Purpose To present the development and current status of keratoprosthesis surgery in Eastern Europe. Methods Collection of data from coauthors and other surgeons involved in k‐pro surgery. Results Large numbers of surgeries were performed in Filatov's Institute in Odessa (Ukraine), where over 1000 different types of devices developed by Puchkovskaya, Yakimienko and Golubenko were imlanted since 1966. The last model, s.c. "universal separable device" was implanted in over 750 with the best results (extrusion occured in about 2.5% cases). K‐pro devices in Russia were mostly developed by S. Fyodorov Z. Moroz, V. Zuyev, ?. Krasnov, V. Volkov, R. Gundorova, N. Ushakov and V. Bedilo. Over 1500 surgeries sine 1969 resulted in the visual aquity improvement in 94% of cases. Haptics were made of titanium, stainless steel and also biocompatible materials (xenopericardium). In Poland about 100 surgeries were performed using mostly Russian and Ukrainian devices. The results were less favorable than in countries of origin. Small numbers were also implanted in other East European states. Conclusion In former Soviet Union keratoprosthesis surgery was well developed in selected centers (Moscow, Odessa). Surgeons in these places have gained extraordinary experience performing hundredes of surgeries. The results presented by the authors were excellent, however they were less favorable in the hands of surgeons from other countries.
Purpose To present methods of teaching residents ocular surgery and present the future needs. Methods Reviewing the existing methods from the literature and selected national society programmes, including the own experience. Results The important features of surgical training programmes are: 1.Selection of trainees, 2.Training methodology, 3.Assessment of results, 4.Disclosure to patients that residents are involved in surgery and informed consent. The training methodology comprises of knowledge of the procedure, supervised training, practical surgical exposure and practice, experience, folow‐up and audit of outcomes. The knowledge comes from reading textbooks, observing videos, 3‐D animation, live surgery and assisting an experienced surgeon. Supervised training should be conducted in skills centers, using practice eyes and/or surgical simulators. Assessment of surgical skills should be a part of continuous assessment of all physicians. Currently no system exists for the routine accurate assessment of surgical skills relating to surgical outcomes in clinical practice. It can be assessed objectively using surgical simulators and by analyzing the database of all surgeries performed by residents and developing an evaluating form of residents surgical skills (OASIS). Patients should be informed that residents may be involved in their surgery in order to avoid possible litigation. Conclusion 1.Reliable methods of candidate selection and assessment need to be developed and established. 2.Continuous assessment of all surgeons and trainers should be introduced. 3.Skills centers and modern training technologies should be available to all trainees. 4.The above considerations could be included in the development of CME programs concerning the improvement of surgical skills
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