Human/robotic interaction: vision limits performance in simulated vitreoretinal surgery

Marc D de Smet, Nicky de Jonge, Danilo Iannetta, Koorosh Faridpooya, Eric van Oosterhout, Gerrit Naus, Thijs C M Meenink, Marco Mura, Maarten J Beelen

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: Compare accuracy and precision in XYZ of stationary and dynamic tasks performed by surgeons with and without the use of a tele-operated robotic micromanipulator in a simulated vitreoretinal environment. The tasks were performed using a surgical microscope or while observing a video monitor.

METHOD: Two experienced and two novice surgeons performed tracking and static tasks at a fixed depth with hand-held instruments on a Preceyes Surgical System R0.4. Visualization was through a standard microscope or a video display. The distances between the instrument tip and the targets (in μm) determined tracking errors in accuracy and precision.

RESULTS: Using a microscope, dynamic or static accuracy and precision in XY (planar) movements were similar among test subjects. In Z (depth) movements, experience lead to more precision in both dynamic and static tasks (dynamic 35 ± 14 versus 60 ± 37 μm; static 27 ± 8 versus 36 ± 10 μm), and more accuracy in dynamic tasks (58 ± 35 versus 109 ± 79 μm). Robotic assistance improved both precision and accuracy in Z (1-3 ± 1 μm) in both groups. Using a video screen in combination with robotic assistance improved all performance measurements and reduced any differences due to experience.

CONCLUSIONS: Robotics increases precision and accuracy, with greater benefit observed in less experienced surgeons. However, human control was a limiting factor in the achieved improvement. A major limitation was visualization of the target surface, in particular in depth. To maximize the benefit of robotic assistance, visualization must be optimized.

Original languageEnglish
Pages (from-to)672-678
Number of pages7
JournalActa Ophthalmologica
Issue number7
Publication statusPublished - Nov 2019


  • Clinical Competence
  • Education, Medical, Graduate/methods
  • Humans
  • Ophthalmology/education
  • Reproducibility of Results
  • Retinal Diseases/surgery
  • Robotics/education
  • Telemedicine/methods
  • Video Recording
  • Vitreoretinal Surgery/education


Dive into the research topics of 'Human/robotic interaction: vision limits performance in simulated vitreoretinal surgery'. Together they form a unique fingerprint.

Cite this