Ophthalmic surgical microscope system and intraoperative navigation method for an ophthalmic surgical microscope
Patent Information
- Application Number
- CN202610507514.9
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2026-04-16
- Publication Date
- 2026-08-21
AI Technical Summary
[0005]然而，现有技术中，手术医师通常需要术中暂停手术操作，在OCT图像上手动测量上述参数，这既会增加手术医生的操作量，也会导致手术时间延长，进而可能增加手术风险
[0011] It should be understood that the above general description and the following detailed description are exemplary and explanatory only, and are not intended to limit this disclosure.
Smart Images
Figure CN122604298A_ABST
Abstract
Description
Technical Field
[0001] This disclosure relates to the field of surgical microscopes, such as to an ophthalmic surgical microscope system, an intraoperative navigation method for ophthalmic surgical microscopes, and an ophthalmic surgical microscope. Background Technology
[0002] Cataracts are currently the leading cause of blindness worldwide. With an aging population, the incidence of cataracts is increasing year by year. Cataract removal surgery, followed by the implantation of an aphakic intraocular lens (IOL) for refractive correction, can improve the vision of cataract patients.
[0003] Furthermore, in recent years, with the increasing incidence of myopia and the improvement of people's living standards, refractive surgeries for myopia correction have become rapidly popularized. Currently, phakic collamer lens implantation (ICL) has become one of the mainstream myopia correction procedures. Because it requires the implantation of an artificial lens when the eye has a normal natural lens, it is called phakic collamer lens implantation.
[0004] In ophthalmic surgeries (including but not limited to cataract surgery and refractive surgeries for myopia correction), measuring parameters of native eye tissue and implanted intraocular lenses using optical coherence tomography (OCT) images can assist surgeons in adjusting surgical procedures in real time based on any abnormalities in the measured parameters. Therefore, real-time intraoperative measurement of parameters of native eye tissue and implanted intraocular lenses has significant clinical value in aiding intraoperative decision-making.
[0005] However, in existing technologies, surgeons typically need to pause the surgical procedure during the operation to manually measure the aforementioned parameters on OCT images. This increases the workload for the surgeon, prolongs the operation time, and may increase the surgical risk. Summary of the Invention
[0006] This disclosure provides an ophthalmic surgical microscope system, an intraoperative navigation method for ophthalmic surgical microscopes, and an ophthalmic surgical microscope. During surgery, the above parameters can be automatically measured based on OCT images without the need for the surgeon to pause the surgical procedure, thus overcoming the above-mentioned defects of the prior art.
[0007] According to a first aspect of the present disclosure, an ophthalmic surgical microscope system is provided, comprising:
[0008] The OCT scanning module is configured to perform intraoperative OCT scanning based on the OCT scanning location in order to obtain the corresponding OCT images; The image processing module is configured to acquire corresponding real-time monitoring values of intraoperative parameters based on the OCT image, and generate corresponding intraoperative navigation information based on the real-time monitoring values of intraoperative parameters. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness; and The display module is configured to display the intraoperative navigation information.
[0009] According to a second aspect of the present disclosure, an intraoperative navigation method for an ophthalmic surgical microscope is provided, comprising: Intraoperative OCT scanning is performed based on the OCT scanning location to obtain the corresponding OCT images; Based on the OCT images, corresponding real-time monitoring values of intraoperative parameters are obtained, and corresponding intraoperative navigation information is generated based on these real-time monitoring values. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness; and Display the intraoperative navigation information.
[0010] According to a third aspect of the present disclosure, an ophthalmic surgical microscope is provided, including the OCT scanning module and display module of the ophthalmic surgical microscope system described in the first aspect; or, the ophthalmic surgical microscope system described in the first aspect.
[0011] It should be understood that the above general description and the following detailed description are exemplary and explanatory only, and are not intended to limit this disclosure. Attached Figure Description
[0012] The accompanying drawings, which are incorporated in and form part of this specification, illustrate embodiments consistent with this disclosure and, together with the description, serve to explain the principles of this disclosure, and are not intended to unduly limit this disclosure.
[0013] Figure 1 This is an architectural diagram of an ophthalmic surgical microscope system provided according to an embodiment of the present disclosure; Figure 2 This is a block diagram of an ophthalmic surgical microscope system provided according to an embodiment of the present disclosure; Figure 3 This is a schematic diagram illustrating the location of an OCT scan based on a camera image, according to an embodiment of this disclosure. Figure 4 This is a schematic diagram of consecutive multiple frames of anterior segment OCT images provided according to embodiments of the present disclosure; Figure 5a This is a schematic diagram of an anterior segment OCT image provided according to an embodiment of the present disclosure; Figure 5b It is based on Figure 5a A schematic diagram of the generated mask; Figure 6a This is a schematic diagram of measuring anterior chamber depth based on a single iris mask according to an embodiment of the present disclosure; Figure 6b This is a schematic diagram of measuring anterior chamber depth based on a dual iris mask according to an embodiment of the present disclosure; Figure 7 This is a schematic diagram of intraoperative navigation during cataract surgery according to an embodiment of the present disclosure; Figure 8 This is a schematic diagram of intraoperative real-time measurement of corneal thickness according to an embodiment of the present disclosure; Figure 9 This is a schematic diagram of intraoperative real-time measurement of ICL arch height according to an embodiment of this disclosure; Figure 10 This is a schematic diagram illustrating real-time intraoperative measurement of the remaining depth of the anterior chamber according to an embodiment of this disclosure; Figure 11 This is a schematic diagram of intraoperative real-time measurement of lens thickness according to an embodiment of this disclosure; Figure 12a and Figure 12b This is a schematic diagram of intraoperative navigation for myopia surgery according to an embodiment of the present disclosure; Figure 13 This is a flowchart of an intraoperative navigation method for an ophthalmic surgical microscope provided according to an embodiment of the present disclosure; Figure 14 This is a block diagram of an ophthalmic surgical microscope provided according to an embodiment of the present disclosure; Figure 15 This is a schematic diagram of a medical device provided according to an embodiment of the present disclosure. Detailed Implementation
[0014] To enable those skilled in the art to better understand the technical solutions of this disclosure, the technical solutions in the embodiments of this disclosure will be clearly and completely described below with reference to the accompanying drawings.
