the columnar portion 31a. Details of the action portion 31 will be described later. A disk-shaped pressing plate portion 33 extending in the up-down and left-to-right directions is formed at the rear end of the insertion portion 32.

[0035] A claw portion 32a is formed in a portion of the insertion portion 32 forward of the center in the front-to-rear direction, protruding toward the upper side of the insertion portion 32 and capable of deforming up and down due to the elasticity of the material of the plunger 30. When the plunger 30 is inserted into the nozzle body 10, the claw portion 32a engages with a locking hole 10f (see FIG. 2(a)) provided on the upper surface of the nozzle body 10, and this engagement determines the relative positions of the nozzle body 10 and the plunger 30 in the initial state. The positions of the claw portion 32a and the locking hole 10f are set so that, when the claw portion 32a is engaged with the locking hole 10f, the tip of the action portion 31 can support the rear support portion 2c located on the rear side of the lens body 2a of the intraocular lens 2 placed on the stage portion 12.

[0036] 4( a) and 4(b) are diagrams showing a schematic configuration of an intraocular lens 2 to be inserted into the eye using the intraocular lens insertion device 1 according to this embodiment. FIG. 4(a) is a plan view of the intraocular lens 2 as viewed from the optical axis, and FIG. 4(b) is a side view of the intraocular lens 2 as viewed from the lateral side. The intraocular lens 2 includes a lens body 2a (an example of an "optical portion") having a predetermined refractive power, and a front support portion 2b and a rear support portion 2c connected to the lens body 2a. The intraocular lens 2 is placed on the stage portion 12 of the nozzle body 10 so that the front support portion 2b is located in front of the intraocular lens insertion device 1 and the rear support portion 2c is located in rear of the intraocular lens insertion device 1. The front support portion 2b and the rear support portion 2c are provided to hold the lens body 2a within the eyeball, and each support portion 2b, 2c has a long, flat plate shape. The front support portion 2b and the rear support portion 2c are connected to the lens body 2a via a joint portion 2d. In this embodiment, the intraocular lens 2 is a so-called one-piece type in which the lens body 2a, the front support portion 2b, the rear support portion 2c, and the joint portion 2d are integrally molded from the same material. The intraocular lens 2 is formed, for example, from a flexible resin material. Note that the intraocular lens 2 may also be a three-piece type in which the lens body 2a and the front and rear support portions 2b, 2c are formed from different materials.

[0037] The front support portion 2 b and the rear support portion 2 c of the intraocular lens 2 are roughened, which prevents the support portions 2 b and 2 c from sticking to the lens body 2 a when the intraocular lens 2 is folded inside the through-hole 10 c of the nozzle body 10.

[0038] Figures 5 to 6(b) are views showing the holding member 50 configured to be detachable from the underside of the stage portion 12. Figure 5 is a plan view of the holding member 50 as seen from above. Figure 6(a) is a perspective view of the holding member 50 as seen diagonally from above. Figure 6(b) is a cross-sectional view of the holding member 50 as seen from the front, cut along line AA in Figure 6(a). The holding member 50 is formed as a separate member from the nozzle main body 10 so as to be detachable from the nozzle main body 10.

[0039] The holding member 50 has a centrally located base 51 and a pair of gripping portions 52 located on the left and right sides of the base 51. The base 51 and the gripping portions 52 are connected by a connecting portion 53. The connecting portion 53 connects the base 51 and the pair of gripping portions 52 by providing a gap 54 between the base 51 and the pair of gripping portions 52. The holding member 50 also has a pair of left and right sidewall portions 55 located on the left and right sides of the base 51 and extending in the front-to-rear direction. Each of the pair of gripping portions 52 has an outer wall portion 52a extending in the front-to-rear direction and having an upper height so that the holding member 50 fits into the left and right outer walls of the stage portion 12. The base 51 is formed with a first mounting portion 56 and a second mounting portion 66 that protrude upward. The first mounting portion 56 and the second mounting portion 66 are an example of a pair of columnar lens fixing portions. Furthermore, a first positioning portion 57 is formed on the upper end surface of the first mounting portion 56 on the side farther from the optical axis of the lens body 2a, protruding above the upper end surface of the first mounting portion 56. Furthermore, a pair of second positioning portions 67 for positioning the lens body 2a and rear support portion 2c of the intraocular lens 2 are formed on the upper end surface of the second mounting portion 66, protruding above the upper end surface of the second mounting portion 66. The first positioning portion 57 is arranged on the right side and front side of the lens body 2a, and the second positioning portion 67 is arranged on the left side and rear side of the lens body 2a. The distance between the first positioning portion 57 and the second positioning portion 67 is set to be slightly larger than the diameter of the lens body 2a of the intraocular lens 2. The pair of second positioning portions 67 are arranged at a distance slightly larger than the width of the rear support portion 2c, and when the rear support portion 2c on the joint portion 2d side is placed between the pair of second positioning portions 67, the rear support portion 2c is sandwiched between the pair of second positioning portions 67, thereby positioning the lens body 2a and the rear support portion 2c relative to the holding member 50.

