Temperature-controlled laser therapy of the retina via robust adaptive H∞-control

Recent studies demonstrate therapeutic benefits in retinal laser therapy even for non-visible effects of the irradiation. However, in practice, ophthalmologists often rely on the visual inspection of irradiation sites to manually set the laser power for subsequent ones. Since absorption properties vary strongly between sites, this procedure can lead to under- or over-treatment. To achieve safe automatic retinal laser therapy, this article proposes a robust control scheme based on photoacoustic feedback of the retinal temperature increase. The control scheme is further extended to adapt to real-time parameter estimates and associated bounds on the uncertainty of each irradiation site. Both approaches are successfully validated in ex vivo experiments on pigs' eyes, achieving consistent irradiation durations of 55 ms despite the uncertainty in absorption properties.