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Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography.

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Date
2016-08-19
Authors
Carrasco-Zevallos, OM
Keller, B
Viehland, C
Shen, L
Waterman, G
Todorich, B
Shieh, C
Hahn, P
Farsiu, S
Kuo, AN
Toth, CA
Izatt, JA
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(12 total)
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Abstract
Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon's capabilities.
Type
Journal article
Permalink
https://hdl.handle.net/10161/12788
Published Version (Please cite this version)
10.1038/srep31689
Publication Info
Carrasco-Zevallos, OM; Keller, B; Viehland, C; Shen, L; Waterman, G; Todorich, B; ... Izatt, JA (2016). Live volumetric (4D) visualization and guidance of in vivo human ophthalmic surgery with intraoperative optical coherence tomography. Sci Rep, 6. pp. 31689. 10.1038/srep31689. Retrieved from https://hdl.handle.net/10161/12788.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Oscar Carrasco-Zevallos

Student
I am a senior graduate student in the Biophotonics Group at Duke. My research focuses on the development of optical imaging technologies for various biomedical applications. My current projects include intraoperative optical coherence tomography (OCT) to guide ocular surgery, eye-tracking for motion-compensated OCT ophthalmic imaging, and novel OCT designs for pediatric imaging. I am currently searching for post-doc opportunities and hope to become a professor in the field of biophotonics in the
Farsiu

Sina Farsiu

Professor in the Department of Biomedical Engineering
I am the director of the Vision and Image Processing (VIP) Laboratory. Along with my colleagues, we investigate how to improve early diagnostic methods and find new imaging biomarkers of ocular and neurological diseases in adults (e.g. age-related macular degeneration, diabetic retinopathy, Glaucoma, Alzheimer) and children (e.g. retinopathy or prematurity). We also develop automatic artificial intelligence machine learning and deep learning algorithms to detect/segment/quantify anatomical/patho

Paul Hahn

Assistant Professor of Ophthalmology
I have been extensively involved in research throughout my academic career. While an undergraduate at Harvard College, I studied various proteins at an ultrastructural level towards rational design of novel drugs. During medical school at the University of Pennsylvania, I continued with basic science research studying mechanisms of action of nuclear receptors and optimizing protocols for gene therapy. I completed my PhD at the University of Pennsylvania studying the role of iron overload
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Izatt

Joseph A. Izatt

Michael J. Fitzpatrick Distinguished Professor of Engineering in the Edmund T. Pratt, Jr. School of Engineering
My research centers on the development and application of cutting-edge optical technologies for non-invasive, high-resolution imaging and sensing in living biological tissues. Our laboratory is recognized for foundational contributions to optical coherence-based approaches for in vivo sub-surface microscopic tissue imaging, particularly optical coherence tomography (OCT) which has become a standard of care in ophthalmology and other clinical specialties. The technologies we employ includ
Keller

Brenton Keller

Affiliate
Kuo

Anthony Nanlin Kuo

Associate Professor of Ophthalmology
Toth

Cynthia Ann Toth

Joseph A.C. Wadsworth Distinguished Professor of Ophthalmology
RESEARCH INTERESTS Dr. Toth specializes in the evaluation and surgical treatment of vitreoretinal diseases in infants, children and adults, and in novel research resulting in the clinical application of optical coherence tomography (OCT) imaging in surgery and at the bedside. Her clinical interests and skills include the surgical treatment of macular diseases (such as, macular hole, epiretinal membrane and vitreomacular traction), retinal detachment, proliferative diabetic ret

Christian Viehland

Research Scientist
Waterman

Gar Waterman

Associate In Research
I am a design/R&D engineer specializing in the multi-disciplinary and application-specific design of devices and instrumentation for medical and life sciences fields. My academic background and experiences have been in biomedical engineering and optomechanics. I have been employed primarily in the research sector and have had exposure to both industry and business.
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Alphabetical list of authors with Scholars@Duke profiles.
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