Autonomous Needle Navigation in Subretinal Injections via iOCT.

IEEE Robot Autom Lett

Department of Mechanical Engineering and the Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21211, USA.

Published: May 2024

Subretinal injection is an effective method for direct delivery of therapeutic agents to treat prevalent subretinal diseases. Among the challenges for surgeons are physiological hand tremor, difficulty resolving single-micron scale depth perception, and lack of tactile feedback. The recent introduction of intraoperative Optical Coherence Tomography (iOCT) enables precise depth information during subretinal surgery. However, even when relying on iOCT, achieving the required micron-scale precision remains a significant surgical challenge. This work presents a robot-assisted workflow for high-precision autonomous needle navigation for subretinal injection. The workflow includes online registration between robot and iOCT coordinates; tool-tip localization in iOCT coordinates using a Convolutional Neural Network (CNN); and tool-tip planning and tracking system using real-time Model Predictive Control (MPC). The proposed workflow is validated using a silicone eye phantom and porcine eyes. The experimental results demonstrate that the mean error to reach the user-defined target and the mean procedure duration are within an acceptable precision range. The proposed workflow achieves a 100% success rate for subretinal injection, while maintaining scleral forces at the scleral insertion point below 15mN throughout the navigation procedures.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10972538PMC
http://dx.doi.org/10.1109/lra.2024.3375710DOI Listing

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