[0040] The base 51 is also formed with a pair of third mounting portions 58 that protrude upward. The pair of third mounting portions 58 are arranged on the front and left side and the rear and right side of the lens body 2a, respectively. A pair of third positioning portions 59 that protrude further above the third mounting portions 58 are formed on the upper end surfaces of the pair of third mounting portions 58 on the side farther from the optical axis of the lens body 2a. The pair of third mounting portions 58 and the pair of third positioning portions 59 are an example of a pair of lens fixing portions having a columnar shape. The distance between the pair of third positioning portions 59 is set to be slightly larger than the diameter dimension of the lens body 2a of the intraocular lens 2.

[0041] 1 when attached to nozzle body 10, holding member 50 has a tubular protrusion 61 that extends toward top surface 13a and is open on its rear side (base end side). Tubular protrusion 61 functions as a flow path that guides the viscoelastic material injected through injection hole 18.

[0042] The holding member 50 also has a pair of claws 62 extending inward in the left-right direction from each of the pair of third mounting portions 58. The claws 62 are provided to engage with the stage portion 12 to fix the holding member 50 to the stage portion 12.

[0043] Next, with reference to FIG. 2( a), the attachment and detachment of the holding member 50 to and from the stage portion 12 will be described using FIG. 7. FIG. 7 is an enlarged perspective view of the stage portion 12 of the nozzle body 10. As shown in FIG. 2( a), the bottom surface portion 12b of the stage portion 12 is formed with four through holes 12c and one through hole 12d penetrating the bottom surface portion 12b in the vertical direction. The four through holes 12c are formed at positions corresponding to the first to third mounting portions and the first to third positioning portions, respectively, and the first to third mounting portions and the first to third positioning portions can be inserted therethrough. The through hole 12d is formed at a position corresponding to the tubular protrusion 61, and the tubular protrusion 61 can be inserted therethrough. The outer shape of the through hole 12c is slightly larger than, but generally similar to, the shapes of the first to third mounting portions and the first to third positioning portions of the holding member 50 when viewed from above. The outer shape of the through hole 12d is formed to have approximately the same size and shape as the tubular protrusion 61 of the holding member 50 when viewed from above. Then, as shown in Fig. 7, when the holding member 50 is attached to the nozzle body 10, the first to third mounting portions and the first to third positioning portions are inserted into the through hole 12c from below the bottom surface portion 12b, and the tubular protrusion 61 is inserted into the through hole 12d from below the bottom surface portion 12b, so that the first to third mounting portions, the first to third positioning portions, and the tubular protrusion 61 protrude above the bottom surface portion 12b.

[0044] The holding member 50 is fixed to the stage 12 by engaging the claws 62 provided on the third mounting portion 58 with the bottom surface portion 12b. The holding member 50 is removed from the stage 12 before moving the intraocular lens 2 with the plunger 30. At this time, the surgeon operates the pair of gripping portions 52 so that they move toward each other inward in the left-right direction. The pair of gripping portions 52 are connected to the base 51 via the connecting portions 53. When the surgeon pinches the pair of gripping portions 52 with their fingers and moves them inward in the left-right direction, the pair of claws 62 open outward in the left-right direction, and the engagement between the pair of claws 62 and the bottom surface portion 12b is released. In this way, the holding member 50 is configured to be removable from the stage 12.

