Cataract surgery is currently the most commonly performed surgery on humans worldwide and treats a disease, which results in clouding of the human lens. If left untreated, cataract can lead to blindness, as light is no longer able to reach the retina. In fact, the world health organization (WHO) estimates that 65.2 million people were affected by vision loss due to cataract in 2019.
The main causes for cataract are trauma, congenital disease and especially age. Demographic changes lead to an increasing incidence of cataracts and thus, to a higher demand for ophthalmologists who can perform cataract surgery. However, cataract surgery is a challenging procedure, as it must be performed under microscope guidance and requires micrometer level precision. Hence it has a long learning curve.
Learning with the support from an expert surgeon is very costly. Students usually rely on constant support from expert surgeons to enhance their techniques. Currently VR training systems are being used to help surgeons and students improve their outcomes, nevertheless, these systems are costly and lack the feedback from real physical instruments and eyes, limiting their use to well-funded hospitals and training institutions
“There is a need to develop tools to help train surgeons and assist the entire population needing ophthalmic surgeries”
The most critical step on cataract surgery is capsulorhexis, and mastering it takes time and practice. We are presenting iTrain Rhexis in collaboration with Bioniko , an accessible augmented reality system to use as training and evaluation solution for capsulorhexis, for any surgeon worldwide. In contrast to the current simulators, our proposed solution is much easier to set up, is able to evaluate the surgeon’s performance based on predefined criteria, and provides the possibility for further research based on the collected data through this training system.
Research made in conjunction with the University of Zurich and the Ludwig Maximilian University of Munich, Dr. Muth showed very promising results using the AR application for training capsulorhexis. Nevertheless, the more interesting discovery, was that the expert support group performed worse than participants with no support. Together with the fact that this group took the least amount of time per run, could indicate that when in presence of a mentor, students feel more pressured, which limits their learning experience. Tools like ours, could enable hybrid data driven education. Students can train alone at the beginning, and use mentor’s time when they are comfortable with the basics and they need support mastering the procedure.
“We can continue implementing Augmented Reality applications that guide students on the different steps of microscopic surgical procedures. This will allow us to create affordable, portable and highly customizable Augmented Reality setups to train large numbers of students in microscopic surgical procedures. Thus, decreasing the learning efforts and time, and therefore increasing the number of qualified personnel to operate.”
iTrain Rhexis is the first AR app to train eye doctors to perform cataract surgery on their own smartphones. Now the training can be much more efficient and use experts’ time more productively.
Students can take their time to understand how it works and get accurate guidance before an expert is ready to give more advanced advice.
This new way of training capsulorhexis empowers students and uses experts’ time more effectively.