Novel Microscope-Integrated Stereoscopic Heads-up Display for Intrasurgical OCT in Ophthalmic Surgery

Abstract

 

Purpose

 

To visualize acquired data in previously reported ophthalmic intrasurgical OCT systems, surgeons must either look away from the surgical microscope to view a computer monitor, or utilize outdated monocular heads-up display (HUD) technology. Real-time volumetric intrasurgical swept-source OCT (SSOCT), by providing multiple views of the surgical field simultaneously, potentially affords the same perceptive advantages of stereoscopy as stereo microscopy. We present a novel compact, microscope-integrated stereoscopic HUD and report on its preliminary use in human vitreoretinal surgeries.

 

Methods

 

A novel stereoscopic HUD was designed based on a single high resolution, high brightness organic light emitting diode (OLED) display (Fig. 1). Independently adjustable beam splitters (Reflection:Transmission=10:90) were placed in the infinity space of each stereo microscope optical channel, aligned to project one half of the OLED display into each ocular. The HUD was interfaced with a custom SS-MIOCT system enabling real-time acquisition, processing, and stereoscopic HUD display of volumetric images in real time during human surgery. The surgeon’s stereo viewpoint of the volume dataset was adjustable by a foot joystick.

 

Results

 

The measured resolution (35.08μm) and field of view (21.0mm) at 10x total magnification of the operating microscope with and without the HUD were same. Stereoscopic, 4D Microscope Integrated OCT (4D-MIOCT) volumetric renders of human retinal surgery were acquired and displayed via the HUD (Fig. 2). The use of an OLED display allowed completely transparent black pixels (contrast=10000:1), unlike LCD displays used in prior work, to ensure that operating microscope view through the HUD was not compromised.

 

Conclusions

 

A novel surgical microscope-compatible HUD for live display of stereoscopic intrasurgical OCT volume data was demonstrated with potential applications in OCT image-guided ophthalmic microsurgery.  

 

Figure 1. Novel microscope-integrated HUD system. (A) Optical design of the HUD mounted on a surgical microscope. (B) Photograph of HUD (white box in red border) mounted on a surgical microscope.

 

 

Figure 2. 4D-MIOCT data displayed on HUD. (A,B) Images seen through the left/right oculars in porcine eye operation. (C,D) Closeup of stereo pair of volumetric renderings (rotated 9 degrees relative to each other), projected into left/right oculars during live human macular surgery.