KR20100103628A - Virtual microscope system for monitoring the progress of corneal ablative surgery and associated methods - Google Patents

Abstract

The system for visualizing the eye of a patient during corneal surgery includes first and second cameras and a processor in signal communication with the processor. The camera can be positioned to focus on the cornea positioned for surgery. The first and second displays and optics are in signal communication with the processor and are positioned for viewing through the first and second eyepieces of the stereo microscope, respectively. The software may be configured to transmit first and second images processed to the first and second displays via display optics, respectively, from the first and second cameras to process the received first and second images for display. It is embedded on the processor to receive the first and second corneal images. The display can then be viewed by the surgeon through the microscope at least during the surgery.

Description

VIRTUAL MICROSCOPE SYSTEM FOR MONITORING THE PROGRESS OF CORNEAL ABLATIVE SURGERY AND ASSOCIATED METHODS}

This application claims priority to US Provisional Application No. 60 / 015,853, filed December 21, 2007.

This application relates generally to surgical methods, and more particularly to systems and methods for monitoring the progress of corneal removal surgery.

Lasik (in situ corneal curvature surgery) surgery is commonly done by cutting thin flaps in the cornea, which is then lifted along the hinge to expose the underlying cornea stroma. Folded back. The ablation laser is used to perform refractive surgery and the flaps are replaced.

Many methods have been used to avoid or detect any “wrinkles” or streaes in the corneal flap after replacement on the brace. For example, the cornea can be marked prior to cutting, whereby markings can be used to realign the flaps. Other methods use diffuse broadband, white light sources and line of sight (direct-view) microscopy to detect the line. Alternatively, refractive surgery may use a dedicated device, such as a handheld slit lamp, to project a thin line of visible white light into the cornea, whereby surface aberration or edge Scan

However, floating eyes with such illumination to detect flap position, debris, and hydration can be inconvenient for the patient, using slit lamps to detect flap replacement and general eye conditions. It can be coordinated with the workflow. In addition, white light may not provide optimal enhancement of a portion of the eye for visualization. To observe at alternating wavelengths, an external camera system with a standard video monitor can be used, but in order to eliminate the high illumination that is caused by direct-view microscopes, large holes must be used, which is a safety for the patient. And a balance between the physician's field of view.

The present invention relates to systems and methods for visualizing the eye of a patient during corneal surgery. The system includes a processor and first and second cameras in signal communication with the processor. The first and second cameras are positionable to focus on the cornea of the eye located for surgery.

Thus, the first and second displays and optics are in signal communication with the processor and are positioned for viewing through the first and second eyepieces of the stereo microscope, respectively. The microscope is associated with the surgical field of the cornea.

The software resides on a processor including code segments for receiving the first and second images of the cornea from the first and second cameras and for processing the received first and second images for the display. Code segments are also provided for transmitting the processed first and second images to the first and second displays, respectively, via display optics. The first and second displays are then visible to the surgeon through the microscope, at least during the surgery, preferably before and after the surgery.

The invention also relates to a method for monitoring a corneal surgery process. Such methods include illuminating the eye including the cornea positioned for surgery and stereoscopically imaging the cornea with the first and second displays. The first and second displays can be seen through the first and second eyepieces of the stereo microscope, respectively.

Features that characterize the present invention, both with respect to the method and organization of the surgery, and with respect to additional objects and advantages thereof, will be better understood with reference to the following detailed description and the accompanying drawings. It is to be understood that the drawings are for purposes of illustration and description and are not a definition of the limits of the invention. These and other objects, and the advantages provided by the present invention, will become more fully apparent in the following detailed description when read with reference to the accompanying drawings.

1 is a schematic diagram of an eye imaging and display system of the present invention.
2 is a schematic diagram of a camera that images the eye.
3 is a side perspective view of the display assembly.
4 is a side perspective view of the viewing and display assembly.
5 is a top plan view of the display element.
6 is a schematic diagram of an eye imaging and display system of the present invention integrated into a LASIK device.
7 is a flowchart of an embodiment of the eye imaging and display method of the present invention.

A description of the preferred embodiment of the present invention will be presented with reference to FIGS. 1-7.

