Adaptive Control Improves Sclera Force Safety in Robot-Assisted Eye Surgery: A Clinical Study

Area of Science:

• Ophthalmology
• Robotics
• Surgical Technology

Background:

• Robotic integration in retinal microsurgery diminishes surgeon perception of tool-tissue interaction forces.
• This sensory deficit, caused by robotic arm inertia, poses an iatrogenic risk in delicate ophthalmic procedures.

Purpose of the Study:

• To evaluate adaptive force control schemes for the Steady-Hand Eye Robot (SHER).
• To mitigate the risk of unsafe scleral forces during robotic eye surgery.

Main Methods:

• Ten ophthalmology trainees performed simulated retinal vessel following using the SHER with adaptive controls and freehand.
• A force-sensing instrument (Fiber Bragg Grating) and a piezo-actuated stage for simulating eyeball motion were utilized.
• Experiments were conducted in a simulated operating room environment.

Main Results:

• The Adaptive Norm Control (ANC) method successfully maintained scleral forces within safe limits.
• ANC demonstrated superior performance in force regulation compared to freehand manipulations.
• Novice users subjectively preferred freehand maneuvers over robotic assistance.

Conclusions:

• Adaptive force control, specifically ANC, is effective in preventing excessive scleral forces in robotic retinal surgery.
• While effective, novice surgeon preference for freehand techniques highlights the need for further training and interface refinement.