Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes.
Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes.
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DOI：
10.1167/iovs.15-18818
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发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
Toth CA
中科院分区：
文献类型：
--
作者：
Todorich B;Shieh C;DeSouza PJ;Carrasco-Zevallos OM;Cunefare DL;Stinnett SS;Izatt JA;Farsiu S;Mruthyunjaya P;Kuo AN;Toth CA
扫频光源光学相干断层扫描（SS-OCT）集成到手术显微镜中，可实现实时组织级三维（3D）成像，以辅助眼科显微手术。在这项前瞻性随机对照研究中，我们评估了SS显微镜集成OCT（MI-OCT）对眼科住院医师眼科显微手术操作性能的影响。将来自一家机构的14名眼科住院医师按培训年限分层，并随机分配至在有（MI-OCT+）或无（MI-OCT-）直接术中OCT引导的情况下对猪眼进行4次眼前节手术操作。随后，两组在没有MI-OCT反馈的情况下重复相同的操作，以测试初始MI-OCT经验是否影响后续手术性能。最后，MI-OCT-组被交叉，并允许在直接MI-OCT引导下重复相同的操作。每位居民在研究结束时完成了一项调查。通过直接MI-OCT反馈，住院医师在基于深度的眼前节操作中表现出增强的性能（角膜缝线通过50%和90%深度和角膜撕裂修复）与无MI-OCT手术的居民相比。当两组随后无MI-OCT手术时，显微镜整合OCT+居民继续优于对照组。对于清晰的角膜伤口几何形状，本研究中应用的MI-OCT没有统计学显著效果。总体而言，住院外科医生对使用MI-OCT的主观体验评价非常好。显微镜集成的OCT反馈增强了眼科住院医师在选择眼前节手术操作中的表现。显微镜集成OCT是眼科住院医师外科教育中的一种有价值的工具。
The integration of swept-source optical coherence tomography (SS-OCT) into the operating microscope enables real-time, tissue-level three-dimensional (3D) imaging to aid in ophthalmic microsurgery. In this prospective randomized controlled study, we evaluated the impact of SS microscope-integrated OCT (MI-OCT) on ophthalmology residents' performance of ophthalmic microsurgical maneuvers. Fourteen ophthalmology residents from a single institution were stratified by year of training and randomized to perform four anterior segment surgical maneuvers on porcine eyes with (MI-OCT+) or without (MI-OCT−) direct intraoperative OCT guidance. Subsequently, both groups repeated the same maneuvers without MI-OCT feedback to test whether initial MI-OCT experience affected subsequent surgical performance. Finally, the MI-OCT− group was crossed over and allowed to repeat the same maneuvers with direct MI-OCT guidance. Each resident completed a survey at the completion of the study. With direct MI-OCT feedback, residents demonstrated enhanced performance in depth-based anterior segment maneuvers (corneal suture passes at 50% and 90% depth and corneal laceration repair) compared with the residents operating without MI-OCT. Microscope-integrated OCT+ residents continued to outperform the controls when both groups subsequently operated without MI-OCT. For clear corneal wound geometry, there was no statistically significant effect of MI-OCT as applied in this study. Overall, the resident surgeons rated their subjective experience of using MI-OCT very favorably. Microscope-integrated OCT feedback enhances performance of ophthalmology residents in select anterior segment surgical maneuvers. Microscope-integrated OCT represents a valuable tool in the surgical education of ophthalmology residents.