[0045] FIG. 8 is a top view of the nozzle body 10, showing a state in which the intraocular lens 2 is placed on the stage portion 12. FIG. 8 also shows a state in which the holding member 50 is attached to the stage portion 12. When the intraocular lens 2 is placed on the stage portion 12, the bottom surface of the outer periphery of the lens body 2a is placed on the upper surfaces of the first mounting portion 56, the second mounting portion 66, and the pair of third mounting portions 58. The edge of the lens body 2a is fixed in the front-rear and left-right directions by the first positioning portion 57, the second positioning portion 67, and the pair of third positioning portions 59. Furthermore, the front support portion 2b of the intraocular lens 2 is placed on the fourth mounting portion 12e, which will be described later, and the rear support portion 2c of the intraocular lens 2 is fixed by the pair of second positioning portions 67. Furthermore, the rear support portion 2c is locked by a locking portion provided on the action portion 31 of the plunger 30. The configuration for locking the rear support portion 2c will be described later.

[0046] When removing the holding member 50 from the stage portion 12, as described above, the surgeon operates the pair of gripping portions 52 so that they move toward each other inward in the left-right direction, thereby opening the first positioning portion 57, the second positioning portion 67, and the pair of third positioning portions 59 that secure the lens body 2a outward in the left-right direction, thereby enabling the lens body 2a to be released from its fixed state. This allows the intraocular lens insertion device 1 to release the intraocular lens 2 from its fixed state by the holding member 50 without applying any unnecessary impact to the intraocular lens 2. The intraocular lens insertion device 1 also allows the holding member 50 to be easily removed from the stage portion 12.

[0047] 10 is a plan view of the stage unit 12 viewed from above with the holding member 50 removed. The stage unit 12 has a stage upper end surface 12g that becomes the upper end surface of the stage unit 12 when the stage lid 13 is open, and is formed with a fourth mounting portion 12e (an example of a "front support shelf") that protrudes from the stage upper end surface 12g toward the stage groove 12a. When the intraocular lens 2 is placed on the fourth mounting portion 12e, the front support portion 2b is placed on it. A fourth positioning portion 12f that protrudes further above the fourth mounting portion 12e is formed on the side of the upper end surface of the fourth mounting portion 12e that is farther from the optical axis of the lens body 2a.

[0048] The front support portion 2b of the intraocular lens 2 is placed on the stage portion 12 in a state where it is positioned further forward than the lens body 2a, and the fourth mounting portion 12e supports the front support portion 2b. The fourth mounting portion 12e is formed at a height such that at least a portion of the front support portion 2b is supported on the top surface portion 13a side of the tip end of the lens body 2a.

[0049] Next, the tip side of the plunger 30 that moves the intraocular lens 2 will be described in detail. Fig. 11(a) is a perspective view of the tip side of the action portion 31 of the plunger 30 as seen from the upper left, and Fig. 11(b) is a perspective view of the tip side of the action portion 31 of the plunger 30 as seen from the upper right. Fig. 12(a) is a left side view of the tip side of the action portion 31 of the plunger 30 as seen from the left, and Fig. 12(b) is a top view of the tip side of the action portion 31 of the plunger 30 as seen from the upper side. The action portion 31 has an upper protrusion 31c provided on the tip side and a lower protrusion 31d provided on the tip side. The action portion 31 also has a tip recess 31e formed between the upper protrusion 31c and the lower protrusion 31d and recessed rearward of the upper protrusion 31c and the lower protrusion 31d. The action portion 31 moves the intraocular lens 2 forward while sandwiching it between the upper protrusion portion 31c and the lower protrusion portion 31d.

[0050] The upper protrusion 31c has an upper surface 310c extending from the protruding front side to the rear side. As shown in FIG. 12( a), the upper surface 310c is inclined upward from the rear side to the front side. The action portion 31 also has a wall portion 31f (an example of a "support portion abutment surface") extending upward from the rear end of the upper surface 310c and facing the front side. As shown in FIG. 9, the tip side of the action portion 31 is exposed inside the stage portion 12 in the initial position of the plunger 30, and the rear support portion 2c of the intraocular lens 2 is placed on the upper surface 310c of the upper protrusion 31c. When the plunger 30 moves the intraocular lens 2, the wall portion 31f abuts against a part of the rear support portion 2c, and the wall portion 31f moves the rear support portion 2c forward. When the tip side of the rear support portion 2c is pushed forward, it moves to the upper side of the lens body 2a, and the intraocular lens 2 is folded into a valley fold in this state and released into the eye. Note that Fig. 9 shows a state in which the rear support portion 2c is placed on the upper surface 310c of the upper protrusion 31c, and the rear support portion 2c is engaged with the upper surface 310c of the upper protrusion 31c and the wall portion 31f. The upper protrusion 31c is formed between the tip recess 31e and the wall portion 31f, and protrudes forward beyond the rear end surface of the tip recess 31e and the wall portion 31f. The upper protrusion 31c presses the lens body 2a toward the inner surface of the tip portion 10a with the most forward-most portion 311c of the upper protrusion 31c.

