Eyeworld

EW NEWS & OPINION 32 April 2017 ulate the instrument. The surgeon maintains direct control and guides the needle into the vein, while the robot eliminates any vibration of the needle. This increases the level of precision more than 10-fold. The precision enhancement is obtained by offering stabilization of the sur- geon's hand, the patient's eye, and the surgical instrument. Ultrathin injection needle After locking the robot, the needle and the eye are automatically stabi- lized. The surgeon can then inject the ocriplasmin (Jetrea, Thrombo- Genics, Iselin, New Jersey) into the vein in a controlled way. In addition to the robot, researchers developed an ultrathin injection needle. The needle they developed has a width of 0.03 mm, which is three times thinner than a human hair. KU Leuven engineers and University Hospitals Leuven oph- thalmologists collaborated for 7 years to develop this robot, which is currently in a Phase 1 trial that aims to demonstrate that it is technically feasible to use a robotic device to insert a microneedle into the retinal vein and to inject ocriplasmin to dissolve the blood clot. On January 12, 2017, the proce- dure was performed for the first time on a University Hospitals Leuven patient. This patient is doing well and is undergoing rehabilitation of the eye. In a subsequent Phase 2 tri- al, researchers will study the clinical effects of the procedure. "We are proud that our robot enables us to perform eye surgery that was previously impossible to perform safely. This brings us one step closer to commercializing this ground-breaking technology. We look forward to making other revo- lutionary procedures possible with this robotic device and to improving the quality of existing surgical treat- ments," said KU Leuven's Dominiek Reynaerts, PhD, in a statement. EW Editors' note: Dr. Stalmans has finan- cial interests with ThromboGenics. Dr. Reynaerts has no financial interests related to his comments. Contact information Stalmans: peter.stalmans@uzleuven.be Reynaerts: dominiek.reynaerts@kuleuven.be by Michelle Stephenson EyeWorld Contributing Writer Hospitals Leuven, said in a press release statement. Addressing the cause of RVO Retinal vein cannulation is a revolu- tionary treatment that addresses the cause of RVO by removing the blood clot in the retinal vein. It requires the eye surgeon to insert an ultra- thin needle into the vein and inject ocriplasmin, which can dissolve the blood clot. This requires extreme precision, because the retinal vein is only about 0.1 mm wide, about the same width as a human hair. Surgeons are unable to hold the nee- dle perfectly still for 10 minutes to manually inject a drug into such a thin vein. The risk of damaging the vein or the retina is too high. For this reason, researchers from the department of mechanical engi- neering of the KU Leuven developed a robotic device that enables sur- geons to insert a needle into these veins in a precise and stable manner, after which the robot can hold the needle perfectly still. Unlike most surgical robots, no joystick is need- ed to operate this robot. The eye surgeon and the robot co-manip- Phase 2 trial is needed to show the clinical effect for patients with RVO. Patients with RVO experience a blood clot in one of the reti- nal veins, which leads to reduced eyesight or even blindness in the affected eye. Treatment consists of monthly injections in the eye, which only reduce the side effects of the thrombosis. Until recently, eliminating the blood clot itself was not possible. Worldwide, there are 16.4 million people with a blocked retinal vein caused by thrombosis in the blood vessel. "Current treatment for retinal vein occlusion costs €32,000 per eye [about $33,948 U.S. dollars], a high price tag, especially if you know that you are only treating the side effects and that there is little more you can do than avoid decreasing eyesight. The robotic device enables us to treat the cause of the thrombosis in the retina for the first time. I am, therefore, looking forward to what is next. If we succeed, we will literally be able to make blind people see again," Peter Stalmans, MD, PhD, an eye surgeon at the University Researchers at University Hospitals Leuven and KU Leuven, with the help of a specially designed robot, are the first to successfully remove a clot from a blood vessel in the retina of a patient with RVO B elgian surgeons at the University Hospitals Leu- ven are the first to operate using a surgical robot on a patient with retinal vein occlusion (RVO). The robot, which is operated by an eye surgeon, uses a tiny needle (0.03 mm) to inject a thrombolytic drug into the patient's retinal vein. The KU Leuven (Uni- versity of Leuven, Leuven, Belgium) developed the robot and needle specifically for the procedure, which is called retinal vein cannulation. This procedure demonstrates that it is technically possible to safely dissolve a blood clot from the retinal vein with robotic support. A Robot injects drug into retinal vein The robot, which is operated by an eye surgeon, uses a tiny needle (0.03 mm) to inject a thrombolytic drug into the patient's retinal vein. Source: Dominiek Reynaerts, PhD

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