Tomita Kosei, Akimoto Masayuki, Ieki Yoshiaki, Miki Atsushi
Ophthalmology, Kawasaki Medical School, Okayama, JPN.
Ophthalmology, Osaka Red Cross Hospital, Osaka, JPN.
Cureus. 2025 Apr 9;17(4):e81965. doi: 10.7759/cureus.81965. eCollection 2025 Apr.
Purpose This study aims to develop a highly reproducible and efficient method for inducing lens nucleus hardening in porcine eyes using a microwave surgical device. The resulting cataract model eyes simulate key aspects of cataract surgery, offering an effective platform for enhancing surgical training. Methods Freshly enucleated porcine eyes were prepared. A microwave surgical device with a pencil-type electrode (PE) and needle-type electrode (NE) was utilized. The PE was inserted through a scleral incision 4 mm from the corneal limbus, positioned at the center of the lens nucleus, and activated at 50 mW for 30 seconds to create a nucleus cataract model eye. The NE was inserted through a scleral incision 8 mm from the corneal limbus, directed towards the vitreous cavity, and activated at 10 mW for less than 10 seconds to create a posterior polar cataract model eye. The created nucleus cataract model eyes (n=23) were evaluated using a phacoemulsification machine's cumulative dissipated energy (CDE) value. Results Thermal coagulation effectively induced nuclear sclerosis, creating a cloudy nucleus cataract model eye without compromising corneal opacity. The anterior capsule was stained with trypan blue to simulate poor visibility in white cataracts, facilitating capsulorhexis training. The hardened lens nucleus allowed for the practice of phaco-chop and divide-and-conquer techniques with realistic tactile feedback, similar to actual cataract surgery. The mean CDE value of the 23 nucleus cataract model eyes was 8.25, indicating increased nuclear hardness. Additionally, posterior capsule thermal denaturation via the vitreous cavity successfully created a posterior polar cataract model eye. Hydrodelineation and irrigation/aspiration were performed without causing posterior capsular rupture. Conclusion This study presents a novel method to create realistic nucleus and posterior polar cataract models using a microwave surgical device in porcine eyes. These models provide a reproducible and effective platform for surgical training, simulating key aspects of cataract surgery, including capsulorhexis under poor visibility and phacoemulsification techniques.
目的 本研究旨在开发一种使用微波手术设备诱导猪眼晶状体核硬化的高度可重复且高效的方法。由此产生的白内障模型眼模拟了白内障手术的关键方面,为加强手术训练提供了一个有效的平台。方法 准备新鲜摘除的猪眼。使用带有笔型电极(PE)和针型电极(NE)的微波手术设备。将PE通过距角膜缘4mm的巩膜切口插入,置于晶状体核中心,以50mW激活30秒,创建核性白内障模型眼。将NE通过距角膜缘8mm的巩膜切口插入,朝向玻璃体腔,以10mW激活少于10秒,创建后极性白内障模型眼。使用超声乳化仪的累积消散能量(CDE)值评估所创建的核性白内障模型眼(n = 23)。结果 热凝有效地诱导了核硬化,创建了一个混浊的核性白内障模型眼,而不影响角膜透明度。用台盼蓝对前囊进行染色,以模拟白色白内障时的可视性差,便于撕囊训练。硬化的晶状体核允许在具有真实触觉反馈的情况下练习超声乳化劈核和分而治之技术,类似于实际的白内障手术。23只核性白内障模型眼的平均CDE值为8.25,表明核硬度增加。此外,通过玻璃体腔进行的后囊热变性成功创建了后极性白内障模型眼。进行水分离和灌洗/抽吸时未导致后囊破裂。结论 本研究提出了一种使用微波手术设备在猪眼中创建逼真的核性和后极性白内障模型的新方法。这些模型为手术训练提供了一个可重复且有效的平台,模拟了白内障手术的关键方面,包括在可视性差的情况下进行撕囊和超声乳化技术。