The schematic system of FIG. 1 shows the components of an exemplary embodiment of the system 10 of the present invention for monitoring the process of corneal surgery by a surgeon. The system 10 comprises first and second high resolution color cameras 11, 12 (FIG. 2), which cameras are adjustable with each separation 13 in a particular embodiment, for example cornea 15. Can focus on a portion of the eye 14 such as An exemplary surgical procedure to which the system 10 can be applied, although not intended to be limiting, is LASIK surgery and is also available for pupilometry, in which case pupil dynamics can be monitored and recorded and corneal briefs Other eye measurements such as briefringence and ophthalmic surgery are available, in which case a surgical microscope may be useful. For this type of surgery, the system 10 may be useful for imaging the cornea 15, flap cuts of the cornea, lower braces, limbus, and other parts of the eye that are desirable to be imaged, with depth Awareness can be provided.

Cameras 11 and 12 can be optimized for low light levels, wide bands, or speeds. Preferably, the speed is sufficient not to exhibit a noticeable lag in imaging. The waveband should preferably include the wavelength expected to be needed for image enhancement, and the sensitivity should allow for a comfortable light level for the patient.

Cameras 11 and 12 are in signal communication with a processor 16 having image processing software 17 present thereon. The cameras 11, 12 are positioned and focused to receive radiation 19 projected onto the eye 14 from the illumination source 20, reflected radiation 18 from the eye 14. In a preferred embodiment, illumination source 20 may include multiple wavelength range sources, which are not intended to be limiting, and the use of illumination sources will be described below.

In use, the software 17 receives images from the cameras 11 and 12 and processes the images for display through a stereo microscope 21, which is generally a component of the surgical system, which the surgeon uses in this process. Familiar In addition, the software 17 may include code segments for superimposing additional data on the output display, which may include microscopic information (zoom, scale factor, measurement bars, etc.) and surgical system information (percent complete of the process). , Laser power statistics, etc.). Incorporating this information into the display eliminates the surgeon's need to remove his / her attention from the patient and to the external display, and the processed image data as well as this data can be saved and restored for future reference if desired. Can be.

The processed images are transmitted to the first and second displays 22, 23 via display optics 24 for viewing through the first and second eyepieces 25, 26 of the microscope 21, respectively ( 3-5). The displays 22 and 23 may include microdisplays to allow form factors similar to the form factors of the microscope 21. This display 22, 23 should preferably have a resolution sufficient to prevent the surgeon from seeing the individual pixels thereon. Preferably, displays 22 and 23 should have adjustable intensity and contrast. Display optics 24 provide a microscopic view of the eye 14 with adjustable parallax and focus for each eyepiece 25, 26.

System 10 may additionally include zoom optics 27, which may have, for example, true zoom, step-zoom or detents. True zoom, which is not intended to be limiting. Since the performance of the optics is keyed to the pixel size of the cameras 11 and 12 rather than the resolution of the retina, the system design is more flexible and larger holes can be used if desired. Preferably the optics should be carried out over the desired frequency band.

The system 10 may further include a spectral filter 28, which may be exchangeable or switchable, and may be manually switched and positioned on the filter wheel or may be electrically inserted into the optical path. Thus, the illumination and images received by the cameras 11 and 12 can be selected to selectively enhance the desired portion of the eye 14 and feature when using a direct-view microscope as known in the art. ) Is not available. For example, near-infrared radiation can be used to enhance the pupil, or ultraviolet light can be used to image the corneal surface, which is transparent to visible light but opaque to ultraviolet light. Invisible light will appear black or white on the display. During the corneal removal process, near-infrared radiation allows for enhanced visualization of the cornea and improves patient comfort, because this range of wavelengths is invisible to the patient. In addition, the processor 16 can process the image, thereby improving the flap and the edge of the flap to visualize the brace. Before the flap is cut, the spectral filter 28 can help align the patient. Additionally, low light levels may be used, which are generally required for direct viewing, because cameras and processors may be used to adjust gain without floating the patient's eye to an uncomfortable level of illumination. Because it can.

In an exemplary embodiment, although not intended as a limitation, surgical monitoring system 10 may be integrated into a LASIK device to perform corneal removal (FIG. 6). Two aspects of the LASIK device include an optical path for a tracker 31 and for an image 30, each of which receives data via beamsplitters 32, 33. Here two illumination sources, an infrared illuminator 20a and a visible light illuminator 20b are shown oriented towards the eye 14. The zoom lens 27 may include continuous or stepped zoom lenses and an optical filter 28 may be included. Cameras 11 and 12 include high resolution 2K x 2K cameras. The dual frame grabber and video processor 16 display the image on two high resolution (2K x 2K) displays 22, 23.

