Table 2.
Ophthalmology-based studies reporting the impact of physiologic tremors on surgical metrics
| Author | Strategy to reduce tremors | Surgical metric | Improved performance | Speciality | Evidence quality | Year | Country | n |
|---|---|---|---|---|---|---|---|---|
| Roizenblatt et al. [23] | Beta-blocker (tremor reducing), caffeine (tremor increasing) | Simulator score | Yes (beta-blocker) | Ophthalmology | II | 2020 | Brazil | 15 |
| Pointdujoir et al. [24] | Beta-blocker (propranolol) | Simulator score | Yes | Ophthalmology | III | 2011 | America | 18 |
| Nakano et al. [14] | Robotic surgical system | Stability and accuracy | Yes | Ophthalmology | IV | 2009 | Japan | NS |
| Yang et al. [15] | “Micron” handheld robotic micromanipulator | Physiologic tremor filtration and RMS error | Yes | Ophthalmology | IV | 2015 | America | 1 |
| Song et al. [16] | Swept source optical coherence tomography-based “SMART” handheld tool | Maintained tool tip offset distance | Yes | Ophthalmology | IV | 2012 | America | 2 |
| Maclachlan et al. [17] | Actively stabilized handheld tool | Position error on several error metrics | Yes | Ophthalmology | IV | 2013 | America | 6 |
| Gonenc et al. [25] | “Micron” handheld robotic micromanipulator | Magnitude of forces during membrane peeling of a phantom bandage and membrane on raw chicken egg | Yes | Ophthalmology | IV | 2012 | America | 1 |
| Song et al. [18] | Fibre-optic OCT sensor-guided SMART microforceps | Targeted grasping and peeling performance | Yes | Ophthalmology | IV | 2013 | America | NS |
| Zhang et al. [19] | Hand-held instrument with active tremor compensation | Tip force applied while peeling inner shell membrane of chicken egg | Yes | Ophthalmology | IV | 2020 | China | 1 |
| Gonenc et al. [26] | Micron with force sensing | Peeling force and peeling speed on phantom bandages and eggs | Yes | Ophthalmology | IV | 2014 | America | 1 |
| Yang et al. [20] | Micron with force sensing | RMS error for holding-still and circle tracing in eye phantom and rubber target | Yes | Ophthalmology | IV | 2013 | America | 1 |
| Okamura et al. [21] | Freely movable arm rest (FMA) | Arm fatigue, subjective tremor score, and suturing accuracy | No | Ophthalmology | IV | 2020 | Japan | 8 |
RMS root mean square, RMSE root-mean-square error, N novice, E expert, L longer time, S shorter time, A average, M maximum, MTS microvascular tremor scale, TTC time to completion, TLM transoral laser microsurgery, RVBS retinal vein bypass surgery, NS not specified