Professor Robert MacLaren, professor of ophthalmology at the Universty of Oxford, used a rotely controlled robot to lift a mbrane 100th of a millimetre thick from the retina at the back of the right eye of a 70-year-old patient.The operation – said to be a ‘world first’ – was undertaken at the John Radcliffe Hospital in Oxford, UK, and Prof MacLaren was assisted by Dr Thomas Edwards, an Oxford Nuffield medical fellow who trained at the Royal Victorian Eye and Ear Hospital in Melbourne.The 70-year-old was said to be the first patient to ever undergo the experimental procedure, which was part of the Robotic Retinal Dissection Device (R2D2) trial. The trial was sponsored by the University of Oxford and funded by the NIHR Oxford Biomedical Research Centre with support from Oxford University Hospitals NHS Foundation Trust, which runs the John Radcliffe Hospital.According to a statent released by the Trust, the robot, which was developed by Dutch medical robotics firm Preceyes, was designed to eliminate unwanted trors in a surgeon’s hand – such as through their pulse – to enable tiny surgical manipulations to be safely carried out within the eye. The robot acts like a mechanical hand with seven independent, computer-controlled motors resulting in movents as precise as 1,000th of a millimetre in scale, the statent explained.A mbrane had grown on the surface of the patient’s retina which had contracted and pulled the retina into an uneven shape, distorting his vision. The mbrane needed to be dissected off the retina without damaging it, which a surgeon could usually achieve by slowing their pulse and timing movents between heartbeats. However, it was said the robot made this process far easier, while also making new, high-precision procedures currently beyond the reach of the human hand possible. The surgeon uses a joystick and touchscreen outside the eye to control the robot whilst monitoring its progress through the operating microscope. This gives the surgeon a notable advantage as significant movents of the joystick result in tiny movents of the robot, the Trust statent explained.While robots have been developed for large-scale surgery, such as in the abdomen, it was said that until now, no device has been available that was able to achieve the 3D precision required to operate inside the human eye.On completing the operation, Prof MacLaren said, There is no doubt in my mind that we have just witnessed a vision of eye surgery in the future. Current technology with laser scanners and microscopes allows us to monitor retinal diseases at the microscopic level, but the things we see are beyond the physiological limit of what the human hand can operate on. With a robotic syst, we open up a whole new chapter of eye operations that currently cannot be performed. The recent operation represented the first phase of the R2D2 trial. The second phase will assess how the robot can place a fine needle under the retina and inject fluid through it. This will help to develop novel surgical treatments for blindness, such as gene therapy and st cells, which need to be inserted under the retina with a high degree of precision, Prof MacLaren stated.
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