Laser photocoagulation is one of the most frequently used treatment approaches in ophthalmology for a variety of retinal diseases. Depending on indication, treatment intensity varies from application of specific micro injuries down to gentle temperature increases without inducing cell damage. Especially for the latter, proper energy dosing is still a challenging issue, which mostly relies on the physician’s experience. Pulsed laser photoacoustic temperature measurement has already proven its ability for automated irradiation control during laser treatment but suffers from a comparatively high instrumental effort due to combination with a conventional continuous wave treatment laser. In this paper, a simplified setup with a single pulsed laser at 10 kHz repetition rate is presented. The setup combines the instrumentation for treatment as well as temperature measurement and control in a single device. In order to compare the solely pulsed heating with continuous wave (cw) tissue heating, pulse energies of 4 µJ were applied with a repetition rate of 1 kHz to probe the temperature rise, respectively. With the same average laser power of 60 mW an almost identical temporal temperature course was retrieved in both irradiation modes as expected. The ability to reach and maintain a chosen aim temperature of 41 °C is demonstrated by means of model predictive control (MPC) and extended Kalman filtering at a the measurement rate of 250 Hz with an accuracy of less than ±0.1 °C. A major advantage of optimization-based control techniques like MPC is their capability of rigorously ensuring constraints, e.g., temperature limits, and thus, realizing a more reliable and secure temperature control during retinal laser irradiation.
Laser photocoagulation is a technique applied in the treatment of retinal disease, which is often done manually or using simple control schemes. We pursue an optimization-based approach, namely Model Predictive Control (MPC), to enforce bounds on the peak temperature and, thus, to ensure safety during the medical treatment procedure – despite the spot-dependent absorption of the tissue. The desired laser repetition rate of 1 kHz is renders the requirements on the computation time of the MPC feedback a major challenge. We present a tailored MPC scheme using parametric model reduction, an extended Kalman filter for the parameter and state estimation, and suitably tuned stage costs and verify its applicability both in simulation and experiments with porcine eyes. Moreover, we give some insight on the implementation specifically tailored for fast numerical computations.
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