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WO2009080793A1 - Système d'observation de l'oeil et procédé associé - Google Patents

Système d'observation de l'oeil et procédé associé Download PDF

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Publication number
WO2009080793A1
WO2009080793A1 PCT/EP2008/068108 EP2008068108W WO2009080793A1 WO 2009080793 A1 WO2009080793 A1 WO 2009080793A1 EP 2008068108 W EP2008068108 W EP 2008068108W WO 2009080793 A1 WO2009080793 A1 WO 2009080793A1
Authority
WO
WIPO (PCT)
Prior art keywords
eye
reliability
radius
limbus
auxiliary information
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2008/068108
Other languages
German (de)
English (en)
Inventor
Thomas Schuhrke
Günter Meckes
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Carl Zeiss Surgical GmbH
Original Assignee
Carl Zeiss Surgical GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Carl Zeiss Surgical GmbH filed Critical Carl Zeiss Surgical GmbH
Publication of WO2009080793A1 publication Critical patent/WO2009080793A1/fr
Priority to US12/801,689 priority Critical patent/US8662667B2/en
Anticipated expiration legal-status Critical
Priority to US14/147,046 priority patent/US9089283B2/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/13—Ophthalmic microscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/11—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring interpupillary distance or diameter of pupils
    • A61B3/112—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring interpupillary distance or diameter of pupils for measuring diameter of pupils

