Robotic Navigation Autonomy for Subretinal Injection via Intelligent Real-Time Virtual iOCT Volume Slicing

In the last decade, various robotic platforms have been introduced that could support delicate retinal surgeries. Concurrently, to provide semantic understanding of the surgical area, recent advances have enabled microscope-integrated intraoperative Optical Coherent Tomography (iOCT) with high-resolution 3D imaging at near video rate. The combination of robotics and semantic understanding enables task autonomy in robotic retinal surgery, such as for subretinal injection. This procedure requires precise needle insertion for best treatment outcomes. However, merging robotic systems with iOCT introduces new challenges. These include, but are not limited to high demands on data processing rates and dynamic registration of these systems during the procedure. In this work, we propose a framework for autonomous robotic navigation for subretinal injection, based on intelligent real-time processing of iOCT volumes. Our method consists of an instrument pose estimation method, an online registration between the robotic and the iOCT system, and trajectory planning tailored for navigation to an injection target. We also introduce intelligent virtual B-scans, a volume slicing approach for rapid instrument pose estimation, which is enabled by Convolutional Neural Networks (CNNs). Our experiments on ex-vivo porcine eyes demonstrate the precision and repeatability of the method. Finally, we discuss identified challenges in this work and suggest potential solutions to further the development of such systems

EyeLS: Shadow-Guided Instrument Landing System for Intraocular Target Approaching in Robotic Eye Surgery

Robotic ophthalmic surgery is an emerging technology to facilitate high-precision interventions such as retina penetration in subretinal injection and removal of floating tissues in retinal detachment depending on the input imaging modalities such as microscopy and intraoperative OCT (iOCT). Although iOCT is explored to locate the needle tip within its range-limited ROI, it is still difficult to coordinate iOCT's motion with the needle, especially at the initial target-approaching stage. Meanwhile, due to 2D perspective projection and thus the loss of depth information, current image-based methods cannot effectively estimate the needle tip's trajectory towards both retinal and floating targets. To address this limitation, we propose to use the shadow positions of the target and the instrument tip to estimate their relative depth position and accordingly optimize the instrument tip's insertion trajectory until the tip approaches targets within iOCT's scanning area. Our method succeeds target approaching on a retina model, and achieves an average depth error of 0.0127 mm and 0.3473 mm for floating and retinal targets respectively in the surgical simulator without damaging the retina.Comment: 10 page

Unsupervised out-of-distribution detection for safer robotically-guided retinal microsurgery

Purpose: A fundamental problem in designing safe machine learning systems is identifying when samples presented to a deployed model differ from those observed at training time. Detecting so-called out-of-distribution (OoD) samples is crucial in safety-critical applications such as robotically-guided retinal microsurgery, where distances between the instrument and the retina are derived from sequences of 1D images that are acquired by an instrument-integrated optical coherence tomography (iiOCT) probe. Methods: This work investigates the feasibility of using an OoD detector to identify when images from the iiOCT probe are inappropriate for subsequent machine learning-based distance estimation. We show how a simple OoD detector based on the Mahalanobis distance can successfully reject corrupted samples coming from real-world ex-vivo porcine eyes. Results: Our results demonstrate that the proposed approach can successfully detect OoD samples and help maintain the performance of the downstream task within reasonable levels. MahaAD outperformed a supervised approach trained on the same kind of corruptions and achieved the best performance in detecting OoD cases from a collection of iiOCT samples with real-world corruptions. Conclusion: The results indicate that detecting corrupted iiOCT data through OoD detection is feasible and does not need prior knowledge of possible corruptions. Consequently, MahaAD could aid in ensuring patient safety during robotically-guided microsurgery by preventing deployed prediction models from estimating distances that put the patient at risk.Comment: Accepted at IPCAI 202

Autonomous Needle Navigation in Retinal Microsurgery: Evaluation in ex vivo Porcine Eyes

Important challenges in retinal microsurgery include prolonged operating time, inadequate force feedback, and poor depth perception due to a constrained top-down view of the surgery. The introduction of robot-assisted technology could potentially deal with such challenges and improve the surgeon's performance. Motivated by such challenges, this work develops a strategy for autonomous needle navigation in retinal microsurgery aiming to achieve precise manipulation, reduced end-to-end surgery time, and enhanced safety. This is accomplished through real-time geometry estimation and chance-constrained Model Predictive Control (MPC) resulting in high positional accuracy while keeping scleral forces within a safe level. The robotic system is validated using both open-sky and intact (with lens and partial vitreous removal) ex vivo porcine eyes. The experimental results demonstrate that the generation of safe control trajectories is robust to small motions associated with head drift. The mean navigation time and scleral force for MPC navigation experiments are 7.208 s and 11.97 mN, which can be considered efficient and well within acceptable safe limits. The resulting mean errors along lateral directions of the retina are below 0.06 mm, which is below the typical hand tremor amplitude in retinal microsurgery