JPH05103803A - Transplantation device of intraocular lens - Google Patents

Abstract

PURPOSE:To provide the title transplantation device capable of supporting the optical part of an intraocular lens at the proper position in an eye by a support part and not damaging the function of the intraocular lens at the time of transplantation. CONSTITUTION:An intraocular lens 20 consisting of an optical part 18 having elasticity and a support part 19 easy to deform by external force is bent to be made small sized and inserted in the insertion cylinder 11 of a holder 10 to be positioned and held and the holder 10 is attached to a device main body 1. The main shaft 7 inserted in the device main body 1 is advanced by the drive mechanism 5 provided to the device main body 1 and only the optical part 18 is pushed by the tip part 9 of the main shaft 7 and the intraocular lens 20 is inserted in an eye from an incision without deforming the support part 19 and the optical part 18 returned to a large size by its elastic recovery force is supported at the proper position in the eye by the support part 19.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an implanting instrument for implanting an artificial intraocular lens in the eye instead of the lens extracted by cataract surgery.

[0002]

2. Description of the Related Art Heretofore, it has been widely practiced to implant an artificial intraocular lens in place of the crystalline lens extracted during cataract surgery. Since 1949 when Ridley first implanted a polymethylmethacrylate (PMMA) intraocular lens into the human eye, many ophthalmologists have shown interest in the complications associated with intraocular lens implantation of cataract surgery.
Although the problem has been dealt with, it is considered that the above-mentioned complications can be roughly divided into the following four at present.

Postoperative inflammation, posterior capsule opacification, intraocular lens deviation, and postoperative astigmatism. For these complications, post-operative inflammation is treated by the use of chemicals or intraocular lens surface treatment / improvement of biocompatibility, posterior capsule opacification is treated by YAG laser, intraocular lens displacement is intraocular. This can be dealt with by improving the bearing capacity by improving the lens.

However, post-operative astigmatism is extremely harmful to the purpose of obtaining better visual acuity without post-operative eyeglasses. Post-operative astigmatism has not been fully resolved despite the use of intraoperative keratometer and ingenuity of suturing and incision, but this is considered to be related to the size of the incision and is only a small incision. It is considered that the change in postoperative astigmatism is small.

It is the advent of a surgical technique called ultrasonic phacoemulsification (KPE) using an ultrasonic emulsification suction device that enables surgery with a small incision. According to this procedure, the opaque crystalline lens is crushed with an ultrasonic tip, emulsified and sucked using the above-mentioned device, and the crystalline lens can be removed with an incision of about 4 mm, which is a conventional external cataract extraction surgery (ECCE). ) About 10 incisions at the time of lens extraction
Small incision surgery is possible compared to mm.

[0006] Similar to the surgical incision, the intraocular lens that can be inserted from a small incision has appeared. A conventional intraocular lens has an optical part made of a hard material such as glass or plastic, and the incision at the time of implantation is larger than the diameter of the optical part, usually 6.5 mm or more. Even when the lens was removed, the incision had to be expanded when inserting a hard intraocular lens.

On the other hand, the optical part as invented in Japanese Patent Application No. 58-18005 (Japanese Patent Application Laid-Open No. 58-146346) has a deformable optical part using an elastic body having a predetermined memory characteristic. An intraocular lens having an optical part made of an inner lens or a foldable hard material, and by compressing, rolling, bending, stretching, or folding the intraocular lens, the intraocular lens from a small incision With the advent of implantable devices, an incision of about 4 mm
The intraocular lens is becoming implantable, and we have found the possibility of small incision surgery from both the surgical method and the intraocular lens to be transplanted.

[0008]

However, in the above-mentioned conventional intraocular lens implanting device, the entire or optical part is made of a deformable elastic body having a predetermined memory characteristic or a foldable hard intraocular lens. The intraocular lens with the optical part of the material is compressed, rolled, bent, stretched, or folded to change from a large shape to a small shape, and a cylindrical shape of the distal end of the implanting instrument or the like. Inserting a shaped insertion tube into the eye through a small incision in the eye, operating it to push out the intraocular lens from the insertion tube, and implanting the intraocular lens in the eye, the following problems was there.

