Abstract Subretinal injection (SI) is considered the most effective approach for treating retinal degenerative and genetic diseases, enabling precise delivery of viral vectors or stem cells into the subretinal space (SRS) for targeted therapy. However, the procedure is typically performed in a highly constrained intraocular environment, where limited visibility, absence of tactile feedback, and retinal fragility substantially increase the risk of surgical complications and further vision impairment. To address these challenges, an integrated force-sensing microneedle with a flexible joint was developed and incorporated into an ophthalmic surgical robotic system. The system offers high-precision control of the needle tip pose and enables real-time sensing of puncture forces. Based on these capabilities, force-guided autonomous retinal puncture is achieved, ensuring accurate and consistent drug delivery into the SRS. Comparative experiments on live Bama pigs demonstrated that the robotic system outperformed manual SI procedures by maintaining stable puncture trajectories despite respiratory and cardiac disturbances. It enabled smoother puncture velocity, consistent insertion depth, and over 90% reduction in average puncture force, thereby improving surgical precision and minimizing iatrogenic retinal injury. Postoperative evaluations further confirmed that the robotic approach significantly reduced drug reflux into the vitreous cavity, ensuring reliable and safe SI outcomes.
Wang et al. (Fri,) studied this question.