[0015] This disclosure is not exhaustive, but merely illustrative of some embodiments, and is not intended to limit the scope of protection of this disclosure. Unless otherwise specified, each step in a particular embodiment can be implemented as an independent embodiment, and the steps can be arbitrarily combined. For example, a solution after removing some steps in a particular embodiment can also be implemented as an independent embodiment, and the order of the steps in a particular embodiment can be arbitrarily interchanged. Furthermore, the optional implementation methods in a particular embodiment can be arbitrarily combined; moreover, the embodiments can be arbitrarily combined, for example, some or all steps of different embodiments can be arbitrarily combined, and a particular embodiment can be arbitrarily combined with the optional implementation methods of other embodiments.
[0016] In the various embodiments disclosed herein, unless otherwise specified or in case of logical conflict, the terminology and / or descriptions of the embodiments are consistent and can be referenced by each other. Technical features in different embodiments can be combined to form new embodiments based on their inherent logical relationships.
[0017] The terminology used in the embodiments of this disclosure is for the purpose of describing particular embodiments only and is not intended to limit the scope of this disclosure.
[0018] In this disclosure, unless otherwise stated, elements expressed in the singular form, such as "a," "an," "the," "the," "the," "the," "the," "the," "this," etc., can mean "one and only one," or "one or more," "at least one," etc. For example, when using articles such as "a," "an," "the," etc. in translation, the noun following the article can be understood as either a singular or a plural expression.
[0019] In the embodiments disclosed herein, "multiple" refers to two or more.
[0020] In some embodiments, the terms “at least one of,” “one or more,” “a plurality of,” and “multiple” may be used interchangeably.
[0021] The prefixes "first," "second," etc., used in the embodiments of this disclosure are merely for distinguishing different descriptive objects and do not impose restrictions on the position, order, priority, number, or content of the descriptive objects. The description of the descriptive objects is given in the claims or the context of the embodiments, and the use of prefixes should not constitute unnecessary restrictions. Furthermore, the objects modified by different prefixes may be the same or different. For example, if the descriptive object is "device," then "first device" and "second device" may be the same device or different devices, and their types may be the same or different. Similarly, if the descriptive object is "information," then "first information" and "second information" may be the same information or different information, and their content may be the same or different.
[0022] It should be noted that the terms "first," "second," etc., used in the specification, claims, and accompanying drawings of this disclosure are used to distinguish similar objects and are not necessarily used to describe a specific order or sequence. It should be understood that such data can be interchanged where appropriate so that the embodiments of this disclosure described herein can be implemented in orders other than those illustrated or described herein. The embodiments described in the following exemplary embodiments do not represent all embodiments consistent with this disclosure. Rather, they are merely examples of apparatuses and methods consistent with some aspects of this disclosure as detailed in the appended claims.
[0023] Figure 1 This is an architectural diagram of an ophthalmic surgical microscope system provided according to an embodiment of this disclosure. (Reference) Figure 1 The ophthalmic surgical microscope system 1a includes an ophthalmic surgical microscope 10, a foot pedal controller 20, a carriage 30, and a control terminal 40. The foot pedal controller 20, the carriage 30, and the control terminal 40 are all communicatively connected to the ophthalmic surgical microscope 10. The carriage 30 has a 3D display function. In other embodiments, the ophthalmic surgical microscope system 1a may not include at least one of the carriage 30 and the control terminal 40; this disclosure does not limit the scope of the embodiments.
[0024] In some embodiments, the ophthalmic surgical microscope 10 may include, but is not limited to: a microscope module 11, a suspension arm module 12, a mid-arm module 13, an upper arm module 14, a movable support 15, an OCT module 16, and a control module 17. The control terminal 40 has essentially the same function as the control module 17, both having a cloud-based imaging client installed (e.g., for patient management, intraoperative image acquisition, postoperative image review and analysis, etc.). In some embodiments, the computing power of the control terminal 40 can be configured to be higher than that of the control module 17, so that in application scenarios with high computing power requirements, the control terminal 40 can replace the control module 17.
[0025] In this embodiment, the foot pedal controller 20 has control functions such as lighting, focusing, and magnification, and is mainly used to control the ophthalmic surgical microscope 10 accordingly.
[0026] This disclosure provides an ophthalmic surgical microscope system.
[0027] Figure 2 This is a block diagram of an ophthalmic surgical microscope system provided according to an embodiment of the present disclosure, such as... Figure 2 As shown, the ophthalmic surgical microscope system may include: an OCT scanning module 201, an image processing module 202, and a display module 203.
[0028] The OCT scanning module 201 is configured to perform intraoperative OCT scanning based on the OCT scanning location to obtain the corresponding OCT image.
[0029] The image processing module 202 is configured to acquire corresponding real-time monitoring values of intraoperative parameters based on OCT images, and generate corresponding intraoperative navigation information based on the real-time monitoring values of intraoperative parameters. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness.
[0030] Display module 203 is configured to display intraoperative navigation information.
[0031] refer to Figure 1 and Figure 2 The OCT scanning module 201 may include the OCT illumination and OCT imaging optical paths from the OCT module 16 and the microscope module 11. Both the control module 17 and the control terminal 40 may be equipped with image processing modules 202. The control module 17, the carriage 30, and the control terminal 40 may all be equipped with display modules 203. The display module 203 can display intraoperative navigation information as well as OCT images. Furthermore, in some embodiments, the ophthalmic surgical microscope 10 may also include a projection module, thereby allowing at least one of the intraoperative navigation information and OCT images to be superimposed and displayed in optical microscopy for the physician's observation.
