Abstract
Purpose: The purpose of the study was to implement a new eye tracking mask which could be used to guide the laser beam in automated non-mechanical excimer laser assisted penetrating keratoplasty. Materials and methods: A new trephination mask design with an elevated surface geometry has been proposed with a step formation between conical and flat interfaces. Two recipient masks of 7.5/8.0 mm have been manufactured and tested. The masks have outer diameter of 12.5 mm, step formation at 10.5 mm, and slope of conical surfaces 15°. Its functionality has been tested in different lateral positions and tilts on a planar surface, and pig eye experiments. After successful validation on porcine eyes, new masks have been produced and tested on two patients. Results: The build-in eye tracking software of the MEL 70 was always able to capture the masks. It has been shown that the unwanted pigmentation/pattern induced by the laser pulses on the mask surface does not influence the eye-tracking efficiency. The masks could be tracked within the 18 × 14 mm lateral displacement and up to 12° tilt. Two patient cases are demonstrated. No complications were observed during the surgery, although it needs some attention for aligning the mask horizontally before trephination. Stability of eye tracking masks is emphasized by inducing on purpose movements of the patient head. Conclusion: Eye-tracking-guided penetrating keratoplasty was successfully applied in clinical practice, which enables robust tracking criteria within an extended range. It facilitates the automated trephination procedure of excimer laser-assisted penetrating keratoplasty.
Highlights
The purpose of the study was to implement a new eye tracking mask which could be recognized by the build-in eye-tracker of the MEL70 excimer laser, and could be used to guide the laser beam in automated non-mechanical excimer laser-assisted PKP
Eye tracking is not needed for donor trephining, since it is performed on a stationary stage and there are no movements expected, the conventional PKP donor mask is suitable for eye tracking without modifications, but since the conventional recipient mask geometry was not suitable for the eye tracking of the MEL 70 excimer laser, a recipient mask has been newly designed to enable eye-tracking for non-mechanical excimer laser-assisted PKP
Various systems are commonly used by different companies: in the previous generation of eye trackers only pupil lateral displacement (2D tracking systems) has been addressed
Summary
The purpose of the study was to implement a new eye tracking mask which could be used to guide the laser beam in automated non-mechanical excimer laser assisted penetrating keratoplasty. Materials and methods: A new trephination mask design with an elevated surface geometry has been proposed with a step formation between conical and flat interfaces. After successful validation on porcine eyes, new masks have been produced and tested on two patients. It has been shown that the unwanted pigmentation/pattern induced by the laser pulses on the mask surface does not influence the eye-tracking efficiency. Stability of eye tracking masks is emphasized by inducing on purpose movements of the patient head. 2013, 13 which enables robbust trackinng criteria within w an exttended rangge It facilitaates the auto omated trephinnation proceedure of exccimer laser--assisted penetrating keeratoplasty.
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