Eye Bank Cornea Screening with Optical Coherence Tomography

描述(由申请人提供)：接受屈光手术(LASIK、RK、PRK)的供体角膜移植可能会导致手术中伤口分离，并增加受者的屈光不正。因此，屈光手术的日益流行引起了人们对进入眼库的移植质量角膜比例的下降以及移植未被发现的屈光手术后角膜的严重后果的关注。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，并检测以前的屈光手术。虽然这些方法能够筛选出许多有问题的角膜，但它们容易受到人为错误的影响。病史可能不可靠，良好的LASIK和PRK可能会留下最小的碎片和疤痕，尤其是很难发现。光学相干层析成像(OCT)能够以微米级的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，甚至不需要从无菌容器和保存介质中取出它。数字OCT数据适用于自动图像处理。这些特性是筛查测试的理想选择。因此，我们的具体目标是：1.开发一种高性能的OCT眼库筛查系统。使用超高速傅立叶域OCT技术，该系统将在3分钟内提供详细的3D扫描。2.开发OCT来检测以前的屈光手术。我们的初步数据显示，OCT可以检测LASIK术后角膜的地形图和反射率变化。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.建立OCT评价供体角膜质量的方法。我们将制定自动量化角膜质量指标的标准：地形图规则性、上皮塌陷、基质混浊/水肿和内皮条纹。4.建立OCT测量供体角膜屈光度，以提高移植手术的屈光度。我们将开发和编程OCT系统，并将其放置在狮子多尼眼库，以筛查所有角膜组织。国际组织银行将转发已知的屈光后手术和患病的角膜。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OCT供体角膜自动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和可靠的筛查方法，将眼库手术增加的时间和成本降至最低，从而保障未来供移植的供体角膜组织的供应。

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..