Distance-Based Shared Control for Vitreoretinal Surgery
Marius Briel, Dongyue Wu, Maximilian Hess, Ludwig Haide, Nicola Piccinelli, Gernot Kronreif, Marco Pellegrini, Eleonora Tagliabue
Abstract
The fragility of ocular tissues combined with the limited surgical workspace demands precise instrument control and focus, making sensor-integrated robotic systems a promising solution. In this paper, we introduce a surgical system for telemanipulated endolaser photocoagulation that leverages instrument-integrated optical coherence tomography (iiOCT) for accurate distance measurement. We have developed a controller that maintains a specified instrument-to-retina distance, complemented by haptic shared control to assist the ophthalmic surgeon throughout the procedure. We conducted a pilot study involving 12 participants, including an expert vitreoretinal surgeon, to evaluate the system's performance across three levels of user assistance. The distance-based controller demonstrated a significant improvement in axial precison compared to telemanipulated trials, achieving a mean error of 4 micrometers and a standard deviation of 69 micrometers across all subjects. Preliminary experiments conducted on porcine eyes confirmed the feasibility of our approach on ex vivo tissues.