Robotic-assisted surgery offers more precision in retinal delivery, but time constraints may hinder success
Robotic-assisted surgery provided high precision positioning in retinal delivery but takes more time than manual surgery, according to a presentation by Richard B. Rosen, MD, DSc(Hon) at the 2020 ASRS Virtual Meeting.
In an in vitro model using porcine eyes, a standard pars plana vitrectomy with IOP control under microscopic visualization through a Rescan 700 Zeiss device was performed, followed by subretinal injection using a 41G Teflon needle with or without robotics (Preceyes Surgical System).
When using manual or robotic assistance, no breech of Bruch’s membrane was observed, however, static positioning in the subretinal space resulted in repeat contact with Bruch’s membrane when done manually due to physiologic hand tremor.
Eighty percent of robotic-assisted surgeries were successful, with 100% bleb creation and leakage in 20% at the time of retraction. In only 40% of cases during manual surgery was a bleb successfully created. In addition, leakage was observed in all cases, and at all stages of bleb initiation, injection and retraction of the needle.
Dr Rosen notes however that bleb creation took longer with robotic-assisted surgery, which may hinder its success.
Rosen R, et al. Time independence, optimized surgical steps – the promise of robotics. Presented at: 2020 ASRS Virtual Meeting.