Purpose
To compare performance with and without an enhanced or augmented reality, modification of a minimally invasive, endoscopic procedure for optic nerve treatment.
Methods
Twelve orbital interventions were performed in six live pigs. Following an Institutional Animal Care and Use Committee approved protocol, the pigs were anesthetized, A matched set of microspherical bulbs were placed in each orbit. One bulb held pure water, the other clear magnevist. Red dye was also placed to either the water or the magnevist bulb to make it have a color. Fiducial markers were applied and magnetic resonance imaging (MRI) performed. The bulbs had opposite image intensity and in surgical observation the bulbs were distinct. The surgeon reviewed the pre-operative image set and used the image guidance system (IGS) to locate the target bulb. The surgeon identified the color of the target. In the first 3 pigs the system was used without the enhanced guidance. In the last 3 pigs the video display module was modified to have an overlay of a 2D/3D registration enhancement which designated the location of the target.
Results
The correct target was identified in all procedures. With the IGS, the average time to find and identify the target was 20 minutes. With the enhanced IGS, time to target was reduced to 3 minutes.
Conclusions
The enhanced IGS afforded a substantial decrease in procedure time. Augmented reality has been demonstrated in rigidly tracked endoscopes. This is fist proof of concept that endoscopic enhancement, which helps to provide a geographic anatomic framework, facilitates minimally invasive flexible orbital endoscopic procedures.
Keywords: 629 optic nerve •
615 neuroprotection •
549 image processing