Today is World Sight Day, which falls on the second Thursday of October. And in the UK, robots are providing new hope in delicate eye operations where a pair of steady hands is a must. The world's first such operation inside an eye took place at an Oxford hospital.
Like walking on a tightrope, operating within the eye is not a forgiving task. The smallest fault triggers failure.
This 70-year-old priest from the UK recently had a membrane lifted from one of his retinas. The tool was a pair of much safer "hands" from a robot. After years of struggling, he finally got his sight back.
"You say robot, we say assistant for the surgeon. We try to enhance the capabilities of the surgeon, so assist him in making really tiny small movements with high precision. It's 10 times more precise," said Gerrit Naus, chief operating officer.
William Beaver, a priest at St. Mary the Virgin Church from Oxford, describes his vision before the procedure, with a membrane growing over his retina. He said it's like looking in a hall of mirrors at a fairground. Last year, he was recruited for a research trial involving 12 patients. Each will have an eye operation done by the robot. What they could be lucky enough to see is a vision of the future of eye surgery.
Operating inside the eye requires 100 percent accuracy. Each throb of the heart and every pulse of blood can hinder surgeons. This makes taking the membrane off the retina without causing damage is tricky.
Professor McLaren, the doctor who performed the operation, said this experimental procedure was carried out by the Robotic Dissection Device. The remotely controlled robot can lift a membrane a hundredth of a millimeter thick, from the retina at the back of Beaver's right eye.
"The robot hand is completely still. The movement is so precise that when the door of the operation room opens, or if the patient breathes, we can see more movements than with the robot. So the robot will make the operation much much more precise," he said.
As the world's first robotic operation inside the eye, it potentially could revolutionize the way such conditions are treated.
The surgeons use a joystick and touchscreen to control the robot while monitoring its progress through the operating microscope.
The robot compensates for unwanted shakes of the surgeon's hands. And researchers are looking into other ways the robot can advance eye surgery in the future.
"I think it's going to do two things: It's going to open up the opportunities of doing new operations that we currently can't do, for instance, injecting gene therapy under the retina, or operations with stem cells. These are very precise, the surgery is not enough to deliver these new treatments, but with the robot system, we can," Professor Mclaren said.
"Other things we might do is to make common procedures safer and perhaps more consistent because all surgeons have a very good skill -- maybe we can operate a bit older when a bit shaky."
Professor McLaren says current technology with laser scanners and microscopes allows doctors to monitor retinal diseases at the microscopic level. But this level is beyond the physiological limit of what the human hand can operate on.
Now William Beaver is recovering with everything under control. Professor McLaren could use the robot to proceed with his experiment in retinal gene therapy, using it to place a fine needle under the retina and inject fluid through it. This holds promise for treating blindness.
"I personally think that the best opportunity for us is to design new operations. We need to think, what can we do now with a robot that we can't do with a human hand?" the professor said.
"Many diseases affecting the eye are incurable, cause blindness, particularly... if we are going to treat these diseases with stem cells, with gene therapy, we need the robot system or something similar for the precision to get under the retina to deliver the treatment without damaging it."
The operation here has carried out a research trial with 12 people in the UK. It aims to collect stronger evidence that robots can indeed carry out more accurate and precise work than people can. Professor MacLaren says that within the next three to five years, the research team may even move to using the robots' capabilities on a routine basis, provided safety is ensured.