[ACNS, by Gavin Drake] An Anglican priest who once served as the head of communications for the Church of England has undergone pioneering eye surgery – by a robot. Currently an associate priest at St Mary the Virgin Church in Iffley, Oxford, the 70-year-old Revd Dr Bill Beaver was the first person in the world to undergo robotic surgery inside the eye. Medics Professor Robert MacLaren and Dr Thomas Edwards used the remotely controlled robot to lift a membrane 100th of a millimetre thick from the retina at the back of Dr Beaver’s right eye.

“The robot needs to operate inside the eye through a single hole that is less than 1mm in diameter and it needs to go in and out of the eye through this same hole during various steps of the procedure, even though the eye may rotate,” a spokesperson for Oxford University Hospitals NHS Trust said.

“The device is designed to eliminate unwanted tremors in the surgeon's hand – such as through their pulse – so tiny surgical manipulations can be safely carried out within the eye. The robot acts like a mechanical hand with seven independent computer-controlled motors resulting in movements as precise as 1,000th of a millimetre in scale.”

For Dr Beaver, a membrane growing on the surface of his retina had contracted and pulled it into an uneven shape, leading to distorted vision described as “looking in a hall of mirrors at a fairground.” The cure is to dissect the 100th of a millimetre-thick membrane without damaging the retina.

“Surgeons can just about do this by slowing their pulse and timing movements between heart beats, but the robot could make it much easier,” the spokesperson said. “Moreover, the robot could enable new, high-precision procedures that are currently out of the reach of the human hand.

“The surgeon uses a joystick and touchscreen outside the eye to control the robot whilst monitoring its progress through the operating microscope. This gives the surgeon a notable advantage as significant movements of the joystick result in tiny movements of the robot.”

“There is no doubt in my mind that we have just witnessed a vision of eye surgery in the future,” Professor MacLaren said after the operation. “Current technology with laser scanners and microscopes allows us to monitor retinal diseases at the microscopic level, but the things we see are beyond the physiological limit of what the human hand can operate on. With a robotic system, we open up a whole new chapter of eye operations that currently cannot be performed.

“This will help to develop novel surgical treatments for blindness, such as gene therapy and stem cells, which need to be inserted under the retina with a high degree of precision.”

Born and brought-up in the US-state of Colorado, Dr Beaver, a veteran of the Vietnam war, spent much of his working life working in communications in the UK. In 1983 he joined the children’s charity Dr Barnardo’s and rebranded it – removing “Dr” from its name. He moved to the Nat West Bank in 1990 as group director of corporate affairs; before joining the Industrial Society as director of marketing two years later.

In 1997 he became director of communications for the Church of England and introduced corporate branding to the Province, including the now-iconic “e” symbol. He was a controversial character and was described as being “direct to the point of brashness.” He left in 2002 to head up communications for the British Red Cross.

Speaking after the pioneering operation, he said: “My sight is coming back. I am delighted that my surgery went so well and I feel honoured to be part of this pioneering research project.”
The hospital spokesperson said that “the current robotic eye surgery trial will involve 12 patients in total and involves operations with increasing complexity. In the first part of the trial, the robot is used to peel membranes off the delicate retina without damaging it. If this part is successful, as has been the case so far, the second phase of the trial will assess how the robot can place a fine needle under the retina and inject fluid through it. This will lead to use of the robot in retinal gene therapy, which is a promising new treatment for blindness which is currently being trialled in a number of centres around the world.

“This follows on from the successful gene therapy trials led by researchers at the Oxford Eye Hospital and includes developing treatments for retinitis pigmentosa, a genetic condition that is one of the most common causes of blindness in young people and age-related macular degeneration, which affects the older age group.”