Innovative microscope simulator for cataract patients: Enhancing understanding and comfort

Phacoemulsification is one of the most common ophthalmic surgical procedures. The outcomes, under topical anesthesia, depend on the comprehension and cooperation of the patient throughout the procedure, as much as they depend on the surgeon's skill and expertise. The procedure leads to complications if the patient is uncooperative intra-operatively.[1] Patient satisfaction should be considered an important clinical outcome.[2] During surgery, patients are instructed to keep their eyes still, avoiding movements. Methods to improve the same are of great importance. But patients often need clarification on where they are supposed to fixate. This leads to an inadvertent rise in eye movements. Various studies have proven that preoperative instructions given to the patient are associated with fewer complications and increased patient satisfaction.[3-5] Hence, priming the patients to fixate appropriately when under the microscope is paramount. We created a novel 3D-printed device that accurately simulates the triangular arrangement of the light sources on the surgical microscope, replicating the visual cues that patients would experience during surgery [Fig 1]. The model closely mimics the alignment of most microscopes, providing a real-world example of the intra-op experience, complete with light intensity, which is far superior to point-light sources or photographs.Figure 1: (a) Three-dimensional rendering of the simulator on modeling software. (b) Three-light, 3D-printed simulator for microscope lighting. (c) Six-light setup on the 3D-printed simulator model for FLACS; the central light denotes battery charge levels. (d) A nurse employing the simulator to educate a patient before his procedure. FLACS = femtosecond laser-assisted cataract surgeryThe device was modeled using the open-source software FreeCAD (from FreeCAD) and sliced and printed using UltiMaker Cura and UltiMaker S3 (from UltiMaker). The material used was polylactic acid. Body dimensions were 6 × 6 × 4 cm. A 9-V battery was installed and connected to a commercially available three-bulb, 6-W, white light-emitting diode setup, with a 10,000-Ω potentiometer to modulate the light intensity. A similar device, simulating the arrangement of the six light sources on the femtosecond laser-assisted cataract surgery machine, was designed. Our surgeons have found that intraoperative compliance is better in patients who have gone through counseling with the simulator, compared to conventional methods like verbal instructions or torchlight. This is similar to how in-flight safety instructions employ models of the actual rescue devices for a better understanding. The utilisation of microscope simulators resulted in enhanced patient experiences during surgery, improved patient cooperation, and, ultimately, better surgical outcomes. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.