Real-time surgical reference indicium apparatus and methods for surgical applications

• US 9,226,798 B2
• Filed: 10/10/2008
• Issued: 01/05/2016
• Est. Priority Date: 10/10/2008
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: TrueVision Systems, Inc.
• Inventors: Tripathi, Ashok Burton, Weissman, Michael
• Primary Examiner(s): EVOY, NICHOLAS LANE
• Application Number:
  US12/249,845
• Publication Number:
  US 20100094262A1
• Time in Patent Office: 2,643 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 3/0025 characterised by electronic signal processing, e.g. eye models
• CPC Class Codes: A61B 3/0033 characterised by user input arrangements
• CPC Class Codes: A61B 3/0058 for multiple images
• CPC Class Codes: A61B 3/14 Arrangements specially adapted for eye photography apparatus or arrangements for taking photographs per se G03B
• CPC Class Codes: A61B 3/145 by video means
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/745 using a holographic display
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 9/007 Methods or devices for eye surgery
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence

Abstract

Described herein are apparatus and associated methods for the generation of at least one user adjustable, accurate, real-time, virtual surgical reference indicium. The apparatus includes one or more real-time, multidimensional visualization modules, one or more 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. 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 into the real-time visualization. In exemplary embodiments, the apparatus and methods are described in relation to ocular surgery, more specifically capsulorrhexis.

Claims

1. An apparatus for the generation of at least one real-time, virtual surgical reference indicium, the apparatus comprising:

at least one real-time, multidimensional visualization module including a photosensor configured to record images of an eye and an image processor configured to produce, using the recorded images a real-time visualization on at least one display;

at least one data processor configured to;

determine at least one distinct visible feature within a patient specific pre-operative still image,

produce the at least one real-time, virtual surgical reference indicium in conjunction with the patient specific pre-operative still image, and

use the at least one distinct visible feature to align the at least one real-time, virtual surgical reference indicium with the real-time visualization of the eye; and

,

at least one user control input in communication with the at least one data processor for adjusting the at least one real-time virtual surgical reference indicium,

wherein the real-time visualization of the eye produced by the at least one real-time, multidimensional visualization module is three dimensional.

6. The apparatus according to claim 1, wherein the patient specific pre-operative still image is captured by a second photosensor, prior to cyclorotation of the eye when the patient lies down for surgery, when the eye has a naturally dilated pupil or naturally constricted pupil.

7. The apparatus according to claim 1, wherein the patient specific pre-operative still image is captured by a the photosensor of the at least one real-time, multidimensional visualization module prior to cyclorotation of the eye when a patient lies down for surgery.

10. The apparatus according to claim 1, wherein the patient specific pre-operative still image is three dimensional.

11. The apparatus according to claim 1, wherein the data processor is included within the image processor.

12. The apparatus according to claim 1, wherein the surgery includes an ocular procedure of capsulorrhexis.

2. An apparatus for the generation of at least one real-time, virtual surgical reference indicium, the apparatus comprising:

at least one real-time, multidimensional visualization module including a photosensor configured to record images of an eye and an image processor configured to produce, using the recorded images, a real-time multidimensional visualization on at least one display;

at least one data processor configured to;

determine at least one distinct visible feature within a patient specific pre-operative still image recorded prior to cyclorotation of the eye when a patient lies down for surgery,

produce the at least one real-time, virtual surgical reference indicium in conjunction with the patient specific pre-operative still image, and use the at least one distinct visible feature to align the at least one real-time, virtual surgical reference indicium with the real-time multidimensional visualization of the eye; and

,

at least one user control input in communication with the at least one data processor for adjusting the at least one real-time virtual surgical reference indicium,

wherein the at least one real-time, virtual surgical reference indicium is three dimensional.

8. The apparatus according to claim 2, wherein the patient specific pre-operative still image is captured by a second photosensor, prior to cyclorotation of the eye when a patient lies down for surgery, when the eye is non-chemically dilated.

9. The apparatus according to claim 2, wherein the data processor is configured to display the at least one real-time, virtual surgical reference indicium at a desired depth with respect to the eye in conjunction with the real-time multidimensional visualization of an eye.

3. An apparatus for the generation of at least one real-time, virtual surgical reference indicium, the apparatus comprising:

at least one real-time, multidimensional visualization module including a photosensor configured to record images of an eye and an image processor configured to produce, using the recorded images, a real-time visualization on at least one display; and

at least one data processor configured to;

determine at least one distinct visible feature within a patient specific pre-operative still image recorded prior to cyclorotation of the eye when a patient lies down for surgery,

produce the at least one real-time, virtual surgical reference indicium in conjunction with the patient specific pre-operative still image, and

use the at least one distinct visible feature to align the at least one real-time, virtual surgical reference indicium with the real-time visualization of the eye,

wherein the real-time visualization of the eve produced by the at least one real-time multidimensional visualization module is high definition.

4. An apparatus for the generation of at least one real-time, virtual surgical reference indicium, the apparatus comprising:

at least one real-time, multidimensional visualization module including a photosensor configured to record images of an eye and an image processor configured to produce, using the recorded images, a real-time visualization on at least one display;

at least one data processor configured to;

determine at least one distinct visible feature within a patient specific pre-operative still a e recorded prior to cyclorotation of the eye when a patient lies down for surgery,

produce the at least one real-time, virtual surgical reference indicium in conjunction with the patient specific pre-operative still image, and

use the at least one distinct visible feature to align the at least one real-time, virtual surgical reference indicium with the real-time visualization of an eye; and

,

at least one user control input in communication with the at least one data processor for adjusting the at least one real-time virtual surgical reference indicium,

wherein a target surgical field includes at least a portion of the eye, and

wherein the at least one distinct visual feature includes at least one structure selected from the group consisting of vasculature, vascular networks, vascular branching patterns, deformities, voids, blotches, sequestered pigment cells, scars, darker regions, and combinations thereof on the surface of said eye.

5. The apparatus according to claim 4, wherein the patient specific pre-operative still image is captured by a second photosensor while the eye is under natural dilation.