**New Technologies in Eye Surgery — A Challenge for Clinical, Therapeutic, and Eye Surgeons**

Patricia Durán Ospina, Mayra Catalina Cáceres Díaz and Sabrina Lara

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/61072

#### **Abstract**

Eye surgery is always progresses as the same way that the science advances. New emerging technologies such as bio-printing in 3D, developments and mathematical modeling in prototyping lab- on- a chip, visual implants, new biopolymers started to use in eye enucleation, detection of eye biomarkers at the cellular level, bio-sensors and new diagnostic tests should be considered to improve the quality of life of pa‐ tients after surgery. This chapter provides a review of new and emerging technologies which are already working on global research centers. Emerging and converging tech‐ nologies are terms used interchangeably to indicate the emergence and convergence of new technologies with demonstrated potential as disruptive technologies. Among them are: nanotechnology, biotechnology, information technology and communica‐ tion, cognitive science, robotics, and artificial intelligence that have been launched as innovative products that promise to improve the quality of life and vision of patients with ocular compromised or low vision impairment. Some acronyms for these are: NBIC: Nanotechnology, Biotechnology, Information technology and Cognitive sci‐ ence. GNR: Genetics, Nanotechnology and Robotics. GRIN: Genetic, Robotic, Informa‐ tion, and Nanotechnology. BANG: Bits, Atoms, Neurons and Genes. Otherwise, to training ophthalmologist on news techniques, sophisticated simulation machines has been developing around the world.

**Keywords:** Artificial retina, nanotechnology, visual health, ocular prosthesis, retina

## **1. Introduction**

Eye surgery always progresses the same way as science advances. New emerging technologies such as bio-printing in 3D, mathematical modeling, and developments in prototyping lab-ona-chip, visual implants, and new biopolymers have started to be used in eye enucleation, the

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detection of eye biomarkers at the cellular level, bio-sensors, and new diagnostic tests that are considered to improve the quality of life of patients after surgery.

This chapter provides a review of new and emerging technologies, which are already working in global research centers. The term "emerging technologies" refers to the implementation of new innovative products designed to improve the quality of life. Some acronyms used are:

**NBIC**: Nanotechnology, Biotechnology, Information technology, and Cognitive science.

**GNR**: Genetics, Nanotechnology, and Robotics.

**GRIN**: Genetic, Robotic, Information, and Nanotechnology.

**BANG**: Bits, Atoms, Neurons, and Genes.

New technologies, such as nanotechnology, artificial intelligence, and genetics among others, have emerged not only to create alternatives to health service, but also to provide alternatives for new ophthalmologists in their surgical practice. There are increasing reviews in literature about the relationship with developments such as new surgical techniques not only for refractive surgery but also for simulation prior to cataract. Retina implants incorporating electronic devices, stem cells, and new inserts for corneal implants are some of the many devices made from biopolymers and electronics that have the promise to be an alternative for visually impaired patients.

Otherwise, as a response to training ophthalmologists on these new techniques, sophisticated simulation devices have been developed around the world [1].

### **2. Problem statement**

Eye surgery has always been characterized by innovation, the introduction of new surgical techniques, and also the inclusion of technology. But being so specialized, this information is not readily disclosed to the targeted patients who directly require these new developments in order to restore their vision or improve the quality of their life. Otherwise, medical students and residents in ophthalmology require an overview of these new developments to plan the training for these new techniques and apply it to patients that have these requirements according to the new protocols, inclusion criteria, and the available technology in the operating room in order to plan new investments for clinical practice and training. Knowing where you are in making this progress, communication and the creation of partnerships between experts are priorities to be able to respond to the patients' needs.

This chapter intends to update eye surgeons in new biopolymers and innovations for ocular prostheses and visual implants for visual care. In the previous years, there are a lot of inno‐ vations such us visual implants, artificial silicon retinas, suprachoroidal transretinal stimula‐ tion (STS), and artificial corneas among others, which are changing nowadays due to the new advancements in technology and also due to the development of new biomaterials, new microelectrodes, and several types of neural devices around the world. Now, real "artificial eyes" are not only the craniofacial, maxillofacial, ocular, and orbital prostheses that replaces an absent eye after an enucleation but they are also new materials such as cryolite glass, gel from cellulose, glass, silicone and porous polyethylene, graphene, dental biopolymers among others that are being implemented as materials for the heart, eye, and other organ implants due to their characteristics to improve good biological compatibility, be more resistant, reduce allergies, and improve durability. These implants are used for the replacement of the orbital content of anophthalmic cavities [2].

The traditional concept of ocular prostheses (ocular, orbital, epithesis, and maxillofacial), visual implants (retinal, optic nerve, cortical, subretinal, epiretinal and cortical), and others of engineering and biomedical sciences have been changing and must be reviewed in the future.

Otherwise, digital cameras, electrodes, and other electronic devices are useful for the visually impaired. In France, there has been some work on retinal implants using nanodiamonds in the artificial retina. This allows converting light signals into electrical signals. In the field of ocular pharmacology, the nanocarrier molecules for the sustained release of drugs and other devices to vitrectomies are some of the significant visual health advancements in the recent years. Additionally, in the field of contact lenses and artificial corneas, biopolymers have been developed for the early detection of keratoconus or systemic diseases. Nanotechnology is emerging as a science applied to the visual industry and medicine, involving a multidiscipli‐ nary team that requires new directions in the role and performance of ocular professionals around the world in the near future. The handling of materials and processes at the nanoscale (one billionth of a meter) level, the instrumentality in the accurate detection, and the telere‐ habilitation intervention using robots of bioelectrical retinal implants nano lenses are just some of the promising developments in the field of eye care. Visual health professionals seek the entry of this science in our curricula, research, and training discipline for innovation and technology based on nanotechnology and robotics. The high costs should not prevent the alliance between university research centers and the private industry in bringing innovation to our population and creating transdisciplinary research lines to improve the quality of life in eye health.

In the recent years, we have reviewed scientific literature regarding publications in surgical techniques of eye surgery. The number of publications on visual implants, artificial corneas, stromal rings, and cross linking has increased in the same manner as the development of new patents did. Also in the recent years, the inclusion of digital imaging systems, visual simulators, and virtual and augmented reality, prior or during the surgeries, have taken place. Some of the ophthalmic surgical procedures mentioned above are useful for improving the life quality of patients. This may pose a challenge to ophthalmic surgeons, but, has improved the quality of life of patients and their rehabilitation. The topics are discussed under the following areas: pre-operative tests, operative surgery, prevention of complications and current and future major advances in eye surgery of importance to surgeons, researchers, physicians, and health personnel.
