Dataset Information

Modified bandage-contact-lens used as a guide-marker for performing continuous-curvilinear-capsulorhexis by a first-year-post-graduate-ophthalmology-resident.

ABSTRACT:

Purpose

To define the use of modified bandage-contact-lens as a guide-marker for performing continuous-curvilinear-capsulorhexis by a first-year-post-graduate-ophthalmology-resident.

Observation

Phacoemulsification has now become the standard cataract surgery in which anterior capsulorhexis is the first and most crucial step. A perfect capsulorhexis is difficult to learn and even more difficult to master with a steep learning curve when performed free-hand especially by a first-year post-graduate ophthalmology-resident. There is paucity of simple, single-use, easily portable, cost-effective and affordable devices designed especially for performing CCCs in a safe and reproducible way.In our technique, the bandage contact lens (BCL) is trephined using a 6mm corneal trephine. After topical or peribulbar block (as the case may be), the 6mm-guide-marker (trephined BCL) is placed on the cornea. The CCC is then completed using the edge of the contact-lens as a guide for CCC.

Conclusion

AND IMPORTANCE: CCC with contact-lens-guide-marker is expected to yield better results in carrying out the procedure more accurately being closer to the target in terms of size, circularity and centration as compared to contact-lens-unassisted conventional CCC. This would eventually facilitate better surgical outcomes and we recommend this to be applied as the standard protocol for first-year post-graduate ophthalmology-resident performing the surgery.

SUBMITTER: Naik MP

PROVIDER: S-EPMC7481527 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo describe a practical, self-assembled continuous curvilinear capsulorhexis (CCC) self-training system to facilitate resident self-training and shorten the CCC learning curve.MethodsThis was a prospective experimental study that included a total of 600 capsulorhexis cases. A device for CCC practice was self-assembled and used for training and testing. Based on capsulorhexis manipulation experience, three main groups of residents (A, capsulorhexis experience with <50 cases; B, capsulorhexis experience with 400-500 cases; and C, capsulorhexis experience with >1000 cases) were created. Furthermore, based on different capsulorhexis conditions, each main group was divided into four subgroups (1, CCC without an anterior chamber cover and capsulorhexis marker; 2, CCC with an anterior chamber cover without a capsulorhexis marker; 3, CCC with an anterior chamber cover and a capsulorhexis marker; and 4, CCC with an anterior chamber cover and a capsulorhexis marker under 2.5 times magnification). Three CCC-related parameters, including acircularity index (AI), axis ratio (AR), and capsulorhexis time, were statistically evaluated.ResultsWe compared the differences in study parameters among 50 consecutively completed capsulorhexis cases by one trainee with different capsulorhexis experience in each subgroup. The CCC-related parameter values in subgroups 1 and 4 were significantly different among the three groups (P < 0.001). The capsulorhexis time in subgroup 2 was significantly different among the three groups (P < 0.001). The capsulorhexis time and AI in subgroup 3 were significantly different among the three groups (P < 0.001). Moreover, with increasing manipulation experience (from group A-C), the capsulorhexis time, the AI, and AR tended to decrease. With the help of the CCC marker, in subgroups 3 and 4, the AI and AR were closer to 1.0.ConclusionThis self-assembled CCC self-training system is practical. The CCC marker seems helpful for size specification and centration during self-training.

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