Simulator for laser photocoagulation in ophthalmology

The practice of laser photocoagulation plays a major role in ocular therapy, but the persistence of many postoperative complications denotes genuine difficulty in mastering the technique. The authors present a device which, thanks to the use of simulation, enables actual practice to be dissociated from apprenticeship. While complying with the constraints of realism with regard to habitual conditions of laser use, the device offers access to a wide variety of clinical situations. The apparatus is built around the traditional instrument. A virtual image of the fundus is produced in real time from the sensors which detect the actual gestures used. The calculations make use of textured geometrical models. Digitized color photographs are organized to form a database which reflects the diversity of pigmentations and pathologies. A software interface has been developed to facilitate the use of the device. The prototype is operated using a PC-compatible computer; it displays the images at the rate of at least seven per second on a miniature CGA screen incorporated in the slit-lamp. It is currently being validated for clinical applications. Above and beyond apprenticeship in laser photocoagulation, its potential applications extend to the entire field of ophthalmological symptomatology and, more broadly, to the simulation of any examination conducted with the help of binocular or endoscopic optics.