Methods for constructing three-dimensional models of the eyeball, surgical navigation methods and systems for macular ligament

Abstract

The application provides an eyeball three-dimensional model construction method, a macular buckle surgery navigation method and system, and the eyeball three-dimensional model construction method comprises the following steps: panoramic scanning of the posterior sclera of a high myopia patient based on wide-angle OCT; three-dimensional reconstruction of the scanned part is performed by using MATLAB software to obtain the posterior segment three-dimensional structure of the high myopia patient's variation area; and a three-dimensional full eye model of the high myopia patient is constructed according to the posterior segment three-dimensional structure of the high myopia patient's variation area and the fixed parameter model of the high myopia patient's constant area. The application constructs an eyeball three-dimensional model based on a wide-angle OCT scanning method, which is more convenient than the traditional MRI method for constructing an eyeball three-dimensional model, has higher detection accuracy for the posterior structure, and is more suitable for navigation application in macular buckle surgery.

Description

Technical Field

[0001] This invention relates to the field of surgical guidance, and more specifically, to a method for constructing a three-dimensional model of the eyeball, a surgical navigation method and system for the macular ligament. Background Technology

[0002] Excessive expansion and bulging of the posterior sclera in high myopia can lead to insufficient coverage of the retina and choroidal tissues, resulting in tractional macular degeneration, a major cause of irreversible blindness in patients with high myopia. It has a high incidence rate and is very difficult to treat.

[0003] Currently, macular buckling surgery for patients with high myopia and tractional macular degeneration is gradually gaining acceptance among ophthalmologists in China. However, the surgery is still constrained by several factors. Firstly, there are technical challenges. The macula is located at the back of the eyeball, an area with many important structures, making surgical exposure difficult and creating blind spots, thus increasing the surgical complexity. Secondly, patients with high myopia and tractional macular degeneration exhibit significant individual differences. Patients with different degrees of myopia show considerable variations in axial length, posterior scleral morphology, foveal position, and the degree of macular degeneration, necessitating individualized surgical planning. Therefore, surgical navigation is a crucial aspect of macular buckling surgery. This involves comprehensively collecting the patient's ocular biological parameters preoperatively to create a digital model. Based on the patient's three-dimensional eyeball dimensions and the estimated surgical volume, specific parameters for macular buckling implantation are customized. This provides precise guidance information for the surgery, significantly shortening surgical time, reducing surgical difficulty, and improving the success rate.

[0004] Traditional macular cingulate surgery navigation primarily relies on MRI (Magnetic Resonance Imaging) to achieve three-dimensional reconstruction of the entire eyeball. However, MRI navigation has several drawbacks that severely hinder its clinical application: firstly, its low resolution makes it difficult for MRI to accurately locate the foveal structure, thus failing to meet the requirements for precise foveal compression; secondly, MRI requires specialized radiologists to assist with sampling and specialized digital modeling, making it difficult to widely implement in ophthalmology. Therefore, there is an urgent clinical need for a precise and simplified surgical guidance technique to help clinicians perform macular cingulate surgery more safely and effectively. Summary of the Invention

[0005] This invention addresses the technical problems existing in the prior art by providing a method for constructing a three-dimensional model of the eyeball, a method and system for macula ligament surgery navigation.

[0006] According to a first aspect of the present invention, a method for constructing a three-dimensional model of an eyeball is provided, comprising:

[0007] A panoramic scan of the posterior sclera of highly myopic patients was performed using wide-angle OCT, and the posterior segment structure of the variable area of ​​the eye in highly myopic patients was obtained by three-dimensional reconstruction of the scanned area using MATLAB software.

[0008] Based on the three-dimensional structure of the posterior segment of the variable region in highly myopic patients and the fixed parameter model of the constant region in highly myopic patients, a three-dimensional whole-eye model of highly myopic patients is constructed.

[0009] Based on the above technical solution, the present invention can also be improved as follows.

[0010] Optionally, the eyeball structure of high myopia includes three regions: the first region is the anterior region with small variation in three-dimensional parameters, called the high myopia constant region; the second region is the posterior region with large individual differences, called the high myopia variable region; and the third region is the region naturally stretched between the constant region and the variable region, called the high myopia transition region.

