Researchers from the Nuffield Department of Clinical Neurosciences at the University of Oxford have completed the first successful trial of robot-assisted retinal surgery. Using the robot, the surgeon was able to perform the procedure with equal or better efficacy than with the traditional manual approach.

The trial, supported by the National Institute for Health Research Oxford Biomedical Research Centre, took place at Oxford’s John Radcliffe Hospital. It involved 12 patients and was published in Nature Biomedical Engineering. Half the patients were randomly allocated robot-assisted surgery and the other half had standard manual surgery to remove a membrane from the back of the eye. In the second phase of the trial, the team used the robot to insert a fine needle under the retina to dissolve blood in three patients who had age-related macular degeneration. All experienced an improvement in their vision as a result.

Robert MacLaren, Professor of Ophthalmology at the University of Oxford commented: “This is a huge leap forward for delicate and technically difficult surgery, which in time should significantly improve the quality and safety of this kind of operation. The trial also showed that the robot has great potential for extending the boundaries of what we can currently achieve. Our next step will be to use the robotic surgical device for precise and minimally traumatic delivery of a gene therapy to the retina, which will be another first-in-man achievement and will begin in early 2019.”

The surgery involved the dissection of the epiretinal membrane and inner limiting membrane over the macula, the central region of the retina responsible for fine visual acuity, in six of the patients, as well as the injection of a therapeutic drug (recombinant tissue plasminogen activator) under the retina to displace sight-threatening haemorrhage in three patients.