Robotic Surgery in Ophthalmology

Innovations in ophthalmology have developed rapidly in recent years with the advent of small incision surgery and the engineering of more efficient phacoemulsification and vitrectomy machines(Georgescu, Kuo et al. 2008; Hubschman, Bourges et al. 2009). We feel that these latest developments lend themselves to the mechanization of ocular surgery, and the next major advancement in ophthalmology will probably be the integration of robotics. The potential benefits of robotic surgery in ocular surgery include increased precision, elimination of tremor, reduction of human error, task automation and the capacity for remote surgery. In increasing complexity and with distinct demands, ocular procedures can be grouped as extraocular surgery, intraocular anterior segment surgery, or intraocular posterior segment surgery. Intraocular surgery currently requires state of the art operating microscopes. Although the requirement of specialized microscopes and visualization systems presents a challenge to the adaptation of robotics in ocular surgery, robotic surgery has the capacity to include new visualization devices such as digital microscopy and/or endoscopy, which would be an advantage over conventional operating microscopes. The purpose of this chapter is to present the unique issues of ocular surgery in the application of robotics and to summarize the progress which has already been made towards the goal of robotic ocular surgery for clinical patient care. We will also discuss the previous and current ocular robotic prototypes and the utilization of surgical motion sensors to assess the mechanical requisites of eye surgery.