Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes

Autor: Sandra S. Stinnett, Christine Shieh, Bozho Todorich, Cynthia A. Toth, David Cunefare, Sina Farsiu, Anthony N. Kuo, Privthi Mruthyunjaya, Philip J. DeSouza, Joseph A. Izatt, Oscar Carrasco-Zevallos
Rok vydání: 2016
Předmět:
Male
Microsurgery
medicine.medical_specialty
Eye Diseases
genetic structures
medicine.medical_treatment
01 natural sciences
law.invention
010309 optics
03 medical and health sciences
Imaging
Three-Dimensional
0302 clinical medicine
Optical coherence tomography
Suture (anatomy)
Randomized controlled trial
Anterior Eye Segment
law
Monitoring
Intraoperative
Ophthalmology
Cornea
0103 physical sciences
medicine
Humans
Prospective Studies
Prospective cohort study
ophthalmologic surgical procedures
Microscopy
optical coherence tomography
medicine.diagnostic_test
business.industry
Corneal laceration
Internship and Residency
Articles
eye diseases
Surgery
medicine.anatomical_structure
Surgery
Computer-Assisted
030221 ophthalmology & optometry
Female
Clinical Competence
sense organs
Operating microscope
business
Tomography
Optical Coherence
resident education
Zdroj: Investigative Ophthalmology & Visual Science
ISSN: 1552-5783
DOI: 10.1167/iovs.15-18818
Popis: Purpose The integration of swept-source optical coherence tomography (SS-OCT) into the operating microscope enables real-time, tissue-level three-dimensional (3D) imaging to aid in ophthalmic microsurgery. In this prospective randomized controlled study, we evaluated the impact of SS microscope-integrated OCT (MI-OCT) on ophthalmology residents' performance of ophthalmic microsurgical maneuvers. Methods Fourteen ophthalmology residents from a single institution were stratified by year of training and randomized to perform four anterior segment surgical maneuvers on porcine eyes with (MI-OCT+) or without (MI-OCT−) direct intraoperative OCT guidance. Subsequently, both groups repeated the same maneuvers without MI-OCT feedback to test whether initial MI-OCT experience affected subsequent surgical performance. Finally, the MI-OCT− group was crossed over and allowed to repeat the same maneuvers with direct MI-OCT guidance. Each resident completed a survey at the completion of the study. Results With direct MI-OCT feedback, residents demonstrated enhanced performance in depth-based anterior segment maneuvers (corneal suture passes at 50% and 90% depth and corneal laceration repair) compared with the residents operating without MI-OCT. Microscope-integrated OCT+ residents continued to outperform the controls when both groups subsequently operated without MI-OCT. For clear corneal wound geometry, there was no statistically significant effect of MI-OCT as applied in this study. Overall, the resident surgeons rated their subjective experience of using MI-OCT very favorably. Conclusions Microscope-integrated OCT feedback enhances performance of ophthalmology residents in select anterior segment surgical maneuvers. Microscope-integrated OCT represents a valuable tool in the surgical education of ophthalmology residents.
Databáze: OpenAIRE
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