Peri-operative Intrastromal Corneal Segmentation after creation of corneal cuts based on Laser Induced Optical Breakdown: A Perspective Study

Significance Assessing refractive correction techniques, such as Lenticule Extraction or LASIK proves instrumental in diagnostics and monitor treatment efficacy. Moreover, these evaluations aid in elucidating potential post-operative complication stemming from imperfect residuals. However, strong noise distribution and low contrast between adjacent faults complicate accurate image segmentation and characteristic inference. This study proposes an image processing algorithm designed to automatically characterize volumes for lenticule extraction or surfaces for flap lift on corneal refractive surgery. Aim The proposed approach fills a current gap in precise reassessment of intrastromal laser cuts where manual expert measurements were seen as the conventional (user-based) standard. Approach The proposed algorithm employs a non-local denoising, the Sobel gradient approach, and Bayesian optimization to delineate and characterize cuts determining their macroscopic parameters. Our analysis involved testing 60 ex-vivo porcine eyes subjected either to flap or lenticule cuts using the SCHWIND ATOS femtosecond laser system. In-situ image analysis was conducted and compared with the intended geometries. Results 60 porcine eyes treated either through flap or lenticule were characterized with our proposed approach exceeding conventional manual measurements. The reproducibility and reliability of the algorithm enabled inferential analysis which might not be achieved with doubted user-base marking. Conclusions Our effort was concentrated on demonstrating the potential of the proposed work, particularly its ability to achieve comprehensive intrastromal characterization—a capability, to the best of our knowledge, being showcased for the first time.