Novel minimally invasive glaucoma surgery training models: corneal rim and tack driver

Session Details

Session Title: Presented Poster Session: Training & Quality of Vision

Venue: Poster Village: Pod 3

First Author: : A.Arora CANADA

Co Author(s): :    D. Wang   S. Nazarali   L. Sawatzky   M. Schlenker   I. Ahmed   P. Gooi        

Abstract Details

Purpose:

To reveal and discuss two novel minimally invasive glaucoma surgical (MIGS) training models called “K-RIM” and “Tackdriver” for training MIGS procedures.

Setting:

Rockyview General Hospital (7007 14 St SW, T2V 1P9), Calgary, Alberta, Canada

Methods:

The corneal rim (K-RIM) and Tackdriver training models utilize human cadaveric corneoscleral rims allowing for minimal preparation required. For K-RIM, two large diameter trephines were used to trephinate the corneoscleral rim at surgical three and nine clock hours. The corneoscleral rim was placed on a Styrofoam base placed at 30-degree angle and fixed upwards while filled with medical lubricant in the anterior chamber to serve as the optical coupler. For Tackdriver, 1-2 tacks are used to secure the apex of the inverted corneoscleral rims. iStent placements were done prior to Gonioscopy Assisted Transluminal Trabeculotomy (GATT) to maximize procedures per tissue.

Results:

These novel MIGS training models allow for ease of preparation with minimal steps required yielding a high volume of surgical training for MIGS procedures. K-RIM was noted to be more challenging to prepare relative to Tackdriver requiring a single step with enhanced tissue stability and consistency. These training models are both economically and ergonomically plausible for trainees and surgeons to utilize. Both models allow iStent injection practice and GATT in 90, 180, 270 and 360-degree fashions. Buckling of Schlemm’s canal in K-RIM resulted in difficulty performing GATT. These training models allow for bimanual technique practice with realistic tactile feedback.

Conclusions:

The two presented novel training models allow for MIGS techniques to be practiced with realistic tactile feedback and use of the bimanual technique with a gonioprism. This recreates the surgical in vivo conditions. There are a limited number of training models for MIGS procedures with an even smaller cohort utilizing cadaveric corneoscleral rims. Our training models are both efficient and cost-effective in set up and have been productively utilized in large group settings such as the Surgical Skills Transfer Courses (COS).

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented