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The focus of this paper is the newly developed Enhanced ChainMail Algorithm that will be used for modeling the vitreous hurnor in the eye during surgical simulation. The simulator incorporates both visualization and biomechanical modeling of a vitrectomy, an intraocular surgical procedure for removing the vitreous humor. The Enhanced ChainMail algorithm extends the capabilities of an existing algorithm for modeling deformable tissue, 3D ChainMail, by enabling the modeling of inhomogeneous material. In this paper, we present the enhanced algorithm and demonstrate its capabilities in 2D.

ABSTRACT.Purpose: To evaluate whether microsurgical steps in vitreoretinal surgery can be taught by a computer-assisted training system. Methods: This prospective, randomized experimental study included 14 ophthalmic residents and medical students who were completely inexperienced in microsurgery. They were randomized into two groups. The study group underwent training programmes in a computer-assisted training system for simulation of pars plana vitrectomy. The control group did not participate in any in vitro training. In the second phase of the study, participants of both groups performed a pars plana vitrectomy in three pig eyes, which included picking a metallic foreign body from the retinal surface. Results: The amount of retinal detachment and the number of retinal defects at the end of the vitrectomies were smaller, the time needed to remove the foreign body was shorter, the number of retinal lesions associated with the foreign body removal was lower, and the mark given was better in the trained study group than in the untrained group. The relatively small number of study participants did not allow the differences between the study and control groups to reach the 5% level of error probability. Conclusions: In an animal model, training by a computer-based medical work station for simulation of pars plana vitrectomy showed better outcome measures for trained study participants compared with untrained study participants. Future studies may show whether further refinements of such training programmes will result in statistically significantly better results in surgical outcome parameters.

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