Toward Improving Patient Safety and Surgeon Comfort in a Synergic RobotAssisted Eye Surgery: A Comparative Study When robotic assistance is present into vitreoretinal surgery, the surgeon will experience reduced sensory input that is otherwise derived from the toolxe2x80x99s interaction with the eye wall (sclera). We speculate that disconnecting the surgeon from this sensory input may increase the risk of injury to the eye and affect the surgeonxe2x80x99s usual technique. On the other hand, robot autonomous motion to enhance patient safety might inhibit the surgeons tool manipulation and diminish surgeon comfort with the procedure. In this study, to investigate the parameters of patient safety and surgeon comfort in a robotassisted eye surgery, we implemented three different approaches designed to keep the scleral force in a safe range during a synergic eye manipulation task. To assess the surgeon comfort during these procedures, the amount of interference with the surgeons usual maneuvers has been analyzed by defining quantitative comfort metrics. The first two utilized scleral force control approaches are based on an adaptive force control method in which the robot actively counteracts any excessive force on the sclera. The third control method is based on a virtual fixture approach in which a virtual wall is created for the surgeon in the unsafe directions of manipulation. The performance of the utilized approaches was evaluated in user studies with two experienced retinal surgeons and the outcomes of the procedure were assessed using the defined safety and comfort metrics. Results of these analyses indicate the significance of the opted control paradigm on the outcome of a safe and comfortable robotassisted eye surgery.

Towards securing the sclera against patient involuntary head movement in robotic retinal surgery Retinal surgery involves manipulating very delicate tissues within the confined area of eyeball. In such demanding practices, patient involuntary head movement might abruptly raise tooltoeyeball interaction forces which would be detrimental to eye. This study is aimed at implementing different force control strategies and evaluating how they contribute to attaining sclera force safety while patient head drift is present. To simulate patient head movement, a piezoelectricactuated linear stage is used to produce random motions in a single direction in random time intervals. Having an eye phantom attached to the linear stage then an experienced eye surgeon is asked to manipulate the eye and repeat a mock surgical task both with and without the assist of the SteadyHand Eye Robot. For the freehand case, warning sounds were provided to the surgeon as auditory feedback to alert him about excessive slclra forces. For the robotassisted experiments two variants of an adaptive sclera force control and a virtual fixture method were deployed to see how they can maintain eye safety under head drift circumstances. The results indicate that the developed robot control strategies are able to compensate for head drift and keep the sclera forces under safe levels as well as the free hand operation.