Here we proposed a designed, built, and evaluated 20G vertically inserted razor edge cannula (VIREC) robotic device guided by optical coherence tomography (OCT) for pneumatic dissection. The fiber sensor was glued inside the needle at a fixed offset of ~500 um. During the experiment, the robotic needle driver precisely moves the VIREC based on the surgeon input which is carefully monitored by the M-mode OCT system. Once the needle is inserted into the desired depth, the air is injected by the surgeon to separate stroma from Descemet’s membrane (DM). During in vivo study (N=8), the “big bubble” was effectively generated in six of eight eyes tested and DM was perforated in two eyes. This demonstrated the reliability and effectiveness of VIREC for “big bubble” DALK.
We reported a design and evaluation of an optical coherence tomography (OCT) sensor-integrated 27 gauge vertically inserted razor edge cannula (VIREC) for pneumatic dissection of Descemet’s membrane (DM) from the stromal layer. The VIREC was inserted vertically at the apex of the cornea to the desired depth near DM. The study was performed using ex vivo bovine corneas (N = 5) and rabbit corneas (N = 5). A clean penumodissection of a stromal layer was successfully performed using VIREC without any stomal blanching on bovine eyes. The “big bubble” was generated in all five tests without perforation. Only micro bubbles were observed on rabbit eyes. The results proved that VIREC can be an effective surgical option for “big bubble” DALK.
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