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Ana Gabriel Montiel García, Diego A. Pérez Juárez, Regina Rodriguez-DeRiquer, Martha P. Jaimes Gutierrez, Enrique O Graue-Hernandez, Jazmín Lucero Pedro Aguilar; Learning curve for in situ corneoescleral excision by health care professionals without previous surgical training. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6305.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the learning curve for in situ corneoescleral excision by health care professionals without previous surgical training, comparing three different approaches in a porcine model.
The study was conducted from March to July 2017 in an ophthalmological center in Mexico City. Participants were randomized into three different learning groups. In each group subjects repeated the technique in pig eyes until satisfactory performance was achieved. Every practice in consecutive eyes was differently distributed over time among groups, for group 1) The whole practice was undertaken in one day having a practice every hour; for group 2) one practice was performed every 24 hours, and for group 3) one practice was performed every seven days. Descriptive statistics were performed by getting central tendency and dispersion measures, as well as an analysis of variance (ANOVA) for independent groups using statistical software STATA version 12.0.
In this study 24 subjects were included. The mean age was 24.8 ± 1.83 years. The average number of attempts needed to obtain the correct corneal recovery technique was 3.0 ± 1.2 times. The average time to perform the technique for each group was: group 1) 25.27 ± 7.41 minutes; group 2) 20.53 ± 5.40 minutes and group 3) 24.12 ± 5.46 minutes. The number of attempts required to perform a satisfactory technique was: group 1) 4.25 ± 0.70 times; group 2) 3.87 ± 0.83 times; group 3) 1.87 ± 0.64 times. In the analysis of variance, there was no significant difference found in the average time to perform the technique, nonetheless, a smaller number of attempts were found in group 3, which performed weekly practice (p <0.01), with an average of 1.87 ± 0.64 times.
Our results suggest that weekly practice of the in situ corneoescleral excision technique, upon meeting the criteria of suitability, reduces the number of attempts required to achieve proper technique, up to an average of 2 eyes per attempt.The standardization of Procurement Protocols by Eye Banks and cornea excision performed by health personnel may increase the corneal donation rate, optimizing human resources and reducing the time between death and recovery. The proper technique of in situ excision allows the procurement of corneal tissue of the highest quality, which could improve resources to increase the amount of viable tissue for transplantation purposes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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