1
|
Xiao J, Chen J, Li M, Zhang L. Design and Experiment of an Ultrasound-Assisted Corneal Trephination System. Micromachines (Basel) 2023; 14:438. [PMID: 36838138 PMCID: PMC9966510 DOI: 10.3390/mi14020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/04/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
According to the advantages of ultrasonic vibration cutting, an ultrasound-assisted corneal trepanation robotic system is developed to improve the accuracy of corneal trephination depth and corneal incision quality in corneal trephination operations. Firstly, we analyzed the reasons for the difficulty in controlling the depth of trephination in corneal transplantations from the perspective of the biomechanical properties of the cornea. Based on the advantages of ultrasonic vibration cutting, we introduced an ultrasonic-vibration-assisted cutting method for corneal trephination and analyzed the cutting mechanism. Secondly, we described the surgical demands of corneal trephination and listed the design requirements of a robotic system. Thirdly, we introduced the design details of said system, including the system's overall structure, the ultrasound-assisted end effector, the key mechanisms of the robotic system, and the human-machine interaction interface. We designed the end effector based on ultrasonic vibration cutting and its eccentric adjustment system in an innovative way. Additionally, we then presented a procedure for robot-assisted corneal trephination. Finally, we performed several cutting experiments on grapes and porcine eyeballs in vitro. The results show that, compared with manual trephine, ultrasound-assisted corneal trephination has a better operation effect on the accuracy of corneal trephination depth and corneal incision quality.
Collapse
Affiliation(s)
- Jingjing Xiao
- College of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361024, China
| | - Jialong Chen
- College of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361024, China
| | - Mengqiong Li
- Affiliated Xiamen Eye Center, Xiamen University, Xiamen 361001, China
| | - Leiyu Zhang
- Beijing Key Laboratory of Advanced Manufacturing Technology, Beijing University of Technology, Beijing 100124, China
| |
Collapse
|
2
|
Li H, Chen M, Dong YL, Zhang J, Du XL, Cheng J, Gao H, Xie LX. Comparison of long-term results after manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty for keratoconus. Int J Ophthalmol 2020; 13:567-573. [PMID: 32399406 DOI: 10.18240/ijo.2020.04.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/07/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To compare long-term postoperative outcomes of manual and femtosecond assisted corneal trephination in deep anterior lamellar keratoplasty (FS-DALK) for keratoconus. METHODS In the retrospective study, 17 consecutive eyes that underwent vertical side cut incision FS-DALK and 22 eyes that underwent trephine incision DALK were collected over a 2-year period. Main measurements included postoperative uncorrected-visual acuity (UCVA), corrected distance visual acuity (CDVA), refractive sphere and cylinder, manifest refraction spherical equivalent (MRSE), flat and steep corneal keratometry (K1 and K2), endothelial cell density (ECD), and time of epithelium healing and suture removal. RESULTS Groups were comparable for diagnosis and preoperative visual acuity. Follow-up averaged 23mo (range, 12-36mo). At 12mo, the mean UCVA was better in the manual-DALK group (P=0.039), and the refractive sphere was lower in the FS-DALK group (P=0.040). MRSE between groups differed at 1, 6, and 12mo postoperatively (P=0.047, 0.025, 0.042, respectively). Mean CDVA, cylinder, K1, K2, corneal astigmatism, ECD, and time of epithelium healing were similar between groups. Stability of MRSE, ECD, and K1 returned sooner after FS-DALK. Initial loosened suture removal time was earlier in the manual-DALK group (P=0.042) while complete suture removal time was similar (P=0.122). CONCLUSION Manual and femtosecond assisted corneal trephination in DALK are options for advanced keratoconus. FS-DALK do not result in improved visual acuity but it is more stable during the follow-up period. FS-DALK in the present form show limited benefit, so surgical design and parameters still need to be optimized and explored.
Collapse
Affiliation(s)
- Hua Li
- Department of Ophthalmology, Qilu Medical College of Shandong University, Jinan 250012, Shandong Province, China.,Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Min Chen
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Yan-Ling Dong
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Jing Zhang
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Xian-Li Du
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Jun Cheng
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Hua Gao
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| | - Li-Xin Xie
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University&Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China
| |
Collapse
|