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IN-HUMAN FEASIBILITY AND SAFETY OF SUBRETINAL DRUG INJECTION THROUGH ATTACHED RETINA USING A ROBOTIC COMANIPULATION
Ivo De Clerck1,2, Maarten Schoovaerts3, Martina Polidoro3
1Military Hospital Queen Astrid, Brussels, Belgium.
Retina (Philadelphia, Pa.)
|January 14, 2026
Summary
Robot-assisted subretinal injections using the Mynutia system are feasible and safe for treating submacular hemorrhage (SMH). This advanced technique allows precise, stable delivery through attached retina, improving visual outcomes with minimal device-related complications.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Robotic Surgery
Background:
- Submacular hemorrhage (SMH) poses challenges for visual acuity.
- Current treatments for SMH may involve invasive procedures with potential complications.
- Robot-assisted surgery offers potential for enhanced precision in delicate retinal procedures.
Purpose of the Study:
- To assess the feasibility and safety of robot-assisted subretinal injections using the Mynutia system.
- To evaluate injections performed through attached retina in patients with SMH.
- To determine the efficacy of this technique in achieving stable subretinal delivery.
Main Methods:
- Prospective, single-center case series of 20 eyes with SMH.
- Vitrectomy with subretinal recombinant tissue plasminogen activator using the Mynutia system and EVA Inicio™ microinjection system.
- Injections performed through attached retina when feasible, with primary outcomes focused on needle insertion, stable positioning, safe withdrawal, and adverse events.
Main Results:
- Robot-assisted injection was successful in all cases, with stable subretinal positioning achieved for ≥3 minutes.
- No device-associated adverse events (DAE) occurred; retinotomies closed spontaneously.
- Significant improvement in best-corrected visual acuity (BCVA) from LogMAR 1.85 to 0.66 at 6 weeks (p < 0.001).
- 95% achieved complete subfoveal hemorrhage displacement.
Conclusions:
- Robot-assisted subretinal injection with the Mynutia system is a feasible and safe procedure for SMH.
- The technique allows for stable, prolonged, low-pressure delivery through attached retina.
- This approach may enhance precision and tissue preservation in subretinal therapies.
