Intraocular lens insertion instrument

Abstract

The purpose of the technology disclosed herein is to provide an intraocular lens insertion instrument with which it is possible to easily confirm the folded state of an intraocular lens. This intraocular lens insertion instrument is for inserting an intraocular lens from an incision formed in an eye, and comprises: an instrument body including a storage part for storing the intraocular lens, and an insertion cylinder part which is disposed closer to the tip side than the storage part so as to communicate with the storage part, and which is inserted into the incision; and an extrusion member for moving the intraocular lens placed in the storage part to the tip side. The instrument body has a standby state visual mark serving as a guide for a normal position of the extrusion member when the intraocular lens is caused to stand by at a lens standby position between the storage part and the insertion cylinder part.

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 lens insertion device. JP-A-2003-144999 describes an intraocular lens insertion device.

[0004] International Publication No. 2020 / 054641

[0005] When an intraocular lens insertion instrument pushes out an intraocular lens, it is common to first move the intraocular lens to a lens standby position and then check the folded state of the intraocular lens.

[0006] The technique disclosed herein aims to provide an intraocular lens insertion device that makes it easy to check the folded state of an intraocular lens.

[0007] The intraocular lens insertion device disclosed herein is an intraocular lens insertion device for inserting an intraocular lens through an incision made in the eye, and includes an instrument body including a storage section for storing the intraocular lens and an insertion tube section that is disposed distal to the storage section and communicates with the storage section and is inserted into the incision, and a pusher member that moves the intraocular lens placed in the storage section toward the distal end, the instrument body having a standby state mark that serves as an indication of the normal position of the pusher member when the intraocular lens is waiting at a lens standby position between the storage section and the insertion tube section. The intraocular lens insertion device makes it easy to check the folded state of the intraocular lens by checking the standby state mark as an indication of the normal position of the pusher member.

[0008] In the intraocular lens insertion device, the standby state mark may include a tip position indicator that serves as a guide for the normal tip position of the push-out member when the intraocular lens is waiting at the lens standby position, and an extrusion direction indicator that serves as a guide for the normal position in the left-right direction that is perpendicular to the extrusion direction and parallel to the bottom surface of the storage section.

[0009] In the intraocular lens insertion device, the tip position indicator may be formed as a line extending in the left-right direction, the extrusion direction indicator may be formed as a pair of lines extending in the extrusion direction, and the standby state mark may form a shape in which the tip position indicator and the extrusion direction indicator are connected.

[0010] In the intraocular lens insertion device, the standby state marker may be formed integrally with the device body using a transparent material, and the tip of the push-out member may be colored a different color from the standby state marker.

[0011] According to the technique disclosed herein, it becomes easy to confirm that the pusher member is in the normal position at the lens standby position, and it becomes easy to confirm the folded state of the intraocular lens.

[0012] 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. 8 is a top view of a nozzle body showing a state in which an intraocular lens is placed on a stage portion of the intraocular lens insertion device according to an embodiment. FIG. 9 is a perspective view showing an enlarged view of the tip side of the action portion of the plunger of the intraocular lens insertion device according to an embodiment.

[0013] 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.

[0014] 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.

[0015] 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.

[0016] 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 on the holding portion 11 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 configured to house 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 portion 13, the upper side of which can be opened and closed, via a connecting portion 14. The stage portion 12 and the stage cover portion 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 portion constitutes the stage portion 12, and the top side of the storage portion constitutes the stage cover portion 13. Furthermore, the space for storing the intraocular lens can be opened by opening the stage lid 13. A holding member 50 is attached to the stage 12 from the underside of the nozzle body 10. This holding member 50 stably holds the intraocular lens 2 within the stage 12 even before use (during transportation).

[0017] 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 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.

[0018] The intraocular lens insertion device 1 according to this embodiment is a preset type in which an intraocular lens 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 is placed on the stage portion 12 with the front side of the optical axis facing upward. Then, the intraocular lens insertion device 1 is shipped after the stage lid portion 13 is closed.

[0019] The stage lid 13 also has an injection hole 18 for injecting a viscoelastic substance onto the stage 12 before moving the intraocular lens forward. The viscoelastic substance functions as a lubricant that reduces friction that occurs when the intraocular lens is moved. The injection hole 18 is a hole that connects the inside and outside of the storage section when the stage lid 13 is closed. An operator, assistant, or nurse (hereinafter sometimes referred to as "operator, etc.") can use a syringe to inject the viscoelastic substance onto the stage 12 through the injection hole 18.

