Sclera Force Evaluation During Vitreoretinal Surgeries in Ex Vivo Porcine Eye Model.

Abstract

Vitreoretinal surgery is among the most challenging microsurgical procedures as it requires precise tool manipulation in a constrained environment, while the tool-tissue interaction forces are at the human perception limits. While tool tip forces are certainly important, the scleral forces at the tool insertion ports are also important. Clinicians often rely on these forces to manipulate the eyeball position during surgery. Measuring sclera forces could enable valuable sensory input to avoid tissue damage, especially for a cooperatively controlled robotic assistant that otherwise removes the sensation of these familiar intraoperative forces. Previously, our group has measured sclera forces in phantom experiments. However, to the best of our knowledge, there are no published data measuring scleral forces in biological (ex-vivo/in-vivo) eye models. In this paper, we measured sclera forces in ex-vivo porcine eye model. A Fiber Bragg Grating (FBG) based force sensing instrument with a diameter of ~900 μm and a resolution of ~1 mN was used to measure the forces while the clinician-subject followed retinal vessels in manual and robot-assisted modes. Analysis of measured forces show that the average sclera force in manual mode was 133.74 mN while in robot-assisted mode was 146.03 mN.