Robotic Vitreoretinal Surgery

Purpose: To review the current literature on robotic assistance for ophthalmic surgery, especially vitreoretinal procedures. Methods: MEDLINE, Embase, and Web of Science databases were searched from inception to August, 2016, for articles relevant to the review topic. Queries included combinations of the terms: robotic eye surgery, ophthalmology, and vitreoretinal. Results: In ophthalmology, proof-of-concept papers have shown the feasibility of performing many delicate anterior segment and vitreoretinal surgical procedures accurately with robotic assistance. Multiple surgical platforms have been designed and tested in animal eyes and phantom models. These platforms have the capability to measure forces generated and velocities of different surgical movements. "Smart" instruments have been designed to improve certain tasks such as membrane peeling and retinal vessel cannulations. Conclusion: Ophthalmic surgery, particularly vitreoretinal surgery, might have reached the limits of human physiologic performance. Robotic assistance can help overcome biologic limitations and improve our surgical performance. Clinical studies of robotic-assisted surgeries are needed to determine safety and feasibility of using this technology in patients.