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P.G. Soderberg, C. Laurell, L. Nord, E. Skarman, P. Nordqvist, M. Andersson; Development of a Simulator for Phacoemulsification Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):186.
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Purpose: It is costly to train a phacoemulsification cataract surgeon. Further, according to the literature, it takes approximately 500 cases to reach an acceptable prevalence for complications during the procedure. For these reasons we have developed a simulator for training of cataract surgeons. Methods: Our system is modulized into an administrator interface, a trainee interface and a processor. The administrator interface provides parameters for the procedure through a keyboard and receives procedure measurements to screen and file.. The trainee interface provides information from a standard operation microscope pedal with x-y positioning, focus and zoom; a standard phacoemulsification pedal, with standard irrigation, aspiration and phacoemulsification positions; a nuclear manipulator and a phacoemulsification handpiece, each with 4 degrees of freedom (x, y, z and rotation). The trainee receives 3-D visual feedback of the operation field through a binocular LCD display, with focus and positioning depending on the trainee choice with the microscope foot pedal. The simulation of the surgery is based on a 3-D model of an eye. The simulation allows random occurrence of air bubbles and patient movements during the procedure depending on the administrator parameter settings. The software uses 3/D Optimizer (Silicon Graphics, USA) and is based on M-base® (Melerit AB, Sweden), a toolbox for surgical simulations. The software provides real-time visual feedback of mechanical input. The software measures a number of variables during the simulation for feedback to the trainee. Results: Early testing of the simulator on very experienced to beginning cataract surgeons have demonstrated that the simulator provides realistic surgery. An evaluation of the simulator on medical students demonstrated that most of the medical students were enthusiastic about having the possibility to try cataract surgery already during undergraduate training. Conclusions: The simulator developed provides surgical training that closely resembles regular phacoemulsification cataract surgery. We anticipate that the simulator will be used to give medical students a possibility to try, and residents a possibility to get training in cataract surgery before involvement with patients. Further, experienced cataract surgeons may in the future have a possibility to get simulator training on uncommon complications during surgery.
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