Intraocular Robotic Interventional and Surgical System for Automated Cataract Surgery

自动化白内障手术的眼内机器人介入手术系统

• 批准号: 10477475
• 负责人: Tsu-Chin TC Tsao
• 金额: $ 56.75万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10477475
• 关键词: Abate; Adopted; Affect; American; Anatomy; Anterior; Aqueous Humor; Automation; Cataract; Cataract Extraction; Clinical; Cornea; Custom; Development; Devices; Docking; Effectiveness; Engineering; Ensure; Environment; Equipment; Excision; Eye; Failure; Family suidae; Feedback; Freedom; Funding; Goals; Grant; Image; Implant; In Situ; Intervention; Intraocular Lens Implantation; Intraocular lens implant device; Iris; Lasers; Manuals; Mechanics; Meridians; Microscope; Modeling; Motion; Motivation; Noise; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Physiologic Intraocular Pressure; Polishes; Population; Positioning Attribute; Procedures; Regulation; Research; Risk; Risk Reduction; Robotics; Rupture; Safety; Scanning; Science; Signal Transduction; Structure; Surface; Surgeon; Surgical Instruments; Surgical complication; Surgical incisions; System; Technology; Time; Tissues; Translating; United States National Institutes of Health; Vision; Visualization; Visualization software; aged; capsule; cost; design; follow-up; image guided; imaging probe; implantation; improved; innovation; instrument; lens; ocular imaging; pressure; real-time images; robot control; robotic system; success; surgery outcome; surgical risk; tool

PROJECT SUMMARY/ABSTRACT The long-term goals of the present study are to improve surgical outcomes and reduce the risk of surgical complications of cataract surgery. It is our central hypothesis that intraoperative stabilization of the ocular structures, complete lens extraction, and accurate positioning of the intraocular lens implant through robotic manipulations and optical coherence tomography (OCT) feedback will significantly improve the safety of critical surgical steps in cataract surgery. Through improvements in visualization and tool control, we theorize that the risk of secondary cataracts, posterior capsule rupture, ametropia, and other surgical complications can be eliminated to improve safety and abate the costs associated with cataract surgery and follow-up procedures. Our main objective is to develop the technology necessary to realize per-operative stabilization and imaging of ocular structures, complete lens extraction, and accurate positioning of the intraocular lens implant. Our group has developed the Intraocular Robotic Intervention and Surgical System (IRISS) to perform semi- automated cataract surgery on ex-vivo pig eyes [1–7] through a combination of internal funding and a recent R21 grant (NIH/R21EY024065). Through transpupillary OCT-guided automation, the IRISS has achieved notable success in semi-automated cataract extraction. There are three independent specific aims. First, to control the surgical environment and improve intraocular imaging quality, an integrated docking apparatus will constrain the eyeball motion and limit the motion of intraocular tissues through intraocular pressure control while allowing tool access for intraocular manipulations. Second, complete lens extraction will be enabled by an intraocular OCT imaging probe; precise feedback control of the tool mounted and driven by the IRISS; and the real-time visualization of the iris, cornea, and entire lens (including its posterior capsule and equator). Third, the ability to intraoperatively sense and control the intraocular lens six degrees-of-freedom position and orientation will be realized through a new custom tool guided by the transpupillary and intraocular OCT feedback. It is important to note that while the ultimate goal is the integration of all three aims into an automated system, their development remains independent and success or failure in one does not affect the outcome of another. The proposed contribution is significant because it offers to eliminate several common complications of cataract surgery including posterior capsule rupture, secondary cataracts, and ametropia. The proposed research is innovative because of its development of (1) a pressure-regulated docking device that stabilizes intraocular tissue while allowing the access of intraocular tool and improved quality of per-operative imaging, (2) visualization of the lens equator through an intraocular OCT probe and real-time image guided robotic instrument control for complete lens extraction and capsule cleaning, and (3) robotic control over the intraocular lens implantation and positioning of the intraocular lens.

项目概要/摘要 本研究的长期目标是改善手术结果并降低手术风险 我们的中心假设是白内障手术的术中稳定性。 结构、完整的晶状体提取以及通过机器人精确定位人工晶状体植入物 操作和光学相干断层扫描（OCT）反馈将显着提高关键的安全性 通过改进可视化和工具控制，我们推测白内障手术的手术步骤。 继发性白内障、后囊膜破裂、屈光不正和其他手术并发症的风险 消除白内障手术和后续程序的相关费用，以提高安全性并降低成本。 我们的主要目标是开发实现术中稳定和成像所需的技术 眼部结构、完整的晶状体取出以及人工晶状体植入物的精确定位。 我们小组开发了眼内机器人介入手术系统（IRISS）来进行半手术 通过内部资金和最近的一项研究相结合，对离体猪眼进行自动化白内障手术[1-7] R21 资助 (NIH/R21EY024065)。通过经瞳孔 OCT 引导的自动化，IRISS 已经实现了。 在半自动白内障摘除术方面取得了显着的成功。 有三个独立的具体目标：第一，控制手术环境和改善眼内情况。 成像质量，集成对接装置将约束眼球运动并限制眼球运动 通过眼内压控制来控制眼内组织，同时允许使用工具进行眼内操作。 其次，通过眼内 OCT 成像探头实现完整的晶状体提取； 控制由 IRISS 安装和驱动的工具；以及虹膜、角膜和虹膜的实时可视化； 整个晶状体（包括其后囊和赤道）第三，术中感知和控制的能力。 人工晶状体的六自由度位置和方向将通过新的定制工具实现 值得注意的是，虽然最终目标是由经瞳孔和眼内 OCT 反馈引导。 将所有三个目标集成到一个自动化系统中，它们的开发保持独立并且 一个人的成功或失败并不影响另一个人的结果。 拟议的贡献意义重大，因为它消除了一些常见的并发症 白内障手术包括后囊膜破裂、继发性白内障和屈光不正。 研究具有创新性，因为它开发了 (1) 一种能够稳定压力的对接装置 眼内组织，同时允许使用眼内工具并提高术中成像的质量， (2) 通过眼内 OCT 探头和实时图像引导机器人实现晶状体赤道的可视化 用于完成晶状体提取和胶囊清洁的仪器控制，以及（3）机器人控制 人工晶状体植入和人工晶状体定位。