Robotic Assisted-Intravitreous Light Pipe Illumination for Cataract Surgery in Eyes with Corneal Opacity: Case Reports

Introduction: In cataract surgery for eyes with corneal opacity, reduced intraoperative visibility remains a major surgical challenge. To enhance intraoperative visualization, OQrimo, a robotic medical device approved in Japan, was used to hold a light guide. Outcomes of three eyes from two cases are reported. Case Presentation: Case 1: A 48-year-old man developed bilateral corneal opacity from graft-versus-host disease following umbilical cord blood transplantation for acute myeloid leukemia. At age 45, he underwent penetrating keratoplasty in the right eye but declined surgery in the left eye. Bilateral cataract surgery under general anesthesia was performed. Due to poor visibility under the surgical microscope in both eyes, a 25-gauge light pipe was inserted into the vitreous cavity and stabilized using OQrimo, thereby improving intraoperative visibility and enabling successful cataract surgery in both eyes. Case 2: A 74-year-old man had previously undergone pterygium excision with conjunctival autograft transplantation for a lesion involving the pupillary area of the left eye. Residual central corneal opacity remained, and cataract surgery was performed six months later. Due to poor microscopic visibility, a 25-gauge light pipe was inserted into the vitreous cavity and held using OQrimo. While visualization improved, the weight of the OQrimo arm caused ocular deviation, preventing stable positioning and necessitating its discontinuation. Conclusions: OQrimo effectively enhanced intraoperative visibility in cataract surgery for eyes with corneal opacity, although stable positioning was occasionally challenging.