Lamellar keratoplasty using position-guided surgical needle and M-mode optical coherence tomography

Deep anterior lamellar keratoplasty (DALK) is an emerging surgical technique for the restoration of corneal clarity and vision acuity. The big-bubble technique in DALK surgery is the most essential procedure that includes the air injection through a thin syringe needle to separate the dysfunctional region of the cornea. Even though DALK is a well-known transplant method, it is still challenged to manipulate the needle inside the cornea under the surgical microscope, which varies its surgical yield. Here, we introduce the DALK protocol based on the position-guided needle and M-mode optical coherence tomography (OCT). Depth-resolved 26-gage needle was specially designed, fabricated by the stepwise transitional core fiber, and integrated with the swept source OCT system. Since our device is feasible to provide both the position information inside the cornea as well as air injection, it enables the accurate management of bubble formation during DALK. Our results show that real-time feedback of needle end position was intuitionally visualized and fast enough to adjust the location of the needle. Through our research, we realized that position-guided needle combined with M-mode OCT is a very efficient and promising surgical tool, which also to enhance the accuracy and stability of DALK

Phase-stability optimization of swept-source optical coherence tomography.

Phase-resolved imaging of swept-source optical coherence tomography (SS-OCT) is subject to phase measurement instabilities involved with the sweep variation of a frequency-swept source. In general, optically generated timing references are utilized to track the variations imposed on OCT signals. But they might not be accurately synchronized due to relative time delays. In this research, we investigated the impact of the signal delays on the timing instabilities and the consequent deviations of the measured phases. We considered two types of timing signals utilized in a popular digitizer operation mode: a sweep trigger from a fiber Bragg grating (FBG) that initiates a series of signal sampling actions clocked by an auxiliary Mach-Zehnder interferometer (MZI) signal. We found that significant instabilities were brought by the relative delays through incoherent timing corrections and timing collisions between the timing references. The best-to-worst ratio of the measured phase errors was higher than 200 while only the signal delays varied. Noise-limited phase stability was achieved with a wide dynamic range of OCT signals above 50 dB in optimized delays. This demonstrated that delay optimization is very effective in phase stabilization of SS-OCT

Mode-filtered large-core fiber for optical coherence tomography.

We have investigated the use of multimode fiber in optical coherence tomography (OCT) with a mode filter that selectively suppresses the power of the high-order modes (HOMs). A large-core fiber (LCF) that has a moderate number of guiding modes was found to be an attractive alternative to the conventional single-mode fiber for its large mode area and the consequentially wide Rayleigh range of the output beam if the HOMs of the LCF were efficiently filtered out by a mode filter installed in the middle. For this, a simple mode filtering scheme of a fiber-coil mode filter was developed in this study. The LCF was uniformly coiled by an optimal bend radius with a fiber winder, specially devised for making a low-loss mode filter. The feasibility of the mode-filtered LCF in OCT imaging was tested with a common-path OCT system. It has been successfully demonstrated that our mode-filtered LCF can provide a useful imaging or sensing probe without an objective lens that greatly simplifies the structure of the probing optics

Characterization of spectral-domain OCT with autocorrelation interference response for axial resolution performance.

We present a class of novel system characterization methods for spectral-domain optical coherence tomography (SD-OCT) particularly on getting optimized axial resolution performance. Our schemes uniquely utilize the autocorrelation interference response, also known as the self-interference product, which is generated by the optical fields from the imaging sample in automatic interferences. In our methods, an autocorrelation-inducing calibration sample was prepared which was made by sandwiching glass plates. OCT images of the calibration sample were captured by an SD-OCT system under testing. And the image data were processed to find various system characteristics based on the unique properties of autocorrelation interferograms, free of dispersion- and polarization-involved modulations. First, we could analyze the sampling characteristic of the SD-OCT's spectrometer for spectral calibration that enables accurate linear-k resampling of detected spectral fringes. Second, we could obtain the systematic polarization properties for quantifying their impact on the achieved axial resolutions. We found that our methods based on the autocorrelation response provide an easy way of self-characterization and self-validation that is useful in optimizing and maintaining axial resolution performances. It was found very attractive that a variety of system characteristics can be obtained in a single-shot measurement without any increased system complexity

Mode-filtered large-core fiber for short-pulse delivery with reduced nonlinear effects.

We present a large-core fiber (LCF) with a reduced nonlinear property for a single-mode beam delivery of intense ultrashort pulses. A tapered-fiber mode filter was fabricated in an LCF with the core diameter decreased from 20 μm to 6 μm at the tapered waist region surrounded by index-matched liquid. By the tapered geometry, the high-order mode was rejected so that our mode-filtered LCF acted as a single-mode fiber despite the multimode property of the original LCF. It has been found that this fiber class is suitable for applications, such as an endoscopic multiphoton microscope, that demand a flexible short-distance (<4 m) delivery medium of ultrashort pulses

Fiber-based polarization-sensitive optical coherence tomography of a minimalistic system configuration.

We present a very simple method of constructing a polarization-sensitive optical coherence tomography (PS-OCT) system. An ordinary fiber-based swept-source OCT system was reconfigured for PS-OCT by adding a long section of polarization-maintaining fiber in the sample arm. Two polarization modes of a large group-delay difference formed spatially distinguished polarization channels. The depth-encoded information on the polarization states was retrieved by an amplitude-based analysis. We found that our method provides an economic scheme of PS-OCT. It demonstrates that an ordinary OCT system can be easily reconfigured for PS-OCT imaging if it has sufficient margins in the imaging range