Definitions

  • the invention relates to an eye-observation system according to the preamble of claim 1 and a method for viewing an eye according to claim 9.
  • Such systems are known both in the field of eye surgery and in the field of eye diagnostics. It is theirs that a surgeon or ophthalmologist looks at the eye through a microscope, camera or other aids. Often, it is of great benefit to the observer to get a position indication or other assistance that provides information about the current position or other properties of the eye to be examined or treated.
  • Laser ablation can be done more precisely from this point than when choosing a theoretically assumed or estimated midpoint of the cornea.
  • Another example is a cataract surgery in which the natural lens of the human eye, which has become clouded, is replaced by an artificial lens.
  • the surgeon performs such an intervention under a surgical microscope. After a circular opening of the front capsule leaf usually the lens is smashed and sucked. Subsequently, an artificial lens is inserted into the empty capsular bag.
  • a surgical microscope for eye surgery is known, which superimposes a pattern on the eye to be operated on.
  • the pattern can be an aid for setting the cutting position, but it can also serve as a guide for the insertion of toric intraocular lenses or also help with the introduction of a seam at a
  • the position is also constantly redefined or tracked during the operation, as it may come during the procedure to movements of the entire eye or the pupil.
  • Impairment of the eye by surgery also be wrong.
  • surgeon or optician to decide to what extent he uses the help offered, in a sense relies on it, or to what extent he tries to cope with his own knowledge or observations. He is responsible, regardless of all technical support. For this reason, the willingness to use the offered assistance and confidence in their reliability is not too great for many treating persons, and many have therefore refrained from using such assistance at all.
  • the invention has for its object to provide an eye-viewing system, which the doctor, surgeons, opticians o. ⁇ . Provide assistance in providing information on the position and / or characteristics of characteristic ocular components during ophthalmologic examination or treatment, and designed to increase their acceptance.
  • an eye-observation system which has, on the one hand, a camera for receiving at least one section of an eye to be treated and, on the other hand, an observation unit, such as, for example Surgical microscope or a fundus camera and a computing unit, through which the image recorded on the camera analyzed and thereby position or property of a characteristic eye component derived can be provided with an assist unit which transmits auxiliary information to the observer, which are formed from the derived from the arithmetic unit size ,
  • the eye-observation system is furthermore equipped with a reproduction unit which, in addition to the offered auxiliary information, provides the user with an indication of its reliability.
  • This additional information is preferably determined by the arithmetic unit directly when determining position or another characteristic of the characteristic eye component.
  • a measure of the correctness of the derivation of the auxiliary information is preferably displayed together with the auxiliary information.
  • the simultaneous indication of help information and reliability of the same supports the user of the help information in his decision to what extent he relies on the offered help information and uses this, for example, in the treatment of the eye. This is always a very critical decision, so it is good to use all available information to make it as transparent as possible.
  • the playback unit that informs about the reliability of the displayed help information is implemented as a visual display. Many of the help information is visually displayed. Therefore, it is advantageous, even the information about their reliability in optical form display.
  • both auxiliary information and the indication of the reliability of these are arranged so that they can be detected at a glance. Ideally, both appear on a single display unit. This allows the attending or examining person to capture both information together at one glance; it does not cost extra time to record the reliability of the derived help information. It is therefore not disturbed or only in as little extent as possible in the treatment process.
  • the reproduction unit is designed as an optical imaging unit for the reliability of the auxiliary information. This opens up the possibility of projecting the information about the reliability to a point at which the treating person at least occasionally looks, so that it is in their field of vision, without the treating person having to look in a different direction. It could, for example, be projected in or directly next to the eye to be treated, but preferably it is projected into the beam path of the eye
  • the optical imaging unit is constructed and arranged such that the information about the reliability of the auxiliary information can ideally be coupled together with the auxiliary information itself into the beam path between the eye to be treated and the eye of the person watching.
  • This can be realized, for example, via a display for generating an image indicating the reliability and optical elements such as a beam splitter, for fading this image into the beam path of, for example, the eyepiece of a surgical microscope.
  • the treating person sees in this way both the eye to be treated and at the same time the help information presented as well as the security of how reliable this auxiliary information is to be assessed. As a result, the treating person is disturbed as little as possible in their treatment or examination procedure, but can still at any time the offered Consider and use information.
  • the indication of the reliability can take place, for example, in the form of a percentage as a number sequence or as a bar chart.
  • the reliability can also be transmitted by varying the auxiliary information according to its security.
  • the auxiliary information may be colored green if the algorithm for its derivation could be carried out very reliably, red on the other hand if the result of the algorithm is not completely reliable or reliable.
  • Those who render the reliability by modifying the help information again have the advantage that the user of an indication can take both information and thus be the least distracted from his treatment or examination.
  • the reproduction unit is designed to indicate the reliability of the auxiliary information as an acoustic unit. This does not impair the view of the treating person, he can continue to devote all his visual attention to the eye to be treated or examined, while at the same time receiving information about the reliability of the offered auxiliary information via his hearing. This can be done for example in the form of a warning tone, if the auxiliary information could not be derived safely.
  • the information about the reliability of the auxiliary information offered which was derived from a derived property such as the radius or the position of a characteristic eye component, for example, of the limbus or the pupil, is also determined in the context of the method for deriving the auxiliary information.
  • a very fast and reliable method which is particularly advantageous both for the determination of characteristic ocular components and for the derivation of the safety of the size determined, consists in preferably to determine the limbus via a convolution of the digital image section with a ring filter corresponding size by the filter response is evaluated.
  • the maximum filter response results if the center of the limbus coincides with the center of the ring filter.
  • the location of the center of the limbus can be found as the location of the maximum filter response.
  • the size of the ring filter must first be determined, since this is not known in advance. Therefore, the digital image is folded with ring filters of different sizes and each time the maximum filter response is plotted against the radius of the ring filter used. It was recognized that the largest radius at which the resulting maximum response filter response curve takes a local maximum corresponds to the radius of the limbus. The radius of the limbus can therefore be read directly from the curve of the radii of the ring filter used over the maximum filter responses achieved thereby.
