Hybrid Robot-assisted Frameworks for Endomicroscopy Scanning in Retinal Surgeries.

High-resolution real-time intraocular imaging of retina at the cellular level is very challenging due to the vulnerable and confined space within the eyeball as well as the limited availability of appropriate modalities. A probe-based confocal laser endomicroscopy (pCLE) system, can be a potential imaging modality for improved diagnosis. The ability to visualize the retina at the cellular level could provide information that may predict surgical outcomes. The adoption of intraocular pCLE scanning is currently limited due to the narrow field of view and the micron-scale range of focus. In the absence of motion compensation, physiological tremors of the surgeons' hand and patient movements also contribute to the deterioration of the image quality. Therefore, an image-based hybrid control strategy is proposed to mitigate the above challenges. The proposed hybrid control strategy enables a shared control of the pCLE probe between surgeons and robots to scan the retina precisely, with the absence of hand tremors and with the advantages of an image-based auto-focus algorithm that optimizes the quality of pCLE images. The hybrid control strategy is deployed on two frameworks - cooperative and teleoperated. Better image quality, smoother motion, and reduced workload are all achieved in a statistically significant manner with the hybrid control frameworks.