U.S. patent application number 13/509467 was filed with the patent office on 2012-10-04 for intraocular lens insertion device.
This patent application is currently assigned to MENICON CO., LTD.. Invention is credited to Kazuharu Niwa, Yasuhiko Suzuki, Masayoshi Tanaka.
Application Number | 20120253356 13/509467 |
Document ID | / |
Family ID | 44059295 |
Filed Date | 2012-10-04 |
United States Patent
Application |
20120253356 |
Kind Code |
A1 |
Niwa; Kazuharu ; et
al. |
October 4, 2012 |
INTRAOCULAR LENS INSERTION DEVICE
Abstract
An intraocular lens insertion device having a novel
configuration in such a manner that, with the displacement of a
haptic toward the convex side of an optical portion, which can be
deformed in a curved shape, restricted by an engaging part provided
to the tip part of a plunger, the haptic is deformed in a curved
shape in the direction in which the haptic approaches the optical
portion. The configuration allows, when the intraocular lens is
pushed out by the plunger, the haptic to enter a gap formed on the
concave side of the optical portion which has been deformed in a
curved shape.
Inventors: |
Niwa; Kazuharu; (Nagoya-shi,
JP) ; Suzuki; Yasuhiko; (Hashima-gun, JP) ;
Tanaka; Masayoshi; (Nagoya-shi, JP) |
Assignee: |
MENICON CO., LTD.
Nagoya-shi, Aichi
JP
|
Family ID: |
44059295 |
Appl. No.: |
13/509467 |
Filed: |
November 17, 2009 |
PCT Filed: |
November 17, 2009 |
PCT NO: |
PCT/JP2009/006173 |
371 Date: |
June 8, 2012 |
Current U.S.
Class: |
606/107 |
Current CPC
Class: |
A61F 2002/16905
20150401; A61F 2/167 20130101 |
Class at
Publication: |
606/107 |
International
Class: |
A61F 9/007 20060101
A61F009/007 |
Claims
1. An intraocular lens insertion device comprising: a tube shaped
device main unit arranged in which is set an intraocular lens
having a pair of haptics projecting from an optical portion; a
plunger adapted to be inserted into the device main unit from a
back side in an axial direction thereof and attached to the device
main unit; a stage arranged on which the intraocular lens is set
being provided in an intermediate part of the axial direction of
the device main unit; and a tapered insertion tube part formed
facing a front side in the axial direction from the stage so that
the intraocular lens set on the stage is able to be inserted into
an eye by being moved in an axial forward direction of the device
main unit by the plunger and by being transformed to be smaller and
extruded through the insertion tube part, wherein: the intraocular
lens is adapted to be set on the stage in a state with the pair of
haptics in a state extending from the optical portion facing
forward and backward in the axial direction of the device main
unit, and by the plunger moving in the axial forward direction of
the device main unit, the optical portion is deformed to a curved
shape which becomes convex facing an outer peripheral side of the
insertion tube part, and a tip part of the plunger that presses the
intraocular lens is provided with an optical portion pressing
surface for pressing the optical portion, a haptic pressing surface
for pressing the haptic extending from the optical portion in an
axial backward direction of the device main unit, and an engaging
part that is adapted to be engaged with the haptic pressed by the
haptic pressing surface, suppressing displacement of the haptic to
a side for which the optical portion is curved and deformed to be
convex so as to enter the haptic into a concave side of the optical
portion.
2. The intraocular lens insertion device according to claim 1,
wherein by the intraocular lens being moved forward by the plunger
in the axial direction of the device main unit, the optical portion
is deformed to be in a curved shape that is convex facing above or
below the stage, and a pressing part is provided so that, with the
intraocular lens in a state set on the stage, the pressing part
pushes the haptic extending from the optical portion in the axial
backward direction of the device main unit in an opposite direction
from above or below the stage for which the optical portion is
deformed and curved to become convex, and causes deformation and
displacement in relation to the optical portion.
3. The intraocular lens insertion device according to claim 1,
wherein by the intraocular lens being moved forward by the plunger
in the axial direction of the device main unit, the optical portion
is deformed to a curved shape which is convex facing above or below
the stage, and at the tip part of the plunger, a step surface is
formed so as to project further in the axial direction at one side
of above or below the stage for which the optical portion is curved
and deformed to be convex than an other side, and by the haptic
being engaged with the step surface, the engaging part that
regulates the displacement of the haptic is constituted.
4. The intraocular lens insertion device according to claim 1,
wherein the intraocular lens set on the stage is constituted as one
piece for which the pair of haptics are formed integrally with the
optical portion.
5. The intraocular lens insertion device according to claim 1,
wherein provided on the device main unit is a deformation guide
member that folds and deforms the optical portion in a mountain
shape or valley shape for which one of above or below the stage
becomes convex using a ridge line or valley line extending in a
movement direction.
6. The intraocular lens insertion device according to claim 5,
wherein the deformation guide member is constituted by a
deformation guide part that interferes with the intraocular lens
moving within the insertion tube part and that gradually deforms
the optical portion of the intraocular lens along with movement
within the insertion tube part.
Description
TECHNICAL FIELD
[0001] The present invention relates to an intraocular lens
insertion device used for inserting an intraocular lens into the
eye.
BACKGROUND ART
[0002] From the past, with cataract surgery and the like, a method
has been used for which the intracapsular crystalline lens is
extracted through an incision provided in ocular tissue such as the
cornea (sclera) or anterior capsule of the lens or the like, and
after removal, an intraocular lens substituted for that crystalline
lens is inserted into the eye using that incision, and arranged
within the capsule.
[0003] With this intraocular lens surgical operation method, there
has been used an intraocular lens insertion device as noted in
Patent Document 1 (Published Unexamined Japanese Patent Application
No. JP-A-2003-70829) and Patent Document 2 (Published Unexamined
Japanese Patent Application No. JP-A-2004-351196). With these
intraocular lens insertion devices, the insertion tube part
provided at the tip of the device main unit is made to be inserted
and enter into the eye through the eye incision, and in a state
with the intraocular lens deformed to be smaller within the device
main unit, it is made to be extruded into the eye from the tip
opening of the insertion tube part. Then, the intraocular lens is
arranged within the capsule by the intraocular lens which was
extruded into the eye expanding by its own restoration force within
the capsule. If this kind of intraocular lens insertion device is
used, it is possible to keep the incision small, making it possible
to reduce the trouble required for the surgical operation and also
possible to reduce the occurrence of postoperative astigmatism and
the risk of infection.
[0004] As described above, with the intraocular lens insertion
device, by the intraocular lens set on a stage provided in the
device main unit being moved by the plunger while being pushed
toward the insertion tube part, the intraocular lens is made to be
extruded into the eye from the insertion tube part tip opening. It
is typical for the intraocular lens to be set on a stage in a state
with a pair of haptics formed projecting on the optical portion in
a state extended facing front and back in the movement direction of
the intraocular lens by the plunger. Because of that, when
extruding the intraocular lens using the plunger, first, the
plunger contacts the haptic (back haptic) extending in the backward
movement direction of the intraocular lens, and by the force
applied from the plunger being transmitted to the optical portion
via the back haptic, the entire intraocular lens is moved toward
the insertion tube part.
[0005] However, when the entire intraocular lens is pushed via the
back haptic and extruded forward to the insertion tube part by the
plunger, there is the risk of the back haptic coming off from the
plunger pressing surface (tip surface). It is hard for a
practitioner to know whether the back haptic has come off the
plunger pressing surface. Because of that, by continuing to press
the pressing member as is, the back haptic that has come off the
plunger pressing surface becomes sandwiched between the inner
periphery surface of the insertion tube part that gradually becomes
smaller toward the extrusion front and the plunger outer peripheral
surface. This sandwiching may cause damage to the back haptic as
well as the risk of the plunger pushing operation resistance
becoming large, causing problems with the intraocular lens
procedure.
[0006] In Published Unexamined Japanese Patent Application No.
JP-A-2009-18009 (Patent Document 3), proposed is an intraocular
lens insertion device with a constitution for which a groove opened
at the outer peripheral surface is formed on the tip part of a
plunger, and the back haptic that has come off the plunger tip
surface is housed inside that groove. However, it is difficult to
reliably house the back haptic inside the narrow width groove, and
also continue to maintain that housed state throughout the
intraocular lens extrusion operation. Also, the back haptic that
has come off from the groove formed on the plunger outer peripheral
surface is wrapped around the plunger outer peripheral surface.
