Laser photocoagulation is used extensively by ophthalmologists to treat retinal disorders such as diabetic retinopathy and retinal breaks and tears. Currently, the procedure is performed manually and suffers from several drawbacks: it often requires many clinical visits, it is very tedious for both patient and physician, the laser pointing accuracy and safety margin are limited by a combination of the physician's manual dexterity and the patient's ability to hold their eye still, and there is a wide variability in retinal tissue absorption parameters. A computer-assisted hybrid system is under development that will rapidly and safely place multiple therapeutic lesions at desired locations on the retina in a matter of seconds. In the past, one of the main obstacles to such a system has been the ability to track the retina and compensate for any movement with sufficient speed during photocoagulation. Two different tracking modalities (digital image-based tracking and analog confocal tracking) were designed and tested in vivo on pigmented rabbits. These two systems are being seamlessly combined into a hybrid system which provides real-time, motion stabilized lesion placement for typical irradiation times (100 ms). This paper will detail the operation of the hybrid system and efforts toward controlling the depth of coagulation on the retinal surface.
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