Deep anterior lamellar keratoplasty (DALK) is an emerging surgical technique for the restoration of corneal clarity and vision acuity. The big-bubble technique in DALK surgery is the most essential procedure that includes the air injection through a thin syringe needle to separate the dysfunctional region of the cornea. Even though DALK is a well-known transplant method, it is still challenged to manipulate the needle inside the cornea under the surgical microscope, which varies its surgical yield. Here, we introduce the DALK protocol based on the position-guided needle and M-mode optical coherence tomography (OCT). Depth-resolved 26-gage needle was specially designed, fabricated by the stepwise transitional core fiber, and integrated with the swept source OCT system. Since our device is feasible to provide both the position information inside the cornea as well as air injection, it enables the accurate management of bubble formation during DALK. Our results show that real-time feedback of needle end position was intuitionally visualized and fast enough to adjust the location of the needle. Through our research, we realized that position-guided needle combined with M-mode OCT is a very efficient and promising surgical tool, which also to enhance the accuracy and stability of DALK.
Eye is an optical system composed briefly of cornea, lens, and retina. Ophthalmologists can diagnose status of patient’s eye from information provided by optical sensors or images as well as from history taking or physical examinations. Recently, we developed a prototype of optical coherence tomography (OCT) image guided femtosecond laser cataract surgery system. The system combined a swept-source OCT and a femtosecond (fs) laser and afford the 2D and 3D structure information to increase the efficiency and safety of the cataract procedure. The OCT imaging range was extended to achieve the 3D image from the cornea to lens posterior. A prototype of OCT image guided fs laser cataract surgery system. The surgeons can plan the laser illumination range for the nuclear division and segmentation, and monitor the whole cataract surgery procedure using the real time OCT. The surgery system was demonstrated with an extracted pig eye and in vivo rabbit eye to verify the system performance and stability.