This causes the problem that it can enter between the plunger outer
peripheral surface and the insertion tube part inner periphery
surface, so it was not a satisfactory product.
BACKGROUND ART DOCUMENTS
Patent Documents
[0007] Patent Document 1: JP-A-2003-70829 [0008] Patent Document 2:
JP-A-2004-351196 [0009] Patent Document 3: JP-A-2009-18009
SUMMARY OF THE INVENTION
Problem the Invention Attempts to Solve
[0010] The present invention has been developed in view of the
circumstances described above as the background, and it is one
object of the present invention to provide an intraocular lens
insertion device with a novel constitution, which makes it possible
to skillfully control the movement of the haptic when extruding the
intraocular lens with the plunger, and to avoid problems such as
damage to the haptic and the like due to the haptic being
sandwiched between the plunger and the device main unit.
Means for Solving the Problem
[0011] A first mode of the present invention provides an
intraocular lens insertion device comprising: a tube shaped device
main unit arranged in which is set an intraocular lens having a
pair of haptics projecting from an optical portion; a plunger
adapted to be inserted into the device main unit from a back side
in an axial direction thereof and attached to the device main unit;
a stage arranged on which the intraocular lens is set being
provided in an intermediate part of the axial direction of the
device main unit; and a tapered insertion tube part formed facing a
front side in the axial direction from the stage so that the
intraocular lens set on the stage is able to be inserted into an
eye by being moved in an axial forward direction of the device main
unit by the plunger and by being transformed to be smaller and
extruded through the insertion tube part, the intraocular lens
insertion device being characterized in that: the intraocular lens
is adapted to be set on the stage in a state with the pair of
haptics in a state extending from the optical portion facing
forward and backward in the axial direction of the device main
unit, and by the plunger moving in the axial forward direction of
the device main unit, the optical portion is deformed to a curved
shape which becomes convex facing an outer peripheral side of the
insertion tube part, and a tip part of the plunger that presses the
intraocular lens is provided with an engaging part that is adapted
to be engaged with the haptic extending from the optical portion in
an axial backward direction of the device main unit, suppressing
displacement of the haptic to a side for which the optical portion
is curved and deformed to be convex.
[0012] According to the first mode, when the intraocular lens is
extruded by the plunger, the haptic to which the plunger tip part
contacts, specifically, the haptic extending from the optical
portion to the device main unit backward axial direction (back
haptic) is curved and deformed in the direction approaching the
optical portion, while the displacement of the back haptic to the
convex side of the curved and deformed optical portion is regulated
by the engaging part provided on the plunger tip part. Owing to
this arrangement, when the intraocular lens is deformed to be small
and extruded through the insertion tube part, the back haptic
enters a gap formed on the inside (concave side) of the curved and
deformed optical portion. As a result, when the intraocular lens is
extruded by the plunger, it is possible to make skillful use of the
gap formed at the concave side of the optical portion and house the
back haptic therein, making it possible to avoid the problem of
damage on the back haptic being sandwiched between the plunger and
the device main unit.
[0013] A second mode of the present invention provides the
intraocular lens insertion device according to the first mode,
wherein by the intraocular lens being moved forward by the plunger
in the axial direction of the device main unit, the optical portion
is deformed to be in a curved shape that is convex facing above or
below the stage, and a pressing part is provided so that, with the
intraocular lens in a state set on the stage, the pressing part
pushes the haptic extending from the optical portion in the axial
backward direction of the device main unit in an opposite direction
from above or below the stage for which the optical portion is
deformed and curved to become convex, and causes deformation and
displacement in relation to the optical portion.
[0014] With the second mode, during extrusion of the intraocular
lens by the plunger, it is possible to do pressing deformation and
displacement of the back haptic of the intraocular lens set on the
stage so as to be relatively displaced to the overlapping surface
side of the optical portion in advance. By doing this, along with
extrusion of the intraocular lens, it is possible to have the back
haptic more reliably and smoothly enter the gap formed at the
concave side of the curved and deformed optical portion.
[0015] The pressing part noted in this mode can be provided on the
device main unit, or can be constituted as a separate member
attached to the device main unit. It is also possible to constitute
it with a special engaging part provided on the tip part of the
plunger. By directly forming on the device main unit and
constituting with the engaging part, it is possible to reduce the
number of parts. When constituting as a separate member attached to
the device main unit, for example if it is a preset type
intraocular lens insertion device provided in a state for which the
intraocular lens is set on the stage in advance, using a support
member provided with projections for positioning and supporting the
intraocular lens attached to the device main unit, it is possible
to form a projection type pressing part for pressing the haptic on
the concerned support member.
[0016] A third mode of the present invention provides the
intraocular lens insertion device according to the first or second
mode, wherein by the intraocular lens being moved forward by the
plunger in the axial direction of the device main unit, the optical
portion is deformed to the curved shape which is convex facing
above or below the stage, and at the tip part of the plunger, a
step surface is formed so as to project further in the axial
direction at one side of above or below the stage for which the
optical portion is curved and deformed to be convex than an other
side, and by the haptic being engaged with the step surface, the
engaging part that regulates the displacement of the haptic is
constituted.
[0017] With the third mode, when the plunger is moved in the axial
forward direction and touches the back haptic of the intraocular
lens, the projecting part of the tip part of the plunger advances
to overlap without touching the back haptic, and the non-projecting
part of the tip part of the plunger touches the back haptic and
starts pushing. Then, the uplift of the back haptic (displacement
to the convex side of the curved and deformed optical portion) is
regulated by the engaging action of the plunger on the step
surface. By doing this, when the plunger presses on the intraocular
lens and moves it forward, overlapping of the haptic on the convex
side (outer surface) of the curved optical portion is prevented,
and it is possible to guide entry to the concave side gap of the
optical portion.
[0018] A fourth mode of the present invention provides the
intraocular lens insertion device according to any one of first
through third modes, wherein the intraocular lens set on the stage
is constituted as one piece for which the pair of haptics are
formed integrally with the optical portion.
[0019] Specifically, the present invention can also of course be
applied to intraocular lens insertion devices such as of a three
piece constitution or the like whereby a haptic formed separately
from the optical portion is attached later to the optical portion.
Preferably, the present invention is applied to an intraocular lens
insertion device used for doing insertion surgery of an intraocular
lens of a one piece constitution as noted in this mode. After all,
with an intraocular lens of a one piece constitution, the haptic is
formed with the same soft material as the optical portion, so
compared to intraocular lenses with a three piece constitution for
which there are many cases of the haptic being formed from a harder
material than the optical portion, the haptic rigidity is lower,
and the haptic cross section area is larger. Accordingly, when the
intraocular lens is extruded by the plunger, it is necessary to
secure a large space to avoid the haptic being sandwiched between
the device main unit and the plunger. In light of that, a space for
allowing the haptic to escape was ensured by skillfully using the
gap formed on the inside of the curved and deformed optical
portion. With this arrangement, even with a one-piece constitution
intraocular lens, when extruding through the insertion tube part,
sandwiching of the haptic between the plunger outer peripheral
surface and the insertion tube part inner periphery surface is
prevented, making it possible to effectively protect the
haptic.
[0020] A fifth mode of the present invention provides the
intraocular lens insertion device according to the any one of first
through fourth modes, wherein provided on the device main unit is a
deformation guide member that folds and deforms the optical portion
in a mountain shape or valley shape for which one of above or below
the stage becomes convex using a ridge line or valley line
extending in a movement direction.
[0021] With the fifth mode, it is possible to give further
stability to the curved shape which is convex in the target
direction in relation to the intraocular lens optical portion. With
this arrangement, when moving the intraocular lens forward, it is
possible to form the gap at the concave side of the curved optical
portion with more stability, and possible to more reliably enter
the back haptic in that gap.
[0022] A sixth mode of the present invention provides the
intraocular lens insertion device according to the fifth mode,
wherein the deformation guide member is constituted by a
deformation guide part that interferes with the intraocular lens
moving within the insertion tube part and that gradually deforms
the optical portion of the intraocular lens along with movement
within the insertion tube part.