That is, the intraocular lens is composed of an optical part and a supporting part for supporting the optical part in the eye. However, since the supporting part of many intraocular lenses is flexible, it has a thread-like shape to some extent. It has hardness and a spring function. However, since the support portion is easily deformed by an external force, when the intraocular lens is transplanted, the support portion is deformed by applying an external force to the optical portion in the eye to support the proper position. There is a risk of loss of function.

The conventional intraocular lens implanting device is
By compressing, rolling, bending, stretching, or folding an intraocular lens made of a deformable elastic body having memory characteristics or an intraocular lens having a foldable hard material optical part, Since the intraocular lens is pushed out from the insertion tube having a cylindrical shape at the distal end portion of the transplantation instrument or a shape similar to this, an external force is applied to the optical portion and the support portion.

Therefore, at the time of implantation of the intraocular lens, an external force is applied to the supporting part, and the supporting part is deformed by this external force, so that the function as the intraocular lens cannot be achieved in the eye. There is a problem in that it can be applied only to the specific intraocular lens having a supporting portion made of a material that does not deform. This invention solves the above-mentioned problems, and does not deform the support portion when implanting an intraocular lens in which the support portion is easily deformed by an external force. Can be supported in position, does not impair the function of the intraocular lens during implantation,
Another object of the present invention is to provide an intraocular lens implanting device that can be widely used for various intraocular lenses.

[0012]

A device for implanting an intraocular lens according to the present invention is fitted into a device body having a substantially cylindrical shape and is axially linearly movable in the device body to push the intraocular lens out of the device. A main shaft, a drive mechanism that is provided in the instrument body to move the main shaft forward and backward, and an insertion tube whose tip portion projects from the tip of the instrument body. The insertion tube is made into a small shape to position and hold the intraocular lens. And a holder that is detachably attached to the main body, and has a shape in which the tip end portion of the main shaft is smaller than the inner diameter of the insertion cylinder and pushes only the optical portion of the intraocular lens.

[0013]

The instrument for implanting an intraocular lens according to the present invention can bend or wind the intraocular lens in the insertion tube of the holder,
By folding and folding the holder, the holder is positioned and held in a small shape, and in this state, the holder is made to protrude from the tip of the instrument body and detachably attached to the instrument body. Next, the main shaft is axially advanced by the drive mechanism, only the optical part of the intraocular lens is pushed by the tip of the main shaft, and the intraocular lens is pushed out of the instrument from the tip of the insertion tube and implanted in the eye. As a result, the intraocular lens can be pushed out of the device and transplanted into the eye without applying an external force to the support portion of the intraocular lens.

Therefore, according to the present invention, the intraocular lens can be implanted without deforming the support portion, and the optical portion can be supported at an appropriate position in the eye by the support portion, so that the function of the intraocular lens is impaired during implantation. In addition, it can be put into the eye through a small incision and the intraocular lens returns to a large size due to its memory characteristic, and can be widely used for various intraocular lenses.

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An implanting device according to a first embodiment of the present invention will be described below with reference to FIGS. 1 and 2
In FIG. 3, reference numeral 1 denotes a substantially tubular instrument body, and a female screw 2 is formed on the inner peripheral surface of the distal side large diameter portion 1a of the instrument body 1, and the tip portion 3a is formed on the upper surface of the tip side small diameter portion 1b. A holder mounting groove 3 having a narrow width is formed along the axial direction.

