Posters

Home-based high fidelity low cost simulation of DMEK using a smartphone and an onion to replace an operating microscope and corneal donor tissue

Poster Details

First Author: C.Gunasekera UK

Co Author(s):    T. Patel   U. Hussain                 

Abstract Details

Purpose:

Endothelial decompensation is the commonest indication to transplant in the United Kingdom. Descemet membrane endothelial keratoplasty (DMEK) is growing with popularity. There is also a growing demand in human corneal graft tissue meaning having tissue to learn new skills is limited. Operating microscopes are limited to theatre use and are usually required gain the motor skills necessary for learning DMEK. Recently, an onion has been found to be a suitable model for DMEK simulation. We report a method using a smartphone to replace an operating microscope and an onion to simulate corneal donor tissue for practicing DMEK surgery.

Setting:

West Suffolk Hospital NHS Foundation Trust, United Kingdom

Methods:

A smartphone mount with light emitting diode ring light was set up on a table with a smartphone attached. An inner membrane of an onion was prepared for use. The camera application was started and a 3 times optical zoom was used. The onion was trephined and stained with vision blue. Forceps were used to peel the onion membrane forming a scroll and the scroll was injected into an artificial anterior chamber.

Results:

Successful simulation of DMEK peeling, aspiration and injection can be undertaken using an onion, smartphone, and smartphone mount. These steps can be practised several times and video recording can also take place for reflective surgical simulation.

Conclusions:

This cost effective technique can be easily replicated for surgeons who wish to practice DMEK surgery. Limitations currently exist including a monocular view from the smartphone versus binocular, however the authors find the motor skills training is similar to binocular practice. This study would be of interest to surgeons wishing to practice steps of DMEK surgery at home.

Financial Disclosure:

None