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Randomized Controlled Trial
. 2022 Dec;50(9):1057-1064.
doi: 10.1111/ceo.14174. Epub 2022 Oct 17.

Randomised controlled trial on robot-assisted versus manual surgery for pucker peeling

Koorosh Faridpooya  1 , Saskia H M van Romunde  1 , Sonia S Manning  1 , Jan C van Meurs  1 , Gerrit J L Naus  2 , Maarten J Beelen  2 , Thijs C M Meenink  2 , Jorrit Smit  2 , Marc D de Smet  2   3
Affiliations
Randomized Controlled Trial

Randomised controlled trial on robot-assisted versus manual surgery for pucker peeling

Koorosh Faridpooya et al. Clin Exp Ophthalmol. 2022 Dec.

Abstract

Background: The aim was to explore the feasibility and safety of performing common surgical steps in epiretinal membrane (ERM) peeling using the Preceyes Surgical System (PSS).

Methods: In a tertiary centre, 15 pseudophakic patients with an idiopathic ERM were randomised to robot-assistance or manual surgery in a 2:1 ratio. In the robot-assisted group, the following steps were performed using PSS: (1) staining the internal limiting membrane (ILM), (2) removal of the dye, (3) creating an ILM flap, (4) completing the peeling, (5) holding a light pipe and (6) fluid-air exchange. Primary outcome measures were feasibility and safety. Secondary outcome measures were duration, best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Moreover, the distance travelled by the instrument during peeling was assessed using motion tracking software.

Results: All steps performed with PSS were feasible with no clinical adverse events or complications. The surgical time was longer in the robot-assisted group (mean 56 min, SD = 12 vs. 24 min, SD = 5). During the study, the duration of robot-assisted surgeries decreased from 72 to 46 min. The distance travelled by the forceps was shorter in the robot-assisted group (mean 403 mm, SD = 186 vs. 550 mm, SD = 134). BCVA and CRT improved equally in both groups.

Conclusions: This is the world's first randomised controlled trial on robotic surgery for ERM. Although more time-consuming, we found that several surgical steps were feasible with assistance of the PSS.

Keywords: epiretinal membrane; retinal disease; surgical instruments; vitreoretinal surgery.

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References

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