Though practicing the various maneuvers involved with the removal of a cataract is the only way to truly get better at the procedure, preparation time for practice surgery can be long, and actual tissue samples can be expensive. Recently, however, two kits aimed at making practicing surgery easier, the Kitaro DryLab and WetLab, made by Japan’s Frontier Vision and distributed by FCI Ophthalmics (Marshfield Hills, Mass.), have been garnering some attention; a video of their use took the grand prizes at both the Asia-Pacific Academy of Ophthalmology and the European Society of Cataract and Refractive Surgery meetings in 2010. The kits are now available to U.S. surgeons. Here’s a look at how they work.
This kit is designed for surgeons to get comfortable with basic instrument manipulation and nucleofractis techniques with three artificial nuclei. The surgeon can use the kit’s mock instruments and three plastic nuclei to practice divide-and-conquer, stopand- chop and phaco chop techniques, as well as nuclear rotation. Malleable resin is used for another nucleus. Tim Johnson, MD, of the University of Iowa, has worked with the Kitaro system and says the DryLab is for mastering the basics. “It’s got the mock phaco handpiece that you insert in the eye,” he says. “You then get an idea of what it’s like to handle the instruments if you’re really a beginner with the surgery.”
With the WetLab, Dr. Johnson says the surgeon gets a nearly complete cataract surgery simulation. “It’s like the real thing in that you’re actually doing all the work of surgery,” he says. “You can practice any or all of the steps from beginning to end, including making the incisions, creating a capsulorhexis and removing the lens, using your phaco machine’s fluidics and tips.” There are also motors to simulate eye movements.
The WetLab comes with four artificial cornea/iris pieces, but the cataractous lenses are sold separately in packs of six and come in a mix of densities. The artificial cornea that comes with the kit is designed to mimic the human cornea in consistency and thickness, although a Japanese surgeon who’s used the device (and who requested that his name not be used) says the feel of the synthetic cornea is noticeably different from that of the human eye.
To get the WetLab up and running, the surgeon pours tap water into the supplied irrigation bag, then connects the bag to a phaco machine. A waterproof box catches the runoff.
Dr. Johnson says that, though nothing can replace a human eye, the system can be useful. “Nothing is exactly like the human,” he says, “but it’s a good adjunct.”
For information, call 1-800-932- 4202 or visit fci-ophthalmics.com or frontiervision.co.jp/index.html.