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Oxford Eye Surgeons Successfully Use Robotic Arm In Retinal Procedures

16.06.2017

A few eye surgeons in the United Kingdom have just become the first in the world to successfully use a robot in retinal surgery. Amazingly, this intricate robotic hand was able to operate on patients' retinae with greater accuracy than actual eye surgeons.

12 British patients with a dangerous membrane growth on their retina were examined in this study. Half of these patients had surgery with an Oxford doctor while the others had a robot surgically remove the membrane. Interestingly, researchers found that the people who had robotic surgery had less negative side effects and less damage to the retina than people who had traditional surgery.

Most eye doctors say retinal surgeries are some of the most difficult in the eye care industry. Not only is the retina very narrow, it's also extremely delicate. Even with great dexterity, the subtle pulsing of blood through a surgeon's hand could have adverse effects on a patient's eye.

These new results prove that the steadiness and predictability of the robotic surgical procedure is far safer than the human hand. Dr. Robert E. MacLaren, the leading ophthalmologist on this study at the University of Oxford, said this robotic retinal procedure will probably become the new normal within the next decades.

As you could imagine, removing the membrane from a patient's eye is an extremely complicated procedure. MacLaren told reporters that the membrane they were aiming to take out was only 10 microns thick, which is thinner than a strand of human hair. Not only is the membrane incredibly thin, the whole eye throbs throughout the procedure with every heartbeat.

The kind of membrane this surgery addressed is called an epiretinal membrane. This membrane often forms due to the eye's vitreous shrinking over time and pulling away from the retina. However, epiretinal membranes can also form due to direct trauma or in relation to diabetes. If not caught early, epiretinal membranes could lead to blindness.

If the epiretinal membrane tears into the eye's macula, patients could experience problems with their central vision. This is usually the first symptom people with this condition experience.

The Dutch professors Marc de Smet and Maarten Steinbuch were behind the design of this robotic hand. Both of these men work for the company called Preceyes BV, which was founded in the University of Eindhoven. It took both of these men a decade to complete their first fully functional robotic system for assisted surgery. Most of De Smet and Steinbuch's machines are used nowadays in cancer surgeries, hysterectomies, and the removal of diseased tissues.

It wasn't until 2011 that De Smet and Steinbuch started work on a robotic arm to handle retinal surgery. In 2015, the duo successfully performed eye surgery using their robotic device on a pig's eye. The next year, they used the robot to remove a membrane from an elderly priest's eye in Oxford.

This ingenious robotic hand is made up of seven motors that move with a precision of 1 micron. A trained surgeon moves the robotic arm using a joystick while s/he looks at high definition images of the patient's retina on a touch screen.

MacLaren publicly announced these findings at the Association for Research in Vision and Ophthalmology (ARVO) in Baltimore. He told the crowd at this assembly that the next step in robotic eye surgery is to place a needle under the retina and inject gene therapy fluids into the eye.






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