Robotic Assisted Cannulation of Occluded Retinal Veins.
OBJECTIVE
To develop a methodology for cannulating porcine retinal venules using a robotic assistive arm after inducing a retinal vein occlusion using the photosensitizer rose bengal.


METHODS
Retinal vein occlusions proximal to the first vascular branch point were induced following intravenous injection of rose bengal by exposure to 532nm laser light delivered by slit-lamp or endolaser probe. Retinal veins were cannulated by positioning a glass catheter tip using a robotically controlled micromanipulator above venules with an outer diameter of 80μm or more and performing a preset piercing maneuver, controlled robotically. The ability of a balanced salt (BSS) solution to remove an occlusion by repeat distention of the retinal vein was also assessed.


RESULTS
Cannulation using the preset piercing program was successful in 9 of 9 eyes. Piercing using the micromanipulator under manual control was successful in only 24 of 52 attempts, with several attempts leading to double piercing. The best location for cannulation was directly proximal to the occlusion. Infusion of BSS did not result in the resolution of the occlusion.


CONCLUSIONS
Cannulation of venules using a robotic microassistive arm can be achieved with consistency, provided the piercing is robotically driven. The model appears robust enough to allow testing of therapeutic strategies aimed at eliminating a retinal vein thrombus and its evolution over time.
MicroInvasive Ocular Surgery Center (MIOS sa), Lausanne, Switzerland.|Preceyes nv, Einhoven, The Netherlands.
Marc D
http://orcid.org/0000-0002-9217-5603
MD
de Smet
Preceyes nv, Einhoven, The Netherlands.
Thijs C M
TC
Meenink
ThromboGenics nv, Leuven, Belgium.
Tom
T
Janssens
ThromboGenics nv, Leuven, Belgium.
Valerie
V
Vanheukelom
Preceyes nv, Einhoven, The Netherlands.
Gerrit J L
GJ
Naus
Preceyes nv, Einhoven, The Netherlands.
Maarten J
MJ
Beelen
Medanex Clinic BVBA, Diest, Belgium.
Caroline
C
Meers
ThromboGenics nv, Leuven, Belgium.
Bart
B
Jonckx
Crystapharm BVBA, Lubbeek, Belgium.
Jean-Marie
JM
Stassen
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