Evaluating Force and Motion in Posterior Vitreous Detachment Maneuvers Using a Robotic Data Acquisition System in Cadaveric Human Eyes

Abstract

Purpose: To evaluate deep vitrectomy procedures by analyzing real-time force and positional data provided by the ARASH:ASiST system.

Design: Experimental/pre-clinical study.

Participants: This study used cadaveric human eyes. Two VR fellows, one early carrier (left-handed) VR surgeon, and one expert VR surgeon acted the deep vitrectomy using the robotic system and contributed to the dataset.  

Methods: The ARASH:ASiST system was utilized to acquire intraoperative force, positional, and temporal data during deep vitrectomy mimicries.

Main Outcome Measures: The correlation between force and time data with procedural subphases, trajectory analysis, and a questionnaire assessing the usability of the system.

Results: A data collection session was conducted, and seven surgical datasets were recorded. The range and sign of the recorded force data differed between right-handed and left-handed surgeons in specific subphases and allowed for comparisons based on their experience. Time data also proved useful in assessing surgeon dominance and control during certain subphases of the procedure. While most deep vitrectomy phases lack specific metrics for performance assessment, the 'posterior vitreous detachment induction' section provided a distinct time window for assessing surgical performance. This phase was particularly informative due to the high variability in force application and control, offering valuable insights into surgeon technique and competence. The graphical user interface used in the operating room offered real-time feedback for observing surgeons, enabling them to guide the operating surgeon during the procedure. It also proved beneficial for postoperative analysis, offering critical perspectives for skill development. Feedback from the 5-point Likert scale indicated that the bystander system was practical and non-intrusive for both the surgeon and the medical team.

Conclusions: The ARASH:ASiST system offered quantifiable, experience-specific understanding into surgeon performance during deep vitrectomy, particularly during posterior vitreous detachment induction, supporting its role as a surgical skills assessment platform.

Keywords: Vitreoretinal Surgery, Surgical Data Acquisition, Cadaveric Human Eyes ARAS HAptic for EYE Surgery Training