[0023] With the sixth mode, in a state with the intraocular lens
set in the stage, it is not necessary for the optical portion to be
curved and deformed in advance, and it is also not necessary to do
a special operation on the stage to do curving and deformation at
one time. Because of that, for example by setting the intraocular
lens placed flat on the stage, by simply the operation of extruding
it through the insertion tube part using the plunger, it is
possible to do a procedure curving and extruding the optical
portion without needing to do a special operation for curving the
optical portion. As a result, the work of the procedure for setting
the intraocular lens on the stage and extruding is easier. Note
that the intraocular lens can be provided in a state set on the
stage in advance, or the intraocular lens can be provided
separately from the intraocular lens insertion device, and the
intraocular lens can be set in the stage at the time of the
procedure.
Effect of the Invention
[0024] According to the present invention, the displacement of the
back haptic to the convex side of the curved and deformed optical
portion is regulated by the engaging part provided on the tip part
of the plunger, and the back haptic is curved and deformed in the
direction approaching the optical portion. This makes it possible
to smoothly enter the back haptic in the gap formed in the concave
side of the curved and deformed optical portion. As a result, when
the intraocular lens is deformed to be small and extruded through
the insertion tube part, it is possible to avoid the problem of
damage such as of the back haptic being sandwiched between the
plunger outer peripheral surface and the insertion tube part inner
periphery surface.
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] FIG. 1 is a plan view of an intraocular lens insertion
device as a first embodiment of the present invention.
[0026] FIG. 2 is a side view of the intraocular lens insertion
device shown in FIG. 1.
[0027] FIG. 3 is a plan view showing an intraocular lens set in the
device main unit of the intraocular lens insertion device shown in
FIG. 1.
[0028] FIG. 4 is a side view of the intraocular lens shown in FIG.
3.
[0029] FIG. 5 is an explanatory plan view showing the nozzle part
provided on the device main unit of the intraocular lens insertion
device shown in FIG. 1.
[0030] FIG. 6 is an explanatory side view of the nozzle part shown
in FIG. 5.
[0031] FIG. 7 is an A-A to C-C cross section view of FIG. 5.
[0032] FIG. 8 is a plan view of the plunger constituting the
intraocular lens insertion device shown in FIG. 1.
[0033] FIG. 9 is a side view of the plunger shown in FIG. 8.
[0034] FIG. 10 is an enlarged plan view showing the tip part of the
plunger shown in FIG. 8.
[0035] FIG. 11 is an enlarged side view showing the tip part of the
plunger shown in FIG. 8.
[0036] FIG. 12 is an explanatory plan view for describing the state
of the intraocular lens being set in the stage of the intraocular
lens insertion device shown in FIG. 1.
[0037] FIG. 13 is an explanatory plan view for describing the state
of the lid unit being closed with the intraocular lens insertion
device shown in FIG. 1.
[0038] FIG. 14 is an explanatory cross section view corresponding
to a cross section view of 14-14 of FIG. 13.
[0039] FIG. 15 is a perspective view shown with the side wall part
of the stage cut away to describe the state with the lid unit
closed with the intraocular lens insertion device shown in FIG.
1.
[0040] FIG. 16 is an explanatory cross section view for describing
the state of the back haptic with the intraocular lens insertion
device shown in FIG. 1 being pressed by the pressing part provided
on the lid unit.
[0041] FIG. 17 is an explanatory cross section view for describing
the state of the back haptic with the intraocular lens insertion
device shown in FIG. 1 entering below the step surface formed on
the tip part of the plunger.
[0042] FIG. 18 is an explanatory plan view for describing the back
haptic being in a curved and deformed state.
[0043] FIG. 19 is an explanatory cross section view for describing
the intraocular lens deformed state.
[0044] FIG. 20 is an explanatory cross section view showing the
state of each haptic entered in the inside of the curved and
deformed optical portion.
[0045] FIG. 21 is a horizontal cross section view for describing
another mode of the deformation guide member that can be used with
the present invention, and is a cross section view of A-A to C-C in
FIG. 5.
[0046] FIG. 22 is an explanatory cross section view for describing
a mode of the pressing part and the tip part of the plunger when
using the deformation guide member shown in FIG. 21.
[0047] FIG. 23 is an enlarged side view showing the tip part of the
plunger used with the intraocular lens insertion device as a second
embodiment of the present invention.
[0048] FIG. 24 is a side view for describing another mode of the
guide surface that can be used with this embodiment.
[0049] FIG. 25 is a side view for describing another mode of the
guide surface that can be used with this embodiment.
[0050] FIG. 26 is a side view for describing another mode of the
guide surface that can be used with this embodiment.
[0051] FIG. 27 is an enlarged side view of the tip part of the
plunger used with the intraocular lens insertion device as a third
embodiment of the present invention.
[0052] FIG. 28 is a side view for describing another mode of the
step surface that can be used with this embodiment.
[0053] FIG. 29 is an enlarged side view of the tip part of the
plunger used with the intraocular lens insertion device as a fourth
embodiment of the present invention.
[0054] FIG. 30 is a side view for describing another mode of the
projection end surface that can be used with this embodiment.
[0055] FIG. 31 is an enlarged side view of the tip part of the
plunger used with the intraocular lens insertion device as a fifth
embodiment of the present invention.
[0056] FIG. 32 is a side view for describing another mode of the
projection end surface that can be used with this embodiment.
[0057] FIG. 33 is an enlarged side view of the tip part of the
plunger used with the intraocular lens insertion device as a sixth
embodiment of the present invention.
[0058] FIG. 34 is a side view for describing another mode of the
projection end surface that can be used with this embodiment.
[0059] FIG. 35 is an enlarged side view of the tip part of the
plunger used with the intraocular lens insertion device as a
seventh embodiment of the present invention.
[0060] FIG. 36 is a side view for describing another mode of the
projection end surface that can be used with this embodiment.
EMBODIMENTS FOR CARRYING OUT THE INVENTION
[0061] Embodiments of the present invention will be explained below
with reference to attached drawings.
[0062] FIG. 1 and FIG. 2 show an intraocular lens insertion device
10 as a first embodiment of the present invention. The intraocular
lens insertion device 10 is constituted with a plunger 16 attached
inserted in the roughly tube shaped device main unit 14 in which
the intraocular lens 12 described later is set. With the
description below, the leftward direction in FIG. 1 is the forward
axial direction of the intraocular lens insertion device 10, and
the rightward direction in FIG. 1 is the backward axial direction.
Also, the vertical direction of FIG. 2 is used as the height
direction, and also, the vertical direction in FIG. 1 is used as
the width direction.
[0063] In more detail, the intraocular lens 12 is an intraocular
lens 12 that is well know from the past, and as shown in FIG. 3 and
FIG. 4, has a one piece constitution for which the pair of haptics
20a, 20b are formed integrally with the optical portion 18. The
intraocular lens 12 can also have a three piece constitution for
which the haptic formed separately from the optical portion is
attached later to the optical portion.
[0064] The optical portion 18 gives the optical characteristics,
and the item in the drawing which is in a state arranged inside the
crystalline lens capsule has optical portion front surface 22
positioned at the cornea side within the capsule and optical
portion back surface 24 positioned at the vitreous body side being
formed with mutually different curvatures.
[0065] The pair of haptics 20a, 20b project from the outer
periphery part facing opposite in the radial direction of the
optical portion 18, and sandwich the optical portion 18 while
facing the outer peripheral side for which they are roughly facing
opposite to each other. Also, the projecting tip parts of the pair
of haptics 20a, 20b extend curving toward the same direction mutual
to each other in the peripheral direction of the optical portion
18.
[0066] The device main unit 14 in which this kind of intraocular
lens 12 is set is formed by a hard synthetic resin material having
optical transparency, and is equipped with a main unit tube part 28
for which a center hole 26 is formed extending straight in the
axial direction with a roughly rectangular cross section shape. A
stage 30 is provided further in the axial forward direction than
the main unit tube part 28.
[0067] On the stage 30, a concave groove 32 extending in the axis
direction opening upward is formed in a state communicating with
the center hole 26 of the main unit tube part 28. Specifically, the
stage 30 is in a state with one long side part removed at the cross
section of the main unit tube part 28, and is in a form so as to
extend facing the axial direction forward. Then, the bottom surface
of the concave groove 32 is used as a lens placement surface 34,
and this lens placement surface 34 is a flat surface that broadens
in the width dimension that is slightly larger than the outer
radial dimension of the optical portion 18 of the intraocular lens
12. Also, the lens placement surface 34 length dimension (axial
direction dimension) is slightly larger than the maximum length
dimension containing the intraocular lens 12 haptics 20a, 20b (FIG.
