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Proceedings Paper

Image-guided feedback for ophthalmic microsurgery using multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography
Author(s): Jianwei D. Li; Joseph D. Malone; Mohamed T. El-Haddad; Amber M. Arquitola; Karen M. Joos; Shriji N. Patel; Yuankai K. Tao
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Paper Abstract

Surgical interventions for ocular diseases involve manipulations of semi-transparent structures in the eye, but limited visualization of these tissue layers remains a critical barrier to developing novel surgical techniques and improving clinical outcomes. We addressed limitations in image-guided ophthalmic microsurgery by using microscope-integrated multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (iSS-SESLO-OCT). We previously demonstrated in vivo human ophthalmic imaging using SS-SESLO-OCT, which enabled simultaneous acquisition of en face SESLO images with every OCT cross-section. Here, we integrated our new 400 kHz iSS-SESLO-OCT, which used a buffered Axsun 1060 nm swept-source, with a surgical microscope and TrueVision stereoscopic viewing system to provide image-based feedback. In vivo human imaging performance was demonstrated on a healthy volunteer, and simulated surgical maneuvers were performed in ex vivo porcine eyes. Denselysampled static volumes and volumes subsampled at 10 volumes-per-second were used to visualize tissue deformations and surgical dynamics during corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. En face SESLO images enabled orientation and co-registration with the widefield surgical microscope view while OCT imaging enabled depth-resolved visualization of surgical instrument positions relative to anatomic structures-of-interest. TrueVision heads-up display allowed for side-by-side viewing of the surgical field with SESLO and OCT previews for real-time feedback, and we demonstrated novel integrated segmentation overlays for augmented-reality surgical guidance. Integration of these complementary imaging modalities may benefit surgical outcomes by enabling real-time intraoperative visualization of surgical plans, instrument positions, tissue deformations, and image-based surrogate biomarkers correlated with completion of surgical goals.

Paper Details

Date Published: 17 February 2017
PDF: 6 pages
Proc. SPIE 10053, Optical Coherence Tomography and Coherence Domain Optical Methods in Biomedicine XXI, 100530I (17 February 2017); doi: 10.1117/12.2254847
Show Author Affiliations
Jianwei D. Li, Vanderbilt Univ. (United States)
Joseph D. Malone, Vanderbilt Univ. (United States)
Mohamed T. El-Haddad, Vanderbilt Univ. (United States)
Amber M. Arquitola, Vanderbilt Univ. (United States)
Karen M. Joos, Vanderbilt Univ. (United States)
Shriji N. Patel, Vanderbilt Univ. (United States)
Yuankai K. Tao, Vanderbilt Univ. (United States)


Published in SPIE Proceedings Vol. 10053:
Optical Coherence Tomography and Coherence Domain Optical Methods in Biomedicine XXI
James G. Fujimoto; Joseph A. Izatt; Valery V. Tuchin, Editor(s)

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