WO2022163189A1 - 画像処理装置、画像処理方法及び手術顕微鏡システム - Google Patents
画像処理装置、画像処理方法及び手術顕微鏡システム Download PDFInfo
- Publication number
- WO2022163189A1 WO2022163189A1 PCT/JP2021/046453 JP2021046453W WO2022163189A1 WO 2022163189 A1 WO2022163189 A1 WO 2022163189A1 JP 2021046453 W JP2021046453 W JP 2021046453W WO 2022163189 A1 WO2022163189 A1 WO 2022163189A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- image
- display image
- boundary
- eye
- display
- Prior art date
Links
- 238000012545 processing Methods 0.000 title claims abstract description 151
- 238000003672 processing method Methods 0.000 title claims description 7
- 210000001508 eye Anatomy 0.000 claims abstract description 142
- 210000005252 bulbus oculi Anatomy 0.000 claims abstract description 116
- 238000001356 surgical procedure Methods 0.000 claims description 65
- 238000000034 method Methods 0.000 claims description 32
- 230000008859 change Effects 0.000 claims description 25
- 230000008569 process Effects 0.000 claims description 22
- 230000009466 transformation Effects 0.000 claims description 11
- 210000001747 pupil Anatomy 0.000 claims description 10
- 230000003313 weakening effect Effects 0.000 claims description 8
- 230000000007 visual effect Effects 0.000 claims description 6
- 210000001232 limbus corneae Anatomy 0.000 claims description 5
- 238000003780 insertion Methods 0.000 claims description 4
- 230000037431 insertion Effects 0.000 claims description 4
- 230000004438 eyesight Effects 0.000 claims description 2
- 238000010586 diagram Methods 0.000 description 47
- 210000000695 crystalline len Anatomy 0.000 description 43
- 230000036544 posture Effects 0.000 description 23
- 235000019557 luminance Nutrition 0.000 description 20
- 230000033001 locomotion Effects 0.000 description 17
- 230000003287 optical effect Effects 0.000 description 17
- 238000006243 chemical reaction Methods 0.000 description 11
- 230000000694 effects Effects 0.000 description 7
- 238000004891 communication Methods 0.000 description 6
- 230000007423 decrease Effects 0.000 description 5
- 230000006870 function Effects 0.000 description 5
- 201000009310 astigmatism Diseases 0.000 description 4
- 238000005516 engineering process Methods 0.000 description 4
- 230000005540 biological transmission Effects 0.000 description 3
- 239000002775 capsule Substances 0.000 description 3
- 210000004087 cornea Anatomy 0.000 description 3
- 239000007943 implant Substances 0.000 description 3
- 238000011282 treatment Methods 0.000 description 3
- 208000002177 Cataract Diseases 0.000 description 2
- 230000001133 acceleration Effects 0.000 description 2
- 230000009471 action Effects 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 2
- 238000012937 correction Methods 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 238000005286 illumination Methods 0.000 description 2
- 230000004807 localization Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012014 optical coherence tomography Methods 0.000 description 2
- 230000008447 perception Effects 0.000 description 2
- 230000004382 visual function Effects 0.000 description 2
- PXFBZOLANLWPMH-UHFFFAOYSA-N 16-Epiaffinine Natural products C1C(C2=CC=CC=C2N2)=C2C(=O)CC2C(=CC)CN(C)C1C2CO PXFBZOLANLWPMH-UHFFFAOYSA-N 0.000 description 1
- 238000009825 accumulation Methods 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 238000004364 calculation method Methods 0.000 description 1
- 230000001886 ciliary effect Effects 0.000 description 1
- 239000003086 colorant Substances 0.000 description 1
- 230000008034 disappearance Effects 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 238000010801 machine learning Methods 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 238000012805 post-processing Methods 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 208000014733 refractive error Diseases 0.000 description 1
- 239000004065 semiconductor Substances 0.000 description 1
- 230000004304 visual acuity Effects 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00216—Electrical control of surgical instruments with eye tracking or head position tracking control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
- A61B2090/3618—Image-producing devices, e.g. surgical cameras with a mirror
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
- A61B2090/3735—Optical coherence tomography [OCT]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/20—Surgical microscopes characterised by non-optical aspects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
- A61F9/00754—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments for cutting or perforating the anterior lens capsule, e.g. capsulotomes
Definitions
- the present disclosure relates to an image processing device, an image processing method, and a surgical microscope system.
- intraocular lens As a method of refractive correction in ophthalmology, by inserting an artificial lens called an intraocular lens (IOL) into the eye, it is widely used to eliminate the refractive error of the crystalline lens and improve visual functions such as visual acuity. It is done.
- the most widely used intraocular lens is an intraocular lens that is inserted into the lens capsule as a replacement for the lens removed by cataract surgery.
- various intraocular lenses such as those that are fixed (dwelled) in the ciliary sulcus (Phakic IOL).
- Patent Literature 1 proposes a technique of changing the position of a mark (pattern) indicating a preoperative plan according to the result of eyeball tracking.
- the present disclosure proposes an image processing device, an image processing method, and a surgical microscope system capable of performing surgery in accordance with a preoperative plan with high precision.
- An image processing apparatus includes an image input unit that receives an operative field image of a patient's eye, an eyeball tracking unit that tracks an eyeball in the operative field image, and a display mode for the operative field image.
- a display image generation unit that sets a plurality of regions having different values, and generates a display image in which boundaries between the plurality of regions indicate at least one of a specific position, a specific direction, and a specific size with respect to the eye, the display image
- the generation unit changes the display mode of any one or all of the plurality of regions based on the tracking result of the eyeball, and changes at least one of the position, direction, and size of the boundary.
- an image processing apparatus receives an operating field image of a patient's eye, tracks an eyeball in the operating field image, and performs a plurality of operations with different display modes for the operating field image. and generating a display image in which boundaries of the plurality of regions indicate at least one of a specific position, a specific direction, and a specific size with respect to the eye, wherein the image processing device tracks the eyeball Based on the result, the display mode of any one or all of the plurality of areas is changed, and at least one of the position, direction and size of the boundary is changed.
- a surgical microscope system includes a surgical microscope that obtains an surgical field image of a patient's eye, an image processing device that generates a display image, and a display device that displays the display image, wherein the image is
- the processing device includes an image input unit that receives the operative field image, an eye tracking unit that tracks an eyeball in the operative field image, a plurality of regions having different display modes for the operative field image, and the plurality of a display image generation unit for generating the display image showing at least one of a specific position, a specific direction, and a specific size with respect to the eye, wherein the boundary of the region of the display image generation unit includes: Based on this, the display mode of any one or all of the plurality of areas is changed, and at least one of the position, direction and size of the boundary is changed.
- FIG. 1 is a diagram showing an example of a schematic configuration of a surgical microscope system according to an embodiment of the present disclosure
- FIG. 1 is a diagram showing an example of a schematic configuration of a surgical microscope according to an embodiment of the present disclosure
- FIG. 1 is a diagram illustrating an example of a schematic configuration of an image processing device according to an embodiment of the present disclosure
- FIG. 3 is a diagram showing Example 1 of a display image according to the embodiment of the present disclosure
- FIG. FIG. 4 is a first diagram for explaining display image generation according to the embodiment of the present disclosure
- FIG. 7 is a second diagram for explaining display image generation according to the embodiment of the present disclosure
- FIG. 10 is a diagram showing Example 2 of a display image according to the embodiment of the present disclosure
- FIG. 10 is a diagram showing Example 3 of a display image according to the embodiment of the present disclosure
- FIG. 10 is a diagram showing Example 4 of a display image according to the embodiment of the present disclosure
- FIG. 11 is a diagram showing Example 5 of a display image according to an embodiment of the present disclosure
- FIG. 11 is a diagram showing Example 6 of a display image according to an embodiment of the present disclosure
- FIG. 11 is a diagram showing Example 7 of a display image according to an embodiment of the present disclosure
- FIG. 11 is a diagram showing an example 8 of a display image according to an embodiment of the present disclosure
- FIG. 11 is a diagram showing Example 9 of a display image according to an embodiment of the present disclosure
- FIG. 10 is a diagram showing Example 3 of a display image according to the embodiment of the present disclosure
- FIG. 10 is a diagram showing Example 4 of a display image according to the embodiment of the present disclosure
- FIG. 11 is a diagram showing Example 5 of a display image according to an embodiment of the present disclosure
- FIG. 11
- FIG. 10 is a diagram showing example 10 of a display image according to an embodiment of the present disclosure
- 11A and 11B are diagrams showing an example 11 of a display image according to an embodiment of the present disclosure
- FIG. FIG. 5 is a diagram for explaining changes in boundary presentation according to tracking conditions according to the embodiment of the present disclosure
- FIG. 4 is a first diagram for explaining changes in boundary presentation according to time according to the embodiment of the present disclosure
- FIG. 10 is a second diagram for explaining changes in boundary presentation according to time according to the embodiment of the present disclosure
- FIG. 11 is a third diagram for explaining changes in boundary presentation according to time according to the embodiment of the present disclosure
- FIG. 5 is a diagram for explaining changes in boundary presentation according to tracking results according to the embodiment of the present disclosure
- FIG. 12 is a diagram showing example 12 of a display image according to an embodiment of the present disclosure
- FIG. 13 is a diagram showing example 13 of a display image according to an embodiment of the present disclosure
- FIG. 14 is a diagram showing an example 14 of a display image according to an embodiment of the present disclosure
- FIG. 14 is a fourth diagram for explaining changes in boundary presentation according to time according to the embodiment of the present disclosure
- FIG. 15 is a diagram showing an example 15 of a display image according to an embodiment of the present disclosure
- FIG. 16 is a first diagram showing example 16 of a display image according to an embodiment of the present disclosure
- FIG. 16 is a second diagram showing example 16 of a display image according to an embodiment of the present disclosure
- FIG. 17 is a diagram showing example 17 of a display image according to an embodiment of the present disclosure
- 1 is a diagram illustrating an example of a schematic configuration of a computer according to an embodiment of the present disclosure
- Embodiment 1-1 Example of schematic configuration of surgical microscope system 1-2.
- Example of schematic configuration of surgical microscope 1-3 Schematic Configuration of Image Processing Apparatus and Example of Image Processing 1-4. Action and effect 2.
- FIG. 1 is a diagram showing an example of a schematic configuration of a surgical microscope system 1 according to an embodiment.
- the surgical microscope system 1 has a surgical microscope 10 and a patient bed 20.
- This surgical microscope system 1 is a system used for eye surgery. The patient undergoes eye surgery while lying on the patient bed 20 . An operator, who is a doctor, performs surgery while observing the patient's eye through the surgical microscope 10 .
- the surgical microscope 10 has an objective lens 11, an eyepiece lens 12, an image processing device 13, and a monitor 14.
- the objective lens 11 and the eyepiece lens 12 are lenses for magnifying and observing the eye of the patient to be operated.
- the image processing device 13 outputs various images, various information, etc. by performing predetermined image processing on the image captured through the objective lens 11 .
