Abstract: Navigation technology in ophthalmology, colloquially called “eye-tracking”, has been applied to various areas of eye care. This approach encompasses motion-based navigation technology in both ophthalmic imaging and treatment. For instance, modern imaging instruments use a real-time eye-tracking system, which helps to reduce motion artefacts and increase signal-to-noise ratio in imaging acquisition such as optical coherence tomography (OCT), microperimetry, and fluorescence and color imaging. Navigation in ophthalmic surgery has been firstly applied in laser vision corrective surgery and spread to involve navigated retinal photocoagulation, and positioning guidance of intraocular lenses (IOL) during cataract surgery. It has emerged as one of the most reliable representatives of technology as it continues to transform surgical interventions into safer, more standardized, and more predictable procedures with better outcomes. Eye-tracking is essential in refractive surgery with excimer laser ablation. Using this technology for cataract surgery in patients with high preoperative astigmatism has produced better therapeutic outcomes. Navigated retinal laser has proven to be safer and more accurate compared to the use of conventional slit lamp lasers. Eye-tracking has also been used in imaging diagnostics, where it is essential for proper alignment of captured zones of interest and accurate follow-up imaging. This technology is not routinely discussed in the ophthalmic literature even though it has been truly impactful in our clinical practice and represents a small revolution in ophthalmology.
Abstract: In the early days of deciphering the injured neuronal tissues led to the realization that contrast is necessary to discern the parts of the recovering tissues from the damaged ones. Early attempts relied on available (and often naturally occurring) staining substances. Incidentally, the active ingredients of most of them were small molecules. With the advent of time, the knowledge of chemistry helped identify compounds and conditions for staining. The staining reagents were even found to enhance the visibility of the organelles. Silver impregnation identification of Golgi bodies was discovered in owl optic nerve. Staining reagents since the late 1800s were widely used across all disciplines and for nerve tissue and became a key contributor to advancement in nerve-related research. The use of these reagents provided insight into the organization of the neuronal tissues and helped distinguish nerve degeneration from regeneration. The neuronal staining reagents have played a fundamental role in the clinical research facilitating the identification of biological mechanisms underlying eye and neuropsychiatric diseases. We found a lack of systematic description of all staining reagents, whether they had been used historically or currently used. There is a lack of readily available information for optimal staining of different neuronal tissues for a given purpose. We present here a grouping of the reagents based on their target location: (I) the central nervous system (CNS), (II) the peripheral nervous system (PNS), or (III) both. The biochemical reactions of most of the staining reagents is based on acidic or basic pH and specific reaction partners such as organelle or biomolecules that exists within the given tissue type. We present here a summary of the chemical composition, optimal staining condition, use for given neuronal tissue and, where possible, historic usage. Several biomolecules such as lipids and metabolites lack specific antibodies. Despite being non-specific the reagents enhance contrast and provide corroboration about the microenvironment. In future, these reagents in combination with emerging techniques such as imaging mass spectrometry and kinetic histochemistry will validate or expand our understanding of localization of molecules within tissues or cells that are important for ophthalmology and vision science.
Background and Objective: Vitreoretinal surgery requires fine micro-surgical training and handling of delicate tissue. To aid in the training of residents and fellows, unique educational modalities exist to help facilitate the development of these microsurgical skills. From virtual simulators to artificial eye models, simulation of the posterior segment has gained an increased focus in vitreoretinal surgical training programs. Development of surgical curricula for vitreoretinal training and attainment of surgical milestones has been a key component in integrating these educational training modalities. We will explore various simulators, eye models, and potential rubrics and discuss unique ways each may help and complement one another to train future vitreoretinal surgeons.
Methods: We conducted a systematic PubMed search of various review studies (from publications in English ranging from January 1978 to December 2020) discussing surgical simulators, eye models, and surgical rubrics for vitreoretinal surgery and their potential impacts upon training.
Key Contents and Findings: Our review assesses the benefits and applicability of various simulators, eye models, and surgical rubrics upon training.
Conclusions: Utilization of vitreoretinal surgical training tools may aid in complementing the hands-on surgical training experience for vitreoretinal surgical fellows. By using simulators and rubrics, we may better be able to standardize training for reaching vitreoretinal surgical milestones and providing adequate feedback to improve surgical competency and ultimately patient outcomes.
