Blockage from a blood clot causing retinal vein occlusion in a patient was for the first time removed with the help of a surgical robot at the University Hospitals Leuven, Belgium.
Operated by Peter Stalmans, MD, PhD, the robot injected ocriplasmin through a 0.03-mm needle into the target vessel. The plasmin enzyme was able to break up and dissolve the blood clot. In a press release, the team of surgeons that carried out the operation called this technique of retinal vein cannulation (RVC) “a revolutionary treatment that addresses the cause of retinal vein occlusion by removing the blood clot in the retinal vein.”
Current treatment modalities that inject anti-VEGF and/or steroids in the vitreous indirectly reduce the effects of thrombosis, but until now there was no way to mechanically remove the blood clots from retinal veins. The tiny diameter of a retinal vein, about a tenth of a millimeter, means that a surgeon would not be able to manually inject a drug without causing damage.
“The robotic device enables us to treat the cause of the thrombosis in the retina for the first time. I am, therefore, looking forward to what is next. If we succeed, we will literally be able to make blind people see again,” Stalmans, associate professor and eye surgeon at the University Hospitals Leuven, said in the release
The surgical robot and RVC technique were the result of 7 years of cooperation between researchers from the departments of ophthalmology and mechanical engineering at KU Leuven. The robot enables the surgeon to insert the micro-fine needle into the vein, eliminating any vibration and holding it still while ocriplasmin is slowly injected over 10 minutes.
“We are proud that our robot enables us to perform eye surgery that was previously impossible to perform safely,” Dominiek Reynaerts, PhD, professor in the department of mechanical engineering, said in the release.
A current phase 1 trial is aimed at demonstrating the technical feasibility of RVC to assist ocriplasmin-induced dissolution of blood clots. The first procedure was performed on Jan. 12, and the patient is currently doing well. A phase 2 trial will soon be starting to assess the clinical effects of RVC. – by Michela Cimberle