[0011] Optionally, the step of constructing a three-dimensional whole-eye model of a highly myopic patient based on the three-dimensional structure of the posterior segment of the variable region and the fixed-parameter model of the constant region of the highly myopic patient includes:

[0012] Cross-modal image registration is performed based on the three-dimensional affine transformation method to smooth the curvature difference at the connection between the three-dimensional structure of the posterior segment of the variable region of the highly myopic patient and the fixed parameter model of the constant region of the highly myopic patient, thereby constructing a three-dimensional whole-eye model of the highly myopic patient.

[0013] Optionally, the wide-angle OCT scanning mode is CUBE 26×21 1024×828 mode, the scanning range is 26mm x 21mm, and the depth is 12mm.

[0014] According to a second aspect of the present invention, a method for surgical navigation of the macular buckle is provided, comprising:

[0015] Based on the simulation and combination of the constructed three-dimensional full-eye model of a patient with high myopia and the digital model of the macular ligament, various surgical navigation parameters for macular ligament surgery are calculated.

[0016] Based on various surgical navigation parameters for macular ligation surgery, macular ligation surgery is performed on patients with high myopia.

[0017] Optional surgical navigation parameters include the size and shape of the buckle material, as well as the suture position of the buckle material on the surface of the eyeball and its anatomical relationship with the limbus.

[0018] Optionally, the calculation of various surgical navigation parameters for macular buckling surgery includes:

[0019] Mark the location of the fovea centralis based on the OCT scan images;

[0020] Calculate the macular top pressure height based on the degree of macular splitting shown by OCT;

[0021] The location of the macular pressure center is determined based on the location of the macular fovea.

[0022] The size and shape of the buckle material are determined based on the arc length of the eyeball that it fits with and the macular pressure height, as well as the suture position of the buckle material on the surface of the eyeball and its anatomical relationship with the angular limbus.

[0023] According to a third aspect of the present invention, a three-dimensional eyeball model construction system is provided, comprising:

[0024] The first building module is used to perform panoramic scanning of the posterior sclera of highly myopic patients based on wide-angle OCT, and to use MATLAB software to perform three-dimensional reconstruction of the scanned area to obtain the three-dimensional structure of the posterior segment of the eye in the variable area of ​​highly myopic patients.

[0025] The second construction module is used to construct a three-dimensional whole-eye model of a patient with high myopia based on the three-dimensional structure of the posterior segment of the variable area of ​​the patient with high myopia and the fixed parameter model of the constant area of ​​the patient with high myopia.

[0026] According to a fourth aspect of the present invention, a macular buckle surgical navigation system is provided, comprising:

[0027] The calculation module is used to simulate and combine the constructed three-dimensional full-eye model of a highly myopic patient with the digital model of the macular ligament to calculate various surgical navigation parameters for macular ligament surgery.

[0028] The execution module is used to perform macular suturing surgery on patients with high myopia based on various surgical navigation parameters for macular suturing.

[0029] According to a fifth aspect, the present invention also provides an electronic device, including a memory and a processor, wherein the processor is used to execute a computer management program stored in the memory to implement the steps of a method for constructing a three-dimensional model of the eyeball and the steps of a method for navigating macular ligament surgery.

[0030] This invention provides a method for constructing a three-dimensional model of the eyeball, a method and system for macula ligament surgery navigation, and a system based on the variation area images of highly myopic patients scanned by wide-angle OCT. This effectively reduces the difficulty of three-dimensional reconstruction of the eyeball and greatly improves the accuracy of macular localization. It provides a simple and efficient new mode for reducing the difficulty of macular ligament surgery, improving the accuracy of macular ligament surgery, and realizing individualized macular ligament surgery. Attached Figure Description

[0031] Figure 1 A flowchart illustrating a method for constructing a three-dimensional eyeball model provided by the present invention;

[0032] Figure 2 A schematic diagram of the constructed three-dimensional model of the eyeball;

[0033] Figure 3 A schematic flowchart of a surgical navigation method for the macular cingulate provided by the present invention;

[0034] Figure 4 A schematic diagram of a three-dimensional reconstructed cross section of the eyeball used for navigation during macular ligament surgery;

[0035] Figure 5 This is a schematic diagram of the structure of a three-dimensional eyeball model construction system provided by the present invention;

[0036] Figure 6 This is a schematic diagram of the structure of a macular buckling surgical navigation system provided by the present invention. Detailed Implementation

[0037] To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention. In addition, the technical features of the various embodiments or individual embodiments provided by the present invention can be arbitrarily combined with each other to form feasible technical solutions. Such combinations are not constrained by the order of steps and / or structural composition patterns, but must be based on the ability of those skilled in the art to implement them. When the combination of technical solutions is contradictory or cannot be implemented, it should be considered that such a combination of technical solutions does not exist and is not within the scope of protection claimed by the present invention.

