iRAM!S is a research project focusing on the research and development of a robotic system for assisting ophthalmic surgeons to perform complex retinal surgeries with reduced tremor and higher precision.

Eye surgeons around the world have to deal with every day scenarios which demand high-precision manipulation of surgical devices. Fragility of the human eye anatomy and surgeon’s hand tremor make the treatment of certain ophthalmic ailments nearly impossible. Retinal Vein Occlusion (RVO) is one such disease without any generally approved surgical treatment. A promising treatment concept for RVO is injecting clot-dissolving drugs like tissue Plasminogen Activator (tPA) directly into the blocked vessel. However, due to the mentioned limitations, this procedure of placing the needle and holding the tip steadily during the injection process is practically impossible for human surgeons. Reports suggest that there are 16 million patients suffering from RVO. If not treated, it causes complete blindness. Few robotic research groups have developed manipulators to address this problem. However, an operation room compatible device is still an open issue.

In this project we are working on the design and development of a robotic device which 1) up-skills the manipulation capabilities of surgeons and 2) is compatible to conventional ophthalmic operation rooms. From the clinical point of view, our main goal is to treat patients with RVO. A robot with the ability of RVO treatment can be also used in various intraocular operations and provides new surgical abilities. Reaching our clinical goals will open the doors to our entrepreneurial objective which is entering the ophthalmic device market.

Based on 23G pars-plana vitrectomy equipment, an additional mounting device was designed to dock to the patient’s eye and provides stability during manipulation. The robot uses a novel kinematics consisting of 6 piezo motors (5 prismatic and 1 rotational). Table below illustrates the characteristics of the robot. According to the surgeons’ motion analysis data, these characteristics are sufficient for all ophthalmic procedures. The robot was designed with an adjustable RCM (remote center of motion) point which allows it to be configured for manipulating the tool pivoting around the insertion point.

Tool tip Precision	Working Volume	Tool Rotation	Linear Velocity	Angular Velocity	Robot Weight	Robot Size
5μm	50x50x50mm	360 deg	40 mm/s	1.11 rad/s	306 gm	185x44x226mm

This project is the flagship project of the Graduate School of Information Science in Health (GSISH) at the Technische Universitaet Muenchen. It is supervised by Prof. Dr.-Ing. Alois Knoll Director of Robotics and Embedded System Group, and Prof. Dr. med. Dr. (Lond.) Chris P. Lohmann Director of Ophthalmology Department, Klinikum Rechts der Isar, Munich. Currently two doctoral candidates, one postdoc and two eye surgeons are involved in the project. Strong collaborations with Johns Hopkins University, University of Tokyo and TU Eindhoven allow us to evaluate our achievements in different workspaces.