The Bioniko ophthalmic surgery model: an innovative approach for teaching capsulorhexis

Abstract

 

Purpose

 

To test new surgery simulation model, the Bioniko ophthalmic surgery model (Bioniko LLC, Miami, FL), and demonstrate its efficacy in assisting teaching of the capsulorhexis technique.

 

Methods

 

The Bioniko ophthalmic surgery model is a synthetic model of the anterior structures of the eye, and is assembled from two parts: an Orbit model and a Rhexis model. The Orbit model simulates structures surrounding the eye including the socket, brows, nasal bridge, and caruncle. The Rhexis model simulates the target tissues and anatomical landmarks of the anterior segment including the sclera,limbus zonules, anterior capsule and lens. Together they represent a new tool for practicing surgical techniques. In this study, focus was given to the capsulorhexis technique. Using this device, trainees may create entry ports at the limbus, practice manipulation of cystitome and use forceps to create a continuous curvilinear capsulorhexis. Three trainees with minimal prior surgical experience underwent 3 consecutive trials using the Bioniko eyes and were evaluated by time and size of capsulorhexis, and for improvements in time between the first and third trials. Complications were noted and participants completed a satisfaction survey.

 

Results

 

All participants were novice surgeons with minimal training. The average time per trial (n =9) was 3:20 from initiation of the entry ports to the completion of the rhexis. The average diameter of rhexis was 5.5 mm (n = 9). From the first to third trial, one participant’s time improved by 59 seconds, while the other 2 participants had only minimal improvements in time (1 and 12 seconds). Complications attributable to participant technique included damage to simulated limbal tissue , poor centration, difficulty initiating the capsule tear, and irregular capsular margins. Overall, trainees found the model useful for practicing the capsulorhexis technique.

 

Conclusions

 

The Bioniko ophthalmic surgery model is a promising new tool which offers an alternative to an animal wet lab in order to assist trainees in learning the capsulorhexis. It is non-perishable, inexpensive, non toxic and allows for an objective assessment of a student’s technique.

 

 

Keywords: 445 cataract • 737 training/teaching cataract surgery