The Surgeon's Role in Inducing and Controlling Motion Errors During Intraocular Membrane Peeling Procedures

Area of Science:

• Ophthalmology
• Surgical Technology
• Biomechanics

Background:

• Intraocular membrane peeling procedures require high precision.
• Movement inaccuracies during surgery can lead to complications.
• Understanding surgeon-induced errors is crucial for improving surgical outcomes.

Purpose of the Study:

• To investigate the surgeon's role in inducing and correcting movement inaccuracies during intraocular membrane peeling.
• To quantify motion errors at the instrument tip and shaft.
• To differentiate between surgeon-induced and inherent instrument errors.

Main Methods:

• Utilized optical sensors to record movement errors of 23-gauge pneumatic forceps.
• Compared instrument tip motion during handheld vs. fixed (non-human contact) actuation.
• Analyzed motion at both distal tip and proximal shaft (sclerotomy site).
• Calculated root mean square (RMS) and range values, applying high and low frequency filters.

Main Results:

• Fixed forceps exhibited significantly lower movement errors (X-axis, high-frequency Z-axis) than handheld.
• Distal tip exhibited significantly higher movement errors than the proximal shaft when forceps were fixed.
• High-frequency movement errors correlated positively with actuation extent in fixed forceps.

Conclusions:

• Both surgeon- and instrument-related errors occur during intraocular procedures.
• Skilled surgeons effectively correct errors using visual feedback and potentially the sclerotomy site as a pivot.
• Teaching novice surgeons to utilize the sclerotomy site for motion dampening is recommended.