[0032] In this embodiment, optical microscopy imaging refers to a high-quality, magnified optical image formed by the front-end optical system of an ophthalmic surgical microscope. Optical microscopy imaging utilizes objectives, zoom, illumination, and a binocular stereoscopic optical path to magnify the surgical area or site, forming a clear, bright, and three-dimensional optical image. Optical microscopy images can be observed by a doctor or recorded by a camera (CCD / CMOS). After being recorded by a camera, optical microscopy images form corresponding camera images.
[0033] In this embodiment of the disclosure, the ophthalmic surgical microscope system can be used for intraoperative navigation of anterior segment surgery, posterior segment surgery, and whole-eye surgery. Anterior segment surgery includes, but is not limited to, cataract surgery and refractive surgery for myopia correction. Refractive surgery for myopia correction includes, but is not limited to, ICL lens-based myopia surgery and laser myopia surgery.
[0034] As people age, their naturally clear lens becomes cloudy and deteriorates, leading to cataracts. Cataract surgery involves removing the cataract (i.e., removing the cloudy, deteriorated natural lens, but preserving the capsular bag), and implanting a clear, matching artificial lens into the capsular bag, fixing it in its original physiological position. Unlike cataract surgery, refractive surgery for nearsightedness correction involves preserving the patient's own natural lens and implanting a matching artificial lens in front of it.
[0035] In implementing the embodiments of this disclosure, the inventors discovered that parameters such as anterior chamber depth, corneal thickness, and lens thickness can provide intraoperative decision support for cataract surgery. For example, based on anterior chamber depth, the surgeon can assess the difficulty of the surgery. A shallow anterior chamber makes it easier to damage the corneal endothelium and iris during surgery, leading to a higher risk of complications. Based on the surgical difficulty assessment results, the surgeon can further determine phacoemulsification parameters and intraoperative operation strategies to reduce the risk of surgical complications. As another example, based on corneal thickness, the surgeon can determine whether the patient has edema and assess refractive calculations. A cornea that is too thin can significantly increase surgical risk. Based on the edema assessment results and refractive calculation assessment results, the surgeon can further determine phacoemulsification parameters and intraoperative operation strategies to reduce surgical risk. Furthermore, based on lens thickness, the surgeon can assess the surgical difficulty level. For example, the thicker the lens, the longer the intraoperative phacoemulsification time, and consequently, the greater the risk of corneal damage, resulting in a higher surgical difficulty level. Based on the surgical difficulty grading assessment results, the surgeon can further determine the phacoemulsification parameters and intraoperative operation strategies to reduce surgical risks.
[0036] In implementing the embodiments of this disclosure, the inventors discovered that surgical parameters such as anterior chamber depth, phakic intraocular lens crown height, remaining anterior chamber depth, and corneal thickness can provide intraoperative decision support for surgeons in refractive surgeries for myopia correction. As mentioned above, refractive surgeries for myopia correction include ICL (Implantable Collamer Lens) surgery and laser-based myopia surgery. Laser-based myopia surgeries include femtosecond LASIK, LASIK, and excimer laser surgery. Corneal thickness determines the amount of tissue that can be ablated, its safety, and whether it will lead to keratoconus risks. Therefore, for laser-based myopia surgery, surgeons may primarily focus on corneal thickness, with anterior chamber depth and lens thickness serving as references. For ICL (Implantable Collamer Lens) surgery, surgeons may primarily focus on anterior chamber depth, phakic intraocular lens crown height, remaining anterior chamber depth, and corneal thickness.
[0037] As an optional embodiment, surgical parameters such as anterior chamber depth, phakic intraocular lens crown height, remaining anterior chamber depth, corneal thickness, and lens thickness can be pre-set in the ophthalmic surgical microscope system for the surgeon to select. The surgeon can choose at least one of these pre-set surgical parameters for intraoperative navigation, based on the specific surgical scenario and personal preferences.
[0038] In this embodiment, the OCT scanning module 201 performs intraoperative OCT scanning based on the OCT scanning location to obtain the corresponding OCT image. Then, the image processing module 202 obtains the corresponding intraoperative parameters based on the OCT image and generates corresponding intraoperative navigation information based on these parameters. Finally, the display module 203 displays the intraoperative navigation information. In this embodiment, the intraoperative parameters measured in real-time based on the OCT image may include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness. The specific surgical parameters that need to be measured in real-time can be determined based on the surgical parameters configured by the user (e.g., the surgeon). The surgical parameters configured by the user can be understood as surgical parameters of interest to the user (hereinafter referred to as point-of-interest surgical parameters).
[0039] For example, in cataract surgery, anterior chamber depth, corneal thickness, and lens thickness can be configured as points of interest surgical parameters. In this case, the surgical parameters measured in real time based on OCT images include anterior chamber depth, corneal thickness, and lens thickness.
[0040] In this embodiment, the OCT scan position can be set or located based on camera images. In some embodiments, the OCT scan position can be a scan position planned and set before surgery; in other embodiments, the OCT scan position can be a scan position planned and set before surgery and located in real time during surgery based on eye tracking; in still other embodiments, the OCT scan position can be a scan position located in real time during surgery based on eye tracking; in yet another embodiment, the OCT scan position can be any point of interest position manually set during surgery; and so on.
[0041] Through the embodiments of this disclosure, not only can OCT images be acquired in real time during surgery, but surgical parameters of points of interest can also be measured in real time based on the acquired OCT images. Based on the measured surgical parameters, corresponding intraoperative navigation information is automatically generated and displayed to assist the surgeon in intraoperative decision-making. In this way, the surgeon does not need to pause the surgical procedure to manually measure the surgical parameters of points of interest, thus not increasing the surgeon's workload or prolonging the operation time, thereby reducing surgical risks.
[0042] As an optional embodiment, the ophthalmic surgical microscope system may further include a microscope imaging module and a camera imaging module. The microscope imaging module is configured to perform microscopic optical imaging of the surgical site during surgery. The camera imaging module is configured to acquire camera images of the surgical site in real time during surgery. Furthermore, the display module 203 is also configured to display the camera images in real time during surgery and to overlay the OCT scan location on the camera images.
[0043] refer to Figure 3 The camera image displays a crosshair, indicating a cross scan. The position indicated by this crosshair is the OCT scan position. Cross scans include horizontal and vertical scans. As shown in the figure, an OCT scan is performed at the horizontal scan position indicated by the crosshair, and the resulting horizontal OCT image is overlaid in the upper right corner of the camera image; an OCT scan is performed at the vertical scan position indicated by the crosshair, and the resulting vertical OCT image is overlaid in the lower right corner of the camera image.
[0044] In addition, as mentioned above, in some embodiments, the ophthalmic surgical microscope 10 may also include a projection module, thereby allowing information such as the OCT scan position to be superimposed on the optical microscopic imaging for observation by the doctor.
[0045] In some embodiments, the OCT images acquired by the OCT scanning module 201 can be multiple consecutive OCT images. (See reference...) Figure 4The consecutive frames of anterior segment OCT images shown in the figure can be obtained by performing multiple OCT scans on the same scanning location. As shown in the figure, the cornea, iris, lens and other tissue structures or implanted lenses (such as ICL lenses, IOL lenses) can be clearly seen in the anterior segment OCT images.
[0046] As an optional embodiment, the image processing module 202 may include an image processing unit and a parameter acquisition unit. The image processing unit is configured to obtain a mask of the target object based on the OCT image, wherein the target object includes native eye tissue and / or an implanted intraocular lens; and the parameter acquisition unit is configured to acquire corresponding intraoperative parameters based on the mask.
[0047] In this embodiment, taking anterior segment OCT images as an example, the target object may include: cornea, iris, lens (including natural lens or artificial lens) and ICL lens.
[0048] In some embodiments, a mask for the target object can be obtained by processing the OCT image using a low-latency image segmentation method. In some embodiments, a mask for the target object can be obtained by processing the OCT image using a boundary segmentation method. In some embodiments, a mask for the target object can be obtained by processing the OCT image using a combination of low-latency image segmentation and boundary segmentation methods. Furthermore, when segmenting the OCT image using low-latency image segmentation and / or boundary segmentation methods, image gradient intensity can be incorporated into the image processing. In some embodiments, the mask for the target object can be obtained based on inference from a trained deep learning multi-class segmentation network model (e.g., UNet or ResNet).
[0049] For example, according to Figure 5a The OCT image shown can be obtained Figure 5b The masks shown are as follows: blue mask is the corneal mask, yellow mask is the IOL (intraocular lens) mask, blue-green mask is the iris mask, and green mask is the lens mask. Based on Figure 5b The mask shown can be used to measure surgical parameters such as corneal thickness, anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, and lens thickness.
[0050] Through the embodiments of this disclosure, after obtaining the mask of native eye tissue and implanted intraocular lens, the relevant surgical parameters during the operation can be automatically measured according to the pre-set point of interest surgical parameters.
[0051] The gas-liquid interface formed between the cornea (refractive index n≈1.376) and air (refractive index n=1.0) distorts the incident light path in OCT. Without correction, the optical path distortion caused by the difference in refractive media can easily introduce more measurement errors in anterior chamber parameters.
[0052] In this embodiment, due to the influence of the cornea, the surgical parameters obtained directly based on the mask measurement without refractive correction of the OCT image may be inaccurate. To overcome this deficiency, this disclosure provides two refractive correction methods: one is to perform refractive correction on the initial intraoperative parameters obtained based on the mask after obtaining the mask; the other is to perform refractive correction on the OCT image before obtaining the mask, then obtain the mask of the target object based on the corrected OCT image, and then obtain the corresponding intraoperative parameters based on the mask.
[0053] As an optional embodiment, the parameter acquisition unit is configured to: acquire the corresponding initial intraoperative parameters based on the mask; and perform refractive correction conversion on the initial intraoperative parameters to obtain the refractively corrected intraoperative parameters.
[0054] In implementing the embodiments of this disclosure, the inventors discovered that although the method of first performing refractive correction on the OCT image, then obtaining the mask, and then measuring the surgical parameters based on the mask can also obtain accurate surgical parameters, this method is relatively time-consuming and inefficient, and is not conducive to real-time measurement of surgical parameters during surgery.
[0055] In implementing the embodiments of this disclosure, the inventors also discovered that by omitting the refractive correction of the OCT image in the early stage and directly obtaining a mask based on the uncorrected OCT image, and then obtaining the initial intraoperative parameters based on the mask, and then performing refractive correction on the initial intraoperative parameters in the later stage, accurate surgical parameters can also be obtained. Moreover, this method is relatively short in time, relatively efficient, and more conducive to real-time measurement of surgical parameters during the operation.
[0056] In this embodiment, the method of omitting refractive correction of OCT images in the early stage and adding refractive correction of initial intraoperative parameters in the later stage is adopted. On the basis of obtaining accurate intraoperative parameters, it is more conducive to improving the measurement efficiency of intraoperative parameters and realizing dynamic real-time measurement of intraoperative parameters.
[0057] In some embodiments, when performing refractive correction conversion, the initial intraoperative parameters can be divided by the equivalent total corneal refractive index to obtain the refractive-corrected intraoperative parameters. In this embodiment, the equivalent total corneal refractive index can be, for example, 1.3375.
