Computer-simulated eye surgery : a novel teaching method for residents and practitioners

Purpose: To describe an eye surgery simulator that uses a computerized graphic display to allow ophthalmic surgeons of all experience levels to enhance their surgical skills. Methods: The eye surgery simulation environment consists of a high-speed computer graphics workstation, a stereo operating system, a wrist rest, and a position tracking stylus connected to force feedback motors. The surgeon views computergenerated images of the eye and surgical instruments through the stereo operating system and controls the position and orientation of the chosen surgical instrument by moving the stylus. During the simulated instrument-tissue interactions, three feedback motors generate component force feedback along three orthogonal axes connected by thin rigid bars to the tip of the stylus. Results: The current proof-of-concept system provides a method for rapid learning experiences in a living eye simulation. Procedures can be recorded for playback and analysis, as well as for examination of techniques from different viewpoints (e.g., from inside the eye). Four simulated surgical instruments are available for use (scalpel, forceps, scissors, and phacoemulsifier). Conclusion: Eye surgery simulation offers both beginning and experienced ophthalmic surgeons an opportunity to learn new techniques and skills and achieve a satisfactory level of proficiency before use of that procedure in the operating room. When fully developed, this system should shorten the learning curve for new surgeons (i.e., residents) and offer an opportunity for practice before doing a difficult case or development of new techniques by experienced surgeons. The goal of replacement of current standard training methods for surgeons awaits further refinement and adjustment of the model.