title: Robot-assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model.
abstract: OBJECTIVE
  To evaluate the feasibility of robot-assisted retinal vein cannulation for retinal vein occlusion.
  
  
  METHODS
  Prospective experimental study performed in in vivo porcine eyes. A standard three port pars plana vitrectomy was followed by laser-induced branch retinal vein occlusion. Consequently, a retinal vein cannulation with the help of a surgical robot and a microneedle was performed. Complete success was defined as a stable intravenous position of the needle tip confirmed by blood washout for at least 3 min. Secondary outcomes were the occurrence of intra-operative complications and technical failures.
  
  
  RESULTS
  Cannulation was successful in 15 of 18 eyes with a complete success rate (duration of infusion of more than 3 min) of 73% after exclusion of two eyes from analysis due to failure in establishing a blood clot. There were no technical failures regarding the robotic device. The intravessel injections of ocriplasmin in two of two eyes led to a clot dissolution. In a subset of five eyes, a second cannulation attempt at the border of the optic disc resulted in a stable intravessel position and infusion during 362 (±138) seconds.
  
  
  CONCLUSIONS
  Robot-assisted retinal vein cannulation with prolonged infusion time is technically feasible. Human experiments are required to analyse the clinical benefit of this new therapy.
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Willekens
authors.affiliation: Department of Mechanical Engineering, University of Leuven, Leuven, Belgium.
authors.forename: Andy
authors.initials: A
authors.lastname: Gijbels
authors.affiliation: Department of Mechanical Engineering, University of Leuven, Leuven, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Schoevaerdts
authors.affiliation: Department of Mechanical Engineering, University of Leuven, Leuven, Belgium.
authors.forename: Laure
authors.initials: L
authors.lastname: Esteveny
authors.affiliation: ThromboGenics NV, Leuven, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Janssens
authors.affiliation: ThromboGenics NV, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Jonckx
authors.affiliation: ThromboGenics NV, Leuven, Belgium.
authors.forename: Jean H M
authors.initials: JH
authors.lastname: Feyen
authors.affiliation: Medanex Clinic, Diest, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Meers
authors.affiliation: Department of Mechanical Engineering, University of Leuven, Leuven, Belgium.
authors.forename: Dominiek
authors.initials: D
authors.lastname: Reynaerts
authors.affiliation: Department of Mechanical Engineering, University of Leuven, Leuven, Belgium.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Vander Poorten
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Stalmans
mesh_terms: D000818:Animals; D002404:Catheterization / Q000379:methods*; D004195:Disease Models, Animal; D010865:Pilot Projects; D011446:Prospective Studies; D012169:Retinal Vein / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D013552:Swine; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*
keywords: ocriplasmin; retinal endovascular surgery; retinal vein cannulation; retinal vein occlusion; robot-assisted intra-ocular surgery