REtinal Surgery systEm for Training – RESET

According to the world health organization, retinal diseases are responsible for at least 10 millions of blind people. They represent already 15% of the causes of visual impairment and are probably underestimated. Diabetic retinopathy is the major cause of blindness in developed countries before 50 years. Apart from diabetic retinopathy, retinal detachment, macular holes, epiretinal membranes and severe macular degeneration are the most current pathologies eligible for retinal surgery.

Retina surgery is complex, various and patient-specific. To master the procedure and anticipate the large panel of possible complications, retina specialists must complete medical school and specialized training as an ophthalmologist, and then pursue additional vitreoretinal training. The full breadth of training for a retina specialist represents on average more than 10 years. This is obviously related to the difficulty of accessing the retina and possible complication rates in case of errors, but also due to the relatively large number of surgical options: retinal laser surgery (used to treat a variety of problems including retinal tears, retinal holes, small retinal detachments and leaking blood vessels); scleral buckling surgery (considered as the traditional surgery for retinal detachments); pneumatic retinopexy (involves the intraocular injection of an inert gas bubble to press on the retina and seal the retinal break); and vitrectomy (used to treat the most severe retinal detachments).

To properly answer requests from clinicians for highly realistic training on one hand, and new requirements from accreditation or recertification from surgical societies on the other hand, we propose to develop a high-fidelity training system for retinal surgery. What we aim for is a complete simulation of the eye during all the steps of a retina surgery. This involves that the physics simulation need to allow mistakes or complications, occurring early in the surgery, to have an impact later on. This level of realism is equivalent to what is called “Level D” simulation in flight simulation. Such simulations do not currently exist in medicine. This simulator will be built upon our strong scientific expertise in the field of real-time simulation, and a success story for technology transfer in the field of cataract surgery simulation. Members of the consortium have a long expertise in the development of prototypes, as well as collaboration with clinical partners. The simulation system that we propose to develop will be based on the Open Source simulation platform SOFA, and will rely on expertise from our partners to ensure clinical and industrial relevance.