Review of the development of optical coherence tomography imaging navigation technology in ophthalmic surgery

Li Yunyao; Fan Jinyu; Jiang Tianliang; Tang Ning; Shi Guohua

doi:10.12086/oee.2023.220027

Article navigation > Opto-Electronic Engineering > 2023 Vol. 50 > No. 1 > 220027

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Li Y Y, Fan J Y, Jiang T L, et al. Review of the development of optical coherence tomography imaging navigation technology in ophthalmic surgery[J]. Opto-Electron Eng, 2023, 50(1): 220027. doi: 10.12086/oee.2023.220027

Citation:

Li Y Y, Fan J Y, Jiang T L, et al. Review of the development of optical coherence tomography imaging navigation technology in ophthalmic surgery[J]. Opto-Electron Eng, 2023, 50(1): 220027. doi: 10.12086/oee.2023.220027

Review of the development of optical coherence tomography imaging navigation technology in ophthalmic surgery

1.
Department of Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
2.
Jiangsu Key Laboratory of Medical Optics, Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Sciences, Suzhou, Jiangsu 215163, China

Fund Project: National Key R&D Program of China Fund (2022YFC2400771), and Jiangsu Science and Technology Plan Program Fund (BK20220263)

More Information

^*Corresponding author: ghshi_lab@126.com

Received Date 28 March 2022

Revised Date 17 October 2022

Accepted Date 21 October 2022

Available Online 22 December 2022

Published Date 25 January 2023

Abstract

Abstract

During ophthalmic microsurgery, the visualization of internal structures is limited by traditional intraoperative imaging methods due to their lack of depth information. Optical coherence tomography (OCT) is a non-contact tomographic imaging technique that is widely used for intraoperative navigation in ophthalmic surgery because of its ability to provide depth information, non-invasiveness, fast imaging, and high resolution. Typical OCT devices can be divided into handheld OCT and microscope-integrated OCT. This article briefly introduces the mechanism and development of time domain OCT and fourier domain OCT, reviews the development of OCT ophthalmic surgical navigation devices, introduces representative OCT systems in each category, describes and compares their imaging principles, performance, advantages, and disadvantages, and finally concludes with a summary and outlook on the applications of this technology in ophthalmic surgery.
- optical coherence tomography /
- surgery navigation /
- ophthalmic surgery /
- intraoperative imaging

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References

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Overview

Overview

With the development of microsurgery, minimally invasive ophthalmic surgery has become the primary means for the treatment of eye diseases. Ophthalmic surgeries need to observe the structure under the surface and accurately locate the surgical instruments in real time. Conventional surgical operating microscope is difficult to use for ophthalmic intraoperative imaging due to its lack of depth information. Optical coherence tomography (OCT) is a non-contact tomography technology that can provide depth information during ophthalmic surgeries. It has been widely used in clinical ophthalmic surgery because of its non-invasive imaging mode, fast imaging speed, and high imaging quality.

Typical intraoperative OCT devices can be divided into handheld OCT (HHOCT) and microscope-integrated OCT (MIOCT). Handheld OCT can be further divided into external HHOCT probe, needle-based HHOCT probe, and OCT-integrated surgical instrument. HHOCT can optimize the volume interference caused by traditional tabletop equipments. The external HHOCT probe has the advantages of non-contact and non-invasiveness. The needle-based HHOCT probe can enter the eye under minimally invasive conditions to image the fundus structure, while the OCT integrated surgical instrument can ensure the alignment between the image and the end of the instrument, which is conducive to the judgment of the position of the instrument during eye surgeries.

Microscope-integrated OCT is another way of intraoperative OCT imaging that is realized by integrating the optical system of both microscope and OCT. In this way, there is no need to interrupt the operation or add operators. At present, MIOCT real-time two-dimensional imaging is relatively mature and has been widely used in ophthalmic ssurgeries. With the development of graphics processing unit (GPU) and the introduction of swept frequency OCT (SS-OCT), intraoperative real-time three-dimensional imaging has become the future trend of MIOCT. However, there are still some problems in 3D OCT imaging, such as blurred structure surface, poor edge definition, and difficult recognition of surgical instruments. Improving image contrast is the key to solve the problems above. An effective approach is to use volume enhancement rendering algorithm for feature enhancement and shadow coloring. Another method is to use coloration in the process of volume rendering based on depth and intensity signals, and thus enhances the ability to recognize the retinal deformation and the contact between instrument and membrane.

The significance of OCT imaging in ophthalmic surgery has been proved in experiments on animal eyes, human eye models, and clinical cases. In recent years, commercial OCT surgical navigation equipment has already been widely used in ophthalmic clinical surgery. With the progress of image processing technology, image and ophthalmology, OCT surgical navigation equipment will further promote the innovation of ophthalmic surgery, and thus promote the development of the ophthalmology field.