Abstract
Purpose :
To develop automated robotic surgery able to perform highly complex retina surgery procedures. Our Robotic Intervention Surgical System (IRISS) is a robotic arm that is AI driven and image guided. In order to operate accurately it uses live feedback from the surgical microscope and surgical Optical Coherence Tomography (OCT). Traditional intraoperative OCT systems have limitations in providing comprehensive 2D or 3D retina images, often due to shared optical paths with surgical microscopes and patient lenses. This study presents an innovative approach using an intraocular high resolution imaging probes, offering real-time, high-precision imaging of the retina and of any ocular structure.
Methods :
A custom-designed apparatus of 1mm imaging probes were affixed to a microsurgical tool held by the IRISS robotic arm. Data analysis was conducted using a specially developed algorithms and modifed OCT device. The IRISS robotic arm successfully operated in porcine eyes using the surgical tool with imaging probes mounted on it, while detecting target tissues at incremental distances of up to 0.5mm
Results :
This intraocular imaging technique offers an expanded view of the intraocular anatomical structures as the retina, encompassing the equatorial zone, surpassing the capabilities of existing surgical OCTs. Real-time imaging of the intraocular structures was conducted with high precision and a mere 2.3-micron average error. Using imaging data as live feedback, the IRISS robotic arm was capable of performing automated retinal surgery procedures as vitrectomy, membrane peeling, and subretinal injection.
Conclusions :
This study represents a pivotal leap in developing an innovative robotic system tailored for performing intricate retinal surgeries. While initially designed for integration with our IRISS robot, this technology is versatile and adaptable for use by human surgeons as well. By incorporating real-time intraocular imaging into a microsurgical tool, it amplifies the capabilities of both robotic and human surgeons, refining surgical maneuvers, and offering a valuable aid in mitigating risks, such as the potential for retinal puncture.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.