Various Cataract Model Eyes for Wet Lab Training Using the Microwave Surgical Device

TL;DR

This study introduces a method to create realistic cataract models in pig eyes using microwave devices for better surgical training.

Contribution

A novel microwave-based technique for creating reproducible cataract models in porcine eyes for surgical training.

Findings

Microwave-induced nuclear sclerosis provided realistic tactile feedback for phacoemulsification training.

Posterior polar cataract models were created without posterior capsular rupture during irrigation/aspiration.

The mean CDE value of 8.25 indicated increased nuclear hardness in the cataract models.

Abstract

Purpose

This study aims to develop a highly reproducible and efficient method for inducing lens nucleus hardening in porcine eyes using a microwave surgical device. The resulting cataract model eyes simulate key aspects of cataract surgery, offering an effective platform for enhancing surgical training.

Methods

Freshly enucleated porcine eyes were prepared. A microwave surgical device with a pencil-type electrode (PE) and needle-type electrode (NE) was utilized. The PE was inserted through a scleral incision 4 mm from the corneal limbus, positioned at the center of the lens nucleus, and activated at 50 mW for 30 seconds to create a nucleus cataract model eye. The NE was inserted through a scleral incision 8 mm from the corneal limbus, directed towards the vitreous cavity, and activated at 10 mW for less than 10 seconds to create a posterior polar cataract model eye. The created nucleus cataract model eyes (n=23) were evaluated using a phacoemulsification machine's cumulative dissipated energy (CDE) value.

Results

Thermal coagulation effectively induced nuclear sclerosis, creating a cloudy nucleus cataract model eye without compromising corneal opacity. The anterior capsule was stained with trypan blue to simulate poor visibility in white cataracts, facilitating capsulorhexis training. The hardened lens nucleus allowed for the practice of phaco-chop and divide-and-conquer techniques with realistic tactile feedback, similar to actual cataract surgery. The mean CDE value of the 23 nucleus cataract model eyes was 8.25, indicating increased nuclear hardness. Additionally, posterior capsule thermal denaturation via the vitreous cavity successfully created a posterior polar cataract model eye. Hydrodelineation and irrigation/aspiration were performed without causing posterior capsular rupture.

Conclusion

This study presents a novel method to create realistic nucleus and posterior polar cataract models using a microwave surgical device in porcine eyes. These models provide a reproducible and effective platform for surgical training, simulating key aspects of cataract surgery, including capsulorhexis under poor visibility and phacoemulsification techniques.

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