[0051] The action portion 31 also has an upper notch 31g formed on the rear side of the wall portion 31f. The upper notch 31g has a bottom surface 310g that extends rearward from the upper end of the wall portion 31f and faces upward, and the bottom surface 310g is formed so that it is longer in the front-to-back direction than in the left-to-right direction. The upper notch 31g is a notch cut out from the upper side of the action portion 31. The action portion 31 forms a two-step structure from the base end side, consisting of the upper notch 31g and the upper protrusion 31c. When the intraocular lens 2 is moved by the action portion 31, the rear support portion 2c on the upper surface 310c is pressed by the wall portion 31f, and when the intraocular lens 2 advances and is folded, the rear joint portion 2d rides up on the upper notch 31g.

[0052] The distal recess 31e is composed of the lower surface of the upper protrusion 31c and the upper surface and rear end surface of the lower protrusion 31d, and is a portion recessed rearward from the distal ends of the upper protrusion 31c and the lower protrusion 31d. The rear end surface defining the rear end of the distal recess 31e is an uneven surface 310e (an example of an "optical unit abutting surface") facing forward. The uneven surface 310e abuts against the rear end of the lens body 2a when the action unit 31 moves the intraocular lens 2. The vertical length of the distal recess 31e needs to be long enough to sandwich the lens body 2a of the intraocular lens 2. The lens body 2a, while its rear end side is pushed forward by the uneven surface 310e, is folded into a valley fold, and advances through the distal end portion 10a while being sandwiched between the upper protrusion 31c and the lower protrusion 31d, and is released from the opening 10b. Furthermore, the upper surface 310c of the upper protrusion 31c is preferably formed into a curved surface that is convex upward so as not to damage the joint portion 2d that comes into contact with the upper surface 310c when folding the intraocular lens 2. In order to form the upper surface 310c into a curved surface that is convex upward, the upper protrusion 31c needs to be formed thicker by the amount that the upper surface 310c rises upward. The upper protrusion 31c is inclined upward from the base end to the tip end to ensure the thickness required to form the upper surface 310c into a curved surface that is convex upward while ensuring the vertical length of the distal recess 31e that sandwiches the lens body 2a. As a result, the upper protrusion 31c needs to be thicker than if the upper surface 310c were formed flat from front to back. However, by forming the upper protrusion 31c so that the upper surface 310c is inclined upward from the base end to the tip end, the vertical length of the distal recess 31e can be ensured, allowing the lens to be moved without being excessively gripped.

[0053] The uneven surface 310e is formed with concave grooves 311e, convex portions 312e, and another groove 311e in this order from top to bottom, with the vertical lengths of the grooves 311e and convex portions 312e being smaller than the edge thickness of the lens body 2a. This results in the uneven surface 310e being formed as a surface in which the concaves and convexes change at intervals smaller than the edge thickness of the lens body 2a. The grooves 311e and convex portions 312e extend in the left-right direction with a width smaller than the edge thickness of the lens body 2a. The edge thickness refers to the thickness at the outer periphery of the lens body 2a, and the left-right direction refers to the front-rear direction connecting the tip end and base end and the direction perpendicular to the optical axis of the lens body 2a.

[0054] The action portion 31 is provided on the tip side and has a lateral notch 31h formed by cutting out a side of the action portion 31. As shown in FIG. 8 , the lateral notch 31h is formed by cutting out the left side where the base of the rear support portion extends. By moving the intraocular lens 2 forward, the rear support portion 2c is placed on the front side of the optical axis of the lens body 2a. In this state, when the action portion 31 moves the intraocular lens 2 further forward, the lateral notch 31h is provided to prevent the rear support portion 2c and the joint portion 2d from being pinched between the action portion 31 and the inner wall surface of the nozzle portion 15 or the tip portion 10a. The lateral notch 31h is formed at a position that forms a space between the action portion 31 and the inner wall surface of the nozzle body 10 so that the rear support portion 2c of the intraocular lens 2 can be accommodated therein when the intraocular lens 2 is moved. The action portion 31 can move the intraocular lens 2 while storing the rear support portion 2c between the side cutout portion 31h and the inner wall surface of the nozzle portion 15 or the tip portion 10a.

