Real-Time Sclera Force Feedback for Enabling Safe Robot-Assisted Vitreoretinal Surgery.

One of the major yet little recognized challenges in robotic vitreoretinal surgery is the matter of tool forces applied to the sclera. Tissue safety, coordinated tool use and interactions between tool tip and shaft forces are little studied. The introduction of robotic assist has further diminished the surgeon's ability to perceive scleral forces. Microsurgical tools capable of measuring such small forces integrated with robotmanipulators may therefore improve functionality and safety by providing sclera force feedback to the surgeon. In this paper, using a force-sensing tool, we have conducted robotassisted eye manipulation experiments to evaluate the utility of providing scleral force feedback. The work assesses 1) passive audio feedback and 2) active haptic feedback and evaluates the impact of these feedbacks on scleral forces in excess of aboundary. The results show that in presence of passive or active feedback, the duration of experiment increases, while the duration for which scleral forces exceed a safe threshold decreases.