A surgical robot that can perform with hyper-precision, beyond what the human hand can perform, is being used to deliver gene therapy that may restore sight to the blind.
United Kingdom eye surgeon and University of Oxford professor Robert E. MacLaren has performed the first robotic retina surgery using a surgical robot designed in The Netherlands. He performed a procedure called a macular peel and then injected gene therapy into the retina.
The Robotics Retinal Dissection Device – cleverly dubbed R2D2 – is the subject of a trial at the University of Oxford involving 12 patients. Macular peels were the first operations retinal surgeons attempted with the robot before accomplishing the fine-needle injections of gene therapy into the retina.
“There is no doubt in my mind that we have just witnessed a vision of eye surgery in the future,” Prof. MacLaren said after completing the first macular peel. “Current technology with laser scanners and microscopes allows us to monitor retinal diseases at the microscopic level, but the things we see are beyond the physiological limit of what the human hand can operate on. With a robotic system, we open up a whole new chapter of eye operations that currently cannot be performed.
The robot access the surgical area in the eye through a tiny opening less than 1 mm in diameter. It uses seven independent, computer controlled motors to carry out hand movements as precise as 0.001 mm in scale. The surgeon uses a joystick and touchscreen at a control console to manipulate the robotic probe inside the eye, viewing the surgical area through the operating microscope.
The robot can be a breakthrough for delivering gene therapy to the back of the eye. This will help to develop novel surgical treatments for blindness, such as gene therapy and stem cell, which need to be inserted under the retina with a high degree of precision, Prof. MacLaren said.
Gene therapy may help those with retinitis pigmentosa and age-related macular degeneration which can cause blindness that until now was considered irreversible.