The method 100 (FIG. 7) for monitoring the process of corneal or other eye surgery includes positioning the patient for surgery (block 101) and illuminating the patient's eye in a desired wavelength range (block 102). . If desired, the light reflected from eye 14 may be filtered spectrally (block 103). The cornea 15 or other eye portion is then stereoscopically imaged (block 104), which may be zoomed to the desired magnification if desired (block 105). Parallax and / or focus of the displays 22, 23 may be adjusted as desired (block 106). The surgeon can view the displays 22, 23 through the eyepiece 25, 26 of the surgical microscope 21 before, during and / or after the surgical procedure (block 108) (block 107).

In the foregoing description, certain terms have been used for brevity, clarity, and understanding, but without the unnecessary limitations imposed by those beyond the requirements from the prior art, as these terms are used herein for illustrative purposes and should be interpreted broadly. Because. In addition, embodiments of the systems and methods shown and described herein are by way of example and the scope of the invention is not limited to the disclosed details.

Explaining the invention, construction, operation and use of the preferred embodiments, advantageous, new and useful results are obtained, new and useful constructions and reasonable and mechanically equivalents are apparent to those of ordinary skill in the art, and In the appended claims.

Claims (13)

A system for monitoring the process of corneal surgery,
A processor;
First and second cameras in signal communication with the process and positionable to focus on the cornea of the eye positioned for surgery;
First and second displays and optics therefor in signal communication with the processor and positionable for viewing through first and second eyepieces of a stereomicroscope, respectively, microscopes associated with the surgical field of the cornea; And
Include software embedded in the processor and including code segments,
The software receives first and second images of the cornea from the first and second cameras, processes the first and second images received for display, and at least processes the processed first and second images. Transmitting through the microscope to the first and second displays, respectively, via a display optics for the surgeon to view during surgery,
System for monitoring the process of corneal surgery.
The method of claim 1,
Each of the first and second cameras comprises a color camera, further comprising an illumination source comprising a wavelength selected to enhance an image of a portion of the eye and oriented towards the cornea;
System for monitoring the process of corneal surgery.
The method of claim 2,
Further comprising a spectral filter positionable in front of the camera to transmit illumination reflected from the eye in the desired wavelength range,
System for monitoring the process of corneal surgery.
The method of claim 2,
The illumination source comprises at least one of a near infrared light source and an ultraviolet light source,
System for monitoring the process of corneal surgery.
The method of claim 1,
The display optics comprises means for zooming the display,
System for monitoring the process of corneal surgery.
The method of claim 1,
Wherein the first and second cameras and the first and second displays each have a resolution at least as large as the resolution of the human retina,
System for monitoring the process of corneal surgery.
The method of claim 1,
The display optics comprises means for adjusting one or more of a parallax and a focus for each of the first and second displays,
System for monitoring the process of corneal surgery.
As a method for monitoring the process of corneal surgery,
Illuminating the eye including the cornea positioned to undergo surgery;
Stereoscopically imaging the cornea with first and second displays; And
Viewing the first and second displays through the first and second eyepieces of a stereo microscope, respectively,
Method for monitoring the process of corneal surgery.
The method of claim 8,
Said imaging is performed using a first and a second color camera,
The illuminating comprises illuminating the eye at a selected wavelength to enhance an image of a portion of the eye,
Method for monitoring the process of corneal surgery.
The method of claim 9,
Further comprising spectrally filtering the illumination reflected from the eye in a desired frequency range upstream of the first and second cameras,
Method for monitoring the process of corneal surgery.
The method of claim 9,
Wherein the selected wavelength comprises one or more of near infrared light and ultraviolet light,
Method for monitoring the process of corneal surgery.
The method of claim 8,
Further comprising zooming the display to a desired magnification;
Method for monitoring the process of corneal surgery.
The method of claim 8,
Further comprising adjusting one or more of parallax and focus for each of the first and second displays,
Method for monitoring the process of corneal surgery.

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