Methods and systems for oct guided glaucoma surgery

Abstract

Disclosed herein is a system for aiding a physician to perform a surgical procedure on an eye. The operation procedure comprises inserting an elongate probe from an opening into the eye across an anterior chamber to a target tissue region comprising a trabecular meshwork and a Schlemm's canal. The system comprises: an optical microscope for the surgeon to view the eye with a microscope image during the procedure; an optical coherence tomography (OCT) apparatus configured to perform an OCT scans of one or more target locations in the target tissue region during the procedure; and an image processing apparatus configured to generate a plurality of augmented images by overlaying (1) one or more OCT images of the one or more target locations and (2) a plurality of graphical visual elements identifying the one or more target locations, wherein the plurality of graphical visual elements is registered with the microscope image to aid the physician in advancing a distal end of the elongate probe to the one or more target locations.

1 . A system for aiding a physician to perform a surgical procedure on an eye, wherein said procedure comprises inserting an elongate probe from an opening into the eye across an anterior chamber to a target tissue region of the eye, the target tissue region comprising a Schlemm's canal and a trabecular meshwork, said system comprising:
 an optical microscope;   an optical coherence tomographer (OCT); and   an image processing apparatus comprising a processor, an electronic storage location operatively coupled with the processor, and processor executable code stored on the electronic storage location and embodied in a tangible non-transitory computer readable medium, the processor executable code comprising machine-readable instructions, that when executed by the processor, cause the processor to generate an augmented image of the eye, the augmented image comprising:
 (i) a microscope image of the eye obtained by the optical microscope, the microscope image corresponding to an x-y plane of the eye, the target tissue region not visible in the microscope image due to total internal reflection of the target tissue region, 
 (ii) an OCT image of the target tissue region of the eye, the OCT image obtained by the OCT, the OCT image corresponding to an anterior-posterior plane of the eye that is perpendicular to the x-y plane of the eye, the OCT image in registration relative to the microscope image, 
 (iii) a graphical visual element overlaid to and in registration with the microscope image, the graphical visual element mapped to a radial target location of the target tissue region, the radial target location based on a preoperative OCT image or a real-time OCT image obtained by the OCT, and 
 (iv) a treatment reference marker overlaid to and in registration with the OCT image, the treatment reference marker mapped to an anterior-posterior depth target location of the target tissue region and to the radial target location of the target tissue region, the anterior-posterior depth target location corresponding to the Schlemm's canal, 
   the graphical visual element aiding the physician in advancing a distal end of the elongate probe to the radial target location and the treatment reference marker aiding the physician in advancing the distal end of the elongate probe to the anterior-posterior depth target location.   
     
     
         2 - 8 . (canceled) 
     
     
         9 . The system of  claim 1 , wherein the OCT comprises a microscope-based OCT. 
     
     
         10 - 15 . (canceled) 
     
     
         16 . The system of  claim 1 , wherein the OCT comprises a fiberoptic-based OCT. 
     
     
         17 - 30 . (canceled) 
     
     
         31 . The system of  claim 1 , wherein the radial target location is based on the preoperative OCT image. 
     
     
         32 . The system of  claim 1 , wherein the radial target location is based on the real-time OCT image. 
     
     
         33 . The system of  claim 1 , wherein the radial target location corresponds to a collector channel network of the eye.