Intraoperative OCT Guidance of Intraocular Surgery

眼内手术术中OCT指导

• 批准号: 9789334
• 负责人: JOSEPH A IZATT
• 金额: $ 76.66万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789334
• 关键词: Achievement; Address; Adopted; Advanced Development; Algorithmic Software; Anatomy; Angiography; Anterior; Archives; Area; Biomedical Engineering; Books; Cataract Extraction; Clinical; Computer software; Cornea; Coupled; Data; Data Display; Decision Making; Depth Perception; Development; Drug Delivery Systems; Engineering; Eye; Eye diseases; Feedback; Funding; Generations; Goals; Head; Human; Image; Image-Guided Surgery; Imagery; Imaging Device; Keratoplasty; Measurement; Methodology; Microscope; Microscopic; Microsurgery; Mission; Modernization; Morbidity - disease rate; Multimodal Imaging; Notification; Operating Rooms; Operative Surgical Procedures; Ophthalmologic Surgical Procedures; Optical Coherence Tomography; Outcome; Patient-Focused Outcomes; Patients; Performance; Publications; Reporting; Research; Resolution; Sampling; Scanning; Speed; Structure; Surgeon; System; Technology; Therapeutic; Time; Tissues; Training; Vendor; Vision; Visual; Work; clinical practice; data visualization; design; ergonomics; experience; eye center; eye preservation; functional outcomes; image guided; imaging modality; improved; improved outcome; innovation; instrument; interest; macula; member; multidisciplinary; new technology; next generation; novel; ocular imaging; operation; pre-clinical; programs; prototype; response; stereoscopic; success; symposium; technology development; tool; virtual reality

PROJECT SUMMARY This is a resubmission application for a Bioengineering Research Partnership (BRP) which brings together a highly collaborative and experienced team of engineers and ophthalmic surgeons to advance the state of the art in image-guided surgical interventions. We seek to overcome limitations to the surgeon’s current stereo microscopic view of ocular structures by continuing to integrate optical coherence tomography (OCT) technology, which is already well accepted in ophthalmic practice, into the operating room. In modern ophthalmic microsurgery, the limited depth perception and capacity for data within oculars, the physically demanding constraints the microscope places on the surgeon, and the inability to distinguish delicate, microscopic tissue structures of subtle contrast limits achievement of surgical endpoints and patient outcomes. Over the past seven years, our team has developed the leading intra-operative OCT program in ophthalmic surgery in the US. Under initial R21 support, our first-generation microscope-integrated OCT (MIOCT) design enabled live cross-sectional imaging during surgery, and is the approach which has been adopted by multiple vendors in current commercial offerings. Our current BRP funded work introduced the first live “4D” (volumetric imaging through time) MIOCT technology which images microsurgery with micrometer-scale resolution at several fully rendered volumes per second, interactively viewable by the surgeon from an arbitrary perspective through a novel stereoscopic heads-up display. We have demonstrated and documented the performance of these systems in over 250 live human eye surgeries at the Duke Eye Center, with innovations and results documented in over 95 publications and presentations resulting from the prior BRP funding period by Partners and other team members. The overall goals of the proposed renewal project are to instigate dramatic technical advances to continue surgeon-driven improvement of live 4D MIOCT surgery, and to enhance the utility of OCT image-guided microsurgery by improving related aspects of the surgical milieu. To do this, we will significantly increase the speed and ease of use of intra-operative MIOCT by developing next-generation OCT engine technology coupled with a novel wide-field automated eye-tracking MIOCT scanner. We will empower surgeons to take full advantage of this new information by developing novel integrated data visualizations including operating room high-definition 3DTV and augmented/virtual reality head-mounted displays. Each of these improvements are motivated by specific current needs in both macular and anterior segment surgery, and will be developed through our well-established translational methodology of incorporating iterative feedback between multidisciplinary team members. We believe this developments will not only improve outcomes in current surgeries, but will also enable novel ophthalmic and other microsurgeries not possible due to current limitations in surgical practice.

项目摘要 这是生物工程研究合作伙伴关系（BRP）的重新提交申请 一支高度合作，经验丰富的工程师和眼科医生团队，以促进 图像引导的手术干预中的艺术。我们试图克服对外科医生当前立体声的局限性 通过整合光学相干断层扫描（OCT）技术，对眼结构的显微镜视图， 在眼科实践中已经被广泛接受，进入了手术室。在现代眼科 显微外科手术，有限的深度感知和眼内数据的能力，物理要求 限制显微镜放置在外科医生上，并且无法区分微妙的显微组织 微妙的对比度限制了手术终点和患者结局的实现。 在过去的七年中，我们的团队开发了领先的Ophthalmic术中OCT计划 在美国的手术。在最初的R21支持下，我们的第一代显微镜集成OCT（MIOCT）设计 在手术过程中启用了实时横截面成像，这是多个采用的方法 当前商业产品的供应商。我们目前的BRP资助工作介绍了第一个现场“ 4D”（体积） 通过时间成像）MioCT技术，该技术以微尺尺度分辨率为微观外科手术进行了几个图像 每秒完全渲染的卷，外科医生可以从任意角度通过 一个新颖的立体视角展示。我们已经证明并记录了这些表现 杜克眼中中心的250多个现场人眼手术中的系统中有创新和结果记录 在合作伙伴和其他团队的前BRP资助期间，在95多个出版物和演讲中 成员。 拟议的更新项目的总体目标是促进急剧的技术进步继续 外科医生驱动的实时4D MioCT手术的改进，并增强OCT图像引导的实用性 通过改善手术环境的相关方面的显微外科手术。为此，我们将大大增加 通过开发下一代OCT发动机技术耦合，速度和易于使用术中的MIOCT 带有一种新型的宽场自动射击mioct扫描仪。我们将授权外科医生充满 通过开发新颖的集成数据可视化（包括手术室）来获得此新信息的优势 高清3DTV和增强/虚拟现实的头戴式显示器。这些改进中的每一个都是 在黄斑和前部手术中都有特定当前需求的动机，并将通过 我们建立了良好的翻译方法，即在多学科团队之间结合迭代反馈 成员。我们认为，这一事态不仅会改善当前手术的结果，而且还将启用 由于手术实践中当前的局限性，新型眼科和其他微生物不可能。