Eye Bank Cornea Screening with Optical Coherence Tomography

描述（由申请人提供）：接受过屈光手术（LASIK， RK， PRK）的供体角膜移植会导致手术过程中的伤口分离，并增加受者的屈光不正。因此，屈光手术的日益普及引起了人们的关注，即进入眼库的移植质量角膜的比例下降，以及移植未被发现的屈光手术后角膜的严重后果。目前，眼库利用患者病史和显微镜检查来评估供体角膜的质量，并检测既往屈光手术。虽然这些方法能够筛选出许多问题角膜，但它们容易受到人为错误的影响。患者的病史可能不可靠，手术效果好的LASIK和PRK可能会留下最小的碎片和疤痕，这尤其难以发现。光学相干断层扫描（OCT）能够以微米分辨率对角膜进行三维成像。它可以可视化角膜层，检测混浊，并测量表面轮廓。在我们的初步研究中，我们发现OCT可以成像供体角膜组织，甚至不需要将其从无菌容器和保存介质中取出。数字OCT数据可用于自动图像处理。这些特征是筛选测试的理想选择。因此，我们的具体目标是：1。开发用于眼库筛查的高性能OCT系统。采用超高速傅里叶域OCT技术，该系统将在3分钟内提供详细的三维扫描。2. 发展OCT检查既往屈光手术。我们的初步数据表明，OCT可以检测lasik后角膜的地形和反射率变化。我们将开发图像处理算法来检测LASIK， PRK， RK和任何改变角膜曲率的手术。3. 开发OCT评估供体角膜质量。我们将制定自动量化角膜质量指标的标准：地形规律性、上皮脱落、基质混浊/水肿和内皮条纹。4. 发展OCT测量供体角膜功率以改善移植手术屈光效果。我们将开发OCT系统并对其进行编程，并将其放置在狮子会Doheny眼库中，以筛查所有角膜组织。组织库国际将转发已知的屈光后手术和病变角膜。1-2年将用于开发OCT系统和图像处理软件。3-4年将用于评估自动OCT供体角膜分类的性能并改进软件。如果成功，我们将通过提供一种客观可靠的筛选方法来保障未来用于移植的供体角膜组织的供应，这将为眼库程序增加最小的时间和成本。

DESCRIPTION (provided by applicant): The transplantation of donor cornea that has undergone refractive surgery (LASIK, RK, PRK) can lead to both wound separation during surgery and to increased refractive error in the recipient. Therefore, the increasing popularity of refractive surgery has raised concern regarding the decreasing proportion of transplant quality corneas coming in to the eye bank and the serious consequences of transplanting a post- refractive surgery cornea that has escaped detection. Currently, eye banks utilize patient history and microscopic examination to assess the quality of donor corneas and detect previous refractive surgery. Although these methods are capable of screening out many problem corneas, they are subject to human error. Patient history may be unreliable, and well-performed LASIK and PRK may leave minimal debris and scarring and which are particularly difficult to detect. Optical coherence tomography (OCT) is capable of performing 3-dimensional imaging of the cornea with micron resolution. It can visualize the corneal layers, detect opacities, and measure surface contours. In our preliminary studies, we have found that OCT can image donor corneal tissue without even removing it from the sterile container and preservation medium. The digital OCT data is amenable to automated image processing. These characteristics are ideal for a screening test. Therefore, our specific aims are to: 1. Develop a high performance OCT system for eye bank screening. Using the ultra-highspeed Fourier- domain OCT technology, the system will provide detailed 3-D scanning within 3 minutes. 2. Develop OCT to detect previous refractive surgery. Our preliminary data showed that OCT can detect topographic and reflectivity changes in the post-LASIK cornea. We will develop image processing algorithms to detect LASIK, PRK, RK, and any surgery that modifies corneal curvature. 3. Develop OCT to assess donor corneal quality. We will develop criteria to automatically quantify corneal quality indicators: topographic regularity, epithelial sloughing, stromal opacity/edema, and endothelial striae. 4. Develop OCT to measure donor cornea power to improve refractive outcome of transplant surgery. We will develop and program the OCT system and place it at the Lions Doheny Eye Bank to screen all corneal tissues. Tissue Bank International will forward known post-refractive surgery and diseased corneas. Years 1-2 will be used to develop the OCT system and image process software. Years 3-4 will be used to assess the performance of automated OCT donor cornea classification and refine the software. If successful, we will safeguard the future supply of donor corneal tissue for transplantation by offering an objective and reliable screening method that adds minimal time and cost to eye bank procedures..