- the monitor 14 displays an image captured through the objective lens 11, various images generated by the image processing device 13, various information, and the like. This monitor 14 may be provided separately from the surgical microscope 10 .
- the operator looks into the eyepiece 12 and performs surgery while observing the patient's eye through the objective lens 11.
- the operator performs surgery while confirming the operative field image, various images (for example, an image before image processing, an image after image processing, etc.), various information, and the like displayed on the monitor 14 . It is also possible to perform surgery using only the image on the monitor 14 .
- FIG. 2 is a diagram showing an example of a schematic configuration of the surgical microscope 10 according to the embodiment.
- the surgical microscope 10 includes, in addition to the objective lens 11, the eyepiece lens 12, the image processing device 13, and the monitor 14, a light source 51, an observation optical system 52, a front image capturing unit 53, a tomographic It has an image capturing unit 54 , a presentation unit 55 , an interface unit 56 and a speaker 57 .
- the monitor 14 and the presentation unit 55 correspond to display devices.
- the light source 51 emits illumination light under the control of the control unit 13A included in the image processing device 13 to illuminate the eyes of the patient.
- the observation optical system 52 is composed of optical elements such as the objective lens 11, a half mirror 52a, and lenses (not shown).
- the observation optical system 52 guides the light (observation light) reflected from the patient's eye to the eyepiece 12 and the front image capturing section 53 .
- the light reflected from the patient's eye enters the half mirror 52a as observation light via the objective lens 11, a lens (not shown), or the like.
- Approximately half of the observation light incident on the half mirror 52 a passes through the half mirror 52 a as it is, and enters the eyepiece 12 via the transmission type presentation unit 55 .
- the other half of the observation light incident on the half mirror 52 a is reflected by the half mirror 52 a and enters the front image capturing section 53 .
- the front image capturing unit 53 is composed of, for example, a video camera.
- the front image photographing unit 53 receives the observation light incident from the observation optical system 52 and photoelectrically converts it to obtain an image of the patient's eye observed from the front, that is, an image of the patient's eye photographed approximately in the eye axis direction. A front image is taken.
- the front image capturing unit 53 captures (captures) a front image under the control of the image processing device 13 and supplies the obtained front image to the image processing device 13 .
- the tomographic image capturing unit 54 is configured by, for example, an optical coherence tomography (OCT), a Scheimpflug camera, or the like.
- OCT optical coherence tomography
- the tomographic image capturing unit 54 captures (pictures) a tomographic image, which is a cross-sectional image of the patient's eye, under the control of the image processing device 13 and supplies the obtained tomographic image to the image processing device 13 .
- a tomographic image is an image of a cross section of a patient's eye in a direction substantially parallel to the eye axis direction.
- the tomographic image capturing unit 54 acquires a tomographic image, for example, using infrared light based on the principle of interference. may be a common optical path.
- the eyepiece 12 condenses the observation light incident from the observation optical system 52 via the presentation unit 55 and forms an optical image of the patient's eye. An optical image of the patient's eye is thereby observed by the operator looking through the eyepiece 12 .
- the presentation unit 55 is composed of a transmissive or non-transmissive display device or the like, and is arranged between the eyepiece 12 and the observation optical system 52 .
- the presentation unit 55 transmits observation light incident from the observation optical system 52 and makes it enter the eyepiece 12, and also displays various images (for example, a front image, a tomographic image, etc.) and various information supplied from the image processing device 13. are also presented (displayed) as necessary.
- Various images, various information, and the like may be presented, for example, superimposed on the optical image of the patient's eye, or may be presented in the periphery of the optical image so as not to interfere with the optical image.
- the transmissive display device and the non-transmissive display device are configured to be switchable, and can be switched as necessary. For example, there are a transmissive mode and a non-transmissive mode, which are changed by an operator or the like to switch between a transmissive display device and a non-transmissive display device.
- the image processing device 13 has a control section 13A that controls the operation of the surgical microscope 10 as a whole.
- the control section 13A changes the illumination conditions of the light source 51 or changes the zoom magnification of the observation optical system 52 .
- the control unit 13A controls image acquisition by the front image capturing unit 53 and the tomographic image capturing unit 54 based on the operation information of the operator or the like supplied from the interface unit 56 and the like.
- the interface unit 56 is composed of, for example, a communication unit and the like.
- the communication unit receives commands from operation units such as a touch panel superimposed on the monitor 14, foot switches, controllers, and remote controllers, and communicates with external devices.
- the interface unit 56 supplies the image processing apparatus 13 with information and the like according to the operation of the operator.
- the interface unit 56 also outputs device control information and the like for controlling the external device supplied from the image processing apparatus 13 to the external device.
- the monitor 14 displays various images such as a front image and various information on the display screen in accordance with the control by the control unit 13A of the image processing device 13 .
- the speaker 57 emits a buzzer sound, a melody sound, or the like in order to notify the operator or the like of the dangerous situation. Outputs sound, message (voice), and the like.
- the surgical microscope 10 may be provided with a rotating light or indicator light (lamp) for informing the operator or the like of a dangerous situation.
- a display presenting one or both of a specific position and a specific size (a specific position and a specific size with respect to the eye) based on a preoperative plan is presented by the boundaries of a plurality of regions with different display modes.
- the difference in display mode is a difference in parameters related to display conditions, such as a difference in brightness, a difference in saturation, a difference in color temperature, a difference in color, a difference in contrast, and a difference in sharpness.
- FIG. 3 is a diagram showing an example of a schematic configuration (configuration and processing flow) of the image processing apparatus 13 according to the embodiment.
- the image processing apparatus 13 includes a preoperative plan receiving unit 13a, an image input unit 13b, a registration unit 13c, an information storage unit 13d, an eyeball tracking unit (eyeball tracking unit) 13e, and a display image generator 13f.
- the preoperative plan receiving unit 13a receives preoperative plan information for the patient's eye (for example, preoperative images of the preoperative plan, posture information, etc.).
- Posture information for preoperative planning includes the size of the index (indicator related to treatment) based on the limbus and other parts in the preoperative image, the position of the index, and the orientation of the index around the eye axis (rotation direction around the eye axis). position) (size information, position information, orientation information, etc.).
- the size of the index, the position of the index, the orientation of the index around the eye axis, etc. include the position, shape, size, etc. of the incision, and the position and orientation of an implant such as an intraocular lens to be inserted.
- the direction around the eye axis is defined by the angle in the direction of rotation around the eye axis with respect to a reference line orthogonal to the eye axis.
- both the position of the index in the coordinate system and the position in the direction of rotation about the eye axis correspond to positional information of the index (positional information of the specific position).
- the image input unit 13b receives an operating field image (front image) from the front image capturing unit 53 (see FIG. 2), and receives the operating field image (for example, an operating field image at the start of surgery or a real-time image during surgery). surgical field image, etc.) to the registration unit 13c, the eyeball tracking unit 13e, the display image generation unit 13f, and the like.
- an operating field image front image
- the operating field image for example, an operating field image at the start of surgery or a real-time image during surgery.
- surgical field image etc.
- the registration unit 13c compares the preoperative image of the preoperative plan and the operative field image at the start of the operation to determine the correspondence relationship between the preoperative image of the preoperative plan and the operative field image at the start of the operation, for example, the preoperative image , a conversion parameter (for example, a conversion parameter for coordinate conversion) to the surgical field image at the start of the operation is obtained. Then, the registration unit 13c supplies the relational information regarding the obtained conversion parameters to the information storage unit 13d together with the surgical field image at the time of starting the preoperative operation.
- a conversion parameter for example, a conversion parameter for coordinate conversion
- the information storage unit 13d converts (changes) the posture information of the preoperative plan in accordance with the surgical field image at the start of surgery based on the relationship information and the surgical field image at the start of the surgery supplied from the registration unit 13c. Then, the operative field image at the start of the operation and posture information of the preoperative plan converted according to the operative field image at the start of the operation are accumulated.
- the eyeball tracking unit 13e tracks the eyeball in the real-time surgical field image by comparing the surgical field image at the start of the surgery and the real-time surgical field image. Further, the eyeball tracking unit 13e stores relational information (for example, conversion parameters, etc.) indicating the relationship between the eyeball posture information in the real-time surgical field image and the posture information of the preoperative plan accumulated by the information accumulation unit 13d. The tracking result (tracking result) is supplied to the display image generation unit 13f.
- eyeball posture information includes information on eyeball size, eyeball position, orientation around the eyeball (rotational direction around the eyeball) (size information, position information, orientation information, etc.). However, both the position of the eyeball in the coordinate system and the position in the direction of rotation about the eyeball correspond to the positional information of the eyeball.
- the display image generation unit 13f sets a plurality of regions having different display modes for the real-time surgical field image by processing the real-time surgical field image, and the boundary of each region is a specific position relative to the patient's eye. Or generate a display image showing a specific size.
- the display image generating unit 13f processes the real-time surgical field image, that is, each region, so that the boundary of each region indicates a specific position or a specific size based on the converted posture information of the preoperative plan.
- the display image generation unit 13f processes the real-time surgical field image so as to change the orientation (position, orientation, size, etc.) of the boundary of each region based on the eyeball tracking result of the real-time surgical field image. and generate a display image.
- the display image generation unit 13f based on the relationship information supplied from the eyeball tracking unit 13e, displays the real-time surgical field so that the relationship between the position and size of the boundary with respect to the eyeball in the surgical field image at the start of the surgical operation does not change. Process the position and size of the borders in the image to generate the display image.
- FIG. 4 is a diagram showing Example 1 of a display image according to the embodiment.
- the display image presents a boundary K1 between two areas (left and right areas) with different display modes.
- This boundary K1 indicates a specific position based on a preoperative plan, other plans, or the like, that is, a specific position regarding surgery.
- the boundary K1 is transformed (changed) so as to move in the movement direction of the eyeball by the above-mentioned movement amount so as to eliminate the change in the posture of the boundary K1 with respect to the eyeball according to the movement direction and the movement amount of the eyeball.
- a display image having such a boundary K1 is displayed on the display screen by both or one of the monitor 14 and the presentation unit 55 .
- the presentation unit 55 displays the display image having the boundary K1
- the transmissive display device is switched to the non-transmissive display device, and the non-transmissive display device is used.
- the boundary K1 is a line-shaped boundary passing through the central position where the intraocular lens B1 such as a toric IOL for correcting astigmatism is desired to be placed.
- This boundary K1 indicates a boundary line for alignment of the intraocular lens B1 (target position for installing the intraocular lens B1).
- Two marks B1a (for example, three points aligned linearly) of the intraocular lens B1 are aligned with this boundary K1.
- the intraocular lens B1 is a toric IOL
- a sufficient astigmatism correction effect cannot be obtained when a deviation occurs. Therefore, two marks B1a indicating the toric axis are engraved at the end points of the toric IOL, so that the orientation of the toric IOL around the eye axis can be grasped.
- the toric IOL mark B1a is aligned with the boundary K1 in the real-time surgical field image, and the toric IOL is placed in the eye.
