A soft micron accuracy robot design and clinical validation for retinal surgery

Abstract Retinal surgery is one of the most delicate and complex operations, which is close to or even beyond the physiological limitation of the human hand. Robots have demonstrated the ability to filter hand tremors and motion scaling which has a promising output in microsurgery. Here, we present a novel soft micron accuracy robot (SMAR) for retinal surgery and achieve a more precise and safer operation. A remote center of motion (RCM) parallelogram structure with a double spring adaptive balancing mechanism is designed and optimized to achieve precise motion and safer operation. The deviation from the expected trajectory with manual operation and robot-assisted operation is 143.06 μm ± 91.27 μm vs 26.39 μm ± 13.22 μm, which has been significantly improved}. We evaluated the safety performance of SMAR in live animals. Furthermore, preliminary human clinical trials showed that the robot-assisted has less drift compared to the manual operation with 41.07 μm ± 20.78 μm vs 299.66 μm ± 85.84 μm. The visual acuity with LogMAR of cases showed higher improvement in the robot-assisted group preliminary, which for manual of 0.78 ± 0.44 vs robot-assisted 1.24 ± 0.70 with no statistically significant difference. This study provides promising options for robot-assisted with very experienced surgeons in the most challenging microsurgery. The system has the potential to effectively reduce the training curve of doctors and alleviate the shortage of ophthalmic surgeons, which is very important for rural areas and underdeveloped countries.