Assessment of corneal suturing performance using the Bioniko ophthalmic surgery models in inexperienced vs experienced ophthalmic surgeons.

Abstract

 

Purpose

 

To assess the corneal suturing performance of inexperienced vs experienced ophthalmic surgeons using a new teaching tool: the Bioniko ophthalmic surgery models.

 

Methods

 

Prospective comparative study performed at Bascom Palmer Eye Institute, Miami, FL, USA. The Bioniko ophthalmic surgery models (Bioniko LLC, Miami, FL, USA) are made of polyacrylate material and are divided in 2 parts: the orbit model and the corneal (kerato) model. The orbit model simulates structures surrounding the eye and the corneal (kerato) model is the replaceable sclera ring with corneal button. Group 1 included inexperienced surgeons who were subdivided in participants undergoing a daily or weekly training on Bioniko ophthalmic surgery models vs participants who did not undergo any training. Group 2 included experienced ophthalmic surgeons who are familiar with corneal suturing. Each participant was asked to perform 16 interrupted corneal sutures in a penetrating keratoplasty fashion on a Bioniko ophthalmic surgery model. Time of surgery, space between each suture, radiality, length and symmetry of the suture (inner length, outer length and delta length = outer length - inner length) were recorded by a masked observer at baseline and 2 weeks after training on Bioniko ophthalmic surgery models.

 

Results

 

At baseline, mean time of surgery was 135min [90-180] in Group 1 and 45 min in Group 2. Two weeks later, mean time of surgery was 40min in Group 1 with training, 90min in Group 1 without training and 45min in Group 2. Mean space range between sutures improved from [1.0-2.5mm] to [1.0-2.2mm] in Group 1 with training. Mean suture length was 1.82mm [1.39-2.2] in Group 1 and 1.69mm [1.2-2.3] in Group2. Delta length improved from 0.53mm [0-1.7] to 0.36mm [0-1.0] in group 1 with training and from 1.03mm [0.3-2.0] to 0.63mm [0-1.5] in Group 1 without training.

 

Conclusions

 

The Bioniko ophthalmic surgery model is a very useful tool to train inexperienced surgeons for corneal suturing. In this ongoing project, marked improvements in corneal suturing skills were noted within a 2 week period of training on those models.  

 

Bioniko ophthalmic surgery model. A. The Bioniko corneal (kerato) model is mounted on the orbit model in order to mimick real surgical conditions. B. The surgeon performs corneal suturing in a penetrating keratoplasty fashion (16 interrupted sutures with 10.0 nylon).