- preoperative images and images at the start of surgery are registered, and then images at the start of surgery and real-time images (real-time operative field images) are registered. Images) are compared (tracked) to map the marks based on the preoperative plan onto the real-time images.
- the mark based on the preoperative plan is superimposed on the operative field image, so occlusion occurs in which a part of the operative field image is obscured by the mark.
- Specific processing flow Specific processing is performed along the following flow. Registration, tracking, image generation and image presentation are performed sequentially. 5 and 6 are diagrams for explaining display image generation (conversion processing) according to the embodiment.
- preoperative planning information including preoperative images (e.g., eyeball images) and images at the start of surgery (operative field images at the start of surgery) are received, and the direction and position of the eyeballs at the time of preoperative planning are determined. Match the orientation and position of the eyeball during surgery.
- alignment method for example, alignment may be performed automatically by image processing using a preoperative image and an image at the start of the operation, or the user may manually align the position and orientation (for example, rotation angle, etc.). Alignment may be performed by Successful registration retains surgical planning information based on the coordinates of the start-up image.
- the movement of the eyeball is tracked from the start of the operation, and the transformation parameters (coordinate transformation parameters) from the image at the start of the operation to the coordinates at the tracking time are obtained.
- the transformation parameters coordinate transformation parameters
- feature points may be extracted from both the preoperative image and the image at the start of the surgical operation, and conversion parameters may be obtained from the corresponding relationship.
- feature points may be extracted from one of the images and Transformation parameters may be obtained after searching for movement of feature points, or an image may be input to machine learning and transformation parameters may be obtained on a learning basis.
- the number of control point coordinates P1 indicating the area is four, but the number of control point coordinates P1 may be three or more. A region surrounded by these control point coordinates P1 is to be processed.
- the number of control point coordinates P1 indicating the boundary line is two, but the number of control point coordinates P1 may be two or more. If the boundary shows a complicated shape, the control point coordinates, that is, the number of control points may be increased. Once the boundary line is defined, one of the left and right (or one of the top and bottom) regions of the boundary becomes the processing target.
- control point coordinates P1 indicating the area or boundary line may be connected by a straight line, may be smoothly connected by spline interpolation or the like, or may be connected by a specific shape such as a semicircle passing through two points. Also, the number of areas to be processed is not limited to one, and may be plural.
- the display image generated by the image generation process is presented as the surgical field image.
- the display image (see FIG. 4) having this boundary K1 is displayed on the display screen by either or both of the monitor 14 and the presentation unit 55.
- Image processing includes brightness (brightness), contrast (shading), saturation, color temperature, sharpness, grayscaling, and parameter adjustment such as changing a specific color to another specific color.
- Image processing is realized by changing the pixel value of .
- processing based on calculation formulas e.g., gain adjustment, offset processing, non-linear operations such as ⁇ processing, etc.
- processing using lookup tables e.g., changing from a specific color to a specific color.
- conversion from a specific brightness value to a specific brightness value to change the contrast, etc. processing using a spatial filter, etc. can be used alone or in combination.
- the display image generator 13f may automatically select and execute a process that makes the boundary stand out on the original surgical field image (original image).
- An example of conversion from a specific luminance value to a specific luminance value is a change in the contrast S-shaped curve.
- a gain is added according to the value of a specific channel.
- saturation for example, a flat gain is applied to a particular channel.
- color temperature a uniform gain that is different for each channel is applied.
- grayscaling for example, certain channel values are changed.
- conversion is performed according to pixel values.
- An image has color information in the form of channels, for example.
- An RGB image has three channels, Red, Green, and Blue.
- the HSL image has three channels of hue (Hue), saturation (Saturation), and brightness (Lightness/Luminance or Intensity).
- a CMYK image has four channels: cyan, magenta, yellow, and black.
- the information pattern to be presented and the method of processing may be changed based on instructions from a user such as an operator.
- the information patterns to be presented include, for example, various information patterns (various display patterns) corresponding to wound preparation, anterior capsulorhexis, toric IOL (astigmatism correcting intraocular lens) axis alignment, IOL centering, and the like.
- the user can operate the operation unit to select the information pattern to be presented or the method of processing.
- the delay in image creation may be suppressed by ignoring the delay of tracking information and using the latest calculated past tracking information for image generation.
- FIG. 7 to 11 are diagrams showing examples 2 to 6 of display images according to the embodiment. Examples 2 to 6 describe variations of the display image.
- two boundaries K2 and K3 indicating the central position are presented in the display image.
- the intersection of the boundaries K2 and K3 indicates, for example, the center position for IOL installation (eg, eye axis position, etc.).
- the area on the right side of the boundary K2 in the operative field image is processed, and the area below the boundary K3 is processed.
- a boundary K4 indicating the incision position is presented in the display image.
- the boundary K4 is two sides of a triangle, and the vertices of the triangle indicate the incision position (for example, the incision start position).
- the area below the boundary K4 (triangular area) in the operative field image is processed.
- two boundaries K5 and K6 indicating the incision position are presented in the display image.
- the intersection of the boundaries K5 and K6 indicates the incision position (for example, the incision start position).
- the area on the right side of the boundary K5 in the operative field image is processed, and the area below the boundary K6 is processed.
- a boundary K7 indicating the incision size and the incision position is presented in the display image.
- the boundary K7 indicates the incision size and incision position (eg, consecutive incision positions, etc.) for CCC (anterior capsulotomy), for example.
- This boundary K7 functions, for example, as a boundary of a shape having a semicircle, ie a semicircle boundary (a semicircle for forming a target circle for the anterior capsulotomy).
- the area on the right side of the boundary K7 in the surgical field image is processed.
- the center of the annular shape such as the target circle described above, other than the eye axis, it is possible to use the center of the corneal limbus, the center of the pupil, the center of the preoperative pupil, the visual axis, the center of the anterior capsulotomy margin, and the like. .
- a specific area is presented in the display image, that is, a boundary K8 indicating the area size and area position of the specific area.
- the boundary K8 is six sides (or four sides) of a hexagon and indicates the area size and area position of the specific area. This boundary K8 indicates to the operator that, for example, if the eyeball is lost during tracking, the eyeball (eye) should be brought to the center of the surgical field image. Also, in the example of FIG. 11, the area outside the boundary K8 in the surgical field image is processed.
- FIG. 12 to 14 are diagrams showing examples 7 to 9 of display images according to the embodiment. Examples 8 and 9 describe additional points for reducing the difference between the pre-processed and post-processed images while maintaining the clarity of the boundary K1.
- the area to which image processing is applied may be an area on one side of the boundary K1.
- the area to which this image processing is applied is the area on one side of the boundary K1
- the amount of change in the one side area to which the image processing is applied is large, and the one side area to which the image processing is not applied remains.
- the modulation is performed at a level at which the boundary K1 can be seen, the difference from the original image increases in the area on the processed side, but there is also an advantage that there is also an unprocessed area. be.
- the areas to which image processing is applied may be areas on both sides of the boundary K1.
- the area on one side (the area above the boundary K1) is 10% brighter than the original image (operative field image before processing), and the area on the other side (the area below the boundary K1) is brighter than the original image. is also darkened by 10%.
- the intensity of processing for the area decreases as the distance from the boundary K1 increases.
- the intensity of the process for increasing the brightness of the area weakens as the distance from the boundary K1 increases, and the luminance of the area decreases as the distance from the boundary K1 increases.
- FIG. 15 and 16 are diagrams showing display image examples 10 and 11 according to the embodiment.
- Examples 10 and 11 describe additional points in presenting 3D images (three-dimensional surgical field images).
- 3D images are often used in ophthalmic surgery.
- a stereoscopic left-eye image and a stereoscopic right-eye image exist so that a sense of depth can be presented as a difference in parallax.
- additional points regarding boundary presentation for stereoscopic left-eye images and stereoscopic right-eye images will be described.
- “for stereoscopic left eye” is simply described as “for left eye”
- “for stereoscopic right eye” is simply described as "for right eye”.
- the boundaries K2 and K3 are presented only on one of the left-eye image and the right-eye image (see FIG. 7). Even if the boundaries K2 and K3 are presented only in the image for one eye, the change in the image from the original image is small, so there is almost no effect on 3D perception, and the operator can visually recognize the boundaries K2 and K3. Therefore, the boundaries K2 and K3 may be presented only for the one-eye image, or different boundaries (for example, the boundary K2 and the boundary K3) may be presented for the left-eye image and the right-eye image.
- different boundaries K2 and K3 are presented to the image for the left eye and the image for the right eye (the boundary K2 is presented to the image for the right eye and the boundary K3 to the image for the left eye), and the boundaries K2 and K3 are presented to the brain. presents the intersection of each boundary K2, K3 by fusing within. In this way, for example, to present the centering position and the wound position, the two boundaries K2 and K3 can be shown at crossed positions or the like. In addition, information that can be presented can be increased by combining various boundaries (for example, boundary K2 and boundary K3).
- different boundaries K2 and K3 are presented to the left-eye image and the right-eye image
- different boundaries K2 and K3 are presented to the left-eye image and the right-eye image based on the information tracked in the one-eye image.
- different boundaries K2, K3 may be presented to the left-eye image and the right-eye image based on the information tracked in the left-eye image and the right-eye image.
- boundary K1 In addition to presenting different boundaries K2 and K3 on both the left-eye image and the right-eye image, the same boundary (for example, boundary K1) may be presented on both the left-eye image and the right-eye image.
- boundary K1 When the same boundary is presented to the image for the left eye and the image for the right eye, depth perception occurs with respect to the boundary, so the position to localize the boundary may be controlled. For example, if the ophthalmic surgery is CCC (anterior capsulotomy), the boundary is localized at the location of the anterior capsule.
- CCC anterior capsulotomy
- the boundary K1 may be processed to create a depth gap in the 3D image.
- the pixels of the image for the left eye are shifted to the right, and the pixels of the image for the right eye are shifted to the left.
- the boundary K1 protrudes forward. This makes it easier for the operator to grasp the position of the boundary K1, so that ophthalmic surgery can be performed with high accuracy.
- the intensity of image processing (for example, the degree of modulation, etc.) is small, even if processing is applied only to the image for one eye or different processing is applied to the images for both eyes, flickering will not occur, unlike superimposition of marks. Since there is no parallax, there is no conflict between the operative field and the depth. In addition, when the same processing is applied to the individual images of both eyes, it is possible to localize them to a desired specific depth position by creating a parallax, and the user localizes them to a treatment position according to the guide. can also
- FIG. 17 is a diagram for explaining changes in boundary presentation according to tracking conditions according to the embodiment.
- 18 to 20 are first to third diagrams for explaining changes in boundary presentation according to time according to the embodiment.
- FIG. 21 is a diagram for explaining changes in boundary presentation according to tracking results according to the embodiment.
- a tracking detection limit may be set. That is, there may be a situation in which the tracking accuracy is confident, or a situation in which the tracking detection limit is approaching.
