Use of Digital Methods to Optimize Visualization during Surgical Gonioscopy.

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.