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 #
5R01EY018184-08
Application #
8726403
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Wiggs, Cheri
Project Start
2007-04-01
Project End
2016-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
8
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Oregon Health and Science University
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
City
Portland
State
OR
Country
United States
Zip Code
97239
Tang, Maolong; Li, Yan; Chamberlain, Winston et al. (2016) Differentiating Keratoconus and Corneal Warpage by Analyzing Focal Change Patterns in Corneal Topography, Pachymetry, and Epithelial Thickness Maps. Invest Ophthalmol Vis Sci 57:OCT544-9
Li, Yan; Chamberlain, Winston; Tan, Ou et al. (2016) Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography. J Cataract Refract Surg 42:284-95
Gao, Simon S; Jia, Yali; Zhang, Miao et al. (2016) Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 57:OCT27-36
Skalet, Alison H; Li, Yan; Lu, Chen D et al. (2016) Optical Coherence Tomography Angiography Characteristics of Iris Melanocytic Tumors. Ophthalmology :
Ma, Jack X; Tang, Maolong; Wang, Li et al. (2016) Comparison of Newer IOL Power Calculation Methods for Eyes With Previous Radial Keratotomy. Invest Ophthalmol Vis Sci 57:OCT162-8
Su, Johnny P; Chandwani, Rahul; Gao, Simon S et al. (2016) Calibration of optical coherence tomography angiography with a microfluidic chip. J Biomed Opt 21:86015
Yokogawa, Hideaki; Tang, Maolong; Li, Yan et al. (2016) Deep Laser-Assisted Lamellar Anterior Keratoplasty With Microkeratome-Cut Grafts. Cornea 35:706-12
Tang, Maolong; Li, Yan; Huang, David (2015) Corneal Epithelial Remodeling after LASIK Measured by Fourier-Domain Optical Coherence Tomography. J Ophthalmol 2015:860313
Su, Johnny P; Li, Yan; Tang, Maolong et al. (2015) Imaging the anterior eye with dynamic-focus swept-source optical coherence tomography. J Biomed Opt 20:126002
Zhang, Chenxing; Liu, Liang; Tang, Maolong et al. (2015) Laboratory Evaluation of Femtosecond Laser Lamellar Cuts in Gamma-Irradiated Corneas. Cornea 34:1499-503

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