April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Computer-Based Simulation of Cataract Surgery: Toward a New Teaching Paradigm
Author Affiliations & Notes
  • N. Boubchir
    CHRU, Lille, France
    INRIA, Villeneuve d'ascq, France
  • S. Cotin
    INRIA, Villeneuve d'ascq, France
  • O. Comas
    INRIA, Villeneuve d'ascq, France
  • F. Roy
    INRIA, Villeneuve d'ascq, France
  • M. Sanz
    INRIA, Villeneuve d'ascq, France
  • C. Duriez
    INRIA, Villeneuve d'ascq, France
  • J. Dequidt
    INRIA, Villeneuve d'ascq, France
  • J. Allard
    INRIA, Villeneuve d'ascq, France
  • J. Rouland
    CHRU, Lille, France
  • Footnotes
    Commercial Relationships  N. Boubchir, None; S. Cotin, None; O. Comas, None; F. Roy, None; M. Sanz, None; C. Duriez, None; J. Dequidt, None; J. Allard, None; J. Rouland, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 5435. doi:
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      N. Boubchir, S. Cotin, O. Comas, F. Roy, M. Sanz, C. Duriez, J. Dequidt, J. Allard, J. Rouland; Computer-Based Simulation of Cataract Surgery: Toward a New Teaching Paradigm. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5435.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : cataract surgery is the most frequently performed procedure in ophthalmology and presents a significant vector of progress in the near future. Current methods of training are based on an apprenticeship model which has two principal limitations: training periods depend on the availability of the instructor, and higher risk of complications due to the inexperience of the operator. Yet, recent reports have demonstrated the added value of computer-based training systems. In the context of cataract surgery, we believe a computer-based simulator could enable new teaching approaches and help assess the level of proficiency of medical residents.

Methods: : this work is the result of a collaboration with researchers in the field of computer science. Through this collaboration, we have developed computer models of the main anatomical structures of the eye as well as biomechanical models of the structures manipulated during the simulated procedure. Real time computation of the behavior of the virtual eye has been made possible by developing specific algorithms and computational models. The complete simulation system consists of a computer, for computing and rendering the virtual eye, as well as devices allowing interactions with the virtual environment. Among the available interfaces is a tracking system that transmits the position of mock surgical instruments and stereoscopic glasses that provide a visual feedback similar to what can be seen through a microscope. The different equipments are integrated in a whole body mannequin and a refurbished microscope to provide added realism and a higher level of immersion of the simulation.

Results: : we have simulated the main stages of cataract surgery, namely capsulorhexis, phacofragmentation and aspiration of the fragments, injection of the IOL and its deployment in the capsule.

Conclusions: : with respect to the state of the art, our simulation offers similar or better realism of the capsulorhexis and phacoemulsification stages than prior work. In addition, it includes a real-time modeling of IOL injection and deployment. This step has not, to our knowledge, been addressed previously. The use of a mock up surgical unit, combined with tracking interfaces for the instruments, helps provide realistic training conditions. This allows medical resident to learn the key steps of cataract surgery, using an operating microscope while familiarizing themselves with hand-foot coordination.

Keywords: cataract • learning 
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