- the intensity of processing for example, the degree of modulation
- the image of the predetermined region can be brought closer to the original image, or the processing of the predetermined region can be reduced.
- an image in a predetermined area may be highlighted as a warning (warning information).
- a message may be overlaid and presented at a fixed position on the display screen. In this way, by presenting the aforementioned tracking situation to the user such as the operator, the user can grasp the reliability of the tracking.
- the boundary K7 rotates 360 degrees around the eye axis or the like.
- the boundary K7 rotates at a predetermined speed (for example, a speed faster than the speed at which the operator moves the distal end of the surgical instrument) from the start of the surgery. This rotation is repeated during the procedure.
- Boundary K7 thereby forms a target circle for the anterior capsulotomy. In this way, visibility can be improved by changing the position of the boundary K7 presenting the same information.
- the above-mentioned predetermined speed is set in advance, and is, for example, a value faster than a general value such as an average value of speeds when the operator moves the distal end of the surgical instrument.
- the rotation speed of the boundary K7 does not have to be a predetermined speed.
- Boundary K7 may be rotated according to the motion of the end point.
- the rotation angle of the boundary K7 may be another angle such as 180 degrees.
- the boundary K1 moves parallel at a predetermined speed.
- the boundary K1 moves left from the reference position by a predetermined distance, returns from the left predetermined position to the reference position, moves right from the reference position by a predetermined distance, and returns from the right predetermined position to the reference position.
- This movement is repeated during the procedure (periodic movement). Thereby, visibility can be improved by changing the position of the boundary K1 that presents the same information.
- the visibility may be improved by periodically weakening the intensity of processing (for example, the degree of modulation, etc.) of a predetermined region.
- the strength of processing is gradually weakened from the initial state, then gradually increased, and then returned to the initial state.
- the visibility can be improved by periodically weakening the strength of the processing of the predetermined area (the degree of image change from the original image) in this way.
- the visibility of the operative field can be further improved by periodically weakening the strength of the processing of the predetermined region (degree of image change from the original image). Also, by periodically shifting the presentation position of the boundary K1 such as the toric axis, it is possible to prevent the boundary K1 from overlapping the mark B1a (see FIG. 4) of the toric IOL and making the mark B1a difficult to see.
- the tracking accuracy tends to decrease when the cornea, which is the object of tracking, is at the edge, it is possible to increase the visibility of the operative field and improve the tracking accuracy by weakening the strength of processing in a predetermined area. The user can be conscious to bring the cornea to the high center.
- the positions of the boundaries K1 and K7 may be changed at predetermined intervals as described above, or may be switched according to the user's instruction.
- the user can switch the positions of the boundaries K1 and K7 by operating an operation unit such as a touch panel, foot switch, or controller.
- image processing may be performed on a predetermined region, or an operating portion of a surgical tool or the like operated by the operator (for example, the tip of the surgical tool) may be detected and the operating portion included.
- Image processing for example, luminance modulation processing, color modulation processing, etc.
- the position and size of the boundary K7 may be changed according to changes in eye size. Since a portion of the boundary K7 is semicircular to indicate the size of the eye, the position of the boundary K7 changes according to changes in the size of the eye. For example, when the size of the eye in the operative field image becomes smaller, the size of the semicircle of the boundary K7 also becomes smaller, and the position of the boundary K7 approaches the center. Conversely, as the size of the eye in the operative field image increases, the size of the semicircle of the boundary K7 also increases, and the position of the boundary K7 moves away from the center.
- the size includes, for example, the diameter of the CCC, the incision width of the wound, and the centering.
- FIG. 22 to 24 are diagrams showing examples 12 to 14 of display images according to the embodiment.
- the boundary K7 presents two specific positions in the displayed image.
- the two specific positions each indicate wound information (for example, wound creation position, etc.).
- part of the boundary K7 is formed in a triangular shape, and the vicinity of the vertex is the wound making position.
- the area on the right side of the boundary K7 in the operative field image is processed.
- the boundary K11 presents the width and position of the main wound in the displayed image.
- the boundary K11 indicates the incision width, which is the width on the corneal limbus of the triangle made from the corneal center.
- the position of the main wound, ie the position of the incision, is the virtual vertical bisector of the triangle.
- the area to the left of the boundary K11 in the operative field image is processed.
- the boundary K11 presents the width of the main wound
- the boundary K12 presents the position of the main wound.
- the boundary K11 indicates the incision width, which is the width of the triangle formed from the center of the cornea on the corneal limbus.
- Boundary K12 indicates the position of the main wound, ie, the virtual perpendicular bisector of the triangle.
- the area on the left side of the boundary K11 in the operative field image is processed, and the area below the boundary K12 is processed.
- a left-eye image including the boundary K11 and a right-eye image including the boundary K12 may be presented, and the boundaries K11 and K12 may be fused in the brain to realize a 3D image (see FIG. 16). .
- FIG. 25 is a fourth diagram for explaining changes in boundary presentation according to time according to the embodiment.
- the width and position of the boundary K11 may be changed periodically in the display image.
- the maximum width of the boundary K11 (the size of the area within the boundary K11) is set as the desired incision width, and the width of the boundary K11 is narrowed in order to know the position of the incision.
- the width of the boundary K11 may be changed periodically to narrow the width of the boundary K11 to indicate the position of the incision.
- FIG. 26 is a diagram showing example 15 of a display image according to the embodiment.
- two brightness areas with different brightness are set, and a boundary M3 between these brightness areas is presented.
- This boundary M3 functions as a line-shaped boundary, that is, a line boundary (a target line for installing the intraocular lens B1).
- the luminance of the right luminance area (the shaded area in FIG. 26) of the two luminance areas is set lower than the luminance of the left luminance area.
- a toric axis is aligned with this boundary M3, and a toric IOL is installed.
- the number of luminance regions is not limited to two, and may be two or more.
- Display image example 16 are diagrams showing example 16 of the display image according to the embodiment. As shown in FIGS. 27 and 28, two brightness areas with different brightness are set and presented as a boundary M4 between these brightness areas.
- This boundary M4 functions as a boundary of a shape having a semicircle, ie a semicircle boundary (a semicircle for forming a target circle for the anterior capsulotomy). It should be noted that in the examples of FIGS. 27 and 28, the boundary M4 of the luminance region is rotated 90 degrees about the eye axis or the like.
- the boundary M4 of the luminance region is 360 degrees around the eye axis or the like at a predetermined speed (for example, the speed when the operator moves the tip of the surgical tool) from the start of the surgery. Rotate. Boundary M4 thereby forms a target circle for the anterior capsulotomy.
- the predetermined speed is set in advance, and is, for example, a general value such as an average value of speeds when the operator moves the distal end of the surgical tool.
- the rotation speed of the boundary M4 may not be a predetermined speed.
- Boundary M4 may be rotated according to the motion of the end point.
- a processing start section 13g which will be described later, can be used to detect the distal end of the surgical instrument and the end point of the anterior capsulorhexis edge.
- the rotation angle of the boundary M4 may be another angle such as 180 degrees.
- FIG. 29 is a diagram showing example 17 of a display image according to the embodiment.
- a plurality of (two in the example of FIG. 29) boundaries M5 are presented. These boundaries M4 and M5 are formed by boundaries between two luminance regions having different luminances, as in example 10 of the display image.
- a boundary M5 is a boundary indicating an incision position.
- the boundaries K1 to K12 and M3 to M5 are not marks that are displayed superimposed on the operative field image, but rather can indicate the visual orientation (position, orientation, size, etc.). It is the boundary that Unlike the superimposed marks, the boundaries K1 to K12 and M3 to M5 do not hide the operative field image at the positions of the marks, so that the visibility of the operative field is improved compared to the case where the superimposed marks are used. be done.
- the surgical field image is fixed, and the boundaries K1 to K12 and M3 to M5 are set in appropriate postures (positions, orientations, etc.) with respect to the fixed and presented surgical field image (for example, The postures of the boundaries K1 to K12 and M3 to M5 may be changed so that the boundaries K1 to K12 and M3 to M5 are not displaced with respect to the eyeball in the operative field image in the fixed posture.
- Changing the attitudes of these boundaries K1 to K12 and M3 to M5 means changing the range (for example, size, shape, etc.) of each area.
- the display image generation unit 13f changes the postures of the boundaries K1 to K12 and M3 to M5 according to the displacement of the eyeballs based on the eyeball posture information. while generating a display image.
- the display image generation unit 13f moves the boundaries K1 to K12 and M3 to M5 with respect to the real-time surgical field image in the eyeball movement direction and movement amount in accordance with the eyeball movement direction and movement amount,
- the attitudes of the boundaries K1-K12 and M3-M5 (for example, the range of each area) are changed. That is, by fixing the operative field image and changing the postures of the boundaries K1 to K12 and M3 to M5, the positional relationships between the eyeballs and the boundaries K1 to K12 and M3 to M5 do not change.
- the display image generator 13f may continue the display by maintaining the orientation of the image at the time when the orientation was last estimated (the last display image).
- the posture of the operative field image at the time when the posture was finally estimated can be changed to uniform velocity, uniform angular velocity, uniform acceleration motion, or uniform acceleration motion. can be maintained with
- the display mode for example, brightness, color, etc.
- Various display images as described above are used, and these display images may be selectable by the operator, staff, or the like. Selection of a display image is realized by an input operation to the operation unit by an operator, staff, or the like. For example, the operator, staff, or the like operates the operation unit to select a display mode for displaying a desired display image. According to this selection, the display image generator 13f generates a display image based on the selected display mode. Similarly, regarding various images, the size, position, etc. of the images may be changed by the operator, staff, or the like. The display image generation unit 13f generates a display image by changing the size, position, etc. of the image according to the input operation to the operation unit by the operator, staff, or the like.
- the image input unit 13b receives the surgical field image of the patient's eye
- the eyeball tracking unit 13e tracks the eyeball in the surgical field image
- the display image generator 13f A plurality of regions with different display modes are set for the operative field image, and the boundaries of each region (for example, boundaries K1 to K12, M3 to M5) define at least one of a specific position, a specific direction, and a specific size with respect to the eye. Then, based on the eyeball tracking result (tracking result), the display mode of any one or all of the regions is changed, and at least one of the position, direction and size of the boundary is changed.
- the occurrence of occlusion can be prevented by presenting the specific position with respect to the eye not by the mark but by the boundaries of the regions with different display modes. Therefore, the operator can easily see the operative field image while grasping the specific position or the specific size, and can perform the surgery accurately, so that the surgery according to the preoperative plan can be performed with high accuracy.
- the displacement includes any change to the subject such as the eyeball, such as parallel movement, rotation, enlargement/reduction, deformation, and combinations thereof.
- the display image generation unit 13f changes the display mode of any one or all of the plurality of regions based on the eye tracking result, and changes at least one of the position, direction, and size of the boundary.
- the processing speed can be improved compared to the case of changing the display mode of all of the plurality of areas.
- the operator can easily visually recognize the boundary of each region, so preoperative planning Surgery can be performed with high precision.
