Clear Corneal Incision Suturing Wet Lab: A Microsurgical Training Model For Ophthalmology Residents

To evaluate suturing skills in ophthalmology residents through a dry lab model using orange peel and a wet lab model involving corneal suturing on sheep eyes, and to assess the association between these skills and the residents’ prior surgical experience.

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Ophthalmology, Ankara, Turkiye.

Ophthalmology residents were grouped into 2 (<12 months vs ≥12 months of training). Junior group performed 5 sutures on an orange model in dry lab setting, followed by 2 sutures on a clear corneal incision created in a sheep eye in wet lab session. Senior group performed only 2 sutures in the wet lab. The first sutures were performed without guidance, than a feedback was provided and subsequent sutures were performed accordingly. Each attempt was evaluated using a 7-item skills assessment, each item scored from 0 to 3. Suturing time and total  performance scores were recorded. Changes in scores and completion times across repeated attempts, as well as their association with residents’ prior surgical experience, were analyzed.

A total of 21 residents' 88 suturing attempts were evaluated. Correlations were identified between duration of training(rₛ=.815, p<.001), experience in pterygium surgery(rₛ=.841, p<.001), experience in corneal suturing(rₛ=.623, p=.003), and initial scores. Microscope experience had higher scores (M=12.73) compared to others (M=6.17) (U=79.0, p =.009). Across the 5 repeated attempts performed in dry lab, an increase was observed (χ²(4)=21.24, p<.001). In wet lab no significant difference was observed between 2 attempts (p=.253) however, a marginal trend was noted in the junior (p=.089).Seniors achieved higher scores in both wet lab attempts (Attempt1: p<.001; Attempt2: p=.001). And positive correlation between seniority and scores (rₛ=.815).

Wet lab practice is an important tool in the microsurgical training of ophthalmology residents. Corneal suturing differs substantially from suturing other tissues such as skin or conjunctiva and has its own distinct learning curve. Although performing suturing attempts in a dry lab setting may improve overall suturing control, it would not necessarily be expected to lead to an improvement in corneal suturing performance. High-quality training in ophthalmology residency can be achieved by integrating newly developed training models with structured clinical experience and accumulated surgical expertise.