  • a ring filter defined radius can be used to fold the digital image section of the eye with this in each case the location of the position of the center of the limbus or to determine according to the pupil.
  • the once-determined radius can thus be used repeatedly in the course of an eye treatment or examination and does not have to be redetermined every time, at least as long as the same eye is viewed and the recording conditions (such as the zoom factor) do not change.
  • This method has proved to be very fast and reliable, since it is even very robust against disturbances occurring during surgery, since the annular character of the ocular components is almost always preserved and since it has no error-prone thresholding gets by.
  • it offers the advantage that the absolute value of the maximum filter response in each case a very meaningful size is available from which the safety of the method can be derived directly. The better the ring filter and the annular characteristic eye component to be determined match and lie one above the other in their position, the greater this value of the filter response is.
  • this value can be used directly to indicate the reliability of the auxiliary information derived from the determined ocular component without having to additionally carry out another method for determining the reliability.
  • FIG. 2 shows an example of a ring filter for locating the limbus of an eye section viewed with the eye-viewing system
  • FIG. 3 shows an example of a filter response of the convolution of the eye detail with a ring filter
  • FIG. 4 shows an example of filter responses of different sized filter, plotted on the radius and FIGS. 5a and b show examples of eye openings with a limbus circuit superimposed as auxiliary information with simultaneous indication of the reliability of the auxiliary information.
  • Fig. 1 shows an eye-viewing system 1, such as may be used in cataract surgery.
  • the patient's eye 2 to be treated which is illuminated by a light source, not shown, is recorded with a camera 3.
  • a beam splitter 4 is arranged, which splits the observation beam path so that the eye 2 to be treated simultaneously by means of a
  • Surgical microscope 5 can be viewed by means of the eye of the attending physician 6.
  • the camera 3 and the surgical microscope 5 are connected to each other via a computer 7, via which they can exchange data.
  • a pattern generator 8 which includes an LCD display 9 and a located inside the device and therefore not visible optical unit for coupling the pattern displayed on the LCD display 9 in the beam path of the surgical microscope 5.
  • the image of the eye 2 to be treated is taken over a camera 3 while the doctor treating it with his eye 6.
  • the acquired digital data of the image of the eye 2 are transferred to a computer 7, where they are evaluated.
  • the position and size of characteristic eye features of the eye 2, such as limb position and radius are derived from the image taken with the camera 3.
  • an auxiliary variable, such as an annular pattern, for example is formed from these variables, and the desired position thereof is determined and the corresponding variable transferred to the pattern generator 8.
  • a method suitable for determining the limbus radius and position and for deriving the auxiliary quantity will be described below with reference to FIGS. 2 to 4.
  • a representation of the annular pattern is on the LCD display.
  • this position e.g. be determined on the basis of the camera 3 recorded image of the eye 2 to be treated.
  • this digital image of the eye detail of the eye 2 to be treated which is shown by way of example in FIG. 2, is folded with a ring filter 10, as is also shown schematically in FIG. 2.
  • the ring filter 10 includes two concentric rings 11 and 12, which are placed in Fig. 2 symmetrically around the limbo 13 to be determined.
  • the ring filter 10 is normalized so that the outer ring 11 provides positive contributions to the filter response while the inner ring 12 gives negative contributions.
  • the ring filter 10 is normalized so that the filter response in the convolution with a gray area is zero. This means that the two rings 11 and 12 are weighted according to their area proportions in the image. This ring filter 10 is now folded with the transmitted from the camera 3 to the computer 7 digital image detail, d. h., the filter response is determined at each point of the captured image.
  • the result of the convolution with the ring filter 10, ie the filter response when the filter center and the center of the limbus 13 are approximately identical, is shown in FIG. 3 as an example.
  • the maximum filter response results here is shown bright.
  • the center of this bright area corresponds to the limbus center point and as such is transferred to the pattern generation unit 8.
  • the exact determination of this center is only possible with the required accuracy when the radius of the ring filter 10 is adapted to the radius of the limbus 13. At the beginning of the process this is still unknown.
  • a folding of the image section is performed with ring filters 10 of different sizes over a radius range to be examined.
  • the image is in each case folded with a ring filter 10 of another radius and the respective maximum filter response is determined.
  • the resulting maximum filter responses are applied over the radii of the associated ring filter 10.
  • a curve is obtained as shown in Fig. 4, for example. At the best fitted radius, the curve shows a distinct peak.
  • the maximum that results at the largest radius of a ring filter 10 indicates that the radius of the ring filter 10 coincides with the radius of the limbus 13.
  • the radius of the ring filter 10 then corresponds to the limbus radius
  • the position of the brightest area in the filter response of the convolution with this ring filter 10 corresponds to the position of the limbus center.
  • FIG. 5a shows the detail of the eye 2 to be treated and a pattern ring 14 superimposed thereon.
  • This pattern ring 14 provides assistance to the doctor to be treated, which makes it easier for him to find a suitable cutting position for the cataract operation. How reliably this pattern ring 14, so the The assistance provided to the surgeon is, but depends on a variety of factors. Especially if the eye is severely impaired by disturbances during the operation itself, the safety of the correctness of the position of the displayed pattern ring 14 can go back. Thus, it is of great importance for the surgeon to find out how reliable the auxiliary variable 14 given to him actually is. For this reason, in the context of the method according to the invention shown here, a variable is also derived which provides information about the reliability of the currently determined position and the radius of the limbus 13.
  • the method of folding with a ring filter 10 used here offers a particularly simple measure for this reliability.
  • the absolute value of the maximum of the filter response of the best matched ring filter 10 may be used.
  • the absolute value of the maximum of the filter response can be compared, for example, with the filter response of the ring filter applied to an artificially generated reference image which, on a light background, shows a dark slice ideally suited to the filter size.
  • the contrast between background and slice in the reference image preferably corresponds to the typical contrast between sclera and iris in a high-contrast eye image.
  • the reliability can be determined as follows:
  • This calculation rule returns a value for reliability between 0.0 and 1.0.
  • a security of 1.0 applies if the reliability is greater than 1.0
  • This reliability of the determined position and thus the reliability of the displayed pattern ring 14 should now also be displayed to the surgeon, preferably directly together with the pattern ring 14, so that this can always gain an impression of how reliable in addition to the offered assistance the auxiliary size 14 is actually.
  • FIGS. 5a and 5b There are various possibilities for this, two of which are shown in FIGS. 5a and 5b.
  • the ring pattern 14 displayed on the LCD display 9 is simply modified depending on the reliability. A solid line, as can be seen in FIG.
  • the beam is extremely short, since, as already explained, the reliability of the method drops significantly as soon as the limbus 13 moves partially out of the image section.
  • a reliability indicator 14 or 15 which is generated on the LCD display 9, the surgeon gains an important help in deciding to what extent he can rely on the position of the offered assistance.

