Head-mounted surgical robots are an enabling technology for subretinal injections

Area of Science:

• Ophthalmology
• Robotic Surgery
• Biomedical Engineering

Background:

• Subretinal injections are crucial for sight-saving therapies but are limited by surgeon dexterity and patient movement.
• Retinal trauma or incorrect product placement can occur due to imprecise cannula control during manual injections.
• Existing robotic systems often do not account for patient head motion, a common challenge in ophthalmic surgery.

Purpose of the Study:

• To evaluate the efficacy of a head-mounted robotic system in improving subretinal injection precision.
• To assess the system's ability to compensate for patient head motion during the procedure.
• To compare the success rate of robotic-assisted injections with manual approaches.

Main Methods:

• A hybrid ex vivo and in situ study was conducted using an enucleated eye mounted on a human volunteer.
• A high-precision teleoperated surgical robot was head-mounted to passively reduce relative motion between the robot and the eye.
• Bleb formation success rates were compared between the robotic system and reported manual injection success rates.

Main Results:

• The head-mounted robotic system achieved a significantly higher bleb-formation success rate on moving eyes.
• This success rate surpassed previously reported manual injection success rates, even on stationary eyes.
• The system effectively mitigated the impact of patient head motion on injection accuracy.

Conclusions:

• Head-mounting a surgical robot offers a viable solution to enhance precision in subretinal injections.
• This approach significantly improves surgical outcomes by compensating for patient head motion.
• Robotic assistance holds great potential for advancing sight-restoring ophthalmic procedures.