Data and code from: Head-mounted surgical robots are an enabling technology for subretinal injections

Therapeutic protocols involving subretinal injection, which hold the promise of saving or restoring sight, are challenging for surgeons because they are at the limits of human motor and perceptual abilities. Excessive or insufficient indentation of the injection cannula into the retina, or motion of the cannula with respect to the retina, can result in retinal trauma or incorrect placement of the therapeutic product. Robotic assistance holds the promise of enabling the surgeon to more precisely position the injection cannula and maintain its position for a prolonged period of time. However, head motion is common among patients undergoing eye surgery, complicating subretinal injections, yet it is often not considered in the evaluation of robotic assistance. There exists no prior study that has both included head motion during an evaluation of robotic assistance and demonstrated a significant improvement in the ability to perform subretinal injections compared to the manual approach. In a hybrid ex/in vivo study, in which an enucleated eye is mounted on a human volunteer, we demonstrate that head-mounting a high-precision teleoperated surgical robot to passively reduce undesirable relative motion between the robot and the eye results in a bleb-formation success rate that is significantly higher than the manual success rates achieved by surgeons even in stationary enucleated eyes.

Methods
All images and videos are of ex vivo (i.e., post mortem) pig eyes. All videos are screen recordings of the Heidelberg Eye Explorer software, which is for use with the Heidelberg Spectralis optical coherence tomography (OCT) system. The screen-recording software used was Open Broadcaster Software (OBS).

The images used for estimating the durations of bleb expansion are video frames that were extracted from the screen recordings described above. The MATLAB Image Segmenter app was used to load the extracted video frames and highlight pixels that corresponded to part of a bleb formed via subretinal injection, and then the results were saved as .mat files.

The pressure data was collected using a pressure sensor (described in the journal article) connected to an Arduino Uno. The data was recorded on a computer running Windows 10 that the Arduino was connected to via a USB cable. CoolTerm, a serial port terminal software application, was used to record the data on the computer running Windows 10.