Real-Time Image-Guided Cooperative Robotic Assist Device for Deep Anterior Lamellar Keratoplasty

Published

Conference Paper

© 2018 IEEE. Deep anterior lamellar keratoplasty (DALK) is a promising technique for corneal transplantation that avoids the chronic immunosuppression comorbidities and graft rejection risk associated with penetrating keratoplasty (PKP), the standard procedure. In DALK, surgeons must insert a needle 90% through the 500 μm cornea without penetrating its underlying membrane. This pushes surgeons to their manipulation and visualization limits such that 59% of DALK attempts fail due to corneal perforation or inadequate needle depth. We propose a robot-assisted solution to jointly solve the manipulation and visualization challenges using a cooperatively-controlled, precise robot arm and live optical coherence tomography (OCT) imaging, respectively. Our system features an interface handle, with which the surgeon and robot cooperatively hold the tool, and a posterior corneal boundary virtual fixture driven by real-time OCT segmentation. A study in which three operators performed DALK needle insertions manually and cooperatively in ex vivo human corneas demonstrated an 84% improvement in perforation-free needle depth without an increased perforation rate.

Full Text

Duke Authors

Cited Authors

  • Draelos, M; Keller, B; Tang, G; Kuo, A; Hauser, K; Izatt, J

Published Date

  • September 10, 2018

Published In

Start / End Page

  • 4013 - 4018

International Standard Serial Number (ISSN)

  • 1050-4729

International Standard Book Number 13 (ISBN-13)

  • 9781538630815

Digital Object Identifier (DOI)

  • 10.1109/ICRA.2018.8463153

Citation Source

  • Scopus