Cataract surgery is arguably the most commonly performed operation in ophthalmology.Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primaril...Cataract surgery is arguably the most commonly performed operation in ophthalmology.Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure.Therefore,wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons,which establishes tissue awareness,dexterity and muscle memory required to perform each step of the procedure,safely.Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs.In the operating room,topical anesthesia is a safe alternative for teaching cataract surgery.There are three well-described approaches to teaching individual steps of cataract surgery:forward,“backwards”,and deconstructed step-by-step instruction.Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room.The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery(OASIS),Global Rating Assessment of Skills in Intraocular Surgery(GRASIS),and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics(ICO-OSCAR).We review the literature on trends in surgical teaching in ophthalmology,with the focus on cataract surgery instruction to the novice surgeon.展开更多
AIM: To compare under similar conditions intraoperative surgical efficiencies metrics between an active fluidics and a gravity based phacoemulsification systems.METHODS: Adult patients who were diagnosed with a catara...AIM: To compare under similar conditions intraoperative surgical efficiencies metrics between an active fluidics and a gravity based phacoemulsification systems.METHODS: Adult patients who were diagnosed with a cataract that compromised visual acuity inferior to 20/40 were included in the study. Patients were excluded from the study if they had a history of severe retinal disorders, clinically significant corneal endothelial dystrophy or history of corneal disease. All phacoemulsification surgeries were performed by a single surgeon. Both phacoemulsification systems used the 0.9 mm 45-degree aspiration bypass system Intrepid Balanced tip and the 0.9 mm Intrepid Ultra infusion sleeve. All cataracts were classified using the Lens Opacities Classification System III, cumulative dissipated energy(CDE) and aspiration fluids were measured in each surgery.RESULTS: Totally 2000 eyes were included in the study. Phacoemulsification was performed in 1000(50%) eyes with an active fluid dynamics system and in 1000(50%) eyes with a gravity-based fluidic system. Mean CDE until fracture of the lens was 1.1 and 1.9 percent-seconds and total mean CDE used was 5.6 and 7.2 percent-seconds using an active fluidics dynamics system and gravity-based fluidic system, respectively(P<0.001). Mean aspiration fluids used were 70 m L using an active fluidics dynamics system and 85 m L using a gravity-based fluidic system(P<0.001).CONCLUSION: This study evidences that surgeries performed under similar conditions(same surgeon, phaco tip and sleeve) with the active fluidics dynamics system required significantly lower CDE and aspiration fluids.展开更多
Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who w...Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who were trained in the third year of ophthalmology at the First Affiliated Hospital of Xi’an Medical University were selected as the research objects.After passing the theoretical examination,they were randomly divided into the pig eyeball group,Eyesi group,and pig eye+Eyesi group,with 5 students in each group.The pig eyeball,Eyesi surgery simulator,and pig eye+Eyesi surgery simulator were used for microscopic technique operation and cataract surgery steps training,respectively.After the training,the overall training effects of the three groups of postgraduates were scored,and questionnaires were used to objectively evaluate the three training methods.Results:The scores of the students in the pig eye+Eyesi group were better than those in the Eyesi group,and the students in the Eyesi group were better than those in the pig eyeball group.Conclusion:The Eyesi surgical simulation training system can evaluate the microsurgical skills of professional masters and improve their surgical skills.This system is of great significance for the training of the cataract surgery skills of professional masters.展开更多
文摘Cataract surgery is arguably the most commonly performed operation in ophthalmology.Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure.Therefore,wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons,which establishes tissue awareness,dexterity and muscle memory required to perform each step of the procedure,safely.Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs.In the operating room,topical anesthesia is a safe alternative for teaching cataract surgery.There are three well-described approaches to teaching individual steps of cataract surgery:forward,“backwards”,and deconstructed step-by-step instruction.Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room.The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery(OASIS),Global Rating Assessment of Skills in Intraocular Surgery(GRASIS),and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics(ICO-OSCAR).We review the literature on trends in surgical teaching in ophthalmology,with the focus on cataract surgery instruction to the novice surgeon.
文摘AIM: To compare under similar conditions intraoperative surgical efficiencies metrics between an active fluidics and a gravity based phacoemulsification systems.METHODS: Adult patients who were diagnosed with a cataract that compromised visual acuity inferior to 20/40 were included in the study. Patients were excluded from the study if they had a history of severe retinal disorders, clinically significant corneal endothelial dystrophy or history of corneal disease. All phacoemulsification surgeries were performed by a single surgeon. Both phacoemulsification systems used the 0.9 mm 45-degree aspiration bypass system Intrepid Balanced tip and the 0.9 mm Intrepid Ultra infusion sleeve. All cataracts were classified using the Lens Opacities Classification System III, cumulative dissipated energy(CDE) and aspiration fluids were measured in each surgery.RESULTS: Totally 2000 eyes were included in the study. Phacoemulsification was performed in 1000(50%) eyes with an active fluid dynamics system and in 1000(50%) eyes with a gravity-based fluidic system. Mean CDE until fracture of the lens was 1.1 and 1.9 percent-seconds and total mean CDE used was 5.6 and 7.2 percent-seconds using an active fluidics dynamics system and gravity-based fluidic system, respectively(P<0.001). Mean aspiration fluids used were 70 m L using an active fluidics dynamics system and 85 m L using a gravity-based fluidic system(P<0.001).CONCLUSION: This study evidences that surgeries performed under similar conditions(same surgeon, phaco tip and sleeve) with the active fluidics dynamics system required significantly lower CDE and aspiration fluids.
文摘Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who were trained in the third year of ophthalmology at the First Affiliated Hospital of Xi’an Medical University were selected as the research objects.After passing the theoretical examination,they were randomly divided into the pig eyeball group,Eyesi group,and pig eye+Eyesi group,with 5 students in each group.The pig eyeball,Eyesi surgery simulator,and pig eye+Eyesi surgery simulator were used for microscopic technique operation and cataract surgery steps training,respectively.After the training,the overall training effects of the three groups of postgraduates were scored,and questionnaires were used to objectively evaluate the three training methods.Results:The scores of the students in the pig eye+Eyesi group were better than those in the Eyesi group,and the students in the Eyesi group were better than those in the pig eyeball group.Conclusion:The Eyesi surgical simulation training system can evaluate the microsurgical skills of professional masters and improve their surgical skills.This system is of great significance for the training of the cataract surgery skills of professional masters.
