Real-time Surgical Reference Indicium Apparatus and Methods for Astigmatism Correction

• US 20110092984A1
• Filed: 10/20/2009
• Published: 04/21/2011
• Est. Priority Date: 10/20/2009
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: TrueVision Systems, Inc.
• Inventors: Tripathi, Ashok Burton
• Granted Patent: US 8,784,443 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 2090/3612 with images taken automatically
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2576/00 Medical imaging apparatus involving image processing or analysis A61B1/00009, A61B6/52 and A61B8/52 take precedence; image processing per se G06T; details of algorithms for analysing medical images G06T7/0012
• CPC Class Codes: A61B 3/13 Ophthalmic microscopes
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 90/20 Surgical microscopes characterised by non-optical aspects
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 9/007 Methods or devices for eye surgery
• CPC Class Codes: A61F 9/0136 Mechanical markers

Abstract

Described herein are apparatus and associated methods for the generation of at least one user adjustable, accurate, real-time, virtual surgical reference indicium including data for making at least one limbal and/or corneal relaxing incision for use in astigmatism correcting procedures. The apparatus used to generate real-time, virtual surgical reference indicium including data for making at least one limbal and/or corneal relaxing incision includes one or more real-time, multidimensional visualization modules, one or more data processors configured to produce real-time, virtual surgical reference indicia, and at least one user control input for adjusting the at least one real-time virtual surgical reference indicium including data for making at least one limbal and/or corneal relaxing incision. The associated methods generally involve the steps of providing one or more real-time multidimensional visualizations of a target surgical field, identifying at least one visual feature in a pre-operative dataset, aligning the visual features with the multidimensional visualization, and incorporating one or more real-time, virtual surgical reference indicium including data for making at least one limbal and/or corneal relaxing incision into the real-time visualization.

Claims

1. An apparatus for guiding an astigmatism correcting procedure on an eye, said apparatus comprising:

at least one real-time, multidimensional visualization module for producing a real-time multidimensional visualization;

at least one data processor configured to produce at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof on an eye in conjunction with said real-time multidimensional visualization of at least a portion of said eye; and

at least one display wherein said real-time multidimensional visualization is presented.

2. The apparatus according to claim 1 wherein at least one of said real-time multidimensional visualization or at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof on an eye is stereoscopic.

3. The apparatus according to claim 1 wherein at least one user control input is in communication with said at least one data processor for adjusting said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof.

4. The apparatus according to claim 1 wherein said at least one data processor includes an input for receiving pre-operative patient data to produce said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof.

5. The apparatus according to claim 3 wherein said pre-operative patient data comprises at least one pre-operative stereoscopic still image.

6. The apparatus according to claim 3 wherein said at least one data processor utilizes said pre-operative patient data to align said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof.

7. The apparatus according to claim 4 wherein said at least one pre-operative stereoscopic still image includes at least one specific visual feature identifiable by said surgeon to which said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof is fixed in orientation thereto.

8. The apparatus according to claim 6 wherein said at least one specific visual feature identifiable by said surgeon comprises at least one structure selected from the group consisting of vasculature, vascular networks, vascular branching patterns, patterns in the iris, scratches on the cornea, dimples on the cornea, retinal features, the limbus, the pupillary boundary, deformities, voids, blotches, sequestered pigment cells, scars, darker regions, and combinations thereof.

9. The apparatus according to claim 4 wherein said pre-operative patient data is captured under a dilation condition selected from the group consisting of natural dilation, chemical dilation and no dilation.

10. The apparatus according to claim 1 wherein said at least one real-time, multidimensional visualization module is three dimensional (3D).

11. The apparatus according to claim 1 wherein said at least one real-time multidimensional visualization module is high definition (HD).

12. A method for stereoscopically guiding a surgeon in performing an astigmatism correction procedure on an eye, said method comprising the steps of:

providing at least one real-time multidimensional visualization of at least a portion of an eye to a surgeon; and

producing at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof on an eye in conjunction with said real-time multidimensional visualization of at least a portion of said eye.

13. The method according to claim 12 wherein said method includes the step of collecting pre-operative patient data and using said pre-operative patient data to align said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof with said at least one real-time multidimensional visualization.

14. The apparatus according to claim 13 wherein said pre-operative patient data comprises at least one pre-operative stereoscopic still image.

15. The method according to claim 13 wherein said at least one pre-operative stereoscopic still image includes at least one specific visual feature identifiable by said surgeon to which said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof is fixed in orientation thereto.

16. The method according to claim 15 wherein said at least one specific visual feature identifiable by said surgeon comprises at least one structure selected from the group consisting of vasculature, vascular networks, vascular branching patterns, patterns in the iris, scratches on the cornea, dimples on the cornea, retinal features, the limbus, the pupillary boundary, deformities, voids, blotches, sequestered pigment cells, scars, darker regions, and combinations thereof.

17. A method for stereoscopically guiding a surgeon in performing an astigmatism correction procedure on an eye, said method comprising the steps of:

providing to said surgeon at least one real-time 3D HD visualization of at least a portion of an eye, said eye having at least one specific visual feature;

aligning at least one pre-operative stereoscopic still image of said at least a portion of said eye including said at least one specific visual feature in said eye with said at least one real-time 3D HD visualization of at least a portion of an eye so that said at least one pre-operative stereoscopic still image and said at least one real-time 3D HD visualization are rotationally accurate; and

incorporating at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof in an eye into said at least one real-time 3D HD visualization of said at least a portion of said eye.

18. The method according to claim 17 wherein said method further comprises the step of correcting astigmatism in an eye under the guidance of said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof.

19. The method according to claim 17 wherein said at least one rotationally accurate virtual indicium including data for making at least one limbal relaxing incision, at least one corneal relaxing incision or a combination thereof is based upon said at least one pre-operative stereoscopic still image of said at least a portion of said eye.