Real-time Deformation-aware Control for Autonomous Robotic Subretinal Injection under iOCT Guidance

TL;DR

This paper introduces a real-time, deformation-aware control method for autonomous robotic subretinal injections guided by iOCT, significantly improving accuracy and success rates in ex vivo experiments by accounting for tissue deformation during procedures.

Contribution

The paper presents a novel real-time segmentation and 3D reconstruction technique using B${^5}$-scans to monitor tissue deformation, enabling dynamic adjustment of needle insertion in autonomous subretinal injections.

Findings

Achieved 90% success rate in subretinal bleb generation, surpassing previous 35%.

Demonstrated improved accuracy in needle positioning during ex vivo experiments.

Enabled real-time tissue deformation monitoring and adjustment during robotic injections.

Abstract

Robotic platforms provide consistent and precise tool positioning that significantly enhances retinal microsurgery. Integrating such systems with intraoperative optical coherence tomography (iOCT) enables image-guided robotic interventions, allowing autonomous performance of advanced treatments, such as injecting therapeutic agents into the subretinal space. However, tissue deformations due to tool-tissue interactions constitute a significant challenge in autonomous iOCT-guided robotic subretinal injections. Such interactions impact correct needle positioning and procedure outcomes. This paper presents a novel method for autonomous subretinal injection under iOCT guidance that considers tissue deformations during the insertion procedure. The technique is achieved through real-time segmentation and 3D reconstruction of the surgical scene from densely sampled iOCT B-scans, which we refer to as B${^5}$-scans. Using B${^5}$-scans we monitor the position of the instrument relative to a virtual target layer between the ILM and RPE. Our experiments on ex vivo porcine eyes demonstrate dynamic adjustment of the insertion depth and overall improved accuracy in needle positioning compared to prior autonomous insertion approaches. Compared to a 35% success rate in subretinal bleb generation with previous approaches, our method reliably created subretinal blebs in 90% our experiments.