Real-time telementoring in ophthalmology

The purpose of the study was to determine if current telemedicine technology can support real time telementoring to teach ophthalmologists in remote areas ophthalmologic surgical procedures. Using an Integrated Systems Digital Network (ISDN) line conveying information at a rate of 128 kilobits per second (kbs), an endoscopic laser assisted dacryocystorhinostomy (ELA-DCR) was transmitted in real time from the St. Francis Medical Center in Honolulu, Hawaii to ophthalmologists at the Makati Medical Center in Manila, Philippines more than five thousand miles away. Live surgical and endoscopic images were sent in real time with ongoing explanation by the surgeon and with interactive questions and answers during and after the procedure. The ELA-DCR procedure was successfully transmitted in real time from Honolulu, Hawaii to over 100 ophthalmologists. It is concluded that current technology in telemedicine can support real time surgical telementoring for teaching complex ophthalmologic procedures. This is the first report of the use of this technology for the purpose of teaching surgery in ophthalmology