Experimental Validation of a Robotic Comanipulation and Telemanipulation System for Retinal Surgery

Retinal Vein Occlusion is a common retinal vascular disorder which can cause severe loss of vision. Retinal vein cannulation is a promising treatment, but given the small diameter of retinal veins and the surgeon´s limited positioning precision, it is considered too risky to perform this procedure manually. The authors previously reported on the development of both a robotic comanipulation and telemanipulation system which have the potential to augment the surgeon´s positioning precision. This work investigates the potential benefit of these systems for retinal surgery. For this purpose, a targeting test setup was developed to quantify the attainable positioning precision one can expect when using the robotic systems during procedures like retinal vein cannulation. Ten subjects completed targeting tests in a free-hand, comanipulation and telemanipulation fashion. Results show that both the usage of the comanipulation and telemanipulation system significantly improve the positioning precision compared to a free-hand test. The telemanipulation system currently outperforms the comanipulation system with respect to precision, while subjects appreciate the remarkable ease of use of the comanipulation system.