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Journal of Robotic Surgery Aug 2023Ophthalmology is one of the most enriched fields, allowing the domain of artificial intelligence to be part of its point of interest in scientific research. The... (Review)
Review
Ophthalmology is one of the most enriched fields, allowing the domain of artificial intelligence to be part of its point of interest in scientific research. The requirement of specialized microscopes and visualization systems presents a challenge to adapting robotics in ocular surgery. Cyber-surgery has been used in other surgical specialties aided by Da Vinci robotic system. This study focuses on the current perspective of using robotics and cyber-surgery in ophthalmology and highlights factors limiting their progression. A review of literature was performed with the aid of Google Scholar, Pubmed, CINAHL, MEDLINE (N.H.S. Evidence), Cochrane, AMed, EMBASE, PsychINFO, SCOPUS, and Web of Science. Keywords: Cybersurgery, Telesurgery, ophthalmology robotics, Da Vinci robotic system, artificial intelligence in ophthalmology, training on robotic surgery, ethics of the use of robots in medicine, legal aspects, and economics of cybersurgery and robotics. 150 abstracts were reviewed for inclusion, and 68 articles focusing on ophthalmology were included for full-text review. Da Vinci Surgical System has been used to perform a pterygium repair in humans and was successful in ex vivo corneal, strabismus, amniotic membrane, and cataract surgery. Gamma Knife enabled effective treatment of uveal melanoma. Robotics used in ophthalmology were: Da Vinci Surgical System, Intraocular Robotic Interventional Surgical System (IRISS), Johns Hopkins Steady-Hand Eye Robot and smart instruments, and Preceyes' B.V. Cybersurgery is an alternative to overcome distance and the shortage of surgeons. However, cost, availability, legislation, and ethics are factors limiting the progression of these fields. Robotic and cybersurgery in ophthalmology are still in their niche. Cost-effective studies are needed to overcome the delay. Technologies, such as 5G and Tactile Internet, are required to help reduce resource scheduling problems in cybersurgery. In addition, prototype development and the integration of artificial intelligence applications could further enhance the safety and precision of ocular surgery.
Topics: Humans; Robotics; Ophthalmology; Robotic Surgical Procedures; Artificial Intelligence
PubMed: 36637738
DOI: 10.1007/s11701-023-01532-y -
Drug Delivery Dec 2023To design and evaluate hyaluronan-based cubosomes loaded with bromfenac sodium (BS) for ocular application to enhance the corneal permeation and retention in pterygium...
To design and evaluate hyaluronan-based cubosomes loaded with bromfenac sodium (BS) for ocular application to enhance the corneal permeation and retention in pterygium and cataract treatment. BS-loaded cubosomes were prepared by the emulsification method, employing 2 full factorial design using Design-Expert® software. Glycerol monoolein (GMO) and poloxamer 407 (P407) as lipid phase and polyvinyl alcohol (PVA) as stabilizer were the used ingredients. The optimized formulation (OBC; containing GMO (7% w/w), P407 (0.7% w/w) and PVA (2.5% w/w)) was further evaluated. OBC had an entrapment efficiency of 61.66 ± 1.01%, a zeta potential of -30.80 ± 0.61 mV, a mean particle size of 149.30 ± 15.24 nm and a polydispersity index of 0.21 ± 0.02. Transmission electron microscopy confirmed its cubic shape and excellent dispersibility. OBC exhibited high stability and no ocular irritation that was ensured by histopathology. Ex vivo permeation study showed a significant increase in drug deposition and permeability parameters through goat cornea, besides, confocal laser microscopy established the superior permeation capability of OBC, as compared to drug solution. In vivo pharmacokinetics in aqueous humor indicated higher AUC (18.88 µg.h/mL) and mean residence time (3.16 h) of OBC when compared to the marketed eye drops (7.93 µg.h/mL and 1.97 h, respectively). Accordingly, hyaluronan-enriched cubosomes can be regarded as a promising carrier for safe and effective topical ocular delivery.
Topics: Hyaluronic Acid; Cornea; Benzophenones; Bromobenzenes; Excipients; Poloxamer; Polyvinyl Alcohol; Particle Size; Drug Carriers
PubMed: 36587627
DOI: 10.1080/10717544.2022.2162162