docOptimEyes Smart Products 2.0 for Cataract Surgery
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OptimEyes Smart Products 2.0 for Cataract Surgery
Integrated Scientific Services Optimeyes Using Advanced Non-linear FEM Models for Patient Specific Modelling of Eye Laser Surgery Harald Studer, PhD Team leader Optimeyes™ ISS AG harald.studer@iss-ag.ch Thierry Marchal Industry Director, Healthcare ANSYS, Inc. thierry.marchal@ansys.com Integrated Scientific Services Optimeyes Motivations • Patient specific • Safer surgery planning • Reduction of cost of Medical Devices & Services Integrated Scientific Services Optimeyes The Role of ANSYS • Best in Class FEM technology combined with the widest range of CAE software portfolio • Large network of partners, including in the medical and clinical world • Clear demand from the clinical community to take advantage of simulation • Joining force with clinical experts towards vertical clinical applications “I don’t understand why simulation is used so much in automotive and aeronautic applications and so little in the medical world, where we directly impact a patient’s life. As surgeons, we are spending years to acquire enough know-how and experience to learn how to react quickly when the patient is lying on the operating table; but simulation is giving us the luxury to examine the situation when we still have plenty of time to think through more quietly. I trust that simulation will be used increasingly in the clinical world in the near future.” Dr. Antoine Lucas Cardiovascular Surgeon University Hospital of Rennes Source: ANSYS Healthcare blog Integrated Scientific Services Optimeyes Retina Crystalline lens Cornea Iris Optic nerve Musculi recti Integrated Scientific Services Optimeyes 60% IOP Integrated Scientific Services Optimeyes Integrated Scientific Services Optimeyes Refractive Surgery • • • • • • • Arcuate Keratotomy Limbal Relaxing Incisions Cataract Surgery Laser In-Situ Keratomileusis Photo Refractive Keratectomy Deep Lamelar Keratoplasty Penetrating Keratoplasty • Automated Lamelar Keratoplasty • Laser Assisted Sub-Epithelium Keratomileusis • Laser Assisted In-Situ Keratomileusis • Radial Keratotomy • Thermal Keratoplasty • Intrastromal Corneal Ring Segments Integrated Scientific Services Optimeyes Refractive Surgery • Arcuate Keratotomy • Cataract Surgery • Laser Assisted In-Situ Keratomileusis Integrated Scientific Services Optimeyes flat axis (Kf) steep axis (Ks) • Arcuate Keratotomy Zone [mm] Nbr 45° [D] 60° [D] 90° [D] 7 1 1.00 1.50 2.00 7 2 2.00 2.25 4.00 6 1 1.50 3.00 3.00 6 2 3.00 4.50 6.00 Integrated Scientific Services Optimeyes Refractive Surgery • Arcuate Keratotomy • Cataract Surgery • Laser Assisted In-Situ Keratomileusis Integrated Scientific Services Optimeyes • Cataract Surgery Integrated Scientific Services Optimeyes Refractive Surgery • Arcuate Keratotomy • Cataract Surgery • Laser Assisted In-Situ Keratomileusis Integrated Scientific Services Optimeyes • Laser Assisted In-Situ Keratomileusis Integrated Scientific Services Optimeyes Statistics / Experience Planning Surgery Integrated Scientific Services Optimeyes Refractive Outcome (Refractive Accuracy a Huge Issue for Private Pay Segment – Bill Freeman) < 0.5D 0.5D-1.0D 1.0D-1.5D 1.5D-2.0D >2.0D Source: ASCRS Study with more than 9000 patients in 1996 Statistics / Experience Planning Surgery Integrated Scientific Services Optimeyes Already highly precise Statistics / Experience Planning Surgery Integrated Scientific Services Optimeyes Can we provide patient-specific surgery planning aid? Statistics / Experience Planning Surgery Integrated Scientific Services Optimeyes Material law Validation Surgery simulation Application Integrated Scientific Services Optimeyes Material law Validation Y = U[J]+ Y[C]+ Surgery ò p 1 p 0 ( Tissuesimulation features modeled: • • • • ) F ( R, j;q ) Y f 1[C, A]+ Y f 2 [C, B] dq Incompressibility Isotropic tissue matrix (Proteoglycans, GAGs, …) Collagen fibers with realistic distribution (x-ray scattering investigations) Collagen cross-links Application Integrated Scientific Services Optimeyes Simulation: Material law • Finite element (FE) model Validation Surgery simulation Application • Patient-specific model • Mesh-warping Integrated Scientific Services Optimeyes Clinical validation: • Prospective clinical study • 13 Patients • 1 month follow-up Surgery simulation Application Material law Validation Integrated Scientific Services Optimeyes Where our technology helps: • R&D (new products) • Daily clinical practice • Embedded in surgical devices • … Surgery simulation Application Material law Validation Integrated Scientific Services Optimeyes Clinics Industry Technology transfer Integrated Scientific Services Optimeyes Integrated Scientific Services Optimeyes Take-home message: Academic results from numerical simulations and biomechanical models can be applied in the industry and daily clinical practice! A close collaboration between ANSYS, its partners and clinicians will make our lives so much better. Integrated Scientific Services Optimeyes Thank you..
