Intraoperative OCT Guidance of Intraocular Surgery

眼内手术术中OCT指导

基本信息

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
项目类别：
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

项目摘要

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.

项目概要这是生物工程研究合作伙伴关系 (BRP) 的重新提交申请，该合作伙伴关系汇集了一支由工程师和眼科医生组成的高度协作且经验丰富的团队，致力于推动眼科疾病的发展我们寻求克服外科医生当前立体手术的局限性。通过继续集成光学相干断层扫描（OCT）技术，获得眼部结构的显微视图，这在眼科实践中已经被广泛接受，并进入了现代眼科手术室。显微外科手术、眼内有限的深度感知和数据能力、对身体的要求显微镜对外科医生的限制，以及无法区分精致的微观组织微妙对比的结构限制了手术终点和患者结果的实现。在过去的七年里，我们的团队开发了眼科领域领先的术中 OCT 项目在最初的 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实时横截面成像，并且是多个已采用的方法我们目前 BRP 资助的工作引入了第一个实时“4D”（体积）。随时间成像）MIOCT 技术，可在数个微米级分辨率下对显微外科手术进行成像每秒完全渲染的体积，外科医生可以从任意角度交互式查看我们已经演示并记录了它们的性能。杜克眼科中心超过 250 例现场人眼手术的系统，记录了创新和结果合作伙伴和其他团队在之前的 BRP 资助期间发表了超过 95 篇出版物和演示文稿成员。拟议更新项目的总体目标是推动重大技术进步，以继续外科医生推动实时 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，显微外科手术将显着增加。通过开发下一代 OCT 引擎技术，提高术中 MIOCT 的速度和易用性借助新型宽视场自动眼动追踪 MIOCT 扫描仪，我们将使外科医生能够充分采取行动。通过开发新颖的集成数据可视化（包括手术室）来利用这些新信息这些改进都是高清 3DTV 和增强/虚拟现实头戴式显示器。受到黄斑和眼前段手术当前特定需求的推动，并将通过我们完善的整合多学科团队之间迭代反馈的转化方法我们相信这一进展不仅会改善当前手术的效果，而且还将实现这一目标。由于目前手术实践的限制，新型眼科手术和其他显微手术是不可能的。