Oxford University researchers have completed the first successful trial of robot-assisted retinal surgery.
The trial, involving 12 patients, was supported by the National Institute for Health Research Oxford Biomedical Research Centre and took place at Oxford’s John Radcliffe Hospital. The results have been published in the Nature Biomedical Engineering journal.
Oxford University signed an agreement with Preceyes, the Dutch medical robotics company that designed the PRECEYES Surgical System, in 2016. It was agreed that a team led by eye surgeon and researcher Professor Robert MacLaren would begin the human clinical trials of the product.
Of the 12 patients in the trial, six were randomly allocated robot-assisted surgery and the other half underwent standard manual surgery to remove a membrane from the back of the eye. The robot allowed the surgeon to perform the procedure with equal or better efficacy than in the traditional manual approach.
In the second phase of the trial, the robot was used to insert a fine needle under the retinas of three patients who needed blood to be dissolved in this location due to age-related macular degeneration. All of these patients experienced an improvement in their vision as a result.
Preceyes chief medical officer Professor Marc de Smet said: “The current trial demonstrated and confirmed the safety and precision of our design. Providing precision, accuracy and stability beyond human capabilities are pre-requisites to push the boundaries of existing surgeries and standardising current procedures.”
In six of the patients, the surgery involved the dissection of the epiretinal membrane and inner limiting membrane over the macula, as well as the injection of a recombinant tissue plasminogen activator under the retina to displace sight-threatening haemorrhage in three patients.
MacLaren said: “This is a huge leap forward for delicate and technically difficult surgery, which in time should significantly improve the quality and safety of this kind of operation. The trial also showed that the robot has great potential for extending the boundaries of what we can currently achieve.
“Our next step will be to use the robotic surgical device for precise and minimally traumatic delivery of a gene therapy to the retina, which will be another first-in-man achievement and is set to commence in early 2019.”