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SP Rabethge, H-J Bender, JB Jonas; Computer Assisted Training System for Pars Plana Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3510.
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Purpose: To evaluate whether microsurgical steps in vitreoretinal surgery can be trained by a computer assisted training system. Methods: The prospective randomized masked experimental study included 14 residents and medical students completely inexperienced in microsurgery. They were randomized into two groups. Members of study group I (n=7) underwent two training programs in a computer assisted training system consisting of computer based medical work station for simulation of pars plana vitrectomy. The surgeon manipulated two original instruments inside a cardanically suspended mechanical eye model in which the positions of the instruments were tracked by CCD cameras and monitored by a PC. Both programs were repeated 10 times. We measured the time taken to perform the tests, and the count of virtual retinal lacerations. Members of study group II (n=7) did not participate in any in vitro training program. In a second step, all participants had to perform a pars plana vitrectomy in 3 pig eyes including removal of the posterior vitreous interface, and picking up of metallic foreign bodies from the retinal surface. The performance of each participant was graded by masked examiners. Results: In study group I compared with study group II, count of retinal lacerations (1.52 ± 0.96 retinal holes versus 1.81 ± 1.37 retinal holes) was lower, amount of detached retina (22.1 ± 9.1 % of retina detached versus 31.9 ± 27.8% of retina detached) was less, the rating (2.6 ± 0.7 versus 3.2 ± 0.8) was better, the time taken to remove the foreign body (1.7 ± 1.3 min. versus 2.4 ± 1.3 min.) was shorter, and the count of retinal holes created when removing the foreign body (0.2 ± 0.4 retinal holes versus 0.7 ± 1.1 retinal holes) was lower. Conclusions: In an animal model, training by a computer based medical work station for simulation of pars plana vitrectomy can improve the surgical performance of surgically inexperienced residents and medical students.
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