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Optical Coherence Tomography Guided Robotic Device for Autonomous Needle Insertion in Cornea Transplant Surgery

机译:基角膜移植手术中自主针插入的光学相干断层扫描机器人装置

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This paper reports the design and evaluation of a novel robotic device for cornea transplant surgery. The device enables the OCT-sensor guided Big Bubble hydro-dissection approach for deep anterior lamellar keratoplasty (DALK) cornea transplant surgery. DALK is highly challenging because it requires precise placement of a needle into the stroma of the cornea down to Descemets Membrane (DM) and injects a fluid to separate the remaining stroma from Descemet's membrane. Finally, the stroma is removed and replaced with the donor cornea graft. Compared to traditional penetrating keratoplasty (PK), which involves a full-thickness graft, this method significantly reduces the risk of rejection of the donor cornea by keeping the DM intact. A comparison of autonomous OCT guided needle insertions with expert manual needle insertions showed that the device significantly increased the precision and consistency of the needle placement, which could lead to better visual outcomes and fewer complications. In a study on cadaver porcine eyes, the measured insertion depth as a percentage of cornea thickness for the robotic device was 90.05% +/- 2.33% compared to 79.16% +/- 5.68% for manual insertions.
机译:本文报道了角膜移植手术新型机器人装置的设计和评价。该装置使OCT传感器引导的深泡型水电剖面术(DALT)角膜移植手术。 DALK具有高度挑战性,因为它需要将针精确地放入角膜的基质中以去除膜(DM)并注射流体以将其余的基质与DESCEMET的膜分离。最后,除去基质并用供体角膜移植物替换。与传统的穿透角膜形成术(PK)相比,这涉及全厚移植物,这种方法通过保持DM完整来显着降低供体角膜抑制的风险。具有专家手动针插入的自主OCT引导针插入的比较表明,该器件显着提高了针放置的精度和一致性,这可能导致更好的视觉结果和更少的并发症。在尸体猪眼的研究中,测量的插入深度作为机器人器件的角膜厚度的百分比为90.05%+/- 2.33%,而手动插入的79.16%+/- 5.68%。

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