Oblique injection depth correction by a two parallel OCT sensor guided handheld SMART injector

Biomechanical considerations for optimising subretinal injections

Subretinal injection is the preferred delivery technique for various novel ocular therapies and is widely used because of its precision and efficient delivery of gene and cell therapies; however, choosing an injection point and defining delivery parameters to target a specified retinal location and area is an inexact science. We provide an overview of the key factors that play important roles during subretinal injections to refine the technique, enhance patient outcomes, and minimise risks. We describe the role of anatomical and physical variables that affect subretinal bleb propagation and shape and their impact on retinal integrity. We highlight the risks associated with subretinal injections and consider strategies to mitigate reflux and retinal trauma. Finally, we explore the emerging field of robotic assistance in improving intraocular manouvrability and precision to facilitate the injection procedure.

Development and ex-vivo validation of 36G polyimide cannulas integrating a guiding miniaturized OCT probe for robotic assisted subretinal injections

We introduced and validated a method to encase guiding optical coherence tomography (OCT) probes into clinically relevant 36G polyimide subretinal injection (SI) cannulas. Modified SI cannulas presented consistent flow capacity and tolerated the typical mechanical stress encountered in clinical use without significant loss of sensitivity. We also developed an approach that uses a micromanipulator, modified SI cannulas, and an intuitive graphical user interface to enable precise SI. We tested the system using ex-vivo porcine eyes and we found a high SI success ratio 95.0% (95% CI: 83.1-99.4). We also found that 75% of the injected volume ends up at the subretinal space. Finally, we showed that this approach can be applied to transform commercial 40G SI cannulas to guided cannulas. The modified cannulas and guiding approach can enable precise and reproducible SI of novel gene and cell therapies targeting retinal diseases.

Enhanced location tracking in sensor fusion-assisted virtual reality micro-manipulation environments

Virtual reality (VR) technology plays a significant role in many biomedical applications. These VR scenarios increase the valuable experience of tasks requiring great accuracy with human subjects. Unfortunately, commercial VR controllers have large positioning errors in a micro-manipulation task. Here, we propose a VR-based framework along with a sensor fusion algorithm to improve the microposition tracking performance of a microsurgical tool. To the best of our knowledge, this is the first application of Kalman filter in a millimeter scale VR environment, by using the position data between the VR controller and an inertial measuring device. This study builds and tests two cases: (1) without sensor fusion tracking and (2) location tracking with active sensor fusion. The static and dynamic experiments demonstrate that the Kalman filter can provide greater precision during micro-manipulation in small scale VR scenarios.