title: ESPRESSO: A novel device for laser-assisted surgery of the anterior eye segment.
abstract: BACKGROUND
  Merging robotics with laser eye surgery could enhance precision, repeatability and automation. During some eye laser procedures the patient is awake, thus eye stabilization is desired to avoid movements that could affect the treatment.
  
  
  METHODS
  The ESPRESSO platform has a two-stage actuation system to position a stabilization tool on the eye, a proximity sensing unit to monitor the stabilization tool position, and a sensing unit to monitor the pressure exerted on the eye. The platform is tested in-vitro and ex-vivo with clinicians. A maximum pressure to be exerted on the eye is defined with expert ophthalmic surgeons to be 22 mmHg: physiological intraocular pressure (IOP) range is 10-21 mmHg. This pressure corresponds to a force of 0.3 N.
  
  
  RESULTS
  The necessary contact force to have eye fixation (according to the clinicians' feedback) is evaluated: maximum values resulted always below 0.3 N. A maximum IOP increase of 4.67 mmHg is observed, that is a slight variation with respect to the performance of other platforms (IOP elevations up to 328 mmHg).
  
  
  CONCLUSIONS
  Design and initial assessment of the platform is presented. Eye stabilization is performed without exceeding the critical contact force value and causing large/sudden IOP increases.
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Sheila
authors.initials: S
authors.lastname: Russo
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Petroni
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Quaglia
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Niccolini
authors.affiliation: b Institute of Applied Physics "Nello Carrara", Italian National Research Council , Fiorentino ( FI ), Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rossi
authors.affiliation: c U.O. Oculistica, Nuovo Ospedale S. Stefano , Prato , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Menabuoni
authors.affiliation: b Institute of Applied Physics "Nello Carrara", Italian National Research Council , Fiorentino ( FI ), Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pini
authors.affiliation: d PhotobiolabResearch Unit, El.En. Group , Calenzano ( FI ), Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Fortuna
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Dario
authors.affiliation: a The BioRobotics Institute, Scuola Superiore Sant'Anna , Pisa , Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Menciassi
mesh_terms: D000869:Anterior Eye Segment / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: Eye stabilization; laser-assisted surgery; ophthalmic surgery; surgical robotics