[0058] As an optional embodiment, the acquired mask may include, for example, a corneal mask and an iris mask. The parameter acquisition unit is configured to: acquire the vertex of the corneal endothelium based on the lower boundary line of the corneal mask; acquire the centroid of the iris based on the iris mask; and acquire the initial value of the anterior chamber depth based on the vertex of the corneal endothelium and the centroid of the iris.
[0059] In this embodiment, when the mask acquired based on the OCT image includes a corneal mask and an iris mask, the initial value of the anterior chamber depth can be measured based on the corneal mask and the iris mask. Specifically, the vertex of the corneal endothelium can be determined based on the lower boundary line of the corneal mask, and the centroid of the iris can be determined based on the iris mask. Then, the initial value of the anterior chamber depth can be obtained based on the vertex of the corneal endothelium and the centroid of the iris.
[0060] In this embodiment, after extracting the lower boundary line of the corneal mask, the corneal endothelial vertex can be obtained by fitting calculation based on the random consistency polynomial fitting method.
[0061] In this embodiment, the obtained iris mask may include one (reference) due to the influence of the OCT scan position. Figure 6a ) or 2 (for reference) Figure 6b ).
[0062] refer to Figure 6a The pink-marked mask is the iris mask. For a single iris mask, after determining the corneal endothelial vertex (X1, Y1) and the iris centroid (X2, Y2), we can further determine the horizontal line passing through the iris centroid (X2, Y2) and the intersection point (X0, Y0) of the horizontal line passing through the corneal endothelial vertex (X1, Y1) and perpendicular to it. The straight-line distance between the corneal endothelial vertex (X1, Y1) and the intersection point (X0, Y0) is the initial value of the measured anterior chamber depth. Further, dividing this initial anterior chamber depth by the equivalent total corneal refractive index yields the refractive-corrected anterior chamber depth.
[0063] refer to Figure 6b The pink-marked mask is the iris mask. With two iris masks, after determining the corneal endothelial vertex (X1, Y1) and the two iris centroids (X2, Y2) and (X3, Y3), the average iris centroid (X0, Y0) can be calculated based on these two centroids (X2, Y2) and (X3, Y3) as ((X2 + X3) / 2, (Y2 + Y3) / 2). The vertical component of the straight-line distance between the corneal endothelial vertex (X1, Y1) and the average iris centroid (X0, Y0) is the initial value of the measured anterior chamber depth. Further, dividing this initial anterior chamber depth by the equivalent total corneal refractive index yields the refractive-corrected anterior chamber depth.
[0064] In this embodiment of the disclosure, the intraoperative navigation information displayed by the display module 203 includes at least one of the following: real-time monitoring values of intraoperative parameters, intraoperative parameter fluctuation range, intraoperative parameter limits, and intraoperative parameter fluctuation monitoring information. In some embodiments, after measuring the anterior chamber depth, for example, it can be displayed as follows: Figure 7The navigation interface displayed shows navigation information. As shown in the figure, the text description indicates that the real-time anterior chamber depth monitoring value is 3.1mm; the anterior chamber depth progress bar represents the anterior chamber depth fluctuation monitoring information, which indicates that the current anterior chamber depth fluctuation is normal; the range defined by the maximum and minimum values of the anterior chamber depth progress bar represents the range of anterior chamber depth fluctuation. The smaller the anterior chamber depth fluctuation, the more stable the anterior chamber, and the less damage to tissues such as the corneal endothelium. Figure 7 The navigation interface shown can be used for cataract surgery navigation. In this embodiment, the anterior chamber depth of interest to the surgeon can be automatically and dynamically measured in real time during cataract surgery, providing the surgeon with real-time feedback on the quantitative values and dynamic changes of the anterior chamber depth. This eliminates the need for manual operation by the surgeon, reducing surgical time and lowering surgical risks.
[0065] As an optional embodiment, the parameter acquisition unit can also be configured to acquire an initial value of corneal thickness based on the upper and lower boundary lines of the corneal mask.
[0066] refer to Figure 8 The green-marked mask is the corneal mask. In some embodiments, after obtaining the corneal mask, the vertex of the upper boundary line of the corneal mask (hereinafter referred to as the upper vertex) can be determined. Then, the intersection point of the vertical line passing through the upper vertex and the lower boundary line of the corneal mask can be found. The straight-line distance between the intersection point and the upper vertex is the measured initial value of the corneal thickness. Further, dividing the initial value of the corneal thickness by the equivalent total corneal refractive index yields the refractive-corrected corneal thickness.
[0067] refer to Figure 8 In other embodiments, after obtaining the corneal mask, the vertex of the lower boundary line of the corneal mask (hereinafter referred to as the lower vertex) can be determined, and then the intersection point of the vertical line passing through the lower vertex and the upper boundary line of the corneal mask can be found. The straight-line distance between the intersection point and the lower vertex is the measured initial value of the corneal thickness. Further, dividing the initial value of the corneal thickness by the equivalent total corneal refractive index yields the refractive-corrected corneal thickness.
[0068] As an optional embodiment, the acquired mask may include, for example, an implantable intraocular lens mask (such as an ICL lens mask) and a lens mask (such as a natural lens mask). The parameter acquisition unit may be configured to: acquire the central vertex of the posterior surface of the implantable intraocular lens based on the lower boundary line of the implantable intraocular lens mask; acquire the anterior capsule vertex of the lens based on the upper boundary line of the lens mask; and acquire the initial value of the phakic intraocular lens arch height (i.e., the initial value of the ICL arch height) based on the central vertex of the posterior surface of the implantable intraocular lens and the anterior capsule vertex of the lens.
[0069] In this embodiment, the method for determining the central vertex of the posterior surface of the implanted intraocular lens and the method for determining the vertex of the anterior capsule of the lens are the same as or similar to the method for determining the vertex of the corneal endothelium described above, and will not be repeated here.
