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Ken Steinegger, Ali Dirani, Ciara Bergin, Cedric Mayer, François Majo, Francine Behar-Cohen, Jean-Antoine C Pournaras; Assessment of the BIONIKO prosthetic surgical training tools. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):136. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Prosthetic models of components of the eye have been developed as surgical training aids in ophthalmology. This study was designed to examine the utility of the rhexis-model and the kerato-model developed by BIONIKO LLC (Miami, Florida, US) as a training tools for surgically naive residents. The aim was to quantify the improvement in surgical skills afforded, in terms of change in speed and accuracy when performing capsulorhexis and corneal sutures.
Nineteen surgically naive ophthalmology residents participated in this study. Every resident had 10 rhexis-models and 5 kerato-models for training. Performance was assessed based on the outcome of the first 2 rhexis-model/the first kerato-model and compared to the outcome from the last 2 rhexis-model/the last kerato-mode. Between the assessment points the resident trained independently using the remaining 6 rhexis-model and 3 kerato-model prostheses provided. A “capsulorhexis score” based on time taken, corneal wound integrity, shape and centration of the rhexis was developed to reflect overall performance. Similarily a “kerato score” based on average time taken to perform sutures, position and integrity of the graft, symmetry, radiality and tightness of the corneal sutures was also developed. Paired t-tests were used to compare pre and post training outcome measures.
In rhexis-model, comparing outcomes at the beginning and at the end of training, the maneuver was performed 39% faster (3.6 minutes vs 2.2 minutes, p<0.01); circularity improved by 42% (0.43 vs 0.25, where 0 represents a perfect circle p<0.01) and rhexis decentration significantly decreased (0.83 mm vs 0.47 mm, p<0.01). In the kerato-model, corneal sutures were performed 42% faster (9.6mins vs 5.5 mins, p<0.01) Position, integrity of the graft, symmetry, radiality and tightness also improved significantly[b1] . The capsulorhexis and kerato scores improved significantly from 2 and 13.8 before training to 5 and 23.1 at the end of training (p<0.01 for both respectively).
The BIONIKO prosthetic models were shown to be effective training tools for improving the accuracy and speed of surgically naive residents in performing the capsulorhexis and corneal sutures. Also since there is no special storage, sanitary or expiration considerations these tools have the potential to simplify practice and maintenance in surgical skills laboratories.
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