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Keratometry device for surgical support.

Liliane Ventura¹, Jean-Jacques De Groote, Paula Saia

¹Dept of Elect Engineering USP (Ophthalmic Instrumentation Division), Av Trabalhador sao-carlense 400, S Carlos, SP 13566-590, Brasil. lilianeventura@usp.br

Biomedical Engineering Online

|December 10, 2009

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A new surgical guidance system significantly reduces postoperative astigmatism by ensuring uniform corneal suturing. This ophthalmic tool helps surgeons achieve better outcomes, lowering residual astigmatism from 8D to 1.4D.

Area of Science:

Ophthalmology
Surgical Technology
Biomedical Engineering

Background:

High astigmatism is often a complication of corneal suturing after transplantation or surgery.
Surgeon skill in achieving uniform stitches is critical for minimizing induced astigmatism.
A prototype ophthalmic surgical support system was developed to address this challenge.

Purpose of the Study:

To evaluate the influence of suturing irregularity on residual astigmatism.
To develop an evaluation tool for guided suturing.
To diminish postoperative astigmatism through improved surgical technique.

Main Methods:

A handheld ring with 36 infrared LEDs is projected onto the cornea's tear film.
Ocular microscope optics reflect the image, and custom software analyzes distortion.

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The system provides intraoperative keratometric and circularity measurements for surgeon guidance.

Main Results:

The system measures astigmatism in the 32D-55D range with +/- 0.25D accuracy.
Intraoperative testing on 14 volunteers showed high correlation with a commercial corneal topographer (0.92 for astigmatism, 0.97 for axis).
Guided patients showed a significant reduction in residual astigmatism (1.4D) compared to unguided patients (8D) at 24 hours post-surgery.

Conclusions:

The system effectively guides surgeons toward uniform suturing, potentially reducing residual astigmatism.
Preliminary data show a substantial decrease in postoperative astigmatism with prototype guidance.
Achieving >=98% circularity is recommended to prevent postoperative astigmatism exceeding 1D.