A screw cylinder 4 is screwed into a screw 2 to form the instrument main body 1, and a driving mechanism 5 is formed by using these as main members.
The operating portion 6 is formed at the end of the male screw cylinder 4. At the end of the male screw cylinder 4, the end of the main shaft 7 is rotatably fitted and supported while restraining its axial movement. The main shaft 7 is arranged concentrically with the instrument body 1 in the instrument body 1 and extends toward the tip side, and a lower portion is flatly cut out along the axial direction to form a cutout portion 7a, and the cutout portion 7a is provided with a tool. By fixing the lower end of the main body 1 and engaging the tip of the anti-rotation pin 8 protruding into the instrument main body 1, the main shaft 7 is restrained from rotating with respect to the instrument main body 1 and supported movably in the axial direction. is there.

A large-diameter guide portion 7b is formed on the tip side of the main shaft 7, and a tip portion 9 on the tip side of the guide portion 7b has a
As shown in FIG. 4, the pushing portion 9b is inserted through the small outer diameter portion 9a.
Are integrally formed. The push-out portion 9b is formed into an oval shape by notching the upper and lower surfaces facing each other, and has an outer diameter shape considerably smaller than the inner diameter of the insertion tube 11 of the holder 10 described later.

As shown in FIG. 5, the holder 10 has a pair of holding plates 12 and 13, and the lower edge portion of one holding plate 12 is at the base end of the insertion tube main body 17 and one half tube. 14 and the lower edge of the other pressing plate 13 is formed integrally with the other half-split tube 1
5 is a molded product made of a flexible synthetic resin, which is formed integrally with 5, and the lower edges of the half-split cylinders 14 and 15 are connected by a hinge portion 16. Then, with respect to the one pressing plate 12 and the half-split cylinder 14, the other pressing plate 13 and the half-split cylinder 15 are opened and closed from the hinge portion 16, and when closed, the half-split cylinders 14 and 15 are concentric with the insertion cylinder main body 17. It becomes the radius, and the insertion cylinder main body 17 and the half-divided cylinders 14 and 1
5 and 5 form the insertion tube 11. Further, the insertion tube main body 17 has a large diameter portion 17a formed on the outer periphery of the base portion and a tapered taper portion 17b formed on the distal end portion.

6 and 7 show a general intraocular lens to be implanted by the implanting device of the first embodiment. In FIG. 6 and FIG. 7, 18 is an optical portion made of a deformable elastic body having a predetermined memory characteristic, 19 is a thread shape in which a base end portion is fixed to the outer peripheral portion of the optical portion 18, and a spring function having a certain hardness. However, the intraocular lens 20 is composed of a pair of supporting portions made of a flexible material that is easily deformed by an external force. The intraocular lens 20 includes the optical portion 18 and the supporting portion 19.

The supporting part 19 extends symmetrically on both sides of the diameter d of the optical part 18 from the outer circumference of the optical part 18, and in the supporting part 19 shown in FIG. 6 and the supporting part 19 shown in FIG. The length differs in the direction orthogonal to the diameter d, and the latter has a longer length in the same direction, which results in different shapes. Further, specifically, the optical portion 18 is made of polyurethane elastomer, silicone elastomer, hydrogel polymer, collagen compound, etc., and the supporting portion 19 is made of polyimide or the like.

In order to implant the intraocular lens 20 shown in FIG. 6 using the implanting device of the first embodiment, first, the holding plate 13 and the half tube 15 of the holder 10 are opened to set the intraocular lens 20 to 1
The pair of supporting portions 19 are respectively positioned and installed on one side on the front side and the other side on the rear side, and the holding plate 13 and the half-split tube 15 are closed to fit the holding plate 12 and the half-split tube 14, and the half-split tube 14,
The optical portion 18 is bent into a fold shape in the inside of 15 to form a small shape, and is positioned and held.

In this holding state, from the base side of the holder mounting groove 3 of the instrument body 1, the half-split tubes 14 and 15 and the insertion tube main body 1
The insertion cylinder 11 constituted by 7 is fitted into the instrument body 1,
Holding the presser plates 12 and 13 projecting out of the instrument body 1 in the closed hand and advancing to the tip side of the instrument body 1, the presser plates 12 and 13 are attached to the tip portion 3a of the mounting groove 3 having a narrow width. The tip of the insertion tube main body 17 is projected from the tip of the instrument body 1 while being engaged and supported.

