谱域光学相干层析成像技术的创新在全眼球光学结构生物测量及人工晶状体个体化的研究

Intraocular lens (IOL) implantation is still challenging for eyes with abnormal anatomy, such as patients after refractive surgery and with high myopic eyes, mainly due to the lack of effective and accurate method for measurement of biometry of the whole eye. The current project aims to improve a very high speed spectral domain optical coherence tomography (SD-OCT) for imaging the whole eye from the cornea to retina and utilize this system to measure the biometry of the whole eye accurately and develop a SD-OCT-based indivadual IOL power prediction model. The specific aims of the application are as follows: (1) The current SD-OCT system based on a high-speed CMOS camera will be improved through implementing a signal channel dual focus probe system, which will be proposed to solve the problem of the limited focus depth of the probing beams. (2) We will explore the 3D image processing method to yeild the accurately quantitative measurement for the biometry of the whole eye, including the axial length, corneal powers of the anterior and posterior surfaces,corneal thickness, anterior chamber depth,crystalline lens powers of anterior and posetrior surfaces, crystalline lens thickness. (3) An indivadual SD-OCT-based IOL power prediction model will be developed using the measurements of the biometry of the whole eye and validated by the clinical study. This project will provide a new valuable technology for the accurate measurement of biomety of the whole eye for intraocluar lens implantation in cataract patients. This project will also lay the foundations for the indivadual intraocular lens design and implantation, which has important application values.

因眼科临床缺乏可靠的全眼光学结构参数生物测量技术，对于异常解剖结构眼白内障患者人工晶状体度数的预测仍是难题。本项目将在前期工作的基础上，对谱域光学相干层析成像技术（SD-OCT）进行创新以研究全眼光学结构参量的精确测定和人工晶状体个体化屈光预测。改进现有SD-OCT的实验平台，在扫描探头中引入单通道双聚焦光路系统，解决系统探测光束的有限焦深问题，实现全眼成像；探索全眼球三维分析方法，获取白内障患者术前、术后全眼球光学结构参量数据；项目将尝试构建基于该技术测量的人工晶状体个体化屈光预测模型，为各类人群白内障患者眼球光学结构的精确测量提供新的技术途径，并为实现人工晶状体个体化设计和手术植入奠定基础，因而具有重要的临床价值。

本研究利用自行研制的谱域光学相干层析成像技术（SD-OCT），开展全眼光学结构参量的精确测定及其在人工晶状体个体化屈光预测相关的临床应用工作。主要取得了以下成果： 1） 改进前期搭建的SD-OCT实验平台，设计并成功搭建单通道双聚焦的扫描探头光路系统，解决了系统探测光束的有限焦深问题，实现全眼成像。所建立的全眼SD-OCT，扫描深度大约40mm，可实现各类眼轴眼的全眼生物参量测量，并通过一套OCT系统实现全眼成像，成本低，临床推广可行度高；2）通过图论和最短路径的优化算法，建立全眼球三维形态分析方法，获取了角膜形态(包括大范围的前后表面形态、厚度地形图等参量）、前房深度、晶状体厚度、人工晶状体在眼内位置、视轴长度等全眼生物参量的测量；利用该系统和分析软件，建立圆锥角膜、白内障人工晶状体术后眼的生物参量数据库；3）根据获取的全眼生物参量数据，重点分析和探索了该技术对圆锥角膜眼形态测量的精准性以及早期病变的检测能力，通过与常规临床测量方法(如Pentacan眼前节分析仪、角膜地形图等)比较，发现本研究建立的全眼SD-OCT就有较高的测量精度，并对病变具有更早的探测能力。该结果为实现该类患者人工晶状体个体化设计和手术植入奠定了基础，并为各类人群白内障患者眼球光学结构的精确测量提供新的技术途径，而具有重要的临床价值。