[0020] The stage lid 13 is also provided with a guide wall 19 for guiding an injection needle for injecting a viscoelastic material into the injection hole 18. The guide wall 19 is provided on the stage lid 13 so as to surround the left side of the opening end of the injection hole 18, passing through the front side of the opening end and continuously surrounding the right side of the opening end. The surgeon abuts the injection needle of the syringe for injecting the viscoelastic material 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 material into the injection hole 18. The surgeon then wets the intraocular lens with the viscoelastic material 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 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, releasing the intraocular lens into the eye through the opening 10b. This allows the intraocular lens insertion device 1 to insert the intraocular lens into the eye through the incision.

[0021] 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 from the nozzle portion 15 and the tip portion 10a through the opening 10b into the eye.

[0022] 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.

[0023] 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.

[0024] 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 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.

[0025] The stage unit 12 is formed with a stage groove 12a having a width slightly larger than the diameter of the lens body of the intraocular lens (lens body 2a shown in FIGS. 4(a) and 4(b)). The front-to-rear dimension of the stage groove 12a is set larger than the maximum width dimension of the intraocular lens 2, including the support portions 2b and 2c extending on both the front and rear sides. The stage unit 12 stores the intraocular lens in a space formed by a bottom surface 12b of the stage groove 12a and a top surface 13a located inside the storage section when the stage lid unit 13 is closed. When the stage lid unit 13 is closed, the bottom surface 12b and the top surface 13a form a space for storing the intraocular lens. As shown in FIG. 2(b), the vertical position of the bottom surface 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 12b and the bottom surface of the through-hole 10g are connected by a bottom slope 10e.

[0026] 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.

[0027] 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. The top surface 13a of the stage lid 13 is also formed with a guide groove 13c that is formed in the center of the rib 13b, extends forward and backward, and guides the reciprocating movement of the plunger 30. The top surface 13a further has upper positioning portions 13d that have a columnar shape protruding from the top surface 13a and that fix 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.

[0028] 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.

[0029] 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.

[0030] 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 and the locking hole 10f are engaged, the tip of the action portion 31 is located behind the lens body 2a of the intraocular lens 2 placed on the stage portion 12, and the tip of the action portion 31 can support the support portion 2c on the rear side of the lens body 2a.

[0031] 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.

[0032] The front support portion 2 b and the rear support portion 2 c 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.

[0033] 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.

[0034] 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 located on the right side and front side of the lens body 2a, and the second positioning portion 67 is located 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.

[0035] 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.

[0036] 1 when attached to nozzle body 10, holding member 50 has a tubular protrusion 61 that extends toward top surface 13a and is open at its rear side (base end side). Tubular protrusion 61 functions as a flow path that guides the viscoelastic material injected through injection hole 18.

[0037] 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.

[0038] 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.

[0039] 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 the plunger 30 is used to move the intraocular lens 2. At this time, the surgeon or the like 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 or the like 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.

[0040] 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.

[0041] When removing the holding member 50 from the stage portion 12, as described above, the surgeon or the like 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 2 a outward in the left-right direction, and enabling the lens body 2 a 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.

[0042] Next, with reference to Figures 7 and 8, a description will be given of the mark on the plunger 30 when the intraocular lens 2 is placed at the lens standby position. When the intraocular lens insertion device 1 is used in surgery, the surgeon's assistant or nurse moves the plunger 30 forward to move the intraocular lens 2 to the lens standby position, and the intraocular lens insertion device 1 is then handed to the surgeon. With the tip 10a inserted into the incision, the surgeon further moves the plunger 30 forward from the lens standby position to release the intraocular lens 2 into the eye. In such a surgical procedure, making it easy to confirm whether the intraocular lens 2 has been correctly moved to the lens standby position can reduce the burden on medical personnel in the operating room, including the surgeon, assistant, and nurse.

[0043] 7 and 8 , the intraocular lens insertion device 1 according to this embodiment includes a standby state mark 80 that serves as an indication of the normal position of the plunger 30 when the intraocular lens 2 is waiting at the lens standby position between the stage portion 12 and the tip portion 10 a. The standby state mark 80 is provided on the nozzle body 10. The lens standby position is a position where the intraocular lens 2 waits in a state where it is folded in a valley fold as viewed from above while moving through the through-hole 10 c of the nozzle portion 15. The standby state mark 80 serves as an indication of the normal position of the plunger 30 when the intraocular lens 2 reaches the lens standby position. The plunger 30 being located in the normal position serves as an indication that the intraocular lens 2, which has moved forward by the pressure of the plunger 30, is properly folded.

