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Use of Digital Methods to Optimize Visualization during Surgical Gonioscopy.

Otman Sandali1,2, Mohamed El Sanharawi3, Rachid Tahiri Joutei Hassani4

  • 1Centre Hospitalier National d'Ophtalmologie des XV-XX, 28 Rue de Charenton, 75571 Paris, France.

Journal of Clinical Medicine
|April 28, 2023
PubMed
Summary

Optimized digital visualization settings, including a cyan filter and warmer color, significantly improved the visibility of iridocorneal structures during surgical gonioscopy. This enhancement aids in visualizing the trabecular meshwork and Schlemm's canal during glaucoma surgery.

Keywords:
Schlemm’s canalcolor filtercolor saturationcolor temperaturecontrastheads-up three-dimensional (3D) digital visualization systemstent implantationsurgical gonioscopytrabecular meshworkvisualization

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Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Medical Imaging

Background:

  • Surgical gonioscopy is crucial for visualizing iridocorneal structures.
  • Enhancing visualization of the trabecular meshwork and Schlemm's canal can improve surgical outcomes in glaucoma.
  • Current visualization methods may have limitations in differentiating key anatomical features.

Purpose of the Study:

  • To evaluate the effectiveness of digital visualization enhancements for iridocorneal structures during surgical gonioscopy.
  • To assess if optimized digital settings improve visualization of the trabecular meshwork and Schlemm's canal.
  • To determine the impact of color saturation, temperature, and cyan filters on image clarity.

Main Methods:

  • Prospective, single-center study involving 26 trabecular stent implantation surgeries.
  • Surgical gonioscopy images were captured using standard settings and optimized digital parameters (color saturation, temperature, cyan filter).
  • Subjective assessment by glaucoma surgeons and objective contrast measurements were performed on the captured images.

Main Results:

  • Optimized digital settings enhanced tissue visibility for the trabecular meshwork and Schlemm's canal in over 65% of cases.
  • Objective measurements showed a significant difference in pixel intensity standard deviation between optimized and standard images (p < 0.001).
  • A cyan filter improved contrast for trabecular meshwork pigmentation, while increased color temperature highlighted Schlemm's canal.

Conclusions:

  • Optimized digital visualization settings, including a cyan filter and warmer color temperature, are effective in enhancing iridocorneal structure visualization.
  • These digital enhancements can improve the visualization of the trabecular meshwork and Schlemm's canal during surgical gonioscopy.
  • The study suggests these settings can be integrated into surgical practice for minimally invasive glaucoma surgery.