# Intrasurgical OCT Image-Guided Robot Assist Device for Partial Thickness Corneal Transplanation

> **NIH NIH R21** · DUKE UNIVERSITY · 2020 · $188,771

## Abstract

PROJECT SUMMARY
 This is an application for an Exploratory/Developmental Research Grant which brings together a team of
experts in ophthalmic imaging, surgery and robotics to advance the state of the art in image-guided robotic
microsurgical intervention. Corneal transplants are one of the most commonly performed allograft procedures
worldwide, although there remains a substantial risk of immune rejection or graft failure. An alternative form of
corneal transplantation known as Deep Anterior Lamellar Keratoplasty (DALK) has been described which solves
most of the drawbacks of conventional corneal transplantation. However, this procedure requires great manual
dexterity and experience because depth is difficult to assess using the standard ophthalmic surgical microscope.
Even in experienced hands, DALK fails more often than not, requiring conversion to the older PKP procedure.
 Over the past decade, our team has become a leading academic research group applying optical
coherence tomography (OCT) technology in ophthalmic microsurgery. Our current surgical microscope-
integrated OCT (MIOCT) systems provide real time, in vivo microscopic imaging of the surgical field, viewed by
the surgeon via a stereoscopic heads-up display or stereoscopic monitor. In the proposed project, we will
leverage this state-of-the-art imaging technology to develop a robotic surgical assist device to enable microscale
maneuverability to match the microscale visualization afforded by OCT. In the envisioned robotic assist device,
the surgeon cooperatively guides an ergonomic tissue dissector handpiece comprising the robot arm end effector
to a corneal insertion site, whereupon novel device control software will generate an optimal needle insertion
trajectory using a cornea soft-tissue deformation model. Following surgeon approval of the plan, the device will
automatically execute the needle trajectory. At all times, the control software will monitor needle position under
MIOCT visualization (also visible to the surgeon), compensate for surgeon hand tremor, prevent penetration of
the corneal endothelium, and allow for surgeon modification or termination of the procedure. The end result of
this project will be a proof of concept of the component and integrated technologies required for robot-assisted
DALK surgery, suitable for advancement to first-in-human trials in a subsequent project.
 The expected outcome of this proposal is a suite of technologies with the potential to significantly enhance
ophthalmic microsurgical technique by overcoming challenges of surgical tool visualization and manipulation on
the micrometer scale. These technologies will facilitate surgeon training, advance the skills of experienced
surgeons, and thus potentially improve surgical outcomes for patients. Further, we believe that development and
demonstration of these technologies forms a foundation for transfer to other microsurgical applications, such as
neurosurgery, hand surgery, and others that may...

## Key facts

- **NIH application ID:** 9913524
- **Project number:** 5R21EY029877-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Kris Hauser
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $188,771
- **Award type:** 5
- **Project period:** 2019-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9913524

## Citation

> US National Institutes of Health, RePORTER application 9913524, Intrasurgical OCT Image-Guided Robot Assist Device for Partial Thickness Corneal Transplanation (5R21EY029877-02). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/9913524. Licensed CC0.

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