Intraoperative OCT Guidance of Intraocular Surgery

描述（由申请人提供）：该生物工程研究伙伴关系提案汇集了眼科成像和手术专家团队，以推进图像引导手术干预的最新技术水平。我们试图克服外科医生的眼睛结构的当前立体显微镜视图的局限性，将光学相干断层扫描（OCT）技术，这是已经被广泛接受的眼科实践，进入手术室。在眼前节和视网膜的现代显微外科手术中，无法区分细微对比的精细微观组织结构，或判断视网膜的位置， 手术器械相对于相邻微结构的差异限制了手术终点和患者结果的实现。该项目的总体五年目标是开发、优化、应用和记录一种临床上有用的、克服这些局限性的显微镜集成OCT（MIOCT）技术。我们还将通过商业伙伴关系促进这一技术的传播。我们相信，这项技术不仅可以改善目前手术的结果，而且还可以实现由于目前的可视化限制而无法实现的新型眼科和其他显微手术。 在之前NIH的支持下（R21 EY 019411），我们的领导团队开发了第一代OCT显微镜，专门用于玻璃体视网膜手术，目前正在杜克大学进行临床试验。第一代系统在手术过程中提供了前所未有的视网膜横截面和三维视图。它现在已经准备好在更广泛的手术中进行临床评估，包括眼前节手术。然而，目前的原型缺乏对外科医生的实时反馈，并且需要在图像采集、数据可视化和集成以及手术器械设计方面取得重大进展，以提供稳健且无缝的平台供眼科医生广泛使用。 我们提出的项目是基于生物医学工程师，外科医生和图像处理专家之间的多学科合作，致力于成像的转化进步，以改善眼科手术的结果。拟议的生物医学研究伙伴关系包括来自杜克大学生物医学工程系（BME）和杜克眼科中心（DEC）的学术和临床教师，克利夫兰临床基金会科尔眼科研究所（CEI）的教师，以及商业OCT系统，手术器械和手术显微镜制造商的大量支持和合作。页1的1

DESCRIPTION (provided by applicant): This Bioengineering Research Partnership proposal brings together a team of experts in ophthalmic imaging and surgery 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 bringing optical coherence tomography (OCT) technology, which is already well accepted in ophthalmic practice, into the operating room. In modern microsurgeries of both the anterior segment and retina, the inability to distinguish delicate, microscopic tissue structures of subtle contrast, or to judge the location of surgical instruments relative to adjacent microstructures, limits achievement of surgical endpoints and patient outcomes. The overall five-year goals of the project are to develop, optimize, apply and document a clinically useful, microscope integrated OCT (MIOCT) technology for ophthalmic surgery that overcomes these limitations. We will also facilitate dissemination of this technology through commercial partnerships. We believe this technology will not only improve outcomes in current surgeries, but will also enable novel ophthalmic and other microsurgeries not possible due to current limitations in visualization. Under previous NIH support (R21EY019411), our leadership team has developed a first-generation OCT- enabled microscope that is specialized for vitreoretinal surgery, and is now undergoing clinical trials at Duke University. This first-generation system delivers unprecedented cross-sectional and three-dimensional views of the retina during surgery. It is now ready for clinical evaluation in a wider range of surgeries, including anterior segment surgery. However, the current prototype lacks real-time feedback for the surgeon, and significant advances are needed in the image acquisition, data visualization and integration, and surgical instrument design, to provide a robust and seamless platform for widespread use by ophthalmic surgeons. Our proposed project is based on multidisciplinary collaborations between biomedical engineers, surgeons and image processing experts devoted to translational advances in imaging for improved outcomes in ophthalmic surgery. The proposed Biomedical Research Partnership comprises academic and clinical faculty from Duke University Biomedical Engineering Department (BME) and Duke Eye Center (DEC), faculty at the Cole Eye Institute (CEI) of the Cleveland Clinic Foundation, and substantial support and collaboration from manufacturers of commercial OCT systems, surgical instruments, and surgical microscopes. Page 1 of 1