[0070] refer to Figure 9 The blue-marked masks are ICL (Implantable Collamer Lens) masks, and the red-marked masks are lens masks. In some embodiments, after obtaining the ICL and lens masks, the lower boundary line of the ICL mask can be extracted, and the central vertex of the posterior surface of the ICL lens can be determined based on this lower boundary line. Similarly, the upper boundary line of the lens mask can be extracted, and the anterior capsule vertex can be determined based on this upper boundary line. The straight-line distance between the central vertex and the anterior capsule vertex is the measured initial value of the ICL arch height. Further, dividing this initial ICL arch height by the equivalent total corneal refractive index yields the refractive-corrected ICL arch height.
[0071] As an optional embodiment, the acquired mask may include, for example, a corneal mask and an implantable intraocular lens mask (such as an ICL lens mask). The parameter acquisition unit may be configured to: acquire the vertex of the corneal endothelium based on the lower boundary line of the corneal mask; determine the intersection point of the vertical line passing through the vertex of the corneal endothelium and the upper boundary line of the implantable intraocular lens mask based on the upper boundary line of the corneal endothelium mask and the upper boundary line of the implantable intraocular lens mask; and acquire the initial value of the remaining depth of the anterior chamber based on the vertex of the corneal endothelium and the intersection point.
[0072] In this embodiment, the method for determining the vertex of the corneal endothelium is the same as or similar to the method for determining the vertex of the corneal endothelium described above, and will not be repeated here.
[0073] refer to Figure 10 The green-marked masks are corneal masks, and the blue-marked masks are ICL (Implantable Collamer Lens) masks. In some embodiments, after obtaining the corneal and ICL masks, the lower boundary line of the corneal mask can be extracted, and the vertex of the corneal endothelium can be determined based on this lower boundary line. The upper boundary line of the ICL mask can be extracted, and the intersection point of the vertical line passing through the vertex of the corneal endothelium and the upper boundary line can be found. The distance between this intersection point and the vertex of the corneal endothelium is the initial value of the measured anterior chamber residual depth. Further, dividing this initial value of the anterior chamber residual depth by the equivalent total corneal refractive index yields the refractive-corrected anterior chamber residual depth.
[0074] As an optional embodiment, the parameter acquisition unit can also be configured to: acquire the vertex of the anterior lens capsule based on the upper boundary line of the lens mask; acquire the vertex of the posterior lens capsule based on the lower boundary line of the lens mask; and acquire the initial value of the lens thickness based on the vertex of the anterior lens capsule and the vertex of the posterior lens capsule.
[0075] In this embodiment, the method for determining the apex of the anterior and posterior lens capsules is the same as or similar to the method for determining the apex of the corneal endothelium described above, and will not be repeated here.
[0076] refer to Figure 11 The mask marked in red is the lens mask. In some embodiments, after obtaining the lens mask, its upper and lower boundary lines can be extracted. The anterior capsule vertex is determined based on the upper boundary line, and the posterior capsule vertex is determined based on the lower boundary line. The distance between the anterior and posterior capsule vertex is the initial value of the measured lens thickness. Furthermore, dividing this initial lens thickness by the equivalent total corneal refractive index yields the refractive-corrected lens thickness.
[0077] In this embodiment of the disclosure, the intraoperative navigation information displayed by the display module 203 includes at least one of the following: real-time monitoring values of intraoperative parameters, intraoperative parameter fluctuation range, intraoperative parameter limits, and intraoperative parameter fluctuation monitoring information. In some embodiments, it may be as follows: Figure 12a The navigation interface displays navigation information. As shown in the figure, the real-time monitoring value of the anterior chamber depth is 3.4 mm; the real-time monitoring value of the remaining anterior chamber depth is 2.7 mm; the thin progress bar (i.e., the lower progress bar) is the remaining anterior chamber depth progress bar, which indicates the monitoring information of the remaining anterior chamber depth fluctuation. This monitoring information indicates that the current remaining anterior chamber depth fluctuation is normal. The range defined by the maximum and minimum values of the remaining anterior chamber depth progress bar represents the range of the remaining anterior chamber depth fluctuation. As shown in the figure, the real-time monitoring value of the ICL arch height is 440 μm; the upper limit of the ICL arch height is 660 μm, and the lower limit of the ICL arch height is 180 μm. The real-time monitoring value of 440 μm is between the lower limit of 180 μm and the upper limit of 660 μm, indicating that the current real-time monitoring value of the ICL arch height is a reasonable value; the thick progress bar (i.e., the upper progress bar) is the ICL arch height progress bar, which indicates the ICL arch height fluctuation monitoring information. This ICL arch height fluctuation monitoring information indicates that the current ICL arch height fluctuation is normal. The range defined by the maximum and minimum values of the ICL arch height progress bar indicates the fluctuation range of the ICL arch height. Figure 12a The navigation interface shown can be used for navigation during myopia surgery. In this embodiment, during myopia surgery, the ICL vault height, remaining anterior chamber depth, and anterior chamber depth, which are of interest to the surgeon, can be automatically and dynamically measured in real time. This provides the surgeon with real-time feedback on the quantitative values and dynamic changes of these surgical interest parameters, eliminating the need for manual operation by the surgeon, thus reducing surgical time and lowering surgical risks.
[0078] In this embodiment, intraoperative parameter fluctuation monitoring information can be in the form of, for example... Figure 7 and Figure 12aIn addition to the dynamic display as a progress bar, it can also be displayed as a fluctuating curve. For example, as shown... Figure 12b As shown in the figure, the fluctuation curve represents the monitoring results of the dynamic change of ICL arch height.
[0079] As an optional embodiment, the image processing unit can be configured to: perform refractive correction based on the OCT image to obtain a refractively corrected OCT image; and obtain a mask of the target object based on the refractively corrected OCT image.
[0080] In this embodiment, a method of refractive correction is performed on the OCT image before obtaining the mask to measure the parameters of each surgical point of interest in real time. In this embodiment, the mask for each target object is obtained based on the corrected OCT image, and then the corresponding intraoperative parameters are obtained based on the obtained mask. In this embodiment, the intraoperative parameters measured based on the mask do not require further refractive correction.