[0044] Specifically, the standby state mark 80 is formed integrally with the nozzle portion 15 on the upper surface side of the nozzle portion 15. For example, when the nozzle body 10 is injection molded using a resin material, the standby state mark 80 is molded in a raised shape on the upper surface side of the nozzle portion 15 and is formed integrally with the nozzle body 10.

[0045] The standby state mark 80 has a tip position indicator 80a that serves as a guide for the normal position of the plunger 30 in the front-to-rear direction when the intraocular lens 2 is waiting at the lens standby position. The tip position indicator 80a is formed in a linear shape that extends in the left-to-right direction relative to the front-to-rear direction, which is the extrusion direction of the plunger 30. Note that the left-to-right direction refers to the left-to-right direction in this specification, and is a direction that is perpendicular to the extrusion direction of the plunger 30 and parallel to the bottom surface 12b, which is the bottom surface of the storage section formed by the stage 12 and the stage lid 13 in the closed state. Ideally, it is preferable that the tip position indicator 80a and the tip of the plunger 30 overlap when viewed from above, but it is sufficient that the tip position indicator 80a and the tip of the plunger 30 are sufficiently close to each other, and it is not necessary that the normal position of the plunger 30 be determined solely by the position where the tip position indicator 80a and the tip of the plunger 30 overlap. Furthermore, it is sufficient that the intraocular lens 2 remains in a valley-folded state at the lens standby position, and a state in which the intraocular lens 2 is pushed closer to the tapered tip of the through-hole 10c of the nozzle portion 15 can be considered within the allowable range of the lens standby position. Therefore, a state in which the entire intraocular lens 2 remains behind the opening 10b can be considered within the allowable range of the normal position of the plunger 30. By checking the relative positions of the tip position indicator 80a and the plunger 30, it can be confirmed whether the intraocular lens 2 or the plunger 30 is within the above-mentioned allowable range.

[0046] The standby state mark 80 also has a pair of extrusion direction indicators 80b indicating the extrusion direction of the plunger 30. The extrusion direction indicators 80b are formed as a pair of lines extending in the front-to-rear direction, which is the extrusion direction of the plunger 30. The distance between the pair of extrusion direction indicators 80b is set slightly wider than the plunger 30 when viewed from above. If the tip of the plunger 30 is positioned between the pair of extrusion direction indicators 80b, this indicates that the plunger 30 is in the correct position in the left-to-right direction. If the tip of the plunger 30 is shifted outward beyond the pair of extrusion direction indicators 80b, the extrusion direction of the intraocular lens 2 is inappropriate, and the intraocular lens 2 may not be properly folded. It is not recommended to insert the intraocular lens 2 into the eye in such a folded state. If the plunger 30 is positioned between the pair of extrusion direction indicators 80b in the left-to-right direction, this indicates that the intraocular lens 2 is properly folded. For example, an assistant or nurse may try to visually check the folded state of the plunger 30 or the intraocular lens, but this check is difficult or time-consuming in the absence of any marks. The intraocular lens insertion device 1 according to this embodiment allows the relative position of the standby state mark 80 and the plunger 30 to be visually checked, thereby enabling the folding state of the intraocular lens 2 to be checked. Therefore, the intraocular lens insertion device 1 makes it easy to check the folded state of the intraocular lens 2.

[0047] Furthermore, in recent years, surgical incisions have become increasingly smaller, and when inserting an intraocular lens 2 through a small incision, it is important that the intraocular lens 2 is properly folded. The intraocular lens insertion device 1 according to this embodiment makes it easy to check the folded state of the intraocular lens 2, making it easier to insert an appropriately folded intraocular lens 2 through a small incision. Therefore, the intraocular lens insertion device 1 can contribute to improving the safety of surgery.

[0048] Furthermore, the standby state mark 80 has the tip position mark 80a and the pair of extrusion direction marks 80b connected to each other. The tip position mark 80a and the pair of extrusion direction marks 80b may be connected directly or via one or more straight or curved lines. The tip position mark 80a and the pair of extrusion direction marks 80b are connected to form a U-shape. When viewed from above, it is easy to confirm with the naked eye that the plunger 30 is within the area surrounded by the tip position mark 80a and the pair of extrusion direction marks 80b. With this configuration, the intraocular lens insertion device 1 according to this embodiment makes it easier to confirm the positional relationship between the standby state mark 80 and the plunger 30.