Next, by holding the operating portion 6 of the drive mechanism 5 and rotating the male screw cylinder 4 in the forward direction, the male screw cylinder 4 and the screw 2 for forming the instrument body 1 are screw-fitted. So
The main shaft 7 moves forward together with the male screw cylinder 4 in the retracted position.
At this time, since the main shaft 7 is engaged with the detent pin 8 having the notch 7a fixed to the instrument body 1, the main shaft 7 goes straight without rotating around the shaft.

As the main shaft 7 advances, its tip comes into contact with the intraocular lens 20 and pushes the intraocular lens 20 out of the insertion tube 11 or the instrument. At this time, the main shaft 7 is guided by the guide portion 7b to move straight in the insertion cylinder 11, and the push-out portion 9b provided at the tip portion 9 of the main shaft 7 has notches on the upper and lower surfaces facing each other, and the main cylinder 7 is cut from the inner diameter of the insertion cylinder 11. Since the intraocular lens 20 has a small outer diameter and the optical portion 18 is bent in two and the supporting portions 19 are positioned on both front and rear sides and are held in the insertion tube 11, As shown in FIG. 3, the push-out portion 9a of the main shaft 7 does not contact the support portion 19 of the intraocular lens 20, but only abuts against the optical portion 18 and pushes it, and the support portion 19 is deformed in the insertion tube 11 without deformation of the eye. The inner lens 20 advances and the insertion tube 1
It comes out from the tip of 1 and enters the eye.

Since the insertion tube 11 of the intraocular lens 20 enters the inside of the crystalline lens through the incision, the deformation of the optical portion 18 when it comes out of the insertion tube 11 is large before bending due to the elastic restoring force based on the memory characteristic. After returning to the shape, the shape of the material is changed to a predetermined shape, and the material is transplanted in the crystalline lens while being supported by the supporting portion 19.
In order to facilitate the advancement of the intraocular lens 20 in the insertion tube 11, it is preferable to put an appropriate viscoelastic substance in the insertion tube 11 and push out the intraocular lens 20 together with this lubricating liquid.

After the implantation of the intraocular lens 20, the driving mechanism 5 is operated to retreat the spindle 7 and the holder 10 is detached from the instrument body 1. Although the above description is for implanting the intraocular lens 20 shown in FIG. 6, the intraocular lens 20 shown in FIG. 7 can be similarly implanted. 9 and 10 respectively show the guide portion 7b and the tip portion 9 of the main shaft 7 of the implanting device according to the second and third embodiments of the present invention. In the second embodiment shown in FIG. 9, the tip portion 9 of the main shaft 7 is shown. The tip is formed in a semi-spherical small-diameter columnar shape, and in the third embodiment shown in FIG. 10, the tip end portion 9 of the main shaft 7 is formed in a small-diameter cylindrical shape of the end face orthogonal to the axial direction. Even when the main shaft 7 according to the third embodiment is used, the intraocular lens can be implanted without deforming the supporting portion by pushing only the optical portion by the tip portion 9 of the main shaft 7 as in the case of the first embodiment described above.

In the present invention, the optical part of the intraocular lens may be formed of a foldable hard material, and the shape of the supporting part may be changed as appropriate. Even if it is miniaturized by bending, bending, or folding, it can be appropriately changed as long as the optical portion has at least a memory characteristic that increases to a predetermined shape after being extruded from the insertion tube.

Further, in the present invention, the drive mechanism may be variously modified as long as it can reciprocate the main shaft linearly in the axial direction in the instrument body, such as a piston type drive mechanism, and the tip end of the main shaft is smaller than the inner diameter of the insertion tube. As long as only the optical part of the intraocular lens can be pushed, the shape is not limited to the shape of the above-described embodiment, various modifications can be made, and the shape of the distal end portion of the insertion tube of the holder is also limited to the shape of the embodiment. Instead, the lower part can be appropriately changed such as being cut out diagonally.

