In a groundbreaking development in the field of ophthalmology, researchers in California are advancing a robotic system designed to transform eye surgeries, particularly for vitreoretinal and cataract procedures. This cutting-edge platform, driven by artificial intelligence (AI) and guided by precise imaging, has already shown exceptional promise in preclinical trials.
Dr. Aya Barzelay-Wollman, MD, PhD, codirector of the Advanced Robotic Micro Surgery (ARMS) Laboratory at the University of California, Los Angeles (UCLA), presented early results of the AI-driven robotic system at the 2024 European Society of Retina Specialists (EURETINA) conference. According to Barzelay-Wollman, the robot has demonstrated extraordinary precision, boasting a resolution down to 1 micron and an accuracy of 10 microns. This level of precision far exceeds that of human hands, which are typically affected by tremors ranging from 30 to 50 microns.
“The robot’s ability to move in 1-micron increments makes it incredibly precise,” Barzelay-Wollman said during her presentation. “With a targeting accuracy of under 20 microns and an orientation error of just 0.15 microns, it outperforms human capabilities in terms of precision.”
The new robotic system was designed to tackle the challenges of vitreoretinal and cataract surgeries. While cataract surgery is well-established, retinal surgery has posed more difficulty due to the challenge of visualizing the delicate retinal structures inside the eye. Traditional commercial surgical microscopes rely on top-down imaging, which provides limited insight into the retina.
To address this issue, Barzelay-Wollman and her team developed innovative intraocular imaging probes that mount directly on the vitrector, providing real-time views of the retina. These probes work in tandem with optical coherence tomography (OCT) to generate high-resolution images of retinal layers, allowing the robot to navigate and perform procedures with incredible accuracy.
“Our system uses detailed anatomical data and real-time imaging to control the robot’s trajectory during surgery,” she explained. “In combination with the OCT images, this data enables the robot to perform fully automated vitrectomies with unprecedented precision.”
The robotic platform operates in two distinct modes. In fully automated mode, the robotic arm performs the procedure independently while the surgeon oversees and monitors the process from a console. The second mode, known as teleoperation or robotic assist, allows the surgeon to control the robot’s movements via a joystick, providing more flexibility during the procedure.
While the technology is still in the preclinical phase, Barzelay-Wollman emphasized the system’s potential to revolutionize retinal and cataract surgeries. “This represents a pivotal leap in surgical robotics,” she said. “It combines superhuman precision with the ability to eliminate hand tremors, allowing us to perform surgeries that were once impossible or highly risky.”
The team’s next steps include conducting in vivo studies on live animals to further refine the technology. Following these trials, the platform will need to obtain approval from the U.S. Food and Drug Administration (FDA) before clinical trials involving human patients can begin.
If successful, this AI-powered robotic system could dramatically change the landscape of eye surgery, offering new hope for patients requiring complex procedures and setting a new standard in the field of ophthalmology.
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