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Common-path optical coherence tomography guided vertical pneumodissection for DALK.

Yaning Wang1, Shoujing Guo1, Justin D Opfermann2

  • 1Electrical and Computer Engineering, Johns Hopkins University, 3400 North Charles Street, Baltimore, Maryland 21218, USA.

Proceedings of Spie--The International Society for Optical Engineering
|December 13, 2023
PubMed
Summary
This summary is machine-generated.

A novel optical coherence tomography (OCT) sensor-integrated cannula (VIREC) enables precise pneumatic dissection of Descemet's membrane (DM). This surgical tool proved effective for generating the "big bubble" technique in Deep Anterior Lamellar Keratoplasty (DALK).

Keywords:
DALKOptical coherence tomographyoptical distal sensor

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Medical Devices

Background:

  • Deep Anterior Lamellar Keratoplasty (DALK) is a surgical procedure to replace diseased corneal layers.
  • Accurate dissection of Descemet's membrane (DM) is crucial for successful DALK.
  • Current methods for DM dissection can be challenging and carry risks of perforation.

Purpose of the Study:

  • To design and evaluate a novel optical coherence tomography (OCT) sensor-integrated 27-gauge vertically inserted razor edge cannula (VIREC).
  • To assess the efficacy of VIREC for pneumatic dissection of Descemet's membrane (DM) from the corneal stroma.
  • To determine VIREC's suitability for facilitating the "big bubble" technique in DALK.

Main Methods:

  • Development of a VIREC device incorporating an OCT sensor for real-time visualization.
  • Surgical procedures performed on ex vivo bovine (N=5) and rabbit (N=5) corneas.
  • Vertical insertion of VIREC to the desired depth near DM for pneumatic dissection.

Main Results:

  • Successful clean dissection of the stromal layer without stromal blanching in bovine corneas.
  • Consistent generation of the "big bubble" in all bovine eye tests without perforation.
  • Observation of microbubbles in rabbit eyes, indicating species-specific responses.

Conclusions:

  • The VIREC device demonstrates potential as an effective surgical tool for pneumatic DM dissection.
  • VIREC facilitates the "big bubble" technique, a key step in DALK procedures.
  • Further research may explore VIREC's application in live DALK surgeries.