Real-Time Surgeon Control of Intraoperative Optical Coherence Tomography

Abstract

Optical coherence tomography (OCT) is the gold standard of care for clinical ophthalmic diagnosis and procedures. It is a non-contact, nonionizing imaging technique that delivers cross-sectional and volumetric images at high resolution. During surgery, OCT is often paired with microscopy to provide micron-scale views in all dimensions. Microscope-integrated optical coherence tomography (MIOCT) systems have been developed, combining the optics of microscopy and OCT to optimize surgical routines. Clinical microscopes often come with hands-free controllers; however, OCT systems are generally controlled by computer applications. This thesis describes 4D MIOCT, the current device used at the Duke Eye Center for guiding ophthalmic surgery. It explores recently-published research involving the 4D MIOCT system. This thesis focuses on the development of a new software program to allow real-time control of OCT via a custom-built footpedal. The software uses Vortex, an open-source library to interact with the OCT engine. With the program, surgeons can dynamically change system parameters and image settings. An automated focusing feature was added as well. The software application eliminates the need for a trained staff member to interpret the surgeon’s instructions and manage the OCT system. Ultimately, it will increase speed, efficiency, and quality of ophthalmic surgery within the operating room.