# Development of Teleoperated Robotic System for Remote Intraocular Microsurgery

## TL;DR

A robotic system for remote eye surgery is developed and tested, showing improved precision and safety compared to manual methods.

## Contribution

A teleoperated robotic system with micrometer-scale precision and remote center of motion design for intraocular microsurgery is developed and validated.

## Key findings

- Teleoperated system achieved nearly twice the first-attempt success rate in subretinal injections compared to manual surgery.
- The system successfully removed microscale intraocular foreign bodies in porcine eyes.
- Communication stability was validated in multicenter remote surgeries, including across the Qiongzhou Strait.

## Abstract

Microsurgery has revolutionized modern surgery through its precision and favorable outcomes, but it remains limited by operational difficulty and the scarcity of skilled surgeons. Advances in robotics and communication technology have enabled the development of robotic telesurgery, with the goal of eliminating healthcare disparities. However, insufficiencies regarding system precision, surgical image transmission quality, and operational latency have made remote microsurgery challenging, particularly in intraocular microsurgery. A teleoperated robotic system is presented, featuring micrometer‐scale precision and remote center of motion design, to ensure safety and flexibility within the confined operating space of the vitreous cavity. To validate its feasibility and safety, a randomized multicenter study is conducted involving in vivo subretinal injections in 51 pigmented rabbits. Surgeons using teleoperated system achieve nearly twice the first‐attempt success rate and significantly fewer surgical complications than manual surgery. Furthermore, the system's versatility is showcased by successfully removing microscale intraocular foreign bodies in 15 porcine eyes and the communication stability is validated in multicenter remote surgeries, including procedures across the Qiongzhou Strait. These findings establish the system's safety, reliability, and versatility for performing remote intraocular procedures, highlighting its potential of remote microsurgery to improve surgical outcomes and broaden access to specialized care.

A teleoperated robotic system, characterized by micrometer‐scale precision and a remote center of motion design, is developed and validated to ensure the safety and flexibility of remote intraocular surgery. This system exhibits superior performance in experimental evaluations and holds significant potential for advancing remote microsurgery—specifically, to enhance surgical outcomes and expand access to specialized ophthalmic care for underserved populations.