OCT-Guided Glaucoma Surgery Targeting Schlemm's Canal
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Solution Overview
Problem
Current glaucoma surgery methods face challenges in accurately visualizing and targeting outflow structures like Schlemm's canal due to total internal reflection, leading to inconsistent and less than ideal surgical outcomes, particularly in minimally invasive glaucoma surgery (MIGS) procedures.
Innovation Solution
The use of optical coherence tomography (OCT) scanning to generate augmented images and graphical visual elements that overlay onto microscope views, allowing surgeons to visualize and accurately target outflow structures, such as Schlemm's canal, even when they are obscured by total internal reflection, using a system that includes an optical microscope, OCT apparatus, and image processing to provide real-time, augmented views during surgery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If goniolenses are used to visualize outflow structures, then visualization capability is improved, but device complexity and ease of operation deteriorate due to significant dexterity requirements and steep learning curve
Solution Approach 1:
The patent replaces the mechanical goniolens system with an optical coherence tomography (OCT) imaging system that uses light waves to generate cross-sectional images of ocular structures. This substitution eliminates the need for complex manual manipulation of goniolenses while providing automated, high-resolution visualization of outflow structures through non-contact optical scanning.
Solution Approach 2:
The patent introduces OCT imaging as an intermediary between the surgeon and the outflow structures. Instead of directly viewing structures through goniolenses, the OCT system captures optical signals from the tissue, processes them into cross-sectional images, and presents them to the surgeon, thereby mediating the visualization process and eliminating dexterity requirements.
2Loss of information
If goniolenses are used to access intraocular outflow system, then visualization is improved, but device complexity and learning curve increase
Solution Approach 1:
The patent replaces the mechanical goniolens system with an optical coherence tomography (OCT) imaging system that uses light waves to generate cross-sectional images of ocular structures. This substitution eliminates the need for complex manual manipulation of goniolenses while providing automated, high-resolution visualization of outflow structures through non-contact optical scanning.
3Ease of manufacture
If traditional surgical methods are used without OCT guidance, then procedure simplicity is maintained, but manufacturing precision and measurement precision of target locations deteriorate
Solution Approach 1:
The patent implements real-time OCT imaging feedback during the surgical procedure. The system continuously captures cross-sectional images of the outflow structures, allowing the surgeon to monitor probe position and tissue characteristics, and adjust the procedure accordingly. This feedback loop enables precise targeting while maintaining procedural simplicity through intuitive real-time guidance.
Solution Approach 2:
The patent performs preliminary OCT scanning to identify and map the outflow structures before the actual surgical intervention. This preliminary action allows the surgeon to plan the precise incision location and depth based on pre-acquired anatomical information, thereby improving targeting precision while keeping the actual surgical procedure simple and straightforward.
4Measurement precision
If OCT scanning is implemented for real-time visualization, then measurement precision and targeting accuracy are improved, but device complexity increases
Solution Approach 1:
The patent merges the OCT imaging system with the existing surgical platform, integrating the optical scanning, image processing, and display components into a unified system. This merging approach consolidates multiple functions into a single integrated device, thereby improving measurement precision while minimizing the increase in overall device complexity through shared components and coordinated operation.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enhances the accuracy and consistency of targeting outflow structures, enabling more precise and effective MIGS procedures by providing surgeons with real-time, three-dimensional visualization of anatomical structures, thereby improving surgical outcomes and reducing the need for goniolenses.
Implementation Method 1
one or more optical coherence tomography (OCT) apparatus configured to perform OCT scans of one or more target locations in the target tissue region in real time during the procedure
Implementation Method 2
total internal reflection occurs and can prevent a surgeon from viewing those outflow structures that reside beyond the 'critical angle' of the optical pathway
Data Source
AI summary
Disclosed herein are systems and methods for aiding a surgeon to perform a surgical procedure on an eye. The surgical procedure includes inserting an elongate probe from an opening into the eye across an anterior chamber to a target tissue region comprising a trabecular meshwork and a Schlemm's canal. Exemplary systems include an optical microscope for the surgeon to view the eye with a microscope image during the procedure; an optical coherence tomography (OCT) apparatus configured to perform an OCT scan of a target location in the target tissue region during the procedure; and an image processing apparatus configured to generate an augmented image by overlaying an OCT image of target location and a graphical visual element identifying the locations, wherein the graphical visual element is registered with the microscope image to aid the surgeon in advancing a distal end of the elongate probe to the target location.