Microstenting is a potentially revolutionary approach to surgical treatment of microvascular retinal disorders that do not resolve using pharmaceutical treatment. This article presents a novel device called a stent deployment unit (SDU) that aims at enabling microstent placement in ophthalmic surgery. The clinical motivation for this work is highlighted in context of microvascular retinal surgery. The proposed SDU is designed for intraocular adjustment of the approach angle and the position of the stent with respect to the retina. The feasibility of this device is experimentally evaluated on chick chorioallantoic membranes and on agar vascular models. Experiments show dependency on the approach angle with respect to the vasculature and on the mobility of the vasculature. Successful placement of stents was achieved in both experimental media. To the best of our knowledge, this pioneering work is the first to demonstrate successful stent deployment in a scale suitable for retinal surgery. We believe that this technique has the promise of enabling effective vascular treatments for blinding conditions such as central and branch retinal vein occlusion.

1.
Gottsch
,
J. D.
,
Stark
,
W. J.
, and
Goldberg
,
M. F.
, 1999,
Ophthalmic Surgery
,
Hodder Arnold
,
London
.
2.
Jagtap
,
A. D.
and
Riviere
,
C. N.
, 2004, “
Applied Force During Vitreoretinal Microsurgery With Handheld Instruments
,”
26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society
, San Francisco, CA, pp.
2771
2773
.
3.
McIntosh
,
R. L.
,
Mohamed
,
Q.
,
Saw
,
S. M.
, and
Wong
,
T. Y.
, 2007, “
Interventions for Branch Retinal Vein Occlusion: An Evidence-Based Systematic Review
,”
Ophthalmology
0161-6420,
114
(
5
), pp.
835
854
.
4.
Grace
,
K. W.
, 1995,
Kinematic Design of an Ophthalmic Surgery Robot and Feature Extracting Bilateral Manipulation
,
Northwestern University
,
Chicago, IL
.
5.
Das
,
H.
,
Zak
,
H.
,
Johnson
,
J.
,
Crouch
,
J.
, and
Frambach
,
D.
, 1999, “
Evaluation of a Telerobotic System to Assist Surgeons in Microsurgery
,”
Comput. Aided Surg.
1092-9088,
4
(
1
), pp.
15
25
.
6.
Riviere
,
C. N.
,
Ang
,
W. T.
, and
Khosla
,
P. K.
, 2003, “
Toward Active Tremor Canceling in Handheld Microsurgical Instruments
,”
IEEE Trans. Rob. Autom.
1042-296X,
19
(
5
), pp.
793
800
.
7.
Fleming
,
I.
,
Balicki
,
M.
,
Koo
,
J.
,
Iordachita
,
I.
,
Mitchell
,
B.
,
Handa
,
J.
,
Hager
,
G.
, and
Taylor
,
R.
, 2008, “
Cooperative Robot Assistant for Retinal Microsurgery
,”
The 11th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI)
, pp.
543
551
.
8.
Ikuta
,
K.
,
Kato
,
T.
, and
Nagata
,
S.
, 1996, “
Development and Experimental Verification of Micro Active Forceps for Microsurgery
.”
International Symposium on Micromechatronics and Human Science
, Nagoya, Japan, pp.
229
234
.
9.
Wei
,
W.
,
Goldman
,
R. E.
,
Fine
,
H. F.
,
Chang
,
S.
, and
Simaan
,
N.
, 2009, “
Performance Evaluation for Multi-Arm Manipulation of Hollow Suspended Organs
,”
IEEE Trans. Robot.
,
25
(
1
), pp.
147
157
.
10.
Dotter
,
C. T.
and
Judkins
,
M. P.
, 1964, “
Transluminal Treatment of Arteriosclerotic Obstruction, Description of a New Technique and a Preliminary Report of Its Application
,”
Circulation
0009-7322,
30
(
5
), pp.
654
670
.
11.
Lim
,
G.
,
Park
,
K.
,
Sugihara
,
M.
,
Minami
,
K.
, and
Esashi
,
M.
, 1996, “
Future of Active Catheters
,”
Sens. Actuators
0250-6874,
56
(
1–2
), pp.
113
121
.
12.
Sears
,
P.
, and
Dupont
,
P.
, 2006, “
A Steerable Needle Technology Using Curved Concentric Tubes
,”
IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2006)
, Beijing, China.
13.
Webster
,
R. J.
,
Okamura
,
A. M.
, and
Cowan
,
N. J.
, 2006, “
Toward Active Cannulas: Miniature Snake-Like Surgical Robots
.”
IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS)
.
14.
Williamson
,
T. H.
, “
Central Retinal Vein Occlusion: What is the Story?
,” 1997,
Br. J. Ophthalmol.
,
81
(
8
), pp.
698
704
.
