RESUMEN
Here we describe a new, non-human, ex-vivo model (goat eye model) for training surgeons in DMEK surgeons. In a wet lab setting, goat eyes were used to obtain a pseudo-DMEK graft of 8 mm from the goat lens capsule that was injected into another goat eye with the same maneuvers described for human DMEK. The DMEK pseudo-graft can be easily prepared, stained, loaded, injected, and unfolded into the goat eye model reproducing the similar maneuvers used for DMEK in a human eye, except for the descemetorhexis, which cannot be performed. The pseudo-DMEK graft behaves similar to human DMEK graft and useful for surgeons to experience and understand steps of DMEK early in learning curve. The concept of a non-human ex-vivo eye model is simple and reproducible and obviates the need for human tissue and the issues of poor visibility in stored corneal tissue.
RESUMEN
A novel simulation model (without using human corneas) has been described for understanding the surgical concepts and developing tactile reflexes of Descemet membrane (DM) endothelium scroll manipulation and orientation in the anterior chamber, which are necessary for performing Descemet membrane endothelial keratoplasty (DMEK). Termed the “DMEK aquarium,” this model helps facilitate the understanding of different maneuvers of the DM graft needed inside the fluid-filled anterior chamber, like unrolling or unfolding, flipping or inversion, and checking orientation and centration in the host cornea. A stepwise plan for surgeons starting to learn DMEK utilizing various available resources is also suggested.
RESUMEN
Purpose: The COVID?19 pandemic has brought medical and surgical training to a standstill across the medical sub?specialties. Closure of outpatient services and postponement of elective surgical procedures have dried up opportunities for training vitreoretinal trainees across the country. This “loss” has adversely impacted trainees’ morale and mental health, leading to feelings of uncertainty and anxiety. Therefore, there is an urgent need to redraw the surgical training program. We aimed to describe a systematic stepwise approach to vitreoretinal surgical training. Methods: We introduced a three?pronged approach to vitreoretinal surgical training comprising learn from home, wet lab and simulator training, and hands?on transfer of surgical skills in the operating room in our institute. Results: Encouraging results were obtained as evaluated by feedback from the trainees about the usefulness of this three?pronged approach in developing surgical skills and building their confidence. Conclusion: The disruption caused by the COVID?19 global pandemic should be used as an opportunity to evolve and reformulate surgical training programs to produce competent vitreoretinal surgeons of the future.
RESUMEN
A relatively simple and inexpensive technique to train surgeons in phacoemulsification using a goat’s eye integrated with a human cataractous nucleus is described. The goat’s eye is placed on a bed of cotton within the lumen of a cylindrical container. This is then mounted on a rectangular thermocol so that the limbus is presented at the surgical field. After making a clear corneal entry with a keratome, the trainer makes a 5–5.5 mm continuous curvilinear capsulorhexis in the anterior lens capsule, creates a crater of adequate depth in the cortex and inserts the human nucleus within this crater in the goat’s capsular bag. The surgical wound is sutured, and the goat’s eye is ready for training. Creating the capsulorhexis with precision and making the crater of adequate depth to snugly accommodate the human nucleus are the most important steps to prevent excessive wobbling of the nucleus while training.