ROBOT-ASSISTED EYE SURGERY

RESEARCH IN FOCUS

The eye is not only our most developed sense, but also by far the most fragile. Worldwide, an estimated 244 million people suffer from visual impairments and disorders for which there is currently no remedy. Many problems are related to the retina, the most sensitive part of the eye. Jonas Smits, researcher at Group T Leuven Campus, developed the technology that allows surgeons to perform eye operations with unprecedented precision. For his pioneering work, he was awarded the James Dyson Award.

More than 1,700 young researchers and inventors from 27 countries competed for the prestigious 2020 James Dyson Awards, named after the famous British inventor, designer, and entrepreneur. From the entries, the jury selected 81 national finalists. The Belgian winner was Jonas Smits, at that time a PhD student at the Robotics, Automation and Mechatronics research unit under Prof. Peter Slaets.

Jonas graduated in 2015 as a master in Electromechanical Engineering Technology, focus ‘Intelligent Mechanics’. Previously, he already obtained a professional bachelor’s degree at the then KH Kempen (now Thomas More - Geel). During his master thesis on hip prostheses, he discovered the wonderful world of biomechanics and Health Engineering and decided to delve deeper into it. Prof. Manu Vander Poorten of the RAM group promptly offered him a research project on robot-assisted surgery.

Jonas Smits

© Filip Van Loock

Microsurgery

“Eye surgery is by definition precision work,” says Jonas. “Retinal microsurgery is the best example of this. The retina consists of, among other things, 126 million sensory cells that catch the light that enters through the eye. These cells are shaped like cones and rods. The cones are occupied by pigmentary cells to perceive colour differences. The rods are used to distinguish light and dark. If you would compare it to digital signals, the retina has a bandwidth of 8.75 megabits per second. So, this is a very complex and delicate sense, which is why retinal surgery often reaches the limits of human precision.”

“Vitreoretinal surgery is a very challenging subspecialty in ophthalmology,” Jonas continues. “It is performed with the aid of a microscope and via hands that are probably already among the most stable in the world. But even then, unintentional movements such as hand tremors or eye rotations can throw a spanner in the works. As a result, some treatments are still limited or simply impossible to carry out. So, there is a need for performanceenhancing technology.

Challenge

In his research into safer treatment methods, Jonas faced three challenges. “First of all, you have to be able to stabilize the eye during the operation. Furthermore, the surgical precision must be increased. And - finally - you must also be able to immobilise the instrument itself. During my research, I had the opportunity to help make a world first in the field of robot-assisted retinal surgery possible. The surgeon succeeded in using a robot to insert a 30 micromillimeter infusion needle into a vein as thin as a hair”.

Jonas’ research uses three methods to optimise retinal microsurgery. The first consists of correcting the surgeon’s hand movements, if necessary, by using opposing forces. The second method involves preventing unwanted eye movements. This is done by a clever combination of connections and couplings. During movement these maintain a fixed point in space, through which the instrument always passes. Once the eye is aligned with the surgical incision, it is held in a stable position throughout the procedure. The third method enables the surgeon to immobilise the instrument at any time using a foot pedal that locks the mechanism.”

Promising

On 23 September 2020 - just over a month after the James Dyson Award - Jonas defended his thesis in the KU Leuven doctoral hall. Once again, the jury made no bones about its praise. “This work represents an important step forward in robot-assisted retinal movement. The initial results are promising and encourage further clinical research”, was the final verdict.

Yves Persoons