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WO2024251604A1 - Procédé de biométrie optique à sensibilité de mesure élevée réalisé sur des yeux présentant une cataracte - Google Patents

Procédé de biométrie optique à sensibilité de mesure élevée réalisé sur des yeux présentant une cataracte Download PDF

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Publication number
WO2024251604A1
WO2024251604A1 PCT/EP2024/064898 EP2024064898W WO2024251604A1 WO 2024251604 A1 WO2024251604 A1 WO 2024251604A1 EP 2024064898 W EP2024064898 W EP 2024064898W WO 2024251604 A1 WO2024251604 A1 WO 2024251604A1
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WO
WIPO (PCT)
Prior art keywords
eye
scans
visual axis
eyes
whose detected
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.)
Pending
Application number
PCT/EP2024/064898
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German (de)
English (en)
Inventor
Roland Bergner
Manfred Dick
Rainer Leitgeb
Milana KENDRISIC
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Carl Zeiss Meditec AG
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Carl Zeiss Meditec AG
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
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Application filed by Carl Zeiss Meditec AG filed Critical Carl Zeiss Meditec AG
Publication of WO2024251604A1 publication Critical patent/WO2024251604A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

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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
    • A61B3/102—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for optical coherence tomography [OCT]
    • 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
    • A61B3/0016—Operational features thereof
    • A61B3/0025—Operational features thereof characterised by electronic signal processing, e.g. eye models
    • 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
    • A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea

