Abstract
Purpose:
Robotic surgery has had a tremendous impact upon the ability to treat disorders in other surgical fields, whereas it remains in the experimental phase for ophthalmic surgery. We propose that robotic surgery including intraocular imaging with a robotic-controlled OCT probe will be useful for vitreoretinal surgery.
Methods:
A miniature 25-gauge forward-imaging probe was designed, developed and optimized to use with an 850 nm spectral domain optical coherence tomography (SDOCT) system (Bioptigen, Inc.) with transmitting power of 700 μW. It was attached to a 6 degree of freedom (DoF) Stewart-Gough parallel robot. The bottom of a glass eyeball model contained an opague agar layer upon which liquid bandage (NEW-SKIN Liquid Bandage) was added to create a mockup membrane. Evaluations of artificial membrane peeling through ports in an ocular phantom were shown with verification of results using the robotic-guided OCT probe.
Results:
The axial resolution of the OCT image was 6 μm and the lateral resolution was 25-30 μm. The robotically controlled OCT probe was able to visualize the membrane which was 10 pixels thick corresponding to 28 μm. A custom-made cam actuation unit was used to control an ophthalmic 25-gauge surgical gripper. A robot-assisted full membrane peeling procedure including insertion, grasping, lifting and detaching was performed.
Conclusions:
An integrated OCT-guided robot for surgical assistance was developed. It is capable of forward-imaging of robotically peeled artificial membrane in an ocular phantom. It has the future potential to guide real-time intraocular surgery.
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
688 retina •
762 vitreoretinal surgery