Rabethge S., Bender H. J., Jonas J. B.

Department of Ophthalmology and Department of Anesthesiology Mannheim of the University Heidelberg

Purpose: Peeling of epiretinal membranes is an important and difficult part of vitreoretinal surgery. The purpose of the present study was to evaluate whether peeling of epiretinal membranes can be training by using a pars plana vitrectomy simulator (Institute for Computational Medicine, ICM University Mannheim).
Material and Methods: Two residents unexperienced in intraocular surgery had then to run through a test parcours in a computer assisted training system consisting of computer based medical work station for simulation of pars plana vitrectomy. The surgeon manipulated two original instruments inside a cardanically suspended mechanical eye model in which the positions of the instruments were tracked by CCD cameras and monitored by a PC. The task was to remove a epiretinal membrane from the foveal surface. Main outcome measures were the total time needed for removal of the epiretinal membrane, and the count of accidental retina touches.
Results: The time needed for each membrane peeling decreased significantly (p<0.05) with increasing number of the test. Both study participants differed significantly (p<0.001) in the time needed for each test, and in the count of accidental retina touches. The count of accidental retina touches was significantly (p<0.05) and inversely correlated with the time needed to perform the test.
Conclusions: Important and complicated steps in vitreoretinal surgery auch as peeling of epiretinal membranes can at least partially be learnt and trained by using a pars-plana-vitrectomy simulator where the training success and the surgical capacity of the test person can be assessed.

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