[0038] Figure 1 A flowchart of a method for constructing a three-dimensional eyeball model provided by the present invention is shown below. Figure 1 As shown, the method includes:

[0039] Step 1: Perform a panoramic scan of the posterior sclera of highly myopic patients using wide-angle OCT, and use MATLAB software to perform three-dimensional reconstruction of the scanned area to obtain the three-dimensional structure of the posterior segment of the eye in the variable area of ​​highly myopic patients.

[0040] Understandably, analysis of anterior segment OCT and MRI datasets from highly myopic patients revealed the following important characteristics of morphological changes in the eyeball: axial elongation is a crucial biological parameter in highly myopic patients, but the differences in anterior segment biological parameters are relatively small among patients with different degrees of myopia; the main structural changes occur in the posterior sclera. The structure of the highly myopic eyeball can be divided into three regions: 1) an anterior region with minimal variation in three-dimensional parameters (constant region); 2) a posterior region with significant individual differences (variable region); and 3) a region of natural stretching between the two (transition region). Using the axial length as a reference, the constant region is roughly located anterior to the eye's equator, approximately 14 mm from the corneal apex, while the variable region is located posterior to the macula, approximately 10 mm from the macular apex. The region between these two is formed by the natural stretching of the eyeball. Based on these anatomical characteristics, theoretically, a full eye scan is unnecessary. If the axial length can be accurately measured and the posterior scleral structure reconstructed, a simpler and faster method can be used to reconstruct a more accurate three-dimensional model of the highly myopic eyeball with more precise posterior parameters, replacing MRI.

[0041] This invention utilizes wide-angle OCT to scan fundus images of patients with dry myopia. The OCT mode is CUBE 26×21 1024×828, with a scanning range of 26mm x 21mm and a depth of 12mm. It performs a panoramic scan of the posterior sclera of patients with high myopia and uses MATLAB software to perform three-dimensional reconstruction of the scanned area to obtain the three-dimensional structure of the posterior segment of the eye.

[0042] Step 2: Based on the three-dimensional structure of the posterior segment of the variable region of the highly myopic patient and the fixed parameter model of the constant region of the highly myopic patient, construct a three-dimensional whole-eye model of the highly myopic patient.

[0043] Understandably, after reconstructing the three-dimensional structure of the posterior segment of the variable region in highly myopic patients using wide-angle OCT, the three-dimensional structure of the posterior segment of highly myopic patients is combined with the fixed-parameter model of the constant region. Cross-modal image registration is performed based on methods such as three-dimensional affine transformation to smooth the curvature difference at the connection between the three-dimensional structure of the posterior segment of the variable region and the fixed-parameter model of the constant region of highly myopic patients. A personalized three-dimensional whole-eye model of highly myopic patients is then constructed. The constructed three-dimensional whole-eye model can be found in [reference needed]. Figure 2 , Figure 2In the diagram, OACDB represents the constant zone of high myopia, extending from the cornea to the equator of the eyeball. AOB represents the corneal portion with a radius of curvature of 8mm. AB represents the limbus, an anatomical landmark, with a maximum distance of 12mm. OM is the axial length (AL), the parameter with the greatest individual variation in high myopia, positively correlated with the severity of fundus lesions, and can be precisely measured by ophthalmologists. AC and BD both represent the constant scleral portion, with a radius of curvature of approximately 13mm. OO' distance is approximately 14mm, and CD is approximately 26mm. 2) EMFM' is the highly variable region of high myopia, generated directly by wide-angle OCT imaging, with a maximum sampling depth of 12mm. In actual measurements, MM' is taken at a depth of 10mm. This part determines the morphology of the macula, the length of the axial length, and the severity of choroidal retinal lesions. 3) O'CEM'FD is the transitional zone of high myopia, stretched from the constant zone to the variable zone. O'M' = OM - OO' - MM' = AL - 24mm.

