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Downward viewing common-path optical coherence tomography guided hydro-dissection needle for DALK.

Shoujing Guo1, Justin Opfermann2, William G Gemsheimer3,4

  • 1Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA 21218.

Proceedings of Spie--The International Society for Optical Engineering
|October 24, 2022
PubMed
Summary

This study introduces a novel optical coherence tomography (OCT) guided needle for deep anterior lamellar keratoplasty (DALK). The system accurately guides needle insertion, improving precision in this challenging cornea transplant surgery.

Keywords:
DALKOptical coherence tomographyoptical distal sensor

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Surgical Technology

Background:

  • Deep anterior lamellar keratoplasty (DALK) is a partial-thickness cornea transplant.
  • The "Big Bubble" technique requires precise needle insertion near Descemet's membrane (DM).
  • Current methods lack real-time guidance for optimal needle placement.

Purpose of the Study:

  • To design and evaluate a common-path optical coherence tomography (OCT) guided hydro-dissection needle for DALK.
  • To improve accuracy and safety during the "Big Bubble" procedure.
  • To enhance visualization of the needle tip and target tissue during insertion.

Main Methods:

  • A downward-viewing common-path OCT system with a bare optical fiber was integrated into a hydro-dissection needle.
  • The OCT probe was encapsulated in a 25-gauge stainless steel tube and aligned with the needle at a 70-degree angle.
  • Porcine eyes (N=5) were used to test the system's ability to guide needle insertion.
  • Real-time imaging of needle tip position, stroma, and DM was performed.

Main Results:

  • The OCT-guided needle successfully identified needle tip position, stroma, and DM during insertion.
  • The system provided accurate guidance for needle insertion in DALK procedures.
  • Improved average insertion depth was observed compared to freehand insertion.

Conclusions:

  • The downward-viewing OCT guided needle is a viable tool for enhancing DALK surgery precision.
  • This technology offers improved accuracy and visualization for hydro-dissection.
  • Further development could refine this system for clinical application in cornea transplantation.