title: Telerobotic contact transscleral cyclophotocoagulation of the ciliary body with the diode laser.
abstract: To assess the feasibility of using the Robotic Slave Micromanipulator Unit (RSMU) to remotely photocoagulate the ciliary body for the treatment of glaucoma with the diode laser. In fresh unoperated enucleated human eyes, the ciliary body was destroyed either with a standard contact transscleral cyclophotocoagulation 'by hand' diode laser technique, or remotely using the RSMU. The treated sections were fixed in formalin, paraffin-embedded, and stained with hematoxylin and eosin. Histological evaluation was performed by a masked observer using a standardized grading system based on the amount of damage to the ciliary body to evaluate effectiveness of treatment. Both methods of contact transscleral cyclophotocoagulation showed therapeutic tissue disruption of the ciliary processes and both the non-pigmented and pigmented ciliary epithelium. Histology examination of remote robotic contact transscleral cyclophotocoagulation and "by hand" technique produced similar degrees of ciliary body tissue disruption. Remote diode laser contact transscleral cyclophotocoagulation of the ciliary body in fresh enucleated human eyes is possible with the RSMU. Therapeutic tissue disruption of the ciliary body was achieved. Additional study is necessary to determine the safety and efficacy of robotically-delivered cyclophotocoagulation in live eyes.
authors.affiliation: Department of Ophthalmology, Medical Faculty Associates, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 2A, Washington, DC, 20037, USA. dbelyea@mfa.gwu.edu.|Uniformed Services University of the Health Sciences, Bethesda, MD, USA. dbelyea@mfa.gwu.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Belyea
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA.|Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mines
authors.affiliation: Department of Ophthalmology, Medical Faculty Associates, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 2A, Washington, DC, 20037, USA.
authors.forename: Wen-Jeng
authors.initials: WJ
authors.lastname: Yao
authors.affiliation: Department of Ophthalmology, Medical Faculty Associates, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 2A, Washington, DC, 20037, USA.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Dan
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA.|The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
keywords: Ciliary Body; Cyclophotocoagulation; Glaucoma; Histopathology; Robotic Slave Micromanipulator Unit (RSMU); Robotic surgery; Telepresence Surgery System (TeSS)