[0044] See Figure 3 A surgical navigation method for the macular cingulate is provided, comprising:

[0045] Step 1': Based on the constructed three-dimensional full-eye model of a patient with high myopia and the digital model of the macular ligament, the simulation is combined to calculate various surgical navigation parameters for macular ligament surgery.

[0046] Step 2': Based on the various surgical navigation parameters of the macular ligation surgery, perform macular ligation surgery on patients with high myopia.

[0047] Understandably, the above embodiments, after constructing a full-eye 3D model of a patient with high myopia based on wide-angle OCT, combine the constructed 3D full-eye model with a digital model of the macular ligament to achieve preoperative surgical navigation and pre-calculate various surgical parameters. Specifically, this includes: accurately marking the position of the fovea of ​​the macular region based on the OCT scan image; calculating the height of the macular apex pressure based on the degree of macular schisis shown by the OCT; determining the center position of the apex pressure based on the actual position of the fovea of ​​the macular region; and determining the size and shape of the ligament material and its suture position on the surface of the eyeball in relation to the angular limbus anatomical relationship based on the arc length of the eyeball that fits with the ligament and the height of the apex pressure. This allows for individualized design of the macular ligament surgery, improving surgical accuracy while reducing surgical difficulty and shortening surgical time.

[0048] Among them, see Figure 4 This is a schematic diagram of a three-dimensional reconstructed cross section of the eyeball established for navigation during macular cingulate surgery. O is the apex of the anterior corneal surface, M is the fovea of ​​the macula, L is the limbus, and ON is the optic nerve; OM is the axial length, and M'M is the estimated apical pressure; the shaded area is the macular cingulate, B is the apical pressure plate of the macular cingulate; P is the anterior suture point of the cingulate, and LP is the distance from the suture point of the cingulate to the limbus.

[0049] See Figure 5 The present invention provides a three-dimensional eyeball model construction system, which includes a first construction module 501 and a second construction module 502, wherein:

[0050] The first construction module 501 is used to perform panoramic scanning of the posterior sclera of highly myopic patients based on wide-angle OCT, and to use MATLAB software to perform three-dimensional reconstruction of the scanned area to obtain the three-dimensional structure of the posterior segment of the eye in the variable area of ​​highly myopic patients.

[0051] The second construction module 502 is used to construct a three-dimensional whole-eye model of a patient with high myopia based on the three-dimensional structure of the posterior segment of the variable area of ​​the patient with high myopia and the fixed parameter model of the constant area of ​​the patient with high myopia.

[0052] It is understood that the eyeball three-dimensional model construction system provided by the present invention corresponds to the eyeball three-dimensional model construction method provided in the foregoing embodiments. The relevant technical features of the eyeball three-dimensional model construction system can be referred to the relevant technical features of the eyeball three-dimensional model construction method, and will not be repeated here.

[0053] See Figure 6 The present invention provides a macular buckling surgical navigation system, which includes a calculation module 601 and an execution module 602, wherein:

[0054] The calculation module 601 is used to calculate various surgical navigation parameters for macular ligament surgery by combining the constructed three-dimensional full-eye model of a patient with a digital model of the macular ligament.

[0055] The execution module 602 is used to perform macular suturing surgery on patients with high myopia based on various surgical navigation parameters of macular suturing surgery.

[0056] It is understood that the macular cingulate surgical navigation system provided by the present invention corresponds to the macular cingulate surgical navigation method provided in the foregoing embodiments. The relevant technical features of the macular cingulate surgical navigation system can be referred to the relevant technical features of the macular cingulate surgical navigation method, and will not be repeated here.

[0057] The present invention provides a method for constructing a three-dimensional model of the eyeball, a method and system for surgical navigation of the macular ligament, which have the following beneficial effects:

[0058] (1) This invention is the first to propose using wide-angle OCT scanning to obtain three-dimensional structural parameters of the posterior scleral variation area and combine them with a fixed parameter model of the constant area to construct a cross-modal fusion three-dimensional eyeball model. This scheme is original, simpler than traditional MRI methods, has higher accuracy in detecting posterior structures, and is more suitable for navigation applications in macular cingulate surgery.

