Guiding The Treatment of Anterior Eye Diseases 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: 7374079
• 负责人: David Huang
• 金额: $ 42.21万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 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 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374079
• 关键词: 3-Dimensional; Ablation; Accounting; Algorithms; Angle-Closure Glaucoma; Animals; Anisometropia; Anterior; Astigmatism; Back; Biological; Biometry; Cataract; Cataract Extraction; Cicatrix; Clinical Trials; Computer Simulation; Computers; Cornea; Corneal Topography; Data; Depth; Development; Devices; Diagnosis; Dimensions; Disease; Dissection; Elevation; Eye; Eye diseases; Future; Goals; Graft Rejection; Healed; Human; Hyperopia; Image; Intraocular Lens Implantation; Intraocular lens implant device; Invasive; Investigation; Keratectomy, Photorefractive, Excimer Laser; Keratoplasty; Lamellar Keratoplasty; Laser Surgery; Lasers; Left; Maps; Measurement; Measures; Methods; Motion; Operative Surgical Procedures; Ophthalmologic Surgical Procedures; Optical Coherence Tomography; Optics; Oryctolagus cuniculus; Outcome; Pathological Dilatation; Patients; Penetrating Keratoplasty; Penetration; Performance; Personal Satisfaction; Plant Roots; Procedures; Rate; Recovery; Refractive Errors; Resolution; Retinal; Risk; Scanning; Screening procedure; Shapes; Simulate; Speed; Spottings; Surface; System; Technology; Testing; Thick; Tissues; Upper arm; Vision; Visual; base; computer studies; corneal ablation; corneal scar; corneal surgery; feeding; healing; improved; instrument; lens; next generation; programs; sensor; simulation; tomography; tool; visual optics

DESCRIPTION (provided by applicant): The long-term goal of this project is to utilize newly available very high-speed optical coherence tomography (OCT) technology to guide surgical treatments of anterior eye diseases. Measuring aberrations in the optical surfaces of the cornea requires great precision. OCT is well known for its exquisite spatial resolution, but until recently it has not had sufficient speed to overcome the inherent biological motion of the eye and capture the shape of the cornea. The development of Fourier-domain (FD) OCT technology has made the requisite speed possible. The specific aims are: (1) To develop a very high-speed anterior segment OCT instrument. An FD-OCT system capable of 26,000 axial scans/second and 5-5m resolution has been tested. Preliminary data show that it is able to map corneal thickness with a precision of 1-5m root-mean-square and measure corneal power with a precision of 0.2 diopters. Motion correction algorithms will be developed to further improve the precision. (2) To develop OCT-guided corneal laser surgery for the treatment of irregular and opacified corneas. Although wavefront sensing and Placido-ring topography have been used to guide laser corneal surgeries, they are often unable to make valid measurements of irregular corneas. Our preliminary results showed that OCT can reliably make measurements in these diseased corneas that are most in need of surgical remedy. Corneal thickness or topography maps obtained by the OCT system will be used to program the depth of femtosecond laser corneal dissection and excimer laser ablation. OCT-guided femtosecond laser lamellar keratoplasty and excimer laser phototherapeutic keratectomy (PTK) will be tested in rabbit studies. Patients with corneal scar, ectasia, dystrophy, or irregular astigmatism following corneal surgery will be scanned, and laser surgery will be simulated by computer to evaluate the visual outcome. The simulation will take into account measurement variability, laser delivery error, healing effects, and visual optics. These tests will prepare for future human trials. (3) To develop an OCT-based intraocular lens (IOL) power formula. IOL power selection is difficult in patients who have had previous laser vision correction, often resulting in significant near- or far-sightedness after the cataract surgery. Laser ablation alters the natural relationship between the front and back corneal surfaces, causing error in conventional keratometry and IOL calculation. This increasingly common problem could be solved by measuring both anterior and posterior corneal powers with OCT. The OCT-based IOL formula will be tested in a clinical trial. The aim of this project is to develop methods for imaging the cornea with a very high-speed and high-resolution optical coherence tomography (OCT) system that will precisely measure corneal thickness and shape and use this information to guide eye surgery. Patients with irregularly shaped or scarred corneas could have their vision restored by reshaping the corneas with a procedure that combines the precision of OCT and lasers instead of traditional corneal transplantation, which is associated with slow visual recovery and risks of transplant rejection. Cataract surgery in patients with previous laser vision correction often leads to significant near- or far-sightedness, a problem that could be resolved by using a more accurate intraocular lens power selection formula based on the measurement of corneal refractive power with OCT.

描述（由申请人提供）：该项目的长期目标是利用新近可用的高速光学相干断层扫描（OCT）技术来指导前眼疾病的手术治疗。测量角膜光学表面的像差需要很高的精度。 OCT以其精致的空间分辨率而闻名，但直到最近，它还没有足够的速度来克服眼睛的固有生物运动并捕获角膜的形状。傅立叶域（FD）OCT技术的开发使必要的速度成为可能。具体目的是：（1）开发非常高速的前部OCT仪器。已经测试了26,000次轴向扫描/秒和5-5M分辨率的FD-OCT系统。初步数据表明，它能够以1-5m的根平方的精度来绘制角膜厚度，并以0.2折射体的精度测量角膜功率。将开发运动校正算法以进一步提高精度。 （2）开发OCT引导的角膜激光手术，以治疗不规则和渗透的角膜。尽管已使用波前传感和Placido-Ring地形来指导激光角膜手术，但它们通常无法对不规则角膜进行有效的测量。我们的初步结果表明，OCT可以可靠地对这些患病的角膜进行测量，这些角膜最需要手术疗法。通过OCT系统获得的角膜厚度或地形图将用于对飞秒激光角膜解剖和准分子激光消融的深度进行编程。 OCT引导的飞秒激光层状角膜置换术和准分子激光光疗法角膜切除术（PTK）将在兔研究中进行测试。角膜疤痕，营养不良或角膜手术后不规则散光的患者将被扫描，计算机将模拟激光手术以评估视觉结果。模拟将考虑测量可变性，激光输送错误，愈合效果和视觉光学元件。这些测试将为未来的人类试验做准备。 （3）开发基于OCT的人眼镜透镜（IOL）功率公式。在先前进行激光视力校正的患者中，很难选择IOL功率，通常在白内障手术后会导致明显的接近或远处。激光消融改变了前角膜表面之间的自然关系，从而导致常规角化测定法和IOL计算中的误差。通过用OCT测量前角膜力量和后角膜力量可以解决这个日益常见的问题。基于OCT的IOL公式将在临床试验中进行测试。该项目的目的是开发使用非常高速和高分辨率的光学相干断层扫描（OCT）系统对角膜进行成像的方法，该系统将精确测量角膜厚度和形状，并使用此信息来指导眼科手术。形状不规则或疤痕角膜的患者可以通过结合OCT和激光的精度而不是传统角膜移植的方法来恢复视力，这与慢速视觉恢复和移植抑制的风险有关。先前具有激光视力校正患者的白内障手术通常会导致近视或远处的显着性，这一问题可以通过使用OICT的角膜折射率测量的测量来解决更准确的眼内镜头功率选择公式来解决。