Safe Robotic Capsule Cleaning with Integrated Transpupillary and Intraocular Optical Coherence Tomography

Secondary cataract is one of the most common complications of vision loss due to the proliferation of residual lens materials that naturally grow on the lens capsule after cataract surgery. A potential treatment is capsule cleaning, a surgical procedure that requires enhanced visualization of the entire capsule and tool manipulation on the thin membrane. This article presents a robotic system capable of performing the capsule cleaning procedure by integrating a standard transpupillary and an intraocular optical coherence tomography probe on a surgical instrument for equatorial capsule visualization and real-time tool-to-tissue distance feedback. Using robot precision, the developed system enables complete capsule mapping in the pupillary and equatorial regions with in-situ calibration of refractive index and fiber offset, which are still current challenges in obtaining an accurate capsule model. To demonstrate effectiveness, the capsule mapping strategy was validated through five experimental trials on an eye phantom that showed reduced root-mean-square errors in the constructed capsule model, while the cleaning strategy was performed in three ex-vivo pig eyes without tissue damage.