Guiding the Treatment of Anterior Eye Disease with Optical Coherence Tomography

光学相干断层扫描指导眼前部疾病的治疗

• 批准号: 8531251
• 负责人: David Huang
• 金额: $ 69.59万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531251
• 关键词: 3-Dimensional; Ablation; Accounting; Anterior; Astigmatism; Back; Beds; Cadaver; Cataract; Cataract Extraction; Cicatrix; Clinical Trials; Collaborations; Computer Simulation; Computer software; Cornea; Corneal Diseases; Corneal Opacity; Corneal dystrophy; Crystalline Lens; Data; Disease; Dissection; Effectiveness; Eye; Eye Movements; Eye Part; Eye diseases; Fuchs' Endothelial Dystrophy; Generations; Goals; Graft Rejection; Grant; Image; Imaging technology; Implant; Intraocular lens implant device; Keratoconus; Keratoplasty; Lamellar Keratoplasty; Laser In Situ Keratomileusis; Lasers; Left; Location; Manuals; Maps; Measurement; Measures; Methods; Motion; Observational Study; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Patients; Performance; Photorefractive Keratectomy; Positioning Attribute; Pupil; Resolution; Risk; Safety; Scanning; Shapes; Source; Speed; Surface; Surgeon; System; Techniques; Testing; Thick; Time; Tongue; Transplantation; United States National Institutes of Health; Videokeratographies; Vision; Visual; base; clinical application; clinically significant; corneal scar; imaging modality; improved; instrument; lens; next generation; prototype; research study; software development; tool; wound

PROJECT SUMMARY Optical coherence tomography (OCT) is a cross-sectional and 3-dimensional (3-D) imaging technology with very fine spatial resolution (5 ¿m). This project develops the methods and software needed for high-precision OCT measurements of the eye to guide implant, laser, and transplant surgeries in the front part of the eye. In the proposed continuation of the project, a new generation of OCT that has very high speed (about 10 times faster than before, taking an image in as little as 2/1000 of a second) and extended range will enable new types of measurements to be done accurately. The Specific Aims are as follows: (1) To develop ultrahigh-speed OCT hardware and software for measuring optical surfaces of the anterior eye. Intrinsic eye movements effectively limit measurement of corneal shape by commercial OCT. This will be overcome by several approaches, including ultrahigh-speed OCT at 500 kHz, dual-beam OCT to simultaneously capture the shape of both the cornea and lens, simultaneous capture of Placido-ring videokeratography, and motion correction software. The goal is to provide reliable measurements on front and back surfaces of both the cornea and crystalline lens. (2) To develop an OCT-based intraocular lens power formula. Currently, surgeons lack an accurate way to calculate precise intraocular lens (IOL) power for cataract patients who previously had laser vision correction. These patients may be left near- or far-sighted after cataract surgery. An OCT-based IOL formula, using measurements of both anterior and posterior corneal powers, can give surgeons more precise information that will significantly improve visual outcomes. The OCT-based IOL formula will be tested in a clinical trial. (3) To develop OCT-guided excimer laser surface ablation. The excimer laser can remove cloudy layers from the front of the cornea and correct distorted shape due to keratoconus or transplant surgery. We have developed 3-D OCT-based planning to optimally remove cloudiness due to corneal scars and stromal dystrophies. This method will be tested in a larger clinical trial. We will improve the method by adding 3-D OCT measurement of corneal shape (topography) to plan the correction of any shape distortion. (4) To develop OCT-guided laser-assisted anterior and posterior lamellar keratoplasty. Most corneal diseases involve only the inner or outer layer of the cornea. Thus a partial thickness transplant can treat these diseases while avoiding the complications of full-thickness transplantations (rejection, irregular wound shape, etc). However, manual dissection of corneal layers is technically difficult and vision after surgery is limited by the rough interfaces. We have developed OCT methods to guide the shaping and smoothing of donor and host corneas with a combination of excimer laser to create smooth interfaces and femtosecond laser to create tongue-in-groove edge fits. Pilot clinical trials of these techniques are proposed. The goal is to develop surgeries that reliably improve the vision in patients with keratoconus, corneal dystrophies, and deep scars.

项目摘要 光学相干断层扫描（OCT）是一种横截面和3维（3-D）成像技术 非常精细的空间分辨率（5€M）。该项目开发了高精度所需的方法和软件 眼睛的OCT测量以指导眼前部分的植入物，激光和移植手术。在 该项目的拟议延续是新一代的OCT，它具有很高的速度（大约10次 比以前快，在几秒钟的2/1000中拍摄图像）和扩展范围将启用新的 要准确完成的测量类型。具体目的如下： （1）开发超高速度OCT硬件和软件，以测量前面的光学表面 眼睛。固有的眼动运动可以通过商业OCT有效地限制角膜形状的测量。这将是 克服多种方法，包括500 kHz的超高速度OCT，双光束OCT至 同时捕获角膜和镜头的形状，同时捕获Placido-Ring 视频观念和运动校正软件。目的是在正面和 角膜和结晶镜的背面。 （2）开发基于OCT的人眼镜内功率公式。目前，外科医生缺乏准确的方法 为先前具有激光视力校正的白内障患者计算精确的眼内透镜（IOL）功率。 白内障手术后，这些患者可能会近似或远见。一个基于OCT的IOL公式，使用 前角膜和后角膜力量的测量可以为外科医生提供更精确的信息 将显着改善视觉结果。基于OCT的IOL公式将在临床试验中进行测试。 （3）开发OCT引导的准分子激光表面消融。准分子激光器可以删除多云的层 从角膜的前部，由于角膜核或移植手术而导致的扭曲形状。我们有 开发了基于3-D OCT的计划，可最佳地消除因角膜疤痕和基质而导致的云彩 营养不良。该方法将在更大的临床试验中进行测试。我们将通过添加3-D OCT来改进方法 测量角膜形状（地形）以计划校正任何形状失真。 （4）发展OCT引导激光辅助前后和后层角膜成形术。最角膜 疾病仅涉及角膜的内层或外层。部分厚度移植可以治疗这些 疾病同时避免了全厚性移植的并发症（排斥，不规则伤口形状， ETC）。但是，角膜层的手动解剖在技术上很困难，手术后视力受到限制 粗糙的接口。我们开发了OCT方法来指导供体和主机的塑造和平滑 角膜与准分子激光的组合，以创建光滑的接口和飞秒激光器来创建 齿条边缘的边缘。提出了这些技术的试验临床试验。目标是发展 可靠地改善角膜角膜营养不良和深层疤痕患者视力的手术。