Definitions

  • the present invention relates to a method for optical biometry, particularly of eyes with cataract disease.
  • the method is based on an optical coherence tomography (OCT) method, in which measuring beams are shifted not only along the visual axis of the patient's eye, but also laterally to the visual axis in order to obtain usable measurement data with a possibly better transmission of the cataract-affected eye.
  • OCT optical coherence tomography
  • a cataract also known as a cataract, lens cataract or lens opacity, is a clouding of the lens of the eye. If you look at people who have an advanced cataract, you can see the gray color behind the pupil, which is where the term "cataract" comes from. In most cases, the clouded lens can be surgically replaced with an artificial lens implant.
  • Intraocular lens - IOL Intraocular lens - IOL
  • cataract surgery Before cataract surgery, it is essential to measure the biometry of the cataract eye in order to be able to calculate the individually appropriate optical refractive power of the IOL and to achieve an eye that is as right-sighted as possible, i.e. emmetropic, after the procedure.
  • optical biometry requires optical media that allow a certain minimum transmission, which may not be the case, especially in eyes with completely opaque cataracts.
  • numerous solutions are known that deal with measuring the biometrics of eyes with cataracts.
  • optical biometers for measuring eyes with cataracts have largely replaced the measurement of eye length using ultrasound methods, as these can collect measurement data without contact with the eye and are also more accurate.
  • optical methods require sufficient transmission of the measuring beam through the clouded lens of the eye in order to be able to collect measurement data at all.
  • These B-scans can measure the optical surfaces (and other optically scattering structures) in the eye at any azimuthal angle within the opening of the pupil using, for example, an x-y galvanometer scanner system. This also makes it possible to capture the optical interfaces in the case of locally dense cataracts in the opening of the pupil despite these local image losses. Consequently, lateral scanning also makes a significant contribution to increasing the measurement sensitivity in the case of very dense cataracts in optical biometry.
  • JP 6198675 B2 describes an ophthalmological device that is able to scan light reflected from a patient's eye without using a galvanometer mirror.
  • the ophthalmological device comprises a light source and an optical system that guides the light from the light source to a patient's eye.
  • the optical system contains a lens that has a lens drive mechanism to move the lens within an orthogonal plane perpendicular to the light axis. The irradiation position and/or irradiation angle can thus be changed for the light generated by the light source and emitted to the subject's eye.
  • the present invention is based on the task of providing a method for optical biometry with which measurement data can also be obtained for eyes with cataract disease.
  • the device to be used for the optical biometry method should be cost-effective and preferably should not require a technical scanner or wobble device.
  • the OCT measuring beam should not only be used on the visual axis of the patient's eye with strict fixation of the patient, but also for Measuring apertures shifted laterally to the visual axis, with possibly better transmission through the optically inhomogeneous cataract.
  • the present task is solved with the proposed method for optical biometry of eyes with cataract disease, based on an interferometric OCT system without active scanner or wobble device, characterized in that in addition to the A-scan along the visual axis, A-scans offset laterally to this are realized with a high repetition rate.
  • the fixation restlessness of the patient's eye is exploited over a longer measurement period.
  • a measurement value for an intraocular distance of each boundary surface of the eye is determined and output.
  • a first group of advantageous embodiments relates to the longer measuring time, which is in the range of 5s to 30s, preferably up to 60s and particularly preferably up to 200s or even longer.
  • a second group of advantageous embodiments relates to the determination of the distance and/or the direction of the A-scans offset laterally to the visual axis. This is preferably carried out by detecting the 1st Purkinje reflex or the reflex of an external light source from an image of the eye.
  • a third group of advantageous embodiments concerns the verification of whether a sufficiently large eye movement is ensured within the fixation restlessness of the patient's eye. In particular, from the large number of A-scans, only those whose detected direction or whose detected distance from the visual axis is not too large are taken into account in the evaluation.
  • a fourth group of advantageous embodiments concerns the assessment of the quality of the measured values.
  • it is checked that, in the large number of A-scans, there are individual A-scans whose detected direction or whose detected distance lies within a tolerance to the visual axis.
  • a final group of advantageous embodiments relates to the measurement method itself.
  • the measurements of the plurality of A-scans within the longer measurement time run automatically as soon as the measurements are activated, whereby no change in the position and/or direction of the fixation light occurs during the measurements of the plurality of A-scans.
  • the present method based on optical coherence tomography, is used to measure distances in an eye suffering from cataracts in order to select the IOL to be implanted with the appropriate refractive power.
  • the method is intended in particular for measurements in eyes already suffering from cataracts, it can in principle be used for measurements in all eyes, e.g. eyes with an IOL already implanted, silicone-filled eyes, aphakic eyes and phakic eyes without cataracts.
  • the proposed method based on an interferometric OCT system without active scanner or wobble device with high measurement sensitivity for optical biometry of eyes with cataract disease, in addition to the A-scan along the visual axis, A-scans offset laterally to this are realized with a high repetition rate.
  • the fixation restlessness of the patient's eye is exploited within a longer measuring time, a large number of A-scans are evaluated and only one measured value is output for an intraocular distance of each boundary surface of the eye.
  • the invention provides for the natural fixation restlessness of the patient's eye to be exploited during longer measurement times with high A-scan repetition rates. This is intended to ensure that, in addition to the A-scan in the visual axis with a possible optical impenetrability, further laterally offset but measurable A-scans of the patient's eye can be recorded.
  • This self-movement should be used to realize A-scans at different points on the eye lens during longer measurement times. It is known from the application of eye trackers that after about 30 - 60 s these eye movements become even larger.
  • the method according to the invention will yield a large number of measurement data (or will not yield them at optically dense locations in the cataract lens), which must be organized in particular to determine the eye length and also to determine the other axial lengths in the eye, such as the corneal thickness, the anterior chamber depth and the lens thickness.
  • criteria are derived based on the known general anatomy and geometry of the position of the optical surfaces of the eye of interest, implemented in algorithms and the plausible biometric data with tolerances evaluated immediately after the measurement using a computer and entered into the biometer for further use.
  • the lateral position of the respective A-scan can be determined by additional detection of the 1st Purkinje reflex in the image of the eye.
  • the use of a fixation mark is advantageous in order to motivate a change in the direction of gaze of the eye to be measured.
  • changing two-dimensional patterns or images can also be used for this purpose.
  • an existing headrest can be designed to allow slight lateral movements or rotational movements of the patient's head.
  • the longer measuring time is in the range of 5s to 30s, preferably up to 60s and particularly preferably up to 200s or even longer.
  • A-scans offset laterally to it are carried out at a high repetition rate.
  • the distance and/or the direction of the A-scans offset laterally to the visual axis are determined. This is preferably carried out according to a second advantageous embodiment by detecting the 1st Purkinje reflex from an image of the eye.
  • A-scans there are individual A-scans whose detected direction or distance lies within a tolerance to the visual axis. This allows the quality of the measured values to be assessed.
  • the measurements are repeated with the predetermined measuring time until at least 1, preferably 5 measured values are available whose detected direction deviates between 0° and 10° or whose detected distance deviates between 0mm and 2mm from the visual axis.
  • the measurements of the plurality of A-scans run automatically within the longer measurement time as soon as the measurements are activated once.
  • the solution according to the invention provides a method for optical biometry, particularly of eyes, which is particularly suitable for eyes with cataracts.
  • the method is based on an optical coherence tomography method in which measuring beams are shifted not only along the visual axis of the patient's eye, but also laterally to the visual axis in order to obtain usable measurement data with a possibly better transmission of the cataract-affected eye.
  • the device used for the optical biometrics procedure is cost-effective and does not require a technical scanner or wobble device.
  • the present method based on optical coherence tomography, is used to measure distances in an eye suffering from cataracts in order to select the IOL to be implanted with the appropriate refractive power.
  • the method is intended in particular for measurements in eyes already suffering from cataracts, it can in principle be used for measurements in all eyes, e.g. eyes with an IOL already implanted, silicone-filled eyes, aphakic eyes and phakic eyes without cataracts.