- the preoperative plan receiving unit 13a receives at least one information of the position, direction, and size of the preoperative image and index based on the preoperative plan for the patient's eye (for example, position, direction, size, etc. on coordinates). Then, the information storage unit 13d compares the preoperative image with the surgical field image at the start of surgery, and changes at least one information of the position, direction, and size of the index according to the surgical field image at the start of surgery. A starting operative field image and information on at least one of the position, orientation and size of the modified index are accumulated. As a result, the surgical field image at the start of the surgical operation and at least one information of the position, direction, and size of the changed index can be used in post-processing.
- An eyeball tracking unit 13e tracks the eyeball in the real-time surgical field image by comparing the surgical field image at the start of surgery with the real-time surgical field image, and calculates the position, direction, and size of the eyeball in the real-time surgical field image. and at least one information of the position, direction, and size of the changed index (for example, coordinate position, orientation, size, etc.) and the display image generation unit 13f.
- At least one of the position, direction, and size of the boundary in the real-time surgical field image is changed so as to eliminate the three changes, and a display image is generated. Accordingly, by changing at least one of the positions, directions, and sizes of the boundaries K1 to K7 with respect to the eyeballs in the surgical field image at the start of the operation, the positions, directions, and sizes of the eyeballs and the boundaries K1 to K7 can be changed. At least one relationship remains unchanged. Therefore, the operator can grasp at least one of the specific position, direction, and size in detail, so that the surgery can be performed more accurately according to the preoperative plan.
- the display image generation unit 13f changes the plurality of regions by coordinate transformation so that at least one of the position, direction, and size of the boundary is changed based on the tracking result of the eyeball, and generates the display image. This makes it possible to reliably change at least one of the position, direction, and size of the boundary based on the eyeball tracking result, and generate the display image.
- the display image generation unit 13f changes the boundary line indicating the boundary based on the tracking result of the eyeball, and changes at least one of the position, direction, and size of the boundary.
- the processing speed can be improved as compared with the case of changing the area.
- a boundary line may have two control points (transformation points), but a region requires three or more control points.
- the display image generation unit 13f performs processing for adjusting parameters of the same type (for example, brightness, color, etc.) for two or more of the plurality of regions. This simple process makes it possible to easily make the boundaries of each region stand out. This makes it easier for the operator to visually recognize the boundary of each region, so that surgery can be performed with high precision according to the preoperative plan.
- parameters of the same type for example, brightness, color, etc.
- the display image generation unit 13f performs processing for adjusting different types of parameters (for example, brightness, color, etc.) for two or more of the plurality of regions. This simple process makes it possible to easily make the boundaries of each region stand out. This makes it easier for the operator to visually recognize the boundary of each region, so that surgery can be performed with high precision according to the preoperative plan.
- different types of parameters for example, brightness, color, etc.
- the display image generation unit 13f weakens the strength of the processing for any one or all of the plurality of regions as the distance from the boundary increases. As a result, while maintaining the clarity of the boundary, it is possible to make the area away from the boundary closer to the original image, so that the surgery can be performed with high precision according to the preoperative plan.
- the display image generation unit 13f generates a display image including a boundary as either a display image for the left eye (for the stereoscopic left eye) or a display image for the right eye (for the stereoscopic right eye), or generates a display image including the boundary.
- the display images including the display image are generated as the display image for the left eye and the display image for the right eye, respectively. Accordingly, when the display image including the boundary is generated as either the display image for the left eye or the display image for the right eye, the display image including the boundary is used as the display image for the left eye and the display image for the right eye, respectively.
- the processing speed can be improved compared to the case of generating. Further, when the display image including the boundary is generated as the display image for the left eye and the display image for the right eye respectively, the display image including the boundary is generated as either the display image for the left eye or the display image for the right eye. As compared with the case of using
- the eyeball tracking unit 13e tracks the eyeballs in one or both of the left-eye and right-eye operative field images
- the display image generation unit 13f tracks one or both of the left-eye and right-eye eyeball tracking results. to change at least one of the position, direction and size of the boundary to generate a display image for the left eye and a display image for the right eye.
- the display image generation unit 13f sets the boundary to the same position in the display image for the left eye and the display image for the right eye. This makes it easier for the operator to grasp the position of the boundary, so that surgery can be performed in accordance with the preoperative plan with high accuracy.
- the display image generation unit 13f causes at least one of the position, direction, and size of the boundary in the display image for the left eye and the display image for the right eye to indicate at least one of a specific position, a specific direction, and a specific size. Generate different display images. As a result, at least one of a specific position, a specific direction, and a specific size can be indicated by a plurality of boundaries, so that surgery can be performed in accordance with the preoperative plan with high accuracy.
- the display image generation unit 13f shifts the display image for the left eye and the display image for the right eye based on the depth information of the desired localization of the three-dimensional image including the display image for the left eye and the display image for the right eye, Generate the original image. This makes it easier for the operator to grasp the position of the boundary, so that surgery can be performed with high precision according to the preoperative plan.
- the display image generation unit 13f maintains the last display image before the eyeball is out. As a result, it is possible to avoid the interruption of the surgery due to the disappearance of the display image, so that the surgery can be performed in accordance with the preoperative plan with high accuracy.
- the display image generation unit 13f changes the display mode of any one or all of the plurality of regions according to the time period. As a result, it is possible to periodically bring the displayed image closer to the original image or make the boundaries of the displayed image stand out. Therefore, since the operator can visually recognize the original image and the boundary with certainty, it is possible to perform the operation according to the preoperative plan with high accuracy.
- the display image generation unit 13f generates a display image in which boundaries indicate a plurality of specific positions. As a result, more specific positions can be presented, so that surgery can be performed accurately according to the preoperative plan.
- the display image generation unit 13f changes the size of any one or all of the plurality of regions in accordance with the change in eyeball size. As a result, it is possible to change the size of one or more regions according to the size of the eyeball, and to change the position and size of the boundary, so that surgery can be performed with high precision according to the preoperative plan. .
- the display image generation unit 13f changes the size of any one or all of the plurality of regions according to the time period.
- the display image can be made closer to the original image by reducing the area, and the operator can visually recognize the original image with certainty, so that the surgery can be performed with high accuracy according to the preoperative plan.
- the display mode of each of the plurality of regions differs depending on the difference in brightness of each of the plurality of regions. This makes it possible to easily make the boundaries of the regions stand out. Therefore, the operator can easily visually recognize the boundaries of the respective regions, so that the surgery according to the preoperative plan can be performed with high accuracy.
- the specific position is the toric axis arrangement position of the intraocular lens, and the display image generation unit 13f changes the brightness of each of the plurality of regions so that the boundary indicates the toric axis arrangement position.
- This makes it possible to easily make the toric axis arrangement position conspicuous. Therefore, it becomes easier for the operator to visually recognize the toric axis arrangement position, so that surgery can be performed with high precision according to the preoperative plan.
- the specific positions are the position of the toric axis of the intraocular lens, the position of the incision for forceps insertion, the position of the anterior lens capsulotomy, the position of the eye axis, the center of the limbus, the center of the pupil, the center of the preoperative pupil, and the visual axis. Either the location and the center of the anterior capsulorhexis.
- the toric axis placement position of the intraocular lens the incision position for forceps insertion, the incision position for the anterior capsulotomy, the axial position, the center of the corneal limbus, the center of the pupil, the center of the preoperative pupil, It is possible to highlight either the visual axis position or the center of the anterior capsulorhexis. Therefore, it becomes easier for the operator to visually recognize those specific positions, so that the surgery can be performed with high precision according to the preoperative plan.
- the display image generation unit 13f changes the display mode of any one or all of the plurality of regions according to the eyeball tracking state (tracking state) by the eyeball tracking unit 13e. This makes it possible to bring the displayed image closer to the original image or to make the boundaries of the displayed image stand out according to the eyeball tracking conditions. degree, etc.) can be grasped.
- Example of schematic configuration of computer> The series of processes described above can be executed by hardware or by software.
- a program that constitutes the software is installed in the computer.
- the computer includes, for example, a computer built into dedicated hardware and a general-purpose personal computer capable of executing various functions by installing various programs.
- FIG. 30 is a diagram showing an example of a schematic configuration of a computer 500 that executes the series of processes described above by a program.
- the computer 500 has a CPU (Central Processing Unit) 510, a ROM (Read Only Memory) 520, and a RAM (Random Access Memory) 530.
- CPU Central Processing Unit
- ROM Read Only Memory
- RAM Random Access Memory
- the CPU 510 , ROM 520 and RAM 530 are interconnected by a bus 540 .
- An input/output interface 550 is also connected to the bus 540 .
- An input section 560 , an output section 570 , a recording section 580 , a communication section 590 and a drive 600 are connected to the input/output interface 550 .
- the input unit 560 is composed of a keyboard, mouse, microphone, imaging device, and the like.
- the output unit 570 is configured with a display, a speaker, and the like.
- the recording unit 580 is composed of a hard disk, a nonvolatile memory, or the like.
- the communication unit 590 is configured by a network interface or the like.
- a drive 600 drives a removable recording medium 610 such as a magnetic disk, optical disk, magneto-optical disk, or semiconductor memory.
- the CPU 510 loads, for example, the program recorded in the recording unit 580 into the RAM 530 via the input/output interface 550 and the bus 540, and executes it. A series of processes are performed.
- a program executed by the computer 500 that is, the CPU 510 can be provided by being recorded on a removable recording medium 610 such as a package medium, for example. Also, the program can be provided via a wired or wireless transmission medium such as a local area network, the Internet, or digital satellite broadcasting.
- the program can be installed in the recording unit 580 via the input/output interface 550 by loading the removable recording medium 610 into the drive 600 . Also, the program can be received by the communication unit 590 and installed in the recording unit 580 via a wired or wireless transmission medium. In addition, the program can be installed in the ROM 520 or the recording unit 580 in advance.
- the program executed by the computer 500 may be a program in which processing is performed in chronological order according to the order described in this specification, or a program in which processing is performed in parallel or at a necessary timing such as when a call is made. It may be a program in which processing is performed in
- a system means a set of multiple components (devices, modules (parts), etc.), and it does not matter whether all the components are in the same housing. Therefore, a plurality of devices housed in separate housings and connected via a network, and a single device housing a plurality of modules in one housing are both systems. .
- this technology can take the configuration of cloud computing in which one function is shared by multiple devices via a network and processed jointly.
- each step described in the flow of processing described above can be executed by a single device, or can be shared and executed by a plurality of devices.
- the multiple processes included in the one step can be executed by one device or shared by multiple devices.
- the present technology can also take the following configuration.
- Department and with The display image generation unit is changing the display mode of any one or all of the plurality of regions based on the tracking result of the eyeball, and changing at least one of the position, direction and size of the boundary; Image processing device.
- a preoperative plan receiver that receives at least one of position, orientation and size information of preoperative images and indicators based on the preoperative plan for the eye; By comparing the preoperative image with the surgical field image at the start of surgery, at least one information of the position, direction, and size of the index is changed in accordance with the surgical field image at the start of the surgery, and at the start of the surgery.
