Eye surgeons at University Hospitals Leuven in Belgium have successfully used a surgical robot to treat the cause of retinal vein occlusion.
Patients with retinal vein occlusion have a blood clot in one of the retinal veins. This leads to reduced eye sight or even blindness in the affected eye. Treatment currently consists of monthly injections in the eye to reduce the side effects of the thrombosis. Until recently, removing the blood clot itself was not possible. This is because the retinal vein is just 0.1 mm wide – similar to a human hair – making it impossible for a surgeon to manually insert an injection and hold it in place for 10 minutes while the medicine is released to dissolve the clot.
Researchers from the KU Leuven Department of Mechanical Engineering developed the robotic device that enables the surgeon to insert the needle into the veins in a very precise and stable way.
They also developed the needle, which is barely 0.03 millimetre – three times thinner than a human hair – to inject a thrombolytic drug into the patient’s retinal vein.
We are extremely proud that our robot enables us to perform eye surgery that was previously impossible to perform safely
Unlike most surgical robots, there is no need for a joystick to operate the device. The eye surgeon and the robot co-manipulate the instrument. The surgeon guides the needle into the vein while the robot eliminates any vibration of the needle, thereby increasing the level of precision more than tenfold. After locking the robot, the needle and the eye are automatically stabilised. The surgeon can then inject the product into the vein in a controlled way.
The robot is the result of seven years of research and a collaboration between KU Leuven engineers and University Hospitals Leuven ophthalmologists. The procedure was performed on a University Hospitals Leuven patient on 12 January 2017 and according to a statement, the patient is doing well and can now start working on the rehabilitation of the eye.
“The current treatment for retinal vein occlusion costs society EUR€32.000 per eye (approximately AU$45,000),” said Professor Peter Stalmans, eye surgeon at University Hospitals Leuven. “This is a high price tag, considering that you’re only treating the side effects and that there is little more you can do than avoid reducing eyesight. The robotic device finally enables us to treat the cause of the thrombosis in the retina. I look forward to what is next: if we succeed, we will literally be able to make blind people see again.”
“We are extremely proud that our robot enables us to perform eye surgery that was previously impossible to perform safely,” said Professor Dominiek Reynaerts from the KU Leuven Department of Mechanical Engineering. “This brings us one step closer to commercialising this ground-breaking technology. We look forward to making other revolutionary procedures possible with this robotic device and to improving the quality of existing surgical treatments.”
The aim of the current phase 1 trial was to demonstrate that it is technically feasible to use a robotic device to insert a microneedle into the retinal vein and to inject Ocriplasmin to dissolve the blood clot. In a subsequent phase 2 trial the researchers will study the clinical effects of the procedure.
Worldwide there are 16.4 million people with a blocked retinal vein caused by thrombosis in the blood vessel.