Automated Retinal Photocoagulation Using Instrument-Integrated OCT and Laser Pattern Mapping
Marius Briel, Ludwig Haide, Dongyue Wu, Justus Hornstein, Philipp Matten, Nicola Piccinelli, Gernot Kronreif, Eleonora Tagliabue
Abstract
Retinal endolaser photocoagulation (REPC) is a repetitive intraocular surgical procedure that could greatly benefit from automation and distance-based control, improving both efficiency and safety. This work presents a robotic system designed for automated REPC, utilizing instrument-integrated optical coherence tomography (iiOCT) to facilitate real-time distance measurements. The system employs intraoperative spherical and ellipsoidal retinal models to convert 2D laser patterns into 3D arrangements, which are further refined through a control loop that incorporates online feedback. Ex vivo experiments in porcine eyes demonstrated clinical-level accuracy, with lateral and axial errors of 44 micrometers and 29 micrometers, respectively. Additionally, the proposed mapping technique produced patterns with greater equidistance than baseline methods. This system showcases the potential to automate repetitive surgical tasks while maintaining the surgeon's control over critical decision-making processes in ophthalmic surgery.