Intraoperative OCT Guidance of Intraocular Surgery

项目总结 这是一份生物工程研究伙伴关系(BRP)的重新提交申请，它汇集了 高度协作和经验丰富的工程师和眼科医生团队，以推动 影像引导外科干预中的ART。我们试图克服外科医生现有立体声音响的局限性 通过继续集成光学相干断层扫描(OCT)技术对眼睛结构进行微观观察， 它已经在眼科实践中得到了很好的接受，进入了手术室。在现代眼科 显微外科手术，在眼睛内有限的深度感知和数据处理能力，对身体要求苛刻的 显微镜对外科医生造成的限制，以及无法区分微妙的微观组织 细微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，我们的团队在眼科手术中开发了领先的OCT计划 美国的外科手术。在最初的R21支持下，我们的第一代集成显微镜的OCT(MIOCT)设计 在手术中启用实时横断面成像，是许多人采用的方法 当前商业产品中的供应商。我们目前由BRP资助的工作引入了第一个活的“4D”(体积 通过时间成像)MIOCT技术以微米级的分辨率在几个 每秒完全渲染的体积，外科医生可通过以下任意角度交互查看 一种新型的立体平视显示器。我们已经演示并记录了这些组件的性能 杜克眼科中心250多例活体人类眼科手术的系统，记录了创新和结果 在合作伙伴和其他团队之前的BRP资助期发表的95多篇出版物和演示文稿中 会员。 拟议中的重建项目的总体目标是推动显著的技术进步以继续下去。 外科医生推动的实时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进行显微外科手术。为此，我们将大幅增加 通过开发下一代OCT发动机技术来提高术中MIOCT的速度和易用性 配备新型广域自动眼球跟踪MIOCT扫描仪。我们将授权外科医生充分利用 通过开发包括手术室在内的新型集成数据可视化来利用这些新信息 高清3DTV和增强/虚拟现实头盔显示器。其中每一项改进都是 由黄斑和眼前段手术的特定当前需求驱动，将通过 我们成熟的翻译方法将多学科团队之间的迭代反馈结合在一起 会员。我们相信，这一进展不仅将改善目前手术的结果，而且还将使 由于目前外科实践的限制，新的眼科和其他显微外科手术是不可能的。

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.