Posters

Simulation and training models for corneal surgery: a systematic review

Poster Details

First Author: Y.Scantling-Birch UK

Co Author(s): Y. Scantling-Birch   H. Naveed   A. Hussein   S. Hamada           

Abstract Details

Purpose:

Corneal surgery consists of several delicate and complex surgical procedures demanding the highest order of manual dexterity and skill. Training for these procedures has traditionally relied on an apprenticeship model involving ‘see one, do one, teach one’. This style of learning has become increasingly marginalised due to concerns around patient safety, outcomes and rising medicolegal complaints. There is now a drive towards developing high-fidelity training models that allow trainees to acquire skills by practising in an artificial and safe environment before operating on patients. Our group performed a systematic review to identify simulation models available to learn corneal surgery.

Setting:

Sussex Eye Hospital, Brighton, UK

Methods:

The databases of PubMed, Embase, Medline and Cochrane Library were systematically searched using key words and MeSH terms: simulation, training, education, model, cornea, refractive, surgery and keratoplasty. The search yielded 1,206 articles and these were filtered by two independent reviewers to 14 articles based on an inclusion criteria. These articles described bench models of training in keratoplasty procedures, conjunctival allografts and foreign body removal.

Results:

We identified 5 studies that described models for practising Descemet Membrane Endothelial Keratoplasty (DMEK) on human cadaveric corneas. 4 studies that described DMEK models using porcine tissue, artificial chambers and onion skin. 2 studies that created porcine tissue models for practising conjunctival allografts and 3 studies that used artificial chambers for practising foreign body removal. All the included studies provided descriptions of these bench models only. No study had investigated the validity or the educational utility of the relevant teaching modality.

Conclusions:

Simulation provides an immersive environment for trainees to practice procedural techniques that increase expertise, reduce learning curves and improve patient safety. This is especially relevant at a time when traditional apprentice-based teaching is on the decline. There are several novel teaching models to conduct bench practice for cornea and conjunctival procedures. Further work is required in understanding and comparing the educational utility of these models.

Financial Disclosure:

None