Purpose To test the feasibility of retinal manipulations using a new micromanipulator (Microhand) for ocular robotic microsurgery. Methods Pneumatically actuated four-finger microhands were developed at UCLA with micro electromechanical systems (MEMS) technology to mimic a human hand for small object manipulation. Microhands with four 4 mm finger lengths were used for this study to lift caliper weights and fresh retinal tissue of porcine cadaver eyes to find the maximum force at a given pressure and feasibility of the microhands for retinal manipulation in real surgery. Results A full closure of the microhand used for caliper weight lifting was achieved under 65 psi (448 kPa) of air pressure. The fourfingered microhand was able to develop about 20 mN of total lifting force and 5 mN per finger at 80 psi (551 kPa), and was strong enough to displace and lift the retina of pig eyes. Conclusions The microhand is able to apply calibrated forces to ocular tissues and is suitable for ocular microsurgical procedures. This new tool would be useful in the development of robotic microsurgery.

Improved understanding of the risk factor, different causes, along with a high degree of suspicion on initial presentation is crucial in order to provide the appropriate management in LASIK-associated infectious keratitis.

The stiffening effect of CXL has made it a promising alternative in the ophthalmologist's armamentarium for treatment of progressive keratoconus and progressive post-LASIK keratectasia. Future studies are needed to determine the long-term stability of CXL, as well as to address possible complications.