Belyea David A, Mines Michael J, Yao Wen-Jeng, Dan Jacob A, Bower Kraig S
Department of Ophthalmology, Medical Faculty Associates, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 2A, Washington, DC, 20037, USA.
Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
J Robot Surg. 2014 Mar;8(1):49-55. doi: 10.1007/s11701-013-0424-1. Epub 2013 Jul 26.
To assess the feasibility of using the Robotic Slave Micromanipulator Unit (RSMU) to remotely photocoagulate the ciliary body for the treatment of glaucoma with the diode laser. In fresh unoperated enucleated human eyes, the ciliary body was destroyed either with a standard contact transscleral cyclophotocoagulation 'by hand' diode laser technique, or remotely using the RSMU. The treated sections were fixed in formalin, paraffin-embedded, and stained with hematoxylin and eosin. Histological evaluation was performed by a masked observer using a standardized grading system based on the amount of damage to the ciliary body to evaluate effectiveness of treatment. Both methods of contact transscleral cyclophotocoagulation showed therapeutic tissue disruption of the ciliary processes and both the non-pigmented and pigmented ciliary epithelium. Histology examination of remote robotic contact transscleral cyclophotocoagulation and "by hand" technique produced similar degrees of ciliary body tissue disruption. Remote diode laser contact transscleral cyclophotocoagulation of the ciliary body in fresh enucleated human eyes is possible with the RSMU. Therapeutic tissue disruption of the ciliary body was achieved. Additional study is necessary to determine the safety and efficacy of robotically-delivered cyclophotocoagulation in live eyes.
评估使用机器人从属显微操作单元（RSMU）通过二极管激光对睫状体进行远程光凝治疗青光眼的可行性。在新鲜未手术摘除的人眼中，使用标准的手动接触式经巩膜睫状体光凝二极管激光技术或使用RSMU进行远程操作破坏睫状体。将处理后的切片固定在福尔马林中，石蜡包埋，并用苏木精和伊红染色。由一位不知情的观察者使用基于睫状体损伤程度的标准化分级系统进行组织学评估，以评估治疗效果。两种接触式经巩膜睫状体光凝方法均显示出睫状突以及无色素和色素性睫状上皮的治疗性组织破坏。远程机器人接触式经巩膜睫状体光凝和“手动”技术的组织学检查产生了相似程度的睫状体组织破坏。使用RSMU对新鲜摘除眼球中的睫状体进行远程二极管激光接触式经巩膜睫状体光凝是可行的。实现了睫状体的治疗性组织破坏。需要进行更多研究以确定在活眼中机器人辅助睫状体光凝的安全性和有效性。