[0029]

As described above, according to the present invention, an optical part made of a deformable elastic body or a foldable hard material having a predetermined memory characteristic, and an optical part provided integrally with the optical part to support the optical part in the eye. A device for implanting an intraocular lens having a support portion of a flexible material, which is a substantially tubular device body, and a main shaft that is inserted into the device body so as to be linearly movable in the axial direction and pushes the intraocular lens out of the device. And a drive mechanism that is provided in the instrument body to move the main shaft forward and backward, and an insertion tube whose tip portion projects from the tip of the instrument body. The insertion tube is made into a small shape to position and hold the intraocular lens. Since the holder is detachably attached to the main shaft, and the distal end of the main shaft is formed to have a shape smaller than the inner diameter of the insertion tube to push only the optical part of the intraocular lens, the following effects can be obtained.

That is, in the intraocular lens implanting device according to the present invention, the intraocular lens is bent, rolled, or folded in the insertion tube of the holder to be positioned and held in a small shape. The holder is detachably attached to the instrument body by protruding the tip of the insertion tube from the tip of the instrument body. Next, the main shaft is axially advanced by the drive mechanism, only the optical part of the intraocular lens is pushed by the tip of the main shaft, and the intraocular lens is pushed out of the instrument from the tip of the insertion tube and implanted in the eye. As a result, the intraocular lens can be pushed out of the device and transplanted into the eye without applying an external force to the support portion of the intraocular lens.

Therefore, according to the present invention, the intraocular lens can be transplanted without deforming the support part, and the optical part can be supported at an appropriate position in the eye by the support part, so that the function of the intraocular lens is impaired at the time of transplantation. In addition, it can be put into the eye through a small incision and the intraocular lens returns to a large size due to its memory characteristic, and can be widely used for various intraocular lenses.

[Brief description of drawings]

FIG. 1 is a plan view showing an intraocular lens implanting device according to a first embodiment of the present invention.

FIG. 2 is a sectional view taken along the line AA of FIG.

FIG. 3 is a perspective view in which a part of FIG. 1 is cut away.

4 is an enlarged perspective view showing a guide portion and a tip portion of the main shaft of FIG.

5 is an enlarged perspective view of the holder shown in FIG. 1 in an open state.

FIG. 6 is a front view showing an example of an intraocular lens.

FIG. 7 is a front view showing another example of the intraocular lens.

FIG. 8 is a partially cutaway perspective view showing the insertion tube of the holder of FIG. 1 in use.

FIG. 9 is an enlarged perspective view showing a guide portion and a tip portion of a spindle according to a second embodiment of the present invention.

FIG. 10 is an enlarged perspective view showing a guide portion and a tip portion of a spindle according to a third embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Instrument main body 3 Holding fixture mounting groove 4 Male screw cylinder 5 Drive mechanism 6 Operation part 7 Main shaft 8 Anti-rotation pin 9 Tip part of main shaft 10 Holding device 11 Insertion cylinder 18 Optical part 19 Support part 20 Intraocular lens.

Claims (1)

[Claims] 1. An optical part made of a deformable elastic body or a foldable hard material having a predetermined memory characteristic, and a support part made of a flexible material provided integrally with the optical part to support the optical part in the eye. A device for implanting an intraocular lens, which has a substantially tubular device body, a main shaft that is inserted into the device body so as to be linearly movable in the axial direction, and a main shaft that pushes the intraocular lens out of the device; A drive mechanism for advancing and retracting the main shaft, and a holder that has an insertion tube whose tip projects from the tip of the instrument body, positions and holds the intraocular lens in a small shape inside the insertion tube, and is detachably attached to the instrument body. An implanting device for an intraocular lens, characterized in that the distal end portion of the main shaft is formed in a shape that is smaller than the inner diameter of the insertion tube and pushes only the optical portion of the intraocular lens.