A Novel Cost-Effective Simulation Model for Continuous Curvilinear Capsulorhexis

Omar Solyman,1,2 Hashem Abu Serhan,3 Hesham F Kamel,1 Amgad Eldib,1,4– 6 Ahmed S Abo Obaia,1 Amr Aref,1 Ibrahim Osama Sayed-Ahmed,7,8 Mohamed Khashaba,9 Mohamed M Khodeiry,1,8 Mokhtar M Abushanab1 1Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt; 2Department of ophthalmology, Qassim University Medical City, Al-Qassim, Saudi Arabia; 3Department of Ophthalmology, Islamic Hospital, Amman, Jordan; 4Division of Paediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA; 5UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 6University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; 7Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 77030, USA; 8Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; 9Department of Anesthesiology, Research Institute of Ophthalmology, Giza, EgyptCorrespondence: Omar Solyman, Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt, Email o.solyman@rio.edu.egIntroduction: We describe and validate a low-cost simulation model for practicing anterior lens capsule continuous curvilinear capsulorhexis (CCC).Methods: A simulation model for CCC was developed from widely available low-cost materials. Ophthalmologists attending the annual scientific meeting of the Research Institute of Ophthalmology, Giza, Egypt, were asked to perform a five CCC model task and then anonymously answer a questionnaire that assessed the realism and training utility of the model using a five-point Likert scale (1 = unacceptable, 2 = poor, 3 = acceptable, 4 = favorable and 5 = excellent).Results: Twenty-seven ophthalmologists completed the task and the anonymous questionnaire. Overall, participants felt that the model simulated CCC step in cataract surgery well (mean: 3.5) and was comparable to other kinds of CCC simulation models (mean: 3.3). The model scored highly for its overall educational value (mean: 4.00) and for enlarging a small CCC (mean:3.7), while the feasibility of this model in practicing the management of a runaway leading edge of CCC scored 2.9.Conclusion: This model may provide an alternative method for training for CCC and other anterior lens capsule-related maneuvers. This option may be particularly helpful for residency training programs with limited access to virtual reality simulators or commercially available synthetic eye models.Keywords: cataract simulation, capsulorhexis, capsulotomy, microsurgical model