[0059] (2) The three-dimensional model constructed based on wide-angle OCT is completed entirely by ophthalmic equipment. The calculation is simple, does not increase the patient's additional testing costs and consultation time, and does not rely on radiology imaging and modeling. This is of great significance for the promotion of this procedure in the future.

[0060] (3) OCT-based navigation systems can accurately locate and quantify macular lesions, which is of great reference value in the individualized design of macular ligation surgery. Its higher precision ensures the accuracy of surgical navigation, effectively reduces surgical operation time, reduces surgical difficulty, improves the effectiveness and safety of surgery, and further promotes the use of macular ligation surgery.

[0061] It should be noted that the descriptions of each embodiment in the above embodiments have different focuses. For parts that are not described in detail in a certain embodiment, please refer to the relevant descriptions in other embodiments.

[0062] Those skilled in the art will understand that embodiments of the present invention can be provided as methods, systems, or computer program products. Therefore, the present invention can take the form of a completely hardware embodiment, a completely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, the present invention can take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, etc.) containing computer-usable program code.

[0063] This invention is described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, special-purpose computer, embedded computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, generate instructions for implementing the flowchart illustrations. Figure 1 One or more processes and / or boxes Figure 1 A device that provides the functions specified in one or more boxes.

[0064] These computer program instructions may also be stored in a computer-readable storage medium that can direct a computer or other programmable data processing device to function in a particular manner, such that the instructions stored in the computer-readable storage medium produce an article of manufacture including instruction means, which are implemented in a process Figure 1 One or more processes and / or boxes Figure 1 The function specified in one or more boxes.

[0065] These computer program instructions may also be loaded onto a computer or other programmable data processing equipment to cause a series of operational steps to be performed on the computer or other programmable equipment to produce a computer-implemented process, thereby providing instructions that execute on the computer or other programmable equipment for implementing the process. Figure 1 One or more processes and / or boxes Figure 1 The steps of the function specified in one or more boxes.

[0066] Although preferred embodiments of the invention have been described, those skilled in the art, upon learning the basic inventive concept, can make other changes and modifications to these embodiments. Therefore, the appended claims are intended to be interpreted as including both the preferred embodiments and all changes and modifications falling within the scope of the invention.

[0067] Obviously, those skilled in the art can make various modifications and variations to this invention without departing from its spirit and scope. Therefore, if these modifications and variations fall within the scope of the claims of this invention and their equivalents, this invention also intends to include these modifications and variations.

Claims

1. A method of constructing a three-dimensional model of an eyeball, characterized by, The method comprises the following steps: Based on wide-angle OCT, panoramic scanning is performed on the posterior sclera of the high myopia patient, and three-dimensional reconstruction is performed on the scanning site by using MATLAB software to obtain the three-dimensional structure of the posterior segment of the high myopia patient in the variation zone; According to the three-dimensional structure of the posterior segment of the high myopia patient in the variation zone and the fixed parameter model of the constant zone of the high myopia patient, a three-dimensional whole eye model of the high myopia patient is constructed; The eyeball structure of high myopia includes three regions, the first region is the front region with small three-dimensional parameter variation, which is called the constant zone of high myopia, the second region is the posterior region with large individual difference, which is called the variation zone of high myopia, and the third region is the region naturally stretched between the constant zone and the variation zone, which is called the transition zone of high myopia; The three-dimensional whole eye model of the high myopia patient is constructed according to the three-dimensional structure of the posterior segment of the high myopia patient in the variation zone and the fixed parameter model of the constant zone of the high myopia patient, comprising: Based on the three-dimensional affine transformation method, cross-modal image registration is performed, and the curvature difference of the three-dimensional structure of the posterior segment of the high myopia patient in the variation zone and the fixed parameter model of the constant zone of the high myopia patient at the connection is smoothed to construct the three-dimensional whole eye model of the high myopia patient.

2. The three-dimensional model construction method of an eyeball according to claim 1, wherein The scanning mode of the wide-angle OCT is CUBE 26x21 1024x828 mode, the scanning range is 26mm x 21mm, and the depth is 12mm.

3. An electronic device, comprising: The method comprises a memory and a processor, and the processor is used to execute the computer management program stored in the memory to realize the steps of the eyeball three-dimensional model construction method according to any one of claims 1-2.

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