Tasaki Kuniharu, Nishimura Tomohisa, Hida Taro, Maruo Kazushi, Oshika Tetsuro
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8575, Japan.
Mikawa Eye Clinic, 4-3-1 Matsubara, Saga 840-0831, Japan.
J Clin Med. 2022 Sep 26;11(19):5666. doi: 10.3390/jcm11195666.
Endoscopic vitrectomy with small gauge probes has clinical potentials, but intraocular visibility is inherently limited by low resolution and dim illumination due to the reduced number of optic fibers. We investigated whether honeycomb-removal and image-sharpening algorithms, which enable real-time processing of live images with a delay of 0.004 s, can improve the visibility of 27-gauge endoscopic vitrectomy. A total of 33 images during endoscopic vitrectomy were prepared, consisting of 11 original images, 11 images after the honeycomb-removal process, and 11 images after both honeycomb-removal and image-sharpening procedures. They were randomly presented to 18 vitreous surgeons, who rated each image on a 10-point scale. The honeycomb-removal algorithm almost completely suppressed honeycomb artifacts without degrading the background image quality. The implementation of image-sharpening algorithms further improved endoscopic visibility by optimizing contrast and augmenting image clarity. The visibility score was significantly improved from 4.27 ± 1.78 for the original images to 4.72 ± 2.00 for the images after the honeycomb-removal process (p < 0.001, linear mixed effects model), and to 5.40 ± 2.10 for the images after both the honeycomb-removal and image-sharpening procedures (p < 0.001). When the visibility scores were analyzed separately for 10 surgeons who were familiar with endoscopic vitrectomy and 8 surgeons who were not, similar results were obtained. Image processing with honeycomb-removal and image-sharpening algorithms significantly improved the visibility of 27-gauge endoscopic vitrectomy.
使用小口径探头的内窥镜玻璃体切除术具有临床应用潜力,但由于光纤数量减少,低分辨率和昏暗照明使得眼内视野在本质上受到限制。我们研究了蜂窝状伪影去除和图像锐化算法(可在0.004秒延迟的情况下对实时图像进行实时处理)是否能够改善27G内窥镜玻璃体切除术的视野。在内窥镜玻璃体切除术中总共准备了33张图像,包括11张原始图像、11张经过蜂窝状伪影去除处理后的图像以及11张经过蜂窝状伪影去除和图像锐化处理后的图像。这些图像被随机展示给18位玻璃体外科医生,他们以10分制对每张图像进行评分。蜂窝状伪影去除算法几乎完全抑制了蜂窝状伪影,同时不降低背景图像质量。图像锐化算法的应用通过优化对比度和增强图像清晰度进一步改善了内窥镜视野。视野评分从原始图像的4.27±1.78显著提高到蜂窝状伪影去除处理后图像的4.72±2.00(p<0.001,线性混合效应模型),以及蜂窝状伪影去除和图像锐化处理后图像的5.40±2.10(p<0.001)。当分别对10位熟悉内窥镜玻璃体切除术的外科医生和8位不熟悉的外科医生的视野评分进行分析时,得到了类似的结果。使用蜂窝状伪影去除和图像锐化算法进行图像处理显著提高了27G内窥镜玻璃体切除术的视野。