Predictive apparatus for assisting a physician during ophthalmic surgery

Abstract

A method and system assist a physician in performing an ophthalmic surgery. The method includes receiving a quasi-real time image of at least a first portion of the eye. The at least the first portion of the eye includes an operating field for the ophthalmic surgery. A recommended next region and a recommended next procedure are determined based on the quasi-real time image and a computational model of the eye. An expected next result for the recommended next procedure is calculated using the quasi-real time image and the computational model. The recommended next region, the recommended next procedure and the expected result are provided to the physician.

We claim: 
     
         1 . A method for assisting a physician in performing an ophthalmic surgery comprising:
 receiving a quasi-real time image of at least a first portion of the eye, the at least the first portion of the eye including an operating field for the ophthalmic surgery;   determining a recommended next region and a recommended next procedure based on the quasi-real time image and a computational model of the eye;   calculating an expected next result for the recommended next procedure using the quasi-real time image and the computational model; and   providing the recommended next region, the recommended next procedure and the expected result to the physician.   
     
     
         2 . The method of  claim 1  further comprising:
 receiving an initial image of at least a second portion of the eye including the operating field, the initial image including an initial region for an initial procedure; 
 calculating an initial expected result for the initial procedure using the initial image; and 
 providing the initial expected result to the physician. 
 
     
     
         3 . The method of  claim 1  further comprising:
 iteratively repeating the receiving, determining, calculating and providing steps after the physician performs at least one procedure. 
 
     
     
         4 . The method of  claim 1  wherein the quasi-real time image includes at least one of an optical coherence tomograph, an ultrasound image, a high frequency ultrasound image, a ultrasound biomicroscopy (UBM) image and a three-dimensional image. 
     
     
         5 . The method of claim further comprising:
 capturing the quasi-real time image.   
     
     
         6 . The method of  claim 5  wherein the step of capturing the quasi-real time image takes not more than thirty minutes. 
     
     
         7 . The method of  claim 5  wherein the step of capturing the quasi-real time image takes not more than ten minutes. 
     
     
         8 . The method of  claim 5  wherein the step of capturing the quasi-real time image takes not more than one minute. 
     
     
         9 . The method of  claim 5  wherein the step of capturing the quasi-real time image further includes:
 acquiring a plurality of quasi-real time images at a plurality of intraocular pressures; and wherein the step of determining the recommended next region and the recommended next procedure further includes 
 determining a stress level at a plurality of regions based on the plurality of quasi-real time images, a first portion of the plurality of regions having a higher stress than a second portion of the plurality of regions; and 
 indicating the first portion of the plurality of regions and the second portion of the plurality of regions. 
 
     
     
         10 . The method of  claim 1  wherein the computational model includes mechanical properties of the eye. 
     
     
         11 . The method of  claim 1  wherein the ophthalmic surgery includes epiretinal membrane (ERM) removal and the recommended next procedure includes a recommended cut of the ERM. 
     
     
         12 . A method for assisting a physician in performing an ophthalmic surgery comprising:
 receiving an initial image of at least a first portion of the eye including an operating field for the ophthalmic surgery;   providing an initial recommended procedure for an initial recommended region;   calculating an initial expected result for the initial procedure using the initial image;   providing the initial expected result to the physician;   after a physician has performed a procedure, providing a quasi-real time image of at least a second portion of the eye, the at least the second portion of the eye including the operating field, the quasi-real time image including at least one of an optical coherence tomograph, an ultrasound image, a high frequency ultrasound image, a ultrasound biomicroscopy (UBM) image and a three-dimensional image, the step of providing the quasi-real time image occurring in-situ and expending not more than ten minutes;   determining a recommended next region and a recommended next procedure based on the quasi-real time image and a computational model of the eye;   calculating an expected next result for the recommended next procedure using the quasi-real time image and the computational model;   providing the recommended next region, the recommended next procedure and the expected result to the physician; and   iteratively repeating the quasi-real time image providing, recommended next region determining, the expected next result calculating and the recommended next region providing steps after the physician performs at least one procedure.   
     
     
         13 . A system for assisting a physician in performing ophthalmic surgery comprising:
 a quasi real-time image capture unit for providing a quasi-real time image of at least a first portion of the eye including an operating field for the ophthalmic surgery, the quasi-real time image capture unit capturing images of the eye in an image capture time not exceeding ten minutes;   a predictive unit for determining a recommended next region and a recommended next procedure based on the quasi-real time image and a computational model of the eye, the predictive unit also for calculating an expected next result for the recommended next procedure using the quasi-real time image and the computational model; and   a user interface for providing the recommended next region, the recommended next procedure and the expected result to the physician.   
     
     
         14 . The system of  claim 13  wherein
 the quasi-real time image capture unit also provides an initial image of at least a second portion of the eye including the operating field, the initial image including an initial region for an initial procedure; and 
 the predictive unit further calculates an initial expected result for the initial procedure using the initial image and provides the initial expected result to the physician. 
 
     
     
         15 . The system of  claim 13  wherein the quasi-real time image includes at least one of an optical coherence tomograph, an ultrasound image, a high frequency ultrasound image, a ultrasound biomicroscopy (UBM) image and a three-dimensional image. 
     
     
         16 . The system of  claim 13  wherein the quasi-real time image is captured in not more than one minute. 
     
     
         17 . The system of  claim 13  wherein the computational model includes mechanical properties of the eye.