3 left and right direction dimensions). By doing this, at roughly
the center part of the lens placement surface 34, the intraocular
lens 12 is made to be placed flat in a free state without touching
both side walls of the concave groove 32. Also, in this placed-flat
state, if an attempt is made to rotate the intraocular lens 12
around the center axis of the optical portion 18, the haptics 20a,
20b touch both side walls of the concave groove 32 and rotation is
prevented.
[0068] Also, on the stage 30, a support member 36 is attached with
the ability to be removed from the outer periphery surface opposite
the lens placement surface 34. The support member 36 is equipped
with a base plate part 38 overlapping at the outer surface of the
bottom wall part of the concave groove 32 forming the lens
placement surface 34 (see FIG. 14), and on this base plate part 38
are formed a plurality of acting projections 40a, 40a, 40b, 40b
which project above the overlapping surface to the bottom wall part
of the concave groove 32. Also, an operating piece 42 which
broadens extending toward the outside opposite to the surface
overlapping on the bottom wall part of the concave groove 32 is
formed as a single unit on the base plate part 38.
[0069] Then, with the support member 36, its base plate part 38 is
attached to the main unit tube part 28 so as to overlap from the
outside in relation to the bottom wall part of the concave groove
32 of the stage 30. Also, a plurality of through holes 44a, 44a,
44b, 44b are formed on the bottom wall part of the stage 30 to
which the support member 36 is attached. Then, the plurality of
acting projections 40a, 40a, 40b, 40b provided projecting on the
support member 36 attached to the main unit tube part 28 project to
the inner surface of the bottom wall part of the stage 30 through
the through holes 44a, 44a, 44b, and 44b.
[0070] The number, shape, and forming position of the acting
projections 40 are not particularly restricted. Preferably, taking
into consideration the shape, size, etc. of the intraocular lens 12
set on the stage 30, setting can be done as appropriate by
supporting the intraocular lens 12 held in a state floating above
from the bottom wall part of the stage 30, and positioning the
intraocular lens 12 within the stage 30, or by preventing
displacement of the plunger 16 in the pushing direction in relation
to the main unit tube part 28. Then, each position and each shape
of the plurality of through holes 44 is set on the stage 30
corresponding to each position and each shape of that plurality of
acting projections 40.
[0071] Specifically with this embodiment, two acting projections
40a, 40a are provided for positioning the intraocular lens 12. The
intraocular lens 12 is made to be positioned by the two positioning
projection parts provided projecting at the projection tip surface
of each acting projection 40a sandwiching the haptics 20a, 20b from
both sides of the peripheral direction of optical portion 18 and
positioning them.
[0072] Also, with the two acting projections 40b, 40b respectively
in a state inserted in through holes 44b, 44b, an engaging claw 41
provided on the side surface is engaged with the lens placement
surface 34. Thus, the support member 36 is attached to the device
main unit 14.
[0073] As a releasable attachment mechanism for stably holding the
support member 36 in an attached state to the main unit tube part
28, in addition to an item that uses the engaging claw 41 provided
on the acting projection 40b, it is also possible to do something
like press fit the acting projection 40 into the through hole 44
and use the frictional force of the two items.
[0074] Meanwhile, a lid unit 48 connected with the stage 30 by a
hinge part 46 is provided at one width direction side of the stage
30 (upward side in FIG. 1), and the upper side opening of the
concave groove 32 is able to be covered by the lid unit 48. On the
lid unit 48, in a state with the upper side opening of the concave
groove 32 covered, a pair of left and right guide plate units 50,
50 are provided extending in the axial direction projecting toward
the lens placement surface 34. Also, on the lid unit 48, between
the pair of left and right guide plate units 50, 50, a center guide
plate unit 52 extending in parallel to the left and right guide
plate units 50, 50 is provided projecting in the same direction as
the left and right guide plate units 50, 50. With this arrangement,
in a state with the lid unit 48 closed, excessive displacement
upward of the intraocular lens 12 is restricted, and it is possible
to smoothly guide the intraocular lens 12 to the nozzle part 56
described later.
[0075] Also, in a state with the lid unit 48 closed, two pressing
parts 54 projecting facing the lens placement surface 34 are
provided on the lid unit 48. These two pressing parts 54, 54 are
each formed as a single unit with the lid unit 48, and they have
the same mutual shape and size.
[0076] The two pressing parts 54, 54 each exhibit a cylinder shape,
and in a state with the lid unit 48 closed, the projection tip
surface is a flat surface that broadens in parallel with the lens
placement surface 34. The projection tip surfaces of the two
pressing parts 54, 54 are at the same height position. The outer
radial dimension of the two pressing parts 54, 54 is greater than
the width dimension of the haptic 20b.
[0077] Also, in a state with the lid unit 48 closed, the two
pressing parts 54, 54 are provided at a position in contact with
the haptic 20b positioned in the backward movement direction of the
intraocular lens 12. In particular with this embodiment, the two
pressing parts 54, 54 are provided so as to be in contact with the
haptic 20b at a position for which the contact position of the
plunger 16 on the haptic 20b is a position for which it is
sandwiched in the groove width direction of the concave groove
32.
[0078] Then, when the lid unit 48 is closed, the two pressing parts
54, 54 press the haptic 20b of the intraocular lens 12 that is
placed flat on the lens placement surface 34 in a free state
against the lens placement surface 34. With this arrangement, the
haptic 20b deforms to the lens placement surface 34 side in
relation to the optical portion 18 compared to when in a free
state. Specifically, by the haptic 20b being pressed by the two
pressing parts 54, 54, compared to when in a free state, it is
displaced in an direction approaching the lens placement surface
34.
[0079] The pressing parts 54 shape and size, forming position,
number installed, and the like are not limited to the mode shown in
the illustrations. For example, it is also possible to have one
pressing part 54 formed only further to one groove width direction
side of the concave groove 32 than the contact position of the
plunger 16 on the haptic 20b, and to have one pressing part 54
formed only at the other groove width direction side.
[0080] Also, from the perspective of ensuring the pressing surface
area in relation to the haptic 20b, the pressing part 54 preferably
has surface contact on the haptic 20b, but it does not absolutely
have to have surface contact. For example, if the pressing part 54
has a tapered shape such as a conical shape, hemispheric shape, or
gabled roof shape, or a shape such as a hipped roof shape, it is
also possible to have point contact or line contact of the pressing
part 54 on the haptic 20b.
[0081] When providing a plurality of pressing parts 54, the shape
and size of each pressing part 54 is set taking into consideration
the contact position on the haptic 20b, and they can be the same or
different from each other. Note that when the projection height of
the plurality of pressing parts 54 are the same, it is possible to
make the haptic 20b pressed on the lens placement surface 34 side
flat by this plurality of pressing parts 54. As is described later,
it becomes easy to enter the haptic 20b at the bottom of the step
surface 86.
[0082] The pressing part 54 does not have to be formed as a single
unit with the lid unit 48. It is of course also possible to form a
pressing part 54 separately from the lid unit 48 and to attach it
to the lid unit 48 later.
[0083] The nozzle part 56 is provided as the insertion tube part
further in the axial forward direction than the stage 30 on the
device main unit 14. As shown in FIGS. 5 to 7, with the nozzle part
56, the sequence from the stage 30 side is the base end part 58,
the middle part 60, and the tip end part 62, and overall this
exhibits an external shape that becomes tapered as it goes from the
base side to the tip side. The base end part 58 and the tip end
part 62 extend straight in the axial direction in a roughly
constant cross section shape. Meanwhile, the middle part 60 is a
tapered shaped gradually contracting cross section part for which
the cross section shape gradually becomes smaller as it goes in the
axial forward direction.
[0084] On the nozzle part 56, a through hole 64 is formed extending
along the entire length in the axial direction in a state
communicating with the concave groove 32, and the width dimension
of the base end side opening part 66 of the through hole 64 is
roughly the same size as the groove width dimension of the concave
groove 32 (width dimension of the lens placement surface 34). Also,
the through hole 64 has a half moon shaped or stacked-rice-cake
shaped opening cross section at the base end side opening part 66,
but the opening cross section is deformed gradually to a roughly
oval shape as it goes to the tip end side opening part 68. By doing
this, with the intraocular lens 12 in a non-deformed free state, it
is difficult to move the middle part 60, and the optical portion 18
is curved and deformed at the stage when delivering to the middle
part 60. As shown in FIG. 7, the through hole 64 of the nozzle part
56 has a horizontally spreading flat cross section shape for which
the vertical direction in FIG. 5 that is the width direction of the
stage 30 is the width direction, and the vertical direction in FIG.
