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J. J. Yunker, K. Jain, K. Sloan, J. A. Kimble; Computer-Based Teaching Program for Laser Retinal Photocoagulation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4991.
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To demonstrate the feasibility and potential applicability of a computer-based graphic simulator for retinal laser photocoagulation for treatment of diabetic macular edema as a training and/or assessment tool for ophthalmology residents and physicians.
Java Runtime Environment and Java programming were utilized to create a digital framework for a computerized laser simulator. A representative set of color fundus photographs depicting various examples of diabetic macular edema with corresponding fluorescein angiography (FA) was assembled. Laser intensity and treatment spot size are set via on-screen controls similar to a "real" ophthalmic laser and are titrated by the user. Realistic simulations include differential retinal laser uptake due to either cataract, retinal edema, or macular pigmentation, as well as simulated patient movement during the procedure.
The computer-based program provides for autonomous use with no risk to actual patients. Ophthalmology residents may complete laser treatment for multiple clinical examples of diabetic macular edema, and then review these with a mentor or attending physician at a later time. In some cases, this program may be utilized for pre-planning of treatment for actual patients.
This program demonstrates the potential applications of a computer-based simulator as a training and skills assessment tool for novice and trained ophthalmic surgeons. The module may be utilized to teach specific points regarding treatment intensity and application, as well as familiarizing the user with some of the subtle challenges to treatment including decreased laser penetration secondary to cataract or patient movement during the procedure. Ultimately, this program may lead to more efficient training, exposure to multiple clinical examples, decreased apprehension, and decreased learning time for ophthalmology residents.
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