Presented in part at: American Association of Pediatric Ophthalmology and Strabismus Annual Meeting, March, 2004; Washington, DC.
Received 13 July 2004; accepted 24 November 2004. published online 09 May 2005.
Purpose
To design a model-system instruction course to prepare trainees for performing goniotomy on patients.
Design
Experimental study.
Participants
Three pediatric ophthalmology fellows and 1 recent graduate of the fellowship program.
Methods
We piloted 3 model systems: human cadaver eyes with and without Marty the Surgical Simulator (Iatrotech Inc., Del Mar, CA, hereafter referred to as Marty Head) eye supporting system and artificial eyes in Marty Head. For improving intraocular view in cadaver eyes, we used epithelial scrapping, intracameral viscoelastic, and/or intracameral lubricating jelly. Each trainee underwent a training course, including background reading, didactic lecture, and video review followed by goniotomy on model systems with the operating microscope.
Main Outcome Measures
Each trainee evaluated each step of the course using modified 5-point Likert scales. Reading material and videos were evaluated for usefulness, readability/quality, and new information obtained. Each model system was evaluated for visibility, ease of setup, surgical feel, and transferability to live surgery. In the end, each trainee was asked to assess the overall course for usefulness.
Results
Trainees rated the reading materials and video highly for their usefulness and quality, yet they believed they did not learn substantial amounts of new information. Visibility and ease of setup was best with artificial eyes in the Marty Head model. Human cadaver eyes in the Marty Head provided somewhat less visibility and ease of setup, but the perceived feel and transferability to live surgery was slightly better than with artificial eyes. Cadaver eyes without the Marty Head got the lowest rating in all categories. At the end of the course, all participants felt more confident and ready to perform goniotomy on patients. All recommended this course as part of pediatric ophthalmology fellowship training programs.
Conclusions
This model system instruction course can assist trainees in learning to perform goniotomy while potentially lessening the risks to patients.
Department of Ophthalmology and Vision Science, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
Correspondence to Alex V. Levin, MD, MHSc, FRCSC, Department of Ophthalmology, M-158, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
Manuscript no. 240556.
The authors have no proprietary interest in Marty the Surgical Simulator or any other device used in the study.
Supported by Brandan’s Eye Research Fund, Concord, Canada.
ABSTRACT