Intravenous injection of psFlt-1-PM decreased the area of CNV.

<p>Quantification of the CNV lesion demonstrated that the neovascularized area in the mice that received psFlt-1-PM was significantly reduced by 60% than that of control mice (n = 7, p<0.01), whereas the administration of pYFP-PM had no significant effects on the neovascularized area. The lower panels show representative micrographs. Arrows indicate the CNV lesion. CNV: choroidal neovascularization, psFlt-1-PM: the PIC micelle encapsulating psFlt-1 (fms-like tyrosine kinase-1), pYFP-PM: the PIC micelles encapsulating pYFP (yellow fluorescent protein).</p

Laboratory data.

<p>Laboratory data.</p

Targeted gene expression in the CNV area after intravenous injection of pYFP-PM.

<p>a: Choroidal flatmount and histological analysis demonstrated YFP fluorescence in the CNV area after intravenous injection of pYFP-PM. b: Western blotting analysis demonstrated that YFP protein was detected in the eyes with CNV, after intravenous injection of pYFP-PM. YFP expression was detected neither after generation of CNV alone nor after intravenous injection of pYFP-PM without CNV. c: The results of immunohistochemistry demonstrated that the expression of F4/80 was partially overlapping the expression of YFP, indicating that YFP protein expressed in F4/80-positive macrophage. CNV: choroidal neovascularization, pYFP-PM: the PIC micelles encapsulating pYFP (yellow fluorescent protein), PC: photocoagulation, bar:100 um.</p

Impact of Robotic Assistance on Precision of Vitreoretinal Surgical Procedures

<div><p>Purpose</p><p>To elucidate the merits of robotic application for vitreoretinal maneuver in comparison to conventional manual performance using an <i>in-vitro</i> eye model constructed for the present study.</p><p>Methods</p><p>Capability to accurately approach the target on the fundus, to stabilize the manipulator tip just above the fundus, and to perceive the contact of the manipulator tip with the fundus were tested. The accuracies were compared between the robotic and manual control, as well as between ophthalmologists and engineering students.</p><p>Results</p><p>In case of manual control, ophthalmologists were superior to engineering students in all the 3 test procedures. Robotic assistance significantly improved accuracy of all the test procedures performed by engineering students. For the ophthalmologists including a specialist of vitreoretinal surgery, robotic assistance enhanced the accuracy in the stabilization of manipulator tip (from 90.9 µm to 14.9 µm, P = 0.0006) and the perception of contact with the fundus (from 20.0 mN to 7.84 mN, P = 0.046), while robotic assistance did not improve pointing accuracy.</p><p>Conclusions</p><p>It was confirmed that telerobotic assistance has a potential to significantly improve precision in vitreoretinal procedures in both experienced and inexperienced hands.</p></div

System to evaluate force applied on the fundus for test procedure 3, perception of contact with the fundus.

<p>An amplifier detected the voltage changes converted from the applied force change on the load cell. The amplifier was calibrated to measure 30 mN as 1 V change. The values of changes in voltage were shown with noise filtering in the data logger, and recorded on the computer.</p

Robotic/manual control of a vitreoretinal surgical instrument and an <i>in-vitro</i> eye model constructed for the present study.

<p>(A) Test procedures were conducted manually and by telerobotic system using the same visual system. A 25G v-lance was introduced into the eye through trocar cannula. (B) A piece of graph paper was attached on the fundus that provided targeting points for the test procedures. The eye model was loosely fixed by a magnet to mimic the eye movement during surgery. (C) In the test procedure 3 to measure the foce applied on the fundus, a load cell was placed beneath the graph paper of the fundus.</p

Comparison of manual and telerobotic control by ophthalmologists and engineering students in test procedure 1, aiming accuracy.

<p>(mean ± SEM; n = 4−5 per group; *P<0.05).</p

Comparison of manual and telerobotic control by ophthalmologists and engineering students in test procedure 3, fine perception of contact with the fundus.

<p>(mean ± SEM; n = 4−5 per group; *P<0.05).</p

Comparison of manual and telerobotic control by ophthalmologists and engineering students in test procedure 2, positioning stability.

<p>(mean ± SEM; n = 4−5 per group; ***P<0.001).</p