
doi: 10.1007/bfb0056279
With the advent of Virtual Reality, surgical simulators have been proposed as a supplement to the education and training of medical residents and post doctoral fellows. A virtual reality simulator can convey the three dimensional anatomical space, provide a means to fine tune surgical skills, and present a variety of pathologies ranging from rare to general cases. Surgical simulators consist of anatomical models, a physics system, a pathology simulation, virtual surgical instruments, and a physical interface. In this study, a new virtual reality system will physically simulate two types of retinal detachment in the human eye: rhegmatogenous detachment and proliferative traction. In addition, a common set of viteoretinal instruments has also been implemented. To accomplish this task, a three dimensional computer eye model was constructed and coupled with a mass-spring system for elastic deformations. Actual surgical instruments were tracked as part of the simulator's physical interface. Rhegmatogenous detachment was physically simulated with an unique force function, while traction was accomplished by reducing the natural rest length of the surface springs. Eight surgical instruments were implemented including: a light probe coupled with a pick, forceps for grasping and elevation, two types of blades for cutting, suction cutter for removal, laser for adhesion, and a drainage needle. The forceps and pick instruments lock the nearest vertex to its position and induce tearing if springs exceed a threshold. A unique 3D surface cutting algorithm subdivides springs and triangles based on the cutting path interactively. The suction cutter simulates material removal by attracting nearby surface elements and subdividing them once they're near its opening. The laser locks nearby vertices and indicates adhesion by altering the retinal texture map. Finally, the drainage needle performs a simple gas-fluid exchange. Four vitreoretinal surgeons evaluated the simulator over two separate testing sessions. A session consisted of three simulated surgical cases followed by a subjective Cooper-Harper survey ranking the simulator's training potential. The completed surveys indicate that with some refinement and better tracking the simulator could be a useful addition to the Ophthalmology training program.
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