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

Mark Draelos, Brenton Keller, Gao Tang, Anthony Kuo, Kris Hauser, Joseph Izatt

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

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.

Original languageEnglish (US)
Title of host publication2018 IEEE International Conference on Robotics and Automation, ICRA 2018
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages4013-4018
Number of pages6
ISBN (Electronic)9781538630815
DOIs
StatePublished - Sep 10 2018
Externally publishedYes
Event2018 IEEE International Conference on Robotics and Automation, ICRA 2018 - Brisbane, Australia
Duration: May 21 2018May 25 2018

Publication series

NameProceedings - IEEE International Conference on Robotics and Automation
ISSN (Print)1050-4729

Conference

Conference2018 IEEE International Conference on Robotics and Automation, ICRA 2018
CountryAustralia
CityBrisbane
Period5/21/185/25/18

Keywords

  • Cooperative control
  • Medical robotics

ASJC Scopus subject areas

  • Software
  • Control and Systems Engineering
  • Artificial Intelligence
  • Electrical and Electronic Engineering

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  • Cite this

    Draelos, M., Keller, B., Tang, G., Kuo, A., Hauser, K., & Izatt, J. (2018). Real-Time Image-Guided Cooperative Robotic Assist Device for Deep Anterior Lamellar Keratoplasty. In 2018 IEEE International Conference on Robotics and Automation, ICRA 2018 (pp. 4013-4018). [8463153] (Proceedings - IEEE International Conference on Robotics and Automation). Institute of Electrical and Electronics Engineers Inc.. https://doi.org/10.1109/ICRA.2018.8463153