Eyeworld

EW NEWS & OPINION October 2017 27 Editors' note: Dr. Wagner has financial interests with Cambridge Consultants. Dr. Bourcier has no financial interests related to his comments. Consultants to build Axsis in a way that might not have been possible before. Axsis was also developed to include force-feedback, so the sur- geon manipulating the robot could sense the robot touching tissues and make decisions based on that feed- back, as if they were performing the surgery with their own hands. "The initial versions of surgical robots reused technology from larger industrial robotics, and their perfor- mance was sufficient so that large surgical robots made it to the mar- ket," Dr. Wagner said. But for all the aforementioned reasons, refinement of these systems for smaller, more delicate surgeries is needed. "We focused on some of the key aspects of the mechanism and the actuation for how to make a robot like this smaller," Dr. Wagner said. "We observed cataract surgery as a potential area to do this. Many challenges remain, however, in de- veloping this technology into a fully approved medical device while still respecting the top-level clinical need that these devices should be much smaller." In addition to tremor reduction and motion scaling, Dr. Wagner en- visioned that a robotic system with a computer coupled with information from real-time 3-D imaging technol- ogy such as OCT, for example, could be used to create "no-fly" zones for surgical safety benefits, such as the posterior capsule in cataract surgery. "The surgeon is in complete control of the robot, executing the motions … but then if the surgeon tries to accidentally command the robot to go past the back of the lens, that won't happen," he said. "We think that further research will bring about the specific im- provements necessary for broader robot use in eye microsurgery," Dr. Bourcier said. "It will also allow us to separate what is considered today a fantasy—fully automated micro- surgery—from what will become our next reality. The robolution is moving forward." EW References 1. Bourcier T, et al. Robotically assisted pterygium surgery: First human case. Cornea. 2015;34:1329–30. 2. Bourcier T, et al. Robotically assisted amniotic membrane transplant surgery. JAMA Ophthalmol. 2015;133:213–4. 3. Bourcier T, et al. Robot-assisted simulated cataract surgery. J Cataract Refract Surg. 2017;43:552–57. // INNOVATION MADE BY ZEISS Carl Zeiss Meditec, Inc. 800 342 9821 www.zeiss.com/med REL.9084 ©2017 Carl Zeiss Meditec, Inc. All copyrights reserved. Transforming your practice with technology that's easy on the eyes. ZEISS ReLEx SMILE ReLEx SMILE from ZEISS The fi rst minimally invasive laser vision correction solution ReLEx ® SMILE is the fi rst and only small incision lenticule extraction (SMILE) laser vision correction solution currently available. The VisuMax laser from ZEISS is the only femtosecond laser that can be used to perform SMILE in addition to creating LASIK fl aps. More options for you and your patients to SMILE about. www.zeiss.com/us/relex-smile Visit ZEISS at Booth 1919 during AAO 2017 to learn more. Contact information Bourcier: tristan.bourcier@chru-strasbourg.fr Wagner: richard.leyland@cambridgeconsultants.com

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