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Real-time tracking and inpainting network with joint learning iterative modules for AR-based DALK surgical

Weimin Liu1, Junjun Pan1, Liyun Jia2

  • 1State Key Laboratory of Virtual Reality Technology and Systems, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100191, China.

Computer Methods and Programs in Biomedicine
|September 24, 2025
PubMed
Summary

This study introduces an iterative network for Augmented Reality (AR) navigation to improve suturing in deep anterior lamellar keratoplasty (DALK). The system enhances surgical precision by providing clear, unoccluded views during corneal procedures.

Keywords:
AR-based surgical navigationDALKInpaintingJoint learningOptical flowSemantic segmentation

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Area of Science:

  • Ophthalmology
  • Computer Vision
  • Medical Imaging

Background:

  • Deep anterior lamellar keratoplasty (DALK) requires precise suturing for successful outcomes.
  • Augmented Reality (AR) navigation systems offer potential to improve surgical accuracy.
  • Clear visualization of corneal regions is crucial for planning stitch placement in DALK.

Purpose of the Study:

  • To develop a joint-learning and iterative network for AR-based suturing navigation.
  • To enhance inpainting performance under severe occlusion during the suturing process.
  • To provide surgeons with clear, unoccluded views of corneal regions for better surgical planning.

Main Methods:

  • A novel joint-learning and iterative network was designed for AR-based suturing navigation.
  • The network utilizes feature reuse, iterative modules, and mask propagation for computational efficiency.
  • A synthetic dataset with occluded/unoccluded image pairs and annotations was created for end-to-end training.
  • A pipeline using grid propagation and inpainted optical flow was developed for stable frame generation.

Main Results:

  • The Iter-S model achieved a mean endpoint error (mEPE) of 1.69, PSNR of 36.86, and SSIM of 0.976.
  • Inpainting inference time was as low as 16.26ms, demonstrating computational efficiency.
  • The developed AR navigation system achieved an average frame rate of 28 FPS.
  • The framework showed a better trade-off between performance and computational efficiency compared to existing inpainting networks.

Conclusions:

  • Iterative modules progressively refine outputs, balancing visual performance and real-time efficiency.
  • The AR navigation framework provides stable, accurate tracking with real-time, well-inpainted results under severe occlusion.
  • This system demonstrates significant benefits for guiding corneal surgical stitching operations.