15.
Chung
,
E. J.
,
Freeman
,
W. R.
, and
Koh
,
H. J.
, 2008, “
Visual Acuity and Multifocal Electroretinographic Changes After Arteriovenous Crossing Sheathotomy for Macular Edema Associated With Branch Retinal Vein Occlusion
,”
Retina
0275-004X,
28
(
2
), pp.
220
225
.
16.
Hayreh
,
S.
, 1983, “
Classification of Central Retinal Vein Occlusion
,”
Ophthalmology
0161-6420,
90
(
5
), pp.
458
474
.
17.
Hayreh
,
S.
, 1998, “
Central Retinal Vein Occlusion
,”
Ophthalmol. Clin. North Am.
,
11
, pp.
559
590
.
18.
Chang
,
S.
,
Tseng
,
J. J.
,
Akar
,
Y.
,
Barile
,
G. R.
, and
Schiff
,
W. M.
, 2005, “
Cataract Progression After Intravitreal Triamcinolone Injection
,”
Am. J. Ophthalmol.
0002-9394,
139
(
6
), pp.
993
998
.
19.
Smithen
,
L. M.
,
Ober
,
M. D.
,
Maranan
,
L.
, and
Spaide
,
R. F.
, 2004, “
Intravitreal Triamcinolone Acetonide and Intraocular Pressure
,”
Am. J. Ophthalmol.
0002-9394,
138
(
5
), pp.
740
743
.
20.
Opremcak
,
E. M.
,
Bruce
,
R. A.
,
Lomeo
,
M. D.
,
Ridenour
,
C. D.
,
Letson
,
A. D.
, and
Rehmar
,
A. J.
, 2001, “
Radial Optic Neurotomy for Central Retinal Vein Occlusion: A Retrospective Pilot Study of 11 Consecutive Cases
,”
Retina
0275-004X,
21
(
5
), pp.
408
415
.
21.
Weizer
,
J. S.
,
Stinnett
,
S. S.
, and
Fekrat
,
S.
, 2003, “
Radial Optic Neurotomy as Treatment for Central Retinal Vein Occlusion
,”
Am. J. Ophthalmol.
0002-9394,
136
(
5
), pp.
814
819
.
22.
Weiss
,
J. N.
, 2001, “
Injection of Tissue Plasminogen Activator Into a Branch Retinal Vein in Eyes With Central Retinal Vein Occlusion
,”
Ophthalmology
0161-6420,
108
(
12
), pp.
2249
2257
.
23.
Bynoe
,
L. A.
,
Hutchins
,
R. K.
,
Lazarus
,
H. S.
, and
Friedberg
,
M. A.
, 2005, “
Retinal Endovascular Surgery for Central Retinal Vein Occlusion: Initial Experience of Four Surgeons
,”
Retina
0275-004X,
25
(
5
), pp.
625
632
.
24.
Da Mata
,
A. P.
,
Burk
,
S. E.
,
Riemann
,
C. D.
,
Rosa
,
R. H. J.
,
Snyder
,
M. E.
,
Petersen
,
M. R.
, and
Foster
,
R. E.
, 2001, “
Indocyanine Green-Assisted Peeling of the Retinal Internal Limiting Membrane During Vitrectomy Surgery for Macular Hole Repair
,”
Ophthalmology
0161-6420,
108
(
7
), pp.
1187
1192
.
25.
Singh
,
S. P. N.
and
Riviere
,
C. N.
, 2002, “
Physiological Tremor Amplitude During Retinal Microsurgery
,”
IEEE 28th Annual Bioengineering Conference
, Philadelphia, PA, pp.
171
172
.
26.
LoRusso
,
F. J.
and
Font
,
R. L.
, 1999, “
Use of Agar in Ophthalmic Pathology: A Technique to Improve the Handling and Diagnosis of Temporal Artery Biopsies, Subfoveal Membranes, Lens Capsules, and Other Ocular Tissues
,”
Ophthalmology
0161-6420,
106
(
11
), pp.
2106
2108
.
27.
Leng
,
T.
,
Miller
,
J. M.
,
Bilbao
,
K. V.
,
Palanker
,
D. V.
,
Huie
,
P.
, and
Blumenkranz
,
M. S.
, 2004, “
The Chick Chorioallantoic Membrane as a Model Tissue for Surgical Retinal Research and Simulation
,”
Retina
0275-004X,
24
(
3
), pp.
427
434
.
28.
Bynoe
,
L. A.
and
Weiss
,
J. N.
, 2003, “
Retinal Endovascular Surgery and Intravitreal Triamcinolone Acetonide for Central Vein Occlusion in Young Adults
,”
Am. J. Ophthalmol.
0002-9394,
135
(
3
), pp.
382
384
.
You do not currently have access to this content.