OPHTHALMOLOGIC SURGERY (see Chapter
65
)
The challenge of creating a robot that is accurate and has an
extremely high level of dexterity and precision was mandated for laser retinal surgery.
Because blood vessels in the retina are only 25 µm apart, high precision is
necessary. Collaboration between Stephen Charles and the NASA Jet Propulsion Laboratory
developed a Robot-Assisted Microsurgery System (RAMS).[79]
It is capable of performing laser microsurgery with 10-µm accuracy. The unaided
human eye can discern an increment of only 200 µm. RAMS provides a 200-Hz
gating system for eye
tracking, and it eliminates the saccades of the eye, allowing the eye to appear perfectly
still to the observer. The system also provides a 100:1 scaling that allows for
10-µm incremental movements. Tremor is filtered out between 8 and 14 Hz to
eliminate inaccuracy. The ability to work at such small scales is the robot's strength.
Newer robotic devices intended for microsurgical application have an accuracy of
5 µm.[80]
Riviere and Jensen[81]
were able to cannulate a retinal vein to administer therapy for retinal vein thrombosis.
This would not be conceivable without the dexterity of robotic technology.
