Clinical diabetes : a publication of the American Diabetes Association · 2025
A Primary Care Guide to the Screening and Pharmacologic Management of Chronic Kidney Disease in People Living With Type 2 Diabetes.
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Wu Dongyue, Lux Florian, Mai Tobon Max, Muenz Holger, Schmidt Soeren, Tagliabue Eleonora, Matten Philipp, Ataman Çağlar
Аннотация
SIGNIFICANCE: Retinal endolaser photocoagulation is a widely performed vitreoretinal procedure but currently lacks real-time intraoperative feedback on treatment outcomes. Integrating optical coherence tomography (OCT) directly into the endolaser probe enables co-localized, intraoperative sensing of tissue response during laser delivery, offering the potential to significantly enhance surgical safety and efficacy.
AIM: The aim of the study is to design, fabricate, and demonstrate a fiber-optic smart instrument with a 3D nano-printed microlens and instrument-integrated OCT sensing that enables co-localized, concurrent surgical laser delivery and tomographic sensing of tissue alterations during REPC.
APPROACH: A dual-clad fiber was used to co-axially deliver surgical and OCT beams through the outer multi-mode and inner single-mode cores. A 3D nano-printed aspherical microlens ( 300 μ m diameter) at the fiber tip optimized beam shaping for both lasers in the intravitreal cavity. The optical performance of the 23G instrument-integrated OCT (iiOCT) probe was characterized, and ex vivo validation experiments were conducted on porcine eyes.
RESULTS: Optical performance assessments demonstrated close alignment between measured and simulated beam profiles, with an OCT spot size of 37.9 μ m at best focus and a surgical laser beam divergence half-angle of 6.0 deg. The probe demonstrated stable power transmission with a mean deviation of 0.35% across repeated pulses. Ex vivo experiments confirmed co-localized, concurrent surgical laser delivery and OCT sensing of retinal tissue alterations.
CONCLUSIONS: The miniaturized iiOCT endolaser probe combines surgical laser delivery with OCT sensing, achieving adequate performance for the targeted clinical application. This sensor-integrated instrument has the potential to enable intraocular, intraoperative, and quantitative assessment of treatment outcomes. It could support feedback-driven, robotic endolaser photocoagulation, enhancing the safety and efficacy of retinal endolaser surgery.
AIM: The aim of the study is to design, fabricate, and demonstrate a fiber-optic smart instrument with a 3D nano-printed microlens and instrument-integrated OCT sensing that enables co-localized, concurrent surgical laser delivery and tomographic sensing of tissue alterations during REPC.
APPROACH: A dual-clad fiber was used to co-axially deliver surgical and OCT beams through the outer multi-mode and inner single-mode cores. A 3D nano-printed aspherical microlens ( 300 μ m diameter) at the fiber tip optimized beam shaping for both lasers in the intravitreal cavity. The optical performance of the 23G instrument-integrated OCT (iiOCT) probe was characterized, and ex vivo validation experiments were conducted on porcine eyes.
RESULTS: Optical performance assessments demonstrated close alignment between measured and simulated beam profiles, with an OCT spot size of 37.9 μ m at best focus and a surgical laser beam divergence half-angle of 6.0 deg. The probe demonstrated stable power transmission with a mean deviation of 0.35% across repeated pulses. Ex vivo experiments confirmed co-localized, concurrent surgical laser delivery and OCT sensing of retinal tissue alterations.
CONCLUSIONS: The miniaturized iiOCT endolaser probe combines surgical laser delivery with OCT sensing, achieving adequate performance for the targeted clinical application. This sensor-integrated instrument has the potential to enable intraocular, intraoperative, and quantitative assessment of treatment outcomes. It could support feedback-driven, robotic endolaser photocoagulation, enhancing the safety and efficacy of retinal endolaser surgery.