Abstract
Purpose :
Recent advancements in treatments for ocular diseases have led to many novel, anterior interfacing medical devices and surgical procedures. This necessitates new methods for visualizing device-tissue interaction and assessing the preclinical performance of these medical devices. One valuable method for visualizing the internal, anterior surface of the eye is the 2004 Miyake-Apple technique. The purpose of this study was to modernize this method using current camera technology.
Methods :
Whole human cadaver eyes (LionsGift) were obtained within 72 hours of donor death. A 25-gauge valved Alcon port was inserted to allow for infusion and intraocular illumination of the eye. Rather than slicing the eye in half as previously done in the Miyake-Apple technique, a 8.2mm temporary keratoprosthesis (TKP) was sutured to the posterior of the eye providing an opening for anterior visualization. A custom designed, 3D printed, fixture (Figure 1) held both the eye and a 4K USB web camera utilizing a Sony IMX317 sensor and 20-degree manual focus lens. The eye was secured to the fixture by holding the optic nerve with an alligator clip. A High-Resolution Volk Wide Field Lens was placed into the channel below the sutured TKP. The camera was aligned with the wide field lens and manually focused. Videos and images were then captured utilizing the camera application on a laptop with the USB camera connected.
Results :
This custom setup provided high resolution still and video imaging of the intraocular anterior surface of the eye (Figure 2). The wide field lens allowed for visualization from the apex of the cornea to approximately 13mm from the limbus. Anatomic features such as the pupil, intraocular lens, ciliary bodies, pars plana, and choroidal vasculature were clearly visible.
Conclusions :
This updated Miyake-Apple technique provides a useful tool for visualizing the anterior surface of the eye. As the globe remains almost fully intact, tissue connectivity is undisturbed which provides a robust anatomic model with visualization for surgical testing. In the future, this model could be used for preclinical assessment of placement and fixation of intraocular lens and drug eluding implants in addition to visualization of intravitreal or suprachoroidal injections and suprachoroidal cannulation.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.