Although EMT provides inferior accuracy and is prone to ferromagnetic distortions, it is complementary to OT. OT is very accurate, but suffers from line of sight deficiency, which may limit surgeons during interventions, especially in the head-neck area, where the operating area is small, and cluttered. The two most widely used technologies are optical (OT) and electromagnetic tracking (EMT). The real-time tracking of the patient and various surgical tools are crucial building blocks. IGS navigation is vital to repeatedly and reliably reach the designated target locations during the aforementioned medical procedures. In radiofrequency (RF) ablation therapies-which are often used to treat tumors with large volume and/or irregular shape-alternating current high-frequency radio waves, dissipated at the tip of an electrode, are used to destroy tumor tissue while simultaneously minimizing damages to neighboring normal tissues.
Another application of IGS is to preserve the facial nerve and cochlea during petrous bone drilling preceding the insertion of a cochlear implant in the middle-ear. Similarly, in intracranial biopsy (where tissue samples are taken by a probe), the tool-tip is guided to target points inside the brain. The positioning of deep brain electrodes is assisted by localizing preoperatively planned targets in the brain for the treatment of epilepsy and Parkinson’s disease while at the same time preventing damages to nearby blood vessels. Navigation is particularly useful in neurosurgery. Within the last decades, surgeons have been aided with image-guided, computer-assisted surgery (IGS) for accurate intraoperative navigation and localization of important critical structures in many interventions. An ongoing study evaluates the proposed system in a preclinical setting for auditory brainstem implantation. The results and participants’ feedback indicate potential to accurately navigate users toward the target with less distraction and workload. The stand-alone and multi-modal versions of the proposed interface outperformed cross-sectional views-only navigation in both quantitative and qualitative evaluations. Clinically experienced users reached the targets with shorter trajectories. The usability study demonstrated that the participants were able to detect invisible targets marked in phantom imagery with significant enhancements for localization accuracy and duration time. The instruments were electromagnetically navigated in phantoms. The latter was presented on a screen both stand-alone and combined with the proposed interface. A usability study with multidisciplinary participants evaluates the proposed interface projected in surgical microscope oculars against cross-sectional views. The estimated 3D pose of the interventional instruments and their positional uncertainty are intuitively presented in a visual interface with respect to the target point. This work proposes an alternative, simple, minimalistic visual interface intended to assist during real-time surgical target localization. Current state-of-the-art interfaces largely employ traditional anatomical cross-sectional views or augmented reality environments to present the actual spatial location of the surgical instrument in preoperatively acquired images.
All rights reserved.Interactive image-guided surgery technologies enable accurate target localization while preserving critical nearby structures in many surgical interventions. Ophthalmologists should be aware of ocular damage caused by these devices.Ĭopyright © 2017 Canadian Ophthalmological Society. Ocular injuries can occur as a result of incorrect use of laser-assisted hair removal devices. Visual acuity at last follow-up (range 3-6 months) was 20/15 to 20/20. One patient presented with acute anterior uveitis, 2 patients with subfoveal choroidal neovascularization, and 1 patient with intraretinal foveal hemorrhage. Data on ophthalmic examination, spectral domain optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany), and fundus fluorescein angiography were collected.įour female patients sustained injuries during alexandrite laser hair removal.
This was a retrospective case series of 4 patients who presented to 2 tertiary eye care hospitals over 2 years. The aim of this study was to describe the clinical manifestations and outcomes of 4 patients who had sustained eye injury during alexandrite laser-assisted hair removal.