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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2021; 13(01): e57-e65
DOI: 10.1055/s-0041-1725093
Research Article

Comparison of Simulation-Based versus Cadaveric-Tissue-Based Ocular Trauma Training on Novice Ophthalmologists: Repair of Corneal Laceration Model

Boonkit Purt
1   Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland
2   Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
,
Timothy Ducey
1   Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Sean Sykes
1   Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Joseph F. Pasternak
1   Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland
2   Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
,
Denise S. Ryan
3   Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
,
Rose K. Sia
3   Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
,
Marcus H. Colyer
1   Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland
2   Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
› Author Affiliations Financial Support Funded by the U.S. Army Medical Research and Materiel Command Award #TL100010.
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Abstract

Purpose The aim of this study was to evaluate whether the simulated tissue models may be used in place of animal-based model for corneal laceration repair for surgical skills acquisition.

Design Prospective randomized controlled trial.

Participants Seventy-nine military and civilian 2nd- and 3rd-year ophthalmology residents and 16 staff ophthalmologists participating in the Tri-Service Ocular Trauma Skills Laboratory at the Uniformed Services University (Bethesda, MD).

Methods Resident ophthalmologists underwent preliminary evaluation of their ability to close a 5-mm linear, full-thickness corneal laceration involving the visual axis. They then were randomized to undergo 90 to 120 minutes of either simulator-based (SIM) or swine cadaveric-tissue-based (CADAVER) corneal laceration repair. The same evaluation was performed post training. On a more limited basis, the study was repeated for attending ophthalmologists to act as a pilot for future analysis and test efficacy for “refresher” training.

Main Outcome Measures Successful wound closure with secondary outcomes of suture length, tension, depth, and orientation, as graded by attending ophthalmologists.

Results No significant difference in CADAVER versus SIM groups in the primary outcome of watertight wound closure of the corneal laceration. CADAVER group performed better than SIM group for certain metrics (suture depth, p = 0.009; length, p = 0.003; and tension, p = 0.043) that are associated with poor wound closure and increased amount of induced corneal astigmatism. For attending ophthalmologists, six of the eight in each group (SIM and CADAVER) retained or improved their skills.

Conclusions For resident ophthalmologists, SIM training is sufficient for achieving the primary outcome of watertight wound closure. However, CADAVER training is superior for wound metrics for the ideal closure. For attending ophthalmologists, SIM training may be useful for retention of skills.

Keywords

ophthalmology - simulation - training - cornea - trauma

Meeting Presentation

Portions of this material were presented at the annual meetings of the Military Health System Research Symposium, Orlando, Florida, August 2016 and 2017.


Disclaimer

The views expressed in this article are those of the author(s) and do not reflect the official policy of the Department of the Army/Navy/Air Force, Uniformed Services University, Defense Health Agency, Department of Defense, or the U.S. Government. Discussion or mention of any commercial products or vendor names within this publication does not constitute endorsement or implied endorsement on the part of the Department of Defense or any other organization as stated above.




Publication History

Received: 04 October 2020

Accepted: 12 January 2021

Article published online:
20 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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