Table 4.

Dry-lab studies.

Model	Description	Reference	Area of training	Training task	Study design	Participants	Training time	Validity evidence	Effectiveness
Aluminium foil with methacrylate support	Methacrylate for hand support, PVC sheet and aluminium foil for performing capsulorhexis on	Abellan et al. [112]	Cataract surgery	Capsulorhexis	Randomised controlled trial	n = 65 (ophthalmologists)	2 h	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	2
Japanese quail eggs	Sharp end of a quail egg cut and fitted with a silicone sclerocorneal cap; the yolk and albumen simulate the vitreous body and the inner eggshell membrane simulates the internal limiting membrane	Hirata et al. [113]	Vitreoretinal surgery	Membrane peeling	Case series	n = 8 (3 experienced vitreous surgeons and 5 inexperienced surgeons)	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: 1 Consequences: N	2
VitRet eye with fluid	An artificial eye model filled with vitreous-like fluid made of dairy creamer + balanced saline	Yeh et al. [114]	Vitreoretinal surgery	Three-port vitrectomy setup; intraocular tasks (e.g., core vitrectomy and membrane peel); wound closure	Case series	n = 13 (8 residents and 5 fellows)	Not specified	Content: 0 Response processes: N Internal structure: N Relations to other variables: 1 Consequences: N	1
Artificial orbit with diascleral illumination	Eye support made from transparent polymethylmethacrylate, fitted onto cylinder and fixed with a metal ring	Uhlig and Gerding [115]	Vitreoretinal surgery	Not specified	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Reusable rubber eye	Rubber globe with removable plastic anterior segment for access to posterior segment; rubber bands used to simulate the rectus muscles and a coat of liquid skin bandage applied to simulate the membrane	Iyer and Han [116]	Vitreoretinal surgery	Epiretinal membrane peeling	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Medium-fidelity model	Wooden frame to simulate patient’s forehead; a table tennis ball to simulate the globe; pre-equatorial holes created light source insertions; tasks performed using real instruments and foot-pedal-controlled microscope	Rice et al. [117]	Vitreoretinal surgery	Sets of exercises including training single hand and bimanual dexterity	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
ILM peeling simulator	Artificial eye model placed in an ocular surgery simulator and an artificial ILM made using a PVA hydrogel. ILM peeling can be simulated under water.	Omata et al. [118]	Vitreoretinal surgery	Inner limited membrane (ILM) peeling	Descriptive study	N/A	N/A	Content: 0 Response Process: N Internal Structure: N Relations to other variables: N Consequences: N	N/A
Nonbiologic Strabismus Surgery Simulator	Components include a rubber ball mounted to on a wooden based simulate the globe. An elastic band is attached to the eyeball, simulating the rectus muscle and a small piece of latex is attached to the eyeball with a thumbtack to simulate the conjunctiva and cornea.	Adebayo et al. [119]	Strabismus surgery	Steps for strabismus surgery	Randomised controlled trial	n = 41 (1st and 2nd year medical students)	1 week	Content: 1 Response Process: 2 Internal Structure: 2 Relations to other variables: N Consequences: N	2
Simulator for practising laser procedures	A model eye with artificial tissues	Simpson et al. [122]	Laser procedures	Peripheral iridotomy, posterior capsulotomy and laser retinopexy	Case series	n = 13 (6 inexperienced and 7 experienced residents)	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: 1 Consequences: N	N/A
Capsulotomy simulator	An adjustable artificial anterior chamber for fitting laser instrument; an intraocular lens coated with a crust at the posterior surface to simulate posterior capsule opacification	Moisseiev and Michaeli [121]	Laser procedures	Neodymium: YAG posterior capsulotomy	Descriptive	n = 3 (residents)	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	2
RETILAPP eye model	A ping pong ball simulating the globe is cut in half; a paper diagram of the lesion is cut out and placed between the two hemispheres of the globe; the eye is clamped to a slit lamp; contact lens is used over the model for practising lasers	Ganne et al. [120]	Laser procedures	Retinal laser photocoagulation	Descriptive	N/A	N/A	Content: N Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
MIRA practice eye	Model eye stabilised onto a wooden mount; the optic nerve and fundal pattern are painted onto the globe for orientation	Weidenthal [123]	Laser procedures	Laser photocoagulation	Descriptive	N/A	N/A	Content: N Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Child skull model	Anatomically correct model of the nasolacrimal duct drainage	Coats [124]	Oculoplastic surgery	Not specified	Descriptive	N/A	N/A	Content: 0 Response processes: 0 Internal structure: N Relations to other variables: N Consequences: N	N/A
