IEEE Trans Biomed Eng. 2021 Jan;68(1):119-129. doi: 10.1109/TBME.2020.2996013. Epub 2020 Dec 21.
Retinal disorders, including age-related macular degeneration, are leading causes of vision loss worldwide. New treatments, such as gene therapies and stem cell regeneration, require therapeutics to be introduced to the subretinal space due to poor diffusion to the active component of the retina. Subretinal injections are a difficult and risky surgical procedure and have been suggested as a candidate for robot-assisted surgery. We propose a different actuation paradigm to existing robotic approaches using remote magnetic navigation to control a flexible microcannula. A flexible cannula allows for high dexterity and considerable safety advantages over rigid tools, while maintaining the benefits of micrometer precision, hand tremor removal, and telemanipulation. The position of the cannula is tracked in real-time using near-infrared tip illumination, allowing for semi-automatic placement of the cannula and an intuitive user interface. Using this tool, we successfully performed several subretinal injections in ex-vivo porcine eyes under both microscope and optical coherence tomography visualization.
视网膜疾病，包括年龄相关性黄斑变性，是全球范围内导致视力丧失的主要原因。由于难以扩散到视网膜的活跃部位，新的治疗方法，如基因疗法和干细胞再生，需要将治疗药物引入到视网膜下腔。视网膜下注射是一种困难且有风险的手术，已经被提议作为机器人辅助手术的候选方法。我们提出了一种与现有机器人方法不同的驱动范例，使用远程磁导航来控制柔性微管。柔性微管允许高度灵活，并具有比刚性工具更大的安全性优势，同时保持微精度、去除手部震颤和远程操作的优势。微管的位置使用近红外尖端照明进行实时跟踪，允许半自动放置微管和直观的用户界面。使用这个工具，我们在显微镜和光学相干断层扫描可视化下成功地在离体猪眼上进行了几次视网膜下注射。