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

Abstract

L'invention concerne un procédé de biométrie optique réalisé notamment sur des yeux présentant une cataracte. Le procédé est basé sur un procédé de tomographie par cohérence optique dans lequel des faisceaux de mesure sont générés non seulement le long de l'axe visuel de l'oeil du patient, mais également avec un décalage latéral par rapport à l'axe visuel afin d'obtenir des données de mesure utilisables présentant une transmission potentiellement améliorée à travers l'oeil atteint de cataracte. Le procédé proposé de biométrie optique réalisé sur des yeux présentant une cataracte est basé sur un système OCT interférométrique sans scanner actif ou dispositif oscillant, dans lequel, en plus du balayage A le long de l'axe visuel, des balayages A décalés latéralement à taux de répétition élevé sont réalisés. Ce procédé permet de collecter des données de mesure biométrique, même pour des yeux présentant une cataracte. Comme le procédé ne nécessite pas de scanner technique ou de dispositif oscillant, il est très simple et peu coûteux à mettre en oeuvre.
PCT/EP2024/064898 2023-06-08 2024-05-30 Procédé de biométrie optique à sensibilité de mesure élevée réalisé sur des yeux présentant une cataracte Pending WO2024251604A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102023205348.9 2023-06-08
DE102023205348.9A DE102023205348A1 (de) 2023-06-08 2023-06-08 Verfahren mit hoher Messempfindlichkeit zur optischen Biometrie von Augen mit einer Katarakterkrankung

Publications (1)

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WO2024251604A1 true WO2024251604A1 (fr) 2024-12-12

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PCT/EP2024/064898 Pending WO2024251604A1 (fr) 2023-06-08 2024-05-30 Procédé de biométrie optique à sensibilité de mesure élevée réalisé sur des yeux présentant une cataracte

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DE (1) DE102023205348A1 (fr)
WO (1) WO2024251604A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10349230A1 (de) * 2003-10-23 2005-07-07 Carl Zeiss Meditec Ag Gerät zur interferometrischen Augenlängenmessung mit erhöhter Empfindlichkeit
WO2010117386A1 (fr) * 2009-04-10 2010-10-14 Doheny Eye Institute Procédés, dispositifs et systèmes d'examen ophtalmique
AT507140B1 (de) * 2008-08-12 2013-03-15 Zeiss Carl Meditec Ag Mehrfach-a-scan kurzkohärenz-interferometrische distanzmessung am auge
DE102012016379A1 (de) * 2012-08-16 2014-02-20 Carl Zeiss Meditec Ag Verfahren zur Vermessung eines Auges
JP6198675B2 (ja) 2014-05-23 2017-09-20 株式会社トーメーコーポレーション 眼科装置
DE102018101917A1 (de) * 2018-01-29 2019-08-01 Carl Zeiss Ag Verfahren und Vorrichtung zur Augenuntersuchung mittels OCT
US20190246898A1 (en) * 2016-07-15 2019-08-15 Carl Zeiss Meditec Ag Method for very sensitively measuring distances and angles in the human eye

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102009041996A1 (de) 2009-09-18 2011-03-24 Carl Zeiss Meditec Ag Ophthalmologisches Biometrie- oder Bilderzeugungssystem und Verfahren zur Erfassung und Auswertung von Messdaten
DE102019214784A1 (de) 2019-09-26 2021-04-01 Carl Zeiss Meditec Ag Verfahren zur Ermittlung physiologisch korrekter, biometrischer Daten eines Auges

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10349230A1 (de) * 2003-10-23 2005-07-07 Carl Zeiss Meditec Ag Gerät zur interferometrischen Augenlängenmessung mit erhöhter Empfindlichkeit
AT507140B1 (de) * 2008-08-12 2013-03-15 Zeiss Carl Meditec Ag Mehrfach-a-scan kurzkohärenz-interferometrische distanzmessung am auge
WO2010117386A1 (fr) * 2009-04-10 2010-10-14 Doheny Eye Institute Procédés, dispositifs et systèmes d'examen ophtalmique
DE102012016379A1 (de) * 2012-08-16 2014-02-20 Carl Zeiss Meditec Ag Verfahren zur Vermessung eines Auges
JP6198675B2 (ja) 2014-05-23 2017-09-20 株式会社トーメーコーポレーション 眼科装置
US20190246898A1 (en) * 2016-07-15 2019-08-15 Carl Zeiss Meditec Ag Method for very sensitively measuring distances and angles in the human eye
DE102018101917A1 (de) * 2018-01-29 2019-08-01 Carl Zeiss Ag Verfahren und Vorrichtung zur Augenuntersuchung mittels OCT

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
CHRISTOPH K. HITZENBERGER: "Optical Measurement of the Axial Eye Length by Laser Doppler Interferometry", INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, vol. 32, no. 3, March 1991 (1991-03-01), XP000923153
MARIANA QUELHAS DIAS RODRIGUES ALMEIDA: "Detection of Purkinje Images for Automatic Positioning of Fixation Target and Interferometric Measurements of Anterior Eye Chamber ", MASTER DISSERTATION, December 2011 (2011-12-01)
SCOTT M. MCRAE: "Customized Corneal Ablation and Super Vision", JOURNAL OF REFRACTIVE SURGERY, vol. 16, no. 2, 2013, pages S230 - S235, Retrieved from the Internet <URL:ttps://doi.org/10.3928/1081-597X-20000302-06>

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