[0055] 12(b), the lateral notch 31h is formed so that its center in the front-to-rear direction is recessed furthest to the right. When viewed from above, the action portion 31 has the uneven surface 310e exposed to the left. The uneven surface 310e, which comes into contact with the lens body 2a when moving the intraocular lens 2, is exposed to the left of the upper protrusion 31c and the lower protrusion 31d when viewed from above, and the lateral notch 31h is formed so that it protrudes to the left as it moves from the center to the front and is continuous with the uneven surface 310e. By forming the uneven surface 310e of the action portion 31 to be wider in front of the lateral notch 31h, the lens body 2a can be reliably moved by the uneven surface 310e.

[0056] Next, the operation of moving the intraocular lens 2 with the action part 31 will be described with reference to Figure 13. Figure 13(a) is an enlarged perspective view of the tip side of the intraocular lens insertion device 1. Figure 13(b) is a front view of the tip part 10a of the intraocular lens insertion device 1 as seen from the opening 10b side. In the state shown in Figures 13(a) and (b), the tip side of the action part 31 of the plunger 30 has moved halfway to the tip part 10a of the nozzle body 10. Note that the intraocular lens 2 moved by the action part 31 is not shown in Figure 13.

[0057] In this embodiment, the intraocular lens 2 is a one-piece type in which the lens body 2a and the support portions 2b and 2c are integrally formed. In the one-piece type intraocular lens 2, the joint portion 2d is thinner than the joint portion of a three-piece type intraocular lens. Therefore, in order to increase the stability of the intraocular lens 2 within the lens capsule, the joint portion 2d needs to be provided with a certain area or more. However, if the posterior support portion 2c is pinched between the insertion tool and the plunger 30 when the intraocular lens 2 is moved, a load is applied to the intraocular lens 2, which may cause scratches at the joint portion 2d or cause the behavior of the intraocular lens 2 to become unstable.

[0058] Therefore, the intraocular lens insertion device 1 according to this embodiment has an action portion 31 configured to reduce the load on the intraocular lens 2. Specifically, the action portion 31 has an upper notch 31g. The upper notch 31g is formed at a position where a gap between its bottom surface 310g and the nozzle portion 15 is provided that is larger than the thickness of the bonding portion 2d of the intraocular lens 2. In other words, when the action portion 31 reaches the nozzle portion 15, a gap larger than the thickness of the bonding portion 2d is provided between the upper notch 31g and the inner wall surface of the nozzle portion 15. When the action portion 31 moves the intraocular lens 2, the rear bonding portion 2d is placed on the bottom surface 310g of the upper notch 31g. By providing the upper notch 31g, the action portion 31 prevents the bonding portion 2d from being pinched between the action portion 31 and the nozzle portion 15. This allows the intraocular lens insertion device 1 to reduce the load on the intraocular lens 2.

[0059] Furthermore, the upper notch 31g is formed at a position where its bottom surface 310g is positioned to provide a gap between it and the tip portion 10a of the nozzle portion 15 that is larger than the thickness of the bonding portion 2d of the intraocular lens 2. In other words, when the operating portion 31 advances to the tip portion 10a, a gap larger than the thickness of the bonding portion 2d is formed between the upper notch 31g and the inner wall surface of the tip portion 10a. By providing the upper notch 31g, the operating portion 31 prevents the bonding portion 2d from being pinched between the operating portion 31 and the tip portion 10a. This allows the intraocular lens insertion device 1 to reduce the load on the intraocular lens 2.

[0060] Furthermore, the upper protrusion 31c is formed at a position where its upper surface 310c is provided with a gap between it and the distal end portion 10a that is larger than the thickness of the bonding portion 2d of the intraocular lens 2. In other words, when the action portion 31 advances to the distal end portion 10a, a gap larger than the thickness of the bonding portion 2d is formed between the upper surface 310c of the upper protrusion 31c and the inner wall surface of the distal end portion 10a. This makes it possible to prevent the rear bonding portion 2d from being pinched between the upper protrusion 31c and the distal end portion 10a when the action portion 31 moves the intraocular lens 2.

