It all started when…
Dr. Stuart Stoll, M.D. is a well-respected ophthalmologist in Beverly Hills, CA who knew there had to be a better way to practice and perfect ophthalmic surgical techniques. After completing residency at Georgetown University Medical Center, Dr. Stoll went on to pursue fellowship training in refractive surgery with Dr. Howard Gimbel in Calgary, Canada who is well known for, among other contributions, his pioneering work in developing the Continuous Curvilinear Capsulorhexis (CCC) technique. Being a US citizen, Dr. Stoll was not allowed to perform cataract surgery in Canada during that time and returned to the US to start practice after not operating inside the eye for a year. Wishing to rapidly advance his surgical skills, he sought out ways to simulate the various intraocular procedures that needed to be mastered. A colleague suggested that a plastic film could be used to practice CCC and while it offered some help, it was a long way from being realistic. Dr. Stoll worked with the concept of using synthetic materials to simulate human tissue and found better materials that could act more realistically.
A simple but important innovation was to wrap the film around a malleable body like Silly Putty so that the device could be held in the non-dominant hand while the surgeon could practice the CCC technique with the dominant hand. A big advantage of this was the ability to increase the pressure of the non-dominant hand which would cause the film to elevate into a dome and simulate the loss of viscoelastic from the anterior chamber. Performing the CCC technique in this way was more challenging as the tear would tend to run downhill and outward just like in a surgical setting. At that moment, SimuloRhexis was born and years later our first patent would be issued.
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Wishing to share this innovative training tool with residents, Dr. Stoll presented a video at the ASCRS Film Festival in 2005. While it was well received, he found that unless residents were provided all the necessary supplies and tools in a readily available kit, they were unlikely to source everything on their own.
The solution seemed to be to work with the large ophthalmic companies to have them purchase kits and provide them to the residents for education and training. However, the recently enacted Sunshine Act led companies to turn away from giving out anything including materials for education. So SimuloRhexis sat idle for years. Then, one day, an email arrived from a company called TrueVision who had found the patent online and was interested in SimuloRhexis to showcase their 3D technology at trade shows.
Dr. Stoll scheduled to meet the TrueVision team to better understand their technology and demonstration needs and remarkably found that they were located only an hour away from his home. The challenge was that the current version of the SimuloRhexis device was handheld and that was not acceptable for demonstrating the high-tech capabilities of the TrueVision viewing system to a demanding audience of ophthalmologists. With a better understanding of their needs, Dr. Stoll set out to create a model that could fill the role. After scouring the isles of multiple hardware stores for days to find existing parts to fit together and work properly in a rather Frankenstein fashion, SimuloRhexis took a giant leap forward as it was transformed from a handheld device to a table top device that could be used at the trade shows. While it didn’t look much like an eye, it did a great job for its intended purpose and SimuloRhexis had found its first customer!
Feedback from the ophthalmologists at the shows was remarkably positive and they were often equally interested in learning about the SimuloRhexis device as the high tech viewing system they came to see. This was a pivotal time in the development of the models as the realization came that industry could also benefit from robust training models. Suddenly the market opportunity and the potential impact expanded greatly. The challenge then was how to get it into the hands of the residents.
Dr. Stoll was determined to share the SimuloRhexis device with more residents and turned to the industry leader in education, Alcon. It became apparent that the way forward to getting access to residents was through the educational programs supported by Alcon known at that time as CORE. To perform well in this environment more realism was needed and SimuloRhexis underwent a major update with custom made parts. With experience and feedback from residents and faculty over multiple years working with the CORE meetings, SimuloRhexis finally arrived in its latest version as a kit with replaceable films and the ability to increase the posterior pressure to cause the capsulorhexis to run out so that rescue maneuvers can be mastered.
As time went by and because of the success in training residents with SimuloRhexis, Dr. Stoll was presented with more opportunities to develop other model eyes. Working with Kevin Miller, MD who runs one of the most respected resident training conferences each year, Dr. Stoll was asked to create an eye for YAG Laser Capsulotomy and so the SimulEYE YAG model was born. In addition to requests for certain models, Dr. Stoll saw first-hand the need to create other models to support surgical training.
Gaining more traction and interest from leaders in resident education and industry partners, it became clear that there was a greater demand for SimulEYE. It was at this time that Dr. Stoll decided to make the change from working on this project simply as a hobby and to start a business. In 2012 insEYEt, LLC was formed as the business entity behind the SimulEYE line of ophthalmic surgical training models.
Since that time growth has been rapid and word has spread internationally of the quality and benefits of the SimulEYE models. One of the greatest joys for Dr. Stoll is seeing a surgeons’ reaction the first time they are introduced to the models under the operating microscope. But without question, the greatest reward is being able to help train surgeons on a larger scale than any one ophthalmologist could ever do individually, to support ophthalmic industry partners to help implement their technology and ultimately to help advance the field of ophthalmology and improve patient outcomes.