[0081] In this embodiment, a method is adopted to perform refractive correction on the OCT image in the early stage and not to perform refractive correction on the intraoperative parameters measured in the later stage. Although the parameter measurement efficiency is relatively low, it is still a method that can obtain accurate intraoperative parameters.
[0082] This disclosure provides an intraoperative navigation method for ophthalmic surgical microscopes.
[0083] Figure 13 This is a flowchart illustrating an intraoperative navigation method for an ophthalmic surgical microscope according to an embodiment of this disclosure. This navigation method can be implemented through software and hardware and can be executed by the aforementioned ophthalmic surgical microscope system. Figure 13 As shown, the method may include the following operations.
[0084] In operation S11, an intraoperative OCT scan is performed based on the OCT scan location to obtain the corresponding OCT image; In operation S12, based on the OCT image, the corresponding real-time monitoring values of intraoperative parameters are obtained, and based on the real-time monitoring values of intraoperative parameters, the corresponding intraoperative navigation information is generated. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness. In operation S13, the intraoperative navigation information is displayed.
[0085] In this embodiment, the intraoperative navigation method for ophthalmic surgical microscopes is the same as or similar to the aforementioned ophthalmic surgical microscope system in terms of the functions and technical effects achieved, and will not be repeated here.
[0086] As an optional embodiment, the intraoperative navigation information includes at least one of the following: real-time monitoring values of the above-mentioned intraoperative parameters, intraoperative parameter fluctuation range, intraoperative parameter limit, and intraoperative parameter fluctuation monitoring information.
[0087] As an optional embodiment, based on the OCT image, the corresponding real-time monitoring values of intraoperative parameters are obtained, including: obtaining a mask of the target object based on the OCT image, wherein the target object includes native eye tissue and / or an implanted intraocular lens; and obtaining the corresponding real-time monitoring values of intraoperative parameters based on the mask.
[0088] As an optional embodiment, based on the mask, the corresponding intraoperative parameters are obtained, including: based on the mask, obtaining the corresponding initial intraoperative parameter real-time monitoring value; and performing refractive correction conversion on the initial intraoperative parameter to obtain the refractive corrected intraoperative parameter real-time monitoring value.
[0089] As an optional embodiment, the acquired mask includes a corneal mask and an iris mask. Based on the mask, corresponding initial intraoperative parameter real-time monitoring values are acquired, including: acquiring the corneal endothelial vertex based on the lower boundary line of the corneal mask; acquiring the iris centroid based on the iris mask; and acquiring the initial anterior chamber depth based on the corneal endothelial vertex and the iris centroid.
[0090] As an optional embodiment, the acquired mask includes an implantable intraocular lens mask and a lens mask. Based on the mask, corresponding initial intraoperative parameter real-time monitoring values are acquired, including: acquiring the central vertex of the posterior surface of the implantable intraocular lens based on the lower boundary line of the implantable intraocular lens mask; acquiring the anterior capsule vertex of the lens based on the upper boundary line of the lens mask; and acquiring the initial value of the phakic intraocular lens arch height based on the central vertex of the posterior surface of the implantable intraocular lens and the anterior capsule vertex of the lens.
[0091] As an optional embodiment, based on the mask, the corresponding initial intraoperative parameter real-time monitoring values are obtained, including: obtaining the vertex of the corneal endothelium based on the lower boundary line of the corneal mask; determining the intersection point of the vertical line passing through the vertex of the corneal endothelium and the upper boundary line of the implanted intraocular lens mask based on the upper boundary line of the corneal endothelium and the vertex of the corneal endothelium; and obtaining the initial value of the remaining depth of the anterior chamber based on the vertex of the corneal endothelium and the intersection point.
[0092] As an optional embodiment, obtaining a mask of the target object based on the OCT image includes: performing refractive correction on the OCT image to obtain a refractively corrected OCT image; and obtaining a mask of the target object based on the refractively corrected OCT image.
[0093] As an optional embodiment, the method further includes: performing microscopic optical imaging of the surgical site during the operation; acquiring a camera image of the surgical site in real time during the operation; and displaying the camera image in real time during the operation, and superimposing the OCT scan location on the camera image.
[0094] As an optional embodiment, the OCT scan location can be a location set preoperatively and obtained in real time during the procedure through eye tracking, or any point of interest location manually set during the procedure.
[0095] This disclosure also provides an ophthalmic surgical microscope.
[0096] In some embodiments, the ophthalmic surgical microscope includes the ophthalmic surgical microscope system described in any of the foregoing embodiments, and the embodiments disclosed herein will not be repeated here.
[0097] In other embodiments, such as Figure 14 As shown, the ophthalmic surgical microscope may include, for example, the OCT scanning module 141 and display module 142 in the ophthalmic surgical microscope system described in any of the foregoing embodiments, and will not be described again in the embodiments disclosed herein.
[0098] Figure 15 This is a schematic diagram of a medical device provided according to an embodiment of this disclosure. The medical device may, for example, include the ophthalmic surgical microscope or control terminal described in any of the foregoing embodiments. Figure 15 As shown, the medical device 1500 includes a computing unit 1501, which can perform various appropriate actions and processes according to a computer program stored in a read-only memory (ROM) 1502 or a computer program loaded from a storage unit 1508 into a random access memory (RAM) 1503. The RAM 1503 may also store various programs and data required for the operation of the medical device 1500. The computing unit 1501, ROM 1502, and RAM 1503 are interconnected via a bus 1504. An input / output (I / O) interface 1505 is also connected to the bus 1504.
