Optical coherence tomography (OCT) is a cross-sectional and 3-dimensional (3-D) imaging technology with very fine spatial resolution (5 ?m). This project develops the methods and software needed for high-precision OCT measurements of the eye to guide implant, laser, and transplant surgeries in the front part of the eye. In the proposed continuation of the project, a new generation of OCT that has very high speed (about 10 times faster than before, taking an image in as little as 2/1000 of a second) and extended range will enable new types of measurements to be done accurately.
The Specific Aims are as follows: (1) To develop ultrahigh-speed OCT hardware and software for measuring optical surfaces of the anterior eye. Intrinsic eye movements effectively limit measurement of corneal shape by commercial OCT. This will be overcome by several approaches, including ultrahigh-speed OCT at 500 kHz, dual-beam OCT to simultaneously capture the shape of both the cornea and lens, simultaneous capture of Placido-ring videokeratography, and motion correction software. The goal is to provide reliable measurements on front and back surfaces of both the cornea and crystalline lens. (2) To develop an OCT-based intraocular lens power formula. Currently, surgeons lack an accurate way to calculate precise intraocular lens (IOL) power for cataract patients who previously had laser vision correction. These patients may be left near- or far-sighted after cataract surgery. An OCT-based IOL formula, using measurements of both anterior and posterior corneal powers, can give surgeons more precise information that will significantly improve visual outcomes. The OCT-based IOL formula will be tested in a clinical trial. (3) To develop OCT-guided excimer laser surface ablation. The excimer laser can remove cloudy layers from the front of the cornea and correct distorted shape due to keratoconus or transplant surgery. We have developed 3-D OCT-based planning to optimally remove cloudiness due to corneal scars and stromal dystrophies. This method will be tested in a larger clinical trial. We will improve the method by adding 3-D OCT measurement of corneal shape (topography) to plan the correction of any shape distortion. (4) To develop OCT-guided laser-assisted anterior and posterior lamellar keratoplasty. Most corneal diseases involve only the inner or outer layer of the cornea. Thus a partial thickness transplant can treat these diseases while avoiding the complications of full-thickness transplantations (rejection, irregular wound shape, etc). However, manual dissection of corneal layers is technically difficult and vision after surgery is limited by the rough interfaces. We have developed OCT methods to guide the shaping and smoothing of donor and host corneas with a combination of excimer laser to create smooth interfaces and femtosecond laser to create tongue-in-groove edge fits. Pilot clinical trials of these techniques are proposed. The goal is to develop surgeries that reliably improve the vision in patients with keratoconus, corneal dystrophies, and deep scars.

Public Health Relevance

Optical coherence tomography (OCT) performs noncontact mapping of corneal shape and thickness with higher resolution and speed than conventional instruments. This project will develop the next generation of ultrahigh-speed OCT instruments and use them to accurately calculate intraocular lens power and improve outcomes of cataract surgery in eyes with previous laser vision correction. These instruments will also provide data to improve the precision, safety, and effectiveness in laser correction of cloudy or irregular corneas and laser-assisted corneal transplantation.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY018184-06
Application #
8324529
Study Section
Special Emphasis Panel (ZRG1-ETTN-E (92))
Program Officer
Wiggs, Cheri
Project Start
2007-04-01
Project End
2016-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
6
Fiscal Year
2012
Total Cost
$751,926
Indirect Cost
$127,181
Name
Oregon Health and Science University
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Ferrara, Daniela; Mohler, Kathrin J; Waheed, Nadia et al. (2014) En face enhanced-depth swept-source optical coherence tomography features of chronic central serous chorioretinopathy. Ophthalmology 121:719-26
Cleary, Catherine; Li, Yan; Tang, Maolong et al. (2014) Predicting transepithelial phototherapeutic keratectomy outcomes using Fourier domain optical coherence tomography. Cornea 33:280-7
Adhi, Mehreen; Liu, Jonathan J; Qavi, Ahmed H et al. (2014) Choroidal analysis in healthy eyes using swept-source optical coherence tomography compared to spectral domain optical coherence tomography. Am J Ophthalmol 157:1272-1281.e1
Huang, David; Tang, Maolong; Wang, Li et al. (2013) Optical coherence tomography-based corneal power measurement and intraocular lens power calculation following laser vision correction (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 111:34-45
Cleary, Catherine; Tang, Maolong; Ahmed, Habeeb et al. (2013) Beveled femtosecond laser astigmatic keratotomy for the treatment of high astigmatism post-penetrating keratoplasty. Cornea 32:54-62
Li, Yan; Lowder, Careen; Zhang, Xinbo et al. (2013) Anterior chamber cell grading by optical coherence tomography. Invest Ophthalmol Vis Sci 54:258-65
Zhou, Shi-you; Wang, Chun-xiao; Cai, Xiao-yu et al. (2013) Optical coherence tomography and ultrasound biomicroscopy imaging of opaque corneas. Cornea 32:e25-30
Tang, Maolong; Stoeger, Christopher; Galloway, Joshua et al. (2013) Evaluating DSAEK graft deturgescence in preservation medium after microkeratome cut with optical coherence tomography. Cornea 32:847-50
Ma, Xingxuan Jack; Wang, Li; Koch, Douglas D (2013) Repeatability of corneal epithelial thickness measurements using Fourier-domain optical coherence tomography in normal and post-LASIK eyes. Cornea 32:1544-8
Cleary, Catherine; Song, Jonathan C; Tang, Maolong et al. (2012) Dual laser-assisted lamellar anterior keratoplasty with top hat graft: a laboratory study. Cornea 31:791-7

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