Robotic posterior capsule polishing by optical coherence tomography image guidance

Int J Med Robot. 2021 Jun;17(3):e2248. doi: 10.1002/rcs.2248. Epub 2021 Mar 8.

Abstract

Background: In cataract surgery, polishing of the posterior capsule (PC) can lead to improved surgical outcomes but is currently avoided due to its high-risk nature. This work developed a robotic system capable of performing PC polishing on ex vivo pig eyes using optical coherence tomography (OCT) guidance.

Methods: The lenses of five ex vivo pig eyes were extracted and a thin layer of glue deposited onto the PC. Transpupillary OCT scans of the anterior segment were used to generate a PC-polishing trajectory. During polishing, OCT B-scans tracked the tool tip and were displayed to the operator.

Results: Complete removal of the glue was accomplished in all five trials with no PC rupture reported.

Conclusions: The feasibility of using a robotic system guided by OCT to perform PC polishing on a biological model was demonstrated. Contributions include modelling of the PC anatomy, intraoperative OCT visualization, and automated tool-tip motion with scheduled aspiration pressures.

Keywords: 3D imaging; PC polishing; cataract surgery; eyes; imaged guided surgery; intraoperative imaging; mechatronics; microsurgery; minimal invasive surgery (MIS); navigation; ophthalmology; optical coherence tomography (OCT); posterior capsule.

MeSH terms

  • Animals
  • Cataract Extraction
  • Robotic Surgical Procedures*
  • Swine
  • Tomography, Optical Coherence