Deep Anterior Lamellar Keratoplasty using Big-Bubble technique (BB-DALK) is a delicate and complex surgical procedure with a multitude of benefits over Penetrating Keratoplasty (PKP). Yet the steep learning curve and challenges associated with BB-DALK prevents it from becoming the standard procedure for keratoplasty. Optical Coherence Tomography (OCT) aids surgeons to carry out BB-DALK in a shorter time with a higher success rate but also brings complications of its own such as image occlusion by the instrument, the constant need to reposition and added distraction. This work presents a novel real-time guidance system for BB-DALK which is practically a complete tool for smooth execution of the procedure. The guidance system comprises of modified 3D+t OCT acquisitions, advanced visualization, tracking of corneal layers and providing depth information using Augmented Reality. The system is tested by an ophthalmic surgeon performing BB-DALK on several ex vivo pig eyes. Results from multiple evaluations show a maximum tracking error of 8.8 micrometers.
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机译:使用大气泡技术(BB-DALK)进行的深层前角膜角膜移植术是一种微妙而复杂的外科手术,具有比穿透性角膜移植术(PKP)更大的益处。然而,陡峭的学习曲线和与BB-DALK相关的挑战阻止了BB-DALK成为角膜移植术的标准程序。光学相干断层扫描(OCT)可以帮助外科医生在更短的时间内完成BB-DALK,获得更高的成功率,但也带来了其自身的复杂性,例如仪器的图像阻塞,不断地需要重新定位和增加注意力分散。这项工作为BB-DALK提出了一种新颖的实时指导系统,实际上是使程序顺利执行的完整工具。该制导系统包括修改后的3D + t OCT采集,高级可视化,角膜层跟踪以及使用增强现实技术提供深度信息。该系统由在几只离体猪眼上进行BB-DALK的眼科医生进行测试。多次评估的结果显示最大跟踪误差为8.8微米。
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