- an information storage unit that stores the operative field image of and at least one information of the position, direction, and size of the changed index; further comprising The image processing apparatus according to (1) above.
- the eyeball tracking unit tracking the eyeball in the real-time operative field image by comparing the operative field image at the start of the operation and the real-time operative field image, and tracking the eyeball position in the real-time operative field image; outputting relationship information indicating a relationship between at least one information of direction and size and at least one information of position, direction and size of the changed indicator;
- the display image generation unit is arranging the boundary based on at least one information of the changed position, direction, and size of the index; altering at least one of the position, orientation, and size of the boundary in the real-time surgical field image to eliminate at least one change in size to generate the display image;
- the image processing apparatus according to (2) above.
- the display image generation unit is generating the display image by changing the plurality of regions by coordinate transformation so that at least one of the position, direction, and size of the boundary is changed based on the tracking result of the eyeball; The image processing apparatus according to any one of (1) to (3) above.
- the display image generation unit is changing a boundary line indicating the boundary based on the tracking result of the eyeball, and changing at least one of position, direction and size of the boundary; The image processing apparatus according to any one of (1) to (3) above.
- the display image generation unit is Performing a process of adjusting the same type of parameter for two or more of the plurality of regions; The image processing apparatus according to any one of (1) to (5) above.
- the display image generation unit is performing a process of adjusting different types of parameters for two or more of the plurality of regions; The image processing apparatus according to any one of (1) to (6) above.
- the display image generation unit is weakening the strength of processing for any or all of the plurality of regions as they move away from the boundary; The image processing apparatus according to any one of (1) to (7) above.
- the display image generation unit is The display image is generated as either one of the display image for the stereoscopic left eye and the display image for the stereoscopic right eye, or the display image is generated as the display image for the stereoscopic left eye and the display image for the stereoscopic right eye, respectively. generate, The image processing apparatus according to any one of (1) to (8) above.
- the eyeball tracking unit tracking the eyeball in one or both of the surgical field images for stereoscopic left eye and stereoscopic right eye;
- the display image generation unit is changing at least one of the position, direction, and size of the boundary based on the tracking result of the eyeball for one or both of the stereoscopic left eye and the stereoscopic right eye, and displaying the display image for the stereoscopic left eye and the stereoscopic vision; generating a display image for the right eye;
- the image processing apparatus according to (9) above.
- the display image generation unit is In the display image for the stereoscopic left eye and the display image for the stereoscopic right eye, the boundary is positioned at the same position;
- the image processing apparatus according to (9) or (10) above.
- the display image generation unit is At least one of the position, direction, and size of the boundary in the left-eye stereoscopic display image and the right-eye stereoscopic display image so as to indicate at least one of the specific position, the specific direction, and the specific size generating said display images that are different from each other;
- the image processing apparatus according to (9) or (10) above.
- the display image generation unit is Shifting the stereoscopic left-eye display image and the stereoscopic right-eye display image based on depth information of a desired localization of a three-dimensional image including the stereoscopic left-eye display image and the stereoscopic right-eye display image to generate the three-dimensional image,
- the image processing apparatus according to any one of (9) to (12) above.
- the display image generation unit is When the eyeball is out of tracking of the eyeball by the eyeball tracking unit, maintaining the last display image before the eyeball is out of the eyeball.
- the image processing apparatus according to any one of (1) to (13) above.
- the display image generation unit is changing the display mode or size of any or all of the plurality of regions according to the time cycle; The image processing apparatus according to any one of (1) to (14) above.
- the display image generation unit is generating the display image in which the boundary indicates a plurality of the specific positions; The image processing apparatus according to any one of (1) to (15) above.
- the display image generation unit is changing the size of any or all of the plurality of regions according to the change in size of the eyeball; The image processing apparatus according to any one of (1) to (16) above.
- the display image generation unit is Varying the size of any or all of the plurality of regions according to a time period; The image processing apparatus according to any one of (1) to (17) above. (19) The display mode of each of the plurality of regions differs depending on the difference in luminance of each of the plurality of regions, The image processing apparatus according to any one of (1) to (18) above. (20) The specific position is a toric axis arrangement position of the intraocular lens, The display image generation unit is changing the brightness of each of the plurality of regions such that the boundary indicates the toric axis placement position; The image processing device according to (19) above.
- the specific positions include the toric axis placement position of the intraocular lens, the incision position for forceps insertion, the incision position of the anterior lens capsulotomy, the eye axis position, the center of the limbus, the center of the pupil, the center of the preoperative pupil, and the visual axis position. and the center of the anterior capsulorhexis,
- the image processing apparatus according to any one of (1) to (20) above.
- the image processing device receiving surgical field images for the patient's eye; tracking an eyeball in the operative field image; setting a plurality of regions with different display modes for the operative field image, and generating a display image in which boundaries between the plurality of regions indicate at least one of a specific position, a specific direction, and a specific size with respect to the eye; including The image processing device is changing the display mode of any or all of the plurality of regions based on the tracking result of the eyeball, and changing at least one of the position, direction and size of the boundary; Image processing method.
- a surgical microscope for obtaining an operative field image of the patient's eye; an image processing device that generates a display image; a display device for displaying the display image; with The image processing device is an image input unit that receives the operative field image; an eyeball tracking unit that tracks the eyeball in the operative field image; A display image for generating the display image by setting a plurality of regions having different display modes for the operative field image and showing at least one of a specific position, a specific direction, and a specific size with respect to the eye as a boundary between the plurality of regions.
