Ross Eye Institute, Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
Department of Biostatistics, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
Int Ophthalmol. 2022 Aug;42(8):2323-2333. doi: 10.1007/s10792-022-02229-1. Epub 2022 Jan 29.
We describe a portable practice model for acquisition of microsurgical skills using widely available inexpensive tools and materials as a model in learning ophthalmic corneal suturing skills.
Interested participants without prior microsurgery experience affiliated with the Jacobs School of Medicine and Biomedical Sciences with no prior microsurgical experience qualified to participate. Each participant completed written informed consent. We developed a 3-dimensional micro-stellated icosahedron model using microtubules, monofilament fishing line, jewelers' forceps, and a basic laboratory dissection microscope. We tested this model in improving microsurgical skills in a randomized, controlled intervention trial. Following a pre-assessment task of passing a microsurgical needle and performing a tie, participants were randomized to a control or an intervention (building the micro-stellated icosahedrons) group. The assessment task was repeated after two weeks. Videos of pre- and post-assessments were rated by two masked ophthalmologists. Technique scores and time to complete microsurgical tasks were analyzed to determine improvement in skills.
A total of 27 microsurgically naïve participants were recruited and randomized (14 Intervention / 13 Control). Comparing pre- and post-assessments, the intervention group showed significant decrease in time required to pass the needle (P = 0.018) and significant improvement in technical scores. (P = 0.001). In the control group, there was no significant decrease in time or improvement in technical scores.
The portable inexpensive micro-stellated icosahedron skills acquisition model is an effective practice model to acquire skills necessary to perform a microsurgical tie. The similarity in dimensions between the model and the eye suggests translatability to ophthalmic surgery.
我们描述了一种使用广泛可用的廉价工具和材料获取显微手术技能的便携式实践模型,作为学习眼科角膜缝合技能的模型。
无先前显微手术经验的、隶属于雅各布斯医学院和生物医学科学学院的有兴趣的参与者,且无先前显微手术经验,有资格参加。每位参与者都完成了书面知情同意书。我们使用微管、单丝钓鱼线、珠宝商镊子和基本的实验室解剖显微镜开发了一个 3 维微星状二十面体模型。我们在一项随机对照干预试验中测试了该模型在提高显微手术技能方面的效果。在通过显微手术针和打结的预评估任务之后,参与者被随机分配到对照组或干预组(构建微星状二十面体)。两周后重复评估任务。两位盲法眼科医生对预评估和后评估的视频进行评分。分析技术评分和完成显微手术任务的时间,以确定技能的提高。
共招募并随机分配了 27 名显微手术新手(14 名干预组/13 名对照组)。与预评估相比,干预组通过针的时间明显缩短(P=0.018),技术评分显著提高(P=0.001)。对照组中,通过针的时间或技术评分均无显著改善。
便携式廉价微星状二十面体技能获取模型是一种有效的实践模型,可以获得进行显微手术打结所需的技能。模型和眼睛之间的尺寸相似表明它可转化为眼科手术。