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Landmark robotic eye surgery trial a success

25/07/2018By Matthew Woodley
Researchers performing robot-assisted retinal surgery have achieved equal or in some cases better results than a control group of surgeons using the traditional approach.

The now complete world-first trial involved 12 patients and was supported by the National Institute for Health Research Oxford Biomedical Research Centre at the University of Oxford.

Oxford’s Professor Robert MacLaren led the trial, which he described as a “huge leap forward” for delicate and technically difficult surgery.

“In time [it] should significantly improve the quality and safety of this kind of operation. The trial also showed that the robot has great potential for extending the boundaries of what we can currently achieve,” MacLaren said.

“Our next step will be to use the robotic surgical device for precise and minimally traumatic delivery of a gene therapy to the retina, which will be another first-in-man achievement and is set to commence in early 2019.”

Professor Robert MacLaren
“Our next step will be to use the robotic surgical device for precise and minimally traumatic delivery of a gene therapy to the retina, which will be another first-in-man achievement.”
Professor Robert MacLaren, University of Oxford

Half of the patients in the trial, which took place at the university’s John Radcliffe Hospital, were randomly allocated robot-assisted surgery while the other half received standard manual surgery to remove a membrane from the back of the eye.

In the second phase of the trial, the team used the robot to insert a fine needle under the retina to dissolve blood in three patients with age-related macular degeneration (AMD). All patients reported improvement in vision following the procedures.

The trials were a result of a 2016 agreement between Oxford and Dutch medical robotic firm Preceyes BV, and surgeons utilised the company’s Robotic Retinal Dissection Device (R2D2) and the PRECEYES Surgical System to perform the operations.

“The current trial demonstrated and confirmed the safety and precision of our design,” Preceyes BV chief medical officer Professor Marc de Smet said. “Providing precision, accuracy, and stability beyond human capabilities are pre-requisites to push the boundaries of existing surgeries and standardising current procedures.”

The surgeries involved the dissection of the epiretinal membrane and inner limiting membrane over the macula, as well as the injection of a therapeutic drug (recombinant tissue plasminogen activator) under the retina to displace sight-threatening haemorrhage in three patients. The results of the trial were publsihed recently in Nature Biomedical Engineering.

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