- the display image generation unit changing the display mode of any or all of the plurality of regions based on the tracking result of the eyeball, and changing at least one of the position, direction and size of the boundary;
- Operating microscope system (24) An image processing method using the image processing apparatus according to any one of (1) to (21) above.
- (25) A surgical microscope system comprising the image processing device according to any one of (1) to (21) above.
Landscapes
- Engineering & Computer Science (AREA)
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Robotics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biomedical Technology (AREA)
- Human Computer Interaction (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Eye Examination Apparatus (AREA)
Abstract
Description
1.実施形態
1-1.手術顕微鏡システムの概略構成の一例
1-2.手術顕微鏡の概略構成の一例
1-3.画像処理装置の概略構成及び画像処理の一例
1-4.作用・効果
2.コンピュータの概略構成の一例
3.付記
<1-1.手術顕微鏡システムの概略構成の一例>
実施形態に係る手術顕微鏡システム1の概略構成の一例について図1を参照して説明する。図1は、実施形態に係る手術顕微鏡システム1の概略構成の一例を示す図である。
実施形態に係る手術顕微鏡10の概略構成の一例について図2を参照して説明する。図2は、実施形態に係る手術顕微鏡10の概略構成の一例を示す図である。
実施形態に係る画像処理装置13の概略構成及び画像処理の一例について図3を参照して説明する。図3は、実施形態に係る画像処理装置13の概略構成(構成及び処理の流れ)の一例を示す図である。
実施形態に係る表示画像の例1について説明する。図4は、実施形態に係る表示画像の例1を示す図である。
具体的な処理は、以下の流れに沿って実施される。レジストレーション、トラッキング、画像生成及び画像提示が順次実行される。図5及び図6は、実施形態に係る表示画像生成(変換処理)を説明するための図である。
実施形態に係る表示画像の例2~6について図7から図11を参照して説明する。図7から図11は、実施形態に係る表示画像の例2~6を示す図である。例2~6では、表示画像のバリエーションについて説明する。
実施形態に係る表示画像の例7~9について図12から図14を参照して説明する。図12から図14は、実施形態に係る表示画像の例7~9を示す図である。例8、9では、境界K1の明瞭さを維持しつつ、処理前画像と処理後画像との差分を小さくするための追加ポイントを説明する。
実施形態に係る表示画像の例10、11について図15及び図16を参照して説明する。図15及び図16は、実施形態に係る表示画像の例10、11を示す図である。例10、11では、3D画像(三次元の術野画像)提示における追加ポイントについて説明する。通常、眼科手術においては3D画像を用いることが多い。この場合、奥行き感を視差の違いとして提示できるように立体視左目用画像と立体視右目用画像が存在する。このため、立体視左目用画像及び立体視右目用画像に対する境界提示についての追加ポイントを説明する。なお、以下では、「立体視左目用」を単に「左目用」と記載し、「立体視右目用」を単に「右目用」と記載する。
実施形態に係るトラッキング状況や時間に応じた境界提示の変化における追加ポイントについて説明する。まず、トラッキング状況(トラッキングステータス)に応じた境界提示の変化について図17を参照して説明し、次に、時間に応じた境界提示の変化について図18から図20を参照して説明し、トラッキング結果(眼のサイズ変化)に応じた境界提示の変化について図21を参照して説明する。図17は、実施形態に係るトラッキング状況に応じた境界提示の変化を説明するための図である。図18から図20は、実施形態に係る時間に応じた境界提示の変化を説明するための第1から第3の図である。図21は、実施形態に係るトラッキング結果に応じた境界提示の変化を説明するための図である。
実施形態に係る表示画像の例12~14について図22から図24を参照して説明する。図22から図24は、実施形態に係る表示画像の例12~14を示す図である。
実施形態に係る時間に応じた境界提示の変化について図25を参照して説明する。図25は、実施形態に係る時間に応じた境界提示の変化を説明するための第4の図である。
ここで、輝度が異なる複数の輝度領域により境界M3~M5を示す場合の表示画像の例15~17について説明する。
図26は、実施形態に係る表示画像の例15を示す図である。図26に示すように、輝度が異なる2つの輝度領域が設定されており、それらの輝度領域の境界M3が提示される。この境界M3は、ライン形状の境界、すなわちライン境界(眼内レンズB1設置用の目標線)として機能する。図26の例では、2つの輝度領域のうち右側の輝度領域(図26中の斜線による塗り潰し領域)の輝度が左側の輝度領域の輝度よりも低く設定されている。この境界M3にトーリック軸が合わせられ、トーリックIOLが設置される。なお、輝度領域の数は、2つに限られるものではなく、2つ以上の複数であればよい。
図27及び図28は、実施形態に係る表示画像の例16を示す図である。図27及び図28に示すように、輝度が異なる2つの輝度領域が設定されており、それらの輝度領域の境界M4として提示される。この境界M4は、半円を有する形状の境界、すなわちセミサークル境界(前嚢切開用の目標円を形成するための半円)として機能する。なお、図27及び図28の例では、輝度領域の境界M4は、眼軸等を中心として90度回転している。
図29は、実施形態に係る表示画像の例17を示す図である。図29に示すように、図27及び図28に示す境界M4に加え、さらに、複数(図29の例では2つ)の境界M5が提示される。これらの境界M4及び境界M5は、表示画像の例10と同様、輝度が異なる2つの輝度領域の境界により形成される。境界M5は、切開位置を示す境界である。
以上説明したように、実施形態によれば、画像入力部13bが患者の眼に対する術野画像を受領し、眼球トラッキング部13eが、術野画像における眼球を追跡し、表示画像生成部13fが、術野画像に対して表示態様が異なる複数の領域を設定して、各領域の境界(例えば、境界K1~K12、M3~M5)が眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す表示画像を生成し、さらに、眼球の追跡結果(トラッキング結果)に基づいて各領域のいずれか又は全ての表示態様を変更し、境界の位置、方向及びサイズの少なくとも一つを変更する。これにより、眼に対する特定位置をマークではなく、表示態様が異なる各領域の境界により提示することで、オクルージョンの発生を防止することができる。したがって、術者は特定位置又は特定サイズを把握しつつ、術野画像を見やすくなり、手術を正確に行うことが可能になるので、術前計画に沿った手術を精度高く実現することができる。なお、変位とは、平行移動、回転、拡大/縮小、変形やその組み合わせ等、眼球等の被写体に対する任意の変化を含むものである。
上述した一連の処理は、ハードウェアにより実行することもできるし、ソフトウェアにより実行することもできる。一連の処理をソフトウェアにより実行する場合には、そのソフトウェアを構成するプログラムが、コンピュータにインストールされる。ここで、コンピュータには、専用のハードウェアに組み込まれているコンピュータや、各種のプログラムをインストールすることで、各種の機能を実行することが可能な、例えば汎用のパーソナルコンピュータ等が含まれる。
なお、本技術は以下のような構成も取ることができる。
(1)
患者の眼に対する術野画像を受領する画像入力部と、
前記術野画像における眼球を追跡する眼球追跡部と、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す表示画像を生成する表示画像生成部と、
を備え、
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
画像処理装置。
(2)
前記眼に対する術前計画に基づく術前画像及び指標の位置、方向及びサイズの少なくとも一つの情報を受領する術前計画受領部と、
前記術前画像と術開始時の前記術野画像との比較により前記術開始時の前記術野画像に合わせて前記指標の位置、方向及びサイズの少なくとも一つの情報を変更し、前記術開始時の前記術野画像と、変更した前記指標の位置、方向及びサイズの少なくとも一つの情報とを蓄積する情報蓄積部と、
をさらに備える、
上記(1)に記載の画像処理装置。
(3)
前記眼球追跡部は、
前記術開始時の前記術野画像と実時間の前記術野画像との比較により前記実時間の前記術野画像における前記眼球を追跡し、前記実時間の前記術野画像における前記眼球の位置、方向及びサイズの少なくとも一つの情報と、変更した前記指標の位置、方向及びサイズの少なくとも一つの情報との関係を示す関係情報を出力し、
前記表示画像生成部は、
変更した前記指標の位置、方向及びサイズの少なくとも一つの情報に基づいて前記境界を配置し、前記関係情報に基づいて前記術開始時の前記術野画像における前記眼球に対する前記境界の位置、方向及びサイズの少なくとも一つの変化を無くすように前記実時間の前記術野画像における前記境界の位置、方向及びサイズの少なくとも一つを変更し、前記表示画像を生成する、
上記(2)に記載の画像処理装置。
(4)
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記境界の位置、方向及びサイズの少なくとも一つが変更されるよう前記複数の領域を座標変換により変更し、前記表示画像を生成する、
上記(1)から(3)のいずれか一つに記載の画像処理装置。
(5)
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記境界を示す境界線を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
上記(1)から(3)のいずれか一つに記載の画像処理装置。
(6)
前記表示画像生成部は、
前記複数の領域の二つ以上に対し、同じ種類のパラメータを調整する処理を行う、
上記(1)から(5)のいずれか一つに記載の画像処理装置。
(7)
前記表示画像生成部は、
前記複数の領域の二つ以上に対し、異なる種類のパラメータを調整する処理を行う、
上記(1)から(6)のいずれか一つに記載の画像処理装置。
(8)
前記表示画像生成部は、
前記複数の領域のいずれか又は全てに対する処理の強さを前記境界から離れるほどに弱める、
上記(1)から(7)のいずれか一つに記載の画像処理装置。
(9)
前記表示画像生成部は、
前記表示画像を立体視左目用の表示画像及び立体視右目用のいずれか一方の表示画像として生成する、もしくは、前記表示画像を立体視左目用の表示画像及び立体視右目用の表示画像としてそれぞれ生成する、
上記(1)から(8)のいずれか一つに記載の画像処理装置。
(10)
前記眼球追跡部は、
立体視左目用及び立体視右目用の一方又は両方の前記術野画像における前記眼球を追跡し、
前記表示画像生成部は、
立体視左目用及び立体視右目用の一方又は両方の前記眼球の追跡結果に基づいて前記境界の位置、方向及びサイズの少なくとも一つを変更し、前記立体視左目用の表示画像及び前記立体視右目用の表示画像を生成する、
上記(9)に記載の画像処理装置。
(11)
前記表示画像生成部は、
前記立体視左目用の表示画像及び前記立体視右目用の表示画像において、前記境界を同じ位置にする、
上記(9)又は(10)に記載の画像処理装置。
(12)
前記表示画像生成部は、
前記特定位置、前記特定方向及び前記特定サイズの少なくとも一つを示すように、前記立体視左目用の表示画像及び前記立体視右目用の表示画像において、前記境界の位置、方向及びサイズの少なくとも一つが異なる前記表示画像を生成する、
上記(9)又は(10)に記載の画像処理装置。
(13)
前記表示画像生成部は、
前記立体視左目用の表示画像及び前記立体視右目用の表示画像を含む三次元画像の所望定位の奥行き情報に基づいて前記立体視左目用の表示画像及び前記立体視右目用の表示画像をシフトさせ、前記三次元画像を生成する、
上記(9)から(12)のいずれか一つに記載の画像処理装置。
(14)
前記表示画像生成部は、
前記眼球追跡部による前記眼球の追跡から前記眼球が外れた場合、前記眼球が外れる前の最後の前記表示画像を維持する、
上記(1)から(13)のいずれか一つに記載の画像処理装置。
(15)
前記表示画像生成部は、
時間周期に応じて、前記複数の領域のいずれか又は全ての表示態様又はサイズを変える、
上記(1)から(14)のいずれか一つに記載の画像処理装置。
(16)
前記表示画像生成部は、
前記境界が複数の前記特定位置を示す前記表示画像を生成する、
上記(1)から(15)のいずれか一つに記載の画像処理装置。
(17)
前記表示画像生成部は、
前記眼球のサイズ変化に応じて、前記複数の領域のいずれか又は全てのサイズを変える、
上記(1)から(16)のいずれか一つに記載の画像処理装置。
(18)
前記表示画像生成部は、
時間周期に応じて、前記複数の領域のいずれか又は全てのサイズを変える、
上記(1)から(17)のいずれか一つに記載の画像処理装置。
(19)
前記複数の領域の各々の前記表示態様は、前記複数の領域の各々の輝度の違いにより異なる、
上記(1)から(18)のいずれか一つに記載の画像処理装置。
(20)
前記特定位置は、眼内レンズのトーリック軸配置位置であり、
前記表示画像生成部は、
前記境界が前記トーリック軸配置位置を示すよう前記複数の領域の各々の輝度を変更する、
上記(19)に記載の画像処理装置。
(21)
前記特定位置は、眼内レンズのトーリック軸配置位置、鉗子挿入のための切開位置、水晶体前嚢切開の切開位置、眼軸位置、角膜輪部中心、瞳孔中心、術前瞳孔中心、視軸位置及び前嚢切開縁中心のいずれかである、
上記(1)から(20)のいずれか一つに記載の画像処理装置。
(22)
画像処理装置が、
患者の眼に対する術野画像を受領し、
前記術野画像における眼球を追跡し、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す表示画像を生成する、
ことを含み、
前記画像処理装置は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
画像処理方法。
(23)
患者の眼に対する術野画像を得る手術顕微鏡と、
表示画像を生成する画像処理装置と、
前記表示画像を表示する表示装置と、
を備え、
前記画像処理装置は、
前記術野画像を受領する画像入力部と、
前記術野画像における眼球を追跡する眼球追跡部と、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す前記表示画像を生成する表示画像生成部と、
を備え、
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
手術顕微鏡システム。
(24)
上記(1)から(21)のいずれか一つに記載の画像処理装置を用いる画像処理方法。
(25)
上記(1)から(21)のいずれか一つに記載の画像処理装置を備える手術顕微鏡システム。
10 手術顕微鏡
11 対物レンズ
12 接眼レンズ
13 画像処理装置
13A 制御部
13a 術前計画受領部
13b 画像入力部
13c レジストレーション部
13d 情報蓄積部
13e 眼球トラッキング部(眼球追跡部)
13f 表示画像生成部
14 モニタ
20 患者用ベッド
51 光源
52 観察光学系
52a ハーフミラー
53 正面画像撮影部
54 断層画像撮影部
55 提示部
56 インターフェース部
57 スピーカ
500 コンピュータ
510 CPU
520 ROM
530 RAM
540 バス
550 入出力インターフェース
560 入力部
570 出力部
580 記録部
590 通信部
600 ドライブ
610 リムーバブル記録媒体
Claims (23)
- 患者の眼に対する術野画像を受領する画像入力部と、
前記術野画像における眼球を追跡する眼球追跡部と、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す表示画像を生成する表示画像生成部と、
を備え、
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
画像処理装置。 - 前記眼に対する術前計画に基づく術前画像及び指標の位置、方向及びサイズの少なくとも一つの情報を受領する術前計画受領部と、
前記術前画像と術開始時の前記術野画像との比較により前記術開始時の前記術野画像に合わせて前記指標の位置、方向及びサイズの少なくとも一つの情報を変更し、前記術開始時の前記術野画像と、変更した前記指標の位置、方向及びサイズの少なくとも一つの情報とを蓄積する情報蓄積部と、
をさらに備える、
請求項1に記載の画像処理装置。 - 前記眼球追跡部は、
前記術開始時の前記術野画像と実時間の前記術野画像との比較により前記実時間の前記術野画像における前記眼球を追跡し、前記実時間の前記術野画像における前記眼球の位置、方向及びサイズの少なくとも一つの情報と、変更した前記指標の位置、方向及びサイズの少なくとも一つの情報との関係を示す関係情報を出力し、
前記表示画像生成部は、
