{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T15:04:41Z","timestamp":1771340681400,"version":"3.50.1"},"reference-count":55,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"99","content-domain":{"domain":["www.science.org"],"crossmark-restriction":true},"short-container-title":["Sci. Robot."],"published-print":{"date-parts":[[2025,2,26]]},"abstract":"<jats:p>Therapeutic protocols involving subretinal injection, which hold the promise of saving or restoring sight, are challenging for surgeons because they are at the limits of human motor and perceptual abilities. Excessive or insufficient indentation of the injection cannula into the retina or motion of the cannula with respect to the retina can result in retinal trauma or incorrect placement of the therapeutic product. Robotic assistance can potentially enable the surgeon to more precisely position the injection cannula and maintain its position for a prolonged period of time. However, head motion is common among patients undergoing eye surgery, complicating subretinal injections, yet it is often not considered in the evaluation of robotic assistance. No prior study has both included head motion during an evaluation of robotic assistance and demonstrated a significant improvement in the ability to perform subretinal injections compared with the manual approach. In a hybrid ex vivo and in situ study in which an enucleated eye was mounted on a human volunteer, we demonstrate that head-mounting a high-precision teleoperated surgical robot to passively reduce undesirable relative motion between the robot and the eye results in a bleb-formation success rate on moving eyes that is significantly higher than the manual success rates reported in the literature even on stationary enucleated eyes.<\/jats:p>","DOI":"10.1126\/scirobotics.adp7700","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T18:58:56Z","timestamp":1739991536000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":8,"title":["Head-mounted surgical robots are an enabling technology for subretinal injections"],"prefix":"10.1126","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1563-7082","authenticated-orcid":true,"given":"Nicholas R.","family":"Posselli","sequence":"first","affiliation":[{"name":"Robotics Center and Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA."},{"name":"Department of Biomechanical Engineering, University of Twente, 7522 NB Enschede, Netherlands."}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-6977","authenticated-orcid":true,"given":"Eileen S.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84132, USA."}]},{"given":"Zachary J.","family":"Olson","sequence":"additional","affiliation":[{"name":"Robotics Center and Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA."}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-6980","authenticated-orcid":true,"given":"Aaron","family":"Nagiel","sequence":"additional","affiliation":[{"name":"Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA."},{"name":"Vision Center, Department of Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA 90027, USA."}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4228-7666","authenticated-orcid":true,"given":"Paul S.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84132, USA."}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-1934","authenticated-orcid":true,"given":"Jake J.","family":"Abbott","sequence":"additional","affiliation":[{"name":"Robotics Center and Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA."}]}],"member":"221","reference":[{"key":"e_1_3_2_2_2","unstructured":"Luxturna [package insert] (Spark Therapeutics Inc. 2022)."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2014.11.025"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"S. P. N. Singh C. N. Riviere Physiological tremor amplitude during retinal microsurgery in Proceedings of the IEEE 28th Annual Northeast Bioengineering Conference (IEEE 2002) pp. 171\u2013172.","DOI":"10.1109\/NEBC.2002.999520"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"F. Peral-Gutierrez A. L. Liao C. N. Riviere Static and dynamic accuracy of vitreoretinal surgeons in Proceedings of the 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE 2004) pp. 2734\u20132737.","DOI":"10.1109\/IEMBS.2004.1403783"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.846782"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.76.10.598"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e31823bea54"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-018-0047-x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S231804"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2014-306467"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31868-8"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2021.100050"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.7.2.19"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40942-020-00216-1"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11164717"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209996"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2021.11.011"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2017.158"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/sctm.18-0210"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41434-021-00294-2"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","unstructured":"E. Vander Poorten C. N. Riviere J. J. Abbott C. Bergeles M. A. Nasseri J. U. Kang R. Sznitman K. Faridpooya I. Iordachita Handbook of Robotic and Image-Guided Surgery M. H. Abedin-Nasab Ed. (Elsevier 2019) chap. 36 pp. 627\u2013672.","DOI":"10.1016\/B978-0-12-814245-5.00036-0"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2022.3169466"},{"key":"e_1_3_2_24_2","doi-asserted-by":"crossref","unstructured":"E. Z. Ahronovich N. Shihora J.