3D-printed orbit models	Use of 3D printing to produce orbit models that replicate a patient’s bony anatomy for use in orbital surgical training	Scawn et al. [126]	Orbital surgery	Orbital decompression	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
3D-printed copies of human cadaveric orbital dissections	Surface mesh of orbit prosections created, processed using 3D laser scan, then printed	Adams et al. [125]	Orbital surgery	Not specified	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Newport eye corneal foreign body training phantom	A polyvinyl and gelatine-based model with resin used to secure a craft eye inside a plastic container; ground black pepper used to simulate a foreign body	Marson and Sutton [127]	Ocular Trauma	Corneal foreign body removal	Case series	n = 23 (6 ophthalmologists, 11 ED physicians and 2 ophthalmology + 4 ED nurse practitioners)	N/A	Content: 1 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	1
EYE Exam Simulator (Kyoto Kagaku Co.)	A mannequin head with adjustable pupil sizes and a holder to place slides showing different retinal conditions; a standard ophthalmoscope is used to simulate fundoscopy examination	McCarthy et al. [132]	Diagnostic examination	Direct ophthalmoscopy	Case series	n = 43 (32 emergency medicine and 11 ophthalmology residents)	N/A	Content: N Response processes: 0 Internal structure: N Relations to other variables: N Consequences: N	N/A
EYE Exam Simulator (Kyoto Kagaku Co.)	Same as above	Akaishi et al. [128]	Diagnostic examination	Direct ophthalmoscopy	Cross-sectional	n = 73 (3 medical students, 41 residents, 29 attending physicians)	Not specified	Content: N Response processes: N Internal structure: N Relations to other variables: 1 Consequences: N	N/A
Toy model eyes	Toy eyes cut around the pupil edge and everted; partial-thickness cuts made to simulate retinal tears; eye re-inverted and mounted on a wooden base; a 90-dioptre lens is mounted in the pupil and fixed with tape	Chew and Gray [129]	Diagnostic examination	Indirect ophthalmoscopy with scleral indentation	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Rubber ball eye	Eye made from rubber ball is cut in half and retinal details drawn on a painted orange background before sticking the 2 halves together; eyeball is inserted into a paperpulp head model	Kumar and Shetty [130]	Diagnostic examination	Indirect ophthalmoscopy	Descriptive	N/A	N/A	Content: N Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Glass vial	Screw-top glass vial filled with mouthwash and face powder to simulate presence of cells and flare in the anterior chamber; holding the vial at different angles and positions in front of a slit lamp simulates appearance of an optical section and variations in thickness of the cornea	Morris [134]	Diagnostic examination	Slit-lamp examination	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Mannequin head model	Vacuum tubes with glue applied to the curved ends inserted into styrofoam mannequins to imitate slit lamp appearance of the anterior segment, flare and cells, hypopyon, hyphema, red reflex, cataract and corneal epithelial defects	Romanchuk [135]	Diagnostic examination	Slit-lamp examination	Descriptive	N/A	N/A	Content: N Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Glass eyeball	A glass marble eye set onto a small bottle cap for stabilisation; piece of paper with letters placed behind the marble to assess visualisation; a hole punched in a separate piece of paper to simulate the pupil	Lewallen [131]	Diagnostic examination	Indirect ophthalmoscopy	Descriptive	N/A	N/A	Content: N Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Origami model	A sheet of letter paper with a retinal drawing or photograph on one side is folded into a box with a small aperture that acts as a pupil	Miller [133]	Diagnostic examination	Binocular indirect ophthalmoscopy	Descriptive	N/A	N/A	Content: 0 Response processes: N Internal structure: N Relations to other variables: N Consequences: N	N/A
Model for simulating indirect ophthalmoscopy and retinal photocoagulation	Model consists of a 60D lens, a bulb syringe to simulate the globe, card paper for the iris and a printed fundus photograph attached to the base	Kylstra and Diaz [136]	Diagnostic examination and laser procedures	Binocular indirect ophthalmoscopy and indirect laser retinal photocoagulation	Descriptive study	N/A	N/A	Content: 1 Response Process: N Internal Structure: N Relations to other variables: N Consequences: N	N/A