Hecht Rachel, Watson Jacob J, Tao Yuankai K
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
Transl Vis Sci Technol. 2025 Jul 1;14(7):13. doi: 10.1167/tvst.14.7.13.
We present an optimized intraoperative spectrally encoded coherence tomography and reflectometry (iSECTR) system integrated with a Zeiss OPMI VISU 200 ophthalmic surgical microscope (Zeiss, Oberkochen, Germany).
An iSECTR scan-head was designed to overcome previous barriers to clinical translation by improving system stability, optimizing optical throughput, reducing reflection artifacts, and adding motorized focus-adjust functionality. The iSECTR imaging performance was demonstrated in in vivo human eyes and during simulated ophthalmic surgical maneuvers in ex vivo porcine eyes.
The optimized iSECTR scan-head achieved a footprint of 19.67 × 30.2 cm (width × length) and a surgical microscope stack height increase of only 6.06 cm. Motorized focusing was able to accommodate for ±10 D of focal shift to accommodate refractive power differences across surgeons. In vivo and ex vivo iSECTR imaging was able to resolve clinically relevant retinal and corneal tissue features and tissue deformation from conventional surgical instruments during simulated ophthalmic surgical maneuvers.
This work demonstrates the performance of our iSECTR scan-head for ophthalmic intraoperative optical coherence tomography (iOCT). Our robust modular design allows for stable performance that is suitable for clinical translation. The improved spectrally encoded reflectometry (SER) imaging performance allowed for reproducible anterior and posterior eye imaging in both in vivo and ex vivo eyes, and independent iSECTR focus-adjust further enhances clinical ergonomics. Clinical translation of iSECTR technologies will provide a research platform for automated retinal- and instrument-tracking and four-dimensional visualization of surgical dynamics.
Design considerations for minimizing footprint, microscope stack height, and integration of motorized focus-adjust were emphasized to benefit surgical ergonomics and clinical translation.
我们展示了一种优化的术中光谱编码相干断层扫描与反射测量（iSECTR）系统，该系统与蔡司OPMI VISU 200眼科手术显微镜（德国奥伯科亨的蔡司公司）集成。
设计了一个iSECTR扫描头，通过提高系统稳定性、优化光通量、减少反射伪影以及增加电动聚焦调节功能，克服先前临床转化的障碍。在人眼活体以及离体猪眼模拟眼科手术操作过程中展示了iSECTR的成像性能。
优化后的iSECTR扫描头占地面积为19.67×30.2厘米（宽×长），手术显微镜堆叠高度仅增加6.06厘米。电动聚焦能够适应±10 D的焦移，以适应不同外科医生的屈光力差异。在活体和离体iSECTR成像中，能够分辨出临床相关的视网膜和角膜组织特征以及模拟眼科手术操作过程中传统手术器械造成的组织变形。
这项工作展示了我们的iSECTR扫描头用于眼科术中光学相干断层扫描（iOCT）的性能。我们强大的模块化设计实现了稳定的性能，适合临床转化。改进后的光谱编码反射测量（SER）成像性能使得在活体和离体眼中均可重复进行眼前部和后部成像，并且独立的iSECTR聚焦调节进一步提高了临床人体工程学。iSECTR技术的临床转化将为自动视网膜和器械跟踪以及手术动力学的四维可视化提供一个研究平台。
强调了在最小化占地面积、显微镜堆叠高度以及集成电动聚焦调节方面的设计考虑，以利于手术人体工程学和临床转化。