[0099] Multiple components in medical device 1500 are connected to I / O interface 1505, including: input unit 1506, such as keyboard, mouse, etc.; output unit 1507, such as various types of monitors, speakers, etc.; storage unit 1508, such as disk, optical disk, etc.; and communication unit 1509, such as network card, modem, wireless transceiver, etc. Communication unit 1509 allows medical device 1500 to exchange information / data with other devices through computer networks such as the Internet and / or various telecommunications networks.
[0100] The computing unit 1501 can be a variety of general-purpose and / or special-purpose processing components with processing and computing capabilities. Some examples of the computing unit 1501 include, but are not limited to, a central processing unit (CPU), a graphics processing unit (GPU), various special-purpose artificial intelligence (AI) computing chips, various computing units running machine learning model algorithms, a digital signal processor (DSP), and any suitable processor, controller, microcontroller, etc. The computing unit 1501 performs the various methods and processes described above. For example, in some embodiments, the above methods can be implemented as a computer software program tangibly contained in a machine-readable medium, such as storage unit 1508. In some embodiments, part or all of the computer program can be loaded and / or installed on the medical device 1500 via ROM 1502 and / or communication unit 1509. When the computer program is loaded into RAM 1503 and executed by the computing unit 1501, one or more steps of the methods described above can be performed. Alternatively, in other embodiments, the computing unit 1501 can be configured to perform the above methods by any other suitable means (e.g., by means of firmware).
[0101] The specific embodiments described above do not constitute a limitation on the scope of protection of this disclosure. Those skilled in the art should understand that various modifications, combinations, sub-combinations, and substitutions can be made according to design requirements and other factors. Any modifications, equivalent substitutions, and improvements made within the spirit and principles of this disclosure should be included within the scope of protection of this disclosure.
Claims
1. An ophthalmic surgical microscope system, comprising: The OCT scanning module is configured to perform intraoperative OCT scanning in real time based on the OCT scanning location in order to obtain the corresponding OCT images. The image processing module is configured to acquire corresponding real-time monitoring values of intraoperative parameters based on the OCT image, and generate corresponding intraoperative navigation information based on the real-time monitoring values of intraoperative parameters. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness; and The display module is configured to display the intraoperative navigation information.
2. The system according to claim 1, wherein, The intraoperative navigation information includes at least one of the following: real-time monitoring values of intraoperative parameters, intraoperative parameter fluctuation range, intraoperative parameter limit, and intraoperative parameter fluctuation monitoring information.
3. The system according to claim 1, wherein, The image processing module includes: An image processing unit is configured to obtain a mask of a target object based on the OCT image, wherein the target object includes native eye tissue and / or an implanted intraocular lens; and The parameter acquisition unit is configured to acquire the corresponding real-time monitoring values of intraoperative parameters based on the mask.
4. The system according to claim 3, wherein, The parameter acquisition unit is configured as follows: Based on the mask, obtain the corresponding initial intraoperative parameter real-time monitoring values; and The initial intraoperative parameter real-time monitoring values are refractively corrected to obtain the refractively corrected intraoperative parameter real-time monitoring values.
5. The system according to claim 4, wherein: The mask includes: a corneal mask and an iris mask; The parameter acquisition unit is configured as follows: Based on the lower boundary line of the corneal mask, the vertex of the corneal endothelium is obtained; Based on the iris mask, obtain the iris centroid; and The initial value of the anterior chamber depth is obtained based on the vertex of the corneal endothelium and the centroid of the iris.
6. The system according to claim 4, wherein: The mask includes: an implantable intraocular lens mask and a lens mask; The parameter acquisition unit is configured as follows: Based on the lower boundary line of the implantable intraocular lens mask, the central vertex of the posterior surface of the implantable intraocular lens is obtained. Based on the upper boundary line of the lens mask, the vertex of the anterior lens capsule is obtained; The initial value of the arch height of the phakic intraocular lens is obtained based on the central vertex of the posterior surface of the implanted intraocular lens and the anterior capsule vertex of the lens.
7. The system according to claim 4, wherein: The mask includes: a corneal mask and an implantable intraocular lens mask; The parameter acquisition unit is configured as follows: Based on the lower boundary line of the corneal mask, the vertex of the corneal endothelium is obtained; Based on the upper boundary line of the implanted intraocular lens mask and the vertex of the corneal endothelium, determine the intersection point of the vertical line passing through the vertex of the corneal endothelium and the upper boundary line of the implanted intraocular lens mask; and Based on the vertex of the corneal endothelium and the intersection point, the initial value of the remaining depth of the anterior chamber is obtained.
8. The system according to claim 3, wherein, The image processing unit is configured as follows: Refractive correction is performed on the OCT image to obtain a refractive-corrected OCT image; and Based on the refractive-corrected OCT image, a mask for the target object is obtained.
9. The system according to claim 1, further comprising: The microscope imaging module is configured to perform microscopic optical imaging of the surgical site during surgery; The camera imaging module is configured to acquire camera images of the surgical site in real time during the operation; as well as The display module is also configured to display the camera image in real time during the operation and to overlay the OCT scan position on the camera image.
10. The system according to claim 1, wherein, The OCT scan position is either a position set preoperatively and obtained in real-time through eye tracking during the procedure, or any point of interest position manually set during the procedure.
11. An intraoperative navigation method for ophthalmic surgical microscopes, comprising: Intraoperative OCT scanning is performed based on the OCT scanning location to obtain the corresponding OCT images; Based on the OCT images, corresponding real-time monitoring values of intraoperative parameters are obtained, and corresponding intraoperative navigation information is generated based on these real-time monitoring values. The real-time monitoring values of intraoperative parameters include at least one of the following: anterior chamber depth, phakic intraocular lens arch height, remaining anterior chamber depth, corneal thickness, and lens thickness; and Display the intraoperative navigation information.
12. An ophthalmic surgical microscope, comprising: The OCT scanning module and display module in the ophthalmic surgical microscope system according to claim 1; or The ophthalmic surgical microscope system as described in claim 1.