6 is the height direction. Also, its flatness ratio (flatness
degree) is greater at the base end side opening part 66 than the
tip end side opening part 68, and gradually changes at the middle
part 60.
[0085] Also, formed on the through hole 64 are a bottom surface 70
connected without steps from the lens placement surface 34, and a
top surface 72 positioned above the bottom surface 70. On the
bottom surface 70, a tilted surface 74 which gradually rises as it
goes in the axial forward direction is formed extending across the
base end part 58 and the middle part 60. The bottom surface 70 is a
flat surface for both side parts of the axial direction sandwiching
the tilted surface 74. Meanwhile, the top surface 72 is a flat
surface with no steps along the entire length of the axial
direction.
[0086] A pair of guide rails 76, 76 projecting toward the top
surface 72 are formed at the width direction center part of the
bottom surface 70 of the base end part 58. The guide rails 76, 76
are projections extending in a straight line in the axial direction
across a specified dimension, and their tip parts (axial direction
front side end part) are positioned at the tip of the tilted
surface 74 (axial direction front end). Note that the tip parts of
the guide rails 76, 76 are made to be gradually drawn into the
bottom surface 70 as they go toward the tip by rising gradually as
the tilted surface 74 goes in the axial forward direction, and have
the same height position as the bottom surface 70. Meanwhile, the
back end part of the guide rails 76, 76 extend out to the lens
placement surface 34 past the back end of the base end part 58.
This kind of guide rails 76, 76 are formed roughly parallel to each
other separated by a specified distance in the width direction
sandwiching the width direction center of the bottom surface
70.
[0087] On both end parts of the width direction on the top surface
72 of the base end part 58 are respectively formed side rails 78
projecting toward the bottom surface 70. The side rails 78 project
extending in a straight line in the axial direction across a
specified dimension, and the tip parts (axial forward direction
side tip parts) are in roughly the same axial direction position as
the tip parts of the guide rails 76, 76. The tip parts of the side
rails 78 are made to be gradually drawn into the inner surface of
the nozzle part 56 as it goes to the tip part (axial forward
direction), and are made to be equivalent to the inner surface of
the nozzle part 56. Meanwhile, the back end parts of the side rails
78 are positioned at the base end side opening part 66 which
becomes the back end of the base end part 58. This kind of side
rails 78 are formed roughly parallel to each other.
[0088] From the axial backward direction of this kind of device
main unit 14, the plunger 16 is inserted into the center hole 26
and attached to the device main unit 14. The plunger 16, as shown
in FIG. 8 and FIG. 9, exhibits roughly a rod shape, and is equipped
with an acting part 80 positioned at the axial direction front side
and an insertion part 82 positioned further to the axial direction
back side than the acting part 80.
[0089] The acting part 80 has a rod shape extending straight in the
axial direction having a roughly oval shaped fixed cross section
shape, and as shown expanded in FIG. 10 and FIG. 11, its tip part
84 has smaller width direction (vertical direction in FIG. 11)
dimensions than the base end part.
[0090] A step surface 86 is formed as the engaging part expanding
across a specified length in the axial direction on the tip part
84. Thus, on the tip part 84, an optical portion pressing surface
88 is formed on the height direction top side (open side of the
concave groove 32) sandwiching the step surface 86, and also, a
haptic pressing surface 90 is formed on the height direction bottom
side (bottom side of the concave groove 32, specifically, the lens
placement surface 34 side). The optical portion pressing surface 88
is positioned further in the axial forward direction of the plunger
16 than the haptic pressing surface 90.
[0091] As long as the step surface 86 axial direction dimension
(depth dimension) is of a size for which it can engage with the
haptic 20b, it is not particularly limited, but it is preferable to
be larger than half the width dimension of the haptic 20b. As is
described later, it is possible to realize stable holding down of
the haptic 20b by the step surface 86.
[0092] As long as the height direction dimension of the haptic
pressing surface 90 is of a size for which it can engage with the
haptic 20b, it is not particularly limited, but it is preferable
that it be larger than the height dimension (thickness dimension)
of the haptic 20b. This makes it possible to realize stable holding
down of the haptic 20b by the haptic pressing surface 90.
[0093] Note that thin plate shaped reinforcing ribs 92 are provided
on both width direction sides of the acting part 80, ensuring the
strength of the acting part 80.
[0094] Meanwhile, the insertion part 82 has a rod shape that
extends straight with an overall letter H cross section, and at its
back end, formed as a single unit broadening in the axis right
angle direction is a pressing plate 94 which adds pushing force
when pushing the plunger 16.
[0095] This kind of plunger 16 is attached to the device main unit
14 by being inserted in the main unit tube part 28 from the acting
part 80 side. Accordingly, the intraocular lens insertion device 10
is obtained. When attaching the plunger 16 to the device main unit
14, the initial position of the plunger 16 in relation to the
device main unit 14 is set by the engaging claw 96 provided on the
insertion part 82 being engaged with the engaging hole 98 formed on
the main unit tube part 28. This plunger 16 is prevented from being
extracted from the main unit tube part 28 by the engaging action of
the engaging claw 96 in the engaging hole 98, and the pushing
direction to the main unit tube part 28 can be displaced using a
specified resistance force.
[0096] Also, the intraocular lens 12 is set in the intraocular lens
insertion device 10 for which the plunger 16 is attached at the
initial position in relation to the device main unit 14 as
described above.
[0097] In specific terms, as shown in FIG. 12, with the device main
unit 14, by housing the intraocular lens 12 in the concave groove
32 of the stage 30 opened with the lid unit 48 open, the
intraocular lens 12 is arranged in the stage 30. In particular with
this embodiment, the intraocular lens 12 is housed in the concave
groove 32 with the optical portion back surface 24 on the bottom
side, and it is positioned and set by the acting projections 40a,
40a of the support member 36 attached to the stage 30. In this
state, the center part of the optical portion back surface 24 of
the intraocular lens 12 is placed after making contact with the
guide rails 76, 76.
[0098] The base end parts of the haptics 20a, 20b of the
intraocular lens 12 are placed on the top end surface of the two
acting projections 40a, 40a, essentially the entire intraocular
lens 12 is brought up from the bottom surface of the concave groove
32, and can be set in a state for which action on the optical
portion 18 by the contact stress on the bottom surface is avoided
as much as possible.
[0099] Also, the intraocular lens 12 positioned by the two acting
projections 40a, 40a is held in a free state with acting stress and
distortion reduced on the optical portion 18, and the pair of
haptics 20a, 20b extend out toward both sides in the axial
direction of the device main unit 14 (forward-backward direction).
Also, the haptic 20b positioned further to the axial backward
direction than the optical portion 18 is positioned slightly
separated forward in the extrusion direction from the optical
portion pressing surface 88 of the plunger 16 in its initial
position.
[0100] By overlapping the step surface 86 provided on the tip part
84 of the plunger 16 from the top side on the haptic 20b, it is
possible to press the haptic 20b on the lens placement surface 34
side, and to displace the haptic 20b approaching toward the lens
placement surface 34. In this case, it is not necessary to provide
pressing parts 54 on the lid unit 48.
[0101] As described above, after housing the intraocular lens 12
inside the concave groove 32 of the stage 30 in this way, by
closing the lid unit 48, the top side opening of the concave groove
32 is covered by the lid unit 48. By doing this, as shown in FIGS.
13 to 15, the intraocular lens 12 is set in a state housed within
the device main unit 14. With the lid unit 48 in a closed state,
the engaging piece 100 provided on the lid unit 48 is engaged with
the engaging notch 102 provided on the stage 30, and the closed
state of the lid unit 48 is maintained.
[0102] Also, in a state with the lid unit 48 closed, as shown in
FIG. 13, one pressing part 54 is in contact more to the base end
side than the contact position of the plunger 16 on the haptic 20b,
and further to the extension end side than the position positioned
by the acting projection 40a, and also the other pressing part 54
is in contact further to the extension end side than the contact
position of the plunger 16 on the haptic 20b. Thus, as shown in
FIG. 16, the contact position of the plunger 16 on the haptic 20b
is positioned further to the bottom side in the height direction
than the step surface 86 formed on the plunger 16.