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  • Life Sciences & Earth Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

L'invention concerne un système d'observation de l'oeil destiné à l'examen ou au traitement d'un oeil. Ce système comprend une caméra destinée à enregistrer une image numérique d'au moins une coupe d'un oeil, une unité de calcul servant à dériver la position et/ou une autre propriété d'une partie caractéristique de l'oeil, en particulier du limbe ou de la pupille, et une unité d'assistance destinée à transmettre une information auxiliaire dérivée de la propriété ou de la position à la personne effectuant l'examen ou le traitement. Le système d'observation de l'oeil selon l'invention se caractérise en ce qu'il comprend une unité de reproduction indiquant la fiabilité de l'information auxiliaire.
PCT/EP2008/068108 2007-12-21 2008-12-19 Système d'observation de l'oeil et procédé associé Ceased WO2009080793A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US12/801,689 US8662667B2 (en) 2007-12-21 2010-06-21 Ophthalmologic visualization system
US14/147,046 US9089283B2 (en) 2007-12-21 2014-01-03 Ophthalmologic visualization system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007055919.6 2007-12-21
DE102007055919.6A DE102007055919B4 (de) 2007-12-21 2007-12-21 Augen-Betrachtungssystem und Verfahren hierzu

Related Child Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2008/068107 Continuation-In-Part WO2009080792A1 (fr) 2007-12-21 2008-12-19 Procédé pour déterminer des propriétés ou pour déterminer et/ou repérer la position d'une partie caractéristique de l'oeil

Publications (1)

Publication Number Publication Date
WO2009080793A1 true WO2009080793A1 (fr) 2009-07-02

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WO (1) WO2009080793A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102440749A (zh) * 2011-09-09 2012-05-09 肖真 手术显微镜辅助装置和手术显微系统
US8308298B2 (en) 2009-06-24 2012-11-13 Carl Zeiss Meditec Ag Microscopy system for eye surgery
US8662667B2 (en) 2007-12-21 2014-03-04 Carl Zeiss Meditec Ag Ophthalmologic visualization system

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Cited By (4)

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Publication number Priority date Publication date Assignee Title
US8662667B2 (en) 2007-12-21 2014-03-04 Carl Zeiss Meditec Ag Ophthalmologic visualization system
US9089283B2 (en) 2007-12-21 2015-07-28 Carl Zeiss Meditec Ag Ophthalmologic visualization system
US8308298B2 (en) 2009-06-24 2012-11-13 Carl Zeiss Meditec Ag Microscopy system for eye surgery
CN102440749A (zh) * 2011-09-09 2012-05-09 肖真 手术显微镜辅助装置和手术显微系统

Also Published As

Publication number Publication date
DE102007055919B4 (de) 2023-08-10
DE102007055919A1 (de) 2009-06-25

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