Images created in a model eye during simulated cataract surgery can be the basis for images perceived by patients during cataract surgery

Abstract

Purpose To evaluate the images created in a model eye during simulated cataract surgery. Patients and methods This study was conducted as a laboratory investigation and interventional case series. An artificial opaque lens, a clear intraocular lens (IOL), or an irrigation/aspiration (I/A) tip was inserted into the 'anterior chamber' of a model eye with the frosted posterior surface corresponding to the retina. Video images were recorded of the posterior surface of the model eye from the rear during simulated cataract surgery. The video clips were shown to 20 patients before cataract surgery, and the similarity of their visual perceptions to these images was evaluated postoperatively. Results The images of the moving lens fragments and I/A tip and the insertion of the IOL were seen from the rear. The image through the opaque lens and the IOL without moving objects was the light of the surgical microscope from the rear. However, when the microscope light was turned off after IOL insertion, the images of the microscope and operating room were observed by the room illumination from the rear. Seventy percent of the patients answered that the visual perceptions of moving lens fragments were similar to the video clips and 55% reported similarity with the IOL insertion. Eighty percent of the patients recommended that patients watch the video clip before their scheduled cataract surgery. Conclusions The patients' visual perceptions during cataract surgery can be reproduced in the model eye. Watching the video images preoperatively may help relax the patients during surgery.

Evaluating the accuracy of a cataract surgery simulation video in depicting patient experiences under conscious anesthesia

“…Compared to our results, Inoue et al reported that video clips were “the same” or “similar” to patient experiences in 50%–70% of patients. [ 20 ] An even higher percentage of patients, 80%, recommended the video clips to future patients. [ 20 ] However, compared to the 20 eyes included in the paper by Inoue et al, our study has a much larger sample size, with 100 eyes included.…”

“…[ 20 ] An even higher percentage of patients, 80%, recommended the video clips to future patients. [ 20 ] However, compared to the 20 eyes included in the paper by Inoue et al, our study has a much larger sample size, with 100 eyes included. Additionally, our study has very significant differences in anesthesia and sedation compared to previous studies evaluating patient visual experiences during cataract surgery [ 4 – 6 , 8 , 11 – 13 , 15 , 17 , 25 – 27 ].…”

“…Previously, it has been reported that patients who received counseling regarding potential intraoperative visual experiences during cataract surgery report significantly less fear during surgery [ 9 ]. Additionally, a number of models for reproducing patient visual perceptions during cataract surgery such as patient generated representations [ 19 ], and model eye video clips [ 20 ], have been found to be effective preoperative communication tools.…”

“…Illustrations have been created based on patient descriptions [ 19 , 21 ]; a model eye was suggested to create short video clips of different portions of cataract surgery from the patient’s point of view. [ 20 ]…”

Light exposure from microscope versus intracameral illumination during cataract surgery

“…This is because our study did not measure the intensity of the light on the macula but at the point of the ocular of an operating microscope. [14] Therefore, it is difficult to compare the light values obtained from this observation to the toxic values reported in the literature. [11]…”