K-RIM (Corneal Rim) Angle Surgery Training Model

Abstract

Purpose: To develop an angle surgery training model for training an array of microincisional glaucoma surgery (MIGS) procedures. Methods: We describe a method for preparing an angle surgery training model using human cadaveric corneoscleral rims. The model provides realistic tactile tissue simulation and excellent angle visualization requiring bimanual technique. Corneoscleral rims may be used multiple times and are prepared at low cost, allowing for a high volume of practice surgeries. Results: This model allows for practice in bimanual surgical training using the gonioscopy lens for visualize alongside surgical tools. The in vivo surgical conditions and limited tactile feedback are recreated using human cadaveric eyes which nonhuman models fail to provide. Our model is prepared at low cost, with relative ease and also provides appropriate positioning of Schlemm canal and for high volume of practice as the canal can be used in 90-degree segments. Conclusions: Few angle surgery training models currently exist and none provide these necessary features. The model presented here aims to meet the growing demand for adequate training models required for technically advanced MIGS techniques.

Prospective Study of Canaloplasty and Trabeculotomy Performed by Trainees

“…Models for practicing angle based glaucoma surgery using cadaveric corneoscleral rims have been shown to be an effective way to introduce and enhance the skill sets needed for gonio-based surgeries. [28][29][30] Specifically, the amount of time to perform goniotomy procedures improved after practicing with the model. 28 A study by Dang et al using an ex vivo pig-eye model for gonioscopic surgery found that trainees' surgical times decreased by 1.4 minutes with each subsequent eye, reducing total operative times from 25 minutes with the first procedure to 5 minutes at the end of the training.…”