[0103] The plunger 16 can also be inserted in the device main unit
14 and set at the initial position before the intraocular lens 12
is housed inside the concave groove 32 of the stage 30, but it is
also possible to insert the plunger 16 in the device main unit 14
after the intraocular lens 12 is housed inside the concave groove
32, or furthermore after the lid unit 48 is closed.
[0104] After that, the intraocular lens insertion device 10 in
which the intraocular lens 12 is set is provided housed and shipped
packed in an airtight case or the like. At that time, suitable
disinfection or the like is implemented with the processes before
or after packing in an airtight case, or with both processes before
and after packing.
[0105] Incidentally, when inserting the intraocular lens 12 into
the eye using the intraocular lens insertion device 10 provided in
this way, first, with the intraocular lens insertion device 10
taken out from the packaging at the surgery location, the support
member 36 is drawn to under the stage 30, and removed from the
device main unit 14. Therefore, the positioning of the intraocular
lens 12 by the plurality of acting projections 40a, 40a formed on
the support member 36 is cancelled, and it is possible to move the
intraocular lens 12 above the lens placement surface 34 of the
stage 30.
[0106] A suitable lubricating agent may be injected into the
interior of the stage 30 or the nozzle part 56 through an injection
hole 104 formed on the lid unit 48. Thus, before extrusion using
the plunger 16, it is possible to have the intraocular lens 12
float above from the guide rails 76, 76. As a result, as will be
described later, it becomes easier to enter the haptic 20b to the
inside of the optical portion 18 which has been curved and deformed
to a mountain fold state, or to enter the haptic 20b below the
optical portion 18 before being curved and deformed to a mountain
fold state.
[0107] When the support member 36 is removed from the device main
unit 14, the tip end side opening part 68 of the nozzle part 56 is
inserted in the incision provided in the ocular tissue. Then, while
maintaining the insertion state of the nozzle part 56 in the
incision, the plunger 16 is pushed into the device main unit
14.
[0108] At that time, the contact site of the plunger 16 on the
haptic 20b is positioned further to the lens placement surface 34
side than the step surface 86 formed on the plunger 16, so when the
plunger 16 is pushed into the device main unit 14, as shown in FIG.
17, the haptic 20b positioned in the intraocular lens 12 backward
axial direction (backward movement direction) enters the bottom
side of the step surface 86 formed on the plunger 16, and contacts
the haptic pressing surface 90. As a result, as shown in FIG. 18,
by the haptic 20b being pressed to the optical portion 18 side by
the haptic pressing surface 90, it is curved and deformed in the
direction approaching the optical portion 18.
[0109] When the haptic 20b is curved and deformed to the optical
portion 18 side to the point that the optical portion 18 is in
contact with the outer peripheral surface, the pressing force from
the plunger 16 is transmitted via the haptic 20b to the optical
portion 18. As a result, the overall intraocular lens 12 is moved
toward the nozzle part 56 while being pressed by the plunger
16.
[0110] In a state with the haptic 20b in contact with the haptic
pressing surface 90, when the optical portion pressing surface 88
is positioned further in the forward movement direction than the
haptic 20b, by the optical portion pressing surface 88 of the
plunger 16 contacting the outer peripheral surface of the optical
portion 18, the pressing force of the plunger 16 is directly
transmitted to the optical portion 18. At that time, it is
acceptable to have the haptic 20b either contact or not contact the
outer peripheral surface of the optical portion 18.
[0111] For some time after the haptic 20b is pressed by the haptic
pressing surface 90, the pressing parts 54, 54 push the haptic 20b
to the lens placement surface 34 side. Therefore, when the haptic
20b starts being pressed by the haptic pressing surface 90, a gap
is formed between the haptic 20b and the step surface 86.
[0112] When the haptic 20b that moves while being pressed by the
plunger 16 is removed from the position at which it is held down by
the pressing parts 54, 54, it is displaced to the height direction
upper side (open side of the concave groove 32) by its own
elasticity. At that time, the step surface 86 is positioned above
the haptic 20b, so the haptic 20b contacts the step surface 86.
Therefore, when the haptic 20b is pressed by the haptic pressing
surface 90, displacement upward in the height direction is
prevented by the step surface 86.
[0113] As shown in FIG. 19A, with the intraocular lens 12 delivered
to the base end part 58, the center part of the optical portion
back surface 24 is in contact with the guide rails 76, 76, and the
side rails 78, 78 are in contact with both side end parts in the
direction orthogonal to the extrusion direction at the optical
portion front surface 22. While external force toward the top
surface 72 is applied to the center part of the optical portion
back surface 24, external force toward the bottom surface 70 is
applied to both side end parts in the direction orthogonal to the
extrusion direction at the optical portion front surface 22. As a
result, with the optical portion 18 of the intraocular lens 12, the
optical portion front surface 22 becomes convex facing the top
surface 72 which is positioned at the top side of the vertical
direction, and also a ridge line is deformed to a mountain fold
extending in the movement direction of the intraocular lens 12.
Note that with FIG. 19, the state of the optical portion 18 of the
intraocular lens 12 being deformed to a mountain fold is
illustrated as a model, and an illustration of the haptics 20a, 20b
has been omitted.
[0114] As shown in FIG. 19B, while the intraocular lens 12 for
which the initial mountain fold state deformation was applied with
the base end part 58 is deformed to be smaller through the middle
part 60, it is sent toward the tip end side opening part 68 of the
nozzle part 56. At that time, the optical portion 18 is deformed
along the internal surface shape of the through hole 64, the
mountain fold state advances even further, and the optical portion
front surface 22 is rounded in a state contacting the top surface
72. Then, as shown in FIG. 19C, the optical portion 18 is rounded
to be small in a roughly oval shape at the tip end part 62 of the
nozzle part 56 by the through hole 64 which is gradually made into
roughly an oval shape as it goes to the tip end part 62.
[0115] Specifically, with this embodiment, a deformation guide
member is constituted including a pair of guide rails 76, 76, a
pair of side rails 78, 78, and a specially shaped through hole 64
formed on the nozzle part 56, and the deformation guide part is
constituted by the pair of guide rails 76, 76 and the pair of side
rails 78, 78.
[0116] Also, as described above, when the optical portion 18 starts
to be deformed to a mountain fold state, a space (gap) appears
formed on the optical portion back surface 24 side (concave side)
of the optical portion 18 deformed to a mountain fold state at the
forward extrusion direction of the plunger 16. When the deformation
volume of the optical portion 18 becomes large, as shown as a model
in FIG. 20, the haptic 20b engaged with the tip part 84 of the
plunger 16 enters the inside (concave side) of the optical portion
18 deformed to a mountain fold state. As a result, the haptic 20b
is protected so as to be wrapped by the optical portion 18. Then,
the intraocular lens 12 moves within the nozzle part 56 with the
haptic 20b wrapped by the optical portion 18 in this way.
[0117] Note that the entry of the haptic 20b to the optical portion
back surface 24 side of the optical portion 18 is not limited to
when the optical portion 18 is deformed to the mountain fold state.
For example, it is also possible to have the haptic 20b enter the
optical portion back surface 24 side before the optical portion 18
is deformed to the mountain fold state by using the float up volume
of the optical portion 18 guide rails 76, 76 or the push-in volume
of the haptic 20b by the pressing parts 54, 54 before the plunger
16 pushes the haptic 20b.
[0118] Also, the haptic 20a positioned at the front of the
intraocular lens 12 extrusion direction is entered into the
interior of the rounded optical portion 18 along with rounding of
the optical portion 18 according to the through hole 64 inner
surface shape. Thus, as shown in FIG. 20, a tucking state is
manifested on the intraocular lens 12 inside the through hole
64.
[0119] Then, in a state with the haptics 20a, 20b entered into the
inside (concave side) of the curved and deformed optical portion
18, the intraocular lens 12 is extruded from the tip end side
opening part 68 of the nozzle part 56 and inserted into the
eye.
[0120] As described above, with the intraocular lens insertion
device 10, in a state sliding under the step surface 86 formed on
the plunger 16, the haptic 20b is made to be pushed to the optical
portion 18, so it is possible to inhibit displacement of the haptic
20b in the direction for which the optical portion 18 is convex
(concave groove 32 opening side). As a result, when the optical
portion 18 goes to a mountain fold state, it is possible to enter
the haptic 20b into the optical portion 18 concave side
(inside).
