Huang Qi, Yu Lanhui, Gu XueJun
The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province Key Laboratory of Ophthalmology and Vision Sciences, Jiangxi clinical research center for ophthalmic disease, Jiangxi Provincial Key Laboratory of Vitreoretinal Diseases for Health, Nanchang, 330006, Jiangxi, China.
Int Ophthalmol. 2025 Apr 2;45(1):142. doi: 10.1007/s10792-025-03507-4.
The study focuses on developing a cataract capsulorhexis training system incorporating 3D printing and machine vision technologies. This system aims to improve surgical skills and proficiency in cataract surgery among medical students and interns. The initiative utilizes an eye model that closely simulates the capsulorhexis phase of real cataract surgeries, thereby providing a realistic training environment.
A comparative study was conducted involving two cohorts of junior ophthalmologists, each comprising 18 participants. Group A, serving as the control group, did not receive any specific training. In contrast, Group B underwent a structured training regimen over a period of 2 months, with a total training duration of 21 days. Participants in Group B performed 20 capsulorhexis procedures daily, adhering to a prescribed training schedule to ensure the cumulative training time reached 21 days. Subsequently, both groups' capsulorhexis performance was assessed and scored using a virtual reality training system and an animal eye practice system. This dual-assessment approach provided a quantitative measure of the training model's efficacy.
Training with 3D-printed models significantly improves cataract surgery accuracy and consistency. In evaluations using Eyesi and animal eyes, the group B (trained with 3D-printed models) showed lower IOL decentration (0.140 ± 0.020 mm vs 0.198 ± 0.032 mm; P < 0.001) and higher capsulorhexis circularity (0.974 ± 0.022 vs 0.937 ± 0.041; P = 0.001) compared to the group A. Similar trends were observed in animal eye evaluations. However, no significant differences were found in capsulorhexis diameter control between groups. Thus, 3D-printed models enhance surgical precision but have limited impact on capsulorhexis diameter.
Group B, trained with 3D-printed models, demonstrated superior surgical precision and capsulorhexis regularity compared to Group A. Specifically, Group B showed significantly lower IOL decentration and a higher circularity index, indicating improved IOL positioning accuracy and capsulorhexis consistency. There was no significant difference in capsulorhexis diameter between the groups in the Eyesi evaluation, but in the animal eye assessment, Group B had a significantly smaller diameter (p = 0.007). Overall, training with 3D-printed models effectively enhances surgical precision and consistency, though its impact on capsulorhexis diameter control is minimal.
本研究聚焦于开发一种融合3D打印和机器视觉技术的白内障撕囊训练系统。该系统旨在提高医学生和实习生在白内障手术中的手术技能和熟练程度。该项目采用了一种眼模型，能紧密模拟真实白内障手术的撕囊阶段，从而提供一个逼真的训练环境。
进行了一项对比研究，涉及两组初级眼科医生，每组18名参与者。A组作为对照组，未接受任何特定训练。相比之下，B组在2个月的时间里接受了结构化训练方案，总训练时长为21天。B组参与者每天进行20次撕囊操作，遵循规定的训练时间表，以确保累计训练时间达到21天。随后，使用虚拟现实训练系统和动物眼练习系统对两组的撕囊表现进行评估和评分。这种双重评估方法为训练模型的有效性提供了定量衡量。
使用3D打印模型进行训练可显著提高白内障手术的准确性和一致性。在使用Eyesi和动物眼进行的评估中，B组（使用3D打印模型训练）与A组相比，人工晶状体偏心度更低（0.140±0.020毫米对0.198±0.032毫米；P<0.001），撕囊圆度更高（0.974±0.022对0.937±0.041；P=0.001）。在动物眼评估中也观察到了类似趋势。然而，两组在撕囊直径控制方面未发现显著差异。因此，3D打印模型提高了手术精度，但对撕囊直径的影响有限。
与A组相比，使用3D打印模型训练的B组表现出更高的手术精度和撕囊规则性。具体而言，B组的人工晶状体偏心度显著更低，圆度指数更高，表明人工晶状体定位准确性和撕囊一致性得到改善。在Eyesi评估中，两组的撕囊直径无显著差异，但在动物眼评估中，B组的直径显著更小（p=0.007）。总体而言，使用3D打印模型进行训练有效地提高了手术精度和一致性，尽管其对撕囊直径控制的影响最小。