[0061] The intraocular lens insertion device 1 according to this embodiment is used when inserting into the eye an intraocular lens 2 having a joint portion 2d that enhances stability within the lens capsule as described above, thereby preventing the joint portion 2d from being pinched between the working portion 31 and the inner wall surface of the device body. This allows the intraocular lens insertion device 1 to reduce the load on the intraocular lens 2. The intraocular lens insertion device 1 according to this embodiment prevents the intraocular lens 2 from being pinched when inserting an intraocular lens 2 made of a relatively soft material into the eye, thereby preventing scratches on the intraocular lens 2 and unstable behavior of the intraocular lens 2.

[0062] Furthermore, by forming the widths of the grooves 311e and convex portions 312e formed in the uneven surface 310e to be less than the edge thickness of the lens body 2a, it is possible to prevent the intraocular lens 2 from sticking to the uneven surface 310e. Generally, the intraocular lens 2 is made of soft acrylic and has some adhesiveness, so the tip of the plunger is roughened or otherwise treated to prevent the intraocular lens 2 from sticking. However, if the tip of the plunger is roughened to a fine shape less than the edge thickness of the lens body 2a, there is a risk of molding defects occurring during plunger molding. The intraocular lens insertion device 1 according to this embodiment can prevent the intraocular lens 2 from sticking to the uneven surface 310e of the operating portion 31 while preventing molding defects of the operating portion 31.

[0063] In general, intraocular lenses are released from an insertion device with the front and rear support parts folded asymmetrically. Intraocular lenses made of soft materials may be released tilted to either the left or right due to the asymmetrical folding of the lens body. The intraocular lens insertion device 1 according to this embodiment has an upper protrusion 31c at the top of the tip of the action part 31. Therefore, when the plunger 30 is pushed forward and the lens body 2a of the intraocular lens 2 passes through the tip part 10a, the most distal end part 311c of the upper protrusion 31c can press the lens body 2a against the inner surface of the tip part 10a. This allows the intraocular lens insertion device 1 to delay the timing at which the lens body 2a separates from the action part 31, and since the action part 31 holds the lens body 2a, tilting of the intraocular lens 2 can be reduced.

[0064] As described above, the intraocular lens 2 maintains a rearward tilted position even after the holding member 50 is removed. When the intraocular lens 2 is in a rearward tilted position, the upper protrusion 31c and the wall 31f lock at least a portion of the rear support portion 2c closer to the top surface 13a than the base end of the lens body 2a. By locking the rear support portion 2c closer to the top surface 13a than the lens body 2a, the intraocular lens insertion device 1 can place the rear support portion 2c on the lens body 2a when the plunger 30 moves forward. The intraocular lens 2 is then properly folded with the rear support portion 2c folded onto the lens body 2a. This allows the intraocular lens insertion device 1 to stabilize the behavior of the intraocular lens. The lens body 2a is pressed by the uneven surface 310e, making it easier to place the rear support portion 2c locked on the upper protrusion 31c on the upper side of the lens body 2a.

[0065] This application describes six orthographic views of the plunger 30 of the intraocular lens insertion device 1 according to this embodiment. FIGS. 14 to 19 are six-view views of the plunger 30 of the intraocular lens insertion device 1 according to this embodiment. FIG. 14 is a bottom view, FIG. 15 is a plan view, FIG. 16 is a front view, FIG. 17 is a rear view, FIG. 18 is a left side view, and FIG. 19 is a right side view. FIG. 20 is an enlarged view of a portion A-A' in FIG. 16. FIG. 21 is an enlarged view of a portion B-B' in FIG. 17. FIG. 22 is an enlarged view of a portion C-C' in FIG. 18. FIG. 23 is an enlarged view of a portion D-D' in FIG. 19. FIG. 24 is a perspective view 1 of the plunger 30 of the intraocular lens insertion device 1 according to this embodiment, viewed obliquely from the upper right in an orthographic projection. FIG. 25 is a perspective view 2 of the plunger 30 of the intraocular lens insertion device 1 according to this embodiment, viewed obliquely from the upper left in an orthographic projection. FIG. 26 is a perspective view 3 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally lower right in an orthographic projection. FIG. 27 is a perspective view 4 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally lower left in an orthographic projection. FIG. 28 is an enlarged perspective view 1 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally upper right in an orthographic projection. FIG. 29 is an enlarged perspective view 2 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally upper left in an orthographic projection. FIG. 30 is an enlarged perspective view 3 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally lower right in an orthographic projection. FIG. 31 is an enlarged perspective view 4 of the plunger 30 of the intraocular lens insertion device 1 according to the embodiment, viewed from the diagonally lower left in an orthographic projection.

