Revolutionising ophthalmic training
Welcome to our first issue of 2024! We have included a review article, two original studies and two case reports in this issue, which is to be published in time for the 2024 OSSA Congress in Gqeberha. One of the original studies hails from the University of Cape Town (UCT), who will also be presenting on the role of simulated surgery training in teaching ophthalmic surgery and the progress that has been made in this regard, at the congress. This topic has been discussed in the SAOJ on a couple of occasions in the recent past and it may be useful to revisit it up here again, especially after the acquisition of the Eyesi virtual simulator and the plan to potentially introduce a similar Alcon unit at the OSSA conference this year.
In November 2023, the UCT Division of Ophthalmology, under the auspices of its Community Eye Health Institute (CEHI), officially launched the Simulation Ophthalmic Surgical (SOS) training programme of its Simulated Surgery Training Unit (SSTU). The launch was attended by, amongst others, representatives from the Royal College of Ophthalmologists (RCOphth) and the European Society of Cataract and Refractive Surgeons (ESCRS). The role of simulation is increasingly being recognised in ophthalmic training for new skill acquisition and refining established techniques. The American Academy of Ophthalmology (AAO) notes that, “Simulation based training has proven value in teaching surgical skills to ophthalmology residents and fellows. Additionally, simulations can be effective for the practicing ophthalmologist to prepare for a specific procedure which he or she has not had recent experience with, prior to performing that procedure on a patient.” While the RCOphth states that, “Simulation training using artificial model eyes and artificial intelligence (AI) is transforming the way trainee ophthalmologists develop surgical and clinical skills by simulating live surgery situations. Frequent practice on simulators enables trainees to become familiar with surgical steps and refine their techniques in a safe environment.” I think that we can all agree that simulated surgery provides a protected environment for developing skills in less experienced trainees; fosters lower stress levels in terms of teaching surgery for trainers; and ultimately is safer for our patients.
The SSTU at UCT, was initiated by Hon A/Prof Will Dean and Emeritus Prof Colin Cook who both helped establish the original wet lab. Will Dean completed the studies that made up his PhD here. These studies centred on manual small-incisional cataract surgery (MSICS) and glaucoma surgery in the form of trabeculectomy. The studies commenced in 2017 and subsequent courses started in 2019. Since 2019, more than 120 trainees from South Africa and 20 other countries around the world have benefited from the courses. Additional courses have since been added, viz. basic microsurgery, cataract surgery by phaco-emulsification and retinal surgery in the form of pars-plana vitrectomy (PPV). Funds raised via donations were used to purchase the Eyesi virtual simulator from Haag-Streit, which is the only one of its kind in sub-Saharan Africa, if not the whole African continent. Eyesi Surgical is a high-end virtual reality simulator for intraocular surgery training. The Eyesi platform can be equipped with interfaces for cataract and vitreoretinal surgery. Training units range from basic skills-training through to surgical procedures and complications management. This acquisition has added tremendous value to the SOS courses.
Orbis International allows access to their online Cybersight platform for pre-training material and videos. Envision Africa set up the initial Phaco lab, Alcon has donated microscopes and phaco machines; and Genop also donated phaco machines. The RCOphth have donated three phaco machines to the unit and ESCRS has agreed to provide funds for expanding the unit, as well as funding trainees and trainers. James Rice was instrumental in acquiring the EyeSi, developing the simulated PPV course and has a keen interest in low-cost simulation. Jonathan Pons from eSwatini, is a regular trainer on the MSICS and glaucoma courses. Jill de Villiers, Jonel Steffen and David Steven have all been actively involved in teaching on courses. Dr Deon Minnies, director of the CEHI, manages many parts of the SOS programme.
The HPCSA / CMSA will now be engaged on the topic and encouraged to consider making simulated cataract surgery courses a prerequisite for trainees who intend applying for registrar training posts, like the AAO and RCOphth, who have already taken this step.
Please continue to support us by submitting your valuable work for publication in the SAOJ.
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South African Ophthalmology Journal
guidelines for authors
The SA Ophthalmology Journal is a peer-reviewed scientific journal and the official mouthpiece of the Ophthalmological Society of South Africa. It appears on a quarterly basis.
- The South African Ophthalmology Journal invites review articles, original studies and case reports for submission. Articles should be the original, unpublished work of the stated author. All materials submitted for publication must be submitted exclusively for publication in this journal. Written permission from the author or copyright holder must be submitted with previously published figures, tables or articles. Authors are solely responsible for the factual accuracy of their work.
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Articles: Kaplan FS, August CS, Dalinka MK. Bone densitometry observation of osteoporosis in response to bone marrow transplantation. Clin Orthop 1993;294:173-78.
Chapter in a book: Young W. Neurophysiology of spinal cord injury. In: Errico TJ, Bauer RD, Waugh T (eds). Spinal Trauma. Philadelphia: JB Lippincott; 1991: 377-94.
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Contents - Academic
FROM THE EDITOR
Revolutionising ophthalmic training
N du Toit
GUIDELINES FOR AUTHORS
An overview of acute management in chemical eye injuries
E Jansen, A Moodley
Outcomes of penetrating keratoplasty at a tertiary institution in South Africa
Y Theron, N du Toit, M Gajjar
A comparative year-on-year study into the change of patterns of Open Globe Injuries (OGI) in two South African academic eye Centres during the Covid-19 crisis
P Snyman, C Kruse
Diagnostic and treatment challenges in a patient with combined superior ophthalmic vein thrombosis and cavernous sinus thrombosis
A Weidemann, N Phatudi
From a BCVA of 0.1 to 1.0 - Refractive correction after radial keratotomy and arcuate keratotomy procedures
S Mallabone, L Coetzee
Contents - Social
MESSAGE FROM THE PRESIDENT
The Delicate Balance: Navigating nuance and diplomacy in discourse
2024 South African & Africa congresses and meetings
2024 International congresses and meetings
The role of metabolites in understanding glaucoma
Ocular Allergy Study reveals preference
Prosthetics for retinal stimulation
Rare eye diseases: A glance at Stargardt disease and keratoconus
Cutting for Stone
Author: Abraham Verghese
Reviewer: René Bosman
SA Ophthalmology Journal
The official journal of the Ophthalmological Society of South Africa
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