From the Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York (Raval, Shrivastava); Albert Einstein College of Medicine, Bronx, New York (Hawn); Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York (Kim, Xie).
J Cataract Refract Surg. 2022 May 1;48(5):611-615. doi: 10.1097/j.jcrs.0000000000000820. Epub 2021 Sep 21.
To evaluate performance and assessments by expert surgeons tasked to create a continuous curvilinear capsulorhexis (CCC) on 3 commercially available surgical simulators.
Montefiore Medical Center Department of Ophthalmology and Visual Sciences, Bronx, New York.
Randomized, cross-sectional, comparative study.
Expert cataract surgeons (N = 7) were tasked to create a 5.5-mm CCC on 3 surgical simulators (Bioniko, Kitaro, and SimulEYE). Surgeons rated how well each simulator approximated human tissue on a modified Likert scale (1 to 7). Duration, size, and number of forceps grabs were evaluated.
7 surgeons performed a total of 63 trials. Bioniko required a greater number (6.53 ± 3.14) of forceps grabs for CCC creation than Kitaro (4.90 ± 2.47, P = .01) and SimulEYE (3.90 ± 1.34, P < .0001). Surgeons created the 5.5-mm CCC most accurately on Bioniko and SimulEYE, with the largest mean CCC performed on Kitaro (8.00 ± 0.84) compared with that on Bioniko (5.24 ± 0.60, P < .0001) and SimulEYE (5.11 ± 0.41, P < .0001). Surgeons spent more time (seconds) performing the CCC on Bioniko (41.95 ± 26.70) than that on Kitaro (32.05 ± 14.99, P = .02) and SimulEYE (28.90 ± 15.18, P = .002). Kitaro (4.56 ± 0.84, P < .0001) and SimulEYE (4.19 ± 0.92, P < .0001) were rated as more realistic than Bioniko (1.38 ± 0.80).
SimulEYE and Kitaro were believed to most closely approximate human capsular tissue, and surgeons performed the CCC fastest on these models. However, surgeons created a 5.5-mm CCC most accurately on SimulEYE and Bioniko. SimulEYE had the best overall performance and fidelity across all studied metrics; however, each simulator demonstrated its own unique advantages and disadvantages. Larger validation studies will help residency programs best use training tools for novice surgeons.
评估专家外科医生在 3 种市售手术模拟器上创建连续曲线囊膜环形撕囊（CCC）的表现和评估。
纽约布朗克斯蒙特菲奥雷医学中心眼科和视觉科学系。
随机、横断面、比较研究。
专家白内障外科医生（N=7）被要求在 3 种手术模拟器（Bioniko、Kitaro 和 SimulEYE）上创建 5.5mm 的 CCC。外科医生使用改良的李克特量表（1 到 7）对每个模拟器模拟人体组织的程度进行评分。评估了手术时间、切口大小和镊夹抓取次数。
7 名外科医生共完成 63 次试验。Bioniko 完成 CCC 所需的镊夹抓取次数（6.53±3.14）多于 Kitaro（4.90±2.47，P=.01）和 SimulEYE（3.90±1.34，P<.0001）。外科医生在 Bioniko 和 SimulEYE 上最准确地创建了 5.5mm 的 CCC，Kitaro 上创建的 CCC 最大（8.00±0.84），而 Bioniko（5.24±0.60，P<.0001）和 SimulEYE（5.11±0.41，P<.0001）。外科医生在 Bioniko 上完成 CCC 所需的时间（秒）（41.95±26.70）多于 Kitaro（32.05±14.99，P=.02）和 SimulEYE（28.90±15.18，P=.002）。Kitaro（4.56±0.84，P<.0001）和 SimulEYE（4.19±0.92，P<.0001）被认为比 Bioniko（1.38±0.80）更逼真。
SimulEYE 和 Kitaro 被认为最接近人体囊膜组织，外科医生在这些模型上完成 CCC 的速度最快。然而，外科医生在 SimulEYE 和 Bioniko 上最准确地创建了 5.5mm 的 CCC。SimulEYE 在所有研究指标中表现最好，保真度最高；然而，每个模拟器都有其独特的优点和缺点。更大规模的验证研究将帮助住院医师培训计划为新手外科医生最好地使用培训工具。