[0066] The above is a description of this embodiment, but the intraocular lens insertion device 1 disclosed herein is not limited to the above embodiment, and various modifications are possible within the scope that does not lose the technical concept and identity of the present invention.

[0067] In the above embodiment, the intraocular lens insertion instrument 1 is a preset type in which the intraocular lens 2 is stored in advance in the stage portion 12, but the intraocular lens insertion instrument 1 disclosed herein is not limited to this. For example, the intraocular lens insertion instrument 1 may be a separate type in which the surgeon places the intraocular lens 2 on the intraocular lens insertion instrument 1 when using it.

[0068] REFERENCE SIGNS LIST 1: Intraocular lens insertion device 2: Intraocular lens 2a: Lens body 2b: Front support part 2c: Rear support part 2d: Joint part 10: Nozzle body 11: Hold part 12: Stage part 13: Stage cover part 14: Connecting part 15: Nozzle part 17: Confirmation window part 18: Injection hole 19: Guide wall 30: Plunger 50: Holding member

Claims

1. An intraocular lens insertion device for inserting an intraocular lens through an incision made in the eye, comprising: a device body including: a storage section for storing the intraocular lens in a space formed by a top surface and a bottom surface; and a nozzle section that is disposed distally of the storage section and communicates with the storage section, and has an insertion tube section at the distal end that is inserted into the incision; and a pusher member that moves the intraocular lens stored in the storage section toward the distal end, wherein the intraocular lens has an optical section, a support section that is disposed proximal to the optical section when stored in the storage section, and a joint section that joins the optical section and the support section, and the pusher member has an upper notch that has a support section abutting surface that faces the distal end and abuts against a part of the support section, and a bottom surface that faces upward and is formed proximal to the support section abutting surface, and the upper notch is formed at a position where a gap larger than the thickness of the joint section of the intraocular lens is provided between the bottom surface and the nozzle section. Intraocular lens insertion device.

2. The intraocular lens insertion device according to claim 1, wherein the upper notch is formed at a position where a gap larger than the thickness of the joint portion of the intraocular lens is provided between the bottom surface and the insertion tube portion.

3. An intraocular lens insertion device according to claim 1 or 2, wherein the pushing member faces the tip side and has an optical part abutment surface that abuts against the rear end of the optical part when the intraocular lens is moved, and the optical part abutment surface is formed with an uneven surface in which the unevenness changes at intervals smaller than the edge thickness of the optical part.

4. An intraocular lens insertion device according to claim 3, wherein the uneven surface of the extrusion member has grooves and protrusions extending with a width smaller than the edge thickness of the optical section, and the grooves and protrusions extend in the front-to-rear direction connecting the tip end side and the base end side and in a direction perpendicular to the optical axis of the optical section.

5. An intraocular lens insertion device as described in claim 1, wherein the pushing member has: an optical unit abutment surface facing the tip side and abutting against the rear end of the optical unit when the intraocular lens is moved; and an upper protrusion formed between the optical unit abutment surface and the support unit abutment surface and protruding further toward the tip side than the optical unit abutment surface and the support unit abutment surface.

6. The intraocular lens insertion device according to claim 5, wherein the upper protrusion of the push-out member presses the optical part toward the inner surface of the insertion tube part with the most distal end part located on the distal end side.

7. An intraocular lens insertion device according to claim 5 or 6, wherein the upper protrusion has an upper surface on which the support part can be placed, and the upper surface is inclined upward from the base end side to the tip end side.

8. The intraocular lens insertion device according to claim 7, wherein the upper protrusion is formed at a position where a gap is provided between the upper surface and the insertion tube portion that is larger than the thickness of the joint portion of the intraocular lens.

9. An intraocular lens insertion device according to claim 1 or 2, wherein the pusher member has a lateral notch formed by cutting out a side surface from which the support portion of the intraocular lens extends, and the lateral notch is formed at a position that forms a space between the pusher member and the nozzle portion that can accommodate the support portion of the intraocular lens.

Images