I remember during one of my ophthalmology residency interviews asking if the program had a “wet lab”. The then senior resident smiled and replied, “The VA is our wet lab”. Sad but true, many programs do not have significant lab training prior to operating on patients. To address this, some training programs will send their residents abroad to indigent countries to increase their surgical experience. Others will use computer simulators. While these can provide excellent teaching points and can simulate any type of complication, tactile feedback is obviously minimal. Surgery “virtual simulators” have also been developed, and while they can provide a breadth of challenging cases similar to the computer simulations, they too are limited in their realism. Other programs, then, choose to have their own wet labs. However, current wet lab programs with animal or human cadaver eyes do not offer the same realistic experience one can only appreciate with hands-on training. Ideally, there should be a way to maximize resident education and productivity by keeping them local to their training center, yet also provide a valuable “hands on” experience. To that end, FCI Ophthalmics has now released the Kitaro Kit.
The Kitaro Kit allows the ophthalmologist or ophthalmologist-in-training, to practice surgical techniques on a model eye. Pig eyes or non-reusable organ donor eyes have traditionally been the practice material for training. These of course have their own downsides: biohazard use and disposal requirements, unrealistic anterior capsule and posterior capsule integrity, etc.. As this eye is comprised of synthetic materials, it does not require those same restrictions. The bigger question, then, is it just as realistic.
The short answer is ‘yes’. That said, I found the Kitaro kit to offer a much more realistic experience than any animal model. The only exception would be for initial corneal incisions; for both paracentesis and keratome incisions, there was more resistance encountered than with cadaver eyes. That said, I find these are the easiest steps to perform and to teach residents (unless of course you speak to a representative selling a femtophaco device).
Filling the anterior chamber with viscoelastic was similar to both cadaver and animal eyes, but performing capsulorhexis was almost eerie in how realistic it was. I performed several maneuvers, including Brian Little’s rescue technique, and the capsule behaved accordingly. Above all aspects of the Kitaro kit, I found this to be the most impressive, and the most helpful in allowing residents to appreciate different vector forces on performing capsulorhexis.
Epinucleus removal, and well as removal of the lens nucleus, was also extremely realistic. I tried both grooving as well as chop techniques and the lens behaved appropriately, with a very satisfyingly real lens crack. Aspiration of the epinuclear shell/cortex also felt very lifelike. While I did not insert an intraocular lens, there is no doubt in my mind that that too would feel completely genuine.
In summary, the Kitaro kit allows ophthalmologists in training as well as ophthalmologists wishing to try new cataract surgery techniques a true lifelike experience that can be performed without the biohazard risks inherent with cadaver tissue, human or animal. While certain parts can be reused, the disposable aspects are appropriately priced so they can be accessible to anyone.