Precision Needle Tip Localization Using Optical Coherence Tomography Images for Subretinal Injection

Abstract

Subretinal injection is a delicate and complex microsurgery, which requires surgeons to inject the therapeutic substance in a pre-operatively defined and intra-operatively updated subretinal target area. Due to the lack of subretinal visual feedback, it is hard to sense the insertion depth during the procedure, thus affecting the results of surgical outcome and hindering the widespread use of this treatment. This paper presents a novel approach to estimate the 3D position of the needle under the retina using the information from microscope-integrated Intraoperative Optical Coherence Tomography (iOCT). We evaluated our approach on both tissue phantom and ex-vivo porcine eyes. Evaluation results show that the average error in distance measurement is 4.7 μm (maximum of 16.5 μm). We furthermore, verified the feasibility of the proposed method to track the insertion depth of needle in robotassisted subretinal injection.

Robotic Retinal Surgery

“…The 3 Hz; 0.2 Hz rat [173]; pig [146] breathing amplitude 50 µm; 300 µm rat [173]; pig [146] heartbeat frequency 0.84 Hz; 2 Hz rat [173]; pig [146] heartbeat amplitude 15 µm; 100 µm rat [173]; pig [146] required positioning accuracy 10 µm general [4,39]. required positioning accuracy 25 µm subretinal injection [221].…”

“…A modified Rose bengal method has been developed to create clotted vessels in live pigs for validating cannulation performance [45,204]. synthetic membranes [7,66,72,140] peeling of membrane gelatin phantom [99] 10% mimics tissue soft cheese [221] similar OCT response rubber band [79] simulates scleral contact agar [107] [199] [17] vitreous humour raw chicken egg [66,95,178] peeling ISM fertilized chicken egg [95,115,183] [ 59,115,183] peeling ISM cadaver bovine eye [41] [99] w/o cornea, lens, vitreous cadaver pig eye [96,14,192] [17] open-sky; 40-60 µm perfused pig eye [195] closure of vessels in-vivo pig eye [45,204] w/ lasering to form clots in-vivo rabbit eye [96, 209] [2, 96] preretinal 60 µm vessels in-vivo cat eye [2] intraretinal vessels i "output" -2018/12/15 -10:06 -page 9 -#9 i i i…”

“…0.13). Studies describe robust segmentation methods to obtain the needle point cloud within the OCT volume and use retinal vessel structures for online registration of OCT and optical images of the retina [221]. Due to the infrared light source of the OCT and using the geometrical features of the surgical instruments, segmentation results are robust to illumination variation and speck reflection.…”

“…The same group has also presented a similar technique, using a larger number of B-scans (128 along x, and the same number along y), to perform marker-free robot hand-eye calibration, which they have demonstrated in intact porcine eyes ex vivo [220]. Tracking of the needle after it enters tissue remains an open research problem [200], which the group has begun to address by registering the needle to a computer-aided design (CAD) model before the tip enters the retina, and then predicting the tip position and orientation after subretinal entry using the known input commands [221].…”

Physician-Friendly Tool Center Point Calibration Method for Robot-Assisted Puncture Surgery

“…These noncontact methods can reach high accuracy and are robust to the environment but are relatively high in cost and require specific trajectories to be preplanned for the robot to ensure accuracy. Vision measurement technology also plays an important role in industry, such as digital image correlation (DIC) [ 11 , 12 ], in surgery, such Optical Coherence Tomography [ 13 , 14 , 15 ]. Liu et al [ 16 ] proposed an automatic TCP calibration method based on a common binocular vision measurement, which reduced the dependence on operating experience while guaranteeing certain accuracy.…”