[0121] In particular, with the lid unit 48 in a closed state, the
haptic 20b is pushed to the lens placement surface 34 side by the
two pressing parts 54, 54, so before the start of extrusion of the
intraocular lens 12 by the plunger 16, it is possible to position
the haptic 20b further to the lens placement surface 34 side than
the step surface 86. Therefore, when extrusion of the intraocular
lens 12 by the plunger 16 starts, it is possible for the haptic 20b
to reliably slide under the step surface 86. As a result, it is
possible to effectively suppress the upward displacement of the
haptic 20b.
[0122] Also, when the intraocular lens 12 is extruded by the
plunger 16, the optical portion 18 is curved and deformed to a
mountain fold state, so it is not necessary to curve and deform the
optical portion 18 to a mountain fold state in advance and set the
intraocular lens 12 in the stage 30. Thus, the work of setting the
intraocular lens 12 in the stage 30 is easier.
[0123] Also, compared to a three-piece structure intraocular lens,
the intraocular lens 12 has a one-piece structure for which the
haptic 20a, 20b volume is large, but the haptic 20b is made to be
entered in a relatively large gap formed in the concave side
(inside) of the optical portion 18 deformed to a mountain fold
state. As a result, even with a one-piece structure intraocular
lens 12, it is possible to sufficiently ensure space for the haptic
20b to escape.
[0124] Also, compared to a three-piece structure intraocular lens,
the intraocular lens 12 has a one piece structure for which the
haptics 20a, 20b have low rigidity, but since this is protected so
as to have the optical portion 18 wrap the haptic 20b with the
haptic 20b deformed to a mountain fold state, it is possible to
effectively avoid damage to the haptic 20b.
[0125] The deformation guide member is not limited to a
constitution consisting of a pair each of the guide rails 76, 76,
side rails 78, 78, and the through hole 64 shown with this
embodiment. For example, even with a through hole 64 not equipped
with the guide rail 76 or side rail 78, by suitably setting the
change mode of the cross section shape, extrusion direction or the
like, it is also possible to constitute a deformation guide member
which folds and deforms the intraocular lens 12 into a mountain
shape, and it is possible to constitute a deformation guide member
by partially forming convex parts or concave parts inside the
through hole 64 or the like.
[0126] Also, the deformation guide member can be not only the item
for which the optical portion 18 is deformed into a mountain folded
state as described above, but can also be an item for which the
optical portion 18 is deformed to a valley fold state for which a
valley line for which the optical portion back surface 24 is made
convex toward the bottom surface 70 positioned at the bottom of the
height direction extends in the intraocular lens 12 moving
direction. As a deformation guide member that realizes a valley
fold state, for example as shown in FIG. 21, it is possible to use
a through hole of a cross section shape for which the through hole
64 of the aforementioned embodiment is vertically inverted, or the
like.
[0127] When using this deformation guide member, if the pressing
part 54 is provided, as shown in FIG. 22, the pressing part 54 is
provided projecting on the lens placement surface 34. The haptic
20b is pressed upward in the height direction (concave groove 32
opening side), and it is possible to displace the haptic 20b to the
top side before extrusion by the plunger 16. To make relative
displacement of the haptic 20b to the top side in relation to the
optical portion 18 easier, it is also possible to push the optical
portion 18 to the lens placement surface 34 side using left and
right guide plate units 50, 50 or the center guide plate unit 52.
As the plunger, it is possible to use an item equipped with a tip
part of a shape for which the tip part 84 of the aforementioned
embodiment is inverted vertically.
[0128] If a deformation guide member that realizes the valley fold
state of the optical portion 18 is used, the pressing part 54 can
also be provided projecting to the base plate part 38 of the
support member 36. In this case, an insertion through hole in which
the pressing part 54 is inserted is formed on the bottom wall of
the concave groove 32, and in a state with the support member 36
attached to the device main unit 14, it is possible to use a method
for which the pressing part 54 inserted through the insertion
through hole is projected on the lens placement surface 34.
[0129] Even in a case of using a deformation guide member that
realizes a valley fold state of the optical portion 18, the
pressing part 54 is not absolutely necessary. It is also possible
to place the haptic 20b on the step surface 86 formed on the tip
part 84 of the plunger 16, and to lift the haptic 20b to the top
side.
[0130] It is also possible to curve and deform the optical portion
18 so as to be convex in the concave groove 32 horizontal width
direction outward direction (specifically, leftward or rightward in
FIG. 14), using the ridge line extending in parallel with the
center axis line of the device main unit 14. In this case, as the
deformation guide member, it is possible to use a through hole or
the like having a cross section shape such as the through hole 64
of the aforementioned embodiment rotated 90 degrees around the
center axis of the device main unit 14. The intraocular lens 12 is
set in the stage 30 with the concave groove 32 placed vertically
and in a state with the optical portion front surface 22 or the
optical portion back surface 24 in a state facing in the outward
horizontal width direction of the concave groove 32. For the
plunger, it is possible to use an item equipped with a tip part
such as with the tip part 84 of the aforementioned embodiment
rotated 90 degrees around the center axis. By doing this,
displacement of the haptic 20b in the direction for which the
optical portion 18 becomes convex is suppressed, and the same as
with the aforementioned embodiment, it is possible to enter the
haptic 20b in the concave side (inside) of the optical portion
18.
[0131] Next, we will describe the intraocular lens insertion device
of another embodiment of the present invention. Each of the second
through fifth embodiments noted below show examples of another mode
of the plunger used with the intraocular lens insertion device of
the first embodiment. With each of these embodiments, only the part
that is different from the first embodiment is described, and for
members and parts having the same constitution as those of the
first embodiment, we will describe them using the same code numbers
as with the first embodiment.
[0132] FIG. 23 shows the plunger 106 that constitutes the second
embodiment of the present invention. This plunger 106 has guide
surfaces 108a, 108b that curve in an arc shape with a side surface
view (axial right angle direction view corresponding to FIG. 10 of
the first embodiment) at the respective boundary part of the step
surface 86 and the optical portion pressing surface 88 and the
boundary part of the step surface 86 and the haptic pressing
surface 90. Note that while the forward guide surface 108a is a 1/4
circumference arc cross section which is convex outward, the back
guide surface 108b is a 1/4 circumference arc cross section which
is concave outward.
[0133] With an intraocular lens insertion device equipped with this
kind of plunger 106, before extrusion of the intraocular lens 12 by
the plunger 106, even if the haptic 20b is further to the top side
than the step surface 86, the haptic 20b is guided toward the
engaging part by the guide surface 108a. Specifically, the plunger
106 advances forward, and if the haptic 20b makes contact with the
forward guide surface 108a, by the haptic 20b sliding on the guide
surface 108a, the haptic 20b moves to below the step surface 86. By
doing this, it is possible to inhibit displacement of the haptic
20b upward.
[0134] Also, when the plunger 106 extrudes the intraocular lens 12,
after the haptic 20b slides on the step surface 86, by sliding on
the back guide surface 108b, the haptic 20b contacts the haptic
pressing surface 90 at a position separated downward from the step
surface 86. By doing this, it is possible to push the haptic 20b in
a state further approaching the lens placement surface 34. As a
result, it is even easier to enter the haptic 20b to the optical
portion back surface 24 side of the optical portion 18.
[0135] It is not necessary to form the guide surfaces 108a, 108b
both at the front end and the back end of the step surface 86. For
example, as shown in FIG. 24, it is also possible to form only the
forward guide surface 108a. In this case, the pressing part 54 of
the first embodiment is not provided, and even if the haptic 20b is
not displaced approaching the lens placement surface 34 side in
advance, entering the haptic 20b to below the step surface 86 is
easy.
[0136] Also, as shown in FIG. 25, it is possible to form only the
back guide surface 108b. In this case, it is possible to have the
haptic 20b even further approach the lens placement surface 34, so
even in a case when there is not sufficient floating of the optical
portion 18 from the lens placement surface 34 based on the buoyancy
due to the lubricant injected from the injection hole 104, or a
case when the haptic 20b is not sufficiently pushed by the pressing
part 54 or the like, it is easy to have the haptic 20b entered into
the optical portion back surface 24 side of the optical portion
18.
[0137] Also, as long as the guide surfaces 108a, 108b are items for
which it is possible to induct the haptic 20b, it is not necessary
to curve in an arc shape with the side view as shown in FIG. 23.