-H. Shen K. Joos N. Simaan Exploring an external approach to subretinal drug delivery via robot assistance and B-mode OCT in 2023 IEEE International Conference on Robotics and Automation (ICRA) (IEEE 2023) pp. 6795\u20136801.","DOI":"10.1109\/ICRA48891.2023.10161441"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1109\/TIE.2019.2937041"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.415477"},{"key":"e_1_3_2_27_2","doi-asserted-by":"crossref","unstructured":"S. Wei J. W. Kim A. Martin-Gomez P. Zhang I. Iordachita J. U. Kang Region targeted robotic needle guidance using a camera-integrated optical coherence tomography in Biophotonics Congress: Biomedical Optics 2022 (Translational Microscopy OCT OTS BRAIN) (Optica Publishing Group 2022) p. CM2E.6.","DOI":"10.1364\/OCT.2022.CM2E.6"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1049\/cit2.12242"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.6.001942"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.410492"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.26.6.068001"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1109\/LRA.2024.3375710"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/app8081287"},{"key":"e_1_3_2_34_2","first-page":"4485","article-title":"Defining parameters for robotic or manual reflux-free subretinal injections in an ex vivo animal model","volume":"61","author":"Ladha R.","year":"2020","unstructured":"R. Ladha, J. Smit, T. Meenink, L. E. Caspers, F. Willermain, M. D. De Smet, Defining parameters for robotic or manual reflux-free subretinal injections in an ex vivo animal model. Investig. Ophthalmol. Vis. Sci. 61, 4485 (2020).","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-022-02720-4"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.448471"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-023-01699-4"},{"key":"e_1_3_2_38_2","first-page":"472","article-title":"OCT-based volumetric measurement of subretinal injection blebs in ex-vivo porcine eyes","volume":"61","author":"Roodaki H.","year":"2020","unstructured":"H. Roodaki, N. A. Maierhofer, A.-M. Jablonka, A. Nasseri, C. P. Lohmann, A. Eslami, OCT-based volumetric measurement of subretinal injection blebs in ex-vivo porcine eyes. Investig. Ophthalmol. Vis. Sci. 61, 472 (2020).","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41434-021-00262-w"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41551-018-0248-4"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1142\/S2424905X2350006X"},{"key":"e_1_3_2_42_2","doi-asserted-by":"crossref","unstructured":"M. A. Nasseri M. Eder S. Nair E. C. Dean M. Maier D. Zapp C. P. Lohmann A. Knoll The introduction of a new robot for assistance in ophthalmic surgery in Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE 2013) pp. 5682\u20135685.","DOI":"10.1109\/EMBC.2013.6610840"},{"key":"e_1_3_2_43_2","doi-asserted-by":"crossref","unstructured":"K. Huang M. Zhou C. Lajblich C. P. Lohmann A. Knoll Y. Ling H. Lin M. A. Nasseri A flexible head fixation for ophthalmic microsurgery in 2017 Chinese Automation Congress (CAC) (IEEE 2017) pp. 6707\u20136710.","DOI":"10.1109\/CAC.2017.8243985"},{"key":"e_1_3_2_44_2","doi-asserted-by":"crossref","unstructured":"M. A. Nasseri M. Maier C. P. Lohmann A targeted drug delivery platform for assisting retinal surgeons for treating age-related macular degeneration (AMD) in Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE 2017) pp. 4333\u20134338.","DOI":"10.1109\/EMBC.2017.8037815"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.3390\/s20020428"},{"key":"e_1_3_2_46_2","doi-asserted-by":"crossref","unstructured":"W. Wei R. Goldman N. Simaan H. Fine S. Chang Design and theoretical evaluation of micro-surgical manipulators for orbital manipulation and intraocular dexterity in Proceedings 2007 IEEE International Conference on Robotics and Automation (IEEE 2007) pp. 3389\u20133395.","DOI":"10.1109\/ROBOT.2007.363996"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1109\/TRO.2008.2006865"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1142\/S2424905X16300016"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-42561-9"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1109\/TRO.2013.2239552"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2021.3071135"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.4051686"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2013.2283501"},{"key":"e_1_3_2_54_2","doi-asserted-by":"crossref","unstructured":"H. Natalius P. Lambert M. K. Tiwari L. da Cruz C. Bergeles \u201cDesign Static and Performance Analysis of a Parallel Robot for Head Stabilisation in Vitreoretinal Surgery\u201d in New Trends in Medical and Service Robotics. MESROB 2020. Mechanisms and Machine Science G. Rauter P. C. Cattin A. Zam R. Riener G. Carbone D. Pisla Eds. (Springer 2021) vol. 93 pp. 169\u2013179.","DOI":"10.1007\/978-3-030-58104-6_20"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000003260"},{"key":"e_1_3_2_56_2","doi-asserted-by":"crossref","unstructured":"P. Calhoun Exact: Unconditional exact test R package version 3.2. (2022); https:\/\/doi.org\/10.32614\/cran.package.exact.","DOI":"10.32614\/CRAN.package.Exact"}],"container-title":["Science Robotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.science.org\/doi\/pdf\/10.1126\/scirobotics.adp7700","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T10:29:52Z","timestamp":1744885792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.science.org\/doi\/10.1126\/scirobotics.adp7700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":55,"journal-issue":{"issue":"99","published-print":{"date-parts":[[2025,2,26]]}},"alternative-id":["10.1126\/scirobotics.adp7700"],"URL":"https:\/\/doi.org\/10.1126\/scirobotics.adp7700","relation":{},"ISSN":["2470-9476"],"issn-type":[{"value":"2470-9476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"assertion":[{"value":"2024-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"eadp7700"}}