Vitreoretinal microsurgery requires precise hand-eye coordination to manipulate delicate structures within the eye on the order of tens of microns. To achieve these tasks, surgeons use tools of diameter 0.9 mm or less to access the eye's interior structures. The level of force required during these manipulations is often below the human tactile threshold, requiring the surgeon to rely on subtle visual cues or to apply larger forces above the tactile threshold for feedback. However, both of these methods can lead to tissue damage. Excursions can be made into tissues which are not felt by the surgeon, while larger forces have a higher chance of damaging tissue within the eye. To prevent damage to the retina and other anatomy, we present the implementation of hybrid position/force control operating in the sub-tactile force range for a handheld robotic system. This approach resulted in a 42% reduction in the mean force and 52% reduction in maximum force during peeling tasks.

This paper presents the characterization and comparison of physiological tremor for pointing tasks in multiple environments, as a baseline for performance evaluation of microsurgical robotics. Previous studies have examined the characteristics of physiological tremor under laboratory settings as well as different operating conditions. However, different test methods make the comparison of results across trials and conditions difficult. Two vitroretinal microsurgeons were evaluated while performing a pointing task with no entry-point constraint, constrained by an artificial eye model, and constrained by a rabbit eye in vivo. For the three respective conditions the 3D RMS positioning error was 144 μm, 258 μm, and 285 μm, and maximum 3D error was 349 μm, 647 μm, and 696 μm. A spectral analysis was also performed, confirming a distinct peak near in the 6-12 Hz frequency range, characteristic of hand tremor during tasks in all three environments.