A critical yet unpredictable complication following cataract surgery is intraocular lens dislocation. Postoperative stability is imperative, as even a tiny decentration of multifocal lenses or inadequate alignment of the torus in toric lenses due to postoperative rotation can lead to a significant drop in visual acuity. Investigating possible intraoperative indicators that can predict post-surgical instabilities of intraocular lenses can help prevent this complication. In this paper, we develop and evaluate the first fully-automatic framework for the computation of lens unfolding delay, rotation, and instability during surgery. Adopting a combination of three types of CNNs, namely recurrent, region-based, and pixel-based, the proposed framework is employed to assess the possibility of predicting post-operative lens dislocation during cataract surgery. This is achieved via performing a large-scale study on the statistical differences between the behavior of different brands of intraocular lenses and aligning the results with expert surgeons' hypotheses and observations about the lenses. We exploit a large-scale dataset of cataract surgery videos featuring four intraocular lens brands. Experimental results confirm the reliability of the proposed framework in evaluating the lens' statistics during the surgery. The Pearson correlation and t-test results reveal significant correlations between lens unfolding delay and lens rotation and significant differences between the intra-operative rotations stability of four groups of lenses. These results suggest that the proposed framework can help surgeons select the lenses based on the patient's eye conditions and predict post-surgical lens dislocation.

翻译：白内障术后一种严重且难以预测的并发症是人工晶体脱位。术后稳定性至关重要，因为多焦点晶体的微小偏心或散光晶体因术后旋转导致的散光轴位偏差，都可能导致视力显著下降。探索术中可能预测人工晶体术后不稳定的指标，有助于预防这一并发症。本文首次开发并评估了一种完全自动化的框架，用于计算术中晶体展开延迟、旋转及不稳定度。该框架结合了三种卷积神经网络（即循环、区域和像素级网络），通过大规模研究不同品牌人工晶体行为的统计学差异，并将结果与外科专家对晶体的假设和观察进行对比，评估预测白内障术后晶体脱位的可能性。我们利用了一个包含四种人工晶体品牌的白内障手术视频大规模数据集。实验结果证实了所提框架在术中评估晶体统计特性方面的可靠性。皮尔逊相关性和t检验结果显示，晶体展开延迟与晶体旋转之间存在显著相关性，且四组晶体在术中旋转稳定性方面存在显著差异。这些结果表明，该框架有助于外科医生根据患者眼部情况选择晶体，并预测术后晶体脱位。