変更した前記指標の位置、方向及びサイズの少なくとも一つの情報に基づいて前記境界を配置し、前記関係情報に基づいて前記術開始時の前記術野画像における前記眼球に対する前記境界の位置、方向及びサイズの少なくとも一つの変化を無くすように前記実時間の前記術野画像における前記境界の位置、方向及びサイズの少なくとも一つを変更し、前記表示画像を生成する、
請求項2に記載の画像処理装置。 - 前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記境界の位置、方向及びサイズの少なくとも一つが変更されるよう前記複数の領域を座標変換により変更し、前記表示画像を生成する、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記境界を示す境界線を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記複数の領域の二つ以上に対し、同じ種類のパラメータを調整する処理を行う、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記複数の領域の二つ以上に対し、異なる種類のパラメータを調整する処理を行う、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記複数の領域のいずれか又は全てに対する処理の強さを前記境界から離れるほどに弱める、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記表示画像を立体視左目用の表示画像及び立体視右目用のいずれか一方の表示画像として生成する、もしくは、前記表示画像を立体視左目用の表示画像及び立体視右目用の表示画像としてそれぞれ生成する、
請求項1に記載の画像処理装置。 - 前記眼球追跡部は、
立体視左目用及び立体視右目用の一方又は両方の前記術野画像における前記眼球を追跡し、
前記表示画像生成部は、
立体視左目用及び立体視右目用の一方又は両方の前記眼球の追跡結果に基づいて前記境界の位置、方向及びサイズの少なくとも一つを変更し、前記立体視左目用の表示画像及び前記立体視右目用の表示画像を生成する、
請求項9に記載の画像処理装置。 - 前記表示画像生成部は、
前記立体視左目用の表示画像及び前記立体視右目用の表示画像において、前記境界を同じ位置にする、
請求項9に記載の画像処理装置。 - 前記表示画像生成部は、
前記特定位置、前記特定方向及び前記特定サイズの少なくとも一つを示すように、前記立体視左目用の表示画像及び前記立体視右目用の表示画像において、前記境界の位置、方向及びサイズの少なくとも一つが異なる前記表示画像を生成する、
請求項9に記載の画像処理装置。 - 前記表示画像生成部は、
前記立体視左目用の表示画像及び前記立体視右目用の表示画像を含む三次元画像の所望定位の奥行き情報に基づいて前記立体視左目用の表示画像及び前記立体視右目用の表示画像をシフトさせ、前記三次元画像を生成する、
請求項9に記載の画像処理装置。 - 前記表示画像生成部は、
前記眼球追跡部による前記眼球の追跡から前記眼球が外れた場合、前記眼球が外れる前の最後の前記表示画像を維持する、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
時間周期に応じて、前記複数の領域のいずれか又は全ての表示態様を変える、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記境界が複数の前記特定位置を示す前記表示画像を生成する、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
前記眼球のサイズ変化に応じて、前記複数の領域のいずれか又は全てのサイズを変える、
請求項1に記載の画像処理装置。 - 前記表示画像生成部は、
時間周期に応じて、前記複数の領域のいずれか又は全てのサイズを変える、
請求項1に記載の画像処理装置。 - 前記複数の領域の各々の前記表示態様は、前記複数の領域の各々の輝度の違いにより異なる、
請求項1に記載の画像処理装置。 - 前記特定位置は、眼内レンズのトーリック軸配置位置であり、
前記表示画像生成部は、
前記境界が前記トーリック軸配置位置を示すよう前記複数の領域の各々の輝度を変更する、
請求項19に記載の画像処理装置。 - 前記特定位置は、眼内レンズのトーリック軸配置位置、鉗子挿入のための切開位置、水晶体前嚢切開の切開位置、眼軸位置、角膜輪部中心、瞳孔中心、術前瞳孔中心、視軸位置及び前嚢切開縁中心のいずれかである、
請求項1に記載の画像処理装置。 - 画像処理装置が、
患者の眼に対する術野画像を受領し、
前記術野画像における眼球を追跡し、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す表示画像を生成する、
ことを含み、
前記画像処理装置は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
画像処理方法。 - 患者の眼に対する術野画像を得る手術顕微鏡と、
表示画像を生成する画像処理装置と、
前記表示画像を表示する表示装置と、
を備え、
前記画像処理装置は、
前記術野画像を受領する画像入力部と、
前記術野画像における眼球を追跡する眼球追跡部と、
前記術野画像に対して表示態様が異なる複数の領域を設定し、前記複数の領域の境界が前記眼に対する特定位置、特定方向及び特定サイズの少なくとも一つを示す前記表示画像を生成する表示画像生成部と、
を備え、
前記表示画像生成部は、
前記眼球の追跡結果に基づいて前記複数の領域のいずれか又は全ての表示態様を変更し、前記境界の位置、方向及びサイズの少なくとも一つを変更する、
手術顕微鏡システム。
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202180091599.2A CN116744838A (zh) | 2021-01-29 | 2021-12-16 | 图像处理装置、图像处理方法和手术显微镜系统 |
EP21923193.3A EP4275647A4 (en) | 2021-01-29 | 2021-12-16 | IMAGE PROCESSING DEVICE, IMAGE PROCESSING METHOD AND SURGICAL MICROSCOPE SYSTEM |
JP2022578131A JPWO2022163189A1 (ja) | 2021-01-29 | 2021-12-16 |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2021-013641 | 2021-01-29 | ||
JP2021013641 | 2021-01-29 | ||
JP2021-031260 | 2021-02-26 | ||
JP2021031260 | 2021-02-26 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2022163189A1 true WO2022163189A1 (ja) | 2022-08-04 |
Family
ID=82654334
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2021/046453 WO2022163189A1 (ja) | 2021-01-29 | 2021-12-16 | 画像処理装置、画像処理方法及び手術顕微鏡システム |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP4275647A4 (ja) |
JP (1) | JPWO2022163189A1 (ja) |
WO (1) | WO2022163189A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2024057162A1 (en) * | 2022-09-13 | 2024-03-21 | Alcon Inc. | Toric intraocular lens alignment guide |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2002328294A (ja) * | 2001-04-27 | 2002-11-15 | Canon Inc | 視線検出装置、視線検出機能付き機器及びカメラ |
JP2008022928A (ja) * | 2006-07-19 | 2008-02-07 | Gifu Univ | 画像解析装置及び画像解析プログラム |
JP2012506272A (ja) * | 2008-10-22 | 2012-03-15 | ゼンゾモトリック インストルメンツ ゲゼルシャフト フュア イノベイティブ ゼンゾリク ミット ベシュレンクテル ハフツング | コンピューター支援眼部手術用の画像処理方法および装置 |
JP2016112358A (ja) | 2014-12-18 | 2016-06-23 | ソニー株式会社 | 情報処理装置、手術顕微鏡システム及び情報処理方法 |
JP2016214781A (ja) * | 2015-05-26 | 2016-12-22 | ソニー株式会社 | 手術システム、並びに画像処理装置および方法 |
JP2018051208A (ja) * | 2016-09-30 | 2018-04-05 | 株式会社ニデック | 眼科情報処理装置、眼科情報処理プログラム、および眼科情報処理システム |
JP2019502415A (ja) * | 2015-10-16 | 2019-01-31 | ノバルティス アーゲー | ライトフィールド顕微鏡法を用いる眼科手術 |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2018105411A1 (ja) * | 2016-12-06 | 2018-06-14 | ソニー株式会社 | 画像処理装置および方法、並びに手術顕微鏡システム |
US11147636B2 (en) * | 2017-10-04 | 2021-10-19 | Alcon Inc. | Surgical suite integration and optimization |
-
2021
- 2021-12-16 JP JP2022578131A patent/JPWO2022163189A1/ja active Pending
- 2021-12-16 WO PCT/JP2021/046453 patent/WO2022163189A1/ja active Application Filing
- 2021-12-16 EP EP21923193.3A patent/EP4275647A4/en active Pending
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2002328294A (ja) * | 2001-04-27 | 2002-11-15 | Canon Inc | 視線検出装置、視線検出機能付き機器及びカメラ |
JP2008022928A (ja) * | 2006-07-19 | 2008-02-07 | Gifu Univ | 画像解析装置及び画像解析プログラム |
JP2012506272A (ja) * | 2008-10-22 | 2012-03-15 | ゼンゾモトリック インストルメンツ ゲゼルシャフト フュア イノベイティブ ゼンゾリク ミット ベシュレンクテル ハフツング | コンピューター支援眼部手術用の画像処理方法および装置 |
JP2016112358A (ja) | 2014-12-18 | 2016-06-23 | ソニー株式会社 | 情報処理装置、手術顕微鏡システム及び情報処理方法 |
JP2016214781A (ja) * | 2015-05-26 | 2016-12-22 | ソニー株式会社 | 手術システム、並びに画像処理装置および方法 |
JP2019502415A (ja) * | 2015-10-16 | 2019-01-31 | ノバルティス アーゲー | ライトフィールド顕微鏡法を用いる眼科手術 |
JP2018051208A (ja) * | 2016-09-30 | 2018-04-05 | 株式会社ニデック | 眼科情報処理装置、眼科情報処理プログラム、および眼科情報処理システム |
Non-Patent Citations (1)
Title |
---|
See also references of EP4275647A4 |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2024057162A1 (en) * | 2022-09-13 | 2024-03-21 | Alcon Inc. | Toric intraocular lens alignment guide |
Also Published As
Publication number | Publication date |
---|---|
JPWO2022163189A1 (ja) | 2022-08-04 |
EP4275647A1 (en) | 2023-11-15 |
EP4275647A4 (en) | 2024-06-12 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US10073515B2 (en) | Surgical navigation system and method | |
CN107111122B (zh) | 眼科手术中的放大及相关联设备、系统和方法 | |
JP5511516B2 (ja) | 眼科装置 | |
US11931292B2 (en) | System and method for improved electronic assisted medical procedures | |
WO2017094343A1 (ja) | 視線検出装置及び視線検出方法 | |
EP2755548B1 (en) | Determination of the azimuthal orientation of a patient's eye | |
WO2017094344A1 (ja) | 視線検出装置及び視線検出方法 | |
JP2022184979A (ja) | 眼科装置 | |
WO2022163189A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
WO2022181194A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
EP3984016A1 (en) | Systems and methods for superimposing virtual image on real-time image | |
JP6880606B2 (ja) | 眼科用手術顕微鏡 | |
JP5570673B2 (ja) | 眼科装置 | |
US20130050645A1 (en) | Microscope for ophthalmologic surgery | |
US20230071841A1 (en) | System and method for improved electronic assisted medical procedures | |
CN116744838A (zh) | 图像处理装置、图像处理方法和手术显微镜系统 | |
WO2022091428A1 (ja) | 眼科観察装置、その制御方法、プログラム、及び記録媒体 | |
WO2022163188A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
WO2022163383A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
WO2022163190A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
JP2022543271A (ja) | 硝子体網膜手術用の適応光学システム及び方法 | |
WO2023047626A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム | |
JP7535785B2 (ja) | 眼科装置 | |
US20220148165A1 (en) | Surgical microscope system, image processing method, program, and image processing device | |
WO2022163362A1 (ja) | 画像処理装置、画像処理方法及び手術顕微鏡システム |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 21923193 Country of ref document: EP Kind code of ref document: A1 |
|
ENP | Entry into the national phase |
Ref document number: 2022578131 Country of ref document: JP Kind code of ref document: A |
|
WWE | Wipo information: entry into national phase |
Ref document number: 18261270 Country of ref document: US |
|
WWE | Wipo information: entry into national phase |
Ref document number: 202180091599.2 Country of ref document: CN |
|
ENP | Entry into the national phase |
Ref document number: 2021923193 Country of ref document: EP Effective date: 20230810 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |