"Feasibility of the BIONIKO 3D-Printed Eye Model as a Training Tool for Internal Limiting Membrane Peeling".

Purpose: To evaluate ophthalmology trainees' experience with BIONIKO 3D-printed eye model in internal limiting membrane (ILM) peeling.

Methods: Ophthalmology trainees were randomly assigned to two groups, BIONIKO-first and Eyesi-first, performing ILM peels on both models. Surgical performance was assessed via Eyesi score output, while an anonymous survey assessed model effectiveness.

Results: Thirty-nine trainees participated (20 BIONIKO-first, 19 Eyesi-first). The BIONIKO-first group had a higher mean Eyesi score (50.63±31.68 vs. 37.53±30.30, p=0.497). The Eyesi-first group achieved a higher ILM peeling rate inside the macula (95.05%±4.58 vs. 92.66%±10.75, p=0.039). Completion time and forceps use were comparable. The BIONIKO-first group had fewer total spotted hemorrhages (2.4±2.1 vs. 4.4±3.6, p=0.035), while macular and retinal injuries were similar.Subgroup analysis by training level showed that in the junior group, BIONIKO-first resulted in fewer hemorrhages (p=0.012), while Eyesi-first had higher ILM peeling rate inside the macula (p=0.002). Among seniors, BIONIKO-first demonstrated a statistically lower area of macular injury (0.02 mm2±0.05 vs. 0.07 mm2±0.12, p=0.020).Survey results favored BIONIKO for tactile feedback (p=0.002) and surgical realism (p<0.001), while Eyesi was preferred for procedural feedback (p<0.001).

Conclusion: BIONIKO and Eyesi models offer complementary advantages. A hybrid approach may optimize skill acquisition and patient safety in vitreoretinal surgery training.