For example, as shown in FIG. 26, it is also possible to use a
tilted surface facing downward gradually in the drawing as it goes
in the backward axial direction as the guide surfaces 108a,
108b.
[0138] Next, FIG. 27 shows a plunger 110 constituting the third
embodiment of the present invention. With this plunger 110, a
gradual tilt is given at the step surface 86 facing the height
direction downward as it goes to the back from the axial forward
direction.
[0139] With an intraocular lens insertion device equipped with this
kind of plunger 110, when the intraocular lens 12 is extruded by
the plunger 110, by part of the extrusion force acting on the
haptic 20b, the haptic 20b slides on the step surface 86 and
approaches the lens placement surface 34. Therefore, the haptic 20b
is more reliably entered to the optical portion back surface 24
side of the optical portion 18.
[0140] The step surface 86 having the guide function as described
above is not limited to the item noted in FIG. 27. For example, as
shown in FIG. 28, it is also possible to be a step surface 86
curved in an arc shape with a side view.
[0141] Furthermore, FIG. 29 shows a plunger 112 constituting the
fourth embodiment of the present invention. This plunger 112 has a
tilt given to the optical portion pressing surface 88 gradually
facing downward as it goes in the backward axial direction.
[0142] With an intraocular lens insertion device equipped with this
kind of plunger 112, even if the haptic 20b is not positioned
further to the lens placement surface 34 side than the step surface
86 in advance, by the haptic 20b in contact with the optical
portion pressing surface 88 sliding on the optical portion pressing
surface 88 and displaced downward based on the partial force action
of the contact force, the haptic 20b is entered at the bottom of
the step surface 86.
[0143] The optical portion pressing surface 88 having the guide
function as described above is not limited to the items shown in
FIG. 29. For example, as shown in FIG. 30, it is also possible to
be an optical portion pressing surface 88 that curves in an arc
shape with a side view.
[0144] Also, FIG. 31 shows a plunger 114 constituting the fifth
embodiment of the present invention. This plunger 114 has a guide
surface 116 curved in an arc shape which is convex outward with a
side view formed at the forward top end part of the tip part 84. As
shown in FIG. 32, this guide surface 116 can also be a tilted
surface of a chamfered shape tilted gradually upward as it goes
from front to back with a side view.
[0145] By using a plunger 114 for which this kind of guide surface
116 is formed, catching is prevented when doing a push operation of
the plunger 114 in relation to the intraocular lens insertion
device, and it is possible to extrude the intraocular lens more
smoothly.
[0146] Furthermore, in FIG. 33, a plunger 118 constituting the
sixth embodiment of the present invention is shown. This plunger
118 has the engaging projecting part 120 formed as a single unit as
the engaging part projecting in the forward axial direction of
plunger 118 in the area of roughly half the top side in the height
direction of the tip part 84.
[0147] The engaging projecting part 120 has a roughly right
triangle shape with a side view, and the side surface 122 as an
optical portion pressing surface constituting the oblique side from
the side view is a tilted surface as it gradually moves downward
from front to back. Then, this side surface 122 constitutes a tip
surface in the area of roughly half the top side in the height
direction of the tip part 84 of the plunger 118. The area that is
roughly the bottom half of the height direction of the tip part 84
of the plunger 118, the same as with the first embodiment, is the
haptic pressing surface 90 having a plane shape that broadens in
the axial right angle direction of the plunger 118.
[0148] With an intraocular lens insertion device equipped with this
kind of plunger 118, when the intraocular lens 12 is extruded using
the plunger 118, the haptic 20b in contact with the side surface
122 of the engaging projecting part 120 slides downward on the side
surface 122 by the action of the partial contact force to cause
displacement. Thus, the haptic 20b moves to the lens placement
surface 34 side. As a result, the haptic 20b more easily enters the
inside (concave side) of the curved and deformed optical portion
18.
[0149] The side surface 122 of the engaging projecting part 120
having the guide function as described above is not limited to the
item shown in FIG. 33. For example, as shown in FIG. 34, it is also
possible to have an item curved in an arc shape that is concave
outward with a side view.
[0150] Also, FIG. 35 shows a plunger 124 constituting the seventh
embodiment of the present invention. This plunger 124 is a tilted
surface that gradually faces downward as the tip surface 126 as an
optical portion pressing surface (upper part thereof) and a haptic
pressing surface (lower part thereof) goes from front to back
across the overall tip part 84. Also, the engaging part is
constituted by this tip surface 126.
[0151] With the an intraocular lens insertion device equipped with
this kind of plunger 124, when the intraocular lens 12 is extruded
using the plunger 124, the haptic 20b in contact with the tip
surface 126 slides in the downward direction on the tip surface 126
by the action of the partial contact force and is displaced. The
haptic 20b moves to the lens placement surface 34 side. As a
result, it is easier for the haptic 20b to enter the inside
(concave side) of the curved and deformed optical portion 18.
[0152] The tip surface 126 of the tip part 84 having the guide
function as described above is not limited to the item shown in
FIG. 35. For example, as shown in FIG. 36, the tip surface 126 of
the tip part 84 can also have a shape curved in an arc with a side
view.
[0153] While the embodiments of the present invention has been
described in detail, the present invention is not limited to those
specific notations.
[0154] For example, with the aforementioned embodiments, the
support member 36 was removably attached to the stage 30 of the
device main unit 14, and with the acting projections 40a, 40a, 40b,
40b of this support member 36, the intraocular lens 12 was lifted
up and set in a state avoiding contact with the optical portion 18
as much as possible, but this kind of support member 36 is not
essential for the present invention. In specific terms, it is also
possible to directly place and set the intraocular lens 12 on the
lens placement surface 34 of the stage 30 without providing the
through holes 44a, 44a, 44b, 44b on the stage 30 of the device main
unit 14, and without using the support member 36.
[0155] Also, when not using this support member 36, rather than
providing the intraocular lens 12 in a state set in advance and
wrapped, it is preferable to provide the intraocular lens 12
wrapped separately from the intraocular lens insertion device 10
and to unwrap it when doing a procedure, and to house and set it on
the lens placement surface 34 of the stage 30 of intraocular lens
insertion device 10. This makes it possible to avoid problems due
to direct contact stress being applied over a long time with the
storage and distribution processes for the lens placement surface
34 in relation to the optical portion 18 of the intraocular lens
12.
[0156] Even when using the support member 36, for example when
contacting the optical portion 18 of the intraocular lens 12 or the
middle part or tip part of the extension direction of the haptics
20a, 20b or the like, it is possible to form acting projection
parts at positions supporting those or the like.
[0157] The shape and configuration of the device main unit 14 stage
30 or insertion tube part (nozzle parts 56) or the like that
determine the variation modes of the intraocular lens optical
portion are items suitably set according to the deformation target
shape when inserting the intraocular lens into the eye, and for
example including whether or not the guide rails 76, 76 or the side
rails 78, 78 or the like are used, is not limited to the items
noted in the embodiments. Specifically, the mode of deforming the
intraocular lens to be small when inserting it is not limited to
the mountain fold state or valley fold state as described
previously, and there are many varieties as is well known in the
prior art, and in specific terms, can be used with a variation such
as being rolled up round or the like, and the various constitutions
of the known prior art can be used for the intraocular lens
insertion device of the present invention according to the target
variation shape.
[0158] Also, with the aforementioned embodiments, the intraocular
lens 12 was placed flat on the lens placement surface 34 in a free
state, but when setting the intraocular lens 12 in the stage 30, it
is also possible to have the optical portion 18 in a mountain fold
state with a ridge line extending in the axial direction of the
device main unit 14 or a valley fold state with a valley line
extending in the axial direction of the device main unit 14. As a
method of setting the optical portion 18 to a mountain fold state
or valley fold state in advance, for example, it is possible to use
one whereby the groove width dimension of the concave groove 32
formed on the stage 30 is made small or the like.
KEYS TO SYMBOLS
[0159] 10: Intraocular lens insertion device, 12: Intraocular lens,
14: Device main unit, 16: Plunger, 18: Optical portion, 20a:
Haptic, 20b: Haptic, 30: Stage, 54: Pressing part, 56: Nozzle part
(insertion tube part), 64: Through hole (deformation guide member),
76: Guide rail (deformation guide member, deformation guide part),
78: Side rail (deformation guide member, deformation guide part),
86: Step surface (engaging part)
* * * * *