[0049] Furthermore, the standby state marker 80 is made of a transparent material and is formed integrally with the nozzle body 10. Meanwhile, the tip of the plunger 30 is colored a different color (blue in this embodiment) from the standby state marker 80. This makes it easier to see the tip of the plunger 30 from outside the nozzle body 10, and makes it easier to confirm the positional relationship between the standby state marker 80 and the plunger 30.

[0050] Furthermore, the intraocular lens insertion device 1 according to this embodiment has an injection amount mark 81 that indicates the injection amount of viscoelastic material and is provided on the upper surface of the nozzle portion 15 between the stage portion 12 and the tip portion 10a. The injection amount mark 81 is formed integrally with the nozzle portion 15. For example, when the nozzle body 10 is injection molded using a resin material, the injection amount mark 81 is molded in a raised shape on the upper surface of the nozzle portion 15 and is formed integrally with the nozzle body 10.

[0051] The injection amount mark 81 is formed in a curved shape that convexly extends forward and is connected to a pair of extrusion direction indicators 80b. In this embodiment, the injection amount mark 81 is formed continuously with the standby state mark 80 and is made of a transparent resin material, just like the standby state mark 80. When the surgeon or other person injects the viscoelastic material from the injection hole 18 onto the stage portion 12, it is preferable to inject an amount of viscoelastic material that reaches the injection amount mark 81. This amount is the amount of viscoelastic material necessary to pass the intraocular lens 2 through the nozzle portion 15 and the tip portion 10a. The intraocular lens insertion device 1 according to this embodiment makes it easy to determine whether the required amount of viscoelastic material has been injected, thereby preventing overinjection or underinjection of the viscoelastic material.

[0052] 8, 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 unit 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. 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, a fourth positioning portion 12f that protrudes further above the fourth mounting portion 12e is formed.

[0053] 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 of the lens body 2a.

[0054] Next, the engagement of the rear support portion 2c of the intraocular lens 2 will be described. Figure 9 is an enlarged perspective view showing the tip side of the action portion 31 of the plunger 30. The action portion 31 has two protrusions 31c, 31d provided on the tip side. The protrusions 31c, 31d protrude forward, and a recess 31e recessed rearward of the protrusions 31c, 31d is formed between the two protrusions 31c, 31d. The upper end surface of the protrusion 31c is formed in a generally flat shape, and a wall portion 31f extending upward is formed behind the flat surface. The action portion 31 is exposed inside the stage portion 12 when the plunger 30 is in the initial position, and the rear support portion 2c is placed on the protrusions 31c.

[0055] The intraocular lens 2 assumes a backward tilted position when the plunger 30 starts to move. When the intraocular lens 2 is in the backward tilted position, the 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 rear 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, and the intraocular lens 2 is 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. Since the lens body 2a is pressed by the recess 31e, the rear support portion 2c locked on the protrusion 31c can be more easily placed on the upper side of the lens body 2a.

[0056] The intraocular lens insertion device 1 folds the intraocular lens 2 while moving it forward with the plunger 30. By checking the relative positions of the standby state mark 80 and the plunger 30, the intraocular lens insertion device 1 makes it easy to confirm that the plunger 30 is in the normal position at the lens standby position, and makes it easy to check whether the intraocular lens 2 is properly folded.

[0057] 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.

[0058] 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.

[0059] 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 80: Standby state mark 81: Injection amount mark

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, and an insertion tube section that is positioned distal to the storage section, communicates with the storage section, and is inserted into the incision; and a pusher member that moves the intraocular lens placed in the storage section toward the distal end, wherein the device body has a standby state mark that serves as an indication of the normal position of the pusher member when the intraocular lens is placed on standby at a lens standby position between the storage section and the insertion tube section.

2. The intraocular lens insertion device according to claim 1, wherein the standby state mark has a tip position indicator that serves as a guide for the normal tip position of the push-out member when the intraocular lens is waiting at the lens standby position, and an extrusion direction indicator that serves as a guide for the normal position in the left-right direction that is perpendicular to the extrusion direction and parallel to the bottom surface of the storage section.

3. An intraocular lens insertion device according to claim 2, wherein the tip position indicator is formed as a line extending in the left-right direction, the extrusion direction indicator is formed as a pair of lines extending in the extrusion direction, and the standby state mark forms a shape in which the tip position indicator and the extrusion direction indicator are connected.

4. An intraocular lens insertion device according to claim 1 or 2, wherein the standby state marker is made of a transparent material and is formed integrally with the device body, and the tip of the push-out member is colored a different color from the standby state marker.

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