Comparison of robot-assisted and manual retinal vessel microcannulation in an animal model.

Department of Ophthalmology, School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
The British journal of ophthalmology (Impact Factor: 2.92). 12/2010; 95(5):731-4. DOI: 10.1136/bjo.2010.193391
Source: PubMed

ABSTRACT To evaluate the performance of a parallel robotic system by comparison with the conventional manual procedure using an animal model.
A new parallel robotic system was developed that features a small cylindrical manipulator (base diameter 76 mm, height 240 mm). The performance of the new system was evaluated for its capability to assist in retinal vessel microcannulation. The test scenario was as follows: (1) introduce the microcannula into a harvested porcine eye attached loosely on the orbital fossa of an artificial face model through a 20G scleral port at the pars plana; (2) cannulate the retinal vessels (inner diameter 60-80 μm); and (3) inject indocyanine green dye into the eye endovascularly. The success rate and procedure quality of the robotic system were evaluated by comparison with the conventional manual procedure.
Retinal vessel microcannulation and dye injection were achieved by the robotic system twice in four attempts, and by the conventional manual procedure either not at all or incompletely in all six attempts. Dye leakage was not observed with the robotic system, indicating that microcannulation was minimally invasive; in contrast, dye leakage was always observed with the manual procedure.
The new system is more accurate than the conventional manual procedure for the tests on a porcine eye model.

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    ABSTRACT: PURPOSE: To elucidate the merits of robotic application for vitreoretinal maneuver in comparison to conventional manual performance using an in-vitro eye model constructed for the present study. METHODS: Capability to accurately approach the target on the fundus, to stabilize the manipulator tip just above the fundus, and to perceive the contact of the manipulator tip with the fundus were tested. The accuracies were compared between the robotic and manual control, as well as between ophthalmologists and engineering students. RESULTS: In case of manual control, ophthalmologists were superior to engineering students in all the 3 test procedures. Robotic assistance significantly improved accuracy of all the test procedures performed by engineering students. For the ophthalmologists including a specialist of vitreoretinal surgery, robotic assistance enhanced the accuracy in the stabilization of manipulator tip (from 90.9 µm to 14.9 µm, P = 0.0006) and the perception of contact with the fundus (from 20.0 mN to 7.84 mN, P = 0.046), while robotic assistance did not improve pointing accuracy. CONCLUSIONS: It was confirmed that telerobotic assistance has a potential to significantly improve precision in vitreoretinal procedures in both experienced and inexperienced hands.
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