title: Feasibility of telerobotic microsurgical repair of corneal lacerations in an animal eye model.
abstract: We evaluated the feasibility of telerobotic microsurgical repair of corneal lacerations. The telerobotic microsurgical device consisted of a Robotic Slave Micromanipulator Unit (RSMU) coupled to a Telepresence Surgical System (TeSS). Five mm central full-thickness corneal wounds were fashioned in five enucleated rabbit eyes and repaired remotely using the telerobotic system. Five additional eyes were also repaired by hand using a standard technique. The primary outcome measure was creation of a watertight seal. All eyes in both groups maintained an intraocular pressure (IOP) of 25 mm Hg without leak. The mean repair time was 80 min (range 50-130) with telerobotic surgery compared to 8 min (range 7-9) by hand. Histological evaluation showed that suture placement was similar in robotically assisted repair and manual repair. Subjectively, the telerobotic system provided adequate three-dimensional visualization of the surgical field. The study showed that a surgeon could close standardized corneal wounds using the telerobotic system. The potential benefits of remote eye surgery include improved access, surgical teleconsultation and telementoring.
authors.affiliation: Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. Michael.mines@na.amedd.army.mil
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mines
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
authors.forename: Brett
authors.initials: B
authors.lastname: Nelson
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Ward
authors.forename: David A
authors.initials: DA
authors.lastname: Belyea
authors.forename: Kenyon
authors.initials: K
authors.lastname: Kramer
authors.forename: Allen B
authors.initials: AB
authors.lastname: Thach
mesh_terms: D000818:Animals; D003315:Cornea / Q000601:surgery; D065306:Corneal Injuries; D005240:Feasibility Studies; D023421:Models, Animal; D011817:Rabbits; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome