In January, the first robot assisted vitreoretinal surgery was performed in Belgium, at the University Hospitals Leuven and KU Leuven (click here). Using a device that provides stabilization of fine movements, without eliminating the surgeon’s control, Marc De Smet, MD and colleagues were able to cannulate an occluded retinal vein with a 0.03 millimeter diameter microneedle and inject Ocriplasmin over a 10 minute period, successfully dissolving the clot. The Surgical Stabilizer Assisted Retinal Vein Cannulation is now being tested in a phase 2 clinical trial.
The technology allows the surgeon the remain completely still, or make very fine movements without any risk of tremors. Although this study is focused on RVOs, there is clearly an exciting potential for other applications. For example, slow delivering cells or vectors into the subretinal space, precise peeling of membranes with intraoperative OCT guidance, thrombolysis of retinal artery occlusions, or local delivery of drug to a tumor. It is conceivable that a robotic device could even be programmed to move independent of the surgeon, such as with OCT coordinates determined prior to going to the OR. Although the device is still in early stages of development, its use in humans is an exciting step forward.